This article originally appeared on VICE UK.
Yesterday, a study published by The Lancet medical journal made waves in the media. It reported that mindfulness-based cognitive therapy (MBCT) might be as effective as antidepressants in stopping the reoccurrence of major depression in sufferers. The study revealed that, between two groups—one on medication, one treated with MBCT—the rate of relapse was similar: 47 percent and 44 percent, respectively.
This is quite the occurrence. With antidepressants making $11.3 billion per year in the US alone, the ability to treat sufferers with something just as effective—and something that's theoretically free once they learn to master it—would be hugely beneficial to everyone but the pharmaceutical giants.
As someone with experience of using both methods to treat his depression, I thought I could add my voice to this. But first let's make clear what mindfulness actually is: Mindfulness is the method of being aware of one's thoughts, learning to disengage from them—if negative—by placing oneself in the present moment. It's common practice in Eastern philosophies like Buddhism, where adherents focus on tasks such as cleaning, eating, and—during meditation—breathing. They claim this allows them to negotiate life on a more even keel.
Today, this has been enhanced by cognitive behavioral therapy—developed into MBCT—which encourages patients to challenge their negative thoughts by doing things against their grain. More exercise, socializing, and healthier eating would be common suggestions for the average depressive.
One problem with this kind of mindfulness is that the depressive's brain is rarely logical. Though it's tempting to think this process will result in writing poetry and climbing mountains, often these high-minded activities don't work. Often it's simply a matter of getting into bed to feel better.
So, with this in mind, how can we say MBCT's an effective stopper for depression reoccurrence when all of us have busy lives; when—outside the confines of a study—most of us can't pop home from work to see this method to fruition?
In my personal experience, mindfulness teaches us to shirk our problems. The difference between depressive thoughts and ones symptomatic of a crap life blur beyond recognition, something that's just as harmful as depression.
I first went on medication at 21, a year after my mom's unexpected death. Despite being depressed my whole life, I'd refused to take anything up to that point, the stigma of it holding me back. After her death, however, I needed something to help me cope, so I began practicing mindfulness and meditation.
Initially they both worked, but after a year that culminated in a full-scale nervous breakdown, I felt not only that I needed medication but also that the mindfulness had bottled me up, giving me permission not to think and process things. The present-moment awareness—supposed to deliver me peace—ultimately did the opposite.
For more on medication, watch our doc 'The Ambien Effect':
Don't get me wrong—antidepressants suck, too. They fuck with our short-term memory and give us brain-zaps. They give us white spots in our eyes and headaches if we forget to take them. They also make us last for ages in bed, which—though I'm sure sounds great initially—gets old quick. But they do work.
They certainly don't cure anything, but they provide breathing room and make life livable, giving us enough perspective to make some changes. Mindfulness, while claiming to do the same, is merely another level of distortion—an unreasonable belief we can control chemical abnormalities with a philosophy. It's a method that neither allows for how little we understand it nor how serious our depression is.
Depression at its best makes long bus journeys nostalgic and music sound better. At its worst, it gives us a tightness of chest and tunnel vision where all we see is failure and black death, where not one light shines up ahead. To experience this is to experience the need for medication. Yet, around antidepressants, people build a stigma; "chemicals" are taboo in relation to mental health, but OK in our food, drink, and cosmetics.
This contradiction has left many of us avoiding them for fear of seeming weak and impure, me being one. In the real world, believing that mindfulness can treat depression as effectively not only enforces this stigma but also suggests an unwillingness to admit our weakness and lack of control. Our egos are constantly searching for new ways to pull ourselves up by the bootstraps, and though this tenacity should be admired, isn't it arrogant to assume we can outmaneuver something fucked-up inside us?
It's arrogant, too, to assume that there's a cure for depression. Yes, some of us grow out of it eventually, but until we embrace the illness' general incurability we'll never make peace with the fact that these discussions will always be about containment. Mindfulness contains depression once its symptoms have occurred. Medication contains depression to where its symptoms, more often than not, don't. It's not a case of pride; simply—having been on both sides of the fence—I know which one I'd rather live on.
People with depression are just as unwilling to waste their lives as anyone—we want what works best and quickest for the cheapest price, the thing that lets us do the most without the barrel of depression's gun pressed to the backs of our necks.
Regarding the study, am I wrong to think the results could be weighted? It was implicitly carried out to prove that MBCT is more effective than antidepressants, the mindfulness group engaging in "daily" exercises, which, if they weren't being studied, I wonder if they'd be so eager to do.
In my experience, the effectiveness of any cognitive behavioral therapy (CBT) largely depends on the therapist and their willingness to cater exercises to one's particular needs. How often I've left places thinking I've been lumped in under some huge umbrella, told to do things which made logical sense but which I needed to do so intensely and frequently that the stress incurred was sometimes worse than the illness.
CBT can be very expensive and time-consuming. Though it's still effective in a group, and so theoretically cheaper per person, this relies on doctors lowering their prices, which doesn't really happen. It's also available for free on the NHS, but as there's a shortage of qualified therapists, you'll need to wait, which isn't always possible if you're in distress. In other words, you'll probably need to go private.
If you can afford it, however, high-quality MBCT in combination with antidepressants would be a great way to go, as would talk therapy, veganism, and winning the lottery. You see what I'm saying? We all have busy lives with limited time and money, as well as dreams and ambitions that go beyond watching Netflix and doing mental exercises for hours on end to get over feeling sad. People with depression are just as unwilling to waste their lives as anyone—we want what works best and quickest for the cheapest price, the thing that lets us do the most without the barrel of depression's gun pressed to the backs of our necks.
Antidepressants are flawed: We don't even know how they totally work. But, for now, they're the best things we have that are compatible with full, fast, fulfilling lives—things which, until we discovered antidepressants, many of us didn't even know existed. So though I'm not advocating popping pills before trying other methods first, don't tell me mindfulness is as effective as medication because—speaking from experiences I don't want to relive—it just isn't.
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