Spirituality for Depression

 

Our Generation has had no Great war, no Great Depression. Our war is spiritual. Our depression is our lives.”- Chuck Palahniuk
Depression is widespread and debilitating. It is the most common mental illness affecting about 4% of the population worldwide. Unfortunately, the word depression is used in everyday language to mean both the clinical disorder and simple sadness. So, someone who for example is grieving about the death of a loved one is often labelled as depressed. That is simply not the appropriate use of the term.

 

Depression is not rooted in an event, a situation, or a characteristic. Sometimes the depressed individual will point to something as the cause, but the tipoff that it’s depression is that once that something goes away or is fixed, the depression still remains. Hence, the permanence of depression in the face of an improving environment suggests that it is more physically than environmentally based. But what to do for the legions of depressed people?

 

The most common solution is drugs. But they have troublesome side effects, are not always effective, and even when they are, can lose effectiveness over time. So, there is a need for other solutions. A number of contemplative practices have been shown to be effective in relieving depression. These include  mindfulness training (see http://contemplative-studies.org/wp/index.php/2015/08/15/spiraling-up-with-mindfulness/), mindfulness based cognitive therapy (see http://contemplative-studies.org/wp/index.php/2015/07/17/dealing-with-major-depression-when-drugs-fail/)  and yoga  (see http://contemplative-studies.org/wp/index.php/2015/09/03/keep-up-yoga-practice-for-anxiety-and-depression/).

 

It has long been reported that spirituality and religiosity are useful in treating depression. In today’s Research News article “Effects of religiosity and spirituality on the treatment Response in Patients with Depressive Disorders”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1097990470224878/?type=3&theater

Kim and colleagues studied depressed patients before and after undergoing 6-months of anti-depressant drug treatment. They found that the personal importance of religion and particularly spirituality were excellent predictors of successful treatment outcome. In other words, being high in spirituality was associated with better treatment response and lower depression at the end of treatment.

 

These results are interesting and potentially important, but how can spirituality improve anti-depressant drug treatment outcomes for depression? If we consider depression as biologically based, then the drug treatment may be addressing the core problem. But, years of depression produces a negative outlook on life that is so entrenched that it continues even after the core brain chemistry problem is addressed. The formerly depressed patient still maintains an expectation of a negative future. Spirituality, by way of giving a positive purpose to life may well be an antidote to the dour expectations of the formerly depressed patient. It provides hope for a better future.

 

Regardless of the mechanism it is clear that spirituality assists in recovering from depression.

 

“Once you have identified with some form of negativity, you do not want to let it go, and on a deeply unconscious level, you do not want positive change. It would threaten your identity as a depressed, angry or hard-done by person. You will then ignore, deny or sabotage the positive in your life. This is a common phenomenon. 
It is also insane.” 
― Eckhart Tolle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

Let Spirituality Help You through Tough Times

“My religion consists of a humble admiration of the illimitable superior spirit who reveals himself in the slight details we are able to perceive with our frail and feeble mind.” ― Albert Einstein

 

Bad things happen even to good people. These negative life events and the distress that comes with them can damage mental health unless the individual has a means to cope with the distress. Religion/spirituality is often used as a refuge during challenging times. Does it actually help? There is some evidence that it does. It has been shown that spirituality works with mindfulness to relieve depression (see http://contemplative-studies.org/wp/index.php/2015/07/17/does-spirituality-account-for-mindfulness-anti-depressive-effects/) and can improve end of life (see http://contemplative-studies.org/wp/index.php/2015/07/17/spirituality-improves-end-of-life/).

 

In today’s Research News article “The effect of spirituality and religious attendance on the relationship between psychological distress and negative life events”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1083437271680198/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4157065/

Kidwai and colleagues investigated this very question. They studied the relationship between attendance at religious services, spirituality, and distress in an urban population. They found that people who were high on spirituality were less likely to be distressed following negative events as compared to those who were low on spirituality. They also found that high levels of spirituality were associated with attendance at religious services and that religious attendance was associated with lower distress. So, spirituality seemed to work indirectly on distress through increasing religious attendance that in turn reduced distress.

 

It appears that spiritual/religious coping is a powerful coping mechanisms that has the potential to buffer the damaging effects of negative life events on psychological functioning. There are a number of processes that could account for this. But, from the results it appears that religious attendance is primary and spirituality works by encouraging religious attendance.

 

It is possible that religious attendance provides social support when traversing difficult life situations. The common belief system connects individuals and promotes support and understanding during problems. In fact, this is precisely what Kidwai and colleagues found. Religious attendance was associated with higher social support which in turn was associated with lower distress. Hence, religious attendance can go a long way toward relieving distress directly and also by recruiting social support.

 

Regardless of the mechanism it is clear that spirituality and religious attendance can be helpful to the individual in difficult times.

