An Interview with Dr. Andrew Weil about Depression

One reason Andrew Weil, M.D., the “father of integrative medicine,” wrote his new book, Spontaneous Happiness, is that the most searched-for term on DrWeil.com is “depression.”

It’s the common cold of modern emotional life. And he thinks we’re thinking about it all wrong. Yes, an imbalance of brain chemicals can trigger depression, but it goes the other way, too: An imbalance of thoughts and habits can change your brain to make depression more likely – – or less likely.

Dr. Weil believes an approach that integrates healthy habits of the body, mind and spirit can play a key role in preventing and alleviating mild to moderate depression. It can foster emotional well-being — and happiness.

Like all of his books, Spontaneous Happiness is a refreshing combination of clarity, science and practical wisdom. But it’s also warm and, indeed, personal: Dr. Weil includes not only anecdotes from people who’ve written to him over the years, but also his own experience in battling mild depression.

What is spontaneous happiness?

I use spontaneous happiness to call attention to the fact that happiness is something that comes from inside. It doesn’t come from getting something you don’t have. You can’t expect to be happy all the time, but you can open yourself up to the possibility of happiness.

A better goal than happiness, actually, is contentment. Contentment is an inner feeling, and it is something that can be cultivated.

Is depression always bad?

I don’t think depression is all bad. Our moods are supposed to vary. We’re supposed to have positive and negative moods. I’m not talking about incapacitating depression. But mild or moderate depression can lead to an inward focus and rumination that may help you solve problems. That’s why depression is often associated with creativity.

Is depression on the rise?

We are witnessing an unprecedented epidemic of depression in this country, mostly mild or moderate. Some may be due to the pharmaceutical industry influence, but maybe only a quarter or so. There’s still a lot of depression to be accounted for. There are many factors: increasing social isolation, disconnection from nature, information overload.

You can’t find cases of severe depression in hunter-gatherer societies. What’s different about them? Almost everything! They eat differently, connect to nature every day and have strong tribal social support. Discontent correlates with affluence — the more people have, the more they are discontent.

Are women more prone to depression than men?

Hormones do play a role. Before puberty, the rate of depression in boys and girls is the same. After puberty, the rates rise [for females]. So, women are more susceptible to depression. That means they should be especially vigilant about their moods, and take this information and put it into practice.

Why is the idea that the mind can affect the body such an important concept?

Changing the way you think and perceive can change the structure and function of the brain. Not to deny brain chemistry, but it’s only one of many factors in depression. Most of psychiatry today only looks at brain chemistry, and so the only solution is drugs. And the drugs don’t even work that well. Physical activity and supplemental fish oil work as well as antidepressant medications.
There are other things you can do, and some are so simple. I was amazed in researching this book how much scientific evidence there is for the power of feeling and expressing gratitude to create lasting changes in mood.

What do you wish primary care physicians would do when someone comes in with mild or moderate depression?

Before reflexively prescribing a drug, I’d like them to look at the person’s lifestyle. Look at all the factors before resorting to medication. Severe depression can be life threatening, and requires medical management, and maybe medication. But even here, I’d like it to be limited to a year, and then [the doctor] should work with the patient to get off the medication and substitute other measures.

You recommend mindfulness for emotional well-being. What is mindfulness?

Mindfulness is the practice of bringing full attention to the present moment. Mindful eating, for example, means eating not in front of the TV or in your car. It means putting the food in your mouth and tasting it. One reason we have an epidemic of obesity is that so much eating is unconscious.

Can mindfulness training be part of the treatment of depression?

Mindfulness is movement that started with the Dalai Lama and collaborations with neuroscientists and Buddhist monks and teachers. They’ve shown that practices like meditation and forgiveness change brain function — and that these practices can be taught.
Mindfulness is now being integrated into cognitive behavioral therapy (CBT). This is very effective for the treatment of depression. It is also very cost efficient and time efficient.

What is the emotional benefit of a “media holiday”?

Addictive listening to and watching news often makes people feel angry, anxious and powerless. It’s not necessary — you can stay informed without it. You can have control over how much you let into your life. Many people tell me that just reducing that input has had major positive benefits on their emotional well-being.

