I think that the r/streamentry Guide to Health, Balance, and Difficult Territory has some good starting points for approaching practice when mental health issues are in the mix.  I also like shargrol's Therapeutic Models for Meditators.

I have to ask - have you pursued medical advice and assistance?

I second the responses above. 

Also want to add that there is no one-size fits-all model to deal with depression and anxiety. Both can have different underlying issues. Good therapy will enable you to identify those underlying issues and work on them.

As for meditation, if the depression is in the severe range, usually intensive meditation is not recommended (especially if you are a beginner). Small doses will be better. 

There are a few individuals I know (one of my current teachers and a previous teacher I had) who suffered intense depressive states and  exclusively used meditation until they gained an awakening that permanently ended their depressive suffering. Still, the current teacher I work with does not recommend doing what he did, and instead recommends also getting other sources of help like therapy along the way. 

Best wishes with your practice.

Hi Rachel, I suffered depression for 10 years before ending it a year ago with intensive meditation. Interestingly my depression only really started a few years after first going into therapy. Thereapy was wonderful at first in terms of understanding my issues, but then it opens up a void - if my personality is just a contingent product of genetics, upbringing, society etc. then what is the real me? I suffered 3 serious depressions and kept trying different therapists and antidepressants but none of it effected lasting change. I got quite suicidal during my last depression, I remember one day where I was suddenly gripped by the idea I was going to kill myself and I started practicing with a noose. I didn't really think I was going to do it at that point, but I felt like 50:50 live or die. It was enough to shock me into looking for a different approach.

I used to fantasize about finding the perfect therapist, then I realized that I could be that therapist if I just listened to myself. I think therapy definitely has a time and place and my first encounter with therapy was life changing at the time, but eventually I got cyncial (I'm just a pampered middle class person paying a stranger to listen to me complain, rather than investing in friends or family or church). So I went cold turkey on therapists and antidepressants and started meditating just to listen to myself, like really listen. So I sat down and said let's really feel what it's like to be depressed, I'm going to sit here all day if I need to and follow the depression wherever it really leads. What I realized very quickly in my case was that depression was a choice. On the days I would wake up depressed there was always a brief window where I wasn't depressed yet and I would wonder 'am I depressed today?', then I would "remember" to put on the heavy jacket of depression. It didn't feel like a choice at the time, but now I can see it was a learned behavior and a response to something else. What was that something else? ANGER. I discovered that I harbored colossal anger. I mean I knew from therapy on an intellectual level that I was angry. But this was really feeling that anger in the belly like a hard ball of physical stress. I had an angry Dad and my Mum  wouldn't stand up to him, so I was uncomfortable with my own anger and depression was my way of ignoring that anger. So yeah there was 40 years of trapped unfelt anger inside me.

Since then, I've hardly felt depressed at all and most of my issues work has revolved around anger - how to feel an appropriate amount at the right time rather than save it all up. I also suffered from anxiety and panic attacks and meditation has helped with that but not in the same way. Actually I've had some very strong anxiety and depersonalization attacks in meditation, worse than before, but incorporating anatta (no-self) helped me to see it for what it was and not get derailed. I'm not giving any recommendations here because everyone is different and it's only been a year, so may return, but that was my experience. The main takeaway I learned was that depression and anxiety are perfectly normal responses to perfectly normal life situations. As I aged and life failed to meet my lofty expectations, the realization that it was all meaningless was bound to make me depressed. But once I let go of my personal self and who I thought I was supposed to be then the depression fell away and I could start tapping into the infinite bliss of being part of the universal consciousness field. By the way I still talk with a therapist occasionally, but he is very spiritually oriented and it's all about how to integrate spiritual developments into daily life. Best of luck and I hope you can find some peace from your depression, anxiety and pain.

Oh yeah, another cool thing I forgot to mention. Reading Daniel's book helped me see that I had been stuck in the Dark Night one way or another for about 40 years (after age 5 spiritual experience). Before meditating, I would get depressed for 2-3 years. After folowing MCTB and heavy meditation for a couple of months I would get depressed for 2-3 weeks. Now I might wake up blue and meditate and the depression will be out of the system within an hour or two. It's the same emotions, I just accept them now and see them for what they are and they pass through naturally like water. 

Why do you think the physical pain is due to your emotions? Did the doctor tell you that? Unless it is something like stress is causing muscle spasms in your back I am very skeptical of doctors saying "it's all in your head". 

When you meditate, watch for the impulse to stop meditating with the intention that you will ignore it when it arises. When you notice it, recognize it as something you are looking out for and ignore it. This can help with anything that makes it hard to meditate (for example cell phone addiction).

Some styles of meditation tell you to focus your attention on the pain. If that doesn't work, try taking your attention off the pain.


When I had a painful shoulder injury, I found that the pain was much easier to bear when I was in a good mood. The mental anguish was a big part of the problem, the physical sensation was less trouble when the mental anguish it caused was releived. I recommend a relaxing type of meditation that I find elevates my mood.

https://sites.google.com/site/chs4o8pt/meditation-1#meditation_serenity

You don't have to reach intense states of bliss from the meditation, just relaxing can make a big difference.

I also suggest doing relaxation exercises before meditation because that also helps to elevate my mood.

http://ncu9nc.blogspot.com/2018/04/the-parasympathetic-nervous-system-and.html



Have you looked into the possibility that your diet is part of the problem? If you are not familiar with how diet can affect serotonin levels, you might try looking into that. In practice it is complicated and different people react differently to the same foods so you may have to experiment. Cutting back on refined sugars might be helpful.

I also think it is best to avoid anything that affects the brain: alcohol, nicotine, caffeine, and any recreational drugs.

About five years ago, someone had great success with a method they wrote about in the thread “Depression disappeared forever.” It might be worth trying. https://www.dharmaoverground.org/discussion/-/message_boards/message/5566891

https://alohadharma.com/the-map/

Cliff notes of the progress of insight. Read that then head to mctb.org and look up what your interested in.
Good luck,
~D