In the beginning of the year I put out the blog post Mindfulness and Psychotherapy Suggestion Box: What Would You Like More of in 2010. One of the suggestions came from Jennifer. She said:
I continue to struggle (15 years) with med-resistant bi-polar disorder where I typically experience severe depression with few manic episodes. There’s such a sense of hopelessness, so I would like to see topics addressing ways to cope when so little works. I would like to see real in-depth articles/discussions on how to continue to go on when the many various approaches fail.
Thank you for what you do here.
There is an enormous world of frustration and despair that builds when we fight against something for so long and very little seems to be shifting this.
There are a number of people in my life that I would look to for answers in how to find hope (the greatest anti-depressant) in the midst of relentless times, including Therese Borchard, Tara Brach, Jack Kornfield, and others.
In her new book, Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes,
As she does in her blog, Therese courageously expresses her ongoing struggles with depression, anxiety, and bipolar disorder and lays out a number of things that have helped her. Tara Brach explores the importance of Radical Self-acceptance as a path toward relating differently to suffering. Jack Kornfield is very clear that there may be no advice or “fix-its” when someone is deeply suffering, but merely being in the presence of another loving person in that moment may be what’s actually best.
A major depressive episode can very well be considered a Trauma (capital “T” because it is a big event) in my mind. What we know about trauma is that when we experience it, the mind becomes hyperattuned to looking for any possible sign of danger that it’s coming again. The problem with this is that when the mind is looking for something so diligently, it is likely going to find it. In other words, any nuance that the depressive episode is happening again triggers the mind into habitual patterns of trying to “fix” the issue.
One example of this is automatic negative thoughts (ANTS). The mind will go into a state of judging the or criticizing whatever seems to be a danger, such as saying, “don’t reach out, it’s much better to just be alone” or “who cares, what’s the point.” The purpose of these ANTS is to keep you away from some potential danger. The problem is, when we’re depressed, the ANTS are utterly convincing and believable and it’s difficult to bring mindfulness to them.
In an earlier interview with Therese Borchard I talked about the importance of distraction at times to interrupt a depressive cycle when you’re in it. Another critical factor is community and support. Therese Borchard’s Community is a great online community to look into. You may also want to join a local support group or have a list of family and friends to call or be with.
When you’re out of it, you may want to look at an earlier blog post I wrote that gives 5 steps to prevent relapse. You can begin creating a “Top 10 Hit List” of your most recurring ANTS and at that time it becomes easier to understand that these thoughts aren’t facts and you can catch them before they bring you to your knees. When you’re not in it, you also may have more courage and ability to bring your attention to your emotional experience and dip your toes in uncomfortable emotions, without judgment. This allows for kindness, compassion, and acceptance to develop which are all resilience factors for the potential relapse.
Relapse may be a part of your life, but there are ways to reduce its severity and likeliness. Mindfulness-Based Cognitive Therapy (MBCT) has been shown to have effectiveness in reducing relapse, but this is for people who are not currently in a depressive episode (because it’s about reducing relapse, not about coming out of a depressive episode).
At the end of the day, while dealing with bipolar disorder or depression can be a deep struggle, it may be worthwhile to inquire what the gifts are from it. Therese Borchard recently wrote a blog post which mentions the Top 10 Good Things about Depression.
May you be free from fear, feel safe and protected, and feel understood and loved.
As always, please share your thoughts, stories, and questions below. What helps you in working with a sense of hopelessness or even experiencing a depressive episode coming on? How do you find hope? Your interactions below create a living wisdom that we all benefit from.