Depression is not a disease, the end
point of a pathological process. It is a sign that our
lives are out of balance, that we're stuck. It's a
wake-up call and the start of a journey that can help us
become whole and happy, a journey that can change and
transform our lives.This book
is the story of that journey and a detailed map of its
challenges and rewards. I'll be your guide. I'll show
those of you who've been suffering with "clinical
depression" how to move, step by step, through and
beyond its dense darkness. And I'll walk with all of you
who are simply unhappy, anxious, or confused, and help
you to discover ways to help and heal yourself.
This journey, which is as old as
recorded history, has seven stages. In Unstuck,
I'll give you the tools and the compass you need to
successfully navigate each one of them. And I'll share
with you the stories of people — the ordinary, and yet
remarkable, men, women, and children — who've taken this
journey with me. Like them, you too can move through and
beyond depression and distress, learn from and be healed
by your experience, and find fulfillment, even delight.
I've been preparing to write this book
for more than forty years, since I myself had an
experience of clinical depression that lasted many
months.
One late-winter morning in 1965 in New
York, six months into a pathology research fellowship,
between my second and third years at Harvard Medical
School, I awoke in a sweat. The sheets were twisted
around my body, and I was clutching the blankets to my
chin. My mouth was dry, and my head ached. My chest hurt
when I breathed, as if a hand had pushed my sternum up
against my spine. I felt feverish, but didn't seem to
have an infection. I didn't know if I could heave my
body out of bed, but I knew I didn't want to.
Several weeks before, my girlfriend
and I had broken up. Now the irritable unhappiness of
our last months together, the loss of our love, seemed
to be breaking open in my body, weighing me down. The
doubts and frustrations of my first years in medical
school—of long days in dry lectures and tedious
labs—rushed back. My mind was filled with anxious,
accusatory questions. What had I done wrong? Why hadn't
I been able to love better? How could I ever find
fulfillment in medicine? What was the matter with me?
I told myself to get over it. I was
young, privileged, healthy. Perhaps my girlfriend and I
would get back together. In any case, there would
certainly be other women I could love, wouldn't there? I
knew I should be able to sort out my confusion and pain
about medical school, to embrace my upcoming years of
work with patients, and find a way to become the kind of
doctor I wanted to be. I said these things to myself,
but none of them seemed to make any difference. I felt
worthless and hopeless, ashamed of my weakness, horribly
lonely, without strength or will or direction. It felt
like the end.
It was actually the beginning.
In the months that followed, I was
wrapped up in and constrained by the damp heaviness of
my depression. It looked to my frantic parents and
bewildered friends as if my easy, confident, forward
progress had come to a crushing halt. It felt that way
too. I resigned my fellowship, left New York, moved back
to Cambridge, Massachusetts, and began to see a
psychiatrist. Before, I'd always been sociable, often
laughing. Now I spent many of my days alone, crying for
lost opportunities, relentlessly examining and judging
my faults, missing my girlfriend. I plodded slowly, head
often down, through Cambridge's lovely spring and
summer. And yet I felt something new, something very
necessary and overdue, was growing in me.
When I returned to medical school a
half year later, I was still unsettled in many ways, but
I felt different, more solid, as if my center of gravity
had begun to drop from my head to my heart. My own
suffering, and the early days of my own journey of
self-discovery, had opened me to people who were dealing
with situations far worse than mine. On the Beth Israel
Hospital surgical ward, I sat with ancient Jewish men
and women, some of them Holocaust survivors, as they
moaned through late-night pain and early-morning
loneliness. On my medical rotation, I held a giant,
bewildered black man who, believing he had to "fl y or
die," was trying to pry open the windows at Boston City
Hospital. While sitting with and caring for these
people, and many others, and sometimes helping them find
strengths they'd forgotten they had, I began to discover
my own strength and purpose and meaning.
In the fifteen years afterward, as a
student at Harvard, a psychiatry resident at the Albert
Einstein College of Medicine, and a researcher and
clinician at the National Institute of Mental Health (NIMH),
I continued to be impressed by the strength and
resiliency, as well as the vulnerability, of troubled
and suffering people. I respected the people I was
helping as full partners in our therapeutic work, and I
began to think of them as fellow travelers on a healing
journey. I developed programs that actively engaged
deeply depressed and psychotic adults and adolescents in
their own care and, later, a national program for
runaway and homeless youth.
