Depression; The Treatment Journey

I have been treating depression for nearly two decades now and I have watched the tools we have used to tackle the illness evolve over this time.

In the latter half of the last century certain therapies grew an increasing bedrock of evidence to support their efficacy in the treatment of depression. We became more and more informed about the specific forms of therapy that worked in depression and even got an idea about the length of time they were needed to produce results. The most prominent of the various therapies with success in depression is cognitive behaviour therapy, or CBT as it is more commonly known. CBT tackles the problem at the level of cognition, as the name suggests, and it examines the way in which ingrained patterns of processing the world around us can influence our mood and our vulnerability to develop or maintain a depressive episode. Versions of this started to be rolled out online, with the advent of Internet therapy and spin offs like dialectic behaviour therapy (DBT) and cognitive analytical therapy (CAT) also grew in popularity.

Each of our solutions thus far essentially address the problem via the realm of thought. The antidepressant medication, that has been around in one form or another for a long time, influences the brain chemistry that in turn influences the way we think, and the talk therapy more directly approaches and challenges the way we think.

What I came to realise, however, over the years was that one of the key factors that contribute to depression – indeed to every form of mental illness – is, to put it simply, too much thought. Whether it’s negative thought cycles in depression, flights of grandiose thinking in mania or whirlwinds of psychotic ideas in schizophrenia, the root here is that the sufferer has become trapped in a world of his own thoughts. I figured sometime ago, therefore – and I know I wasn’t alone in this – that solutions that approach the problem from a perspective of helping people go beyond thought, and learn to experience themselves and the world around them, as much as possible, in a deeper mindful way, might have a greater chance of success.

Therapies that centred around meditation techniques began to be trialled at the turn of the century and now we are in the very exciting moment of watching the results coming in. Recent trials have found that mindfulness or mediation based exercises are having huge success in reducing relapse rates for depression. One study found that relapse rates reduced from 66% to 37% and a second found a reduction from 78% to 36%.

The results were so compelling that the UK National Institute for Health and Clinical Excellence (NICE) now officially recommends such interventions as an effective treatment for depression and healthcare professionals in the UK are encouraged to utilise them.

The consciousness around this is expanding so rapidly that even schools in the UK are beginning to provide regular mediation sessions for their pupils as part of a holistic preparation for life. All in all, it feels like we have come a long way; from medication through CBT, DBT, Internet therapy and CAT (all of which continue to have a place), the hyperactive world of psychiatry has arrived at stillness (which is where meditation gradually takes you) as itself a cure and I must say that from my perch it has been a joy to watch.

Time to get back to that mediation group I think...

Meditation Techniques for Gwyneth Paltrow

Keanu Reeves does it, Orlando Bloom does it, Tina Turner does it, even Steven Segal does it – and apparently he does it a lot. Kate Bosworth does it and last year, Beyonce Knowles talked openly about doing it too. Some of these guys are probably even doing it right now. Then this week we discovered that at the top of her 2010 to-do list, Gwyneth Paltrow has committed herself to doing it as well.

Like a lot of people, these celebrities have spent much time thinking about it before they actually took the plunge and started to do it in practise. That’s because meditation is one of those things that is a lot easier said than done.

Last year Beyonce talked about her virtual addiction to analyzing things. “I analyze. It’s really easy to fall into your own world, really, really easy. Every day, it’s something that you have to be aware of.” It’s probably the same for most of us. The world of thought has a way of blossoming a life of its own and, though much good can come of it – ask any of the artists above – it can also become self defeating too. This is exactly what Gwyneth Paltrow seems to have discovered with her latest commitment to self improvement, “My brain drives me mental. I am going to start. Tomorrow." She wrote in her blog. She has been reportedly going through some marital difficulty lately and it is often during times of adversity that people start to experiment with meditation techniques as a route inner renewal and self discovery.

"My friends who do it say it’s really freakin' brilliant. It’s always sounded like something I should do, but I don’t know how to." Paltrow says.

Meditation is like finding a new channel - a new frequency to exist on - if even for a few minutes a day. The greatest mistake people make is in trying to push themselves to stop thinking and analyzing in order to meditate, but the truth is that we are no more able to do that than we are able to stop breathing. Even the Dalai Lama’s unlikely to avoid a thought or two when he’s been meditating for a few minutes. One of the more effective meditation techniques is to look at your thoughts like waves on a shore. As they lap in and out, so will our thoughts. Sometimes we’ll be thinking, but as soon as we become conscious of it, we can return to awareness – a global non-thinking awareness – again, and then it will go, and then again it will return, because that’s how it’s meant to be.

We may spend much of our time, watching the likes of Gwyneth Paltrow, Keanu Reeves and Beyonce Knowles and that’s fine, but now and then we can truly benefit from just watching the most important person of all – ourselves.