Meditation or medication?

Cliff Bostock, Creative Loafing Atlanta: In January 1991, I woke up one morning in the blackest depression of my life. There was nothing unusual about the day, although Operation Desert Storm had begun the day before. I remember lying in bed, listening to reporters on CNN describe what sounded like a video game. No death or blood.

For months afterward, I felt as if I awoke every morning covered in black soot. I’d have to spend a few hours sweeping the soot away before I could do anything productive. The psychic pain of depression this deep is difficult to describe. Contrary to what many people think, it can produce a physical sensation, pain that cannot be exactly located. For me, it was this pain that made me contemplate suicide continually. The wish was not so much to die as to end the pain with a violent act.

I made a contract with my therapist that I would not kill myself until I’d given a tricyclic antidepressant time to take effect. As I’ve written before, I recall the exact moment the drug took effect. I’ve heard many people over the years report the same experience. For me it was as if my heart suddenly revved up and I became fully present in my body. The depression vanished.

As is also true of many others, I realized that I’d probably been depressed most of my life. A few months later, my doctor switched me to the relatively new drug called Prozac. This produced a phenomenal change in me, not only treating my depression, but making me far more productive in my work and more extroverted than I’d ever been.

My doctor told me I’d likely need to be on the drug the rest of my life. My depression was not situational. In fact, my bout of suicidal thinking came during a good period of my life. Like many others, I seem to be predisposed to depression.

I certainly didn’t mind the idea of being on an antidepressant the rest of my life, if it continued to work so well. Unfortunately, though, after two years, the drug had little effect and I returned to a state of dysthymia – low-level depression. I tried many other antidepressants but nothing ever returned me to the state I enjoyed as a newcomer to Prozac.

I’ve got plenty of company. Repeated studies of the drugs have also demonstrated another surprise. Although the actual figures are debatable, the placebo effect is remarkably high in the use of antidepressants, particularly in treatment of mild depression. It’s no wonder they seem to lose effectiveness after a period. Considering that antidepressants are among the most prescribed drugs in the country, finding a way that more effectively treats depression is a priority in the mental-health field.

To many Atlantans, it was probably a surprise last week that the Dalai Lama, the exiled leader of Tibet, has become part of the effort to find an effective, long-term treatment. Here to accept a professorship at Emory, the Dalai Lama conducted a daylong conversation with scientists on the subject of “Mindfulness, Compassion and the Treatment of Depression.” Incredibly, 4,000 people showed up to hear the conversation – which ought to be indicative of the topic’s importance, as well as the Dalai Lama’s celebrity.

I did not attend, but like many others who have been engaged in a meditation practice for some time, even if fitfully, it is no surprise that an increasing body of evidence suggests that it not only can reduce the pain of depression but actually help restructure the brain, which the new science of neuroplasticity has observed in studies of Buddhist monks.

The direct benefit of meditation is that it develops awareness – or “mindfulness” – of the way one’s thoughts and feelings arise spontaneously. With practice, it becomes increasingly easier to leave behind the array of symptoms (including physical ones) that add up to the experience of depression – or any other habitual way of thinking, for that matter.

This is especially true in the practice of compassionate mindfulness. Studies have shown that compassion can literally be taught (which is one reason I believe meditation should be taught in public schools). When we approach the world and ourselves with compassion, suffering paradoxically becomes less burdensome.

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