Combination of Modern and Ancient Practices May Prevent Depression Relapse

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Treatment of Depression

Oxford psychologists are examining whether a combination of modern psychotherapy and ancient meditation can help prevent the recurrence of suicidal depression.

Professor Mark Williams and Dr Melanie Fennell are undertaking a large-scale trial in Oxford involving classes for people who have been depressed and suicidal in the past but have now recovered. The idea is to help people cope with changes in mood so as to prevent future periods of stress or sadness spiralling into full-blown depression.

The technique, Mindfulness-based Cognitive Therapy, joins modern Cognitive Behavioural Therapy with the ancient practice of mindfulness meditation. It is already used in Oxford in helping those with Chronic Fatigue Syndrome, and is now being extended to help those who have been through crises in which they felt hopeless or despairing.

Dr Williams said: "We have found that, during a period of crisis in which someone becomes depressed and suicidal, an association is learned between the various symptoms (low mood, physical pain, suicidal tendencies, and so on). This means that when the negative mood happens again, for any reason, it will tend to trigger all the other symptoms. This is called 'cognitive reactivity'. The discovery that, even when people feel well, the link between negative moods and negative thoughts remains ready to be reactivated, is of enormous importance: it means that preventing future crises depends on learning how to keep mild upsets from spiralling out of control."

By attending a course of classes and listening to CDs or tapes at home during the week, participants learn how to practice mindfulness meditation. The classes also include education about depression and how best participants can look after themselves when their feelings threaten to overwhelm them.

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"The classes help participants to see more clearly the patterns of the mind, and to learn how to recognise when their mood is beginning to go down," said Professor Williams. "This helps to halt the escalation of the negative or suicidal thinking. People become able to allow distressing mood, thoughts and sensations to come and go, without having to battle with them. They find that they can stay in touch with the present moment, without having to ruminate about the past, or worry about the future."

Clinical depression affects around one in four people, and for some of those people it can get so bad that they feel life is not worth living at all, and become suicidal. Suicide and attempted suicide (sometimes termed 'deliberate self-harm') are major problems in most countries in the world. In the UK alone there are approximately 5,000 suicides per year, considerably more than deaths following road traffic accidents, with more than 170,000 people attending hospital having deliberately harmed themselves in some way. Fifty per cent of people who have recovered from one episode of depression find themselves experiencing another bout within the next year or two, and for those who have been suicidal in the past, this depressed mood is likely to be accompanied by the return of suicidal thinking.

"Suicidal feelings are more common than many people think," said Professor Williams. "Sometimes it is just a fleeting idea, but sometimes it is a whole plan for ending life. Once these suicidal ideas are established, it is very difficult to let go of them and they can come back with full force when depression spirals downwards."

The team are currently sending letters to GP practices around Oxford to invite people who have been depressed and suicidal in the past (and who are now feeling better) to see if they want to be part of the research. Volunteers come in for psychological testing before and after the nine week course (which is free of charge). "It is not suitable for everyone," says Professor Williams. "The classes are designed for people who are feeling much better at the moment. This is because there is a need to practice what is learned in the classes on a daily basis, which can take quite a bit of time and effort."

The pilot classes that Professor Williams and Dr Fennell have run in Oxford over the last year have shown that the method can be very effective. "We are on the brink of discovering really important things about how to prevent depression and suicidal feelings," said Professor Williams. "We are moving away from simply treating people's problems to helping people to find a life worth living."

Anyone interested in finding out more about the classes should contact the research team by telephoning 01865 226468 or Freephone 0800 0836130, or by emailing the team at [email protected]. All information will be treated in the strictest confidence.

University of Oxford

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