Chapter 11 - Mindfulness

What is Depression?

DEPRESSION IS an illness that is becoming more prevalent with the pressure of life building up in our modern society. It is one of the most upsetting experiences a person can go through and is often much harder to endure than physical illness. Usually, depression is the result of some emotional experiences that go unchecked. If they were to be examined and recognised early, they would not lead to depression. Depression often helps to bring out more anxiety, resentment, frustration and agitation, which could result in a personality change. There could be a lack of interest in life and a feeling of worthlessness. Blaming others and creating illusions to make oneself feel better, adopting a "why me" attitude, irritability, being over anxious and worried about the future, being over suspicious, feeling guilty about the past, fear of rejection and lack of confidence, difficulty in seeing anothers viewpoint, inability to make decisions, easily losing concentration, losing a sense of priority and proportion, being easily confused, forgetful and panic are some of the psychological manifestations of depression.

Headaches, chronic neck, shoulder and back pain, migraine, sexual difficulty, rapid heart beat, breathlessness, picking at food, loss of appetite, being unable to sit still or talking constantly are some of the physical appearances of the depression. Medical experts say that it is difficult to differentiate between stress and depression, because in both of these conditions the emotion plays a big part.

People become stressed when they cannot cope with increasing demands of work or, for example, when frustrated or when there is too much pressure in life. Unbalanced postures of the day also could put strains on the body and create stress. Stress is related to a growing number of problems — high blood pressure, stomach ulcers, migraines, eczema, asthma and mental disorders.

Physiologically Interconnected

Stress is a part of life. We have to learn to accept and live with it, else it will become a destructive force. Stress is caused by internal and external factors, which evoke a response. This is known as stress response. The internal and external factors causing stress are called the stressors. Mind and body are closely related and affect each other in stress responses. Buddhist scripture is full of such reminders that the states of mind and body condition each other in both good and bad ways. The portion of physical body affected by the mental state is called cittaja rupa or citta samutthana rupa. The Patthana, the last text of the Theravada Abhidhamma scriptures shows many of such close relationships. When someone is faced with anger, anxiety, worry, fear, disappointment and so on, the muscles of his body become very tense and require more blood. The hearts and lungs start to work overtime to supply more blood to the muscles for action. The heart rate, breathing rate and blood pressure all go up. Hyperventilation and over breathing may occur to supply more oxygen.

The blood is diverted from abdominal viscera and skin to action stations of muscles, heart and lungs. The skin, consequently begins to pale. The internal secretions which are to enable good digestion are immediately withdrawn as they are required elsewhere. So, the mouth, throat, the stomach and intestines dry up.

Accumulated

Whenever there is a stress there is stress reaction in terms of anxiety, worry fear, agitation and so on. At such time the body accumulates stress chemicals, tension and strain. With accumulated stress chemicals, tension and strain, the recovery from stress takes longer than it should. Dislike attracts dislike. Anxiety brings anxiety. Worry conditions worry. It is easier for a new stress to come up but more difficult to go away. This is how the circle of suffering goes on here and now. Psychological stress reactions begin to accumulate as well. In the long term, such accumulated stress reactions are called latent defilement (anusaya) in Buddhist psychological analysis.

It all starts from lack of awareness, non acceptance of the stress reactions. A mature stress that lasts longer leaving its effect even after the causes of stress disappeared is known as depression. The recovery is not instant any longer, as the mind and body are stretched to their limit. Mindfulness helps us detect stress reactions immediately and provide an outlet through non judgmental awareness and acknowledgment.

Wild Animals

An example is given to help understand repeated stress reactions. Imagine yourself in an open field where a wild animal suddenly appears and you have to escape. You will run quicker than you thought you could. This is a stress response. Say you have escaped. Before you recover, another wild animal appears in front of you that you have to make another escape from. You will still flee as quickly as before but this time the recovery will take longer. If you have to flee in this way continuously three or four times, your getting back to normal is expected to be longer.

