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LCSW
Clinical Social Worker/Therapist

You've seen the advertisements. They say: "I've been on my medication for a long time and I still suffer from depression. So maybe I should add a second medication."

On the other hand, people say that one definition of craziness is when you are doing something that doesn't work, and you go on doing it. (One medication isn’t working so I’ll take another. That sounds like, "it's bad enough being depressed, they think I'm crazy also?")

I understand where these drug companies are coming from. They say that "depression is a real disease" so it necessitates a real medication. I agree that medication can be an important, and sometime critical, component of the fight against depression. But who says that medication is the only cure for a disease?

You know what depression is: That heavy darkness in which your mind gets stuck on dark thoughts. There is no strength or pleasure. Life seems to continue against your will.

We often find that even after medication helps, there is still no real joy in life. The pain might be gone, but there is still a lingering "stuckness." It seems like sooner or later there will be that inevitable hurdle in life, a wrench in the works, that can push you down again into that black abyss.

So you'll go running for the shelter of some sad little helper (to paraphrase the Stones).

But is there another way? Do you have to rely only on another chemical? What about dealing with the depression itself? Dealing with the thoughts that bring us down? Is there an effective way to move away from depressing thoughts?

CBT and Medication - Can They Bring You Back to Joy?

Many therapists will tell you about Cognitive Behavioral Therapy (CBT), which has been shown in research, when used with antidepressants, to be one of the most effective forms of therapy.

That means that it works about 60% of the time.

That's great if you are not part of the other 40% and you don't mind the side effects of the medication.

Also, CBT does not get you to a place of joy and happiness. While you might not be depressed, most of us still want to feel good and have a real sense of well-being. We would like to be one of those people who are happy to get out of bed in the morning.

While CBT is really on to something when it teaches us to attack depressive thoughts, there is an alternative that will work for many of the people who don’t succeed with CBT. CBT teaches us to confront, attack and change our patterns of thinking. But do we really want to attack, conquer and change our depressive thought patterns. That is a lot of work, and who wants to fight when you're depressed? That is where mindfulness comes in. Mindfulness is a technique that allows us to have thoughts and keep them from bothering us.

Feeling Better with Mindfulness

The main idea in mindful meditations is to look at your thoughts as fleeting curiosities. This is added to a perspective that we need to live in the present. Not to ruminate about the past or worry about the future. Now that already sounds good to people who suffer from depression. It is sort of like when I was a kid, and there was a big kid who would threaten me. My mother would tell me to ignore him. She said if you don't react he'll leave you alone. I said, "But he's going to beat me up!" She told me that he is looking for a reaction and I need to let him find it somewhere else. I said, "but he's picked on me in the past!" She said, "That's in the past. Let it go!"

That's the attitude you need for mindful meditation. You learn to ignore the threatening thoughts. Especially with negative, beating-you-up type thoughts, but also for any thought. In mindful meditation you learn how to observe your thoughts without letting them conquer you or control you or your emotions. You learn to detach yourself from your thinking in such a way that you can consciously decide whether or not the thought is worthwhile engaging or not.

So if you are living in the present, and monitoring your thoughts, what might happen? Let's say you’re eating dinner. Taking your time. Since everybody’s mind is constantly wandering, you might come up with a thought such as, "this is like the time we went out and I messed up." You didn't ask to think this thought. You don't even like it. Usually you begin to push it out. Or embellish it. Or think about how bad it is to think that way. But with a mindful perspective you are able to say to yourself, "Interesting that I have that thought. I wonder what thought will come up next." As you watch your thoughts flow by, sooner or later there might be one you like. You can then decide whether or not to hold on for a few moments or let that one go by also.

Mindfulness - The Two Basic Methods

There are two basic methods to achieve this goal:

One is a quiet training and the other is an active meditation. How are they done?

1. Quiet Mindfulness Training

To train your brain to refrain from unhealthy engagement in its own thoughts you need to practice on a daily basis. Here are the basic steps:

  1. Get comfortable. You do not need to be sitting cross-legged on a mat. Any comfortable position is fine. You can even lay in bed, but not if you are going to fall asleep.
  2. Make sure that you won’t be disturbed. Shut off your phone. Close the door. You do not really need quiet, since you want to learn to use extraneous noises for your meditation also.
  3. Most people find it necessary to close their eyes. This helps you tune into you internal processes. Some people can do this with their eyes open. In the long run it is helpful to gain the skills to be mindful when you are engaged in other activities.
  4. Use your mind to focus on your internal processes. “Watch” yourself breathe. Notice the flow of air going gently through your nostrils and into your lungs. Observe the other sensations of your body like the pressure of the chair, the sounds in the air, etc. Breathe normally, and continue to breathe normally.
  5. As your mind begins to wander gently bring your attention back to your breath. This is the most important step. This is the actual skill you need to practice. You can note that your thinking has wandered, but don’t engage in the thought. Just say to yourself something like, “Oh, my mind wandered off. OK. Let’s go focus back on the breath.”
  6. Continue for at least ten minutes. Some recommend at least 20 minutes. I think everybody is different. Find you own optimal time.
  7. Repeat every day.

 2. Active Mindfulness Training

The second method of mindfulness is based on connecting actions with specific thoughts. You take some normal activity and infuse it with a mindful purpose and direction. It should be a normal daily activity and a positive thought that is generalizable to your whole life. 

I want to share with you one of my favorites.

We all wash our hands multiple times a day. We do it without thinking or at least while thinking about something else. We think about the food we are about to eat, or the meeting we are getting late for. Washing hands is a healthful activity which we waste as either protective or preparatory. Why not make it healthful for the emotions and spirit?

This is the suggestion: Take time to notice how the water flows over your hands. Think of this as a metaphor for life. Life flows by, and all things pass. Good and bad. Life just flows on by, and we can catch the opportunity to savor the good parts and allow the bad parts to flow by.

Since you have opportunities to practice this a few times a day, you will begin to train yourself to adapt this perspective.

Give it two weeks of consistent practice, I assure you, you will feel better.

About the author Ari Hahn:
I am a professional helper since 1976 and an LCSW since 1991. I have specialized in survivors of trauma. Presently I also have an on-line therapy and coaching practice where I also specialize in helping families and loved ones of ex-abused people. I also am a full professor at TCI College in NYC.
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Page last updated Jul 07, 2015

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