Beliefnet: The Only Way Out Is Through

Twelve ways to heal depression and find the true self.
By Kenneth Porter, M.D.



An ancient Scandinavian fairy tale tells of a kingdom falling into ruin that can only be saved if the beautiful princess marries a dragon. The reluctant princess is instructed by a wise woman to wear 10 layers of wedding dresses and to ask the dragon to shed a layer of his skin each time she sheds a dress. When in fact he does so, the dragon stands revealed as a prince, and the couple and kingdom live happily ever after.

Like the dragon in the story, depression can be healed, and we can find our true self, the prince in each of us. The transformation requires the help of the princess--the feminine wisdom that is also in each of us. And even though it may seem strange, depression, when viewed in this way, can be a gift and a teacher. It allows us to grow.

Depression, which afflicts about 19 million Americans each year, consists of four "dreadful d's": deadness, defectiveness, despair, and defeat. When we're depressed:

* we don't feel alive (deadness)
* we feel there's something wrong with us (defectiveness)
* we lose power and hope (despair)
* we can't act (defeat)

Awareness, acceptance, appreciation, and action can all be used in order to heal depression in 12 different ways:

1. Use awareness to transform deadness. Try mindfulness meditation, as taught by various Buddhist traditions. Let yourself feel the actual physical and emotional sensations of the depression. With practice, you may discover deeper feelings of hurt and sadness. When you are able to feel these, the depression may decrease.

2. Use understanding, another aspect of awareness, to transform defectiveness. Depression often occurs when we are in legitimate emotional pain but misinterpret the pain as being an indication that something is wrong with us. Remind yourself that emotional pain is a healthy part of life and does not mean you are defective.

3. Combat the critical judge. Many of us have an internalized critic or judge that incorrectly tells us we're bad. Use understanding--a form of awareness--to counter this pattern. When you find you are down on yourself, simply record the self-criticisms, then add realistic refutations. (You may find the book "Feeling Good" by David O. Burns, M.D., helpful.)

4. Use acceptance to transform defectiveness. Practice opening-the-heart meditation toward yourself. Find the right combination of words and images that evoke in you a feeling of caring toward yourself and practice this 5 to 15 minutes a day. You might try "May I be happy" or "I'm OK" or "I love you" directed toward yourself.

5. Use appreciation to transform despair. Make a practice each day of finding one thing in your life that you appreciate and dwell on it for five minutes--even if there are many other things you don't appreciate or even dislike.

6. Action: Take SAMe, the new supplement for depression that is more powerful and has fewer side effects than St. John's Wort, and is also safe and natural. (For details, see the book Stop Depression Now by Richard Brown, M.D.)

7. Action: Start a regular practice of spiritually oriented body work, such as yoga, chi kung, or tai chi, to increase your energy flow on many levels at once.

8. Action: Light therapy. This new approach is now known to work for all depressions, not just Seasonal Affective Disorder (SAD), which generally comes on in winter. You'll need to buy a light box ($200-$500)--even broad-spectrum regular light is not strong enough. You'll need just 30 minutes a day. Two of many manufacturers: Enviro-Med 800-22-DAWN and Apollo 800-545-9667.

9. Action: Aerobic exercise. Perhaps the quickest, safest, and most natural antidepressant is exercising aerobically 30-45 minutes, 3-5 times weekly.

10. Action: Learn to express your feelings to others constructively. Learn how to ask for what you want and do it separately from expressing your anger. When you express your anger, do it with control and without attacking the other person.

11. Action: Psychotherapy. I strongly recommend you consider psychotherapy for depression. Try different therapists and approaches until you find the right one for you. It can help enormously.

12. Action: Medication. Finally, if you suffer from severe depression--depression that makes you suicidal or significantly interferes with your functioning--don't shy away from antidepressants. Under the supervision of a psychiatrist, they are safe and effective, and you will need them.

Kenneth Porter, M.D., is co-director of the Center for Spirituality and Psychotherapy of the National Institute for the Psychotherapies in New York City.