Depression and mindfulness

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We can all feel low, sad or unhappy at times but these feelings usually pass.  With depression, these feelings last for more than a couple of weeks and start affecting your daily life.  You can lose interest in things you previously enjoyed and it can affect you in other ways such as feeling tired, having trouble sleeping, difficulty concentrating, a change in appetite, a sense of worthlessness, agitation or slowing of movements, and in some cases recurrent thoughts of death.

Depression is often trivialised, but it’s a serious medical condition.  It can be mild, where you can feel low and are able to continue with daily life, but if it’s severe, it can be debilitating and make you feel suicidal.  It isn’t always clear-cut and with subthreshold depression you can have fewer symptoms that are still troublesome and distressing.  If you feel depressed at the same time each year, usually during the winter months, then you may have seasonal affective disorder (SAD). Depression can also affect pregnant women either during their pregnancy, or after delivery, which is known as postnatal depression.

Depression is the third most common reason for consulting a GP. Every year 1 in 20 adults will experience it; 1 in 4 women and 1 in 10 men will have an episode severe enough to need treatment at some point in their lives.1 People with chronic health problems are also much more likely to have depression compared with those who are physically healthy.

What treatments are available?

Most people with depression will get better without treatment, but it can take several months and it can have a negative impact on many areas of life.  Self-care including a healthy diet, reducing how much alcohol you drink and regular exercise can all help.  But you don’t have to suffer in silence.  There is effective treatment for depression and you should speak to your GP if you’re struggling.

Talking therapies (psychological treatments) have been shown to work for all types of depression.  These can be accessed through IAPT (Improving Access to Psychological Therapies), and you can either self refer (see link below) or be referred by your GP.  The type of therapy you are offered depends on the severity of your symptoms.

Antidepressants are an option for moderate or severe depression.  They play an important role in easing symptoms, allowing you to function more normally and face difficult circumstances.  However, it’s important to remember they’re not a cure and they’re not given out lightly.

 Mindfulness as a treatment for depression

A report in the international JAMA Psychiatry Journal looked at studies on mindfulness-based cognitive therapy (MCBT) in the treatment of recurrent depression4 and found that it can help prevent recurrence.  Mindfulness has also been shown to have other benefits, including reducing stress, improving sense of happiness and wellbeing, and helping to better manage chronic pain.

 So what is mindfulness?

Mindfulness is a practical technique that focuses your mind on being present in the current moment, not being reminded of the past or worrying about the future.  It allows you to watch your thoughts and feelings, with a sense of curiosity and openness, and without judgement.  You are able to let these thoughts pass without engaging with them.  It acts like a gentle alarm bell as you start to recognise patterns of thinking and unhelpful behaviours before they spiral into stress and depression.  You can then choose to react or respond in a different way and become more skilful at handling the challenges of daily life.

 How can you practice mindfulness?

There are different practices that can help to ground you in the present moment, break out of autopilot and have a renewed awareness of yourself and your surroundings.

Where better to start than focusing on your breath with guided meditations.  You don’t have to sit cross-legged on the floor or chant.  You can sit comfortably wherever you choose.  Inevitably your mind will wander in all directions.  When you become aware of this you gently bring your attention back to your breath.  There are also body scan meditations, which move your focus of attention around the body as well as the breath.

Mindful movement involves practicing awareness in the moving body.  It can be done through movement meditations.  Yoga and T’ai Chi are also techniques that lend themselves naturally to the practice of mindfulness.  In fact you can bring mindful awareness to anything you are doing.

Remember mindfulness is not a goal, but a continual process.  It is a way of being, helping you to live your life fully, moment to moment, giving you back that sense of joie de vivre.

There is currently limited access to MBCT on the NHS, but there are a range of other resources you can use, including books, audios, online information and apps.  Here are a few to get you started:

Mindfulness resources

NHS choices
http://www.nhs.uk/conditions/stress-anxiety-depression/pages/mindfulness.aspx

Oxford mindfulness centre
http://oxfordmindfulness.org/consumer-homepage/

Mental health foundation
http://bemindful.co.uk

Book – Mindfulness: A practical guide to finding peace in a frantic world by Dr Mark Williams Dr Danny Penman

Depression resources

Accessing IAPT
https://www.england.nhs.uk/mental-health/adults/iapt/

NHS choices
http://www.nhs.uk/conditions/depression/Pages/Introduction.aspx

MIND charity
http://www.mind.org.uk/information-support/types-of-mental-health-problems/depression 

References

This article is for information only and should not be used for the diagnosis or treatment of medical conditions. myHealthSpecialist makes no representations as to the accuracy or completeness of any of the information in this article, or found by following any link from this article. Please consult a doctor or other healthcare professional for medical advice.

Dr Farzana Vanat
Dr Farzana Vanat, GP