Chapter 12
Stopping the Cycle of Depression
In This Chapter
Understanding how and why depression appears
Observing your personal symptoms
Tackling unhelpful thought processes
Breaking free of depression
Depression is a growing malaise of the 21st century. People’s lives are getting faster and more pressured, with longer working hours and stressful commutes causing exhaustion. Experts estimate that one in five people in the UK are going to suffer an episode of clinical depression. So if you’re standing in a queue of ten people waiting for a bus, the chances are that two of them are suffering or have suffered from depression; if you’re one of those two, at least you know that you aren’t alone.
My aim in this chapter to is to show you ways of thinking that you can use to help overcome depression. I describe the nature and causes of depression and some of its different forms and manifestations. In addition, I encourage you to investigate your own personal type of depression; that is, what occurs emotionally in your thoughts and how depression manifests itself in your life. I also explore how you can use mindfulness-based cognitive therapy (MBCT) to shorten and lighten episodes of depression and reduce/prevent relapse in the future.
I guide you through a number of mindfulness interventions to practise regularly in order to stabilise your mood and act as an anchor when the going gets tough. To a large extent, these meditation exercises come from the eight-week course that forms the basis for Chapters 4 to 11, and so where necessary I direct you to other relevant chapters. In particular, your mindfulness diary (which I describe starting and maintaining in Chapter 4) proves highly useful in showing how specific practices affect you and what insight you gain by exploring them.
MBCT is particularly useful for preventing depression relapse, and it works best when you’re no longer severely depressed. Why? One problem with depression is that it affects the areas in your brain that you need for learning new tools and skills and retaining new information – your memory function is inhibited when you’re depressed. So if you are currently depressed and feel vulnerable please see your GP or a psychiatrist and accept medication if they prescribe it to you. The time when you come out of the black tunnel of depression and begin to see light again is the right time to start learning MBCT.
Staring into a Black Hole: Understanding Depression
An episode of depression involves a state of very low mood, and can affect your physical wellbeing, your sleeping pattern and your motivation as well as your emotional stability. Depression is often brought on by feelings of stress and/or anxiety, and can occur as early in life as 12 years of age; the earlier you have your first episode of depression, the more likely it is that you’ll also experience reoccurrences later on in life. Sometimes, people go on to experience bouts of depression throughout the course of their lives, and it is for these people that MBCT can act as an extremely effective and comforting coping mechanism.
Many people trying to explain their own understanding or experience of depression tend to use analogies, such as being stuck with no way out, receiving a visit from the black dog (Winston Churchill) or ‘feeling the blues’. People equate certain moods and mind states to the image of somebody curling up in the back of a cave in darkness and waiting in limbo until something happens. Initially, no light is visible on the other side.
One vivid and insightful description of depression is an account by the talented writer Jeanette Winterson. In a BBC documentary on her life, she describes how she was totally unprepared for it (read the nearby sidebar ‘Jeanette Winterson on depression’). Winterson’s experience reveals that in the end the only option is to surrender to your suffering and pain and start afresh. The human experience is one of joy and sorrow, and in essence people experience less suffering if they can accept this fact.
Kindly read or reread the poem ‘The Guesthouse’ (in Chapter 8) and remember that uninvited guests may come but that they also leave. You sometimes need to accept your struggle mindfully and then start again. I invite you to trust that each moment is a new beginning and after accepting what is, even if this acceptance is a most difficult thing to do, you can then move forward and respond wisely to the challenge.
In this section, I look at the nature, experience, causes and symptoms of depression.
Becoming depressed: You’re not alone
Human beings become depressed in many different ways. It can initially start with you feeling a little down because of the weather or even your body fighting a cold virus. You may also feel lethargic and a bit pessimistic. Slowly but surely your thinking engages in negative ruminations and downward spirals (problems I describe in Chapters 4 and 9, respectively) as well as catastrophic predictions, as if you’re locked in a bad dream. Everything loses its spark.
The more often depression occurs, the more likely you are to get depressed again. Each episode of depression increases by 16 per cent the chances that you’re going to experience another instance. Therefore, developing mindfulness skills to avoid relapses is an urgent priority.
