In the May 2007 issue of Harper’s Magazine (which should be on newsstands shortly – I am a subscriber), a fascinating cover article appears entitled “Manufacturing Depression: A Journey into the Economy of Melancholy.” Written by Gary Greenberg, a psychotherapist, the article’s main idea is that true depression is actually an extremely rare event and the prevalence of depression in America is manufactured.
So why are so many Americans “depressed,” at least in the eyes of modern medicine?
First, most of the people who are currently diagnosed as depressed are actually just melancholic, which is a normal, healthy mood. Often, people who are strongly melancholic a good deal of the time are also not depressed – they merely have other factors in their life that are contributing to a melancholic mood. I admit that I often am in a melancholic mood and have wondered if I am depressed, but often doing certain activities repeatedly will improve the mood over time, so this part of the article seems highly true to me.
Second, the tests for identifying the depressed and also measuring the progress of the depressed rely on each other for statistical validity. From the article:
The way that these researchers decide whether these tests can accurately indicate depression is by correlating responses on them to reponses on tests already known to measure depression – a good idea, unless there is no anchor on the end of the chain, in which case you may have created a self-validating semiotic monster.
In other words, the only evidence that a test for depression actually indicates depression is that another pre-existing test says so.
Third, in FDA clinical trials, antidepressants only make a very small difference in treating depression, as compared to placebos. Another quote from the article:
The advantage of antidepressants over placebos in those trials [FDA trials for Celexa] was an average of two points on the HAM-D [a very common test for registering improvement in treating depression], a result that could be achieved if the patient ate and slept better. The average improvement in antidepressant clinical trials is just over ten points, which means, according to Irving Kirsch, a University of Connecticut psychologist, that nearly 80 percent of the drug effect is actually a placebo.
Given that antidepressants can easily cost as much as $3 a pill, this is a pretty significant article worth reading for people who are suffering from clinically diagnosed depression. The questions raised by this article, written in a highly reputable and fact-checked publication, are serious enough that a person taking antidepressants should ask some serious questions about what they’re really taking – and why.
While I am the last person to claim any sort of medical expertise, I do know what it feels like to exhibit many of the symptoms of depression and my own experience showed me that making some lifestyle changes and committing myself to them enabled me to move away from a constant state of melancholy into a much happier life. The tips below are no substitute for medical advice, but if you are concerned about feeling depressed, here are ten tips for battling a melancholic mood with free or nearly free things that may help.
Have fun. Do something that can completely take you away from the feelings of your everyday routine. Turn off your cell phone for a few hours and dive into something with your whole heart. For me, this is actually the library, or else a long walk in the wilderness. Because I’m cut off from the routine and the pressures that go with it, I come back feeling genuinely reinvigorated and ready to meet the challenges of life.
Eat well. Make sure you’re getting enough fruits and vegetables in your diet – and, no, the lettuce on your fast food hamburger doesn’t count. If you don’t prepare food for yourself, try eating food at restaurants that prepare well-balanced meals.
Get some exercise. If you’re out of shape, just go for a walk around the block. Stretch yourself out a time or two a day by flexing all of your joints as far as you can. A strong exercise regimen is a big commitment for some, but anyone can take the time to stretch and go for a walk.
Drink lots of water. The USDA recommends eight 8 ounce glasses of water a day, not soda or beer or anything else. Turn on your tap and drink – it’s really inexpensive and one of the best things you can do for yourself.
Associate with people that you primarily associated with when you were happy. In other words, try to reconnect with old friends and family members. Sometimes, you’ll discover that your social crowd is sometimes responsible for your negative feelings – and if that’s the case, you need to make some changes to your social life.
Set small goals – and reach them. Don’t go home and sit around in a state of sadness because you can’t accomplish anything. Set a very small goal that you can reach in an hour or two, then just try to do it. When you’re able to do that, try easing into a productivity plan like GTD which anyone can use and is very effective at making you feel really productive. A sense of achievement is one of life’s greatest natural boosts.
Get a normal amount of sleep. For most people, a normal night of sleep is between seven and ten hours. If you’re getting significantly less or significantly more than this, try to adjust your sleep so that you’re in that range.
Get regular massages. My wife and I give each other massages and it may in fact be the most consistent long-term mood elevator in my life. If you don’t have a significant other or a close friend who can give you a gentle massage, it may be worth saving up nickels and dimes to get a professional one.
Don’t expect dramatic mood improvement overnight. If you walk around the block, get an endorphin rush, and use that rush to do four or five things that have been nagging you, and suddenly you feel really good, don’t despair if the sadness returns. An overall mood, especially an entrenched one, doesn’t change overnight. Try doing more of the positive things that made you feel better instead.
Go to sleep thinking about the positive things you did today, not the negative ones. Make it a goal to do at least one positive thing in a day – walking around the block, going to work and getting your tasks done, sweeping the kitchen floor, getting through your GTD inbox, whatever it takes – and then think about that success as you go to sleep at night. It gives your mind something good to focus on as you wind down in the evening and drift off to dreamland.
If it is true that you are merely suffering from melancholy and not depression, some combination of these activities can almost assuredly lift your mood – and save you the tremendous cost of professional help and antidepressants. However, if these do not help, please seek a medical professional.