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Sitting with Depression

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

By Mark Epstein

The imagery that describes this transformation in classical Asian cultures is revealing. When nourished with meditative awareness, the mind unfolds like a lotus, symbol of the primordial Buddha-nature that is obscured by our identifications with our problems. Buddhas themselves sit upon a lotus throne, symbol of a mind that contains everything but holds nothing. The lotus is another way of evoking the womblike nature of emptiness or sunyata, whose translation is literally "pregnant void." In Batchelor's book he describes how the understanding of emptiness "eases fixations," another way of talking about freeing the mind from an obsession with "problems." A translation of the Sanskrit prapanaca, "fixations" take root when we turn fleeting and ephemeral pleasures or displeasures into objects that we then try to hold on to.

They are evidence of a kind of psychological materialism that holds us as much as we would like to hold it. Sally felt that she should go more deeply into her problems, not to understand their empty nature, but to admit the awful truth about herself. But this sort of truth-seeking masked a continuing attachment to the kind of person she thought she should be: a person without problems.

We are freed from our problems, I have learned, not by going into them more deeply, but by knowing the empty and womblike nature of our minds. Sally did not need to make Zoloft into another problem. She could use it, rather, to help unfold her lotus mind in meditation.

Mark Epstein, M.D., is a psychiatrist in New York and author of Thoughts without a Thinker: Psychotherapy from a Buddhist Perspective (Basic Books, 1996) and Going to Pieces without Falling Apart (Broadway Books, 1999). He's been a student of Buddhist meditation for 25 years.

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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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