Depression: when brain gears grind slow

When people start to feel overwhelmed and lose their interest, energy, and sense of competence for more than a few weeks, they are said to suffer from “depression.”  Several Canadian sources show that about one in five people  are seriously depressed in this way at some point in their lives, and a certain number are “clinically depressed” on the long-term.  So what can be done?

We can avoid the issue, I suppose.  We can go drinking, though alcohol is a depressant beyond its short-term effects.  But if we don’t deny the problem, we could force ourselves to get exercise.  It can help just to keep moving, and if we exercise with other people, so much the better.  Although that may not keep depression from returning.

We could blame others for the way we feel, but since we can’t change them, that won’t do us much good.  We can expose ourselves daily to motivational slogans (“think positively, be all you can be, just tell discouragement where to go,” and so on), though ultimately lack of motivation is a symptom of depression that mere slogans will not cure.  We could also use a religious approach, which may provide some hope and a better outlook on life, as long as it doesn’t become a form of denial (e.g. “I’ll just praise the blues away”).  Perhaps we can join a musical group (sing the blues away), and though the socialization of that may certainly be a benefit, we also know there are large number of depressed musicians and entertainers out there.

Or, we can get some antidepressant medication and go for talk therapy.  Let’s take the therapy first.  There is a very wide-spread approach called CBT, that’s Cognitive Behavioral Therapy, which focuses on a person’s habitual beliefs about reality.  It’s known as a good therapy but it needs the client to be able to think matters through fairly logically  – and that is sometimes not the case.  Many people who come for help are indeed able to benefit from a CBT approach, as long as their issues are not too deeply-rooted, their trauma not related to more than one event, their personalities not being too damaged, or their mental-emotional development not too stunted.  For them CBT can be useful.  Governments around the world with budget problems in their medical and social programs have been favoring this short-term approach so that clients can be quickly discharged from services.  The political thinking is that those who need more can always apply again later for another cost-cutting dose of short service.

These thoughts were triggered by a recent discussion I had with a friend of mine about the views and writings of a clinical psychologist named Jonathan Shedler. Shedler has serious doubts about the much-publicized usefulness of CBT, and he has also questioned what he calls the “antidepressant superstition.” Though acknowledging that these pills really are effective for a minority of depressed people, he points out that the medication doesn’t just drop out of the sky but is given only when a person finally goes for help, opens up about the problem of depression, and has the doctor or therapist explain and “normalize” depression (to make the person feel they are not crazy or alone).  Studies show that this process of going for help already makes the person be less passive and hopeless, and start feeling better even before therapy is begun or any drugs are prescribed.

So we can certainly help ourselves, if we have depression, by acknowledging the problem and looking for support.  If the problem is moderate or temporary (e.g. seasonal), some of the above methods may help us get over a hump and move on with life.  But otherwise we need to open up to our partner, a good friend, or a professional person, and ask for understanding and help.  And if it’s not our own issue, we can support a friend, co-worker, client or relative, by making it easier for them to get help.  We can aid them with making an appointment, provide transportation, or other assistance.  Most importantly, we can help by having a genuine acceptance of the depressed person, encouraging them with the hope of a nonjudgmental relationship.

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