You Can Recover From Depression

I am 57 years old. I am a lawyer. And I struggle with depression.

I was diagnosed when I turned forty.  I didn’t know what was happening to me. But I knew something was wrong. I was crying quite a bit.  My sleep became disrupted. It became difficult to concentrate.  I felt no joy in my life.

Ultimately, my family doctor diagnosed me with major depression and provided me with the help I needed. I started going to therapy and was put on anti-depressants. This saved my life.

Since being diagnosed all those years ago, I have learned to live with depression as have many of the 20 million people who are living with this illness right now in this country.

“Aren’t Your Meds Working?”

A friend I hadn’t seen in months bumped into me at Starbucks.

I’d been standing in line waiting for coffee.  There was a tap-tap on my shoulder. Turning around, I saw my friend, Brian, who, like me, had been a lawyer for over twenty-five years. 

Accomplished and well-connected, Brian had a quiet composure that appeared to follow him wherever he went. I liked him. You could look into his eyes.  And he would look attentively back.  He knew I had struggled with depression.

“How are you?” he said.

“Not so great,” I slumped.

Recovery from Depression: The Power of Expectation

Recovery from depression depends in part on what you believe is possible for the future. If you are to recover at all, you have to take action at some point. It could be a series of small steps about your daily routine – eating breakfast, walking out the door to get fresh air and natural light, making a point of talking to someone each day.

Or it could be much larger, like going to a psychiatrist and starting treatment, regularly meditating, exercising frequently, taking long walks. Whatever it is, you need to feel motivated to overcome the inertia, to stop the loss of warming energy to the cold stillness of depression.

To feel motivation, you need to believe, however tentatively, that you can change for the better, to expect recovery from the worst symptoms. You’re likely to hit a lot of barriers, though, that make it hard to keep up positive expectations.

When you expect to fail, it often happens that you stop taking action to help yourself recover. The deeply ingrained habits of depressive thinking and belief can quickly take over. You might start making rules and setting goals.

If recovery is not total and permanent, it’s not recovery. Treatments can’t fail, depression relapse can’t happen. You can’t be recovered if you’re still on medication. You have to get better in six months or a year, or some fixed period of time.

Of course, the rules and goals are entirely your invention, but they’re part of the expectations you feel in your gut. If you can’t meet them, the disappointment confirms your deepest conviction that you can never succeed.

Finding Meaning in the Legal Profession:An Interview with Dr James Hollis

This is my interview with psychoanalyst, James Hollis, Ph.D., author of the best-selling books, “What Matters Most: Living a More Considered Life,” and “Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up

Dan:  What is depression?

Jim:   I think first of all we have to differentiate between depressions because it‘s a blanket term which is used to describe many different experiences, different contexts and different internalized experiences of people.  First of all, there is the kind of depression that is driven by biological sources and it is still a mystery as to how that works.  We know it affects a certain number of people in profound ways.   Second, there is reactive depression which is the experience of a person who has suffered loss and as we invest energy in a relationship or a situation and for whatever reason, that other is taken away from us, that energy that was attached to him will invert as depression.  Reactive depression is actually normal.

We would have to figure out where that fine line is and where it might cross over into something that was more than normal.  When we say that a person is grieving too long or it is affecting their lives so profoundly, that’s a judgment call, of course, but we do know people that have been sort of destroyed by reactive depression because they had attached so much of their identity to the other, whatever it might be: a position in life that they lost or a relationship that was important.

But I think none of us can avoid occasional reactive depressions because life is a series of attachments and losses.  Most commonly, when we think about depression, however,

Seasonal Affective Disorder: What You Need to Know

We set our clocks back an hour in early November, resulting in shorter days, and darker skies before most of us leave work each afternoon.

It is important to understand the effect that light has on us. If you find yourself falling into the doldrums at this time of year as the number of daylight hours dwindle, seasonal affective disorder (SAD), sometimes called seasonal depression, may be to blame. Most SAD sufferers experience symptoms during the winter months, causing researchers to conclude that inadequate sunlight may play a role. But you don’t have to spend the winter months feeling depressed and unmotivated. Here’s what you need to know about SAD and how to alleviate it.