 

So, be spiritual to help get you through life’s challenges.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

 

 

Prayer helps Cancer Patients

 

Prayer is not asking. It is a longing of the soul. It is daily admission of one’s weakness. It is better in prayer to have a heart without words than words without a heart.Mahatma Gandhi

Depression affects approximately 15% to 25% of cancer patients. This is not surprising as a diagnosis of cancer can cause a number of patients to become depressed. The problem is, though, that depression can affect the course of the disease, with mortality rates 25% to 39% higher in cancer patients who are also depressed. So it would appear that the two are linked such that cancer diagnosis can induce depression and depression can reduce the prognosis for recovery.

Many cancer patients pray to help cope with the disease, but it is not known if prayer is in any way affective in helping the patients with either depression or with dealing with cancer and its treatment. In today’s Research News article “Types of prayer and depressive symptoms among cancer patients: the mediating role of rumination and social support”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1074914312532494/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183194/

John Perez and colleagues investigated the relationship between different kinds of prayer and depression in cancer patients and find that certain types of prayer are associated with lower depression in these patients.

They investigated eight different types of prayer—adoration, confession, reception, supplication, thanksgiving, prayer for one’s physical health, prayer for emotional strength, and prayer for others’ well-being. They found that more adoration prayer, reception prayer, thanksgiving prayer, and prayer for the well-being of others the lower the level of depression.

In looking deeper at the pattern of results they determined that prayers of thanksgiving acted by decreasing ruminative self-focused attention which in turn reduced depression. It would make sense that prayer that helped focus the patient on what they are thankful for in life would result in an increase in positive emotions and a decrease in the time spent ruminating about the cancer, leading to lower depression.

They also found that that prayer for the well-being of others was directly associated with lower depression and indirectly by being positively related to social support which is in turn associated with reduced depression. Praying for others directs attention away from the patient toward the problems of others. This can help provide a perspective on their problems with cancer and thereby reduce the depression. People who are thinking of the well-being of others tend to be better cared about and liked by others. The increase in the social support for them may follow. If someone cares about others, others care about them.

Reception and adoration prayer are both forms of contemplative prayer which is a form of meditation. Mindfulness meditation has been shown to improve the negative psychological issues that can go along with a cancer diagnosis http://contemplative-studies.org/wp/index.php/2015/07/17/tackle-cancer-with-mindfulness/. So engaging in these forms of prayer may work through the same mechanism as meditation in improving the mood of cancer patients.

Hence it appears that the common response of cancer patients to pray is more than just an expression of religious faith. It has a positive impact on the patient’s psychological well-being which is known to improve the prognosis for recovery.

So, pray when cancer is diagnosed, reduce depression, and increase survival chances.

CMCS

 

Why are we Spiritual/Religious?

Spirituality/Religion are characteristic of humans from the earliest recorded history. Even today in an increasingly material world with all of the advances of science, Spirituality/Religion persists and in some areas thrives. In addition, as people get older they become more and more spiritual or religious. What accounts for its pervasiveness? Why is it so ubiquitous in wide ranging societies from primitive to very advanced, widespread areas throughout the globe, and over wildly different eras of recorded history?

I believe that the pervasiveness of Spirituality/Religion results from an ever-present unchanging awareness. When looking at our sensory experience we come to realize that there is something that appears to be seeing, hearing, touching, tasting smelling, feeling. There is something that seems to be looking out through our eyes, listening through our ears, etc. There seems to be something there that is constantly witnessing whatever is going on in the environment. There even appears to be something there that is listening to our thoughts and internal speech, that’s observing us reviewing our memories, and that’s watching us plan for the future.

Whatever it is, it appears to be always present and always the same. As we’ve aged it’s always been there and has never seemed to vary. When we were a child we had the same awareness that we now have as adults. Our ability to think, our storehouse of knowledge and experiences, our wisdom, our bodies, and our emotions have all changed over the years. But that which is witnessing it all has never changed.

This internal entity appears to be making decisions and guiding behavior. It is the unseen chooser. It is the ever present director of our actions. It is what’s responsible for our volition, our free will. It doesn’t actually guide the details of action. These seem to be well learned and have become automatic. Rather, it appears to be what lies beneath making the decisions and guiding and directing the general course of our actions.

It is that never changing sense of presence, of being, of watching, of willing, of choosing that makes us feel that there has to be more than simply physical existence. We experience it as something that transcends the physical, something that cannot be simply explained by biology, physics, and chemistry, something that isn’t just a very complex computational device in action. It is the underlying awareness, presence, and being that just seems to be our spiritual self.

We are aware of this even if we can’t put our fingers on it exactly. There just seems to be something enduring and special about us that transcends the physical. This leaves us in a quandary. We can understand and work with the material world. But, how can we grasp awareness? What does it all mean?

