Did we get depression all wrong?

Woman with depression holding her knees to her chest

If you read the statistics about depression in the U.S., you’ll probably want to go straight back to bed and stay there. According to the Anxiety and Depression Association of American (ADAA) almost 7% of U.S. adults experienced a major depressive episode in the past year. To put that in context, that’s 322 million people in the U.S. alone.

The official word (from the National Institutes of Health) says: “Our ability to treat mental illnesses like depression has changed the lives of millions of Americans and their loved ones. Today the vast majority of people, even those with the most severe depression, can get better with medications or cognitive behavioral therapy or a combination of both.”

The NIH and its associated medical professionals recommend the following:

  • Increased education and awareness steers more people with depression to effective therapies, saving millions in health care costs and lost productivity in the workplace.
  • Genetic markers for depression risk match patients to the best treatments for them.
  • Antidepressants relieve depression within hours, reducing the rate of suicide, substance abuse, and disability.

But what if that’s only half the story?

It’s entirely possible that we’ve got depression all wrong. Not just in the way we categorize it and view it, but treat it. If you feel you might be descending into depression, read on, we have some hope to share. And, right at the end, we suggest a few tips you could try today to avoid any impending dark clouds on the horizon.

However, we just want to say that if you’re experiencing any suicidal ideation, get help ASAP. You’re the only one of you we’ve got. You’re not alone. We’re in this together.

Reframing depression for a new generation

Award-winning investigative journalist Johann Hari was diagnosed with depression when he was a teenager. He told his primary care provider that he felt “like pain was leaking out of him,” and he couldn’t understand it or control it. Like many, he was given medications with the intent of rectifying some chemical imbalance. They worked for a while, and then they didn’t, and he was utterly bereft once more.

But because Hari is a journalist, he decided to research the subject and go deep into the causes and conditions of his state of mind. You can learn more in his TED talk where he describes going on a 40,000 mile journey across the world to talk with leading experts, as well as those suffering or in joyful remission, from similar situations. For a more in-depth exploration, check out his excellent book “Lost Connections.”

Hari’s main argument is that it’s not (just) biology. Yes, some of us might have a genetic heritage which gives us a tendency towards depression, but, as Hari points out: “genes don’t write your destiny.”

Instead he wants us all to look at the wider implications of societal-imposed structures which leave many lacking family or like-minded community. He makes an impassioned argument for finding meaning and purpose. Because in the end, why are we here as humans, if it’s not to help one another and make a difference by being on the planet for the short time we have?

Maybe it’s the three brain problem?

The British psychotherapist Philippa Perry, in her book “How to Stay Sane,” talks about the constant dialogue between our three different brain structures – left brain (linear, analytical), right brain (emotional, sensory), and brain stem (aka reptilian brain, controls involuntary processes like keeping your heart pumping). Her point is that early childhood experiences are vital for proper cognitive development, but if trauma is experienced, the neurons in the brain are unable to form networks which establish security, trust and the elements required for true mental health.

However, as Perry points out, all is not lost. The brain is remarkable in its plasticity – which is how we are able to acquire new skills, different languages, survive unforeseen life experiences and, on a mundane level, drive a car.

Through talk therapy, due to the nature of our brains, Perry says: “we learn to stand outside ourselves in order to experience, acknowledge, and accept feelings, sensations and thoughts.” The development of this capacity allows us to grow and move beyond trauma, which may have led to depression. We can literally “process” and move on. We are not stuck in the diagnosis but equipped to move beyond it – and thrive.

So if you’re sitting in front of a medical professional and all they offer you is pills, tell them you want more help than that. Because it’s not just good to talk – it’s essential.

Enlightened witnesses

Interestingly, what Hari and Perry (and many others) agree on, is that talking about our story literally changes the structure of our brains. We all have a story – a narrative if you like – about what happened to us, or how we perceived it (that’s an important point we’ll come to in a moment). Due to these beliefs, we might have slipped into a depressive state, because it felt as if there was no other option. Maybe we just need to examine that story – tell someone the truth about what happened – and be able to repair our psyche again.

Talking to what Perry calls “enlightened witnesses” (non-judgemental people who will just listen – not narcissists who wait and then dump their pain back on you) is the key to healing. Hari agrees with this – and centers his experience within community.

In his book, Hari talks about finding companions who are either informed and sympathetic, or similarly suffering, and finding relief through identification. Interestingly, if you look at the etymology of the word “companion” it means someone with whom you “break bread” (“panis” being Latin for bread and “com” means “with”).

The concept of “fellow companions” occurs in many modalities, including group therapy and 12-step based recovery programs. You may have heard of 12-step recovery for those dealing with addiction, but it’s become widely used for a number of disorders, including depression. In fact, researchers have validated the molecular neurobiological effects of such groups and their work is published by the National Institutes of Health. Talking with others going through the same stuff not only provides hope and support, but literally changes your brain.

Is depression just a sane response to an insane situation?

