Mindfulness and Depression: A Matter of Acceptance?

Are you able to accept depressed mood as it is? Being more accepting of negative thoughts and emotions does not necessarily mean to give up. In the contrary, it can be the first step toward change. In one of our recent mindfulness meditation group sessions in Hillcrest some participants noted that “depression” is not necessarily a “bad thing.” This was a keen statement that made me think about mood disorders in new ways.

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There is something I would call the “depression paradox” in America. On the one hand, people feel depressed perhaps more than ever before in human history, on the other hand, it seems to have become ever more unacceptable to feel down.

In the American popular culture there is a tacit imperative to claim that everything is fine even if that’s simly not true.  Particularly in Southern California to smile and be happy all the time can be an expectation that is not conducive to wellbeing. Feelings of sadness are commonly not talked about. Above all, it is unacceptable to display them in public even though going inward and being unhappy can be an important way of processing life events.

As a family therapist I meet many people who have difficulties to accept that symptoms of depression such as hoplessness, irritability, loss of energy or interest in daily activities, and fatigue may come and visit for various reasons. The result of avoiding negative feelings is often rigid emotion management based on social conventions in which any negative feeling must immediately be reframed and turned into something positive. Sometimes this is promoted by psychological self-help literature that asks people to smile or engage in positive self-talk when there is actually a need to acknowledge a moment of suffering.

If the symtoms become severe and last longer than two weeks it is important to seek professional help, but even then, the first step towards healing is to accept the fact that you are hurting. This sounds more simple than it is.

In the 1980s, the Stanford anthropologist Gananath Obeyesekere claimed that in Buddhist cultures, i.e. in Sri Lanka, the renunciation and withdrawing from the world is considered a way to enlightenment rather than a sign of psychopathology. He argued that the Western psychiatric diagnostic category of Major Depressive Disorder does not necessarily apply to people who follow Theravada Buddhism. Although this is a bold assertion, it remains a fact that in countries where Buddhism is commonly practiced, the psychiatric prevalence of depression is very low.

This makes sense if one considers the first Noble Truth of Buddhism, namely, that life means suffering and that suffering stems from attachment to transient things. From this point of view depressed mood can be a normal consequence of human craving and aversion. Perhaps it becomes more prevalent in neo-liberal consumerist cultures that make us obsessed with ‘progress’ and ‘success.’ To what extent does our longing for the latest and most cutting-edge style, body image, product, degree, or job make make us prone to ‘depression’?

Ultimately, I believe that whole-hearted acceptance of where I am at right here and now can lead to new actions rather than fatalism or the believe that nothing can be changed. With a little bit more awareness of what is going on, I’m more prepared to notice that change is inevitable. But maybe acceptance is too big of a word. As the meditation teacher Jason Siff argues, “tolerance” may be all we can hope for in the face of dispair. In an open meditation practice it is important how we relate to negative thoughts and rumination rather than to pull ourselves out of them. Simply denying that they are there and wishing that they would be gone has never served me in reaching greener pastures.

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