Mabel Martinelli, director of the Cambridge Centre for Cognitive and Behavioral Therapy, believes meditation is the best way to reduce the severity of depression – Geoff Pugh for The Telegraph
‘I’m a psychologist who’s treated hundreds of patients with depression – this is what works’
Story by Lauren Shirreff
We’re used to hearing that depression is a chemical problem, one that starts in the brain and can only be fixed with medications like SSRIs which alter the levels of “happy” hormones in your system.
But the reality is that antidepressant medications only work for three in five people with moderate to severe depression. Those who don’t see any benefit from antidepressants or other mainstream treatments, such as cognitive behavioural therapy (CBT), are often referred to as having “treatment-resistant depression”. Many more people with mild depression would rather stay away from medications completely.
“Depression is an emotional state that makes people interpret the events in their lives in a negative way,” explains Mabel Martinelli, the director of the Cambridge Centre for Cognitive and Behavioural Therapy. “It’s only by helping someone to find some space from that feeling that they are able to get back in control of their thoughts.”
The best way to do that is through meditation, Martinelli says. You’ve likely heard before that this practice is the best tool for staying in control of your mind, yet it can be daunting or seem too “woo-woo” to really work.
But if you’re someone living with depression, stress or anxiety, it’s a technique psychologists want us to take seriously – and Martinelli, with 25 years of experience as a psychologist, has found that incorporating it into her practice has been hugely effective.
“Brain scans show that meditation alone can reduce the severity of depression,” Martinelli says. “Studies using MRI scans have demonstrated that meditation both quiets activity in the brain networks associated with depression, and that these effects last even after someone has finished meditating.”
Sessions that combine meditation with conventional therapy techniques have a name: mindfulness-based cognitive therapy (MBCT). “It was created for those with treatment-resistant depression where medications and other therapies don’t work,” Martinelli explains. “Studies show that MBCT is at least as effective as antidepressants when it comes to preventing people from being sucked back into depression.”
Why mindfulness-based cognitive therapy works
Two decades since it was developed, there is clear data to show that MBCT can treat both depression and anxiety. Studies have shown that an eight-week course of MBCT can dramatically reduce the severity of depression in people who haven’t responded to antidepressants, and can treat other people at least as well as those medications themselves.
“Mindfulness-based cognitive therapy is the most powerful intervention I use in my practice,” says Martinelli, who is a qualified psychotherapist and also uses traditional methods such as CBT.
It may also leave people happier than antidepressants. “Antidepressants aren’t meant to bring people out of depression and into a happy psychological state, but to a neutral one,” says Martinelli. “MBCT looks at how people can change their lives not just to end or avoid depression, but to be truly happy.”
What mindfulness-based cognitive therapy involves
MBCT “took elements of that older technique and combined it with cognitive therapy to see how it could treat mental illness,” says Martinelli. It’s inspired by another therapy called mindfulness-based stress reduction, which teaches meditation and acceptance to people over the course of eight weeks to help them cope with stress and anxiety.
Every session of MBCT involves 40 minutes of meditation, with participants meditating alone for 40 minutes each day between sessions. A course of MBCT also lasts for eight weeks. It is “best delivered to a group rather than one on one, but can work either way,” Martinelli says.
The therapy also draws on principles from CBT. “After four weeks we introduce those cognitive therapy elements, which involve looking at people’s thoughts, emotions and routines,” Martinelli says. “In the same way as traditional CBT, this helps people to break the cycle between their thoughts, emotions and actions.”
The best-proven benefit of MBCT is that it prevents relapse where someone has already suffered from depression and has made a partial or full recovery.
“Where someone has experienced a significant bout of depression once, the chance that they’ll experience this again is 50 percent,” Martinelli says. “After three or more episodes, that rises to 75 to 80 percent. We call this the kindling effect, where people become much more likely to go back into depression when they experience negative thoughts or emotions,” says Martinelli.
“Normal therapy sessions won’t work at that point, because you can’t think yourself out of a truly deep depression. But MBCT can still be effective, and has been shown to be more effective than antidepressants when it comes to preventing a relapse in the first place.”
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I don’t like meditation. I battle depression daily, even with antidepressants. I don’t like meditation because either I get bored, or I hallucinate. I have enough trouble with random hallucinations as it is. I get tired of telling my brain to just shut up and send the dancing bananas home. Yes, animated dancing bananas with canes and straw boaters. Amusing, but only for a few bars. Mindfulness is just part of my everyday experience and training.
