Over the years of my involvement with The Institute for Cultural and Healing Traditions, the
question of depression has surfaced again and again. About fifteen years ago, Harvard Medical
School made a striking declaration: mild to moderate depression has no pharmaceutical cure.
The drugs most often prescribed are little more than placebos. Only in severe cases do
medications show limited effect, sometimes alongside treatments such as electroconvulsive
therapy — a practice largely abandoned.
This announcement sent shock waves through the medical world, not least because
pharmaceuticals are deeply embedded in American life. If so many people are depressed, and the
“cures” are ineffectual, what does that say about our understanding of depression itself?
A Personal Encounter
The first time I noticed the presence of depression in someone’s life was during my
Buddhist studies when I was at a Dharma Center which someone had started at their
home. The Buddhist nun, a friend and companion at that time, was with me. The owner of
the home and the Dharma Center was with us as we sat at her kitchen table. By chance I
looked up, glancing at the cupboard shelves along the top of the kitchen. The doors of the
cupboards were all open. I casually noted all the shelves were packed with boxes of Paxil. I
was making a casual note of them. Silently. The owner of the home saw my looking at them,
rush to shut the closet doors and said, with great resentment and bitterness, said to me: “You
don’t know what it is like to be depressed.
Then, no hearing any response from me, she continued, still enraged: You don’t know what
it is like to struggle with depression every day.”
She came and sat down at the table with the Buddhist nun and me.
The Buddhist nun then taught me the most valuable lesson on depression. This lesson I
have often repeated on co-workers and friends, and is the one which I wish to weave into
my essay here in formulating a formal definition of Depression.
Buddhism has two kinds of Depression, she said. One Depression is when you cannot get
out of bed. The maximum you can perhaps do in a day is get out of bed and have a shower.
You have no appetite, no interest in anything, can not get anything done. The other
Depression is when you cannot be still. You are running around all day trying to do things
most of which are useless. You cannot be silent. America has a big problem of this type of
Depression. It is much harder to cure because you do not recognize it. You think you are
doing something useful, but its really running around in circles. The other Depression is
easier to recognize, so it is easier to cure. The second one is harder to cure because you do
not see it easily. “You” she said looking at me directly: “ had that. Very bad. You are
much better now.” I was surprised to hear her words thinking : was I really depressed or
just running around getting classes for my daughter? I remembered my mother’s words
when she had visited us and said: Children need quiet time of doing nothing. They do not
need to be pushed for classes all the time.
I learnt from that. Though that time has gone, my daughter is grown up now, but I
remembered. And I put those two concepts together, linking them. I remembered what the
Buddhist nun said.
America, said the Buddhist nun, has a big problem of this type of depression, empty,
purposeless movement. Unnecessary activity and outside sound. TV, outside music. Always
something going on.
I am so grateful to her teaching and the Buddhist years. I have thought of this often over
many years. I decided to connect it and write it, make a definition of what I am seeing.
She looked at me and said gently: “You had that. Very bad. You are much better now.”
Her words stayed with me. They resonated with my mother’s wisdom: “Children need quiet
time of doing nothing. They do not need to be pushed endlessly into classes.”
Definitions in Context
Definitions matter because they draw boundaries: what something is, and what it is not.
1. Clinical / Medical
Depression (Major Depressive Disorder, MDD): a mood disorder
characterized by sadness, hopelessness, emptiness, and loss of
interest lasting two weeks or more, impairing daily functioning.
Symptoms include fatigue, appetite and sleep changes, guilt, difficulty
concentrating, slowed movements, and suicidal thoughts.
In the DSM-5, depression is coded for diagnostic, insurance, and
pharmaceutical purposes.
My comment: Please note: DSM 5 is now a massive tome, maybe 4 inches thick, and is
restricted to physicians and courts. I actually saw it in court for judges. This is very
serious. The general public does not have access to it easily. The original DSM was a thin
book easily available to all. What does this mean? Does it mean that people are actually
getting MORE sick, or that the medical and pharmaceutical companies are creating more
categories so that they have more medications to give? Keep that in mind as we go through
the definitions.
Going outside the medical diagnosis we have a general meaning of depression in the
dictionary, and its is :
2. General / Dictionary
Depression: a state of low mood and aversion to activity, which may be
temporary (sadness, grief, discouragement) or long-lasting (clinical
depression).
It may be temporary (situational sadness, grief, discouragement) or
long-lasting and pathological (clinical depression).
My comment: Lets look at the Western and Social, Cultural definitions. There is a big difference
between the Western world and how the West sees these concepts and situation and how the
Eastern world sees them. Looking at the Western world:
3. Social & Cultural (Western)
Depression is often seen as an individual illness, but it is also a social
condition — linked to isolation, loss of community, economic pressures,
and cultural displacement.
