Full Name:

Address 1:

Address 2:

City:
State:
Zip Code:
Email (required):

If I like it and decide to continue, I'll pay just $16.95, and receive a full one-year subscription (9 issues in all), a 62% savings off the newsstand price!

Today's Daily Tip

Surround Sound

Drop in on a yoga class anywhere in America, and chances are good that you'll hear a melody wafting from a ... (continued)

Multimedia

Video Channel:
From the Magazine

Behind the Scenes at a Yoga Journal Photoshoot

See the work and dedication of our editorial and art teams as we create the images to illustrate Chaturanga.

Watch Video



Print Print Email Email Comment Comment Add to Favorites
Log in to save to My Yoga Journal!
Add to Favorites
Bookmark Bookmark

Sitting with Depression

Depressed people think they know themselves, but maybe they only know depression.

By Mark Epstein

A woman named Sally called me not long ago seeking advice. I had seen her for a single session in consultation months before, and we had talked about a variety of therapeutic and spiritual issues. Like many people with an interest in spirituality, she was suspicious of the role of psychiatric medications in today's culture. It seemed like the mark of some kind of Brave New World to have mood-altering drugs so readily available. But like many others, Sally wondered if there might be a medicine that could help her. She had been plagued with chronic feelings of anxiety and depression for much of her adult life, and despite a healthy investment in psychotherapy, she still felt that there was something the matter with her. When I spoke with Sally the second time, she had been taking a small dose of an antidepressant for several weeks, 25 milligrams of Zoloft, and she was finding that she felt calmer, less irritable, and, dare she say, happier. She was going on a two-week meditation retreat later that month. Something about taking her medication while on retreat made Sally uncomfortable, and that was the reason for her call. "Perhaps I should go more deeply into my problems while I'm away," she said. She worried that the antidepressant would impede that process by making her problems less accessible to her. "What do you think?" she asked.

Let me be clear right from the start that there is no universal answer in a situation like this. Some people notice when they take drugs like Prozac, Paxil, or Zoloft, antidepressants of the SSRI (selective serotonin re-uptake inhibitor) variety, that they feel cut-off from themselves as a result. They don't feel their feelings quite so acutely and sometimes report feeling numb. Some, both men and women, find that the drugs interfere with their ability to reach orgasm. Many others find that the damping down of their feelings is more subtle. One of my patients notices she no longer cries in movies, for example, but she is willing to accept this because she also no longer worries to the point of exhaustion about things she can do nothing about.

I was relieved to hear that Sally was feeling better. People who respond well to these antidepressants often have none of the side effects mentioned above. Instead they feel restored, healed of the depressive symptoms that they were expending so much of their energy trying to fend off. Less preoccupied with their internal states, they are freer to participate in their own lives, yet they often wonder if they are cheating. "This isn't the real me," they protest. "I'm the tired, cranky, no-good one you remember from a couple of weeks ago." As a psychiatrist, I am often in the position to encourage people to question those identifications. Depressed people think they know themselves, but maybe they only know depression.

Sally's question was interesting not only because of the drug issue but because of her assumptions about the nature of spiritual work. The notion that we need to go more deeply into our problems in order to be healed is a prevalent one, and one that, as a therapist, I am sympathetic toward.

Page 1 2 3

See All Meditation Articles »

Print Print Email Email Comment Comment Add to Favorites
Log in to save to My Yoga Journal!
Add to Favorites
Bookmark Bookmark

Subscribe to Yoga Journal Magazine

Reader Comments

MLR

I have Bipolar Disorder and I am glad to find this article. In my experience it would be impossible for me to deal with my feelings or to meditate if I were unmedicated. All these meds just make me feel normal, not drugged. For those who may disagree with me just consider this: when I get sick I am suicidal, delusional, and have hallucunations. Full blown psychosis. Would you be able to meditate and "think positive" under those circumstances? I guess I am just tired of people thinking that they are more "spiritual" than me, because I use meds.

So happy to read this!

I don't have depression, but I have had terrible, paralyzing anxiety and panic attacks. I struggled for years thinking medication was a "cop out" and I should be able to fix everything on my own through therapy, yoga, exercise, etc. While all that is helpful and healthy, I have recently tried medication again (after trying 2 at different points that had horrible side effects) and think I have found one that works, doesn't make me feel numb and helps me reclaim a normal life. I am commenting on this article, because anxiety, like depression, is a serious illness, that can derail someone in the worst way. We would not tell diabetics or people with high blood pressure to just change their diets and get some exercise. Medicine has a useful purpose for many with mental illness and is often absolutely necessary to have a sense of recovery. I hope the "laypeople" who think depression is completely controllable will understand it isn't, and that will help destigmatize depression and other mental illnesses that so many people suffer from.

