Your own anti-depressant response
Unless
your ‘deep driving desire' is to find ways of getting well, then
your destiny is to remain depressed. To take on the responsibility for
getting well is to empower yourself. Here, Aine Tubridy and Michael Corry explain how you can create your own anti-depressant response
Our central premise is that
depression is an emotion, a natural response to our experiences of
life, just like fear, anger, sadness, love, and joy. The word emotion
derives from the Latin movere meaning to move. If somebody
pinches you, who feels it but you? Nobody else. Nor does anyone know
what it's like to wake up inside your head, with your unique thoughts,
moved by your feelings, and inside your skin.
Few
states touch so many aspects of the self as depression, undermining
body, mind, heart and spirit. In its most severe forms depression can
devitalise a person's soul, to the point where they are unable to work,
love, or find meaning in life. It can lead to serious alterations in
personality, sapping an individual's self-confidence, undermining
independence and severing their ties to the world and the people who
care for them. Depression can turn fatal.
Like
a fingerprint, we are all one-offs. We come into the world by
ourselves, and we leave it the same way. For the duration of the
journey in between, we are extremely fortunate if we are able to raft
up with a number of close friends, soul mates who we can share the
journey with, and who empathise with our unique experience of it.
Since
your uniqueness is therefore a given, the responsibility for how you
live your life — the ability to respond to it, to become your own
personal agent and come up with creative solutions to the many
situations which arise — rests solely with you. Life is not a
dress rehearsal.
We cannot put off living until we are ready.
The most salient characteristic of life is its
coerciveness: it is always urgent, ‘here and
now' without any possible postponement.
Life is fired at us point-blank.
Jose Ortega Y Gasset
If
you define your depression as a disease, then you are likely to put off
playing one's part. Now you immediately find yourself on a well-worn
conveyor belt, like a can of beans, an object, a thing being moved
along through a predefined process identical to all the others. There's
no place here for uniqueness or personal journeys. The moment of
diagnosis, ‘you have a chemical imbalance, which can be rectified
with an anti-depressant', and the passing of the prescription across
the desk, mark a major turning point. You now have a sick brain.
From
this point on, it is the job of the pills, your emotional painkillers,
to fix you, and your doctor's responsibility to oversee that process.
You move into the passive state of waiting and watching. ‘Did the
doctor say they'd kick in at three weeks or six weeks?' In a disorder
which is in essence a disempowered state, you have now placed your
locus of control inside the package. ‘What's happening? They
don't seem to be doing their job? Maybe I need stronger medication? Or
does it mean I have something more serious?'
Once
you're on the sick-brain conveyor belt, a series of different
antidepressants will be prescribed, with or without sedatives or
sleeping pills. A psychiatrist may offer a more elaborate cocktail,
with a suggestion of a hospital stay if these fail to provide the lift
you're hoping for. If all fails, electro-shock therapy may be
recommended, the end-point of the conveyor belt.
This article is Chapter 14 of Depression: an Emotion, not a Disease, by Aine Tubridy and Michael Corry, published by Mercier Press, October 2005
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Become your own author: bite the bullet
At the core of life is the central issue of being authentic, which derives from the Greek authentikos, meaning to be your own author, to write your own script. This stance is
proactive. Those who live life from this perspective know that in times
of difficulty there is no ultimate rescuer to wait around for, no
cavalry about to appear over the hill ready to save the day. Such
people accept that life can be turbulent, with distressing times
built-in, and that depression can be one of the responses to such
times. Nevertheless, they also appreciate that ways can be found to
negotiate such difficult periods without going under. Their motto would
be ‘you can't stop the waves, but you can learn to surf'.
They
understand the deal. In the interest of rising to the challenge and
mounting a campaign to change their unhappy state — their
feelings of depression — the responsibility will have to be
shouldered by them, and them alone. They also factor that in; risks
will have to be taken, appropriate back-up support found, and crucial
new information entertained as to what will enhance their healing and
what will sabotage it. They are crystal clear that their depression is
a messenger, an experience which should be listened to rather than
silenced, and its information used to initiate change.
Those
who have had a near-death experience, life-threatening illness, or
‘road to Damascus' moment are forever changed by it, and they
find that every aspect of life is is given a new priority.Suddenly and
dramatically they ‘get it'. From then on, life is a journey
imbued with meaning and purpose, one which may include a spiritual
aspect, where each second of it is precious and not to be wasted. For such people there is no longer any room for complacency.
You are what your deep driving desire is.
As your desire is, so is your will.
As your will is, so is your deed.
