Oct 1, 2010

Depression and Buddhism Part 2

October is National Depression Awareness Month

Video Created by Loflo 

By Lee Wolfson
World Tribune 02/09/01 n.3332 p.8 WT010209p08

If we recognize that depression is a serious and debilitating illness, then it is only natural
to ask what causes this kind of depression? Common sense tells us that depression is
most often brought on by life events; i.e., death of a loved one, loss of a job, divorce,
etc. Life has a way of providing us with an unending supply of difficulties. It is only
natural to think of depression as a reaction to stressful life events, and in many cases,
this is true. If this were the entire story, then one might assume that depression only
afflicts people with “weak character,” or a “low life-condition.” However, there have
been many people of outstanding character and courage who struggled with depression,
such as Abraham Lincoln and Winston Churchill.

So what is the rest of the story? We know that there are numerous risk factors for
predicting who might be more susceptible to depression. Depression can run in families.
Evidence from studies of twins supports the existence of a genetic component. Across six
studies, the average concordance rate in identical twins (40 percent) for unipolar
depression is more than twice the concordance rate in fraternal twins (17 percent). The
rate of depression in women (12 percent) is twice that of men (7 percent). There are
numerous theories about this gender difference, but there is no consensus in the scientific
community about the underlying cause.

Early life experiences also make people more vulnerable to depression. If one of your
parents died when you were a child, or if you are the victim of childhood abuse you have
a higher vulnerability to depression. Chronic medical conditions as well as life-threatening
medical events like stroke and heart attack can also lead to depression.

Medical research has shown that depression may be related to a chemical imbalance of
serotonin, one of the substances called neurotransmitters that transport signals between
nerve cells in the brain. This has led to the introduction of Prozac, Zoloft, Paxil and
Celexa. These serotonin specific uptake inhibitors have proved effective in treating
depression with minimal side effects but have not come without controversy. Some people worry that the widespread marketing and availability of these medications may be
anesthetizing large segments of our society to the healthy travails of life. This may or may
not be the case, but for those like Jen who have suffered with the torment of a major
depression, these new medications have been a blessing.

Another helpful way of understanding depression is to view it as a spectrum disorder.
In other words, the milder manifestations of depression that we all experience have some
of the same root causes as the more severe forms of clinical depression. Martin Seligman,
Ph.D., in his book What You Can Change and What You Can’t presents a compelling
argument for viewing depression this way: “Mild depression is usually caused by
pessimistic habits of thinking. The pessimist sees the causes of failure and rejection as
permanent (It’s going to last forever), pervasive (It’s going to ruin my everything), and
personal (It’s my fault). These habitual beliefs are just that, mere beliefs. They are often
false, and they are often inaccurate catastrophizing” (p. 115).

Dr. Seligman goes on to argue that optimistic thinking may be a powerful antidote to
pessimism and depression. Contained within the worldview of Nichiren Daishonin’s
Buddhism is a profound capacity to look at the totality of life with all of its travails and
suffering and still find hope and fundamental goodness at the core. In October 1992, I
wrote an essay for the Seikyo Times (now Living Buddhism) in which I demonstrated the
inherent psychological strength of the Daishonin’s Buddhism as reflected in his views of
the self, the world and the future. The purposes of this article do not permit me to
reintroduce the evidence for this. Let me just say that in all three areas, we find robust
examples of the Daishonin encouraging and exhorting his disciples to embrace Buddhism
with optimism and hope, despite the dire social, economic and personal circumstances of
13th-century Japan.

It had been several years since Jen last saw a psychiatrist, and she was not looking forward to seeing one again. The last time was before she began her Buddhist practice, and it had never been a satisfying experience. He prescribed a variety of antidepressant medications,which were only moderately successful, but he never seemed to have time to talk. She eventually stopped the medication and stopped seeing the psychiatrist.
Several months later, an old friend introduced Jen to Buddhism. Jen was drawn to her
friend’s explanation of Buddhist theories and felt that she was hearing a wonderful
explication of her own view of life. However, she was skeptical that chanting Nam-myoho-renge-kyo would somehow change her life. Nevertheless, she sat down with her friend a few days later and tried chanting.