Anxiety, worry fear and so on are like a wild animal that appears almost from nowhere.

The practice of mindfulness meditation is to help you see if such wild animals are there in our mind. The practice could not only help someone in stress reactions or even depression with regard to his medication needs, but also could bring insight into stress reactions and depression itself. From the point of view of the meditation experience, depression is the result of being unable to accept and see things as they are.

Breathing Exercise

One should start with a short breathing exercise, perhaps about ten minutes. Use the technique of breathing deeply and slowly. One can also count the breaths while inhaling and exhaling slowly and deeply This exercise can increase the supply of oxygen needed for the liver. Do not start with a long session, as it could then produce pressure in itself.

Breathing is a very important factor for us to get right if we expect ourselves to deal well with the daily pressure of living. Normal breathing could keep us fresh and remove stress. It also builds up energy which we can draw and make use of it at work.

A babys breathing is very interesting. The baby breathes with chest and navel movements in rhythmical rise and fall, whereas an adult breathes upward starting from the navel. The babys way of breathing supplies sufficient oxygen to the tissues. As breathing becomes abnormal, the oxygen supplied is reduced. This creates some problems for energy flow.

General Mindfulness

General mindfulness of the situation helps one put it into proper perspective. Be mindful that you are in a depressed state either hormonal or exogenous. When one is hungry or does not have enough sleep, one could be easily irritated due to hormonal and biological changes within the body. One could feel very low by just suffering from a headache. It is always helpful to have a general awareness of such situations.

Recognising Emotions

As you go on contemplating breathing, fears, worries and other negative thoughts, they may come to dominate your mind. As you become aware of them, name them individually as fear or worry as appropriate three or four times, and leave it there. Accept any emotional reactions including feeling helpless and worthless. Return to breathing again. This is the first step of giving recognition to factors of depression.

People often dismiss these factors of depression by advising sufferers to forget about them. This will only lead to ignorance of depression and consequently worsen the situation. We have to change the attitude of ignoring depression. We must learn to recognise any emotion that arises. Do not dwell on it by going on thinking and speculating about it, but pay necessary attention as we said earlier, and keep returning to the breathing, which is the primary object. The emotions can be easily controlled once they are recognised (sati) and understood (sampajanna).

Gradual Practice

Practise this simple method of Vipassana twice a day or at least once daily. While under depression, try to reduce your work load substantially. After about a week, make an effort to increase the length of the session to about 15 minutes. It is important not to overdo it, and to increase the duration of the session when the right time has come for you to do so. This should be done in consultation with a meditation instructor. Actually talking to the meditation teacher itself could bring a great relief.

Diet and Exercise

A balanced and moderate diet is highly recommended by the Buddha and Venerable Sariputta, His chief disciple. With a balanced food, a good diet and regular physical exercise, Vipassana meditation could help one out of depression, be it endogenous — that is a result of hormonal and biological changes within the body or exogenous — that is influenced mainly by outside factors. Breathing meditation not only helps develop mindfulness but, it is said, also improves liver functions and blood filtering. Fresh air and a simple and quiet place are conducive to the practice of meditation.

The Right Attitude

Ones right attitude towards depression is very crucial when taking the first step. Regard depression as the meditation object. Do not be so judgmental about it. Do not think of it too much. It is already there. Observe it as it comes up at the present moment. Stop complaining and start recognising it as a reality. If we identify depression at its early stage, we stand a better chance of coming out of it. At the outset of the practice, it may seem more disturbing as one becomes aware of stress responses. However, from meditation and also Buddhist psychological analysis, this is a healthy practice because one does not store stress reactions but let them go. One should not imagine a problem free life, having a problem is the very real sign of being alive. The Buddha said that understanding problems means understanding life itself. New stress responses may keep appearing as there are causes for them to do so, but this will give one a chance to deal with them there and then. Suppressing them through some sort of distraction requires more strength and energy. And it is not a healthy exercise.