As your deed is, so is your destiny.
The Upanishads
These
lines take no prisoners. Unless your ‘deep driving desire' is to
find ways of getting well, then your destiny is to remain depressed.
Once that desire is your top priority, then the will and motivation
will be there to take the necessary steps to make absolutely sure that
happens. If it isn't, if you want to avoid making changes more than you
want recovery, if you want to blame others more than to feel inner
contentment, if you want to get well without spending any money on the
venture, if you prefer the role of poor me rather than personal
liberation: then continued depression will be your lot.
Throughout
our book we have put forward the notion that depression is a messenger,
a wake-up call, announcing to you over and over to dig deep, to trawl
to the depths of your being for solutions. Such depth can give birth to
a newly-developed awareness that you are a spiritual being having a
human experience and that your spirit, if tapped into, can infuse your
life with meaning, purpose, and a sense of your destiny. Thereafter
nothing can prevent your will and your actions guiding you towards that
destination. Then you will know the port to which you're sailing.
Mounting your own anti-depressant response
Healing is cumulative, everything works some of the time.
Walter Makichen
There
are many roads leading to depression, and there are as many leading out
of it. We are inviting you to consider methods of healing depression
which we have personally found to be invaluable. We run a holistic
practice and have seen through the years what works and what doesn't.
What always strikes us is the unique healing effect which can result
when the correct match is found between sufferer and healer, and where
the timing is right. We have witnessed individuals who for years have
been caught up in the psychiatric or counselling treadmill, who
suddenly cross a line after an intervention which, to everybody's
delight, has clicked with them.
Healing
the emotion of depression can sometimes happen miraculously, in an
instant. For others, it can be a pilgrimage through a variety of
methods and therapists. The most important person in the healing
process is the sufferer, and we professionals are merely the handmaids.
The sufferer has the biggest investment in the outcome, and if their
intuition tells them to pursue a certain healing avenue, then they
should be supported in that, and criticisms and detractions of their
chosen method should not be thrown in their way.
The
healing power of desire and intention cannot be underestimated as a
force in its own right. Given the weight of opinion which sufferers
place on their doctor's recommendations, vigilance is required lest a
door is closed and the benefits for them ruled out. Clichéd
scientific jargon such as ‘don't bother with that, it's not
evidence-based' has no place, particularly if that person has not been
helped by conventional approaches and they see some ray of hope in the
new intervention. In the scientific world, the power of the placebo
response is so appreciated that it is now being seen as a healing
intervention in its own right.
Comparative
studies between the effectiveness of medications and that of
sugar-coated pills (the placebo) bear this out. The response occurs at
the level of consciousness and emotion, qualities which cannot be
measured by science. Evidence for precisely how healing occurs still
eludes us. What we need to respect is that it happens. Without being
trivial, there is many a lotto win which would lift a serious
depression.
Off duty: time for sanctuary
Depression
is a wound. It can cut to the very heart and soul, and the wounded need
sanctuary in order to allow healing. The first stage of treatment for a
broken leg is rest and, weeks later, gradual mobilisation. The limb is
not expected to function normally, and we allow ourselves to be cared
for by others in every way.
The
same urgent need for rest and time out from their responsibilities
applies to some of the depressed. Many somehow manage to keep the ship
afloat, struggling hard not to give in, yet paying a high price daily.
However, just as many reach a point where they no longer have the
energy or the will to struggle any more. This can come early on, in the
initial stages after a trauma, or later when they've become burnt-out
by the effort of dealing with their distress over months or years.
Regardless of cause, a moment is reached when the need for sanctuary,
and for permission to be off-duty, become pressing. It affects equally
those whose depression arose following some distinct emotional incident
or those for whom it emerged gradually without any obvious reason.
One
aspect of this stage of depression, which is shared by all, is the
overriding impulse to recoil from the world, batten down the hatches,
crawl into the shell and disconnect. One of the difficulties in our
modern quick-fix society is that such time-out is often not an option.
The unrelenting treadmill beckons, propelling us from behind to keep
moving forward, and to keep the juggling act going. Mortgages have to
be paid, children cared for, job prospects have to be considered and
the stigma of a stay in hospital factored in. As in the story of the
frog in the pot, we need to jump out of the boiling water, but often
can't.
