Depression And Our Forgotten Magnificence

Forty-one-year-old art historian "Elizabeth" knew that something beyond the pain she was feeling in her joints was wrong, but she didn't know what it was. She rarely thought about Tom anymore, but the unexpressed grief she had felt after the breakup of their marriage three years earlier had frozen into depression characterized by numbness.

When Elizabeth's mother died unexpectedly of a heart attack two years later, she watched her younger sister go to pieces at the funeral and wondered why she also didn't cry, why, in fact, she felt nothing. But though she didn't mourn her mother, she had trouble getting out of bed and was often late for work or called in sick. She decided to take a leave of absence from the museum where she was a curator to work on her medical problems-and never went back. The money her mother had left her paid off the mortgage and covered most of her monthly expenses, and she added a little extra with occasional freelance jobs writing catalog copy. She underwent a series of tests to determine the source of her problems, and when they came back negative, she felt even worse.

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Grief is an important emotion, a cleansing emotion that comes as a natural response to loss. Our tears can refresh our spirit, emptying out old, held-in pain. When we deny our grief, depression may show up in our body as physical symptoms. This is the condition in which Elizabeth found herself. Her depression is the most commonly experienced form, known as dysthymia. Like a low-grade fever that never goes away, dysthymia colors our perceptions about the world. A person suffering from dysthymia can function in her job, may have friends and relationships and what appears to be a satisfying life. She may hardly be aware of the absence of joy in her life, because most likely she's rarely known anything else. She may speak softly, her breath may be shallow, and her shoulders may slump. Her lack of zest and enthusiasm seems almost a natural outgrowth of her personality.

Five years after the end of her marriage, two years after her mother died, Elizabeth's depression had become her way of life. Her house, which she had enjoyed decorating when she'd bought it seven years earlier, deteriorated. She didn't call the plumber when her toilet leaked, and the hardwood of her bathroom floor darkened and warped. She rarely changed her sheets and almost never made the bed. Most of the time her shutters stayed closed against the Arizona sun, and when her dishwasher, then her disposal broke down, she didn't bother to have them fixed. Elizabeth was experiencing an episode of major depression, common to those who suffer dysthymia. She began psychotherapy and tried a number of different antidepressants. The combination eventually brought her out of the major depressive episode, but her life still felt joyless and empty.

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Elizabeth was not alone in her feelings of emptiness. "Living in this mortal body," said the Buddha, "is like living in a house on fire." We suffer. We have always suffered. So why do we see statistics for depression tripling in the years since World War II? When Eli Lilly in 1987 introduced Prozac, the first selective serotonin-reuptake inhibitor (SSRI), it was going to revolutionize the treatment of depression. Millions of people worldwide take this or one of the newer SSRIs, and in 1988, after several years of suffering from dysthymia, I became one of them. Within several months I felt well enough to begin a yoga practice. It changed my life. After a year of daily hatha I no longer needed Prozac or any other medication. A few years later I became a certified teacher in Kripalu Yoga. Since then, in addition to researching and writing about why yoga helped me return to a sense of emotional well-being without medication, I've been passionate about sharing the practices that have helped me and hundreds of my students recover from depression.

Despite the revolutionary claims for the new SSRIs, according to the World Health Organization suicide is now the fourth-leading cause of death in the world, and by the year 2020 suicide is expected to be the second-leading killer. Why? Is it that the stressors inherent in our modern culture are the source of an international serotonin deficiency, causing depression in epidemic proportions? Is the species mind of our postmodern world depressed?

If so, there may be good reason for this-it may be the flip side of our ever-advancing technological culture. From the beginning of the Christian era, it took 1,500 years for our collective knowledge of the universe to double. Currently, scientists estimate that our collective knowledge doubles every eighteen months. But with that increased information, we have lost the sense of how it is interconnected, of what it means. Some of us carry that loss of meaning in the form of psychiatric symptoms. Many of us carry that loss of meaning in the form of depression. We are suffering in epidemic proportions-as individuals, as a community, and as a culture. We may have more information, but we have lost the sense of who we are.

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The ancient Sanskrit texts call this sense of loss avidya--ignorance. And they tell us that through the practice of yoga we can awaken to the knowledge that we have lost nothing. There is only one soul, they say, one consciousness, whether we are in human form in this lifetime or not. That is our true nature.

Hatha yoga helps us awaken to our true nature through the physical practice of asana and pranayama, through the healing power of deep relaxation and meditation, and through the therapeutic effects of sound and chanting. But the most essential component in this awakening is the container of self-awareness we build through the practices.

There is a difference between the Western therapeutic model of depression, which looks at trying to "fix" it, and the yogic tradition, which allows us to remember our true nature through the daily practice of yoga. Each time we step on our yoga mat, sit down to meditate, or chant our favorite bhajan, we are given the opportunity to remember who we really are. As we do the practices we are reminded that we are not our body, not our emotions, not our job, not our house, not our desires, not our failures or successes, not even our thoughts. We may love our job, our house, our family, and our friends, but we are not any of these. Our everyday yoga practice brings us home, allows us to abide in our natural state, that universal place inside ourselves--changeless, eternal, whole--a place that contains and embraces all the emotions. The ancient yogis called it Atman, or Self with a capital S.