What Causes Seasonal Affective Disorder?

Most researchers believe decreased access to sunlight plays a role in seasonal affective disorder. Light affects our circadian rhythms, and UV rays can also change how the body processes vital minerals and other nutrients. For example, inadequate sunlight exposure is linked to low Vitamin D, which, in turn, has been linked to depression and other physical and mental health woes. So, the effects of darkness on the body—not just darkness itself—might be partially to blame.

A recent study, published in the Journal of Affective Disorders, bolstered the connection between SAD and inadequate sunlight. It found that weather and climate—including rain and pollution levels—don’t appear to alter mood. But access to sunlight is a major predictor of mental health. In the study, people who lived in regions with shorter, darker days were more likely to experience poor mental health.

While light almost certainly plays a role, not all cases of SAD occur during the short, dark days of winter. A small fraction of cases occur on a seasonal basis during the spring or summer, which suggests that no single factor can fully explain SAD. Other potential risk factors include:

  • Seasonal lifestyle changes. If you only work during a portion of the year, have less to do during a specific time period, or face annual stress, you may experience seasonal depression.
  • Seasonal associations with previous trauma and grief. Our minds form strong connections between the sights and sounds of seasonal shifts and memories of the past. You may find yourself growing depressed each year around the time you suffered a trauma or loss.
  • Cultural norms and traditions. The high of the holiday season followed by the low of the new year can spur depression in some people.
  • Certain health issues are more likely to manifest at specific times of the year. For example, if you have severe allergies, you may get depressed in the spring, while chronic bronchitis can make the winter months depressing.

Each of these factors alone is unlikely to trigger depression, but in conjunction with other risk factors—including a family history of any form of mental illness—they can lead to SAD.

Symptoms of Seasonal Affective Disorder

Cyclical depression that occurs around the same time each year or that relents when the season changes, is the hallmark of SAD. If symptoms are not cyclical, you might be diagnosed with another disorder, such as major depressive disorder or dysthymia.

People with SAD often experience depressive symptoms which are less severe than those associated with major depressive disorders. Though suicidal thoughts can and do occur—particularly if SAD is left untreated—these thoughts are less common. Some common symptoms include:

  1. Low energy, feelings of grogginess, or excessive sleep. People with summer SAD may experience insomnia.
  2. Changes in appetite. People with SAD are vulnerable to weight gain. SAD sometimes causes carbohydrate cravings, because carbs offer a temporary energy boost.
  3. Irritability and anger.
  4. Changes in your relationships with others: People with SAD often feel lonely and rejected.
  5. Loss of interest in previously enjoyed activities.
  6. Feelings of guilt.
  7. Dread or uncertainty about the future.
  8. Loss of motivation.
  9. Feelings of sadness.

Treatment for Seasonal Affective Disorder

People with winter SAD often respond well to light therapy, which involves sitting under a UV lamp for a short period of time each day. If you have access to daylight and can spend time outdoors, you might also find your symptoms improving if you receive 20-40 minutes of daily direct sun each day.

Treatment for major depression can also prove effective at treating SAD. Those treatment options include:

  • Psychotherapy to help you talk through your feelings, identify problematic thought patterns, and more effectively cope with your depression. If causes relationship problems, therapy may also help improve your relationships. Your therapist can also talk to you about lifestyle changes—diet, exercise, activities—that may complement your treatment and help to alleviate your depression.
  • Antidepressants: Depression alters chemicals in your brain. Sometimes lifestyle remedies are inadequate to get things back on track. Antidepressants can be effective and often need only to be taken for a short period.

Is It Possible to Prevent Seasonal Affective Disorder?

Research on the prevention of SAD is mixed. However, there is some evidence that light therapy can help prevent SAD in people with a previous history of the condition. If you’re worried that you might develop SAD this winter, talk to your doctor about preventative strategies. Also, maintain a healthy lifestyle—overeating during the holidays, excessive spending, and low motivation can all make SAD worse.