I couldn’t do science without it, being aware of every change and sensation as I peer through a microscope or view the contents of a test tube. I go into sort of a trance state as I do science, observing everything and incorporating what is relevant to what I’m doing. What it doesn’t do is ease my depression. It’s just something I do
I use music as a form of meditation. I find new groups (or rely on known favorites) that play complex, asymmetrical music that challenges the brain, and has so many different instruments and sounds that I have to listen multiple times trying to focus on each. Beats Antique, Shadowfax, Snarky Puppy and Polyphia are a few. Apparently, I also do mindful eating, which I didn’t realize until reading this article.
I eat slowly, sometimes focusing on the flavors and textures, but also sometimes focusing on reading or listening to music while I eat. Multitasking like this is a good way to keep the mind from engaging in negative thoughts. Hobbies can also help, like painting miniature figures. Analyzing things like investments (stocks, funds, bonds, etc) or sports statistics can also keep the mind occupied. It’s all about keeping the mind occupied with things I like.
Read the book Brain Energy. Stop medicating everyone. – Search
Mabel Martinelli’s tips to practice MBCT at home
1. Three minutes of meditation
“When someone is sceptical that meditation can help them, I encourage them to try just three minutes of sitting to see how it makes them feel,” Martinelli says. “Most people feel better even after this, and notice the difference it makes to their thoughts.”
While it’s conventional that people focus on their breath while they meditate, “it’s also possible to focus on another sensation in your body or on a sound. There are lots of guided meditation soundtracks available online that can be very helpful for this”.
2. Do a survey of your day
One of the last steps in MBCT is for people to make a list of everything they do in a day.
“The point is that people identify things that are depleting them, and that are neutral, and try to change the depleting events into neutral ones, and the neutral ones into positive ones,” says Martinelli. “The point of this is that it leaves people feeling happier, and more in control of their lives, which improves the quality of their thoughts.”
This is easily done at home. Martinelli recommends that you try making a list once a month to track how your habits are changing. “Especially at the end of the year, it’s such a lovely experiment to do – and you can also give yourself a pat on the back for how much you actually deal with in a day.”
3. Make your first bite of the day a mindful one
“There’s a well-known practice of eating a raisin as slowly and as mindfully as you can,” Martinelli says. “Mindful eating can be very powerful, but it doesn’t have to involve raisins.”
When having your first bite of breakfast or sip of coffee in the morning, “just try to be present with that experience and bring curiosity to it, about what it’s like to be in the moment”. This will help to keep you centred throughout the day and in better control of your thoughts.
4. Get grounded
“When you’re anxious, your body is pumping adrenaline and you can feel quite out of control,” Martinelli says.
The trick is to make your brain realise that it isn’t in immediate danger. “This can be as simple as just looking outside and counting the number of objects that you can see, or just feeling the sensation of your feet on the floor,” says Martinelli.
“It isn’t about telling yourself that there’s nothing to be worried about, but letting those feelings pass without judging yourself for having them.”
5. Find something that you love, and have more of it
“When you purposely do things that you enjoy and pay attention to what makes you feel happy when you do them, you’re training your brain to reach out for positive experiences,” says Martinelli. “Then you start to bring the good things to your attention, instead of just the bad.”
Doing so is as easy as “finding something that gives you pleasure, whether that’s your favourite song or a piece of chocolate,” Martinelli says. “Just really notice how pleasant it is and how good it makes you feel in your body.”
6. Nature is what works. Get out and take a hike.
It is good for the body, mind and soul. And inexpensive. Much cheaper than therapy. There is vast evidence that demonstrates healing power in nature!! Actually, there’s a book, Awestruck, by a psychologist, Jonah Paquette – Search that addresses this excellent intervention!
Though I totally agree with you regarding a need to get outside and be active, due to various reasons, i.e., debilitating physical/emotional trauma, etc., many cannot even leave their bed, unfortunately! In such situations, more intensive treatments are necessary. I’m also not a fan of meds, but for certain people, they’re quite effective, along with dietary health and other interventions. I consistently favor natural solutions, but for those who can’t partake in them, I’m very grateful other options exist!
7. After losing my husband, I found myself in a deep depression.
I tried medication but that made me feel worse. What finally worked was having things to do. Hobbies and ‘to do’ lists were my new best friends. Boredom creates depression. Talking about it or meditating only delays the feelings. Work them off and feel better.
