Sitting with the Shadows: Mindfulness Based Cognitive Therapy for Depression
Because if Mindfulness is only about being present with the pleasant, then it really isn't all that useful is it? Here's a little something about how MBCT can help you be present with the darker days.
In literal terms, depression can be defined as “a sunken place or hollow on a surface”. In psychological terms that sunken place and hollowness is often felt far, far deeper than just on the surface. Even so, many people may focus on the surface - keeping up the appearance of wellbeing and everyday functioning. Because let’s be honest, in a very real way, talking about depression is… well, a bit of a downer. So much so, that those who suffer with it, tend to do so feeling deeply alone and misunderstood.
If you suffer with depression, you probably often feel betrayed by your own mind that just doesn’t seem to see sunset colours or silver linings as vividly as others do. It just doesn’t seem to generate the motivation needed to do the exercise you were promised would boost your mood or tickle your dopamine receptors or whatever.
Your mind probably seems to be exceptionally finely tuned in on the exact frequency of the downside of each technicolour yawn of toxically positive post that is your carefully curated, wellness-focused Instagram feed.
I mean, have you seen what @SelfLovingTwyla* had to work through in order to become the influential hashtagwellnessgoddess she is today?! And you know what, some days, when she doesn’t have her superfoods smoothie after her dawn beach stretch, she really feels down you guys. And then she has to whip out those affirmations and remind herself that she is in fact a hashtagwellnessgoddess who can manifest her own… super…ness. And then she feels a bit better, and she can sit on a big smooth rock in the lake in front of her house with her blonde hair whipping gently in the breeze while she meditates the shit out of her demons and ponders this very post. She is a hashtagwarriorwomanbaddassfeminist. Like. So inspiring, queen. Praise hands. Delete praise hands. Flower. Never mind. Man I’m lame. hashtagdepressionsucks.
In the meantime, life goes on - your sense of self is the thing that oscillates between occupying a limited set of crusty hoodies and a limited set of comfy pyjamas. You sip your chamomile before bedtime while your mental ghosts unrelentingly haunt you, even at this hour, about the fact that you didn’t make your bed again this mid-morning - seriously Beth, it was the one thing that podcast said you needed to do today. Play next episode. Perhaps the latest generation of antidepressants your psychiatrist is so excited about will finally kick in this week.
We’ve thrown everything at depression - we’ve done intensive psychotherapy, we’ve thrown buckets of drugs at it, we’re trying some illicit fungi (off the record), sometimes we even try a hard reboot by literally shocking the brain. Some people are ‘lucky’ enough that some of these approaches or a combination of them does the trick beautifully.
And yet, here we are, depression is still a thing - perhaps more of a thing than ever. The staggering figures of its prevalence suggests that it is something at least a 10th of us will experience at some point in our lives. It is ruthless - it can debilitatingly affect mood, motivation, cognition, appetite, relationships, sex drive, sleep… you name it. What we’re starting to come to terms with, is that for many people with depression, it is eventually considered “chronic”, “recurrent” or “relapsing”. Half of patients who recover from an initial episode of depression are expected to have at least one more episode. Those who have had two or more past episodes are considered up to 80% more likely to experience relapse . This is not inspiring, queen.
Generally speaking - our best bet has been to be in longterm psychotherapy and staying on your meds. Until now. I mean, please do continue seeing your therapist and taking your meds, but there’s more, is what I’m saying…
Mindfulness Based Cognitive Therapy seems to be onto something. In fact, the research suggests that it’s considered to be most effective for those who have had at least three episodes. Yeah you read that correctly - the crappier your depression, the more likely MBCT is to help you. How? Because it doesn’t zoom in on trying to ‘fix’ one part while depression affects all the parts. Remember, depression moves into all the rooms of the house - it affects the bod, the feels, the mind, all of it. So while the meds can help the bod, and the classic talk therapy can help the thoughts and the feels, MBCT is focused on helping you see the relationship between all the parts. Those relationships are the things that actually need the support. For example, some very interesting research suggests that people who struggle with depressive relapse have a tendency to automatically and subconsciously, but mistakenly interpret certain emotional or physical states as a sign of coming depression. The really trippy part is that it can be that very interpretation - not the thoughts themselves, not the feelings themselves, not the actual likelihood of oncoming depression, but the very relationship and ‘dialogue’ between thoughts, physical and emotional states - that triggers the onset of a depressive relapse.
Depression stealthily, and without you noticing, ties things together that don’t belong together, and the next time you pull at an innocent string of sadness, depression thunks the whole damn mess of knots into your mind. Tadah! Relapse.
MBCT, very stealthily also, but definitely with you noticing, helps you to understand the actual mechanisms of depressive relapse patterns, helps you disentangle those mental knots, so that you can intervene before they move in and start wearing your comfy pyjamas without your permission.
* If you happen to be @SelfLovingTwyla - my bad, I was totally making this up. I’m sure you really are an inspiring queen. And for the record - yoga, self love, beach days and smoothies really are awesome, and in fact are a few of my favourite things. They’re just also not always the ‘full fix’ and there’s really no need to feel crappy about yourself if they’re not your thing or if you don’t get around to them as often as my girl Twyla does.
* If you'd like to know more about where I got all these stats, please feel free to get in touch