Men Overcoming Depression

Even if the events of my life were to conform to the rosy-hued, Hollywood-style success story formula, and I could describe how, after a virtuous and noble struggle, I overcame my chronic depressioneven if this were true, which it's not, I wouldn't waste your time by relating My Seven Secrets to Beating Depression. The truth of my relationship with depression is messier and more difficult to characterize, and besides, such soapbox sermons already abound in the self-help aisles of your local bookseller.

Truth be told, in working with my own depression I have read some of these books, as well as others by mental health professionals, providing a multitude of explanations of and treatments for this disease. I have also participated in numerous types of psychotherapy and taken antidepressants and various other pharmaceuticals. I joined a closed men's group, was a drop-in support group regular, and later facilitated groups at the Men's Resource Center for Change, which I still do; any of the men who have known me in those settings could tell you (if they weren't bound by our confidentiality rule) that depression figured prominently in my thoughts and struggles. All these "treatment modalities" have been useful at various times, but I've always looked for something more.

On one hand, when I plummeted into a brutal depression nine years ago I found connection and companionship at the MRC support groups which helped to bridge the isolation that was smothering me; these groups were my lifeline. Still, what about the 166 hours a week when I wasn't in a group? This is where the hopelessness and helplessness cut deeply. I thought then that if I only read, talked, emoted more, my depression would lift. I was wrong--and thus I became increasingly mired in dejection and despair even as I did the things you are supposed to do to treat depression. So while therapy, reading, and groups all have their place, my depression does not yield to once-a-week therapy sessions or the clever analysis contained in any of the many self-help books on my shelves.

I need a practice, a program I can work on daily, not another book explaining yet again the origins of my depression. Earlier in my life I lived and practiced meditation in a Zen Buddhist center. I had hoped then that meditation would free me from depression, but I found instead that working with koans, the meat of Zen practice, led me only to greater self-torment and self-judgment. The hours spent on the meditation cushion provided ample opportunity for berating myself for failing to loosen depression's hold, and my internal critic had a field day.

More recently, I decided to give meditation another try in a different venue: the Cambridge (Mass.) Insight Meditation Center. Instead of koans, dogma, and scriptures, there is in many Vipassana (Pali: "insight") Buddhist centers like CIMC an emphasis on finding out for yourself what works--on looking carefully, attending to whatever practice you adopt to see if it brings greater freedom. In the end, this is all that matters in Buddhism: freedom.

As I began to investigate Vipassana's primary teaching--the value of seeing/hearing/feeling experiences minute by minute with clarity--I attended a lecture at CIMC in which a book entitled Mindfulness-Based Cognitive Therapy (MBCT) for Depression was mentioned. Given my disinclination to read more depression books, I was wary, to say the least. But this book helped me to distinguish between reading for intellectual understanding and reading as a tool for gaining direction and traction on a path. In the latter case, reading is only a first step pointing the way. With the direction and some concrete steps in mind, the real work begins: the daily practice and commitment to the course outlined in the book. Although this sounds basic, it was relatively unexplored territory for me; I have spent my life reading books like a beleaguered high school English composition student, always ready to tell you the facts but never being changed by them.

Following their personal, in-depth immersion in Jon-Kabat Zinn's techniques for living and coping with debilitating chronic physical pain, the authors of MBCT adapted his approach to the mental and emotional pain wrought by depression. The MBCT program extracts the essential practice or skill from its origin in Buddhism, making it accessible to a much wider audience. And what is this skill? Cultivating mindful awareness of the present moment in order to see things clearly, just as they are.

Many decades of psychological research have shown the strong correlation between long-term depression and the presence of ruminative thinking patterns--the automatic, often obsessive thoughts and schemes for fixing one's problems. Ironically, it is this obsessive desire and struggle to fix and thus avoid the pain of depression that seems to promote it. In part this is because the struggle is often connected with negative thoughts and judgments about oneself: the internal message is that there is something "wrong" with you and you must whip your unruly self back in line in order to extricate yourself from the depression. Aaron Beck's work in cognitive-behavioral therapy in the 1960s suggested that mood was often improved dramatically when patients practiced catching these negative thoughts and replacing them with more realistic ones.

The mindfulness-based approach is a deeper and more general application of the phenomenon explored by Beck. MBCT teaches patients to focus attention on an object such as the breath. Inevitably one's attention wanders, often leading to self-criticism, judgment, or planning but also to more mundane concerns such as the pain in the body as it is asked to remain still. The simple (but remarkably difficult) task is to notice that you have wandered, and gently, nonjudgmentally return the attention to the breath. This practice focuses the mind, so that it has the inner steadiness to refrain from the cognitive wandering that is directly connected with negative thoughts and ideations about oneself.

Make no mistake; these simple instructions are difficult to carry out. The mind usually does not want to keep quiet and focus on one thing. Mine certainly doesn't. In fact, for years the constant noise in my head was a jumble of voices discussing a dozen different ideas. This internal cacophony often takes a self-reflective, self-critical turn in my head, especially when I'm already headed into depression.

MBCT urges you to look at all your experiences with great care and mindfulness. If at a particular time we experience depression, we turn our compassionate attention to depression itself and try to see it clearly. How does depression appear under such scrutiny? To truly see the nature of depression in a fresh way is to change your life. I do not know what your answer will be.

Indeed, I am often still caught by the maelstrom of my depression, hardly able to find any stillness or focus at all. However, when I have been able to disengage from the internal noise--just enough to notice the way thoughts, sensations, feelings, and all else arise and eventually fall away--it becomes difficult to believe that depression should be any different. If, as is commonly described, depression is the perception of "stuckness," a hopelessness that things will ever change for the better, how to reconcile such a perception and belief with the irrefutable evidence of the impermanence of all things?

Tim Gordon is a mechanical engineer and a volunteer facilitator in the men's support groups of the Men's Resource Center for Change. He lives in Cambridge, Mass.