Question: How does a meditator deal with episodes of major depression?
Narayan Helen Liebenson: Major depression is one of the more difficult situations one can encounter. My experience is that meditation can be beneficial, if practiced under the supervision of a skilled therapist or teacher.
I recommend The Mindful Way through Depression by Mark Williams, John Teasdale, Zindal Segal, and Jon Kabat-Zinn. Based on outcome research, this book is easy to read and useful, with sound guidance for how the tool of mindfulness can help one work with the thoughts and feelings that can fuel depression. Its limitation is that one has to be self-motivated, which is usually a problem when one is depressed. However, if the ideas, concepts, and practices can be worked with at times when one is not depressed, then perhaps they can be practiced during a depressive episode as well.
It may also be helpful to work with a teacher who knows this terrain personally, someone who has worked with it in their own experience. There is a Burmese teacher named U Tejaniya who talks about his own history of depression quite candidly and who used the practice of mindfulness to alleviate his suffering. He knows what a terrible mental and physical state depression can be, and he also knows that freedom from depression is possible.
I feel it is crucial to be open to anti-depression medication. Although times have changed and meditators these days do seem more open to taking medication when needed, it can still be a sticking point for some who think they should be able to free themselves without medication or think of themselves as “less than” for having to medicate, believing they should be able to rely solely on Buddhist practice.
This is not a wise and openhearted attitude. Antidepressants can be an enormously useful sacred medicine meant to balance that which is unbalanced. Taking them can be compassionate action, enabling someone who is incapacitated from this kind of suffering to meditate in a fruitful way. It is true that the issue of medication is complex and controversial, and that while antidepressants seemed some years ago to be a miracle of sorts, this is not always so. But for many, they are clearly helpful.
Tenzin Wangyal Rinpoche: The powerful support of a practitioner of the buddhadharma is refuge in the three jewels: the Buddha, the dharma, and the sangha. It is important to have a connection to these three.
One can experience refuge in the Buddha as a changeless, single-faced, reliable connection that is always available and is an inexhaustible treasure. The truth is always to be found here. With the second support, the dharma, we have faith and trust in the teachings and the knowledge we have received. Finally, there is much support in our connection to the sangha, the warmth of those who dedicate their practice to the benefit of others.
We have the notion of refuge because as sentient beings we suffer and need help. Depression is a time when one can experience a strong sense of being cut off, disconnected, and miserable. If you are a practitioner going through such difficulty, it is important to know this is not a personal failure. Don’t get caught in the trap of feeling guilty or of thinking you have no value. That only adds suffering to the suffering that is part of the human condition.
At these times, it is important to trust in the power of the three jewels, the foundation of refuge. The familiar analogy is that when the weather is cloudy and stormy, you trust that the sun is still there, shining in a clear open sky. Even if this is not your experience in the moment, you still know the general direction of the sky, and even if you cannot see the sun, you know it is there. Similarly, you can trust that your suffering is impermanent.
In the West, some people come to the study and practice of Buddhism through a sense of dissatisfaction with their own beliefs and culture. Buddhism can seem attractive because it is intellectually rich. Some people engage with the teachings with more of an intellectual understanding than experiential depth. Very often what is missing is this experiential trust in the refuge and the inner experiences that result from this. When depression comes, it is not easy to rely on a refuge that is an intellectual construct and not deeply rooted in experience.
In everyday life, even when we are feeling well, aside from things that need to be done, like paying taxes and bills, taking care of children, and eating food, there are a lot of things that do not have to be done. Sometimes we commit to doing things based on temporary excitement without knowing what it means for the long term, and we exhaust ourselves through engagement in unfulfilling tasks. Even within the supposed refuge of your own home, you can feel your house is calling you to do something—there are dishes to wash, clothes to fold, floors to vacuum. And there are endless connections to be maintained through returning phone calls and email, not to mention our habits of endless searching in cyberspace. Sometimes there are things we need to do, but many times our doing masks an underlying restlessness. From the point of view of meditation practice, we have lost the abiding, or resting, quality. We have lost our connection to the inner refuge.
