How to Wade the Great Divide Without Drugs—Part 1
“The blues are because it’s been raining too long. You’re just sad, that’s all. But the mean reds are horrible. Suddenly you’re afraid, and you don’t know what you’re afraid of.”
—Holly Golightly, lead character in Truman Capote’s Breakfast at Tiffany’s
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When I initially conceptualized this article, I was thinking of writing it in the same way as my other factual and research-based articles for publication in newspapers and magazines. But I thought that would bore the heck out of our readers. They need something they can use right away and apply in their day-to-day lives.
I found that our 21st-century attention spans can only handle so many serious matters that it’s up to the disseminators of information to break it down into readable chunks. So let’s get to it.
What Is Depression?
Depression is a mood disorder brought on by many different causes. It is an actual medical illness and not just an emotional ploy by whiners to get attention. The latter is a concrete example of how some people accuse those who are depressed. Other accusations include: ”Depressed people are lazy, self-indulgent, wallowing in self-pity, or losers.”
Even if depression is officially classified as a mental health disorder, it doesn’t mean those who are experiencing it are crazy. You cannot simply “suck it up,” “snap out of it,” or “get over it.” Depression cannot “go away by itself.”
Accepted Treatments for Depression
Doctors and scientists are still debating on the best course of action to deal with it. Some, especially psychiatrists (who are licensed to give prescriptions; psychologists are not), believe that medication is the way to go. This is true for severe cases and suicidal patients, but has been found to be detrimental to (and can even worsen) mild and mid-range cases.
There is no magical pill that can cure depression, but there are specific medications that can relieve its symptoms. Many mental health practitioners are wary about giving their patients heavy drugs because many of these are addictive.
So they suggest psychotherapy instead, which has multiple branches and includes talk therapy and cognitive-behavioral therapy. Currently, the most recommended treatment plan is a combination of medication and psychotherapy—treating mental disorders using psychological (rather than medical) methods.
The good news is, depression is manageable and treatable. But there is no perfect solution. The type and duration of treatment vary per individual.
Types of Depression (in layman’s terms)
We can discuss the many types and sub-types of depression as categorized in the Diagnostic and Statistical Manual of Mental Disorders (DSM), but we will tackle these in a future formal article to avoid overwhelming people who just want quick answers. (But not quick solutions—there isn’t any).
A simplified way to classify depression is to group them according to their most common causes:
Clinical—caused by a chemical imbalance in the brain; includes psychological disorders
Circumstantial—caused by life events like job loss, financial difficulties, relationship breakdown, or the death of loved ones
Medication-induced—depression as a side-effect of medications, including those that treat high blood pressure, cardiovascular diseases, Parkinson’s, hormonal problems, arthritis, anxiety, insomnia, seizures, and glaucoma
Substance-induced—caused by excessive intake of alcohol or drugs
Genetic—caused by a family history of depression or other mental health issues
Seasonal—brought on by weather changes; usually occurs in the winter when daylight is scarce. An example is Seasonal Affective Disorder (SAD).
Hormonal—those that occur due to hormonal changes. Examples are postpartum (after childbirth) depression and that which accompanies menopause.
Age-related—associated with middle age, the twilight years, or retirement. Contrary to popular belief, seniors are not the leaders in the age groups suffering the most from depression. According to the Centers for Disease Control and Prevention’s National Center for Health Statistics Data Brief No. 379, September 2020, depression is highest among 18-29 year olds (21%). They are followed by the 45-64 age group and 65 and over (both 18.4%), then those aged 30-44 (16.8%).
The World Health Organization’s January 2020 fact sheet on depression states that “Suicide is the second leading cause of death among 15 to 29-year-olds.”
How to Know if It’s Depression or Something Else
You, or someone you care about, feel you (or they) may be depressed but aren’t sure. How do you know if it’s depression and not just deep sadness, loneliness, or grief?
But first, note the difference between these terms:
Solitude—a conscious, voluntary effort to be alone. One does this on purpose. A person who chooses to be alone isn’t necessarily lonely.
Loneliness—a reaction to being alone. Unlike going into solitude, you do not “volunteer” to be lonely.
Sadness—(aka feeling down/low/blue) is a normal reaction to problems, losses, disappointment, or bothersome situations. Feeling occasionally sad is part of being human. Normal sadness doesn’t last long and doesn’t affect regular activities. Once gone, it allows you to return to daily life and carry on normally.
