Mindfulness and Depression: When Antidepressants Aren’t Enough

Introduction — Beyond Medication

For many people, antidepressants provide important relief from depression. But sometimes, medication isn’t enough. Dr. Stuart J. Eisendrath, MD, in his work on mindfulness-based treatment for depression, suggests that the practice of mindfulness can provide another path forward.

Mindfulness doesn’t replace medical care—it complements it by offering tools to change our relationship with thoughts, emotions, and suffering.

Acceptance — A Different Kind of Strength

One of the core lessons of mindfulness is acceptance. This doesn’t mean passively giving up. Instead, it means:

• Recognizing the reality of your present situation.

• Acknowledging facts as they are.

• Then deciding what action—if any—to take.

Acceptance opens the door to clarity and agency, breaking the cycle of resistance that often fuels suffering.

Mindfulness — Awareness Without Judgment

Mindfulness is the practice of paying attention to the present moment, intentionally and without judgment.

• It helps us notice thoughts and feelings without being consumed by them.

• Thoughts are seen for what they are—mental events, not facts.

• By observing thoughts as temporary and fleeting, we create space between stimulus and response.

This shift is especially powerful for those struggling with depression, where negative thought patterns often feel permanent and absolute.

Ruminative Thinking — The Trap of the Past

A major contributor to depression is ruminative thinking—going over and over the same negative events or imagined scenarios, hoping to solve what cannot be changed.

• We replay mistakes, regrets, and losses.

• We search for answers to insoluble problems.

• Instead of resolution, we sink deeper into despair.

Mindfulness helps us step out of rumination by gently redirecting attention back to the present.

The ABC Model — How Beliefs Shape Feelings

Cognitive psychology offers the ABC model to explain how our minds create emotions:

• A = Activating Event (something happens).

• B = Belief (our thought about the event).

• C = Consequence (our emotional response).

It’s not the event itself that creates suffering—it’s our belief about the event. By shifting beliefs, we can shift emotional outcomes.

Stories We Tell Ourselves

Our minds are natural storytellers. We weave events into narratives that help us feel secure and give meaning to our experiences. But these stories are not always accurate.

• Stories can exaggerate fears.

• They can trap us in cycles of negativity.

• Mindfulness teaches us to recognize stories as constructions, not reality itself.

Happiness and Suffering — Two Simple Equations

Two powerful formulas help us rethink our mental patterns:

• Happiness = Achievements ÷ Expectations
  → The higher our expectations compared to what we achieve, the less happy we feel.

• Suffering = Resistance × Pain
  → Pain is inevitable in life, but suffering increases when we resist it.

👉 Key insight: Fear of experiencing pain is often the biggest driver of suffering.

Conclusion — A Path of Compassion and Awareness

Mindfulness doesn’t erase depression, nor does it magically eliminate pain. But it offers a way to relate differently to thoughts and emotions—seeing them as passing experiences rather than unchangeable truths.

By practicing acceptance, breaking free from rumination, and questioning the stories we tell ourselves, we can reduce suffering and open space for healing.

As Dr. Stuart Eisendrath reminds us, when antidepressants aren’t enough, mindfulness can become a powerful companion on the journey toward recovery.