Friday, October 9, 2015

Major Depression: 4 Steps to Navigating Rough Waters

Image by George Hodan

After suffering a lifetime of Major Depression, I have found 4 strategies that minimize the damages and maximize the benefits of this disorder. Yeah, there are actually benefits!

STEP 1: Get treatment!

Let’s start with separating “normal” depression that everyone experiences from clinical depression which affects 20-26% of women and 8-12% of men over the course of a lifetime[1]. Normal depression means feeling blue or having a down day. Clinical depression means that for most days, over at least a two week period, you experience 5 or more of these symptoms:

  • Feeling sad, empty, depressed, or tearful
  • Loss of interest or pleasure in almost all activities
  • Increased or decreased sleep
  • Restlessness or a sense of being slowed down
  • Loss of energy
  • Feeling worthless or guilt ridden
  • Trouble concentrating or making decisions
  • Thoughts of death or suicide
  • Unintentional weight loss or weight gain of over 5% of your body weight (within a two week period).[2]



Prior to coming to terms 
with my depression, I was completely against medical treatment and in severe denial. I felt like getting such treatment somehow spoke to my character, as if it meant I was weak or less of a man. I employed every alternative strategy I could come up with. I tried yoga, running, diets, self-hypnosis, weight lifting, meditation, talk therapy, and every holistic treatment I could find.

By age 28, I was at the end of my rope. Fortunately, a doctor friend insisted on a trial of antidepressant medication. This changed my life. Over the course of a couple of weeks, my mental processes became clear, my sleep and appetite improved dramatically, and my overall level of functioning skyrocketed. I went from the being the lowest to the highest producer in my office. I had always been a “C” student, but when I returned to grad school after treatment, I earned all “A”s. Once I treated the underlying illness, all of the other strategies I had tried in the past were able to take root. It was as if I had been wearing dark glasses with the wrong prescription my whole life and suddenly they had been removed. This was how “normal” people felt!?! I had been dragging a boulder behind me while everyone else skipped along unencumbered!

Depression is a serious illness and should not be ignored. We lose many good people every day to suicide. Often, well-meaning, but ignorant, family and friends tell sufferers of depression to “get over it” or “suck it up.” The proper advice to give a sick loved one is to get treatment. No one would advise a heart patient to, “Stop taking your medication. You don’t need that shit!” However, depressed people hear such comments frequently, and from people who are supposed to care about them!

Treatment programs may include medication, talk therapy, physical exercise, yoga, meditation, dietary changes and numerous other strategies. A major obstacle to any treatment program is patient noncompliance[3]. Depressed patients often feel shame and embarrassment about their condition. It takes precious little social pressure from the people in his/her life to get a depressed person to stop treatment or fail to seek treatment. The results can be tragic. Statistically, death by suicide tops chronic liver disease, Alzheimer’s, homicide, arteriosclerosis and hypertension.[4]

Even with excellent compliance, depressive episodes still happen. But, sticking with the treatment program can make episodes much less frequent and much less severe.

STEP 2: Don’t trust your gut feelings.


Emotions evolved in humans because they helped our ancestors survive.[5] Feelings of love and affection motivated them to protect younger and weaker members of their social group. Anger and fear, associated with the fight or flight response, gave early humans the instinct to protect themselves by confronting danger or fleeing to safety. In a modern society, in certain situations, some of these primitive instincts can be a hindrance. For instance, if one were to act on every violent impulse one experiences when angry, the social, legal and physical consequences would be catastrophic.

During depressive illness, gut feelings are out of whack.[6] Because they evolved from survival instincts, gut feelings can be overwhelmingly powerful and difficult to overcome. Most people assume their feelings are accurate without question. This can be a HUGE problem for people with depression. Messages from the guts of depressed people can look like this:

“You are useless.”

“All you do is screw up.”

“Your life is terrible.”

“You are a failure.”

“Everyone can see that you are a loser.”

When people trust this faulty sense they are worthless and life sucks, depression is intensified. When clinical depression manifests, symptoms are unavoidable. “Thinking your way” out of an organic, depressive episode is akin to “thinking your way” out of having a bad cold. You can be aware that you have a cold and think positive, healthy thoughts… but you will still have a cold. The depressive episode will pass, but it will do so gradually, the same way a head cold subsides.

