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Sitting with Depression

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

By Mark Epstein

Certainly, ignoring the shadow side of our personalities can only lead to what Freud once called the "return of the repressed." Yet it struck me that there was a remnant of American Puritanism implicit in Sally's perspective, or at least a Judeo-Christian tendency to divide the Self into lower and higher, or better and worse.

When people believe that they are their problems, there is often a desire to pick away at the Self. People think that if they could just admit the awful truth about themselves they would start to feel better. But going more deeply into our problems can be just another variant on trying to get rid of our problems altogether to return to a state of original purity like the Garden of Eden. While most therapists would probably deny a religious influence on their thinking, many collude unconsciously with this mode of thought. Going more deeply into one's problems is the standard approach of most therapies, and it can lead to a kind of sober honesty and humility that gives people a quiet strength of character.

But to go more deeply into our problems is sometimes to go only into what we already know. I was sure that Sally did not have to go looking for problems on her retreat. Retreats are difficult enough even for people who are not depressed.

Sally's unresolved issues would come rushing in to fill every space whether she took her antidepressant or not, but she might have more success in not being sucked in by them with the medicine inside of her.

I told her that at this point I felt she needed to come out of her problems, not go into them more deeply, and that the antidepressant should not get in her way in that regard. To be overwhelmed while on retreat would not be useful. As a therapist influenced by the wisdom of the East, I am confident that there is another direction in which to move in such situations: away from the problems and into the unknown. If we stay with the fear this often induces, we have a special opportunity to see our own egos at work, defending against the unknown while hiding out in the very problems we claim to want freedom from. Buddhism is very clear about how important it is to move in such a direction.

The Buddhist writer and translator Stephen Batchelor, in his austere new book on the teachings of a third-century Indian philosopher-monk named Nagarjuna, Verses from the Center: A Buddhist Vision of the Sublime (Riverhead Books), eloquently describes how the mind can be set free of all constraints in meditation. He tells of how the eighth-century Indian monk Shantideva, author of A Guide to the Bodhisattva's Way of Life, was liberated upon uttering the following words: "When neither something nor nothing/Remains to be known,/There is no alternative left/But complete non-referential ease."

Rather than going more deeply into his problems, Shantideva learned how to disentangle his mind from them. This is an approach that Western therapy has little experience with, but it is the foundation of Eastern wisdom. The contents of the mental stream are not as important as the consciousness that knows them. The mind softens in meditation through the assumption of a particular mental posture called "bare attention," in which impartial, nonjudgmental awareness is trained on whatever there is to observe. Problems are not distinguished from solutions; the mind learns how to be with ambiguity.

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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.

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