Knowing the common symptoms of depression
The diagnosis of clinical depression indicates that you suffer from a minimum of five of the following symptoms for two weeks or longer:
Difficulty concentrating or remembering
Dramatic decrease/increase in weight
Experiencing a sense of dread first thing in the morning
Feelings of guilt, worthlessness, anxiety, irritability
Indecisiveness
Lack of interest and pleasure
Loss of desire for intimacy
Reduction in personal hygiene and looking after yourself
Sense of being without hope or purpose
Sleep disturbance – early morning waking or sleeping much longer than usual
Thinking about ending your life – wanting to disappear into thin air
Tiredness in general or upon waking; loss of energy
Particularly low mood; becoming upset for no specific reason
Withdrawal from the world around you
Depression in numbers
Here are some cold, hard facts about depression:
Typically, a first episode of major depression occurs between the ages of 18 and 44. Yet, sometimes it can happen as early as 14 and as late as after retiring.
Sometimes the depression persists even if treatment is attempted: 15–39 per cent of cases may still be clinically depressed one year after the onset of symptoms and 22 per cent of cases remain depressed two years later.
Depression is three times more likely to occur in women than men, at least among the reported cases. Men tend to try and ignore it, hoping it’ll go away. Often, however, depression doesn’t. So kindly remember that help is at hand if you go and seek it.
The highest suicide risk is for separated, divorced and recently widowed people who are experiencing depression. So having friends or a life partner is vital in managing depression.
Identifying the causes
Depression arises for all sorts of reasons. More often than not it’s caused by a big blow, such as losing a job, feeling rejected by a partner, close relative or friend, or making a mistake for which you can’t forgive yourself. The following list contains some other triggers for depression. See whether or not you’ve experienced these triggers or think that they may apply to you (if so, consider how you reacted and make notes in your diary):
Assertion skills: If you can’t assert yourself at home or work, you may end up doing things that you’ve no time for or that aren’t part of your job description. Doing compassionate acts to help out in areas outside your expertise is fine, but if you do this too often you can end up exhausted and depressed.
Biological factors affecting brain chemistry: High levels of stress chemicals can spiral you down into burn-out, where all desire and energy disappear. When depression follows, it can be the body’s way of hibernating in order to regain balance for returning to active life.
Genetic predisposition for depression: Maybe you’re aware of relatives who are or were depressed. Perhaps mental health problems run in your family. While these situations may mean that you’re prone to the causes and effects of depression, you are by no means destined to have the same experiences with it as your family members. You may even be able to find more support and compassion from them than you first expected, as they will know what you’re going through.
Learned predisposition for depression: Maybe you picked up behaviour patterns from a close relative when you were too young to distinguish between wholesome and destructive ways of being. If your parents or other close adults always thought the worst if, say, somebody was late for dinner, or always complained about what a horrible place this world was, you may have bought into this belief and now carry it on yourself. Like any bad habit, however, you can be weaned off the tendency to bring depression upon yourself, and MBCT can be very helpful in doing this.
Loss, decrease or absence of rewards, or inability to obtain rewards: You may have a boss or partner who doesn’t praise you when you do things well. Maybe they’re introverts who find giving compliments to people awkward or they simply don’t realise that you need it (everyone does really).
Try to start the praise cycle by mindfully observing your boss or partner and giving them praise occasionally. This way they may come to appreciate positive feedback and start giving it back.
Perfectionism: The ‘healthy pursuit of excellence’ (as coined by psychotherapist Albert Ellis) is a commendable attitude. But perfectionism makes you ‘drive in fifth gear’ without ever achieving the 101 per cent you’re looking for. No human being is perfect.
Poor problem-solving skills: If you simply don’t have the skills you need to solve recurring problems in your life, compassionately ask yourself how you can expand your knowledge. Watch how others do it, read up on it or attend a course.
Relationship factors/loss of a relationship, feeling unwanted or taken for granted, lack of intimacy: If you lose somebody you love through death or separation, your world can be shattered. Similarly, you can feel this way if your family takes you for granted or your partner seems no longer interested in being intimate with you. In these cases, try to speak up mindfully for yourself and express your needs.
