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The Dalai Lama's Advice on Depression
Inner peace is a gift -- nurtured through meditation, empathy, and compassion.
By Jeanie Lerche DavisWebMD Feature


Reviewed by Louise Chang, MD


Have your job, your mortgage -- your life -- pushed you into depression? The Dalai Lama can help.
The ancient practices of Tibetan Buddhism -- meditation, mindfulness, empathy, and compassion -- are offering world-weary Americans a better perspective on life and its hardships.
By feeling compassion for others -- seeing even our enemies in a new light -- we can ease our own stress and anxiety, the Dalai Lama told a crowd of thousands, gathered for his visit to Atlanta in October 2007. Through "inner disarmament" -- reducing anger, hatred, and jealousy -- we create a path to our own happiness and world peace, he said.
The Dalai Lama has long shown the world that, even in adversity, inner peace is possible. In his many books, he has taught us The Power of Compassion, The Power of Patience, and The Art of Happiness. As the spiritual leader of Tibet, he has toured the world, inspiring multitudes to embrace this philosophy of compassion.
He has also inspired leading scientists at Emory University and elsewhere to study traditional Tibetan Buddhist practices and ethics, researching them as a treatment for depression.
Much of our inner turmoil is due to negative feelings like fear and anger, the Dalai Lama said during his Atlanta visit. "Those emotions that disturb our peaceful mind must be eliminated. In times of great distress, our best friend is inside the heart ... it is our compassion."
A compassionate attitude sustains one's good health, whereas feelings of anger, hate, and fear can hurt the immune system, he said. Trust develops between people when there is evidence of genuine concern and warm-heartedness. Good creates more good -- even if it comes slowly.



Cultivating Compassion as Depression Therapy
In developing compassion and inner peace, daily meditation is key, explains Geshe Lobsang Tenzin Negri, PhD, a senior lecturer and director of the Emory-Tibetan Partnership.
During meditation, one becomes mindful of one's thoughts and feelings, he tells WebMD. "Meditation is a moment-by-moment awareness of your thoughts. Then, we work to change those negative feelings -- to view other people and their actions differently."
It is a human tendency to react to certain thoughts and feelings in a preconditioned way, says Geshe Lobsang. "We all have aversions and cravings, likes and dislikes. If a thought of a person comes up, we tend to immediately react based on whether we like or dislike them. That sets up a chain reaction about what's wrong with that person."
That cycle of preconditioned reactions is what we seek to change. "When people cause us difficulty, we can learn to see that they have difficulties in their own lives -- and that they act from ignorance or weakness," he says. "It's not about condoning injustice. What's wrong is wrong. But we can see them as our spiritual teachers, teaching us lessons like patience."
We can also look for "unintentional kindness" from people who help us survive -- providing the food we eat, the clothes we wear, etc., he explains. "We need to see beyond the superficial relationships to connect at a deeper level, where we all share the same aspirations." The world begins to feel less harsh, more nurturing.
"The challenge is to develop a deep sense of empathy for all people we interact with -- whether they are friends, people who give us difficulty, or people who are neutral to us," says Geshe Lobsang. "It's all about recognizing that they, too, have misfortunes and difficulties in their daily lives -- and that all beings want to be free of these difficulties, for their own happiness."

Through these practices, we can develop a real sense of connectedness with other beings, which is the source of empathy, compassion -- and, ultimately, our happiness. "That's how Martin Luther King Jr., Ghandi, and the Dalai Lama can feel compassion for their enemies," he says.
You'll notice the spillover effect into your daily life, Geshe Lobsang adds. "When certain thoughts arise that might disturb you, you are able to notice them so you don't get stuck with them. You move on with the job at hand."



