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The Way Out from Depression – A Guide to Help You Heal

“I can’t go back to yesterday, because I was a different person then.” – Lewis Carroll

A famous foot trail, the Camino de Santiago, otherwise known as “The Way,” meanders through mountains, fields, and windy plains, some 500 miles from southern France to the northwestern tip of Spain, to the Cathedral at Santiago de Compostela. For centuries, pilgrims have been making this trek through rugged terrain and weather as a renewal of faith, as spiritual growth, and as a test of inner strength. The journey takes many months of committed effort, yet each year some 272,000 people from all over the world feel blessed to make it.
An estimated 13 million people in the U.S. are suffering from major depression. According to the CDC, about 41,000 people will commit suicide per year from depression. Yet, half of those suffering depression don’t seek treatment. And of the half that do, an estimated 70% will slide back into depression within 6 months.
Depression, as we define it in the U.S., isn’t an illness, disease, or defect of character, but an “extreme of mood.” The counterpart of depression is abnormal happiness called “mania,” which is often dismissed as more functional and socially acceptable.
More than a bout of the blues, true depression (Major Depressive Disorder) can go on and on, leading either up to a more positive change of mind or down to disease and possibly death.

The Reality of Depression

As one sufferer explained, “All of a sudden this overwhelming sadness rushes over me. And I get discouraged and I get upset and I feel hopeless, sad and hurt. And once again, I feel numb to the world.” For those afflicted with clinical depression the question of do I really want to live? lingers, and sticks like glue.
Whether it’s this powerful mood that creates an equally powerful chemistry, or it’s chemistry that creates the mood is hard to say and probably case-dependent. But the numb negatives of depression ferment a toxic brew of brain chemicals that filters out hope and promotes an overwhelming sense of helplessness.
According to a report done by the NY Daily News, teenagers who feel powerless in their home situations become susceptible, with 20% saying that they “have seriously considered suicide.” Those in the midst of depression succumb to its withdrawing nature, or what Dr. Jonathan Rottenberg calls “organized disengagement.”
Not only does depression put individual lives at risk from an increased probability of disease and suicide; the CDC reports that it also cuts into U.S. productivity, costing $80 billion annually in lost productivity and medical treatment costs.
In spite of all the therapies available, levels of depression have remained remarkably steady at about 10% of the U.S. population. The fact that 70% of those receiving treatment backslide into depression within six months – almost as if nothing had been done at all – cries out for a new approach. We can do better.


Treatment and Therapy Options for Depression

Many of those in depression – about half – prefer to get through their “black moods” on their own, or with alcohol, drugs, or marijuana. Others find solace in faith and spirituality. Famous actors, writers, poets, and artists sometimes find positive outlets for their depressions, drawing from the emotional depths of this “mood.”

“The real reason for not committing suicide is because you know how swell life gets again after the hell is over.” – Ernest Hemingway

For those that seek treatment, more and more doctors and therapists are combining therapies, using Integrative, Holistic, or individualized therapeutic approaches that work on altering patient beliefs, lifestyle, nutrition and exercise.
Comprehensive treatment regimens tailored to each patient usually take one or more of the following approaches:
Psychotherapy: Behavioral and Cognitive
Pharmacological: Five categories of Antidepressants
Electroconvulsive Shock Therapy (ECT)
Electrical Stimulation
Holistic or Integrative


Each psychotherapeutic approach has its proponents, but they all have one thing in common: successful treatment makes permanent changes in the neurochemistry and neuroanatomy that form the basis of new and more positive thinking.
After years of research and new techniques, the primary message that behavioral and cognitive psychotherapists convey as they treat depression:

“You’ve got to accentuate the positive, eliminate the negative, latch on to the affirmative, and don’t mess with Mister In-Between.”