If you experience SAD, you don’t have to suffer through months of misery. SAD is one of the most treatable forms of depression, and with the right care, you can feel better in weeks, or even days.

This article originally appeared in Psychology Today magazine

Joel L. Young, M.D., is the Medical Director of the Rochester Center for Behavioral Medicine outside of Detroit and teaches Psychiatry at Wayne State University School of Medicine. Trained at the University of Michigan, Dr. Young is certified by the American Board of Psychiatry and Neurology and holds added qualifications in geriatric and forensic psychiatry. In addition, he is a diplomate of the American Board of Adolescent Psychiatry.

Dr. Young and his clinic have been primary investigators in a number of clinical trials involving antidepressant, AD/HD, and bipolar medications. He has authored three books and more than 70 textbooks and articles. His most recent book, When Your Adult Child Breaks Your Heart: Coping with Mental Illness, Substance Abuse, and the Problems That Tear Families Apart, was published by Lyons Press in December 2013.

 

References

 

Good is Not Enough: You Need More Than Getting Rid of Your Depression Symptoms

If you asked any one of us, we would say that top on our list of what we want is to feel better.  But what is “better”?  To most, it means that the symptoms of depression have gone away.  However, just the absence of symptoms is not enough to feel well.  Being well is not only freedom from the episodes of a mood disorder or depression symptoms.  It’s an ongoing process that includes participating in the world around you, being in control of your life, having a sense of personal growth and relationships that matter.  It means that you have a sense of competence and mastery in the things you do in your life and that you feel good about who you are.  How do you get there?

There is an interesting professional article by C.D. Ryff from the University of Wisconsin-Madison (2014) that discusses psychological well-being.  In the past psychologists thought of well-being as happiness, satisfaction with life, and a positive affect (similar to mood).  Thinking about well-being in deeper terms, Ryff describes the essential features of well-being which I will summarize for you here.

What are the components of well-being?  First is having a purpose in life, where you feel your life has meaning, purpose, and direction.  You might find this as a working or volunteer person, student, parent, or whatever it is that guides you.  It’s something that’s easy to forget when we are depressed, so you do have to work on it.  Next is whether you are living a life based on your own personal convictions, beliefs, opinions, and principles.  You are free to make decisions for yourself (that is called autonomy).  For example, if you are an adult, do you feel controlled by another person?   The third feature of well-being is making use of your personal talents and potential, called personal growth.  This could be in your work, school, volunteering, or family life.  Another feature is how well you are managing your life situations, the ups, and downs of daily life called mastering your environment.  We all have fluctuations: the key is how we learn to deal with them.

The fifth feature of well-being is in having positive relationships, with deep ties to others.  It could be with friends or family members, just as long as you have close personal connections.  That is very important to maintaining your mental health balance and definitely helps with depression, a time when isolation can occur.  The last is self-acceptance, which means having knowledge and acceptance of who you are, including your own personal limitations.  Nobody’s perfect – we all have our strengths and weaknesses and do better when we learn to accept and work with them.

This list must seem daunting!  How in the world can I be well if I have to achieve all of these things that are difficult for anyone to do, let alone someone with a mood disorder?  Good question!   It’s not the kind of thing that happens overnight; it takes a lot of time and effort on your part.  And you don’t have to master them all, certainly not all at once.  Begin by having a conversation with your therapist about this and try to identify one or two areas in your life from this list that you want to work on.  Then put those two areas into a clearly stated goal.  Having a goal set in this way helps you to achieve the kind of life you want.  Understand what you have going for you that will help you, such as your strengths, and what you might have to change about yourself and your world to reach this goal.  Try to identify how you personally impact the situation and potentially get in the way of reaching your goal.  Is it negative thoughts you may have?  Are there barriers that exist to achieve your goal?  Find a way to work around them.  Make a list of the first 3-5 steps to reach your goal.  Stay focused on the goal and not how difficult it is.  Care for yourself as you work to achieve it.