Can silence improve emotional well-being?

Many people aren’t aware how powerful an influence noise is on the nervous system. It really works to cultivate silence.

What do you do every day to foster emotional well-being?
Every day, I try to get physical activity, spend time in nature and get enough good-quality sleep. I follow an anti-inflammatory diet and take fish oil. I meditate and do breathing exercises. And since writing this book, I make notes of things to be grateful for and remember. I also seek out the company of people who are positive. There is very strong evidence that depression is contagious, and so is happiness.

Watch this T.V. Interview where Dr. Weil talks about depression

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Mindful On The Job

 

Work is about a search for daily meaning as well as daily bread, for recognition as well as cash, for astonishment rather than torpor; in short, for a sort of life rather than a Monday through Friday sort of dying – Studs Turkel, author

Sunday night rolls around all too quickly.  The weekend, if we actually give ourselves a break from our jobs, can’t often prepare us for the frenzy of the week’s activity at the office that awaits us.  If we like our jobs as lawyers – and granted there are alot of us who do – we still may feel it’s half-baked- “it still could be better” we think to ourselves.

Michael Carroll, author of the book, Awake at Work, was employed at such places as Shearson Lehman, American Express and The Walt Disney Company.  More recently, he has been a consultant and coach to such companies as Starbucks and Proctor and Gamble.  His comments, into what workers really want out of their jobs, is insightful to the lives of lawyers on the job:

“In my role as a business consultant, I regularly ask my clients to complete the following sentence with the first word that comes to mind:

At work, I want to be. . .

While my survey is not scientifically reliable, I can report there are some patterns to the responses.  Here are the four most frequent answers:

  • Successful
  • Happy
  • Rewarded
  • Stress-free

Such responses come as no surprise.  Given the demands, risks and relentless pace of our modern-day workplace, it is little wonder that most of us would like a little stress-free happiness on occasion.  Rewards and success-isn’t that what we are all looking for at work?”

Who can’t relate to that take on the legal profession?  Whether we are happy in our jobs or not, we all think about how we can embrace more of these intangibles while at the office.

Carroll, in addition to being in the business world for the past forty-four years, is a long-time meditator and proponent of mindfulness meditation.  Here’s a great introduction to what Mindfulness is about:

You don’t have to be a Buddha sitting in a lotus garden to appreciate this fundamental and simple way of approaching your day.  It’s not so much a different way of doing and accomplishing stuff; lawyers are great at that.  Rather, it’s a different way of seeing at work.  Moreover, seeing via a discipline of mindfulness meditation, seeks to plant our feet directly on the carpet. It’s not so much about being alert and wired to the swirling stimuli peppering us from every angle.  It’s taking a time-out and leaning against the wall; it’s about letting the other half of our brain complement our eagerness to get things done.

Coming back to Michael Carroll’s survey about what people want out of their work, he opines that it’s not really success, happiness, being reward and a stress-free work-life: 

“My survey indicates that most of us think we want to happy, successful, and to be stress-free at work, but we also know that such aspirations are wishful thinking.  We all know work offers both success and failure; happiness and angst.  We know that work, indeed all of life, unavoidably presents both rewards and penalties; joys and disappoints. So, while most of us wish to be happy and successful at work, what we really want, from my vantage point, is to be confident: confident that no matter what work offers up, we remain self-assured and at our ease.”

In my experience, truer words were never spoken. As lawyers, there is a wonderful sense we get about our craft when we achieve a certain level of competence and feel that we can handle whatever down the pike.  We can acheive this sense of competence not just through the nuts and bolts of accomplishments in the courtroom, but through practice as sense of presence in our daily lives.

Explore how mindfulness meditation can help you at the office.  Also, for those so inclined, check out the wonderful book, which I’ve previously raved about, The Mindfulway Through Depression.  It’s not only for those with depression, but suitable for anyone who struggles with a sense of dissatisfaction and/or unhappiness at work.