Meditation in Depression Therapy
Regularly meditating on compassion can also help prevent depression by reducing a person's emotional and physical reaction to stress in his or her daily life, says Charles L. Raison, MD, a psychiatry professor and co-director of Emory's Collaborative for Contemplative Studies.
"We look at compassion meditation as a protective strategy, sort of like exercise," he tells WebMD.
Over the past three decades, research has shown that meditation produces a relaxation response that helps decrease metabolism, lowers blood pressure, and improves heart rate, breathing, and brain waves. As the body receives a quiet message to relax, tension and tightness seep from muscles.
Meditation has gained millions of converts, helping them ease anxiety, stress, and chronic pain, improve heart health, boost mood and immunity, and resolve pregnancy problems.
By learning the Tibetan practice of "mindfulness meditation," it is possible to break the cycle of negative thinking that feeds depression, says John D. Dunne, PhD, co-director of Emory's Contemplative Practices and Studies programs.
"Negative thoughts are very real to depressed people," says Dunne. "They interpret their own actions in a very negative way ... have a very negative sense of self. They hold onto these thoughts very, very strongly."
Because a depressed person is so self-focused, it's difficult to convince them that their negative thoughts are not reality, he adds. "The goal of mindfulness meditation and compassion is to end this self-focus this negative tone."




Learning to Be Compassionate
A secularized version of the practice called compassion training is a step-by-step method for developing compassion. It is being used in Emory's research studies to examine the health benefits of meditation and compassion, says Geshe Lobsang.
At its essence, compassion requires that we develop a sense of connectedness to others, which will give us empathy for them, he explains. "If we are genuinely able to feel empathy for others, then compassion is the natural outcome."
In compassion training, students focus on developing that sense of deep connection with all beings, he says. "We develop a way of seeing how others are kind to us, even if it's unintentional kindness. Whether they intended to be kind to us or not, we can choose to perceive it as kindness."
Compassion Training Transforms the Mind
Using MRI brain scans, scientists have begun tracking the effects of compassion training.
"We are finding that we can transform the brain by changing the mind," says Richard J. Davidson, PhD, director of the Laboratory for Affective Neuroscience and the Keck Laboratory for Functional Brain Imaging and Behavior at the University of Wisconsin at Madison. The brain region related to compassion, the insula, "is quite special," he explains. "It is the only brain area that monitors the body and provides the brain with information on what is going on in the body. It sends signals to the body that might change during emotional distress."





Compassion training can generate a state in which loving and compassion envelops the whole brain, he says. When people meditate on compassion, the signals to the insula and other brain regions involved in empathy and understanding are changed. The change is more dramatic among advanced practitioners, compared with novice practitioners, he adds.
His studies have shown that with even a little compassion training, people can reap a physical benefit.
Volunteers who received compassion training online -- and practiced it for 30 minutes a day for two weeks -- showed significantly greater propensity to want to help people who were suffering. They also reported a higher level of well-being, confidence, and positive feelings. MRI brain scans of these volunteers showed greater activation in the insula, Davidson reports.
Raison has studied the effects of compassion training in Emory freshmen -- examining the body's stress response system, specifically inflammation that links stress with depression. These same inflammatory processes are risk factors for other diseases including heart disease, stroke, diabetes, cancer, and Alzheimer's disease.
In one of his studies, freshmen who got six weeks of compassion training had less physiological stress response in a test -- heart rates, blood pressure, stress hormone levels, and other stress-related markers -- compared with students who participated in a discussion group instead.
Not only that, students in the "compassion group" who actually practiced the meditation -- rather than just taking the training classes -- fared the best in the stress test. They had the least stress reaction, he reports.
"They came in the door a little different than the other kids who didn't practice it," Raison says. "These types of meditations help people reduce their reaction to stress."
Meditation: No Magic Depression Treatment
While meditation can help many who are depressed, it's not a sure-fire cure, Raison tells WebMD. "In fact, many people with mood disorders find they can't do meditation when they're depressed." Their thoughts are too overwhelming. They are anxious, nervous, and can't sit -- and likely they need antidepressants, he says.
"For people who are seriously depressed -- or whose depression involves too much internal focus and rumination -- meditation can make their depression worse," he tells WebMD. "Early on, they begin to realize things about themselves they are uncomfortable with."
Meditation provides true insight into why we behave as we do, Raison says. "There can be a shocking realization when you start watching your thoughts. You see the junk that's in there, and it can be very distressing. Every individual case is different. With depression, which can be so disabling and overwhelming, we need to use wisely all treatment modalities to give people the best outcomes."