Keep going even when you are feeling okay, writes PADRAIG O'MORAIN
EVERY MORNING I used to meet him as I walked along the Liffey. He would stride along with enormous determination, head down, looking up only to nod before he headed off in the opposite direction.
Then he wasn’t there any more. I assumed he had grown tired of his regime of walking, as people do, and had abandoned his walking boots.
A couple of months later I ran into him at a bus stop. I said I had noticed he wasn’t walking any more.
“I knocked all that on the head,” he said. “I was only doing it under doctor’s orders. I had a bit of depression, fairly bad actually, and she had me walking to get rid of it. I’m grand now. Never liked it.”
“I had an uncle who used to walk off his depression,” I said (I didn’t but I was being diplomatic), “and the doctor told him he had to keep it up after the depression was gone.”
“Here’s my bus,” he said, and that was that.
But the fictional doctor who treated my fictional uncle was right. If you suffer from recurring bouts of depression, you can gain huge benefits from keeping up your anti-depression strategies when you are feeling okay.
Researchers at the University of Wales, Bangor, looked at the value of mindfulness for people with recurring depression. I suspect that their findings might apply to mental health strategies other than mindfulness also but this is what they were studying.
They wondered why people with deep depression are prone to a recurrence of this condition. They started from the basis that when you have a serious depression, you suffer three fairly obvious symptoms. The first is low mood, the second is negative thinking and the third is fatigue.
If the depression continues for long enough, they assumed, your brain makes a strong link between those three symptoms.
The depression lifts, for whatever reason: exercise (a much under-rated mental health strategy), counselling, medication or a change in life circumstances.
All is well for a time. Then one day one of those symptoms returns as it does for all of us: a day of low mood, negative thinking or fatigue. Usually we just ride out that bad day and hope for better luck tomorrow. But if your brain has connected those three symptoms with depression, the outcome can be very different.
You waken up in a low mood (perhaps because of a dream you have already forgotten); you assume the depression is back – a crushing disappointment so now you have negative thinking; and perhaps you stay in bed because you feel you cannot face the day, so when you get up you will have fatigue as well.
Indeed, even if you don’t stay in bed for too long, you may be fatigued because mental distress uses up enormous amounts of energy.
Now you have all three conditions present – negative thoughts, low mood and fatigue and it is a short step from this to a full-blown depression.
What the researchers found was that if people followed a programme of mindfulness training in between bouts of depression, they reduced their chances of relapse by 50 per cent to 75 per cent.
These are dramatic results and, as I said above, I suspect good results might also be expected from following other mental health strategies after a bout of depression.
None of this is easy, of course. When you’re depressed, those close to you are encouraging about efforts to deal with it, even if these efforts don’t work. When you’re feeling okay they may be reluctant even to mention the depression for fear of bringing it back. So keeping your mental health strategy going may be up to you.
What of the man I mentioned at the start of this article? I haven’t seen him walking along the river since. But I did spot him striding through the Phoenix Park, head down. Perhaps he left the river to avoid me and my unwanted advice.
Padraig O’Morain (pomorain@yahoo.com) is a counsellor accredited by the Irish Association for Counselling and Psychotherapy. His book, Light Mind – Mindfulness for Daily Living, is published by Veritas. His monthly mindfulness newsletter is available free by email.