Updated: Oct 3, 2022
Today we're here with Sarah Vallely, mindfulness teacher, coach and author. Sarah has been teaching meditation and mindfulness for the past two decades training and certifying others to teach mindfulness as well. Sarah is the author of four books. Her latest book is titled time to dwell the 55 teachings of TSD mindfulness. On this episode, we discuss the mindfulness definitions of depression, the blues and sadness, how they are similar and how they differ. We also discuss practices and techniques that you can use to help you through these inevitable times in our life. This is Jacob Derossett, here with Sarah. How are you, Sarah?
I'm great, Jacob, thank you. There is A book called A Stolen Life. And it's a memoir about this woman who was abducted at age 11, I think, and she was held hostage and abused until she was 18 when she found her freedom. Ahe writes about how she became obsessed with pine cones. She figured out the reason she was so obsessed with pine cones, was because a pine cone was the last thing she looked at before she lost her freedom. I want to put that out to you all. What is your last memory before you realized this pandemic is going to be here for a while and it is going to change life as we know it?
I remember the moment I realized the pandemic is going to be around for a while. Before that, I just kept thinking, “Oh, in a week, we'll go back to normal.” And it actually took me a while to get to that point because I was working at a psychiatric treatment facility and we weren't wearing masks, we didn't have the patients wear masks because it was all too triggering. And honestly, that job was so intense, the pandemic took the back seat. We were dealing with runaways. We were putting foam pads on the wall between patients and the wall when they were doing head banging, we were trained to do takedowns. So it took me a little while for it to settle in that this pandemic was going to be around for a while and really affect our lives.
I remember being pretty debilitatingly anxious for myself and feeling really hopeless that everyone was going to try to ignore it. And it was going to be devastating. And I remember actually when everything shut down, I had a huge sense of relief. Prior to that I just remember feeling debilitating anxiety.
Before the pandemic, 8% of Americans were considered to have depression. About a month into the pandemic, April 2020, that rose to 28% of Americans having depression. That tripled. A year later, it even went up a little higher. April of 2021. It was 32% of Americans having depression; and the peak was in December 2020. Now we are at about 20% of Americans experiencing depression, which is still high. If we compare that to pre pandemic statistics of 8% of Americans having depression, now we're at 20%. We still haven't moved back to pre pandemic depression rates. And some of the contributing factors are little things that add up such as this past Christmas, a lot of travel plans were cancelled. Bigger things, such as, healthcare workers seeing hospitals return to similar situations as in 2020--and just starting to feel that sense of “Oh, this is happening all over again.” Some colleges going back online, which again, “Oh, no, not this, again,” kind of that retriggering feeling. I think it's fair to say that politics play a role no matter what side you're on, such as people who are not vaccinated and not able to go to certain establishments.
So there's a lot of contributing factors. For me personally, I have two teenagers and their father, my ex husband, has cancer. And so we are all being really careful and that definitely takes its toll on me personally--the isolation and not getting out and doing some of the things that I like to do. If you're listening and your mental health has maintained and you feel great, and the pandemic isn't affecting you in some of these ways that other Americans are affected, please keep listening because what we talk about today, in this episode, will help you better understand some of what the people in your life are going through who are having a hard time.
This episode is going to be about identifying whether you are experiencing depression, the blues or sadness, and how to use mindfulness to make that differentiation and how to use mindfulness to address the circumstances depending on if you're experiencing depression, the blues or sadness. The DSM V diagnostic criteria for depression is having five out of the eight symptoms of depression, during a two week period. I'm not in any way trying to overwrite the DSM V definition of depression, I'm going to offer something that you can tack on to this current definition. The TSD mindfulness definition of depression, which is in by no means a replacement for the DSM V is feeling difficult emotions, such as loss, pain, emptiness, rejection, and believing they are permanent.
Studies show we can hold four thoughts at a time in our consciousness. So let's imagine that over a five minute period of time, maybe we cycle through 10 thoughts. So the way I like to think about this is we have ten compartments that we can each have a thought in. If you're depressed, each one of those compartments is filled with a thought that has something to do with permanence. Thoughts such as, “There's no end,” “I'm doomed,” “I can't get out of this misery.” And so when we're in that place, sitting and practicing mindfulness doesn't make any sense, because we have bought into this idea of our discomfort being permanent. Imagine there's a rock that weighs a ton, and you can't move the rock no matter what. You wouldn't go over and try to move the rock because you know, you can't move it. That's kind of how we are when we're depressed. We probably aren't going to go sit and meditate because in our minds, we know it's not going to help.
The medical take on the difference between depression and the blues is how long it lasts and how much it affects your daily life. This mindfulness definition of the blues is a little bit different. Again, consider those 10 compartments with your thoughts. If we're having the blues, some of those compartments contain thoughts that have to do with permanence. “I'm doomed,” “I can't get out of misery,” “There's no end.” But some compartments have thoughts that have to do with impermanence. “This sucks, but I'll get through it.” “Maybe I'll feel better tomorrow.” “If I take a walk, I should feel better.” “One day this shall pass.”
