About three-quarters of patients who are treated for depression take one or more antidepressant medications. In fact, about 10% of all Americans are taking these drugs.
Antidepressants, including Prozac and other selective serotonin reuptake inhibitors (SSRIs), can help patients with severe depression, but they are not effective for most patients with mild-to-moderate depression. A recent report in The Journal of the American Medical Association concluded that some of the most widely prescribed antidepressants are no more effective than placebos for these patients.
Also, these drugs commonly cause sexual problems, weight gain and other side effects, including an inability to feel empathy for others. These side effects might be acceptable for someone who is incapacitated with depression, but the risk-benefit ratio isn’t acceptable for the types of depression that can be treated with other methods. Here’s how to relieve depression without taking medications.
Important: Never stop taking an antidepressant without your doctor’s approval, and be sure to taper off slowly.
We have learned in recent years that chronic depression causes significant brain damage. Patients produce less dopamine, one of the neurotransmitters that affects the ability to feel pleasure. The hippocampus, one part of the brain associated with emotions, can shrink by up to 20%. Cells lose endorphin (the pleasure hormone) receptor sites, which further inhibits pleasurable feelings.
Good news: Much of this damage can be reversed with positive emotions—by trying the strategies in this article and continuing to use the ones that work for you. Just as the areas of the brain associated with hand coordination get larger when a musician practices his/her instrument, people with depression can increase the areas of the brain associated with positive emotions.
Sudden mood changes can be a hallmark of depression. The dramatic ups and downs that some patients experience are triggered by unfelt feelings. Because of their past experiences (such as childhood trauma), they have learned to mute their feelings — experiencing them is too painful.
Example: You might go to bed feeling fine, then wake up in the throes of depression. You are reacting to something, but because you don’t know what that something is, you feel buffeted by forces beyond your control.
Solution: A mood journal. Every day, keep track of what’s happening when you experience any type of mood change. Write down what you’re feeling, what you were doing when you first noticed the feeling and what you were thinking about or remembering at the time.
This is a powerful tool to help you circumvent your defense mechanisms. You will start to recognize more of your feelings and understand why you’re having them. This won’t make the emotional pain disappear (you might even feel more upset when you first start doing this), but you will start to recognize emotional causes and effects. This knowledge will lead to solutions as well as a greater sense of control.
Patients with severe depression can be almost catatonic—just getting out of bed or taking a shower can seem impossible. With milder forms of depression, procrastination is one of the biggest hurdles. Starting something is risky. There might be failure. There will be frustrations and setbacks. Self-esteem may be threatened. Doing nothing can feel like a safer alternative, even though the lack of accomplishment will make the depression worse.
People don’t accomplish things because they are naturally productive and energetic. They become productive and energetic by doing things.
Solution: Every day, make yourself do something that gives you a sense of accomplishment. You might make a commitment to work in the yard or fix a garden fence. You might decide to write a few lines of a poem.
It doesn’t matter what the activity is, as long as you do something. People who set goals and deadlines (I’m going to write for 10 minutes tomorrow at 10 am) and follow through almost always notice an improvement in mood. Once they experience that uplift, they are more likely to keep trying new things.
Depression is accompanied by thought patterns that are rife with distorted perceptions and faulty logic.
Example: A healthy individual who gets a flat tire will focus on the immediate problem—Darn, I have a flat tire. I’ll have to get it fixed.
Someone with depression will imagine the worst possible scenario. All of my tires must be going bad. I don’t have the money to replace them all. I might have to get another job…
They get so worked up that they forget they are dealing with a simple problem. Instead, the imaginary scenario dominates their thinking.
Solution: Take yourself off the mental roller coaster. When you start imagining the worst, think Stop. Ask yourself how likely any of these dire outcomes really is. Once people understand that they’re prone to making exaggerated—and erroneous—generalizations, they find it easier to mentally step back and focus on the real problem. Oh, it’s just a flat tire. It feels like a huge problem, but it’s not.
Recent studies have found that people who practice mindful meditation—noting the thoughts that run through their minds without letting those thoughts upset them—have increased activity in the prefrontal part of the brain. This is where positive emotions are processed and negative emotions are controlled.
Mindfulness means watching your mind at work. You are aware of yourself and your thoughts, but you are detached from the emotional components. People who practice mindfulness become more thoughtful about their emotions and are less likely to react to them.
This is critical for people with depression. They tend to ruminate too much. They worry about things that haven’t happened and attach too much importance to things that don’t matter.
Solution: Daily meditation. Find a quiet place where you won’t be interrupted for 20 or 30 minutes. Get comfortable, close your eyes and start to breathe slowly and deeply. Focus only on your breathing. As thoughts or feelings drift in and out of your mind, acknowledge them, then let them float off, like bubbles in a pool of water. Whenever you get distracted, return your mind to your breathing.
Don’t expect to experience bliss—that’s not the purpose. It’s more like exercise for the brain. People who do this daily find that they’re generally calmer and more resilient against stress. They learn to detach from their emotions long enough to think about what those feelings really mean and how important (or unimportant) they are.
Studies of depressed adults show that those who exercise three times a week improve just as much in the short-term as those who take antidepressants. People who continue to exercise are more likely to avoid future depressive episodes than those who rely solely on medication.
Exercise appears to stimulate the growth of new brain cells, the opposite of what happens with depression. It stimulates the production of endorphins. It also promotes feelings of accomplishment and physical well-being.
Solution: Walk briskly three or more times a week. You will probably notice significant improvement in mood within the first week. Those who exercise harder or more often tend to report the greatest improvement.
