Depression: How We Get Stuck and What Can Help

Elisha Goldstein, Ph.D. Updated: Mar 26th 2009

depressed woman The World Health Organization predicts that by 2020, depression will become the second greatest world issue in respect to ill health. Recent evidence points to depression as being as debilitating to day to day impairment (measured in days spent in bed) as major medical illnesses such as cancer and coronary heart disease. There is still a profound subversive element in our culture that doesn't believe depression exists and therefore does not gain the awareness and tools to treat it. The even greater issue is that the more often a person experiences a relapse of depression, the more likely they are to relapse again.

Statistics speak for themselves. There is a 70-80% relapse rate in people that have experienced two or more episodes. Awareness and a radical acceptance of the reality of what is occurring in the present moment is key begin working with the issue. Otherwise, without this awareness, we live in a state of auto-pilot day-to-day as our minds continue to do what they do, naturally settling into well worn grooves that can lead to the all-too-familiar depressive episode. In this place, the self and world is seen in a negative and judgmental light and felt as inadequate, blameworthy, hopeless, and worthless.

The interactions that make up this experience and cycle into depression are thoughts, emotions, sensations, and behavior. The more often this occurs, the deeper the grooves get set. When we're traveling these grooves on auto-pilot, there is no conscious decision or choice occurring. It becomes difficult or impossible to just read a blog or a book and expect an insight to come up and the depression to lift. Instead, we need to actually cultivate experiences in day to day life that will touch on these deep grooves and provide an alternative relationship to our experience (aka, thoughts, feelings, and emotions).

Those of you who have been reading my blogs likely have a sense that I am a big promoter of mindfulness-based approaches to living. The reason I am a promoter of this is because I believe that awareness is the starting point of making any kind of real change. Mindfulness practice provides a practical way to bring us down from our busy minds of rumination and gives us the experience of directly touching the present moment and becoming more aware of the cycle of thoughts, feelings, and emotions that comprise our experience. With this awareness, we begin to reclaim our ability to choose a different response to this experience. In becoming present to our thoughts, feelings, and emotions we also send the nonverbal message internally that we're worth paying attention to which is something we all have wanted since being a child. In cultivating a nonjudgmental presence to ourselves, we stop damning our pain and in doing this, compassion begins to emerge and this provides strength and resilience.

The difficulty in practicing this is having the understanding that this is a practice. Just like walking took practice as a baby or learning an instrument takes practice for most of us, this is also something to cultivate with practice over time. If frustration arises in the midst of practice, it would be naturally for the auto-pilot to take over and for thoughts to emerge "this isn't working, why am I even doing this?" Remember, those are just thoughts, part of the practice is to notice those habitual mind patterns, let them be, and gently bring the focus back to what you are meaning to attend to in the moment. After doing any practice, always thank yourself for taking time out of your daily busy-ness (even if it is only busy in the mind) for your own health and well-being.

If you are interested in learning more about how mindfulness works with depression, Zindel, Williams, and Teasdale have published the book Mindful Way Through Depression and I also have an audio CD with psycho education and guided practices called Mindful Solutions for Stress, Anxiety, and Depression. If you are interested in experiencing a "taste" of mindfulness, Mentalhelp.net has a free audio example as an introduction to practice.

As always please share your thoughts and question below. Your interaction here provides a living wisdom for us all to benefit from.

Elisha Goldstein, Ph.D. is a clinical psychologist in private practice in West Los Angeles and is author of the upcoming book The Now Effect, co-author of A Mindfulness-Based Stress Reduction Workbook, Foreword by Jon Kabat-Zinn, author of the Mindful Solutions audio series, and the Mindfulness at Work™ program currently being adopted in multiple multinational corporations.

Check out Dr. Goldstein's acclaimed CD's on Mindful Solutions for Stress, Anxiety, and Depression, Mindful Solutions for Addiction and RelapsePrevention, and Mindful Solutions for Success and Stress Reduction at Work. -- "They are so relevant, I have marked them as one of my favorites on a handout I give to all new clients" ~ Psychiatrist.

If you're wanting to integrate more mindfulness into your daily life, sign up for his Mindful Living Twitter Feed. Dr. Goldstein is also available for private psychotherapy.

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Discuss this issue below or in our forums.

i got very typical wierdness. - - Dec 20th 2010

Hey,

I am suffereing from very wierd stuff, if I am not wrong I was suffering from that since childhood. I can talk to anyone, and be friendly, but when it comes to spend time with them, I back off. I feel so happy to alone rather than being with friends whom I cannot accpet. I do not know what's thsi absurd behaviour. I do not know, some how I should be accepting that person. Only then I give them time, or say I will be with them. The horrible thing is that my heart choose two friends, in my 23 years fo life and I got none. I got 100 friends, but I feel only 2 are my actual friends, worst is they abanddoned me. I am panic, what's wrong with me? I think of killing myself. I know it is diease well trying to cure it. But I am from India. Looking for Counselling in India.

Regards,

O Cassandra.

depression - - Jul 22nd 2009

I am a second year university Student who is studying UK. I did not know how did I get the depression or what I did wrong. I did not know why God give me this, I did not do any harm to anyone. I have tried the antidepressant it did not work at all. I have been going to counselling.

The worse thing of all is that my family does not believe in me.

I hate myself!!!!!!!!!!!!!!!!!!!

I've learned to live with Depression! Had too! - Paula - Apr 11th 2009

I never understood why there is a point to living when no one understands the pain that you feel. What is the point of enduring this everyday pain just to be somewhere that you aren't wanted and no one cares. Depression is such a everyday thing that it has become part of my life that seems wrong if it isn't there. How is it that I have come to this where I can't function without it anymore? The pain leads to such suffering that there is no stopping it. How did it get so bad? Well I guess that I can't hide from something that won't go away. No one cares and no one's there. I depend on myself and that isn't even enough sometimes. The pain overcomes me and engulfs me in it's internal and endless suffering.

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