It is frequently experienced as disconnection: from self, purpose, or
roots
My comment:
Let us look very briefly from the Asian aspect. From the Vedic aspect. I always include Vedic
thinking to my writings because to me that is the reality which is ignored by Western writings, it
is very important in my view because the Vedas actually influence the majority of the world. If
you look at the entire world, Europe, where the Western thinking actually began, is a very small
area. It would not fit into more than one of the countries of Africa. The other areas where the
Vedic influence is, Chinese, Japanese, the Pacific islands, are older and have deeper concepts
that have been worked out or a longer time, and to exclude that is, I think, very territorial,
colonial and imperialistic. I am against imperialism and I always include the whole world in my
writings and in my presentations.
Vedic thought can been seen here in this dimension :
4. Spiritual & Philosophical (Eastern / Vedic)
In Vedic thought, depression is a clouding of consciousness (In Sanskrit this is known
as ‘moha’) or an imbalance in the gunas — sattva, rajas, tamas.
Depression corresponds to tamas (inertia, heaviness, lack of clarity). Healing requires
awakening sattva (clarity, harmony, light).
My comment:
This makes a lot of sense.
But when you are looking at all these definitions, it is important to notice they are cursory,
like as the top of an ocean, shallow and surface definitions. Nothing goes into the causes for
the feeling except a bit in the Spiritual and Philosophical dimension.
This is why I decided to address this issue and write an essay on it.
The clinical people and pharmaceutical based definitions have actually gone deeper in
defining categories, and created, in my view, unbeatable systems for medication, because
they have put it into further categories. They actually have sub-types of clinical categories
which are separate and there is a lot of it. It is the gain of treating these categories as
diseases. Somewhat alarming:
5. Types of Depression (Clinical Subtypes)
Major Depressive Disorder (MDD) – Persistent, severe episodes.
Persistent Depressive Disorder (Dysthymia) – Milder but chronic (2+ years).
Bipolar Depression – Depression alternating with manic episodes.
Seasonal Affective Disorder (SAD) – Linked to seasonal changes, often winter.
Postpartum Depression – After childbirth, due to hormonal and social shifts.
No doubt, all of these will be treated by different chemical intervention in the form of
pharmaceutical pills.
While not discarding what we have already in the clinical definitions, I wish to focus on
purpose. The feeling introduced by my Buddhist studies. No doubt I am certainly
influenced by my Buddhist studies and my Sikh studies, to formulate a definition of
depression to go to the next level beyond all of this surface, cursory and chemical
pharmaceutical based categories of DSM. And notice that DSM is really for insurance
purposes. That big, thick book of 4’ thick DSM 5 is not used anywhere else in the world
except the United States. I know I am onto something here because I am marginalizing, I
am eliminating the chemical and going into the real life situation.
Because of my upbringing in India I would like to introduce as a definition of depression
from Bahadur Shah Jaffar, who, in exile wrote and recited poetry:
This composition, so extremely beautiful, has become a base for the terminology used in
India for depression. I am using this to define the true human dimension and to include it
in the definition of depression at the global level. I will say it in Devnagari and then
translate it for those who do not understand Devnagari.
Keep in mind, ultimately, it is what works. That is the human way. When you are working
and living in a society the practical level is : what works. Ultimately that is what we have:
what works.
This defines the goal: treatment or pharmaceuticals.
Philosophy and Spirituality:
Beyond medicine, in the realm of philosophy and spirituality the larger Truth.
The ghazal “Na Kisi Ki Aankh Ka Noor Hoon” — captures depression’s essence with haunting
clarity.
English Translation:
I am not the light in anyone’s eyes,
I am not the solace in anyone’s heart.
Of no use to any soul,
I am but a handful of dust, scattered apart.
This very deep expression which is poetic actually is more than poetry . It is the
philosophical expression of a real life situation. I guarantee you, if you go to Nursing
Homes today, to go to people’s homes today in America, you will find this 4-line stanza as a
full real experience in America. And they fill this emptiness with T.V. ongoing T.V, with
all of this nonsense, and now going even deeper with all these Reels, Tic Tok now coming
in, short term reduced attention-spans becoming shorter. I am seeing the increase of
depression: the second meaning of the Buddhist nun. So if you look at the two Buddhist
meanings through the lens, like a prism of what Bahadur Shah Zaffar said in his poetry,
you really understand the true meaning of depression. You can possible say, for the sake of
argument, that you are dejected. But it is, after all, the same thing. There is an overlap.
These words placed together in poetry, are very moving. They move us to tears. They are a
Human experience. All of us relate to this experience.
There are two more stanzas for this Gazal. You can look up the entire Gazal. There are
only 3 stanzas It has been sung for many years in India. Many people relate to it. This is
very important to me. When I am writing the definition, part of what a definition is, is how
many people relate to it. You can make all kinds of definitions but they are just words on a
piece of paper if people do not relate to it. The clinical definition is only used by doctors,
psychiatrists and some physicians which is a code, which is linked to insurance, which is
linked to payments, which is linked to pharmaceuticals, so that the doctor gets paid and the
hospital gets paid, and the insurance uses that domino structure. But that is it.