What is this inner refuge that is our protection in times of difficulty? Look inward and become aware of the stillness of the body, the silence of the inner speech, and the spaciousness of the mind. As we draw our attention to these three places, we discover the ground of being, or unbounded spaciousness, and the awareness that connects us to this ground, along with the warmth that genuinely arises from this connection. So I prescribe three “pills” to my students—stillness of the body, silence of inner speech, and spaciousness of mind—as a means to connect with the inner refuge and as a support for those suffering with depression. Take these three pills as often as you are able, day and night; they have no negative side effects. Take them the moment you feel overwhelmed or ungrounded. We need something we can immediately turn toward when we are unsettled.
Sometimes depression is so pervasive that we are not able to get out of bed. At times like this, open a window to experience fresh air and look out and gaze at the sky and the light. Try to connect with inner refuge through this exposure to the outer sky and light. That might open the door of spaciousness for you. Rest, with your eyes open, for five or ten minutes at a time, simply watching the sky and light and not doing anything else, such as looking at the overwhelming things in your house that need to be taken care of. Instead of looking at your kitchen, which is a mess, rest your eyes on the sky and the light as a support for connecting with inner spaciousness. Remember that your true nature is open and clear like the sky and is only temporarily obscured by the clouds of anxiety and depression.
As a practitioner, it is most important to develop trust in yourself and your ability to experience the inner refuge. The three pills are an experiential means of coming to know and trust yourself, and to connect again and again with your true nature, your buddhanature. Through becoming increasingly familiar with the inner refuge, we interrupt our patterns of anxiety and can recognize a true sense of inner home. We encounter the Buddha within. While this dharma advice is not meant as a substitute for proper medical or therapeutic attention, the awareness of one’s nature is ultimately the light that will clear the darkness of depression.
Zenkei Blanche Hartman: Since my personal practice these days has gravitated so strongly toward the cultivation of metta, or loving-kindness, my first response is to recommend that you regularly give yourself as much metta as you can muster, especially when you are feeling depressed. But I know that major depression is a serious illness and I am not trained to treat it, so I turned to two of my good friends who are trained and licensed psychotherapists as well as lay Zen teachers for a more informed response to your question.
One suggested that it’s good to practice with others at least three times a week. You don’t want to become isolated. She also explained that much of depression is brain chemistry, and that if you get your heart rate up for twenty minutes a day by brisk walking, biking, swimming, or running, you will increase your serotonin and dopamine levels as well as produce endorphins. All of these, she says, will help undermine your depression.
She pointed out that it’s helpful to be mindful of what you are running in your head. If you are getting caught in negative loops, it’s good to pause when you notice it, then congratulate yourself for having noticed and find something (anything) that you can appreciate in your surroundings, even if it’s just a pleasing color. It’s helpful to continue this practice of appreciation whenever you think of it.
My other Zen psychotherapist friend explained that sometimes meditators blame themselves for feeling depressed, as if they were in control or the cause of their depression (“I’m in pain and it’s my fault”). She points out that many of us have learned that feeling bad means we are bad, and so we may try to get rid of or fix or talk ourselves out of an experience that may be numbing for some and excruciating for others.
She notes that an experienced teacher will invite a student to accept what is happening as what is happening and not put a story on top of present experience. The teacher can offer this as a supportive step toward accepting a discouraging internal experience as it is—discouraging—while acknowledging that this is difficult for most of us because our common human tendency is to run away from pain.
She cautions that when we are engaged in honest meditation, we may discern that meditation is not at all helpful with the pain we are feeling right here, right now, and thatsometimes we need to turn away from our suffering as the most compassionate response. Honest discernment, she explains, helps us tap into whether to keep sitting on a knee that is getting swollen or relate to a throbbing toothache or sciatica. She suggests that we may need to take a break from meditation for a while and that the teacher can offer deep listening company as to the best course of action in this moment, and then the next.