May 6, 2015
It is estimated that 18 million American adults suffer from depression every year. The suggested origin of this disorder ranges from genetic predisposition and neurological anomalies to inadequate diet and poor quality of sleep. The domineering theory about depression in contemporary psychiatry is that sufferers of depression have a chemical imbalance in the brain. This theory is supported by research that demonstrates how the brain chemistry of people who are depressed is different than the brain chemistry of those who are not depressed. Further research showed that this “imbalance” could be corrected by giving patients medication that would alter their brain chemistry and make it more “normal”. For this reason, medications such as Prozac, Paxil, Effexor, Lexapro, Celexa, Wellbutrin, Zoloft and the like came into existence.
There is no question that the brain chemistry of a person who is depressed is different from the brain chemistry of a person who is not. But that “depressed” brain chemistry has not always been there. Most people were not born with this chemical imbalance.
Depression is a disorder that is experienced by people at different stages of their lives. People may have lived healthily for twenty, thirty, or forty years prior to having their brain chemistry change on them. As a result of this sudden change their bodies react by causing their emotions to go haywire. Such individuals fail to cope with this change and they begin feeling sad, unhappy, apathetic, remorseful, guilty, and hopeless. Does this outlook make any sense?
I share the belief held by such doctors as Peter Breggen, MD, Gerald Epstein, MD, and William Glaser, MD that there is no such thing as a chemical imbalance. Our brain chemistry is always in balance and corresponds perfectly with our emotional state. Imagine receiving a phone call informing you that you have received your dream job, or that you have won the lottery, or that you are being given whatever it is you desire most. What happens? Your brain chemistry changes instantly. And it is in perfect balance with your emotional state.
Now imagine receiving news about a great misfortune concerning someone you care about and love. Once again your brain chemistry changes but this time it corresponds with emotions such as pain, loss, and helplessness. But wait; let’s say you suddenly come up with an idea of how to remedy the situation. Your emotions change to hopefulness, excitement, and resolve. What happens to your brain chemistry? Of cause it changes, once again it catches up with your emotional state.
One’s brain chemistry may also change slowly as a consequence of continuous feelings of anger, dissatisfaction, disappointment, guilt, shame, jealousy, regret, remorse, helplessness, hopelessness and the like.
Most people return to their normal functioning and their usual mental and emotional disposition after having suffered “hard times.” Those who do not are the people diagnosed with depression. Having been labeled chemically imbalanced, or in other words flawed, they begin to take mood-altering medications. These people become chemically imbalanced after taking medications and their brain chemistry no longer corresponds with their emotional state. Nothing changed. Taking the medication did not create any positive change in their lives. They did not overcome the sadness of failure, the pain of loss, or the feeling of hopelessness. They did not learn new tools of dealing with their life circumstance. Rather their feelings were temporarily numbed. The medication does not have intelligence of its own and therefore cannot choose to numb “unsettling” feelings. Instead it disrupts the ability to feel so that individuals will no longer feel pain but they become incapable of feeling joy as well. If individuals that are taking medication stop doing so, their feelings of pain return but if people are kept on medication they do not feel at all.
The answer is not “knocking” people out of their depressive state as quickly as possible. It is in helping them find new and effective ways of coping with life's challenges. In guiding them to make peace with their losses, find meaning in their lives, and assisting them in the development of tools and strategies that they can use to pursue their goals.
If the theory that the faulty brain chemistry was responsible for causing depression and not the other way around, psychotherapy would never work in treatment of depression. Yet, numerous studies have demonstrated that Cognitive-Behavioral Psychotherapy is as effective in treating all forms of depression as medication.
So, let us now set aside the chemical imbalance theory and consider other possibilities of treating depression.
What is depression? First, the term itself. The word depression comes from the Latin word Depression which translates to pressing down. If people are suffering from depression, something is pressing down on them. Whether it is guilt, remorse, longing for something that has not yet happened, or grieving about something that has happened, there is always a burden weighing them down.
