Dr Melane van Zyl
MBCT: An effective relapse prevention program
Depression is a common condition that brings great suffering. The COVID -19 pandemic and its socioeconomic consequences have contributed to even higher rates of depression and suicide. Luckily, depression is seen as a treatable condition.
We want to feel better and be functional, but chronic depression has many undesirable consequences, including:
• The condition becomes more and more difficult to treat
• Depression causes “damage” to the brain and can contribute to dementia in the future
• The patient must continue taking medication which might have side effects like weight gain and low libido
• On a psychological level, chronic depression steals our lives. There is a constant feeling of missing out on life.
Ideally, like with any medical condition, we want to treat depression as quickly as possible and prevent it from coming back. However, about one out of three patients do not recover after trying two different antidepressants and psychotherapy. Many of these patients carry on with their lives as best they can without feeling “normal.” Some are “lucky” that their antidepressants cured their depression but cannot stop their medication because they fear falling depressed again.
We aim to treat every patient into remission, and we, as psychiatrists and psychologists, should pursue this goal aggressively.
When the patient has been well enough, we should aim to get the patient off medication without risking a relapse.
Again, like with other medical illnesses, it is essential to treat into remission and prevent a relapse. Most serious illnesses are worse when they come back for a second time. Think about heart attacks, cancer, tuberculosis, strokes, etc.
Regarding depression, there is good news. MBCT is an effective psychotherapy treatment that prevents depression from returning. For some patients, this means that they can stop their medication.
We know that our thoughts contribute to how we feel. Our brains are problem-solving machines that try to plan for everything that can go wrong. Our brains do not want us to be happy and relaxed; it wants us to be alive. The primitive part of the brain is like Tarzan- strong but stupid. It overrides logic and is like an overcautious grandmother that wants us to be safe at all costs.
MBCT is a combination of mindfulness skills and CBT (Cognitive Behaviour Therapy) skills. As we learn the skills to watch and manage our thoughts, we become free of our thoughts’ power over our lives.
MBCT skills can be learned effectively online. Most medical aids reimburse this program.
To read more about MBCT
Next MBCT: 4 May-22 June 2023, 15:30-17:00 per Zoom