Last night a participant asked about how to practice MBCT with depressive / lonely thoughts.
Q: Depression… Everyone experiences depressed mood at some point in their lives. A depressive episode can last for days, weeks or months. How can we be mindful when we can even seemingly get up out of bed?
A: Low mood states can cause a reverse motivation – it’s the “I’ll do it when I feel up to it,” which we may not feel like for some time and we may not think we will ever. Practicing mindfulness we need to have motivation that is the “I do this even if I don’t feel up for it.” The key is to understand that intention and motivation for practising is what calls us to take action, even when we don’t feel like it. We understand that practising mindfulness, we create an anchor in the present moment where we can create a space around problematic thinking patterns, more readily. The practice is the teacher.
Depression can be pervasive because we cannot see past the fog of it. It’s heavy and we feel weighed down by the enormity of our being. Winston Churchill described his depression as a “black dog” that followed him everywhere. The World Health Organization has this wonderful video that shows us about the black dog of depression is like:
Depression can be caused by life circumstances such as loss – losing a job, death of a loved one, end of a relationship. It can be a product of overwhelm – having been fighting too long to try to be happy, we make ourselves miserable. It can be a chemical imbalance within the brain – lack of serotonin and an influx of other stress related chemicals such as cortisol. It can be related to lifestyle – poor nutrition, lack of exercise, exasperated health problems. Perhaps it all of the former that are contributing to a cycle of depression. Whatever the catalyst for depression, it’s our relationship to it that matter most.
When dealing with low mood states in a depressive episode, it’s important to understand that rumination is often at the foundation of it. Rumination means to chew again and again on what has already been chewed.
The second definition above is “to engage in contemplation.” In low mood states, this contemplation and ruminates in a pessimistic pattern of thinking that discounts all positives in our life. We see and think about the problems we have experienced in the past and anticipate that this is the way it will always be. There is a sense of hopelessness to this. Our mind is full of the black dog… and we cannot see our way out of it. Every avenue of thought ends with things not changing and the fuels the hopelessness. We become more disconnected from life and this can fuel feelings of loneliness.
When our mind if full of depression and this gives rise to feelings of hopelessness and loneliness, learning a new skill such as mindfulness can prove quite difficult. It is recommended that although you can cultivate an understanding of mindfulness practice, the actual practice is best saved until you are out of your depressive episode. Episodes have a lifespan – at some point you will begin to feel a bit better – and in that moment, when you decide that you are willing to do something different is the time to begin the practice. The reason is that with your current mindset, you may be experiencing reverse motivation or the actual practice difficult. The experience of difficulty creates a barrier to the practice as you evaluate the difficulty of practising as meaning something about your abilities or capabilities or it’s yet more evidence of perceived inadequacy or that it doesn’t work. This feeds into a negative loop that deepens the feelings of hopelessness.
This negative loop is a pattern matching process in the mind that occurs and reinforces the depressive cycle which can make a person more susceptible to depressive moods and refreshing those losses again. For example, you begin to feel sad, you may not even know what you are sad about, you may look for a reason why you are sad, perhaps you do have a reason to be sad – your mind will reawaken like and similar thoughts of sad times in your mind creating a more profound and persistent state of sad. You begin to ruminate on this state with thoughts such as, “Here we go again. When will it end this time? I really cannot stand any more of this. It’s all so hopeless.” The negative thought loop on a downward spiral and you’re feeling more and more depressed and lonely. The black dog is here again. How long will he stay?
People experiencing depression can benefit from practice if they are beginning to get to a point of hopefulness – even the smallest spark to be willing to do something to change their thoughts to something more resourceful. This change is, “I want to feel better.” This intention to feel better can bring you to the very action to find support for yourself – through an empathetic friend, therapist or counsellor – or learning a skill which gives you a sense of mastery such as mindfulness.
Mindfulness can help you at this point to change your relationship to your black dog. Just like in the video – you learn to manage it differently. You learn to settle the unsettled mind. Tame the intrusive thoughts through practice and take mindful action to be kind to yourself – eat well, exercise and engage more with life – all a part of a healthy and contented lifestyle. I tell participants that, “Compassion is the opposite of rumination.” It is the practice of clearly seeing your suffering and meeting it with kind action.
Is mindfulness the cure for depression? No. Not in and of itself. It is a powerful tool to help you to break out of rumination and negative thought patterns by changing your relationship to it. You will learn the early warning signs of depressive relapse and take mindful action in a kind and compassionate way towards yourself that can bring lasting change. Your black dog may still come for a visit occasionally the length between visits and the duration of each visit will be shortened with your mindful mindset. “You are what you practice.” If you practice being sad, you’ll get really good at it and it will seem natural state of mind for you. Practising being mindfulness means you are practising a whole different way of relating to life from a present moment perspective, with motivation based on value, intention, and acceptance.