For example, your goal might be a purpose in life and personal growth as a musician. You might state it as “I want to improve my skills as a musician and get more professional gigs.  That will make me feel good about myself, bring people pleasure, and earn some money to support myself.”  You might then identify that you are not always consistent with practice time, and feel shy about going out and promoting your musical performance.  Neighbors might complain about hearing you practice. Thinking about it, you may identify one or two negative thoughts you have about your skills (I’m not very good” or “Nobody will hire me”) that are behind these behaviors.  Use CBT to challenge those negative thoughts and behaviors and replace them with more realistic thoughts.  Then think of your strengths, of past successes you have had in this area, and use these to boost your confidence.

Next make a to-do list of what steps you might take to make this happen, and who can help support you in this. That might include: set aside a specific practice time and place each day; take a music lesson(s); make a CD of your performance and bring it around to a few places where you want to perform; put a small sample of your music on social media to attract audience members , such as YouTube, Facebook, LinkedIn, Twitter; make attractive posters to promote your skills and performance dates; put the posters on social media and hang them up in a few select areas around your town announcing your performances and availability.  It’s a lot to do when depressed; have a friend help you.  Do these one-at-a-time, so you don’t get overwhelmed. It is possible and realistic for those of us who have depression to expect wellness.

By Susan J. Noonan, MD, MPH.

Susan is a graduate of Mount Holyoke College, Tufts University School of Medicine, and the Harvard School of Public Health. She is a long-term patient and the author of two books on managing depressionManaging Your Depression; What You Can Do To Feel Better, and When Someone You Know Has Depression: Words to Say and Things to Do, with a companion website and blog. She is also a mental health Certified Peer Specialist, counseling fellow persons with mental illness. In these ways, she bridges that space between recipient and provider of healthcare services. This blog was previously posted, in modified form, on website www.susannoonanmd.com.

 

The Return: Slipping Back Into Depression

I’ve slipped a bit, lately.

After months of relative peace, a return.

First, it was the sadness.  I feel it when I wake up, eat my lunch, drive home from work, and hit the hay at night.  While its intensity varies, it’s always there coloring my days.

My good sense of humor caught the last bus. A bone-wearying fatigue settles in as I withdraw from activities involving people.

I go into hibernation.  I reserve my limited supply of energy for the essential things: work, a limited amount of outside commitments that can’t be avoided or rescheduled, my wife and daughter, a few clients, and filling up my truck with gas.

Life becomes pared down. It loses its sense of richness.  This as a painful, the absence

Finding Motivation Even Through the Apathy of Depression

From Esperanza magazine, blogger Margaret Lanning writes, “Lack of motivation is probably the most difficult part of depression I continue to wrestle with. Trying to figure out how to get up and get moving is extremely challenging. It can make or break a day. When I feel apathetic, my senseless thought cycle starts with the notion that I need to choose to do something (clean the kitchen). Then comes immediate resistance (I don’t want to clean the kitchen), then the guilt trip (good mothers clean kitchens so the family can be healthy), then the compromise (I can have a bite of chocolate if I clean the kitchen), then the shut-down (but I still don’t want to clean, and I’ll probably eat the whole chocolate bar), then the self-punishment (I am a bad person because I’m still sitting here).” Read the blog.

The Neuroscience of Depression: An Interview with Dr. Alex Korb

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The following is an edited transcript of the podcast recorded interview with Dr. Alex Korb.  This transcript has not been reviewed and is not a word-by-word rendering of the entire interview.

Hi, I’m Dan Lukasik from lawyerswithdepression.com. Today’s guest is Dr. Alex Korb.  Dr. Korb is a neuroscientist, writer, and coach.  He’s studied the brain for over fifteen years, attending Brown University as an undergraduate and earning his Ph.D. in neuroscience from UCLA. He has over a dozen peer-reviewed journal articles on depression and is also the author of the book, The Upward Spiral: Using Neuroscience to Reverse the Course of Depression One Small Change at a Time. Interesting, he’s also coached the UCLA Women’s Ultimate Freesbie team for twelve seasons and is a three-time winner for Ultimate Coach of the Year.  His expertise extends into leadership and motivation, stress and anxiety, mindfulness, physical fitness, and even standup comedy. Welcome to the show.