These lyrics were written in 1944 and sung by an upbeat Bing Crosby. Listening to positive, upbeat songs with great messages results in positive, upbeat brain waves and brain chemistry, where each positive molecule becomes, in itself, a positive message. It’s that simple.
Good things take time. As neural pathways are re-conditioned, neurons sprout new dendrites (or appendages) that make new connections. Creating a healthier outlook creates healthier brain chemistry, leading to a happier, balanced, and more natural outlook.
Recommended read: 16 Habits of Happy People


The pharmacological approach doesn’t “mess with Mister In-Between” but heads straight for brain chemistry, directly affecting levels of neurotransmitters and neurohumors.
An entire generation has relied on medications like Paxil, Prozac, Zoloft, Celexa, Wellbutrin, Cymbalta, Effexor, Lexapro, Sarafem, and many more that increase neurotransmitters such as serotonin, norepinephrine, and dopamine at synaptic junctions between neurons.
According to the National Center for Health Statistics (NCHS), the number of Americans taking antidepressants increased nearly 400% in the decade from 1995 to 2005!
Antidepressant medications require four to six weeks to take full effect and can work well for a time thereafter. But the mood that results is no cure-all.
An “artificial happiness” from antidepressant drugs comes with it’s own subset of problems with side-effects like violent behavior, mania, and aggression. After half a year of drug treatment, effects in many patients can wear off. Neural pathways can slowly become desensitized, or “habituated,” drug effectiveness can decline, and prescriptions must be changed.
Year after year, however, 35 million Americans (or 11% of the population) swear by their antidepressant medications. Yet studies link antidepressants to increased incidence of suicide, especially in teens.


Electroconvulsive Shock Therapy (ECT)

For the most severe cases of depression, studies show that ECT works twice as well as antidepressants. For those with psychotic or suicidal depression, ECT is the current treatment of choice.
Advocates like “Shock Doc” Sarah Lisanby at the Duke University School of Medicine are using a kinder, gentler shock therapy with anesthesia, muscle-relaxants and no convulsions, and achieving “full remission” in many patients. “Depression kills, while ECT saves lives,” says Dr. Lisanby.
The drawback with ECT: more shock treatments are required. After 6 months the benefits wear off. Unless followed by a reconditioning of behavior and thought, the positive effects of ECT revert back to old patterns over time.

Electrical Stimulation Treatments

This treatment approach uses a variety of electrical stimulations to target the neural pathways most responsible for elevation of mood. Directly stimulating specific neural circuits produces higher levels of natural mood-enhancing transmitters and neurohumors.
In theory, such stimulations improve mood by releasing feel-good reward transmitters such as dopamine, serotonin, and oxytocin in the brain. As of yet, no hard evidence has been collected for the long-term effectiveness of this technique in treating Major Depressive Disorder (MDD).

Holistic, Integrative, and Mindful Approaches

The most promising treatment approaches are more natural, multidisciplinary, individually-tailored, Holistic, and Integrative that recognize the prevalence of “depressive non-disease” in our culture.
According to Nassir Ghaemi in the book On Depression, this “non-disease” form of depression may be best treated without medication.
By combining cognitive/behavioral therapies that reverse negative thinking and eliminate self-destructive habits through a daily practice of meditation, body work, mindfulness, and affirmations, both sides of the brain become engaged. Restoring the balance in cerebral activity can restore the balance in your life.

“Your entire universe is in your mind and nowhere else…” Deepak Chopra


Walking “The Way”

The cumulative message from all these therapeutic approaches: There’s no quick and easy, lasting cure for depression – period.
The recipe for happy living is a universal, and applies to the depressed as well as the joyous. For the depressed, however, the first steps are the longest and the most challenging – the beginnings of a journey that requires moment-to-moment effort every day.
Through sustained inner work, thirteen million Americans could begin this journey of transformation (beliefs, attitudes, self-talk, meditation, and spirituality) combined with challenging body work (relaxation, exercise, and yoga to flush out the old and pump up the new), to help their depression melt away . . .
. . . And slowly, an invigorated and enthusiastically new person will emerge. Proud of their effort, they will move beyond where they once were, finding gratitude within, and appreciation for everyone and everything around them by walking “the way,” and feeling their natural, re-born happiness.
Author: Burton Glenn is a former Biology and Chemistry Professor and current world traveler. He studies and writes about the effects of aging on the body and mind.

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