Zen and the Art of Lawyer Maintenance

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I grew up in the seventies; 1979 was the year of my high school graduation.  Next weekend, I will be going to my 30th high school reunion.  How time flies, no?  One book from the seventies that made a big impact on me was Zen and the Art of Motorcycle Maintenance by Robert M. Pirsig. 

The book is about the author and his young son’s 17-day motorcycle journey across the United States.  The trip is filled with a number of philosophical discussions by the author where he explores the meaning and concepts of quality.  His approach is that quality has to do with a non-intellectualizing, non-conceptualizing, Zen-like direct view of the universe.  Yet he also argues that Western rationality is just as important in seeking understanding.

I like Pirsig’s approach as it applies not only to the practice of law, but depression as well.  We need the approaches taken by Western rationality – medication, psychotherapy, etc.  But the legal profession would do well to heed some of the advice from the East and its approaches to depression.

In The Mindful Way through Depression:  Freeing Yourself From Chronic Unhappiness, four uniquely qualified experts explain why our usual attempts to “think” our way out of depression or “just snap out of it” lead us deeper into a downward spiral where depression only worsens.  Through insightful lessons (and an included CD with guided meditations) drawn from both Eastern meditative traditions and cognitive therapy, they demonstrate how to sidestep the mental habits that lead to depression, including rumination and self-blame, so that one can face life’s challenges with greater resilience. 

The authors explain how our trying to outthink depression is problematic:

“When depression starts to pull us down, we often react, for very understandable reasons, by trying to get rid of our feelings by suppressing them or by trying to think our way out of them.  In the process we dredge up past regrets and conjure up future worries.  In our heads, we try this solution and that solution, and it doesn’t take long for us to start feeling bad for failing to come up with a way to alleviate the painful emotions we’re feeling.  We get lost in comparisons of where we are versus where we want to be, soon living almost entirely in our heads”

Lawyers, by the nature of our work, are required to live in their heads a lot.  Not only that, our thinking habits are prone to pessimism –we look for problems everywhere and try to fix them.   We are the ultimate “fixers”.  This can get us into trouble, however, if we are prone to or suffer from depression.   The authors point this out:

“Once negative memories, thoughts, and feelings, reactivated by unhappy moods, have forced their way into our consciousness, they produce two major effects. First, naturally enough, they increase our unhappiness, depressing mood even further.  Second, they will bring with them a set of seemingly urgent priorities for what the mind has absolutely got to focus on – our deficiencies and what we can do about them.  It is these priorities that dominate the mind and make it difficult to switch attention to anything else.  Thus we find ourselves compulsively trying over and over to get to the bottom of what is wrong with us as people, or with the way we live our lives, and fix it.”

The author’s solution to this virtual swampland of depression:  mindfulness.  The practice of mindfulness is actually quite simply to do and involves sitting in silence and watching our feelings and thoughts float by the stream of our consciousness.  But instead of taking them literally – that such depressing thoughts and feelings are REALITY – we just detach from them and let them continue to float down the river.  We stop trying to react to these states by stopping our attempts to try to fix them.  We move from a “doing mode” to a “being mode.”  We pay attention to a neutral experience – the in and out sensation of our breath.  When we notice a thought or feeling flowing by and see that we are getting embroiled with it, we let it go and return to our breath.  Check out this great video, “Mindfulness with Jon Kabit-Zinn.”

 In “The Zen Path through Depression”, Philip Martin advises us to stop running away from our depression and face it.  It can even provide us with a unique type of experience:

“In depression our back is often against the wall.  Indeed, nothing describes depression so well as that feeling of having nowhere to turn, nothing left to do.  Yet such a place is incredibly ripe, filled with possibility.  It gives us the opportunity to really pay attention and just see what happens.  When we’ve done everything, when nothing we know and believe seems to fit, there is finally the opportunity to see things anew, to look differently at what has become stale and familiar to us.  Sometimes when our back is against the wall, the best thing to do is to sit down and be quiet.”

Part of the quality of our lives, of maintaining ourselves, is learning and growth.  The ongoing pain of our depression is a wakeup call that we need to think about how we typically respond to our depression and how we might respond differently – by moving from a doing to a being mode. This can be achieved with mindfulness meditation.

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