Depression is a major public health problem, in part because like other chronic conditions it tends to run a relapsing course. According to the Western Biopsychosocial perspective, the onset and course of depression have been shown to relate to a variety of biological, historical, environmental, and psychosocial variables. These include the biomedical perspective of disturbances in neurotransmitter functioning, a family history of depression or alchoholism, early parental loss or neglect, recent negative life events, a critical or hostile spouse, lack of a close confiding relationship, lack of adequate social support, and long-term lack of self-esteem.
On the other hand, in many Shamanic traditions worldwide, depression is universally characterized by "soul loss" or feelings of emptiness. However, the rGyud-bzi lists five groups of causes of psycholgocial disorders namely, karma, grief-worry, poison, humoral imbalances (rlung), and unseen demons( kun-brtags gdon-nad)(Clifford,1993). This contrasts with the Traditional Chinese medicine known as Zhongyi, which according to Zhang (2007), feelings of unhappiness and sadness are associated with the experience of stagnation and blockage of flow of emotions that impede the chi mechanism. Yu (stagnation/blockage) occupies such an an important role in the clinical manifestation of Chinese medicine that some famous doctors in the history of Chinese medicine insist that yu is the single most important factor that results in medical disorders. Zhongyi refers mainly to a body of accumulated healing knowledge and practices based on a naturalistic explanation of disease and health rationalized in the language of "Yin-Yang", and "Wuxing" or the five transformative phases. Taking all this into perspective, the reality of multiculturalism in the West is seeing a new development of a new healing tradition which seeks to integrate traditional healing practices into counselling and psychotherapy.
Although the list above of Eastern ethnomedicines is by no means exhaustive, nonetheless Western scientific research suggests that without treatment, people suffering recurrent depression experience relapse at rates as high as 80%. Unlike those not living in the Western world, the majority of those with depression are treated in primary care, and maintenance anti-depressant medication is the mainstream approach. To stay well, people with a history of recurrent depression are recommended to continue antidepresant medication for at least 2 years (Cooper et al., 2007; NICE, 2004; Olfson, Marcus, Tedeschi, & Wan, 2006; van Schaik et al., 2004).
On the other hand, many experience unpleasant side effects, rates of adherence tend to be low, and many express a preference for alternative ethnomedicines, spiritual practices or psychological interventions. In response to this challenge, mindfulness-based cognitive therapy (MBCT) was developed with a specific focus on preventing relapse/recurrence of depression (Segal, Williams,& Teasdale, 2002). MBCT is a relatively brief, 8-week group program. With 8-15 service users per group, MBCT has the potential to help a large number at relatively low cost compared with individual therapies, and may provide an alternative approach for relapse prevention (Teasdale et al., 2008).
Cognitive therapies are based on the idea that faulty or unrealistic, irrational patterns of thinking can create a constricted and distorted outlook on life, which manifest as a wide range of psychological disorders. This is very congruent with the Buddhist view of suffering. However, one reason why people may prefare to opt for traditonal healing is not only due to the emphasis on natural remedies, but also in their ability to share the universal value of connectedness and non-competitiveness, over individualism. To its disadvantage Vajrayana practices may also attract neurotic people in search for a cheap miracle, who find some relief from anxiety and resolution of everyday conflicts and problems in such religious activity.
"If the aspiration for enlightenment is your motivation in coming to see me, there is no remedy except meditative practice. I, too, will only practice." - Zurpoche Sakya Jungne