This is where religion comes in. It provides an explanation for where it comes from what it is, and where it’s going. This can be very comforting. If we can’t quite accept someone else’s explanation as outlined in the texts or dogma of the religion, then the approaches of eastern spirituality become a solution. We can seek out an understanding through contemplative practices. These approaches do not provide answers but produce comfort by providing a methodology, the answers can be found through internal reflection.

All of this is not necessarily processed in a logical way or even in a conscious way. But regardless, the urge to grasp and understand our being is compelling. It motivates the need for a frame of reference for existence. Spirituality/Religion provides that. It always has and probably always will. Right or wrong, it satisfies a very basic human need and so is likely to continue far into the future.

CMCS

Spirituality Improves End of Life

Death in inevitable, but that does not mean that it has to be awful. We don’t know how or when we will die, but we will die. It could be sudden or gradual or prolonged. We don’t know which it will be. But, regardless, how we approach it makes a huge difference.

Suzuki Roshi at the end of his life was in excruciating pain from cancer yet he told everyone around him “Don’t worry, It’s just Buddha suffering”. He passed with a smile on his face. Augustus Montague Toplady, the preacher author of the hymn “Rock of Ages” dying from tuberculosis said “”Oh, what delights! Who can fathom the joy of the third heaven? The sky is clear, there is no cloud; come Lord Jesus, come quickly!” These stories exemplify how our religiousness and spirituality can influence the quality of our passing.

In today’s Research News article “Religion, Senescence, and Mental Health: The End of Life Is Not the End of Hope”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1051111154912810/?type=1&theater

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4357420/

Van Ness & Larson showed that individuals with high levels of religiousness/spirituality had significantly higher levels of well-being and were less likely to be depressed or suicidal at the end of life.

Americans 65+ portray themselves as more religious than do their younger counterparts. Hence it would appear that people understand that religiousness/spirituality can help in confronting end of life. But, how exactly does religiousness/spirituality help when dealing with eminent death?

Religiousness/spirituality can function by providing hope that helps the individual overcome increasing disease, disability, and emotional difficulties. Indeed, it has been shown that people high in religiousness/spirituality are significantly lower in hopelessness. This hope may take the form of belief in a life after death, reincarnation, or rebirth. Such a hope may be interpretable as a symbol of personal integrity that survives the indignities of illness, disability, and dissolution. This can be a great comfort to the dying person improving well-being and decreasing depression.

Religiousness/spirituality in older individuals is associated with a higher sense of well-being. This in turn can help the individual cope with the afflictions and challenges they face as death approaches. It can also help to bring families and communities to the dying process. It is often these connections that are the most important to the dying.

When approaching death, religiousness/spirituality can provide the structure to grapple with the basic questions of existence. Without it the person may experience spiritual distress. “When our bodies are under assault from disease or illness and our minds are reeling from the threat of disability or death, our spirit is there to hold it all together.” (Rev. Dr. Walter J. Smith).

So, practice religiousness/spirituality to be better prepared for death.

CMCS

Does spirituality account for mindfulness’ anti-depressive effects.

Mindfulness training has physical, psychological, emotional, and spiritual components. Mindfulness-Based Stress Reduction (MBSR) is even more complex as it contains yoga and body scan in addition to meditation. Because of the complexity and the variety of effects of these practices it is difficult to know which components are effective in promoting well-being and which are not.

In today’s Research News article “Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age.”

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1046335465390379/?type=1&theater

It is well established that MBSR is quite effective in treating and preventing depression. But it is not clear who benefits the most and what characteristics of the individual might be related to MBSR effectiveness. Greeson and colleagues investigate this question, particularly whether spirituality and religiosity or other demographic characteristics might be important for MBSR effects on depression. They demonstrate that MBSR acts independent of these other characteristics; it works regardless of level of spirituality or religiousness.

These results should not be surprising as chronic depression, as opposed to reactive depression, appears to be primarily physiologically based. It appears to be a problem with neurotransmitter balance in the central nervous system and is highly related to genetic inheritance. So, it is not surprising that behavioral and psychological characteristics such as  spirituality and religiousness would not be associated with effective treatment.

MBSR, like all contemplative practices, has marked physiological effects. It is known to change the nervous system, increasing the size of some areas, decreasing others, and altering connectivity. It also changes hormonal balances and activity in the peripheral nervous system producing greater calm and lower arousal. It is likely that these physiological effects of MBSR are responsible for its effectiveness in treating depression.

This is not to discount the importance of spirituality and religiousness. They can be very helpful with a number of conditions. Had Greeson and colleagues investigated MBSR effects on more experientially based psychological problems, such as eating disorders or panic disorder, they might have seen a large impact of spirituality and religiousness.

It is clear though that depression can be treated effectively with Mindfulness-Based Stress Reduction.

CMCS