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This is not to say that we should toss our antidepressants into the trash. But when we look at the rising statistics on depression and the growing number of suicides, especially among young people, it is clear that antidepressants aren't the answer for the species mind. They aren't even the real answer for the individual mind. We're treating the symptoms when we take our Paxil or our St. John's wort, but we're not addressing the root of our suffering. We are not meeting our suffering at its source. Biomedicine treats symptoms. It treats the tumor, the virus, the infection, but it doesn't treat the whole person. It does not make whole what has been severed.

Talk therapy is a vital component in our understanding of ourselves and our individual recovery from depression and other psychological disturbances, but it too has its limits. Most psychologists agree that the seeds for depression are sewn in infancy through patterns of relationships with significant others, prior to the acquisition of language. And research shows that when we suffer trauma it is mostly the lower, more primitive parts of the brain that are involved. According to Maryanna Eckberg, Ph.D., a psychologist who treats survivors of abuse, "A body-oriented treatment model speaks the language of these areas of the brain-sensation, perceptual experience, and somatic responses. Cognitive restructuring is, of course, important, but the healing process must also include bodily experience."

Because yoga has the potential to treat the whole person, the road to recovery from depression may very well be finding the balance of medication, talk therapy, and yoga that works for you. There are, to be sure, some yoga masters who, like Western medicine, address the symptoms, advocating a specific practice for depression, which keeps the introspection to a minimum. But I prefer a "the only way out is through" approach for most of us who are grieving or who suffer from dysthymia. In the tradition in which I've received my primary training, the yoga mat itself becomes the place you show up with your whole self-your grieving self if you're grieving, your angry self if you're angry. And the practice itself brings the emotional body back into balance.

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In Swami Venkatesananda's translation of the the Yoga Sutra, Patanjali, the first codifier of yoga, says, "By study [not necessarily nor exclusively] of scriptures, and of oneself, the consciousness is united with the desired [or loved] divinity." Or as modern yogis have put it, "The highest spiritual practice is self-awareness." If you can begin to observe yourself on and off the mat, with love and acceptance, you are creating a container in which obstacles that block the free flow of thought and feeling will dissolve. In a yoga posture, you begin to do this by breathing into the area of the body where discomfort is strong. Instead of distracting yourself, as you may too often do in your ordinary life, you accept the sensation, breathing with it, as though it were your mantra. And as you stay with the sensation, watching, allowing thoughts and feelings to rise to the surface-"riding the wave," as Kripalu teachers like to say-you are often able to release the areas of tension in your body and mind. This is "the only way out is through" approach that, in combination with a well-designed set of asanas, pranayamas, and meditation, can alleviate your depression.

Self-awareness is also important. Whether you feel anxious and active in your depression or fogged in and passive, understanding the subtleties of your state of mind is important. Are there manic aspects to your depression? Is your depression accompanied by anxiety? Or are you feeling listless and depleted? It is vital to understand these subtleties if you are going to meet the depression where you are. An active, anxious mind will reject any attempt to immediately relax. And a mind numbed by melancholia will reject any attempt to suddenly perk up. "Meeting the depression," says Richard Miller, clinical psychologist and international yoga teacher in the lineage of Krishnamacharya and T. K. V. Desikachar, "means hanging out in the chaos and then slowly introducing alternatives."

In other words, in order to choose which practices will be most effective for you, it's important to think about your depression and understand the nature of your state of mind. If you have too much energy, as in anxiety or mania, you may feel more comfortable beginning with an active practice that matches your state of mind, and then gradually, over the course of your session, slowing down until you are using soothing and calming postures and breathing exercises and are finally able to relax fully. On the other hand, if your depression is characterized by a lack of prana (energy), you may feel more comfortable if you begin with a posture that closely follows your own (perhaps shallow) breath. Then gradually, over the course of your session, you can begin to introduce a more expansive movement with a more active breath, and work slowly towards an energizing practice that awakens your prana.

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We can see all of the elements of a strong yoga practice-the healthy container of self-awareness, the physical practice that meets the depression, and a willingness to stay present with all that comes up-in the way in which Elizabeth handled her depression. When she entered my class two years ago, I was not aware of her beauty. She shielded her face with her long brown hair, and her shoulders slumped forward as though she were trying to conceal her heart. During the class, while other students were actively pumping their bellies in kapalabhati (skull-shining breath), with its passive inhalations and forceful exhalations through the nostrils while snapping the navel towards the spine, Elizabeth's diaphragm remained still. After class, she asked if I would work with her privately, and over the course of several weeks we found that a slow, gentle practice with longer holdings, some dynamic movements, and energizing breathing exercises worked best to alleviate her symptoms. I encouraged her to accept herself as she looked on her mat, even if she felt depressed or numb. In so doing, she has learned to meet her feelings of depression with her practice.