The third category is sadness. And this is healthy sadness. In this situation, most of or all of your compartments have thoughts that are filled with ideas about the discomfort being temporary. And then let's say we also have ten compartments that hold our emotions. We might be feeling loss, sadness, pain, regret, abandonment, inadequacy. We're feeling those genuine emotions, but our mental capacities are filled with thoughts about it being temporary. And that's actually a really healthy place to be in, that will lead to processing through those emotions, and to healing. This is what Tara Brach talks a lot about in Kristin Neff about this idea of leaning into these emotions in a healthy way. And knowing that this is temporary. This happens to me, I will feel this sadness and move through it. And then I feel really stable and good for a few days or a couple of weeks.
You just had me realize a time in my life when I was depressed versus another time in my life when I was using mindfulness and sitting a lot. The first time, I had less reasons for depression, and second, I had a lot more reasons. The first time, a few years ago, I had a panic attack. And I believe I've talked about that on the podcast. The thing about having a panic attack is if you don't know what's going on, and you don't know what caused it, you don't have anything to attach it to. And if one of your tics is control, it can cause a depressive episode. I assume this is common. It happened to me and people that I know. It was like, any moment I could have a panic attack. It can happen anytime. I figured, there's no way out of this. I have no way of controlling this. So that caused me to get very bummed out. And I remember even having a period where I couldn't even understand how somebody could make plans for a year in advance. Like you don't even know if you're going to be alive. How could you even do that? So that was a very thick veil. There was not a lot of positive thoughts going on. I wasn't really seeing out and then it went away, over time.
A lot of life changes happened to me and I started sitting a lot. Fast forward a few years later, recently, actually, I had an injury that kept me from moving for a month. I had to basically be sedentary. I moved to a new city--I didn't really know a whole lot of people. I was taking a gigantic financial hit. I remember having a really firm idea that “Oh, this is obviously impermanent, and I'll be able to move my body again, I will make more money, and I will make more friends--I know that these things are going to happen. But had I have not had those tactics, that would have been a very serious depressive episode. So you saying all these things, it really helped me to identify that I had the blues recently, and I had depression years ago. But they were unequivocal events like what happened more recently, I had a lot more reasons to be experiencing a depressive episode. But because of all the practice that I've done, I felt very confident in the fact that I’d get through it.
You've done so much reading and studying of Buddhism--the crux of Buddhism is impermanence. That's such a big part of the path and the practice. It seems like a simple concept, but it underlies every single thing in our life. And it really helps us start to see our attachments and our cravings and our avoidant tendencies. And can be a huge push to help us through depression.
If anyone is experiencing an uncontrollable level of depression, we recommend you go and seek help. I know really deep sadness and can lead to suicide, so you should 100% consult all resources,. What we are talking about, is more of a prescription for someone who is noticing a very acute episode, I would say or perhaps chronic, but one that they still feel that they have some amount of control over. If you feel like you're anywhere farther down that spectrum, you should absolutely go and seek professional help.
Ideally, if you're struggling with depression, you're already under the care of a doctor. And the information that we're sharing in this episode is something that you can add to what you're already doing.
According to the mindfulness definition I'm giving here, all of your mental capacities are filled with thoughts about your discomfort being permanent. If this is the case, my recommendation is to simply sit there and say, “I'm depressed right now, because I have bought into the idea that this is permanent.” This is what I do. This happened to me just last week. It's like when your alarm is going off at six in the morning, and you're trying to wake up your consciousness, and it's a struggle, and you're trying and you're trying. And that's what it's like when you say to yourself, “I'm depressed right now, because I bought into the idea that this is permanent,” you just keep saying it maybe five times--waking yourself up and out of it. Mindfulness is al reality check. The other core driving force of mindfulness is opening up to the reality of what is happening right now.
Since your mental compartments are all filled with this idea of permanence, using mental processes, is actually very difficult to use to address depression. Sitting and practicing mindfulness is a mental process--that's one of the reasons why that's tricky. However, we can use mindfulness to help us become mindful of any upward waves, maybe just for ten seconds, you feel a little bit better. So being mindful of when that upward wave happens, and then jumping on--it going and taking a cold shower to stimulate your vagus nerve or exercising.
Andrew Huberman was talking about the neuroscience of happiness and dopamine and serotonin. When I was going through my recent bout of the blues, I couldn't do intense exercise. I couldn't do a lot of bending and things like that, but I could walk. So, I made a real commitment to the science. I said, “Okay, I know scientifically that this is the right thing for me to do.” So I woke up every morning and took off walking. I'm very lucky to live next to a beautiful mountain and it was about a 15-minute walk up and at the top I would have hard respiration. I'd be breathing through my nose. When I got up to the top, I would slow my respiration--six seconds in, six seconds out. And then I would make my vision very wide. I would try to take in everything I could--I don't remember the exact science on this, but something about pupil dilation and then getting that sun exposure also early in the morning. I'd get to the bottom and I'd take a cold shower. This was my cocktail. I did this and it 100% was like a medical prescription. It helped me a ton. I did have negative thoughts but I knew that if I leaned into the science on this my brain chemistry would improve and I’d be able to sleep at night. I was able to have somewhat of a glimmer of a positivity throughout my day.
