Depression The Mindful Way Out How to pay attention to change your mood
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1 Depression The Mindful Way Out How to pay attention to change your mood Richard W. Sears, PsyD, PhD, MBA, ABPP Clinical/Research Faculty, UC Center for Integrative Health & Wellness Vol Assoc Prof, UC Clinical Psychiatry & Neurosciences
2 The Problem of Depressive Relapse The more you get depressed, the higher the chances of getting depressed AGAIN After 2 nd episode, 70-80% relapse rate First and second episodes tend to occur after something stressful happens After that, depression takes on a life of it s own
3 Triggers for Depressive Relapse Takes longer to pull out of dips in mood Sad moods trigger negative thoughts, attitudes, and beliefs Leads to withdrawal & reduced activity Then more depression
4 Mindfulness-Based Cognitive Therapy (MBCT) MBCT cuts relapse rates in half for those with 3 or more episodes (Hofmann, Sawyer, Witt, & Oh, 2010; Kuyken, Crane, & Dalgleish, 2012; Ma & Teasdale, 2004; Piet & Hougaard, 2011; Teasdale, Segal, & Williams,1995; Teasdale, Segal, Williams, Ridgeway, Soulsby, & Lau, 2000; Williams & Kuyken, 2012) MBCT on par with maintenance antidepressant medication (Kuyken, Byford, Byng, Dalgleish, Lewis, et al, 2010; Segal, Bieling, Young, McQueen, Cooke, et. al., 2010)
5 What is Mindfulness? the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment to moment (Kabat-Zinn, 2003, p. 145)
6 What is Mindfulness? How it Works Noticing worry/rumination, feeling the body Exposure therapy Swimming pool analogy Decentering/Defusion I have thoughts Attention in the moment vs. avoidance Self-compassion attitude of kindness toward one s own thoughts, emotions, & body sensations Need for Systematic Training 8-week Programs Home Practice
7 How Mindfulness is Different Transcendental/Absorption Meditation Hypnosis Relaxation Methods
8 What is Mindfulness? Mindfulness-Based Stress Reduction (MBSR) Mindfulness-Based Cognitive Therapy (MBCT) Dialectical Behavioral Therapy (DBT) Acceptance and Commitment Therapy (ACT) Mindfulness-Based Relapse Prevention (MBRP) Mindfulness-Based Eating Awareness Training Mindfulness-Based Elder Care (MBEC) Mindfulness-Based Childbirth & Parenting (MBCP)
9 Mindfulness-Based Stress Reduction (MBSR) Pioneered by Jon Kabat-Zinn (Full Catastrophe Living) 8-week program Large groups Daily homework Incorporates yoga Initially used for stress and chronic pain
10 Mindfulness-Based Cognitive Therapy (MBCT) Pioneered by Segal, Teasdale, & Williams 8-week program, based on MBSR Smaller groups Daily home practice Elements of cognitive therapy (recognizing thought distortions, relapse prevention plan, etc) Initially used for prevention of depressive relapse
11 MBCT Principles First step is just to notice what is, then responding rather than reacting Noticing vs. arguing with thoughts Paying attention to signs of oncoming stress or depression (instead of avoidance) allows you to take action
12 Studies using MBCT Prevention of Depressive Relapse Stress, Anxiety Chronic Pain Cancer PTSD Children (MBCT-C) Bipolar Disorder
13 MBCT Books The Mindful Way Through Depression By Williams, Teasdale, Segal, & Kabat-Zinn Guilford Press The Mindful Way Workbook By Teasdale, Williams, & Segal Guilford Press Mindfulness: Living Through Challenges and Enriching Your Life in This Moment By Sears Wiley-Blackwell
14 MBCT Session Outline 1: Awareness and Automatic Pilot 2: Living in Our Heads 3: Gathering the Scattered Mind 4: Recognizing Aversion 5: Allowing/Letting Be 6: Thoughts are Not Facts 7: How Can I Best Take Care of Myself? 8: Maintaining and Extending New Learning
15 3 Minute Breathing Space Minute 1- Notice what is here: o Body sensations o Feelings/emotions o Thoughts Suspending judgments it s already here, just let me feel it
16 3 Minute Breathing Space Minute 2 Focusing on the breath o Pay attention to one spot rising and falling of abdomen, nostrils, etc o Mind wanders, just gently bring it back, again and again
17 3 Minute Breathing Space Minute 3 Expand awareness Expand from breath to body-as-a-whole
18 Session 7: How Can I Best Take Care of Myself? Home practice review Links between activity and mood o Write down a list of daily activities
19 Session 7: How Can I Best Take Care of Myself? N = Nourishing D = Draining
20 Session 7: How Can I Best Take Care of Myself? Pleasure vs. mastery Generate a list for you Plan how to schedule
21 Session 7: How Can I Best Take Care of Myself? 3-mbs action step o o o Do something pleasurable. Do something that will give a sense of satisfaction or accomplishment. Act mindfully.
22 Session 7: How Can I Best Take Care of Myself? Identify early warning signs Action plan to deal with signs of relapse
23 Questions/Comments?
24 Contact Info Richard W. Sears, PsyD Clinical Psychologist
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