In the short period of 15 minutes, she sensed something shifting in her life, and when
they finished, she felt more relaxed and open than she had in years. Her friend connected
her with the local SGI-USA organization and she began attending meetings. All the
smiling people she encountered initially put her off, that is, until she listened to their
experiences. She came to realize that their smiles were born of great struggles to overcomemany of the same problems she was facing.

She bought a copy of For Today and Tomorrow by SGI President Ikeda, and the words
practically leapt off the page at her. Reading his guidance was like finding an oasis in the
desert. In spite of the many years of having no hope for the future, she found herself
becoming more optimistic and cheerful. Each Nam-myoho-renge-kyo she chanted felt like
a powerful challenge to her deeply held feelings of worthlessness. And her interactions
with other Buddhists reinforced her determination to take responsibility cheerfully for her
own life. The dark curtain of depression had finally begun to lift.

Jen sailed along majestically in her life, thinking that since she had become a Buddhist,
she was impervious to problems. But when her husband became ill, she felt like the world
had come to a crashing halt. She could not understand how this could happen to someone
who practiced sincerely. Rather than resolve her doubts, however, she gradually
succumbed to the darkness of her depression once again.  
Jen’s husband continued to gently, but firmly encourage her in any way that he could.
Mostly, he just chanted with her every chance that he had.
Several weeks went by before she got the courage to call a psychiatrist. She hoped her
Buddhist practice would provide a foundation for a more rapid and full recovery, but she
felt anxious and a little embarrassed when she walked into her new psychiatrist’s office for the first time. Before she knew it, she was crying. The story of her husband’s illness
poured out of her.

After she finished telling her story, her psychiatrist carefully reviewed her symptoms
and their duration. It came as no surprise to her when he told her she was in another
episode of depression, but it was strangely comforting to give this darkness that had
become her constant companion a name. He then explained to her that in the years since
she was last treated for depression, there was important new research on the treatment
of depression. He told her that combining medication with weekly psychotherapy would give her the best chance at a quick and robust recovery.

Jen left the office with a prescription for one of the new antidepressants, and a referral
to see a therapist. When she arrived home, there was a message on her answering machine from her district leader reminding her about the district discussion meeting. She had not taken any calls from her leaders in faith and had not been to a district meeting in months. She began taking her new medication that night. She experienced no immediate
response to the medication, but she realized it might take weeks for the medication to
begin working.

A few days later she went to her first appointment with her therapist, who specialized
in treating depression. Over the next few weeks, Jen explored her interpersonal
relationships with her therapist. He proposed that they focus on her feelings about her
husband’s poor health. He suggested to her that in addition to her genetic predisposition
to depression, this current episode might be about her grieving over the life she would
never have with her husband due to his poor health. His attempts at helping her to find her strengths in the midst of a very difficult situation felt very compatible with her beliefs as a Buddhist.

She also told him about her Buddhist practice and her involvement with the local
community of SGI-USA members. He was keenly interested in her perceptions of how the
practice of chanting Nam-myoho-renge-kyo was helpful to her and about how she got
along with her friends in the organization. Jen appreciated his open-mindedness and was
surprised when he actually encouraged her to be consistent in her practice. He told her that maintaining consistent daily social rhythms would be helpful to her recovery. Even thought he was referring to sleep, diet, exercise, etc., she immediately associated this with a consistent daily Buddhist practice.

When it came time for her next district meeting, Jen decided she was well enough to
attend. Much to her delight, they warmly welcomed her back to the meeting. It was as if
she had never left. The discussion that night was about turning poison into medicine.
Before she knew it, she was sharing her experience of struggling with depression. Jen told
the group that in spite of their encouragement, she still could not see how she could turn
her depression from poison into medicine.
One of the members looked at her very intensely and said softly, “Perhaps your
willingness to share and encourage us through your experience is part of the process of
transforming the poison of your depression into medicine?”