Loss has a timeframe of its own and you have to support yourself with kindness to ‘be’ with it rather than denying it. Check out the meditation on being with difficult thoughts and experiences in Chapter 7. Also, meditating on your loss regularly can be helpful. However, don’t attempt to deal with recent bereavement by yourself; seek the help of a qualified bereavement counsellor to guide you through this process. The most helpful elements of MBCT at this point are those that help to expand your awareness of the world around you, outside your grief, such as going for a mindful walk or practising the sound meditation.
Skills deficits: If you’re struggling at work because you lack important aptitudes, consider sharing this problem with the Human Resources department, who can treat the matter confidentially and may well offer you courses. Or perhaps a kind colleague can help you. And of course For Dummies books are available for almost everything you may want or need to know. For example, perhaps you want to learn better time management, assertiveness skills, communication skills or self-presentation skills.
If you continue working without the skills you need, you’re in danger of losing your job or getting highly stressed, which can ultimately lead to depression.
Specific stressful life events: Two of the most stressful events in life are changing jobs and moving home. As well as the obvious possible disruptions and challenges, you may also have lost the kind colleague at work or the neighbour who always offered a listening ear and a cup of tea. In general, people take a year or so to get used to a new job, a new home or being able to accept that a loved one is no longer with them.
Depression can also arise slowly and not be caused by one single event. The onset can be so gradual that you can’t pinpoint exactly what caused it in the first place. A negative mood is fed by negative thoughts, which feed into more negative thoughts (check out the later section ‘Overcoming Unhelpful Thoughts’).
Observing the effects that feed depression
Certain ways of being and thinking can deepen and worsen your symptoms of depression. If you already have a sense of inertia or lack of interest in life, the worst you can do is to do nothing. The following list itemises certain depression feeders, so that you can be alert for them and nip them in the bud before they take over your life:
Biological changes: The more stressed you become, the more changes take place (the more stress chemicals are released), which can make things worse, causing heightened emotions, thoughts and sensations.
Negative thoughts: Your thoughts play a powerful role in controlling depression, which tends to focus your mind on being unlovable, inferior, worthless, defeated and trapped. Getting caught up in a ruminative thinking loop only gets you more stuck (see the later section ‘Deleting the Depression Loop’).
Discovering how to see your thoughts for what they are – occurrences or hiccups in the brain rather than facts – can be the first and best step on your way out of depression.
Procrastination: Not making decisions you need to make can affect your work and home life negatively and eventually result in more problems. For example, postponing a dentist appointment can cause the need for a simple filling to develop into losing a tooth.
Self-blame: Blaming yourself can activate more stress and guilt and therefore more symptoms of depression.
Withdrawal from life’s activities: Often this withdrawal becomes a self-fulfilling prophesy. Less people get or keep in touch with you if you don’t make the effort, which leads to a deeper sense of being alone or forsaken.
Breaking Down Common Symptoms: Your Personal Narrative
In the earlier section ‘Staring into a Black Hole: Understanding Depression’ I state some common manifestations and signs of depression, but of course the list isn’t (and can’t be) complete. You probably have other significant personal signatures that are particular to you, and which you need to discover and observe in order to tackle your own depression.
Searching for your personal signature
Do you perhaps self-medicate by drinking excessive amounts of alcohol or using other non-medical drugs? Do you find yourself having loads of short-lived relationships, or constantly changing jobs or homes in order to get to the greener grass on the other side? These behaviours and many others can be distractions or cover-ups for depression.
Before you can truly come to terms with your depression and gently work your way out of its doughy nature, you need to understand your personal concoction of depression. Here are a few questions to ask yourself:
Why has your subconscious resolved to enter a state of depression?
What is your depression really about? Is it about avoiding pain (letting go of something or getting through something) or even inviting pain?
Are you punishing yourself? If so, what for?
How much of your depression has been brought on by your lifestyle and how much is biological (for example, through stress hormones) or inherited (for example, through a genetic biochemical imbalance in the brain)?
How much is the healing process under your control? Do you want to get better and feel balanced again, when that may mean having to re-enter busy life again. Perhaps hiding under the duvet appears much safer right now.
MBCT can help you find answers to many of these questions. Mindfulness research and clinical experience shows that practising MBCT regularly can significantly decrease the chance of relapsing into depression. Unless you try it, you’ll never know.