Yet a stay
somewhere is exactly what many need. At present the only available
place is the psychiatric hospital, which may turn out to be a far from
healing experience. Many are post-traumatically stressed by their stay,
terrified by the ‘Cuckoo's Nest' antics of some co-habitees,
particularly those who have been involuntarily detained. Others become
distressed by the dumbed-down feeling which accompanies the excessive
medication regimes, rarely seeing their doctor, and the realisation
that they are now on that conveyor belt. And perhaps most despairing of
all is the fear that they might eventually join the population of
revolving-door patients they meet, those who for years have been on
every possible combination of medications and perhaps had
electro-convulsive shock therapy, yet are no better.
This
scenario can be avoided, and with the compassion, good-will and support
of others, a sanctuary experience devised elsewhere.
A
restful safe environment: this can be provided in one's own home, the
home of a friend, or some other suitable place where support is
available — a spa, a meditation or healing centre, or any place
of retreat.
Supportive
minders: supportive in the sense of not being critical, not pushing
advice, and allowing the individual to access and articulate their
needs in their own time. Depressed individuals need to feel that the
minder's presence is unconditional and compassionate, and the
legitimacy of their experience is validated instead of questioned.
Exhortations to do this or that, helpful as they may seem to the
minder, are counter-productive as they can put pressure on an already
overloaded individual, and interfere with a process which has its own
unique time-frame. A minder's role is to take responsibility for all
the individual's basic needs; shopping, cooking, family duties, and
managing the boundary relative to visitors, phone calls and
work-related issues. In other words keeping the world out, offering
companionship without intrusion, and essentially providing a
cotton-wool experience.
Sleep therapy:
in order to restore normal sleep patterns through sedative medication,
the general practitioner can be invited to become a co-participant in
the project. Many with depression have an element of anxiety which is
associated with racing thoughts, ruminations and vigilance. Sleep is
nature's balm, and allows the restorative properties of the life-force
to flow unimpeded.
Body therapies:
massage, reflexology, acupuncture may be particularly appropriate as
home visits to rekindle the individual's own healing response.
We
are made in order to connect. In the depressed individual this
essential need has been sidetracked, resulting in further isolation. By
the time depression reaches its peak, the individual has often
distanced from those around them to the extent that touch, affection
and sexual intimacy rarely occurs. Yet touch is what anchors us into
life. At this point, touch with a loving intent could be our most
potent healer, but is often unavailable, or not availed of, such is our
estrangement from loved ones.
At
such a time professionals can provide a vital link back to that anchor,
through bodywork. It has the added advantage that, at a time when
energy is low, nothing is required of the individual but to receive.
Time:
the body has its own optimum heal-by dates for a variety of traumas and
illnesses. In the case of the broken leg, if re-mobilisation is
delayed, then healing is disrupted and things go backwards. Unused
muscles atrophy, skin degeneration occurs, blood supply stagnates, and
weight-bearing becomes impossible. In the case of an emotion such as
depression, the natural healing responses are also arrested if
re-engagement with life fails to occur. For this reason the time-out
stage, like the immobilised leg, should be limited. Gradual
re-engagement with the world is critical — through gentle
exercise, incremental social contact, and the re-establishment of basic
routines. In the same way that re-mobilisation with the broken leg is
lengthy, difficult and initially painful, so can be the depressed
individuals first forays out into the world.
The bridge into the future:
Consideration, where appropriate, must be given to in-depth
psychotherapy, grief counselling, marital counselling, mediation,
career changes, retirement, financial restructuring, etc.
Exercise: lifting your energy quotient
Depression
is a state in which your mind and body become disconnected. The mind
rules supreme, with its dark, hopeless, pessimistic and self-loathing
thoughts. The body's energy is at an all-time low, and it has lost the
ability to feel pleasure. Studies have established beyond doubt that
regular exercise affects all these for the better, most immediately by
increasing energy levels through its overall stimulating effect on the
‘chi' or life-force.
No
matter what age you are, there is a form of exercise to suit you. It
can include solitary exercising, such as gardening, fishing, walking,
cycling, jogging, swimming or going to the gym. If you've played social
sports before, such as tennis, golf or five-a-side football, you could
recommence them, without necessarily having to play at a high level. If
it's a type which involves being out in nature, then that's an added
bonus. There can be an immense sense of exhilaration when one connects
with an activity that is associated with good times, jogging old
memories such as those from summer holidays by the sea, which are
timeless and ageless, emphasising that you are more than your
depression. Alice, in our article on the Lost Tribe, found her turning point in this way.
