Research into the prevention of depression relapse

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Some of you will remember a trip I made to CAMH a while back, to explore the possibility of helping with some research into the prevention of depression relapse. Aptly enough, it being Mental Health Month, I’ve begun my participation in the Mindful Mood Balance Study. This study, run by Drs Zindel Segal and Sona Dimidjian, combines Cognitive Behavioural Therapy (CBT), which I received when I was diagnosed with Borderline Personality Disorder (BPD) ten years ago, with mindfulness meditation. It’s testing the effectiveness of an online-based programme, developed to make the treatment more widely accessible and cost-effective. It’s more achievable for me than weekly evening trips into Toronto. This blend of techniques is designed to help me learn skills that will enable me to work wisely with my thoughts and emotions. Studies have shown it can cut the risk of future depression by half.

CBT was developed by integrating behaviour therapy with cognitive therapy to focus on the “here and now”. It works on the premise that if you can change the faulty thinking, this will have a knock-on effect of changing the faulty behaviour. Mindfulness lends itself easily to marriage with CBT. It’s origins lie in Buddhist meditation and Indian Sanskrit and it’s about bringing a conscious, non-judgmental awareness to your thoughts and feelings in the present moment.

Before you dismiss it as being some kind of ineffectual, hippy mumbo-jumbo, take a minute to think about the benefits of locating the solution to your difficulties within yourself and learning the tools to apply it. Now contrast this with society’s current preferred method of treatment: swallow a handful of pills for a while and hope it goes away.

By blending CBT and mindfulness together, this study aims to show participants ways to bring awareness to activities that have become automatic. This “automatic response” is a major part of depression. Although it took me years to understand where the root of my problems lay, that knowledge, revelatory though it was, wasn’t enough to change the deeply embedded automatic responses that I always fell back on. Can you imagine the frustration? You know what’s wrong, but when push comes to shove you find yourself making the same old mistakes over and over, which just pushes you further into negativity and self-loathing. This study helps people to step out of automatic emotional patterns and make a choice about their feelings and responses by training them to be more attentive and aware of the patterns of their thoughts.


Automatic response is a necessary part of human life. It lets you function without having to concentrate on every small adjustment. For an idea of how powerful it is, try taking the Stroop Test. It becomes a problem when, instead of being applied to something like walking or reading, we use it to deal with emotions. Depression is driven by thoughts; I knew I over-analysed everything, close friends would tell me I “thought too much.” Being on “autopilot” makes you more vulnerable to patterns of unwanted or negative thoughts and feelings, our response becomes habit and we forget we have a choice: to continue with autopilot, or choose to be mindful. My thoughts had complete control of me. They were like a movie-reel in my head I couldn’t turn off. There were times when I would try to knock myself unconscious to get some respite from their unrelenting influence. I used drugs and alcohol to muffle them, but any relief was transitory. They always came back.

Practicing mindfulness lets you take back control of your thoughts. It makes life more interesting and vivid and I know it will bring amazing benefits to my writing, but it also brings you closer to the unpleasant and difficult thoughts and feelings. By facing these and dealing with them sooner, I can reduce the likelihood of them progressing to a more intense level.

The study runs for eight weeks with weekly sessions and daily “homework”. As with CBT, most of the progress takes place between sessions, when you apply what you’ve learnt in the session to your everyday life. I’ll be keeping a log of my daily home practice and helping to assess the efficacy of the treatment, and the wonderful Ariel, who’s the Project Coordinator has been actively encouraging and emphatic in her assurance that the team are available at any time to deal with questions or concerns. I’ll keep you posted on how I progress…

Related links:

Mindfulness meditation found to be as effective as antidepressant medication in prevention of depression relapse

Mindfulness in Depression Relapse Prevention – 1 Autopilot & Raisins
Mindfulness in Depression Relapse Prevention – 2 The Body Scan
Mindfulness in Depression Relapse Prevention – 3 The Breath
Mindfulness in Depression Relapse Prevention – 4 Exploring the Landscape of Depression
Mindfulness in Depression Relapse Prevention – 5 Facing Difficulties
Mindfulness in Depression Relapse Prevention – 6 Thoughts Are Not Facts

Whitby Shores, Whitby, Ontario

By Aisha Ashraf

An autistic Irish immigrant in a cross-cultural marriage, Aisha Ashraf is the archetypal outlander, writing to root herself through place and perspective. Published in The Rumpus, The Maine Review, River Teeth, HuffPost and elsewhere, her work explores the legacy of trauma, the nature of being an outsider and the narrow confines of belonging. She currently lives in Canada.