Engaging in mindfulness exercises increases awareness and enhances creative thinking, memory, patience and curiosity. Every human being is unique and so no single answer or prescription exists for your depression, but the power of your mind and awareness can lead you in the direction of wellbeing, especially if you’re open-minded and write down in your diary everything that comes up as a possible explanation for why you’re depressed and how you can best beat your blues.
Another important ingredient is to observe patiently all aspects of your sadness, and trust that, even though it may seem impossible at first, a way out is available. And don’t forget to show yourself a little compassion as you start moving back into the adventure of life.
Consider the following points and, if appropriate, put into action the relevant intervention:
See whether you recognise any of the following examples of depressive thoughts or something similar. ‘I’m a complete idiot and nobody cares for me. I’m lazy and no good and even if I try I’ll only fail again.’ Identify the terms you use to describe yourself in these situations, and investigate deeply what these negative evaluations do to you; thoughts aren’t facts, but they can still hurt you if you believe in them.
Consider whether you tend to hold on to the same old thinking spirals or patterns, fully knowing that they’re neither true nor helpful. If so, see the thought as just a thought and let it pass away like a balloon you can let go of, or a cloud in the sky that passes by. (Check out the sitting with difficult thoughts meditation in Chapter 7.)
Ask yourself whether any advantages or disadvantages exist to holding on to or changing this particular belief about yourself. What evidence may support your belief? The advantages may be that staying with the ‘devil you know’ is easier. The disadvantage would be continuing to be in mental pain and distress for longer and longer.
Design appropriate experiments to prove to yourself that you’re not an idiot, lazy or a failure. The fact that you’re reading this book and experimenting with the meditations is definite proof that you aren’t any of these negative self-concepts. As an experiment, you could choose one part of your job description you find difficult and ask colleagues and friends whether they do or would find it easy. If they do, ask them how they go about it. Now choose part of your job that you find easy. Again ask other people how they feel about this particular aspect of your work. You may find that some people don’t find it as easy as you do, but that doesn’t make them stupid. Nobody is perfect in everything.
Consider how you’d see yourself if you weren’t depressed. Ask friends, family or other people how they perceive you. What do they like about you?
If you’ve been depressed before, you probably remember when depression gently lifted like a veil and life looked more colourful again. If so, ask yourself: ‘How do I see life when I’m well and how do I see life when I’m depressed?’ Also, how may this period of unwellness look three months from now?
When you’ve developed an idea of the causes and symptoms of depression, focus on each symptom and see which ones sound all too familiar to you. Perhaps you know some of these low moods well but never saw them as signals of your depression. For example, changes in eating patterns, such as over-eating, can signify the onset or depth of depression. Similarly, changes in sleeping patterns are often an aspect of depression.
Write down the symptoms that fit your experience in your diary, perhaps giving them a funny name. Doing so can help bring a little lightness into the dark depressive cave.
Noticing how depression affects you
In this section, you get to know your particular and personal depression triggers and manifestations. I ask you to slip into the role of a master detective (such as Columbo, Morse, one of the cool CSI detectives or anybody else who takes your fancy). The idea is to remember the minute details that trigger or prolong and deepen your personal experience of depression.
Please go to your meditation place and get into a comfortable and dignified position, as I describe in Chapter 4:
1. Focus on becoming grounded. Feel your feet on the floor and your sitting bones on the chair, and then focus on your breathing. Allow it to continue as usual and bring your awareness to your breath (acting as your anchor of attention – see Chapter 4).
2. Say the following words to your inner self when you become settled or even calm: ‘Let me see you, depression. Let me remember you in all your detail.’ Keep breathing and notice any information that arises in your awareness: single words, sentences, feelings, sensations, colours, shapes, and so on.
3. Notice each piece of information as it arises. Let it pass by like a bird flying into the deep sky of your mind.
4. Return to your breath as your anchor of awareness when the information starts to repeat itself or stops. End this meditation when you like.
Now pick up your diary and note down all the information gained through this exercise. When you get going, you may even remember more details about how depression manifests in your life. Each person is unique, and so each experience of depression is different.