Depression—extreme, seemingly uncontrollable, or prolonged sadness or hopelessness that interferes with activities of daily living and negatively impacts one’s functioning
Choose Your Sanctuary Wisely
Holly Golightly, Audrey Hepburn’s character in the classic movie, Breakfast at Tiffany’s, called depression “the mean reds.”
She (or rather, Truman Capote, the author of the book the movie was based on) nailed down the distinction between sadness and depression with these lines: “The blues are because you’re getting fat, and maybe it’s been raining too long. You’re just sad, that’s all. The mean reds are horrible. Suddenly you’re afraid, and you don’t know what you’re afraid of.”
She said that whenever she had one of the mean reds, she went to Tiffany’s (the upscale jewelry store) and it would immediately calm her down.
We recommend people with depression to identify their own Tiffany’s. It may be the beach, your mom’s kitchen, a place of worship… even under the piano. For many people, it’s a bar, wild parties, or a drug den. These three are the worst Tiffany equivalents ever. Choose yours carefully.
How to know if you are depressed:
1) Get a diagnosis from a mental health professional, like a counselor, psychologist, or psychiatrist. In this COVID environment, you don’t even need to get out of the house. Many medical practitioners are now offering consultations and treatments online.
Telehealth (aka telemedicine) is only one example. Private video conferences have taken the stink out of sitting in clinic waiting rooms where most patients are afraid of running into people they know.
2) For those who don’t want to waste a single dime, or can’t be bothered to take heavy-duty action, there are free online tests to find out if you are clinically depressed. You’ll be given a series of easy questions (most of them multiple choice) so you don’t need to be an astrophysicist to answer them.
The test result will pertain only to you and will depend on your honesty. Most of the tests will give you results right away in a snapshot. But if you want an in-depth interpretation, you have to register with the website. Take note that online tests are never substitutes for consultations with medical professionals.
3) Your sadness, loneliness, or grief lasts longer than two weeks and starts to negatively affect your daily functioning: like making decisions, going to work, getting out of bed, or remembering where you put things. Two weeks is the clinical rule, but we, as grief sufferers, think this criterion should be expanded to a much longer period when it comes to grief from bereavement (experiencing the death of loved ones).
4) Check if you have any of the symptoms of depression below. A minimum of five may indicate that you may be suffering from major depressive disorder (aka clinical depression). This is the most common form. More than 16 million US adults have had at least one episode, according to Web MD.
Symptoms of Depression
Doctors make a diagnosis by looking for at least five of these symptoms affecting how people feel, think, and behave:
Long-term sadness
Loss of interest in activities that were enjoyable before
Difficulty sleeping or oversleeping
Difficulty making decisions
Difficulty concentrating
Extreme forgetfulness
Suicidal thoughts or actions
Loss of, or increase in appetite
Feeling unreasonably guilty or worthless
Feeling hopeless
A marked increase in irritability
Uncontrollable anger
Unexplainable pain
A massive decline in energy levels
Heaviness in the arms and legs not caused by tiredness
Practical Ways of Dealing With Depression
✓ ”Normal” exercise:
walking
jogging/running
weight training and using gym equipment
spinning
swimming
✓ Indulge in sports. We recommend tennis, baseball, boxing, and kickboxing for people who need anger management. (There’s something incredibly satisfying about hitting or smashing something that’s guaranteed not to get you in trouble with the authorities, whether it’s a baseball, tennis ball, or punching bag.)
✓ Do a variation of the above without hitting anything. How? I perform kathas (a series of memorized moves) from Shotokan karate, for example. But equivalent regulated sets of movements from other martial art forms will do, too. Anyone can learn these online.
✓ This is difficult for depressed people, but try to maintain your normal routine or activities of daily living: going to bed and waking up the same time every day, making up the bed, brushing teeth, showering and other hygienic practices, eating, changing clothes, doing laundry, etc. If you can’t do these yourself, ask a trusted person to help you. Inga, for example, asked her younger sister to spritz her with cold water if she doesn’t get up at a specified time, promising not to be angry with her.
Sven temporarily switched to paper plates and biodegradable disposable cutlery because he couldn’t bring himself to wash dishes. Previously, he had let them pile up until there was nothing left to hold his food and insects had started making nests in his dirty sink.
✓ Stack up on vitamin B complex (especially B12) and Omega 3 fatty acids (from oily fish like salmon; also available in pill form). These are examples of evidence-based natural remedies for depression with little to no side effects.