Dr. Korb:

Thank you, great to be here.

Dan:

Let’s begin for our audience.  You’re a neuroscientist. What is neuroscience?

Dr. Korb:

Neuroscience is simply the study of the brain and nervous system. It’s a branch of biology, but it also incorporates aspects of psychology, psychiatry, and neurobiology.  It’s anything that’s going on in the brain and nervous system all under the purview of neuroscience.

Dan:

You’ve studied depression as a neuroscientist?

Dr. Korb:

Yes, that’s what I wrote my dissertation on. The aspect of neuroscience that I’m most interested in is what underlies the neural basis for our moods and emotions, behaviors, and psychiatric illnesses. Some peer-reviewed articles look at schizophrenia as well as other psychiatric disorders like depression which have a lot of basis in neuroscience and we just don’t fully understand what is happening in the brain.

Dan:

Based on your research, can you tell us what’s going on in the brain when someone is suffering from depression?

Dr. Korb:

The best way to describe it is a dysfunction in frontal-limbic communication. To simplify it, there’s a problem with the way the thinking, feeling, and action circuits in the brain are communicating with each other.  Those all have different regions of the brain that are more dedicated to each aspect of thoughts, feelings, and actions. But, normally, there’s a dynamic of how these regions are supposed to communicate with each other, and there’s something with depression that’s a little bit off.

Dan:

Can the same be said for anxiety as far as what’s going on in the brain?

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Dr. Korb:

Yes, anxiety and depression have a lot of overlap regarding the neuroscience and neurobiology behind them.  A lot of the same brain regions are involved. For example, the amygdala, which is often called the fear center of the brain, but is involved in a lot of emotional expressions, that’s one of the core emotion regions in the brain, and it plays a role in both depression and anxiety.  And there’s just a lot of overlap in brain regions, and neurochemistry that underlies these disorders and it’s one of the reasons why anxiety is one of the most common features of depression and they often co-occur together.

Dan:

When I’ve tried to explain what I was suffering from, and my symptoms and I called it “depression,” most people didn’t have any frame of reference for that. They usually thought of it as “sadness.” With respect to sadness and depression, are there different areas of the brain that pertain to sadness that are different from clinical depression?

Dr. Korb:

There’s a lot of overlap between sadness and depression, but a lot of the misunderstanding that people have is that we use the term depression and sadness, “I’m feeling depressed” or, “I’m feeling sad,” we use those colloquially, very interchangeably.

But medically, or neuroscientifically, they’re very different.

Depression and the diagnosis of depression are a lot more than simple sadness.  In fact, a lot of people who suffer from depression don’t feel sad per se. They can often feel an emptiness where emotion should be.  They have a lot of other symptoms such as hopelessness and feelings of helplessness, guilt and shame, isolation, and anxiety can be a part of it.

They can have fatigue, problems falling asleep or staying asleep or even sleeping too much and, generally, the things that they used to find enjoyable they no longer find enjoyable. Everything just feels very difficult.

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It’s hard to explain to someone why it’s difficult because it seems like it shouldn’t be. It’s a much deeper feeling of being stuck than most people experience.  I think the average person if you can think of how you felt after the week of your greatest heartbreak, that sort of touches the edge of what it means to be depressed. It’s not the depth of how badly you feel, but that you can’t escape it. For example, I like to think of depression as a traffic jam.  When you enter a traffic jam, sometimes there’s an accident. The cars are stopped, and you sit there and wait.  And you don’t know how long the traffic jam is going to be. But for most people, it was just a little stoppage on their way. But for people with depression, it’s something that their brain just can’t quite escape. They can try and try, but their brain is stuck in the pattern of activity that just drags along, and the traffic jam just continues.