Lacking drive or energy
When you aren’t depressed, you most likely enter each day’s activities without thinking about it. Depression, however, tends to take the wind out of your sails. Hence, in this section I invite you to decide to do certain things even if you really don’t feel like it.
Setting realistic goals that you can achieve is extremely important, because the danger exists that failure can result in you feeling even lower than before. So make an appointment with yourself to practise a meditation, and engage mindfully in regular activities.
Mindful breathing
Your breath is always present and you can access it without too much trouble. Kindly carry out the breathing meditation in Chapter 4. Afterwards, write down in your diary what comes up, what you notice and how you’re feeling.
In order to expand your awareness of breathing even further, see whether you notice the in-breath being cooler around your nostrils and the out-breath warmer. Focusing on such minute details really hones your deep awareness skills.
Mindful walking
The tiredness of depression has nothing to do with ordinary tiredness so, to activate yourself, try fast mindful walking. Find a spot where you can walk up and down swiftly for about 20 steps:
1. Stand in the mountain posture (from Chapter 6). Place your legs hip width apart, grounding yourself by sensing three points of contact (heel, big toe and little toe), letting your shoulders hang loosely and keeping your head and spine upright.
2. Let your gaze focus on one spot ahead. Avoid looking at your feet.
3. Start walking with vigour. Your anchor of awareness is each step on the ground. Focus on your breathing too, noticing its intensity rising with each ‘lane’ you complete. Continue for around 20 minutes.
You can also listen to this exercise in Track Nine.
Brief body scan
You know how wind often changes lingering unpleasant weather? Well, here’s a chance to help your system free itself from damp sadness!
Please read the instructions for the body scan meditation in Chapter 4. This time, however, consider sweeping through your body more quickly. Pay attention to each body part in a less detailed way than in the long body scan, breathing into each part and imagining a strong gust of wind sweeping through it. Hold the intention of cleansing the whole system. Experiment so that the body scan becomes more active and invigorating while still attending to yourself with kindness and patience.
Feeling helpless
In the past you may have felt helpless when you began to notice depression visiting for the first time, or again. Depression tends to be a place that doesn’t let the light in, that crushes you down and seems to be at the end of time. Feeling helpless is so frightening and without end: often feelings of forever more and ultimate pain are all around you.
Biochemically you’re producing none of the wellbeing chemicals at such times, whereas the adrenaline-fuelled fight-or-flight response increases your focus on all that’s negative and appears threatening. When you understand that this reaction is merely your brain and body doing their jobs (helping the species survive), you may be able to bring a kind of soothing awareness to this. Consider grounding yourself by feeling your feet connected to the floor and see whether you can gently expand your breathing.
The first intervention is always the emergency breathing space meditation (from Chapter 6). After bringing awareness to what you’re thinking, feeling and sensing, you’ve already left the state of helplessness. Then you may want to reread this chapter and the notes in your diary that describe how depression manifests in your personal experience. Seek to understand and know what your depression is and how you can intervene, while remembering that everything passes eventually.
Understanding why some people self-harm
At times you may feel like harming yourself, whether by overusing alcohol or drugs or physically hurting yourself. Sometimes strong physical sensation can be a way of getting in touch with the pain of depression or a distraction from it. Self-harming is a particular method of expressing extremely deep distress, of conveying anguish that seems beyond words. Whatever the reason for self-harming, most people still find excuses for visible signs of self-harm (‘Oh, I just fell over’ or ‘I burned myself cooking’) or perhaps they hide the obvious marks away. Excuses and denials like these show that an inherent feeling of embarrassment is attached to self-harm and not being able to cope, which makes it even more difficult for people to seek help or be offered it.
Self-harming behaviours include:
Scratching, cutting or burning yourself
Banging your head or fists against hard surfaces
Taking an overdose or swallowing/putting sharp things inside yourself
Less obvious ways are taking unnecessary risks, remaining with an abusive partner, developing an eating disorder, being addicted to substances or just not looking after yourself (in other words, self-neglect).
When you understand why you self-harm, you can try a new way of dealing with depression as follows:
1. Know what depression is and that depression is usually transient.
2. Bring awareness to your tool kit (see the earlier ‘Lacking drive or energy’ section).
3. Work on accepting that the human condition means that you’re sometimes going to experience suffering, but also that mindfulness can shorten the stay of this unwanted visitor.