✓ St. John’s Wort is a popular herbal medicine that has been scientifically proven to be effective in treating mood disorders and mild to moderate depression. It has been receiving some bad rap lately, so we don’t necessarily recommend it but feel the need to mention it because it is included in evidence-based therapies.
The National Center for Complementary and Integrative Health (under the US Department of Health and Human Services) has published the results of clinical studies on the herb.
Many physicians prescribe it to patients suffering from depression who are not on any prescription medication. In Europe, it is widely prescribed for treating depression. In the US, it is sold as a dietary supplement. Consult your doctor before adding it to your regimen because it has been known to interact with certain medications (primarily reducing their efficacy), such as blood thinners, oral contraceptives, and antidepressants.
✓ Get lots of fresh air and sunshine. If you don’t feel inclined to go out, at least open windows and curtains/blinds.
✓ Sleep deprivation is a major problem for people with depression. Instead of taking prescription tranquilizers, which can be addictive, choose herbal medicine or aromatherapy instead.
Ask your physician to refer you to a naturopathic, homeopathic, or Ayurvedic doctor for this. Or ask your neighborhood pharmacist. They may start you off with melatonin, a naturally occurring hormone from the pineal gland that regulates sleep and reproductive cycles.
There are some exercises you can do to induce sleep. Yoga, mindfulness, meditation, and t’ai chi instructors can help with these. Lots of YouTube videos tackle the topic too but keep to those connected with the medical profession (Mayo Clinic, Web MD, Harvard Medical) or experts in the alternative medicine community.
✓ Change your environment:
Go on a trip, but you don’t have to go abroad. As we’re limited by the pandemic, a nearby mall or community garden will do.
If accessible, visit the oceanside (or any natural body of water), a park, or a meadow with lots of open space.
If the above isn’t possible, follow Ulrika’s example. She longs to go to the beach but lives in a landlocked area. So she decorates her living room with tropical plants, a portable water feature with a sandy base, and runs slides of ocean-related wallpapers on the screens of her computer and mobile devices.
Make small doable changes to your surroundings, like switching drapes, rearranging furniture, adding accents or soft furnishings, or repainting the walls. If you can afford it (or have willing friends or relatives), have others do this for you. Most depressed people don’t have the inclination to move, much less do new things.
Art lovers: visit galleries, museums, exhibits, retrospectives. (Online, during quarantine.)
✓ Distraction Therapy:
Read books (or other literature).
Listen to audiobooks if you have vision problems or couldn’t be bothered to hold a physical book.
Listen to peaceful music to calm your nerves. Download audio files from providers like Spotify or stream tunes on YouTube, which also feature relaxing sounds and white noise that you can set to loop repeatedly to help you sleep. Or listen to CDs, records, or tapes. (Not everyone is digitally inclined, you see.)
Watch TV, movies, or videos. Maximize comedies and minimize/avoid dramas, horror flicks, and extremely violent media.
Play games: physical, board, social, or video.
Take up gardening, scrapbooking, needlework, craftwork, or other hobbies. These should be activities you enjoy. Otherwise, doing them would feel like a chore.
The objective of distraction therapy is to move your attention away from sadness, negative thoughts, and ruminating on problems. However, potentially addictive activities like playing video games and watching TV should be done in moderation.
Final Thoughts
There are more ways to battle this disease. For the more adventurous—or those who have tried allopathic medicine (aka Western medicine) or traditional remedies but haven’t had relief or resolution—we suggest some wacky methods too.
Check them out in part two of this series: Wacky Ways to Deal With Depression.
We hope this post helps you in some way, whether small or significant. Here’s to a clear, targeted path toward healing.
Sources:
Centers for Disease Control and Prevention’s National Center for Health Statistics Data Brief No. 379 (based on 2019 statistics; published on September 2020)—Symptoms of Depression Among Adults: United States
World Health Organization’s January 2020 fact sheet on depression
National Center for Complementary and Integrative Health: St. John’s Wort and Depression—In Depth
Photo Credits:
Time lapse—Simon Zhu
Kermit the frog and Pink Panther—Alexas Fotos
Glass head—Jill Fulton
Sad pug—Matthew Henry
Tennis—Moises Alex
Kickboxing/karate—Kinna Mikitas
Open window—Venita Oberholster
Exercise in silhouette—Sasin Tipchai
Boy with a book—Ben White
Kid watering plants—Filip Urban
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