Jen’s favorite part of the meeting was always the lively discussions that ensued “on the
way out the door.” She had a lot of catching up to do. The last person she spoke to was her district leader, Sarah. She apologized for her long absence. She told Sarah that as a
Buddhist, she knows she isn’t supposed to feel guilty, but these feelings of guilt were what kept her from returning to the meetings. She felt like a failure as a Buddhist because she saw her depression as an inability to manifest “actual proof.”

Jen was surprised when Sarah apologized to her. Sarah told her that she felt like she had
let Jen down because she had not realized how much Jen was suffering. “When you
stopped coming to meetings and wouldn’t return my phone calls, I was at a loss,” Sarah
said. “I should have tried harder to reach you. Now that you’re back, I don’t want you to
disappear again. Let’s keep chanting together to overcome your illness.” They hugged and
made plans for Sarah to come over.

A few days later, Sarah came over to chant with Jen. They decided to chant for an hour.
Jen wondered if she had the stamina to sit for that long, but she was determined to do her best. Over the course of the hour, she went from tears of grief to a deep sense of
appreciation. In those precious moments of complete concentration, with her heart fully
open and her voice deep and sonorous, the chattering of her mind quieted and true wisdom appeared. She understood, more with her heart than with her mind, that by embracing this wonderful law, she was severing the roots of her suffering. She knew that finding the right medication and a therapist she could trust and talk to was a benefit from her Buddhist practice.

How swiftly the days passed. The first signs of improvement from the medication were
improved sleep and appetite. Jen felt her therapy was going very well. She noticed that
when she chanted more, her daily life continued to improve and she had better therapy
sessions. She also noticed that the more honestly and openly she engaged in her therapy,
the more motivated she was to return to the Gohonzon and ponder the issues before her.
She was also discovering new and better ways of communicating with her husband. Her
feelings of resentment and grief were giving way to a renewed determination to embrace
her husband and their shared life.

Jen returned to see her psychiatrist several months after her initial visit. She was feeling
much better. So she asked him how long she would need to keep taking the medication.
He told her that she needed to stay on her medication for at least four months if not six
months from the point in time when she really began to feel better because she would be
at significant risk for a relapse if she discontinued her medication sooner. Jen agreed to
meet again in four months and decide then what to do about the medication.

Jen’s depression is now in complete remission. She has decreased the frequency of her
therapy sessions, but has decided to keep seeing her therapist for a few more monthly
sessions to solidify the gains she has made in her interpersonal life. While she would
rather never see the dark cloud of depression in her life ever again, she is appreciative of
the gifts her suffering brought her: a more committed relationship with her husband, a
fresh start with her Buddhist practice, and a deeper and more authentic connection with
the members in her district.

There are many SGI-USA members who have found the optimism, hope and life force
they needed to overcome depression through the practice of Buddhism alone. There are
also members like Jen who may need the help of compassionate professionals, support
from their families and fellow members, and a strong daily practice to return to a healthy

Lee Wolfson is a psychologist at Western Psychiatric Clinic and Institute (WPIC), a
division of the University of Pittsburgh Medical Center. WPIC is an international leader
in the research and treatment of mood disorders. For the past 11 years, Lee has worked
on several landmark studies in the treatment of depression and bipolar disorder. He has
published several papers on psychotherapy and regularly presents symposia at
professional meetings. He is also a founding member of the International Society of
Interpersonal Psychotherapy. He has practiced Nichiren Daishonin’s Buddhism with the
SGI since 1972.

1 comment:

KRYS said...

Thank you so much for posting this..I am a YWD member of the SGI and I am glad that I read your blog every now and then. I've been battling depression for many years, when I started practicing it would come and go but overall it got a lot better. Recently I've been stuggling with it, blaming myself that maybe I'm not practicing or studying our buddhist faith as much as I should. The reality is, however, that I haven't come to terms with myself that I might actually truly have an illness and should treat it. Thanks again, blessings and love to you!