  1. Makes sense to me. I’ll say it again: you’re very brave, Aisha, and I will be reading along as you share more about CAMH’s efforts to marry mindfulness with CBT. Your willingness to write candidly about difficult aspects of mental illness (e.g., borderline personality disorder, depression, anxiety, etc.) not only helps to de-stigmatize these topics but also offers help, solace and hope to others currently suffering from them and the people that love and care for them.

    1. Thanks Linda. Bravery doesn’t come into it, it’s more about making use of an opportunity to “give something back” and help others who, but for the grace of God, I would still be among in terms of struggle and desperation. Sometimes all you need is someone to tell you that things WILL get better, show you how and support you in your efforts. If it wasn’t for my husband and the team at Edinburgh House, St Albans, I wouldn’t be here to write this.

  2. Aisha, I too think you are very brave and wanted to say also how much I appreciate your blog posts on this issue. I understand that “automatic response” – it is so immediate sometimes and you find yourself going down that same old road. I am now trying to cut back on anti-depressants (slowly) but am so afraid of a relapse. Mindfulness could be the answer. DO keep us updated on how you get along with this, and good luck!

    1. Thank you Emma, I hope the posts are of some help to you. Did you read the related link at the bottom? Perhaps Mindfulness Behavioural Therapy (MBT) could be of help to you. I can’t comment on it’s availability in Jamaica but if this study shows favorable results, an online programme shouldn’t be too far away. The biggest key to success with this kind of therapy is the daily practice of it, which is totally in the hands of the participant. It might be something for you to research. Thanks again for your continued support, it’s important for me to know that it reaches people who understand. I wish you strength and success in finding your balance.

  3. This is a subject everyone needs to hear about, because if you haven’t struggled yourself with some form of depression, I’ll bet you know someone who has.
    Throughout my life I’ve had a few serious bouts with panic. Medication only makes me more depressed…
    Much like you describe above, I learned to battle through my bad thoughts, at least for the most part.
    Thanks Aisha and all the best to you…

  4. Hi. This is a subject very close to my heart. I’ve been taking anti-depressants for years, and sadly I seem to need them. I’ve read tons of books on depression, but when I stumbled across mindfulness I finally found something that I knew would really help.
    It’s hard to change, and progress is slow with me. I find meditation wonderful, and I am slowly enjoying more about the present than ruminating over the same old stuff.
    I will be following your posts, and I am so glad you are writing about this.

    1. Thanks for your heartfelt comment. I remember stumbling across meditation at the age of 15 and realising it’s benefits. Looking back now, I can see that even then, I was desperate for some balance in my life – a way of detaching myself from all the negativity that surrounded me. Back then I would get comfortable and try to empty my mind. The exercises I’m doing at the moment are based around being mindful when doing a routine task, for example, brushing your teeth or eating a meal. The aim is to stay present and mindful of what all your senses are experiencing IN THE MOMENT, and stop your mind wandering off on other things, by bringing it back to the present when it does.
      It really opens up what you can experience in a small space of time doing something mundane. It’s taught me these things are only mundane because we label them that way.
      Good luck on your journey xxx

      1. Thank you very, very much. This makes perfect and absolute sense to me. It’s something I am trying to train myself to do, now that I am no longer working. But your last sentence is so true! I will let you know how I get on…

  5. Hi Aisha, Thank you so much for bringing my attention to this thoughtful and most intelligent post I’ve ever seen on such a matter. I will certainly feature you on my new blog and we’ll follow your posts. it will be an honour.

    1. Thank you Anya, and wonderful to hear you’ll help bring the concept of mindfulness to a wider audience – it has the potential to help so many people if they only knew about it.

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