All
exercise puts a halt, at least temporarily, to the flow of thoughts,
which rarely come up spontaneously during the activity. If they do,
dislodging them is easier during exercise, because you can redirect
your attention to the sound of your feet pounding the pavement, or the
movement of your limbs through the water as you swim. Your mind is put
aside as you are drawn to the sensations in your chest as you breathe
faster and faster, or the pounding of your heartbeat. Many people
describe an almost meditative stage in their exercise where they become
less aware of themselves, and go into a zone where they lose
themselves, and they spontaneously feel moments of positivity and joy.
In moments like these the old stagnation can give way to creative ideas
and solutions.
Depression
can be defined as the absence of pleasure as much as by the presence of
sadness, which is undoubtedly why exercise is so well known to have an
anti-depressant effect. It leads to a release of endorphins, such as
serotonin and other neurotransmitters. Normally, when artificial
psychic energisers are used for some time, the receptors in the brain
become less responsive to them, and for the same effect you need to
take more and more. Moreover, because the receptors become less and
less sensitive, normal pleasures such as sex lose their pleasurable
feeling. Exercise-induced endorphins do the exact opposite and, working
on the pleasure principle, the more this natural mechanism of producing
these pleasure molecules is used, the more effective the mechanism
becomes. Exercisers simply get more pleasure out of life.
Exercise,
like meditation, is a practice and, if it can, should be done every
day. If that's not possible at least at the weekend or three to four
times a week. The effects build exponentially. One cannot continue
feeling like the walking dead during exercise: the two states are
simply incompatible, and with time cancel each other out. Everything
about exercise is in the opposite direction to the medicated depressed
state.
A nutritional programme to improve your mood
As
the saying goes ‘You are what you eat', so it follows that it's
worth looking at your diet and considering all the current information
relating to depression that is now available. If you think you could
improve the quality of your diet, then here is a brief outline of areas
you might look at. We would suggest you take it further and consult
with a nutritionist. To facilitate clarity in the vast field that
nutrition has become, we sought the knowledge and guidance of Brenda Duffin, who trained with Patrick Holford, author of Optimum Nutrition for the Mind.
Feeling
depressed can lead to a series of bad eating habits which can put a
strain on an already low energy system. Eating the right foods will
boost your energy and so increase your ability to make changes in your
life. Our brain uses up to 30 per cent of all energy from the foods
that we eat. The billions of cells in the brain form a complex, not
unlike the worldwide web, allowing communication with each other
through chemical messengers, such as serotonin, noradrenaline, and
acetylcholine. If this finely tuned mechanism becomes imbalanced it can
result in depression, anxiety, panic attacks, insomnia, lack of
concentration, poor co-ordination, and memory deficits to name but a
few.
A pioneer in the
field of mental health and nutrition was Dr Carl Pfeiffer, an American
doctor and biochemist, whose work is being carried on by Patrick
Holford, the nutritionist. Types of mental difficulty were identified
that could be influenced by particular nutrients and diet. They have
paid particular attention to:
Omega
3 and 6 Fatty Acids Since two thirds of your brain is composed of fatty
acids, the entire range of depressive symptoms improves with a good
blood level of omega-3 and omega-6 fatty acids. If blood levels are
low, depression, lethargy and poor motivation are common, along with an
inability to relax, memory deficits and difficulty concentrating. The
capacity for pleasure is reduced.
As
omega-fats decrease in the diet of any population, as they have in the
west, the incidence of depression rises. Sadness and fatigue, decreased
libido, and persistent thoughts that life is not worth living, insomnia
and anxiety — all can be influenced as you rebalance these fats.
Nutritionists
say that our brains are akin to sophisticated race car engines which
are meant to run on highly refined fuel, but unfortunately are being
asked to get by on diesel. Fish eaters are less prone to depression.
Why? Because oily fish is the major source of omega-fats, specifically
herring, sardines, salmon, tuna and mackerel. In countries where fish
consumption is high, such as Asian countries, the rates of depression
are considerably lower than in the west. Certain seeds and eggs are
other equally good sources.
You
can influence how you feel, both your energy level and your mood, by
giving yourself the ideal quantity and type of protein every day.
Hippocrates said ‘Let your food be your treatment and your
treatment be your food' as far back as 2,400 years ago. For most people
their diet is the main source of these vital substances. While foods
such as fish, seeds and eggs, are the best natural way to get enough of
these essential amino acids, supplementing them is the surest way to
ensure you're taking in enough of them. Many reporting depression have
significantly lower blood levels of these fats. Supplements can reverse
that.
Omega 3 doses:
Within this family of fatty acids the two essential ones are DHA and
EPA. In order to obtain the anti-depressant effect, you must consume a
combination of at least 240mg of DHA and at least 340mg of EPA a day.
