There's hope. New approaches are showing promise in working with depression. I have been working with Mindfulness-Based Cognitive Therapy (MBCT) and am excited to offer clients another angle on depression management. The inability to feel possibility can be one of the cruelest aspects of this habit of unhappiness. New medications have provided relief to many people, but research shows the chronic quality of depression, and its epidemic presence in our society.

MBCT gives us some options for working with the habit of depression. We can cultivate practices and transform habits that keep us stuck in painful emotional states. We can learn to relate differently to our unhappiness and then find a way through to more ease and well-being.

Mindfulness is a way of paying attention on purpose. Some say it should be called Heartfulness, because the intention is to move from an evaluative, judgmental way of paying attention, to one of kind and keen curiosity. Mindfulness practice asks us to come to the present moment, to shift from being only in thoughts to a more embodied experience.

I like to think of "draining the brain", actually feeling the shift of attention from being in the head to being in the body's experience. The breath is a dependable anchor for this shift, a thread of connection to our life as it unfolds. Some of that unfolding may be challenging or unpleasant, but it is our authentic experience and a next step on our way to greater understanding. Mindfulness is a lifestyle practice; "attitudes of patience, compassion for yourself, open-mindedness, and gentle persistence" (Williams, et al) are needed. I know from personal experience the enormous shift that can happen when attention moves from the figuring-out mode to a broader, more compassionate view. Possibilities never considered may become clear; a way through depression is possible.

The cycle of depression links thoughts, mood, body experience such as exhaustion or anxiety, and behavior. This linkage facilitates depression's return once the brain and body pathways are created. In a way it becomes a habit. Mindfulness introduces new pathways to interrupt the habit. In the 1990s three researchers Williams, Teasdale, and Segal questioned the progression of depression, wondering how an initial feeling, a passing sadness, spirals downward into true depression's grip. They concluded that the sad mood was not the problem, but rather how we respond to our sad mood.

One way people tend to respond to feeling bad is rumination, which is a way of focusing thoughts. We go around and around trying to figure things out, often with increasing anxiety and sometimes with a growing obsessive quality. Rumination is a part of the loop described above: thoughts affect mood, the body informs thoughts, and our behavior reinforces the cycle. Around and around we go, not feeling better and often feeling worse.

Williams, Teasdale, Segal, and Kabat-Zinn present their findings in a very useful book, "The Mindful Way through Depression" (available at www.Amazon.com). They show how awareness practices affect depression by cultivating a whole new way to be in relationship to the mind/ mood/ body pattern. Mindfulness practice is proving to be a powerful tool for developing awareness and changing the habitual course of depression.

The development of a Mindfulness practice and the ongoing "practice" of these skills, as applied to depression, may need the encouragement and support of others. Research confirms the most successful treatment for depression combines medications with therapy for long lasting results. The latest findings suggest that the addition of Mindfulness skills supports the long-term shift from chronic unhappiness and depression to a more joyful life.

Some people find benefit from a class for support. If you are interested or curious there is an eight-week series offered through UCSF based on MBCT. The personalized attention of individual therapy, utilizing the skills of Mindfulness practice, is the support many others choose. Please call me at (707) 573-9575 for more information and a free introduction to Mindfulness practice. You can do something about your depression.