In honor of Depression Awareness Month (October), the next few blog posts will be dedicated to promoting a better understanding about what depression is, what it is not, and how to treat depression.
Misconceptions About Depression
There is a misconception floating around our society that people suffering from depression are just lazy or weak, and that if they tried harder, they could will themselves out of depression. This simply isn’t true. That’s not how depression works.
Yes, it is true that many people recover from depression without taking a medication. But that doesn’t mean that willpower alone is what got them there. Major depression, or clinical depression, is a problem with the neurochemistry of our brain not properly regulating our moods, and just willing yourself to feel better isn’t going to cut it.
But all is not lost. There are many things that do help with treating depression, and in certain cases, willpower can help us implement some of those things.
What Is Depression?
As I said above, true major depressive disorder is what happens when there is an imbalance in the neurochemistry of our brains. When our brains are working normally, our mood is being regulated by neurochemical systems in our brain. I’m sure you’ve heard of some of these different neurotransmitters: serotonin, dopamine, norepinepherine, and many others.
To overly simplify things, the neurons in our brains send and receive chemical signals to communicate with each other much like we send our friends or co-workers an email. When things are working normally, emails flow back and forth at appropriate levels and are received on the other side. This regulates our mood and we have a proportionate response to our circumstances (i.e., when there is something to be happy about, our brain releases happy chemicals and we feel happy, and wen there is something to be sad about we feel sad).
In the brain of someone suffering from major depression, there is a glitch in their email system. This can happen in multiple ways: sometimes it’s that not enough happy emails are being sent, and sometimes it’s that there aren’t enough accounts to receive those emails, so they don’t have the intended effect. Either way, an experience that might produce a happy response in a normally functioning brain will not generate the same response in a brain suffering from depression.
What this means is that someone who is depressed might have to work two or three or more times as hard to generate the same happy chemical response in their brain as someone without depression. And that’s tough, because some of these same neurotransmitters also affect willpower and energy, so someone suffering from depression will have less of those as well to work with.
What Depression is NOT
You might be thinking, okay…so someone with depression just has to try harder, exert more willpower, but they can still do it, they can still pull themselves up by their bootstraps.
Perhaps. With a herculean effort they might be able to muster the same level of energy or effort as someone without depression for a period of time. But all energy resources are finite, and at some point they will run out. It’s the equivalent of asking someone if they want to race, and then tying a 100lb weight to their feet. Can they still race you? Yes. But they have to work WAY harder to get to the same finish line than you do.
See, the problem is not that people with depression have a lack of willpower or that they are lazy. In fact, in my own personal experience and all my work with depressed clients, what I have seen is that more often than not they exert more willpower just to make it through everyday tasks than the average person. They just don’t get the same reward for their efforts.
Who is Affected by Depression?
So who are these people suffering from major depression? According to the National Institute of Mental Health, major depression is one of the most common mental health disorders in the United States, affecting more than 16 million people every year (or about 6.7% of the population). It is also the leading cause of disability world wide. And remember, these are just the people who report their depression in some way that can be aggregated for statistical analysis. It doesn’t include the millions of people who are undiagnosed and suffer in silence.
Depression affects people from all walks of life, celebrities and everyday folks like you and me alike. Some people are able to work even while they’re suffering from depression, some are not. Just because one person is able to push through a work day and another is not, doesn’t mean the first person has more willpower than the second. They might simply be affected differently. We don’t know what’s going on in their internal landscape unless we ask them. It’s possible they go home at the end of the day, cry in their car, and do nothing else but get into bed and show up the next day for work, suffering all along in silence, hiding their symptoms from the world.
So What Does Work for Treating Depression?
Luckily, there are many treatments that have been proven to be effective against depression. And according to the National Institute of Health, 80% of those who seek treatment of depression show an improvement of their symptoms within 4-6 weeks of beginning treatment with medications, psychotherapy, attending support groups or a combination of above.
Psychotherapy Helps Depression
Multiple studies have shown that treatment of depression with medications is more effective if also combined with psychotherapy. There are many types of psychotherapy that can help with treating depression, and each person might find a certain style more helpful than others. Some of the most common and effective forms of therapy for depression are:
Cognitive Behavioral Therapy - CBT has long been studied as an effective treatment for depression. It’s aim is to work with thought patterns common in depression and to help stop the cycle of rumination and negative thinking.
Mindfulness-Based Treatment - Research around mindfulness has been growing over the past decade or so, and the consensus from a multitude of studies now shows that mindfulness is as effective a treatment for depression as CBT.
Nature-Based Therapy - Much like mindfulness, the research on the effectiveness of nature-based and wilderness therapy has been growing in recent years. Studies have shown that traditional treatments like CBT and mindfulness are more effective when done in a natural setting. One 2009 study even showed remission rates were 20-30% higher in a forest therapy treatment group than with medication alone (Selhub & Logan, Your Brain on Nature).
Trauma Therapy - If the root cause of your depression stems from trauma, then treating the trauma will be an integral part of your recovery from depression. There are many forms of trauma therapy, including EMDR and many somatically-based trauma therapies.
Lifestyle Changes/Factors that Influence Depression
I’m sure you’ve also heard all the typical advice about the lifestyle factors that can have an effect on depression. These include things like:
Eating a healthy diet
Reducing or eliminating alcohol intake
Getting enough sleep
Reducing your stress level
Reaching out for social support from friends, family, etc.
I assure you, these are more than just platitudes. They have a real and profound effect on depression, and I could write an entire article about each one.
This is where willpower might be able to play some role in your recovery from depression. It takes a lot of effort to implement these lifestyle changes, I’m not going to lie. There will likely never be a time that it just feels easy to go for a run or cook a healthy meal. But if you take it slowly and do just a little at a time, you can slowly start to reverse the spiral.
That’s where it can be helpful to reach out for support to help create and sustain some of these changes. You don’t have to do it alone.
Why Asking for Help is a Smart Move
Here in America, we tend to have a very independence-based culture. While this can bring us many benefits, it can also have downsides. When someone is suffering from depression, it is unrealistic to expect them to just think happy thoughts and get better on their own. Nobody should have to carry the burden of depression alone. Support is an essential part of recovery, whether it comes from a friend or family member, a support group, or a professional.
If you or someone you know may be struggling with depression, I would be happy to offer a free consult and discuss the options and next steps that are best for you. We can come up with a plan together to get you on the road to recovery. I have years of experience offering CBT, mindfulness, and nature-based therapy for the treatment of depression.
If you would like to learn more about what depression looks like and how it can be treated, visit the Depression Treatment page.