Feeling sad or being depressed about a loss is a common occurrence in everyday life. Everyone experiences ups and downs; we all go through our mini-depressions, and mini-rebounds. The majority of people who go through days or even weeks of being depressed about their loss do recover. Their attention is drawn to other things in their lives such as, daily responsibilities, new goals, new relationships, and new opportunities. Shortly, the things that are meaningful to them require their attention and rescue them out of their sadness, or grief.
These mini-depressions and mini-rebounds happen to many people, but not all people. Some do not have rebounds that are strong enough to bring them back into the flow of everyday life. Finding out why some people recover relatively quickly from the shocks of life while others do not I believe is not a productive way to address the problem. Such an enquiry may take us away from attempting to help the person and throw us into the abyss of infinite guesses.
Each of us had a different genetic history, different life physiology, different health history, different life experiences…etc. All of these factors could play a role in why we respond differently to the same events. No matter how hard we try to understand why we will never know because the reality is that some individuals “get over it” and some others do not.
In some cases the event or circumstance that originally triggered depression may no longer exist or may become irrelevant, but for people who are suffering from depression, the focus on negativity and sadness becomes a deeply engrained habit. From the moment they wake up the “doom and gloom” of the present, the bleak events of the past or the grim perspectives for the future become an unavoidable focal point of their attention.
Unavoidable? Is it really? Let us consider a hypothetical situation. A depressed man is sitting in his room feeling sad and hopeless when suddenly he smells smoke. He then notices flames emerging from underneath the door.
What are the chances that after noticing the flames he would go back to his gloomy thoughts? More than likely he would take action of escaping from danger. During the time he would fight for his life, he would stay live in the present moment and he would not be depressed. Still, after the danger would be over, in the absence of another powerful stimulus he could go back to his depressive thoughts and attitudes. Or not. Some other powerful jolt could shake up his way of perceiving reality and he could develop a new attitude, new goals, and get absorbed by the excitement of new possibilities in his life. It would all depend on how powerful the jolt would be, whether or not he could afford to go back into the slumber of depression, and what kind of new possibilities would open for him.
Mahatma Gandhi said, “Every night when I go to sleep I die, and in the morning I am born again.” Every morning we have 24 brand new hours to live. The way we go through these 24 hours largely depends on our thoughts. Our thoughts affect the way we feel, the way we feel determines our behavior, the consequences of our actions have an impact on our thoughts, and our thoughts affect the way we feel… And here goes another cycle.
People who are depressed may not choose to have sad thoughts from the get going. The thoughts develop. Although we have no control over which thoughts develop in our minds, we do have control over what we do with those thoughts once we become aware of them.
The way out of depression is through becoming aware of and interrupting the pattern of negative thinking, releasing the guilt and /or regret about the losses in life, creating a new vision of life, and moving towards fulfilling possibilities of a new vision.
Following is the six-step process of overcoming depression:
It is possible that as you attempt to carry out the following steps you may find that you need support in understanding some concepts and assignments. Than it is advisable that you seek counsel of a mental health professional, not for doing any kind of introspective psychotherapy, but simply helping you to clarify the concepts and tasks offered in this six-step process.
1. Look at the content of depressing thoughts and determine what issues can be addressed and resolved through deliberate action, and what issues are products of cognitive errors (making up stories).
2. Do the work of clarifying and/or finding meaning for living your life.
3. Identify and learn the tools you need in the pursuit of that, which makes your life meaningful.
4. Make an absolute commitment (a written statement) to do all that is necessary to fulfill your intention (maybe even a schedule with suggested “deadlines”). Write about the price you are paying and the price you will pay in the future (1 year, 5 years, 10 years) if you are not totally committed to succeed. Write about the rewards of succeeding (1 year, 5 years, 10 years).
5. Develop or strengthen your will power so you could follow through with your commitments.
6. Keep weeding out negativity and depressing thoughts from your mind
(A helpful tool is to read my article “Beating the unbeatable”, you can find it on my website:drpeterreznik.com under Articles).