Check the concentrations on whatever product you settle on. Cod liver
oil capsules contain low amounts of the fats, so choose fish oil
concentrates instead to create the level required to influence mood.
The liquid forms, such as Eskimo-3, are absorbed more directly, but may
be found unpalatable by some.
Omega 6 doses:
Within this family of fatty acids the essential one is GLA. The best
source is starflower oil or evening primrose oil, and you need at least
100mg a day.
Tryptophan:
is an amino acid precursor of the much talked-about neurotransmitter
serotonin. In some individuals it can be lacking, which leads to
various signs and symptoms. Serotonin plays a role in the female
hormone cycle. It's generally lower in women, which may explain the
moodiness, irritability and sensitivity to pain experienced by some
women before and/or during their periods. ‘Women with low
serotonin are more likely to express their anger inwardly, with
depression and even suicidal behaviour. Men with low serotonin are
often violent and can even engage in dangerous criminal acts. Alcohol
and drug users also turn out to be low in serotonin.' (Optimum Nutrition for the Mind, by Patrick Holford, Piatkus, 2003)
In
order for tryptophan to break down into serotonin, adequate levels of
vitamins B3, B6, folic acid, vitamin C and zinc are required. The
following are good examples of meals high in tryptophan: oat porridge,
soya milk and two scrambled eggs, baked potato with cottage cheese and
tuna salad, chicken breast, potatoes au gratin and green beans,
whole-wheat spaghetti with bean, tofu or meat sauce, salmon fillet,
quinoa and lentil pilaf and green salad with yoghurt dressing. If
you're taking this in supplement form, you'll need 500mg twice a day.
Blood sugar balance: stop the junk food
Signs
of blood sugar imbalance include depression and crying spells,
irritability, dizziness, insomnia, excessive sweating (especially at
night), excessive thirst, blurred vision, lack of concentration,
forgetfulness, drowsiness after meals, unexplained fatigue and/or
craving specific foods such as chocolate and sweets.
Junk
food has little or no nutrients in it. After ingesting it there is an
initial sugar surge, which is followed by a release of insulin, the
hormone which clears it from the bloodstream for absorption. However
this clearing process causes an energy low, a trough which in a
depressed person comes on top of an already depleted system. The dip
makes you feel you need a top-up, which, if it's more low quality
sugar, will repeat this peak/trough cycle again. The end result is that
you never end up holding on to the high-energy feeling for long.
A
nutritionist will direct you towards the kind of foods which release
energy slowly. The scale that scientists have created to describe this
process is called the glycaemic index (GI).
If
you want to keep your energy at a constant level without peaks and
troughs, then eat foods which have a low GI. Bookshops have an
abundance of material on this and on optimum nutrition.Exponents of
optimum nutrition such as Holford give good evidence-based reasons for
including, in a minority suffering from depression, folic acid
supplements, and recommend ruling out a possible congenital histamine imbalance.
Alcohol and recreational drugs
The
association between alcohol use and depression is irrefutable. While
its use is understandable as an anaesthetic to ease anxiety or help
insomnia, or as a means of temporarily lifting the mood, the effect
several hours later is a lowering of energy and a dampening of the
spirits. There are often maudlin or melancholic elements to this, with
the nostalgic bitter-sweet tendency to revisit past times. More often
than not this inevitably opens the door to sadness, a sense of loss,
missed opportunities, regret and ultimately self-loathing and
hopelessness. Alcohol consumption often acts as a tipping point,
triggering suicide.
Add
to this the actual toxic effect of the alcohol by-products as they are
broken down in the blood-stream over the next 12 hours or so;
sluggishness, lethargy, and a slowing down of all the mental processes.
Sleeping through breakfast, the day kicks off with you in an already
low energy state before it has begun. The hangover state creates a
vulnerability which may bring on panic attacks. Your body inevitably
will be suggesting you stay in bed a couple of hours longer, and put
off going out and interacting with the world until you feel more up to
it. As another futile day passes, possibly notched up as a sick day
from work, your internal critic takes a reading, and begins its work of
reminding you what a waster you are. And as evening approaches the
cycle will need to be repeated. At an interpersonal level alcohol
destroys relationships, robs childhoods, depletes finances, and turns
users into selfish individuals. Nobody likes living with a drunk.
The
aim of all recreational drugs is to create a high, but what goes up
must come down, so an inevitable low follows, having a greater effect
on someone who is already depressed. This is common knowledge to any
user. If you want to create an anti-depressant response, cut them out.
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