JRB

In response to Deanna's comment and anyone else who has a similiar perspective re: depression....Perspective is the key word....as individual as we all are, in our physical bodies, as well as the emotional/mental body....what works for one, or even many, will not work for all. As it should be.
I agree that it would be absolutely wonderful (as Helen commented) if everyone had unlimited resource/access to both eastern/western medicine to treat all health issues, but especially diseases like depression that cannot be objectively/physically measured easily. Depression's spectrum is from A-Z....you cannot compare a person who occasionally has hard times & feels overwhelmed to the person who has idealized suicide for over 20 yrs. and everything in between. You really can't compare ANYONE, for that matter.
I do suffer from depression, so I speak from experience when I say that sometimes, unfortunately, it is not as easy as just stopping negative thinking or focusing on the positive. I wish it was. There is only so much we can do about our genetic pre-disposition, our chemical makeup or what diseases our body acquires despite being healthy & doing everything "right". I absolutely believe anti-depressants are widely over pre- scribed. I also believe they have their place & can save lives.
I believe our society as a whole is HIGHLY addictive. Addicted to whatever will distract from uncomfortable thoughts/feelings. Shopping, yoga, "looking good", exercising, career, money, drugs, alcohol, sex, love, hollywood, positive thinking, negative thinking, being stoic, victimization, being nice, being tough & unaffected, being the clown.....WHATEVER, as long as it distracts us from ourselves and whatever it is about us that is just plain & simple & boring & REAL & maybe unpleasant or uncomfortable or embarrassing AND maybe NOT, but just REAL.
The reason I decided to comment, and I hope you read this Deanna, is because having this attitude that "we cause our own depression" is a very common (sometimes hurtful) and way simplistic perspective. You are so fortunate, and I am envious of anyone who has the ability to snap themselves out of a depression without the use of some treatment (natural or chemical, it is all expensive & a lot of work). Having a chemical imbalance is no fun. It can also be humiliating, shameful & embarrassing...but WHY, when it is a biological fact? Because we can't see it, and some people cannot relate so they don't totally buy it and give well meant advice like, "just choose to be happy!" and "have you read The Secret?" (which is a great book!). Fair enough. But as the world slowly
becomes more aware & validating of the things we cannot see, hopefully attitudes toward mental health & those who suffer from depression (& must take medication) will expand to include compassion & acceptance of the unglamorous, unexciting & sometimes uncomfortable truths of our differences. However uncomfortable, REAL is HEALTHY. We are all so flawed and so beautiful at the same time.
I really liked the article by Dr Epstein. He validates both eastern/western treatments while acknowledging depression as something we all must learn to sit with, rather than cling to.

See All Comments »      Add a Comment »

Your Name:

Comment:

Join Yoga Journal's Benefits Plus

Liability insurance and benefits to support teachers and studios.

Learn More »

Enter to Win Great Prizes!

Enter to Win Great Prizes! Enter to Win Great Prizes! Prizes include a Yoga Journal conference pass, yoga mats, clothes, books, jewelry, energy bars, Yoga Journal DVDs, and more...

Enter Now »

Get 2 FREE Trial Issues and 2 FREE Gifts!

FREE Gifts! Your subscription includes
2 FREE GIFTS:

Yoga for Neck & Shoulders

A digital guide to 11 postures that relieve neck, back and shoulder tension.

Yoga Remedies for Everyday Ailments

A digital guide to 8 postures that relieve common health problems such as stress, backache, wrist strain, and insomnia.

Yes! Please send me 2 FREE trial issues
of Yoga Journal and my 2 FREE GIFTS

Full Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Email (req):

If I like it and decide to continue, I'll pay just $16.95, and receive a full one-year subscription (9 issues in all), a 62% savings off the newsstand price!

Offer valid in US only.
Canadian subscriptions | International subscriptions

Save 62% off the cover price Pay Now and Get 2
Bonus Issues
Pay now and get
TWO EXTRA ISSUES FREE!
That's 10 issues for the
same low price!
Click Here to PAY NOW!