Overcoming Unhelpful Thoughts
The eight-week MBCT course in Part II offers clear insights into the nature of thoughts. Although they can seem real and permanent, in reality they may be figments of your imagination, incorrect interpretations, conclusions you’ve jumped to or just mental irritations based on no facts whatsoever. In this section, I take a look at a couple of particularly insidious thoughts.
Imagine for a moment that you’re thinking: ‘I haven’t been in a relationship for two years now; this means I’m utterly unlovable.’ Ask yourself, does it really? Kindly mull over the following two statements and see how you feel then:
What would you say to your best friend if she made such a statement?
How would you see this situation if you weren’t depressed?
Consider your responses and write down in your diary how your perspective has changed, if at all. Plus, add a pinch of compassion to the part in you that’s hurting. Maybe you can tell yourself: ‘I know I feel lonely right now but everything passes eventually. What can I do for myself to accept that right now I’m hurting? Maybe I can ring a friend.’
Thoughts are by no means reliable. If you give them too much time and power, unhelpful negative ones can spiral out of control in depression. This is a key insight to understand – and only you can do it for yourself.
‘Snapping out’ of it
Earlier in this chapter (in ‘Searching for your personal signature’) you discover the benefits of observing and getting to know your own manifestations of depression and what you can do when they threaten to come back. Therefore, you may well feel annoyed when well-meaning friends or relatives suggest that you attempt to ‘snap out of it’. After all, you know your depression and its disguises and how it can creep up on you. The sad fact is that people who’ve not experienced depression often show little empathy towards sufferers.
Don’t take such advice too seriously and if at all possible ignore it and try not to succumb to anger. Easier said than done, of course, but honestly . . . they simply don’t understand and anger only feeds your negative mood.
Instead, get in touch with your black dog of depression. Perhaps say to it, ‘I know you only too well, but this time I’m not going down this road with you. This time I choose another route.’ If doing so proves impossible this time, bring kindness in as your aid. No use in simply slapping yourself in the face. Allow yourself to take the time you need.
Believing that you’re against the world
Obviously everyone’s experiences in life are unique – no one can completely understand what you’re going through. But that doesn’t mean that you’re totally isolated and can’t find ways of communicating with others during this time – you never know who can help. Kindly accept the company of those who are open or offering to assist you and remember not to dump your problems on others or blame them. Instead, bring a kindly curiosity to a conversation about depression. Compassion is a two-way street – if you wish your friends to show you compassion, you must offer compassion to them.
Here are a few more suggestions for communicating your way back into joining the world:
Share your experience with close friends or relatives; be interested in their own experiences of low mood and how that relates to what you’re going through.
Talk to your GP and see whether any local self-help groups are available for you to join.
Ask your Human Resources department at work whether your employer offers any free counselling to employees.
Deleting the Depression Loop
Research shows that, during depression, certain aspects of emotions, sensations and thoughts join together. On their own they may be manageable, but as a combined force they appear and feel overwhelming, forcing you into a depression loop. In this section, I describe the ways in which mindfulness can assist you with breaking this cycle.
A depression loop is a particular circle of events that feed on one another and eventually, like quicksand, take hold of you and drag you down.
Encountering a depression loop
Here’s an example of a depression loop. You’ve had your annual review at work and it was quite outstanding and positive in most parts. One particular criticism, however, rankles with you: your team-leader writes ‘tends to arrive late a little too often.’ Now, negative thoughts are like sticky tape and stick in the forefront of your memory, overshadowing all the positive ones, even if they’re smaller in number. As a result, all you can think about is the one criticism.
You rerun mentally all the times you were late, trying to find proof that you’re being unjustly held responsible for the bad public transport service. Then you add some other negative thoughts about life: all the stresses you face, and how useless everything is, including you.
Soon, you’re feeling anxious, irritated and upset. You may even have one too many drinks or start over-eating. Doing so affects your sleeping pattern and makes things worse and voila! – you’re in a depression loop. One negative thought causes a negative feeling, which causes a negative behaviour. The more often you travel down this alleyway, the quicker your loop ends up in a full-blown depression relapse.
