Archive for April, 2009

Depression: Medicate, Meditate or both?

Monday, April 6th, 2009

The World Health Organization estimates that by 2020, depression will be the second largest issue in ill health worldwide. Clinical depression is defined as a persistent depressed mood or loss of interest or pleasure for at least two weeks along with a number of other physical and psychological symptoms. These could include poor sleep, loss of appetite, a sense of hopelessness and others. Studies have now found that the more often a person experiences depression, the more likely they will be to experience it again (70-80% chance of relapse for people who have suffered two or more episodes). Depression doesn’t usually occur alone and is often mixed with other issues such as anxiety and panic. So what do we do, medicate, meditate, both?

The Psychiatric field has found medications that increase the flow of certain neurotransmitters in the brain that can help relieve these feelings of depression. However, because of the relapse rate, the American Psychiatric Administration had to come up with three phases of treatment with medications, acute, continuation, and maintenance. Acute medication treatment was aimed at relieving symptoms during a depressive episode. Continuation treatment was for prescribing medication for 6 months after the episode had passed and maintenance was to prescribe for up to 3 years. So what’s the problem here? What happens after 3 years? What about the people whom medication doesn’t agree with or unable to take?

Medication was not meant to be a permanent solution to mental health issues because they don’t target the supposed causes of the episode itself, but more to help relieve symptoms for a period of time so people who are suffering could cultivate the stability and skills to support themselves moving forward. Medication can be a wonderful support; however, it’s important to also cultivate the skills to work with the potential relapse of depression moving forward. This is a more effective long term strategy.

Based on Jon Kabat-Zinn’s Mindfulness-Based Stress Reduction (MBSR) program, Zindel Segal, Mark Williams, and John Teasdale developed Mindfulness-Based Cognitive Therapy (MBCT)  for depressive relapse. Teachers of this program support participants in cultivating mindfulness meditation skills to foster the ability to be more nonjudgmentally …

How Does Your Mind Hold You Back?

Friday, April 3rd, 2009

Imagine that you’re walking in a park and you here some birds chirping. The sun is shining on your face and then you notice you’re feeling pretty lousy. Then you think, “What’s wrong with me, it’s a beautiful day, I should be feeling great.”

Sit with that for a minute, “I should be feeling great.”

Our minds do this all the time, they focus on where we should be rather than where we are and in turn are focusing on a gap, a deficiency. When we’re focusing on an idea that we are not where we want to be, it often makes us feel worse.

Indian Poet Kabir writes, “Oh mind you carry on your back, Your actions like a heavy sack.”

Your mind can’t help it. It’s trying to help, trying to get you out of what it perceives to be a problem. So it thinks about the deficiency, which leads to the thought that you are not where you want to be, maybe a judgment that you are “weak” or “lousy”, and potentially a fear about where you will end up.

Kabir continues, “No wonder that your shoulders ache, Another strain’s enough to break Your neck, So drop this stupid load.”

Thanks Kabir, but easier said than done. One of the central attitudes that is important to cultivate and develop over time when it comes to our minds is patience. Oh, none of us want to hear that, patience may be the last thing we have. However, in reality, often times change doesn’t happen as quickly as a click of the mouse on your computer. It happens through first cultivating an awareness and curiosity about what unconscious strategies we’re using that are ineffective and then beginning to do something different. In this case, we can become aware of the stories our minds begin to spin.

And the response to this might be, “yeah right, I can’t do that.” Let’s look at this statement for a second with a different lens. Where is this coming from? Might this statement be trying to keep you safe from venturing out and doing something different? Imagine this voice as a young child inside of …

Need to De-Stress? Try Laughing Yoga

Wednesday, April 1st, 2009

When dealing with distress, you’ll often hear me quote the late author of Man’s Search for Meaning with his words “Between stimulus and response there is a space. In that space is our power to choose our response. In our response lies our growth and our freedom.” I often point to mindfulness as a way to increase that space between what triggers us and the way we respond to it, so we can break out of our habitual patterns of the mind and choose a different way that will lead to less stress and more health and well-being. Well, there’s another way to create that space as author Therese Borchard writes in her recent blog On April Fool’s Day: 9 Ways Humor Heals.  She writes “Laughter forces a few steps–some much-needed distance– between a situation and our reaction.” Today reminds us to bring more laughter into our lives as a way to bring more healing. But what if you’re not in a space to laugh, what if there is too much distress going on?

Dr. Madan Kataria tells us that it doesn’t make a difference whether you force laughter or it comes naturally, eventually it becomes contagious and it just flows. He is the founder of, hold onto your seat, Laughing Yoga. This form of yoga combines laughter exercises with yoga breathing, moving and stretching, which releases much needed endorphins and brings more oxygen and energy into the body. Just like in mindfulness work, we practice just being present for its own sake, in laughing yoga, we just laugh for the sake of laughing and you can’t help but be present to it.

Sound ridiculous? If it does, we can just notice our initial judgments, let them be and come back to reading more. This started in 1995 and there are now over 6000 laughter clubs around the world in 60 countries. It’s been featured on CNN and the Oprah Winfrey Show. According to Dr. Lee Burk at Loma Linda University, laughter can decrease stress hormones, improve immune system and boost endorphins.  Dr. Michael Miller from the University of Maryland suggests that laughter can improve circulatory and …



Books and CDs by Dr. Elisha Goldstein:
Mindfulness Meditations for the Anxious Traveler: Quick Exercises to Calm Your Mind

The Now Effect: How This Moment Can Change The Rest of Your Life
A Mindfulness-Based
Stress Reduction Workbook

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