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The Journal Gazette

Thursday, March 01, 2018 1:00 am

Depression relief - there's an app for that

Keri Wiginton

Keri Wiginton is a writer and photographer focusing on issues related to health, psychology and feminism. She wrote this for the Washington Post.

I've been on the wrong side of happy since I was 4, when my parents split up. I don't remember a sense of devastation, but I doubt this was a coincidence. An adverse childhood event such as divorce increases the risk of depression, especially when coupled with my father's history of mental illness.

Genes play a role in mood disorders, but they don't write your destiny – the same way having a family history of alcoholism doesn't mean you'll become an alcoholic. I had been moderately depressed my whole life. I seized control of it when I stopped blaming my history and focused on my brain, specifically the negative thought loops that were keeping me down.

Research shows that factors such as unfulfilling work and increasing isolation affect our mood, but the idea of making grand life changes such as quitting your job so you can toss your meds isn't a realistic option for most. And for many, such as me, that might not even do the trick.

I loved my first job. I worked with inspiring colleagues on meaningful projects, but the pressure of proving myself left me with butterflies in my stomach for a year. Anxiety worsened my depression, triggering a panic attack that left me gasping for air and feeling as though the world were disintegrating around me. A calming nurse and a prescription for Xanax may have saved my life.

Lifelong issue

It's hard to pinpoint when my depression started. I know my habit of ruminating – a risk factor for depression – started before I could tie my shoes. I worried about everything from the decimation of the rain forests to my family's safety. I was sure disaster would strike if I let my guard down.

But my first diagnosis didn't come until my final year of high school. After more than six months of spontaneous crying spells, bouts of paranoia and a diagnosis of irritable bowel syndrome, I told my mom I needed help. My father never got a handle on his mood, so I knew the warning signs. A psychiatrist diagnosed me with clinical depression at 17 and suggested Prozac, but I was hesitant to try it.

I managed without medication in college. My spells of gloom lasted only a few days at a time, but that changed soon enough. Anxiety plagued me once I started my career as a newspaper photojournalist. My depression settled in like a virus that wouldn't go away. I held out hope that I would spontaneously wake up energized. But day after day, I didn't heal. I still did all the things normal people did. I even got to do them while falling in love and pursuing my passion. But it felt as though I were trudging through every day with lead-filled boots and a rock on my chest. Knowing the world shouldn't feel so heavy made me feel even worse.

When I married at 29, I could no longer hide how depressed I was. My understanding husband urged me to seek outside help. It's not normal to want to lie in bed all the time, he accurately pointed out.

My despair was not the result of an underlying condition such as a thyroid disorder or hormone imbalance, my doctor told me. Efforts at positive lifestyle changes made little a difference; no amount of exercising or socializing made getting out of bed easier. Talk therapy was a bust, too – psychoanalysis never eased my symptoms. Somewhere along the way, I didn't develop the right coping skills.

These futile attempts led me to medication. I tried a selective-serotonin reuptake inhibitor for anxiety, but it didn't help with my depression. I did find a serotonin-norepinephrine reuptake inhibitor that eased my depressive episodes, but it failed to relieve my anxiety. And accompanying this new drug were side effects such as weight gain and constipation that I couldn't tolerate for a lifetime.

Medication is successful for some, and studies show it can be most effective for treating those with severe depression. Unfortunately, anti-depressants often provide inadequate relief for those with moderate depression.

Phoning it in

I decided to try meditation when pharmaceuticals let me down. A growing body of research supported the use of mindfulness techniques for preventing a depression relapse, and a friend of mine who battled anxiety had found relief through the practice.

I downloaded the Headspace app on my phone and set aside time to try it out. My mind felt jumbled for the first few 10-minutes sessions with Andy Puddicombe, the former Buddhist monk who guides listeners step by step through meditation.

But after about a week, I noticed a shift in my thinking. In the session, Puddicombe advised not stopping negative thoughts but rather pausing and noticing them, then returning focus to breathing. This helped me distance myself from the ideas in my head.

I stuck with it every day. A month later, my attention felt more solid. I could see my thoughts more clearly. I was struck by how often I was caught up in a negative thought loop: Was I doing well at work? Did I get new wrinkles? Is the economy going to crash? The more I observed this, the more I interrupted it before it spiraled out of control. I could see the worry, and I could let it go without dwelling.

Soon I realized I wasn't having these thought loops at all. I was taking back control of my mind and, by extension, my mood.

This breakthrough was huge. I had been clinically depressed for more than 15 years. I thought this disorder would last forever. No one had ever suggested that I could change these thought patterns that made me worried and anxious.

Meditation “kind of shows us how to step back from that thinking and that feeling and to actually witness it,” said Puddicombe, co-founder of Headspace. “As you dig into that, then even the feeling or the sensation of anxiety starts to break down a little bit and not feel so stark or so permanent.”

Rumination is when the brain gets caught up in negative thoughts as it tries to problem-solve and make unpleasant feelings go away, said Judson Brewer, director of research at the Center for Mindfulness at the University of Massachusetts Medical School. This process can be hard to let go of if you've been trapped in such thinking for a long time, even if you don't want to do it anymore.

“The familiarity of feeling anxious is comfortable because it's familiar,” said Brewer, a psychiatrist and the creator of the Unwinding Anxiety app. “Our brains really don't like things that are different, and so they can get anxious that they're not anxious.”

Research shows that depressed people might stay that way because it's part of their sense of self. Lifting my down mood was hard because it had been a part of my identity for so long. It was unpleasant, but it was what I was used to.

Before I became actively mindful, my worrying could go on for hours or days before a rapidly beating heart alerted me to my concerns. Anxiety led to depressive spells and nightmares. When I became more aware, I consciously halted my thoughts and returned my focus to the moment, stopping my roller coaster of reactions and improving my sleep.

After six months of training my mind I tapered off my antidepressant, with my doctor's help. Meditating every day is harder than taking a pill, but I find it more effective, there are no negative side effects, and I don't get withdrawal symptoms if I forget a session.

Increasing awareness with an app might seem counterintuitive, but using my phone responsibly – and having a psychiatrist and trained Buddhist monk at my fingertips – helps tend to my mental health daily. So far, it's working.