Dan:

That’s a great explanation of the experience of depression. Both what’s going on in the brain and psychologically. I think people want to know what are some of the causes of depression? Many people once they’ve often been diagnosed try to figure out for themselves, and people who care about them try to figure out?

Dr. Korb:

Depression can have a huge number of different causes. This is where the traffic jam analogy does a lot to help us understand depression. If you see a traffic jam, you can say, “Oh, what caused it?” Well, a traffic jam can come from any number of causes. There’s construction on the freeway, or there was an accident, there was heavy rain or fog, or it could just be that everyone decided to leave work at the same time, and there’s no specific “cause,” it’s just that the interaction – the dynamic interaction – of all those cars just reaches a tipping point.

With depression, it’s the same way. Often, it can be precipitated by a big life event such as a divorce, or breakup, or death in the family. Or smaller life events such as a perceived emotional embarrassment or you didn’t get that promotion.  But, often it’s not “caused” by anything.  It’s just the dynamic interaction of your brain circuits with each other, combined with the sum of your current life circumstances, which causes the brain to get stuck in a certain pattern of activity and reactivity.

That’s much more likely to happen for some people than others because some people’s brains are just more at risk for falling into that pattern. This can be based on the genes you got from your parents, and your early childhood experiences and the coping patterns you’ve been doing your whole life shaped the neurocircuitry and neurochemistry of your particular brain.  So, it’s not always a specifically, identifiable cause.  I think that’s one of the reasons why people, sometimes, don’t quite believe that it’s real or don’t think they should be suffering it. But, it’s very similar to that traffic analogy where it just “sort of happened” for seemingly no reason. It’s just caused by the fact that is vague, nonlinear, dynamic system.

Dan:

Why did you write the book, The Upward Spiral? There are plenty of scientists out there who study depression, but not many of them write a book for the general public on the topic.  What is it that led you to write this kind of book?

Dr. Korb:

I just realized that there was so much useful neuroscience out there that wasn’t being effectively delivered to the people who needed it most. One of the things that made me realize that is from when I was coaching Ultimate Freesbie. After a few months, one of the girls on the team revealed to me that she had been suffering from major depression and that she’d been suffering for years, and, tragically, many months later she ended up committing suicide. It was a devastating event in my life. This was back when I was still studying neuroscience, but before I had decided to go to grad school and study depression. That event led me to want to understand exactly what was going on in her brain that could lead her to do something like that. How could the brain get stuck in a disease like this?

That lead me to going to grad school and doing my dissertation on depression to try and understand and share some of these things with other people. As I was doing my dissertation, I realized that, yes, it’s good to advance the science, but there was already so much good science out there that was so beneficial. I didn’t think that anyone was doing a good enough job communicating clearly exactly about what was happening in the brain in depression and about all the little life changes that you can make that have measurable effects on brain activity and brain chemistry.

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Dan:

The second part of your book is devoted to eight specific things you can do to alleviate depression. Quickly, they exercise your brain, set goals and make decisions, give your brain a rest, develop positive habits, biofeedback, develop the ‘gratitude circuit,’ the power of others, and your brain in therapy. We don’t have enough time to focus on all eight, so why don’t we focus in on one or two. What I thought was fascinating is that you give the backdrop for what is going on in the brain when you do these things.  A few things that popped into my mind were gratitude and your brain in therapy. What about gratitude? How can it help depression?

Dr. Korb:

Gratitude can have a lot of powerful effects on the brain. And one of the reasons going back to why I wrote this book, is that there are tons of books out there that will tell you different life changes that you can make that will help with depression, but I’ve found that a lot of them are unsatisfying because they don’t explain, why. Therefore, it’s not as convincing, and it’s very easy for people to dismiss.

