When Nick Robinson invited me to prepare a third edition of Overcoming Depression I was both delighted and daunted. I was delighted because it is over 10 years since the second edition was written and so much has happened in that time in regard to working with depression. I was daunted because I knew there would have to be a fairly substantial rewriting. So, over a year and many five o’clock in the mornings later, here we are.
What is so new that we should get excited? One thing is that the past 10 years has seen a major focus on what is called mindfulness. Mindfulness was originally developed within ancient spiritual traditions in the East. Like many other traditions, it proposes that our attention and thoughts contribute to our well-being or distress. It teaches ways to attend to the thoughts and feelings in our minds by becoming more observant and non-judgemental. It also provides various ‘exercises’ we can practise, which help to balance our state of mind. There is increasing research evidence that this can be extremely helpful to us when we are depressed (and throughout our lives). It is particularly helpful when we tend to avoid our feelings or ruminate on them or judge them to be bad or overwhelming. Chapter 7 is dedicated to this approach.
The second major excitement is the way that our understanding of compassion has developed in the past 10 years. We are learning how we can develop it as a major antidote to depression. There is increasing evidence that training ourselves in compassion and kindness, with regular practice, can actually change our brains. Researchers are now exploring this in detail.
This is exciting, because humans have evolved to be very responsive to kindness. For example, babies don’t survive or grow without care and support. If we think about times when we’re distressed, it is easy to recognize that the kindness of others helps to soothe us and pull us through. We have also discovered that individuals who are kind and supportive to themselves are also more resilient to life’s difficulties than those who are critical and self-condemning. Our brain does not respond very well to self-criticism.
In the preface to the first edition, written 15 years ago, I wrote that ‘I see depression as a state of mind that we have a potential for, just as we have a potential to feel grief, fear, sexual arousal and so forth. And like any state of mind, depression is associated with very real changes in the brain.’ I went on to say that depression is a brain state and a brain pattern that can affect any of us to differing degrees. Once we know this, then all efforts can be aimed at changing this brain pattern, trying to shift brain states (discussed on my CD Overcoming Depression). This is where kindness comes in again, because in Chapter 2 I outline in detail how our emotional systems work to create different patterns and states of mind. I also describe how a combination of mindfulness and compassion can help balance them.
The key message is that there are many ideas to help us when depression grabs hold of our feelings, thoughts and behaviors. We can however learn to act against the desire to withdraw that operates within depression. We can stand back and view our thoughts from the balcony, as it were, and develop a balanced perspective rather than an overly hostile, critical or pessimistic one. We can learn to develop and seek out helpful and supportive relationships.
Whatever we choose to do to bring more balance to our minds, if we learn to do it with the feelings and intentions of kindness, support and encouragement, recognizing how painful and hard depression is, we are more likely to be successful. When we allow ourselves to feel compassionate – and for some people that is quite a big step – we open ourselves up to being helped and to healing things we may be ashamed of.
Many of the original ideas are still core to this book, but they are now more linked to the importance of compassion for oneself and others, and how to develop it. If you like this approach you may want to pursue it further in other writings, or perhaps further your own explorations into its healing properties.
You will see that as in the previous editions I use a lot of case material. For confidentiality reasons I can only include stories that people have agreed I can use; elsewhere I have combined themes and created fictional characters. To protect confidentiality they are designed to be non-identifiable, and are used primarily to create a narrative that helps the reader’s understanding.
I know this a long book but we cover a lot of ground, and you can easily dip in and out of it. Good luck.