During those years and since then,
I've worked closely with and learned deeply from some of
the great physicians and researchers of our time. I've
also studied with remarkable traditional healers from
India, Tibet, Africa, China, and the Americas, exploring
ways of understanding and treating depression that have
been used successfully by cultures around the world for
thousands of years. With the help and guidance of these
men and women, I developed and refined the
comprehensive, practical, individualized, non-drug
approach to depression that I'll teach you in this book.
This "Unstuck approach" will equip you
with the perspectives and attitudes and the mental,
emotional, and physical techniques you need to sustain
yourself as you make the journey through and beyond
depression. It includes:
Simple, effective meditations that
can enhance the biology of your brain and body, and
make it far easier for you to deal with and
transform the beliefs and fears that have inhibited
and overwhelmed you.
Clinically tested experiments with
words, images, drawings, movement, yoga, and dance
that can help you mobilize your intuition—and your
body—to move surely and often swiftly through each
of depression's seven stages.
Detailed, practical plans for using
food and supplements, and the ancient, powerful
methods of Chinese medicine to balance your physical
and mental functioning.
Ways to make the world's spiritual
wisdom and spiritual practices a sustaining part of
your healing journey.
Strategies for tailoring all of these
approaches and techniques to your unique, individual
situation, to your life.
In the years since I left NIMH, I've
used this model in my own private practice, with many
hundreds of depressed people of every age, class, and
race. The results, as you'll see, have been deeply
satisfying for my patients and for me, and often quite
miraculous. Since 1991, as the founder and director of
The Center for Mind-Body Medicine (CMBM), I've brought
the
approaches and techniques I describe
in Unstuck to tens of thousands of troubled and
stressed-out people around the world. Together with my
CMBM colleagues, I've created groundbreaking programs
for health professionals and medical students who are
hoping to live lives of greater professional fulfillment
and personal satisfaction. We've helped people with
cancer and other chronic illnesses, as well as those who
are anxious and depressed, to feel far healthier, vastly
more optimistic and energetic, far more in control of
their lives. And we've made it possible for many
thousands of people who've been depressed and
traumatized by war and disaster, in Kosovo, Israel, and
Gaza, and in post-9/11 New York City and post-Katrina
New Orleans, to find new hope as well as emotional
healing.
Now, for the first time, I'm offering
this program, this Unstuck approach, to you, in
a form you can use on your own at home. This Unstuck
program is not a substitute for consultation with a
physician or sessions with a skilled psychotherapist. It
is a powerful, user-friendly way for you to help and
heal yourself, as well as a practical plan for enhancing
your experience with the professionals with whom you
work.
As you read Unstuck, I'll be
by your side, explaining and guiding you through every
stage of your healing journey, leading you in exercises
and experiments that you can use to explore and resolve
the difficulties that trouble you. At the end of each
chapter, I'll give you simple, practical Prescriptions
for Self-Care, methods you can use every day to
transform yourself mentally, physically, and
spiritually; methods that will help you lift the weight
of depression and soar beyond it.
This book will challenge the
prevailing "medical model" of depression and the
widespread, even epidemic, use of chemical
antidepressants. This narrow model of diagnosis and
treatment insists that those who feel helpless and
hopeless, unhappy and uncertain, have a disease, like
insulin-dependent diabetes, that requires a
pharmacologic treatment. I'll offer you evidence that
strongly suggests that this model is poorly justified,
largely inappropriate, limited and limiting, and, often
enough, dangerous to your physical, emotional, and
spiritual health. The antidepressants that it dictates
should be used seldom, as a last resort — and generally
briefly — not as a form of primary care.
What I'm sharing with you here is a
newer, more hopeful and far more comprehensive and
effective model for healing depression — both the
clinical depression that is diagnosed in sixteen to
eighteen million Americans each year and the chronic,
low-grade dissatisfaction, unhappiness, and anxiety that
affect so many more of us. It's a model you can start to
use right now, one that will meet your unique individual
needs and give you positive results that you can begin
to experience immediately.
This Unstuck approach marries
modern science with the perennial wisdom of the world's
great psychological and spiritual traditions. It makes
use of the remarkable capacity each of us has to recover
— physically, emotionally, and spiritually — from the
hurts and trauma we have experienced, to transform our
fears into teachers, and to restore and renew our brain,
body, mind, and spirit.
The path is realistic, hopeful, well
traveled. The people I've worked with have learned to
reduce their stress and improve their moods. They've
changed their attitudes, their biology, their
relationships, and their lives in profound, and
sometimes immeasurably enriching, ways. In the midst of
loneliness, confusion, and despair, they've found
meaning, purpose, and peace, as well as love and
delight. They feel better, not only better than before
they became depressed — but often better, more fulfilled
— than they ever have. And so can you.
