We take up today the often neglected cause of distress due to comebacks of depression, so we think it might be better if this post carries an alternate title: How Can You Fight The Return of Depression. And, can we really fight back depression in its second and third coming without drugs?
In a few words, depression is a mood disorder that causes a continuing feeling of sadness and loss of interest. It is treatable, but not curable. The antidepressant therapies do not cure depression — they keep the depression and its symptoms under control.
Returns of Depression
Depression has a terrible tendency of striking back with return of symptoms within 4 to 6 months of treatment. These are of two types — Relapse and Recurrence.
Relapse occurs at a time when the person is still on antidepressant drugs (maintenance therapy). The current recommendation is that people take their medicine for up to 1 year after they recover from their first episode of depression.
Recurrence occurs when the depression returns as a new episode after the earlier one has been treated successfully. This new episode presents itself within 4 years, with up to 90% of people becoming its second-time victim.
Mindfulness and Depression
Mindfulness Based Cognitive Therapy (MBCT) is a type of therapy getting together aspects of cognitive therapy and mindfulness principles. MBCT has been found to be effective for those who have suffered multiple episodes of depression. It is a group-based skills training that enables depressed patients to learn skills that prevent the recurrence of depression.
If you are interested, here’s the definitive short guide to learn mindfulness: Mindfulness In 7 Steps.
In MBCT, participants learn mindfulness practices and cognitive-behavioural skills both in classroom sessions and through homework assignments. They learn how to become more aware of their bodily sensations, thoughts, and feelings associated with depressive relapse or recurrence. MBCT.com lays out the three steps through which MBCT can help:
- Understand what depression is.
- Discover what makes you vulnerable to downward mood spirals, and why you get stuck at the bottom of the spiral.
- See the connection between downward spirals: High standards that oppress us or feelings that we’re just “not good enough,” the ways we pressurize ourselves or make ourselves miserable with overwork and ways we lose touch with what makes life worth living.
Antidepressants v/s Mindfulness
In the first ever study on a large scale, that compared the results of maintenance therapy with mindfulness therapy, the researchers concluded that Mindfulness Based Cognitive Therapy (MBCT) could be an effective ‘drug-free’ treatment for people with severe depression at a high risk of relapse. Called the PREVENT study, its results have just been published in the peer-reviewed medical journal, The Lancet.
In their study with 424 adults with major depression, funded by the National Institute for Health Research, the researchers taught half of the participants mindfulness and behavioral exercises while weaning them off the drugs, and let the remaining half continue with their medication. During the two years of study, every one of them was tested for an episode at regular intervals.
A study period of 2 years was chosen because according to current practices, that is the minimum time a person should be on maintenance therapy.
Participants were randomly clubbed into either of the following two groups:
- MBCT-TS: An 8-week MBCT class (two and a quarter hours per class) that included support to taper or stop their maintenance antidepressants.
- ADM: Continued antidepressant maintenance treatment
The time to relapse or recurrence of depression over two years of study was very similar between the two groups:
- 44% of the MBCT-TS relapsed
- 47% of the ADM group relapsed
The researchers wrote:
We found no evidence that MBCT-TS is superior to maintenance antidepressant treatment for the prevention of depressive relapse in individuals at risk for depressive relapse or recurrence. Both treatments were associated with enduring positive outcomes in terms of relapse or recurrence, residual depressive symptoms, and quality of life.
So, since the study finds no significant difference between two treatments, can we say mindfulness is almost as good as antidepressant therapy to prevent a reappearance of depression? Can we fight back depression with mindfulness?
If you want to know more about what depression does to the father and the unborn child when a pregnant woman suffers from depression, read here: Depression And Pregnancy.
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