This one is a cultural phenomenon. There are so many musical pieces and songs written to
this using these actual words. And it is written by Bahadur Shah Zaffar maybe 200 years
ago. It is STILL active. It is still used as a feeling of the real life experience of what it is like
to be depressed.
English Translation:
I am not the medicine for a wounded (heart),
Nor the sweetness of anyone’s tender gaze.
I am not the secret of someone’s heart.
Nor the pathway that someone seeks
The original here “jigar” (literally liver) symbolizes the seat of deep emotion. Its the
emotional seat in the stomach. In Asian thinking, in Vedic thinking, in Persian thinking the
seat of emotional pain is in the stomach, or the Jigar. Its not just the physical organ. Like
even the heart: you have the physical heart, and then you have the emotional heart. The
heart feels the pain, the heart has an eye of its own, a mind of its own. These are very
powerful social expressions of what it is like to feel, and the different areas of your body
where you carry your feeling. And they are very valid. So this poetry from 200 years ago is
valid even today.
My time has broken away from me,
Very emotion. Very deep. Now he is going into the emotions of age.
My colors and form have slipped, decayed.
The garden that joyously bloomed till yesterday
Of that garden I am the broken flower.
This is an experience of age and it cannot be changed. We have to learn how to be useful or
make that very age become productive.
The reason why this is valid and I bring it up is because it does not matter where he is. He
happened to be in exile, but one does not need to be in exile to experience this. You see in
right here. In our friends home, in our personal homes. Where we have the feeling of not
being of use of feeling love.
My essay is on definition and not on solution.
However, I want to add this one sentence: when you realize the definition according to
Buddhist and Sikh concepts of the philosophical depression, the real depression, then the
solution becomes apparent: it is to do work for others Buddhist and Sikhi have exactly the
same concept: to contribute to others, to live your life for others. The Sikh will do much
for the community. It is something they just do. It is something taught to them by the
founder of Sikhi, Guru Nanak, a basic Sikh Tennant is to contribute to the community.
This is the same in Buddhist Tennant.
On realizing these concepts, then this poetry which Bahadur Shah Jaffar wrote in exile,
which everyone relates to, even after 200 years, no longer controls you. Because, suddenly,
you are of use.
So the solution of depression is activity. There are other ways too, but that is for another
essay. This short essay is for the definition of depression, and including the real one, which
is not clinical. The reason I wish to include the philosophical definition, is so that if you
have the philosophical balance, then there is no need to go to the clinical. The clinical is
required when they give you medication and all this other kind of procedures. But if your
philosophical perspective is well balanced you do not need the clinical interventions and if
you are on the clinical interventions, and want to discontinue, you need the philosophical
perspectives. You cannot separate the two. That is the reason for my writing this essay.
Toward a True Definition
Clinical categories are useful for billing and treatment, but they stop short of meaning.
Philosophical models point deeper, but often remain abstract.
This definition makes depression real, universal, and human. Ultimately, an accurate definition
allows us to find the correct healing, as and when needed.
In closing, there is a concept I wish to mention:
From the Bhagavad Gita, the Mind’s Nature is action, therefore chose your
action. Because Nature abhors a vacuum. In Nature a vacuum cannot exist.
The Nature of Mind.
The way you relax your mind is to switch the activity. The mind is always
doing activity. Even when you sleep, Consciousness is active.
This is my personal opinion, endorsed by my observations and the facts
mentioned.
If you want to forget something you have to replace it, not just struggle to
create an empty space or a vacuum, for Nature abhors a vacuum.
This is a fact.
Look at the other the fact from Buddhist and Sikh concepts: Fill your Mind
with selected activity:
I connect these two facts:
21st C Three-Layered Definition of Depression
Clinical / Medical
• Depression (Major Depressive Disorder, MDD): a mood disorder characterized by sadness,
hopelessness, emptiness, and loss of interest lasting two weeks or more, impairing daily
functioning.
• Symptoms include fatigue, appetite and sleep changes, guilt, difficulty concentrating, slowed
movements, and suicidal thoughts.
“Depression is where the Self feels useless, unseen, or withered. It is a human condition which
may need pharmaceutical relief if unresolved.
Buddhist definition: Depression shows up in two forms —
• The inability to function on a daily basis, when one cannot rise from bed, eat, or act to meet
daily responsibilities.
• Purposeless activity — restlessness, meaningless activity, running in circles, sometimes
accompanied with excessive talk. The first is easier to heal, for it is easier to recognize. The
second is harder to recognize, therefore harder to heal, for the person suffering feels he or she is
‘doing something,’ effectively hiding the affliction.
Sikh definition: Depression arises in the lack of grounding — in the ego-disease (haumei rog)
and the lack of remembrance (Naam) and service (Sewa). Healing begins when the Self
reconnects through remembrance, service, and community, restoring usefulness and dissolving
the sense of withering.”