At any point in this example (or, rather, your own version of it), you can try to intervene and do something different. Immediately following the event, you can carry out a breathing space meditation (from Chapter 6) to take stock, observing and identifying your thoughts instead of believing that they’re 100 per cent correct. Then you can look mindfully at the particular negative experience more objectively, accepting the rising anxiety or unrest and gently breathing into it. You may be able to stop the loop from completing and taking hold of you. As a result, you probably experience a low afternoon or day rather than a full relapse of depression.
You really do benefit from regularly committing to MBCT practice. The fact is that your mind and body need looking after. No quick-fix, once-and-for-all solution exists; the answer is regular practice, but don’t be scared by this! When you establish a routine of meditating mindfully, you may even miss it when you don’t sit down to practise. Ideally, give mindfulness a good eight weeks before you decide whether to continue or not.
Making time, not finding time
Like most people, you aren’t simply going to find more time, like an old chocolate bar that slipped down the back of the sofa! You only have 24 hours in a day, like anybody else. Instead, you have to take responsibility for making the time to meditate to help you avoid relapsing into depression. So make a point today of asking yourself what you can reduce or give up in order to make room for regular mindfulness: what times of the day offer you the best opportunities to do everyday activities mindfully and to create a space for a longer meditation?
Your mind and body are too important to take second place behind other things. You can’t function properly without looking after yourself, so please don’t take yourself for granted or think that overcoming this obstacle isn’t as important as your work, watching the news or having time for your hobbies. In fact, right now, overcoming your depression may well be the most important thing.
If giving mindfulness practice a proper space in your life allows you to avoid painful and long periods of depression, you gain plenty of time in return: 40 minutes a day can save you weeks of beating the blues later. Plus, brain research shows many more benefits of meditation, such as better memory, a more efficient immune system and a more compassionate mind and heart (see Chapter 3 for many more benefits).
Following up on your progress
If you’re the type of person who initially commits to things full of enthusiasm before the old lethargy returns and takes over again, maintaining a mindful viewpoint of your daily meditation practice is vitally important.
Kindly recall the benefits of sticking to a daily routine, such as carrying out the body scan and focusing on your breath (Chapter 4), sitting with a sound (Chapter 5) or engaging in mindful movement (Chapter 6). And don’t forget everyday mindful activities, such as having a mindful shower rather than making to-do lists in your head while all the pleasure of hot water and wonderful scents passes you by. Ensure that you make the effort to notice any changes. After a week or so of daily practice, do you feel that making the time for mindfulness is easier? Keep a written record of your progress and discoveries because it really does help.
Using MBCT to prevent depression relapse
Two clinical trials in the UK and Canada show that MBCT is helpful in stopping depression from recurring in people who’ve suffered several previous episodes of depression. It helps to combat the worrying reality that if you’ve been depressed once, the amount of triggering required for subsequent episodes is lower each time (see the sidebar ‘Thoughts like a broken record’ for more).
Even when you feel on top of the world, your brain has developed memory pathways that link negative mood with negative thoughts, and this ticking time bomb can go off at any time. So keeping practising mindfulness is undoubtedly beneficial even when all’s going well. This way you find out how to keep mild states of low mood from escalating out of control.
Believing that things can and will improve
A real evidence-based strong possibility exists that you are going to beat depression with regular MBCT practice. The UK National Institute of Clinical Excellence (NICE) has recently approved MBCT as being an effective treatment for prevention of relapse into depression. Research has proven that people who’ve experienced clinical depression three or more times (sometimes for twenty years or more) greatly benefit from the eight-week MBCT program. The evidence indicates that the program reduces rates of relapse by 50 per cent among patients who suffer from recurrent depression. I hope that this fact helps you to want to put your trust in this approach and in yourself.
Even if depression returns, it may not stay as long as before and you may experience fewer volatile symptoms. The only truth is that everything is constantly changing and that nothing remains forever. Even your depression has a sell-by-date! Kindly trust the power of your positive thoughts: if you believe that things will get better, they will get better!
An old Yogic saying goes as follows: if you want to learn, read; if you want to understand, write; and if you want to master, teach! If any of your friends share low moods and feeling down, introduce them to the mindfulness lessons you discover. Educating others strengthens your own new ways of thinking even more quickly.