So when I talk about gratitude and how practicing gratitude can be so powerful in overcoming depression, a lot of people can resist that idea because it sounds so hokey.  But if I can point to specific neuroscience studies that show that it has measurable effects in changing brain activity and brain chemistry, then you’re much more likely to do it and it gives you a much better understanding of what’s going on. Gratitude has been shown to, if people who keep a gratitude journal, improve the quality of their sleep, and sleep symptoms of depression are one of the causes of depression. The reason why I called my book, The Upward Spiral because depression can sort of be seen as a “downward spiral” where one symptom or one event can lead to seemingly to a whole cascade of events that keep you stuck. So, gratitude can help break the downward spiral that’s coming from sleep problems that are leading to difficulty in concentration, and that’s one place to break the loop.

Dan:

After reading the chapter on gratitude, I picked up a spiral notebook and started a gratitude list. It was more of a lifetime gratitude list. It’s amazing. I came up with eighty things. I was surprised. So often my experience with depression is that we ruminate about negative things. We just don’t take the time, or don’t have the skill to savor and reflect on the good things in our lives.  It seems what you’re saying is that this practice has effects in the brain.

Dr. Korb:

Yes, when you’re in a depressed state it’s much harder to see the positive aspects of your life. But that’s why it’s all the more important to build a habit of looking for those positive things because often the most important feature of gratitude is not finding something to be grateful for. It’s remembering to look in the first place because that activates the prefrontal cortex which is the more thinking part of the brain which helps it to regulate the emotional regions of the brain that are going haywire in depression.

And gratitude increases activity in the key region of the brain called the cingulate cortex that sits at the intersection between the emotional limbic system and the rational prefrontal cortex and helps modulate communication between those. Remembering things in your past that you are happy or grateful for actually increases the production of the neurotransmitter serotonin in that same brain region and serotonin is one of the most common targets for antidepressant medications.  Practicing gratitude is having effects in key brain regions that we know contribute to depression and in the neurotransmitter systems that are contributing to depression.

Dan:

I also found it interesting your chapter on our brains and therapy. What’s interesting is that many people who treat with a therapist find comfort and solace in going to therapy when they are struggling with depression. They walk out, and they often do feel better at times don’t’ always understand why they feel better.  Or, we know, there’s a recent study from National Institute of Mental Health, which concluded that as many as eighty percent of people in this country get no treatment for depression whether it be antidepressants or therapy.  So, why is it important, if at all, for people to go to therapy who struggle with depression?

Dr. Korb:

The chapter that I wrote on therapy encompasses not just psychotherapy – going to talk to someone – but it also includes medical therapy such as antidepressant medication or other forms of therapy like neuromodulation techniques. These have been demonstrated through rigorous, double-blind studies that show they have powerful effects on treating depression.  Going to see a professional if you think you are depressed is a hugely important step because they can put at your disposal all the advances of western medicine.

What’s interesting – and it’s the last chapter in the book – and it’s funny how many comments I get because they say, “You left antidepressants to the end because it’s not that important and there are other life changes people can do.” Another psychiatrist will say to me, “Why are you so dismissive of antidepressant medication? They are hugely important in the treatment of depression.”  It’s neither of those. I agree that antidepressants and psychotherapy are extremely important in the treatment of depression, and if you think you are suffering from depression, you should go to see a health professional whether it’s just your doctor or you go to see a psychotherapist.

I just don’t think antidepressants are the entire answer.

For some people, I would say about one-third of people suffering from depression; antidepressants are the answer. You can get over your depression completely simply be taking a pill. You don’t know if you might be one of those people. So, you might as well see a doctor and find out.

For the other half or two-thirds of people, antidepressant medication can still be a huge part of the answer, even if it’s not the entire answer. Taking antidepressants can also help you make these other small life changes such as increasing exercise, or changing your sleep habits, or practicing gratitude.  As you make the other small life changes, then things can start to spiral upward.

Dan:

It’s been an informative and very interesting interview with you Dr. Korb.  I want to thank you for being on the show and I highly recommend listeners to pick up and read his book, The Upward Spiral: Using Neuroscience to Reverse the Course of Depression One Small Change at a Time.  Join us next week for another interesting interview at Lawyerswithdepression.com.

I encourage everyone to check out Dr. Korb’s website at alexkorbphd.com.

 

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