8. Depression is mental, is it not?
Seems like one could look in the mirror and say….””SNAP OUT OF IT…you’ve got a job that pays a living wage and you’re healthy, so straighten up and stop whining”” wait until you can’t afford food or shelter, THEN WHINE and feel “”victimized”” !
Cognitive Dissonance is a thing…it’s real.
Understanding the above works wonders…not just for depression but for all things in life. Making the decision to ‘Not Be Depressed’ is the most helpful ‘cure’ to removing depression. Depression is a conscious decision. Ergo, MAKE the conscious Decision to ‘NOT be Depressed’
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7 Free Ways to Ease Depression
It’s the NEED to ACCEPT TO BE ABLE TO MOVE ON AND AWAY FROM THIS EMOTION OF DEPRESSION. I know, unlike millions other’s, I’ve had changes with the first impression perspective and can only think on how people take their lives for granted. Accepting certain fields of emotions is the KEY as you do move on and away, only to be in the same position for depression and to ACCEPT never changes and only those who do this will be only ones on how this works.
I start my day off with a sermon. everything else on this list is spot on. I’ve experienced situational depression, but it didn’t change when my situation changed. It took a while and a couple of different doctors. I was prescribed Duloxetine for chronic pain and depression, and Lamotrigine for mood stability. Explosive anger which usually ends in breaking something or getting’ my butt broken. Meditation, yoga, tai chi, and any other gentle workouts will really help the most. Learn conscience relaxation to experience full awareness of relaxing every part of your body starting with your toes.
Learn to use controlled breathing while you do these things. Be good to yourself and show gratitude and praise for your life, no matter how bad of a situation you’re in. The last one I went through took fifteen years. I prayed and thanked Jesus every time I thought about it. If you need a doctor, don’t settle. They say not to doctor shop.
When it comes to finding a doctor make sure he gets you and you feel comfortable, because it will speed up your recovery. When you find one, you listen to and be open and honest to your doctor. It will help you heal even more. Mental functionality isn’t always healable, but it is treatable. The trick is to learn coping skills so you can apply them whenever you need them. God Bless,
LoaAnyone with depression should look into ALL side effects from EVERY medication that they are on. I was diagnosed with depression until I went off of every medication I was prescribed (NINE!!) and found out that I was SO much healthier underneath than doctors led me to believe. Living a healthy lifestyle with nutrition, exercise, meditation, and self-care was the magic cure for me along with avoiding all man-made chemicals such as OTC meds and food additives.
Jan 8 Eric E.
Something I’m sure that doesn’t get brought up a lot and people aren’t willing to talk about: stop drinking alcohol. Our culture in America is constantly surrounded by the consumption of alcohol and the majority of television and online advertisements are for alcohol products.
Friday and Saturday nights are connected to going out to bars and having a few drinks. I received treatment for alcohol abuse and something that a counselor said that stuck with me was “cut out alcohol for 6 months and see if you still have depression.” It took me a year of sobriety to get completely off of any depression/anxiety medication I was on.
Since not everyone thinks they have a problem with alcohol, they don’t think their depression has anything to do with drinking. So my advice: try being sober for 6 months and see if your depression symptoms are still there. It’s one of those topics where if people don’t see themselves as an alcoholic they don’t think they have a problem with alcohol, so they don’t correlate their depression with alcohol consumption. Yeah, if you’re depressed, maybe don’t take a depressant (alcohol).
I’ve learned not to drink if I am sad, depressed, angry, stressed, etc. But I did get into craft beers and higher end bourbons kind of as a hobby, an exploration. It was more about trying new and unique things than getting drunk. But I also try to have 2-4 days a week where I don’t drink, once every two years I go a month without alcohol, and I am religious about not mixing drugs and alcohol on the same day. However, if someone is experiencing extreme or even moderate depression, avoiding alcohol is probably a good idea.
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NOTE: When I went through severe depression in 2005 and early part of 2006 it was like falling into black hole and when I was about to climb out of it falling deeper back into it. Caused by Lexapro. It wasn’t until my doctor finally told me after my father was gone.
Well, he’s gone now and he wouldn’t want to see you go through depression much like you didn’t want him going through cancer and I myself wouldn’t want to go through it.
So Now Is the Time to Get The F*ck Over It Sermon That Worked. Depression is a side effect of feeling sorry for yourself and focusing too much on a cantaloupe size tumor on someone’s breastbone.
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