When something happens, perhaps depression is a natural response to an unbearable situation. Johann Hari says he stopped looking for biological reasons for his depression, and, instead, looked at his life. He realized he had no sense of belonging, of meaning or purpose. He didn’t feel that people valued him, or saw him for who he really was. He had no hope for the future. No wonder he felt depressed.

“Most of the factors that have been proven to cause depression and anxiety are not in our biology. They are factors in the way we live,” said Hari in his TED speech. “And once you understand them, it opens up a very different set of solutions that should be offered to people alongside the option of chemical antidepressants. I really wrestled with the idea of shifting from thinking of my depression as just a problem in my brain, to one with many causes, including many in the way we’re living.”

Can we think about depression differently?

Perhaps it’s more helpful to look at depression as a “signal” that some basic unmet psychological needs need to be met. The need to break out of isolation (hint: get out of the house, start talking to people), find meaning, discover a real purpose, build connections.

The World Health Organization recommends we all talk about depression and, instead of asking “what’s wrong?”, we need to start asking “what happened?”. Even the future King of England is willing to start the dialogue (check out #oktosay) – as is Lady Gaga, (one of) the Queen(s) of Pop with her mental health for teens focus at Born This Way Foundation.

Don’t fix the symptoms, you’re not addressing the cause. It’s becoming clearer that psychosocial factors can cause depression. Hari talks about “junk values” in his book. Take a look at your life. Are you pursuing materialism at the expense of deep spiritual satisfaction? You know the “stuff” (cars, gadgets, bigger houses, prestigious jobs) can’t fix you. It just drives a greater need for acquisition and status.

The incredible weirdness of being human

Let’s look at the notion of being human – because, when you really consider it, it’s a deeply strange thing to be. For a start, we’re on a planet, spinning on an axis, orbiting our heat/light source (the Sun – 92 million miles away), in a relatively small cluster of galaxies (known as the “Local Group”) and, not to freak you out, but the Sun is predicted to “go code red” in 5 billion years and wipe out this planet. As you might expect, this is the big push behind going beyond a single planet species.

Although we’ve been scanning the solar system for decades, to all intents and purposes, we appear to be alone (or just not interesting enough for “first contact”) – apart from some (long dead) bacteria on Mars. Plus humans die – a fact most people can’t really get their heads around because it’s unfathomable, so most of us (in the Western world at least) avoid thinking about it. Then there’s tragedy – both personal and global – wars, famines, natural disasters, sickness, injury, the list goes on. When you think about it, it’s a miracle not all of us are depressed.

History shows us that human beings are capable of inflicting senseless and immense cruelty. But here’s the good news: humans are also the arbiters of an astonishing level of compassion, have the ability to create beauty, to build ties that bind, and bridges across cultures and understanding. This is why not everyone is depressed – there’s an enormous amount to be hopeful about.

Changing your perspective

Medical researchers have proved that choosing to focus your attention away from the catastrophic and onto something positive works. You might roll your eyes at the concept of doing a “gratitude list” but shifting from what’s wrong to what’s right, even if the latter is a much shorter list than the former, is a step in the right direction.

You won’t be alone – almost 19,000 people have posted their examples on IG to date. You don’t have to go public with your positivity, perhaps share it with like-minded friends, or just write one for yourself, before you start your day, just to clear the cobwebs from your mind.

Other tools

We want to reiterate that if you’re feeling depressed and suicidal, you need to seek help right now – Call 1-800-273-8255 – people who care are waiting to listen 24/7.

But what we wanted to do here is provide a more holistic, and hopeful, look at depression. To examine whether it’s “just biology” or whether it could have more psychosocial causes around meaning, purpose, the human condition and the modern malaise around “junk values.”

If you’re feeling anxiety (which can become a precursor to deeper feelings of depression), check out our article here for some helpful tips around mindfulness and a breathing exercise deployed by the U.S. Marines.

Turn your day around with some of these tips to find community, connection and well-being – the ultimate salves for depressive downers.

  • Rethink your meals: take a look at your nutritional choices – are you supporting your optimum health? Remember sugar is a depressant.
  • Build a better sleep environment: watching television in bed? Checking your phone in the middle of the night? You might want to address your nightly habits to stave off sadness during the day. Here’s how.
  • Get moving: grab those sneakers and find a walking trail near you. Go with a friend if you can – or take Sinatra with you to put a spring in your step.
  • Help others: Locate a good volunteer program and get out of your head by helping others less fortunate – it’ll give you a glow, and you’ll meet great people.
  • Get creative: Groupon has a list of deals on arts and crafts activities in your area – express yourself (it’s the antithesis of depressing yourself after all).
  • Only connect: the prison system has a long-running program for pen pals – your letters could be the only connection someone has with the outside world.
  • Bring books to life: volunteer for the Reach Out & Read program at your local library.
  • Deliver sustenance: sign up for Project Angel Food to take meals to housebound people dealing with serious illnesses.

Finally, practice kindness: smile at everyone you meet today – you have no idea what others are going through – and a smile usually engenders one in return – we’re in this together, remember. It takes work to stay sane, but it’s so worth it.