Elizabeth begins slowly in a seated meditation, focusing on the breath, and scanning both her physical and emotional bodies to determine the kind of practice she needs. If she is feeling lethargic, she simply watches the way her mood is affecting her breath. Most often her breath is shallow, and when this is the case she begins to deepen it, gradually expanding her lungs with dirga pranayama (three-part breath), breathing into the bottom of the lungs and expanding the pelvic region and belly, then into the midsection of the lungs, then all the way up to the clavicle. Anuloma krama, from the Viniyoga tradition, is another slow but energizing breath with which she likes to begin her pranayama practice. In this breath, she fills the chest with half the inhalation, holding for four seconds, then expands the pelvic region with the breath, holding for four seconds, then pours the breath out. As Elizabeth's energy begins to increase during a session, she can practice more energizing breaths like kapalabhati. And she often, by now, feels strong enough to begin a posture flow, often starting with some energizing, standing breaths.

Elizabeth enjoys practicing long holdings. She holds a posture like tadasana (mountain pose) or vira bhadrasana (warrior pose) in order to witness all the feelings she is experiencing with equanimity and awareness, without reaction. Holding gives her the opportunity to notice the places in the body where energy is blocked, where emotion or even trauma is stored. These energy blocks show up as strong sensation, and eventually they can lead to symptoms and then illness, both physical and mental. By focusing the breath and the awareness where the sensation is strongest, Elizabeth has begun to allow energy to flow through the areas of her body where she feels blocked.

In her practice, slow and steady works best for Elizabeth. "Yoga short-circuits the downward spiral for me," she told me a year into our work together. "Yoga makes me feel less hateful toward my body, mind, and emotions." One day, while we were working together, Elizabeth was holding pashchimottanasana (seated forward bend) for an extended period of time. Eventually she moved into a relaxed position with her spine somewhat rounded, her arms slack and her belly soft, a posture that more or less duplicates her own stance when she is depressed. I coached her to become aware of the physical sensations, to breathe into the places where the energy felt blocked, and to watch the feelings that arose in the emotional body. After she had been in a relaxed state for some time, her back showed the signs of deep breathing, her legs began to tremble, and she started to cry. She had experienced a flash of memory from early childhood, when she had seen her beloved terrier run over by a car. A few moments later, she felt hot white light in her thighs and groin area and a pleasant burning in her sacrum. The tears were still flowing as she re-leased the posture, but the lines that usually tightened her face had softened. From the forward bend, she spontaneously moved into matsyasana (fish pose) in a prone position, lifting her chest and rolling onto the crown of her head. As she released down into shavasana (corpse pose) tears were still rolling down her cheeks, but now her face was radiant. Gradually, as she took long, deep ujjayi (ocean sounding) breaths, her tears subsided, and it was then that I could truly see her beauty. With her eyes closed, she was smiling, and when she opened her eyes she described her state as blissful. Elizabeth was experiencing her wholeness, the place beneath and beyond her depression, where she was no longer separate from her authentic Self. In the long holding of pashchimottanasana she had experienced her suffering and released it. Later she was able to describe the experience more fully. Holding pashchimottanasana, she had remembered her taciturn grandmother admonishing her not to cry. When she released her long-held-in grief for her dog, repressed feelings of grief for other more current losses in her life came with it-all of which she processed with her therapist later that week.

That day in pashchimottanasana was the beginning of Elizabeth's recovery from depression. She felt more open to give and receive love at a deeper level. The daily practice of asana and pranayama within the container of loving self-awareness had prepared her for sitting with and then moving through her depression. In practice together, we hadn't avoided her pain but worked with it as it showed up in her body. In class, her affect was entirely transformed. Her posture was straighter, her voice was stronger, and she greeted the other practitioners when she entered the room. Within a month, she told me that she was in a new relationship and feeling more open and willing to surrender than she ever had before.

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No matter what form of depression you or your students may suffer from, self-awareness and acceptance are the two essential elements for developing control over your symptoms. Cultivating both elements will, over time, allow you to embrace the you who may sometimes be depressed, and this will lead to your recovery. Both self-awareness and self-acceptance grow with practice. All of the practitioners I have interviewed for my book on yoga and depression owe their improve-ment, in part, to their growing ability to accept themselves, through the practice of yoga, no matter how chaotic or tormented their mental state.

But how, after a lifetime spent listening to your inner critic, of judging yourself too harshly, of feeling ashamed because you suffer from depression, do you suddenly begin to love yourself? Self-acceptance isn't automatic just because your yoga teacher encourages you to love yourself. It doesn't happen just because you repeat affirmations. Learning to love yourself happens slowly, over time.

After two years of daily practice, Elizabeth has learned to stay open to her feelings. She experiences her grief directly, and also her joy. What she now understands is that she can contain it all. Her practice has instilled in her an abiding sense of Self that is based on the knowledge of her wholeness, an understanding that she is not separate from the universe. In the moments when the old negative thinking and the self-doubts reassert themselves, the strong container of her practice allows her to embrace it all.o

Amy Weintraub, RYT, MFA, has written extensively on yoga and depression for many magazines, including Psychology Today and Yoga Journal. She is an award-winning fiction writer, who teaches yoga and writing in Tucson. Her book on yoga and depression, Compassionate Practice, is due out from Broadway Books in 2004.
We thank Amy for her kind permission in allowing us to print this articlewhich appeared in Yoga International Magazine.