The research out there for mindfulness and depression is primarily dedicated to showing how mindfulness helps us avoid depression. It's preventative, specifically how a mindfulness practice helps us prevent a relapse. The reason this is , is because of the way our brain works. There are tracks in our brain that we use when we are not concentrating--when we are daydreaming, and what they call “mind wandering”. This part of the brain is called the default mode network. The research shows, if we are prone to depression, and we spend a lot of time in the default mode network, meaning we're not concentrated on something, and we are doing mind wandering and daydreaming, that often leads to depression. Mindfulness pulls us out of the default mode network because it involves concentration. As far as the blues, sitting mindfulness practice is helpful. My definition of mindfulness is: paying attention to sights, sounds, physical sensations, breath, paying attention to thoughts and emotion. And paying attention to the way we are paying attention to our thoughts, emotions, and stimuli in our environment. The loving kindness meditation can be really helpful too. I hear time and time again, from my students and my clients, how life changing the loving kindness practice is for them. We choose somebody outside of ourselves, and we wish them happiness, peace, to be free, and then we choose possibly ourselves next. And then we choose all beings—"May all beings be happy, may all beings be free, May all beings be at peace.” There's different variations.
I start with somebody that it's easy for me to feel very good emotions towards. I usually build to people that I have near neutral and the neutral feelings about. Typically, I use a barista--somebody I can visualize their face, wishing them happiness and love. Ideally, you know, you can build this practice up to people that you really don't like very much. I've gotten into people that annoy me and that feels very good. But I've never gotten to people that I don't care for--people that I think are problematic. Yeah, that's the goal, working towards it.
Loving kindness practice is so powerful and changes people's lives. And it's kind of like threatening to my livelihood, because, maybe you don't really need to hire me as your mindfulness coach, maybe you don't need to take my mindfulness classes, all you need to do is just practice loving kindness and you’ll cure all your problems. But it is it's a super powerful practice.
The most powerful practice I've ever done is to sit and just wish people well--it feels very good. And I'll say that you mentioned during sadness, to have self-compassion. I was not somebody that could understand that at all. At first, I wasn't in tune with my emotions at all. But then to wish myself compassion seem weird and wrong. Now it's gotten a lot easier. I have access to those emotions now. And I believe that if I wouldn't have been doing this practice, I would not have that.
A exercise I like to give my clients to help them with the blues, is for a few minutes, consider different aspects of your life and put a satisfaction level on it. Maybe it's your job, what's your satisfaction level with your job? What is your satisfaction level and your relationship with your significant other. Consider different aspects of your life for no other reason than they are there in your life. Then shift your attention toward the present moment and notice your satisfaction level of the present moment. Notice the temperature in that room. Notice the furniture you're sitting on? What's your satisfaction level of the desk that you're sitting in front of? Notice these things that are right there in your moment? What is your satisfaction level? What usually happens is, people find that their satisfaction level on these aspects of their life are lower than if they bring it into the present moment. Their satisfaction level in the present moment is actually not too bad. That's a really great practice for showing you and proving to yourself that if I stay in the present moment, it's not too bad.
Consider the stages of grief if you're having the blues. My clients are often in the bargaining stage. What the bargaining stage is, is we are in denial that we need to go through a grieving process. It's a little bit different than the denial stage. In the denial stage, we are in denial that the event happened. For example, being in denial that we're in a pandemic. But when we move through, we get to the bargaining stage. We don't deny that the event is happening. We realize it's happening, but we're denying our need to go through a grieving process to heal through it. A lot of people get stuck in that stage.
The stages again are denial, anger, bargaining, depression, and moving into acceptance. What I help my clients with is identify that they're in the bargaining stage and to use mindfulness to move into a healthy state of state sadness--they experienced the depression stage in a healthy way. They move through the sadness stage by embracing their emotions and keeping their mental capacities in a state where they realize that this is temporary.
If you're experiencing sadness, my recommendation is to limit trying to figure out what's going on, limit logical thinking and limit self-critical thoughts. And keep those ten compartments that house your different thoughts filled with thoughts about your discomfort being impermanent, “This sucks but I'll get through it.” “Maybe I'll feel better tomorrow if I take a walk, I should feel better.” “One day this too shall pass” Hold these authentic emotions of sadness in your heart and feel them, Have a physical response to these feelings of sadness, abandonment, rejection inferiority, even though it's difficult. Have a physical response such as crying, collapsing, or shrieking. This is a practice of mindfulness because we're leaning into the authentic experience and we're doing it while we understand this is a temporary state. Also use a self-compassion practice, such as validation-- just letting yourself know “I's understandable that I'm feeling this pain. It's understandable that I'm feeling this loss.” Self-compassion of comfort might include, stating “Even though I feel this sadness I'm loved. Even though I feel the sadness I'm worthy of that love, I'm connected and I am a good person.”