At this stage in the game, I am acutely aware of the physical and cognitive symptoms of emerging depression. My concentration and memory slip. My ability to do complex tasks becomes impaired. Everyday activities feel overwhelming. My sleep patterns change. I know the experience is unavoidable, but I also know that it is temporary.

STEP 3: Be kind and patient with yourself.


If you have depressive illness, you have an ILLNESS! Ease up on yourself.[7] How would you treat a sick friend? Would you tell them to get over it? Would you tell them that they are worthless and lazy?

As soon as I become aware of depression, I consciously start to shift my inner dialogue:

“Take it easy. You can’t rely on your feelings today.”

“This is like a thunderstorm. It will eventually move on.”

“You can’t trust the emotional signals you’re getting today.”

 “Depressed feelings are not evidence of anything but depressed feelings. They don’t mean a damn thing.”

“Just like a head cold. Take care of yourself and it will eventually pass.”

“You are doing the best you can and that is enough.”

“If these exact same things happened on a day when you were not depressed, they would not affect you at all.”

When I realize I am dealing with a depressive episode, my priorities also shift. I know that the machine I use for problem-solving, planning, and social interactions is malfunctioning, so it’s a bad time to engage in those activities. I know not to make big decisions about my life when I’m depressed.

For some people, socializing eases depression. But for me, solitude can also be helpful. I communicate that I’m not feeling well and need some time. Then, I go off by myself and nap, read, listen to music, write, play guitar, watch movies, or do light exercise. These solo activities can be comforting to me when I’m depressed. The best strategy, when you are having severe depression, is to fill your time with any non-hazardous activities that help you cope until the episode passes.

STEP 4: Appreciate the experience.

I am a fortunate man. I was thrown into the world an intelligent, reasonably attractive, white, male American with a loving, stable family. I have received a lifetime of benefits (seen and unseen) associated with these qualities, even though I did nothing to earn them. Under other circumstances, I could have easily become an arrogant, self-righteous, uncaring, privileged jerk. But, depression has made me keenly aware of human suffering. Depression helped make me an empathetic, caring human being. Depression has given me the opportunity to experience depths of emotion that are not available to people without the condition. I wouldn't wish it on my worst enemy, but I wouldn't be me without depression. And, I love being me!

People say they want a “happy life.” I consider this a foolish aspiration. Every healthy person will live through a complete repertoire of emotional experiences. Each of us will know joy, sadness, boredom, love, hate, excitement, bliss, pain, and on, and on. Emotions give color and texture and meaning to our lives. Often times the most difficult emotional experiences are the most necessary ones for our own development.[8]

I don’t think anyone would actually want a “happy life” even if it were possible. Less emotional experiences would mean being less human. Why are there movie genres for horror, comedy, tragedy, action, romance, and fantasy? Because people want to experience a full range of human emotions!

No one “enjoys” having depression, but the experience is wasted if you fail to, at least, appreciate it.



[1] "Hotline Information." Depression Statistics. N.p., n.d. Web. 21 Apr. 2015.
[2] "Major Depressive Episode Symptoms." Psych Central. N.p., n.d. Web. 21 Apr. 2015.
[3] Martin, Leslie R., Summer L. Williams, Kelly B. Haskard, and M. Robin DiMatteo. "The Challenge of Patient Adherence." Therapeutics and Clinical Risk Management. Dove Medical Press, n.d. Web. 21 Apr. 2015.
[4] "Hotline Information." Depression Statistics. N.p., n.d. Web. 21 Apr. 2015.
[5] "The Nature of Emotions." » American Scientist. N.p., n.d. Web. 21 Apr. 2015.
[6] "Corsair Philosophy." : Why You Can't Always Trust Your "Gut Feelings?" N.p., n.d. Web. 21 Apr. 2015.
[7] "Depression Acting Up? 5 Ways To Be Kind to Yourself." Depression Acting Up? 5 Ways To Be Kind to Yourself. N.p., n.d. Web. 21 Apr. 2015.
[8] "Negative Emotions Are Key to Well-Being." Scientific American Global RSS. N.p., n.d. Web. 21 Apr. 2015.

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