Posted by: cg00n | March 26, 2011

Mindfulness vs. Depression & Anxiety: 4/4

I’ll just start with a few words about my general state of being before getting to the meat of this posting.  A couple of months ago my psychiatrist suggested that I should try moving outside my comfort zone a bit more.  I have tried two major exercises since then.

The first was to visit K (whose blog you may recall) a fellow depressive whose mother died of melanoma just after Christmas.  Since she lives relatively close and we have some “issues” in common I’ve been wanting to meet her in person for some time.  I really was not sure what sort of reception to expect but it all turned out very well, a pleasant two-hour meeting over beer and snacks.  Perhaps I’ve made a new friend!

The second was to take a trip to Boston with P which we succeeded in doing last week.  I don’t travel well. All the security arrangements make me feel as though there is a real and imminent threat to my safety, being in an unknown city with unknown risks pushes my panic button and my irritable gut requires a great deal of TLC to cope with all the restaurant food.  However, other than a few twinges during the first few days I had a great time.  It was a most memorable trip.

All right, time to get this over with. I have an alarming backlog of news roundup items that I’d like to share with you in the near future so here is a description of the last two weeks of the 8-week course I took late last year.

Access other parts of the course coverage:

Week 7 – How to take care of yourself.

Ask yourself three questions:

  1. what are my “up” activities?
  2. what are my “down” activities?
  3. am I choosing (as far as possible) to spend more time “up“?

When you become aware of a negative thought or feeling, take a 3-minute breathing space break to help you cope.  Then, take action:

  1. do something pleasurable
  2. perform an activity that gives a sense of accomplishment or control; be sure to give yourself a pat on the back when you’ve made some progress.
  3. act mindfully all the time

Try not to prejudge how you will feel when you have completed the activity.  Experiment with new ones: don’t just stick to old favourites.  Don’t expect miracles.

Values and Goals

  • Values are deeply held beliefs that give purpose or meaning to our lives
  • Goals are what we want to achieve in pursuit of our values
  • Activities are what we do to reach a goal

Up activities are ones that are in accordance with one of our values and generally produce a lasting sense of pleasure.  Down activities are contrary to a value and generally leave a bad taste.  Viktor Frankl suggested that suffering stops when meaning is found.  He said a lot of very wise things.

A few value domains to consider:

  • family relationships
  • friends and social life
  • work and career
  • health and well-being

So, for example, if I value friendship one of my goals might be to help a friend to be happy.  An activity in pursuit of this goal might be to suggest we get together for a beer.

A short parable:

An old native Indian was talking to his young grandson one day about why there are good people and bad people.  He explained:

“Every person is born with two wolves inside them:  the good wolf and the bad wolf.  These two wolves fight all the time.  Sometimes one will be on top and sometimes the other.  Eventually one will become the dominant wolf and that will determine whether a person is good or bad.”

“Which wolf will win inside me, grandfather?”, the young boy asked.

“Whichever wolf you feed”, his grandfather replied.

Relapse Prevention First Aid:

Prepare two lists:

  • Activities you could perform to promote your values.
  • Those thoughts and feelings that usually precede an episode of depression for you.  Here are some common possibilities:
    • no interest in doing things
    • no enjoyment of life
    • lots of alcohol or drug use
    • worried about the future
    • feeling bad for no reason
    • feeling depressed or worthless
    • too aggressive or pushy
    • angry about little things
    • feeling anxious much of the time
    • no interest in own appearance
    • trouble sleeping
    • tense and nervous
    • eat very little
    • short of breath
    • frequent aches or pains
    • losing or gaining a lot of weight
    • distant from family and friends
    • seldom seeing friends
    • trouble getting along with family or friends
    • feeling that people are making fun of me
    • afraid of making a mistake in front of others
    • getting into a lot of arguments
    • others don’t care about me
    • trouble concentrating
    • thoughts going by too fast
    • trouble making minor decisions
    • bothered by recurring thoughts
    • trouble remembering things
    • thoughts of hurting or killing myself or others
    • fears of going crazy
    • my surroundings are strange or unreal
    • preoccupied with sexual thoughts

Then take these three steps:

  1. identify warning sign; be aware of it, notice it.
  2. do short tonglen:  breathe in suffering & breathe out loving kindness; expand from self to everyone who suffers.
  3. perform an activity in pursuit of a value.

Homework:

Week 8 – Review and Conclusions.

During the eight weekly sessions we did quite a bit of meditation practice in class and a whole lot more at home using several different forms:

We learned that a lot of what happens to us when we get depressed or anxious is the result of automatically occurring trains of thought.  If we can interrupt these trains of thought we can respond rather than reacting but we have to notice the train starting to roll before we can do anything about it.  That’s where mindfulness and awareness come in.  We need to pay attention to our thoughts, emotions and bodily sensations to give us more hints about what is happening right now.  If we are off in the future thinking about what might happen or bogged down in some past event we may miss the train.  Meditation is a way to practice mindfulness and improve awareness of what is happening in the present moment.  It is an extremely powerful tool but not easy to use effectively without a lot of practice.

Having said that, once we are fully aware of what is happening sometimes the only thing we can do in a bad situation is to accept it as it is.  This is, at least, an improvement on worrying about it or spinning our wheels and much better than trying to deny its existence or trying to put it out of our mind by sheer force of will.  Observing the situation mindfully allows us to be more objective and less emotionally involved in it.  The allowing and letting be and tonglen (loving kindness) forms of meditation can be particularly helpful in these cases.

Being prepared to cope with depression or anxiety, noticing when one or the other is closing in, observing the process mindfully and responding appropriately can go a long way to preventing a relapse.

Here is one way to try integrating mindfulness into a typical day:

  • Before getting up watch 5 breaths mindfully.
  • Get up and prepare for the day mindfully.
  • Eat mindfully.
  • Use short interludes to practice breathing.
  • Pay attention to posture and physical sensations.
  • Before going to sleep watch 5 breaths mindfully.

The Guest House

This being human is a guest house.
Every morning a new arrival.

A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.

Welcome and entertain them all!
Even if they are a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.

The dark thought, the shame, the malice.
meet them at the door laughing and invite them in.

Be grateful for whatever comes.
because each has been sent
as a guide from beyond.

— Jelaluddin Rumi,
translation by Coleman Barks

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Responses

  1. Congratulations on getting our of your comfort zone and trying two new things that were meaningful and pleasurable. 🙂 You have dealt with so much in the past few years, and have had so much change, I’m not surprised that you tend to retreat to places of safety, familiarity and comfort. I like the course review and agree so often it is repetitive negative thoughts that drag me down. I have much less of that with my son in my life as I’m usually too busy to dwell on anything other than what I’m doing in the moment. That also means I need more lists or I forget things and have fewer of the ah-ha moments that come with time to ruminate on a problem in a good way. The ying and yang of life.


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