Depression

Depression is a mood, condition, or mental disorder characterized by persistent low mood, negative feelings, and loss of motivation and enjoyment of life. Depression also manifests itself in actions: withdrawing from activities, and closing off from other people. The term depression encompasses many different named psychological disorders, such as major depressive disorder, minor depressive disorder, and dysthymia. These disorders overlap a fair amount, and there is a degree to which the very definitions of these conditions as distinct categories is highly subjective. Depression also overlaps a great deal with anxiety, as the two conditions often feed off each other.

Causes of Depression

Nearly all "causes" of depression are also results or symptoms of depression.

The mind and body are complex systems with numerous feedback loops. Rather than thinking of causes of depression in terms of a root cause that results in depression in an A->B manner, I find it more constructive to think of depression as a state that the mind (and body) is in. Depression has numerous factors that feed into it, and it also produces numerous symptoms or results. Most of these factors are both symptoms and causes, creating feedback cycles that cause the depression to persist. For example:

• Inactivity and inaction - Depression causes a person to become less active, and yet, inactivity can cause depression.
• Indecisiveness - Indecisiveness can cause depression by leading a person to not act on important decisions. Yet indecisiveness is also one of the symptoms of depression.
• Negative attitudes and beliefs - A negative view of the world, the self, and other people can cause depression, and yet these views or beliefs are often one of the symptoms or results of depression.
• Weak or negative relationships with other people - A weak social support system, or negative social relationships that cause stress or sadness, can contribute to depression. Yet depression also causes a person to cut off ties or withdraw from friends, family, and other people, and a depressed person's negative mood can sour relationships and cause others to withdraw or close off from a person as well.
• Poor health - Depression is often brought on by health problems such as a serious injury or major disease. Similarly, minor health problems can exacerbate existing depression. Yet depression is also a cause of poor health. Through the mind-body connection, depression has negative effects on healing, the immune system, and overall health. Depression also causes inactivity which leads to declining health, and which can make recovery from an injury or illness take much longer.
• Diet - A deficiency in a number of different essential nutrients is known to cause depression. And yet depression can take away a person's motivation to eat well, or lead to impulse eating, thus contributing to poor nutrition.
• Brain chemistry - Western medicine, driven in large part by the profit motive in the pharmaceutical industry, tends to explain a lot of health problems and conditions in terms of chemistry, as these explanations lead to drug treatments. It is definitely true that certain chemical states in the brain and body can lead to depressed mood, and that certain drugs can treat them. However, it is not true that these chemical issues are a "root cause" of depression, as they themselves are symptoms in addition to causes. Treatments, including non-pharmaceutical ones such as talk therapy and exercise, which alleviate depression will also result in corresponding changes in brain chemistry.

As one quickly sees by examining these potential "causes" of depression, nearly all the possible causes of depression are also results or symptoms of depression. Each of these factors exists within some sort of feedback loop: depression causes a certain state in the mind, body, or life of a depressed person, and then that state in turn causes the depression to persist.

Curing, Preventing, or Overcoming Depression

People are often discouraged or overwhelmed by the fact that depression seems to be such a complex, nebulous condition that has so many different causes and symptoms. Because depression is reinforced by a number of strong feedback cycles, it can seem difficult to break out of. However, the fact that depression has so many causes, and that nearly all of the causes exist in the context of feedback loops, can also be empowering, for the following reasons:

• Because depression has so many different causes, it can be tackled (effectively) from many different angles. Even if one, two, or three approaches prove difficult within the context of your life, there are still numerous things you can do to overcome depression.
• Because depression is ultimately about cycles and feedback loops of negative states of mind and body, you can overcome depression by treating or alleviating the symptoms. This stands in stark contrast to treating colds or other illnesses, where the symptoms are the body's way of healing or overcoming the infection, and stopping the symptoms can prolong the illness. In depression, when you stop the symptoms, you overcome the illness.

Immediate Relief from Depression

Most forms of therapy and drug-based approaches to treating depression take considerable time to work. While these approaches are helpful for some individuals, they are not always the best approach, and even when they are used, some other approaches are often warranted to provide immediate relief. Even if you take antidepressants, you are always going to be better off if you take multiple other approaches to overcoming depression. I have found the following approaches to provide the strongest and most immediate relief from depression:

• Physical exercise - Anything helps. Aerobic exercise, a strength-building workout, stretching, and mind-body exercises like yoga, qi gong, or tai chi can all be helpful, but moderate aerobic exercise is probably best. Any activity that involves physical motion, such as vigorous walking, or dancing, helps immensely.
• Focus - Focusing on specific, small, easily accomplished tasks and carrying them out can do wonders to provide immediate relief to depressed mood. Besides the sense of accomplishment of completing tasks, focus gets at some of the core causes of depression, indecision and inaction. Taking focus one step further, having a routine or planning or scheduling one's day or week can also help with depression by making it easier to focus.
• Clear, rational, constructive, positive thoughts - This point is more subtle, but I have found it to be one of the most effective ways to draw another person out of a depressed state of mind. Sometimes a single well-placed question or statement can result in a profound change in a person's mental state if it moves them into a more constructive, rational, and empowering way of thinking.

Long-term treatment for depression

I tend to be skeptical of drug-based approaches to depression. These approaches may help some people but I think they tend to be unnecessary in most cases, and I also think they tend to act slowly as well as not doing anything in the long-run (once the drugs are discontinued).

I find some forms of therapy, capably executed, can be very helpful for depression. I recommend cognitive behavioral therapy (CBT), but I want to emphasize that many types of therapy claim to be based on CBT because CBT is well-regarded by science and by the public. But not all approaches claiming to be influenced by CBT actually embody the core approach of it. I recommend to seek out actual CBT practitioners rather than people who merely claim to be influenced by CBT or use it as one technique among many.

Diet is very important in treating depression. In some cases, improvement in diet alone can provide substantial relief of depression. Diet is one important factor to consider in the long-term prevention of depression and maintenance of good long-term health of both mind and body. Learning how and where to buy healthy foods for a reasonable price, and how to prepare tasty healthy foods, are both key ingredients in the process of learning to eat a healthy diet.

Further Resources

I also maintain a page on how to help someone with depression which is oriented to people who are not themselves struggling with depression, but who wish to help someone close to them who is.

For a radio program about depression, I recommend Combating Depression With Meditation, Diet which is an interview with Dr. Andrew Weil on NPR.

There are numerous outstanding web resources about depression. I recommend the following pages:

• Wikipedia's Pages on Depression:
  • Depression (mood) - This page focuses on the immediate mental state or mood, rather than the chronic condition or illness.
  • Major Depressive Disorder - About the more serious form of depression.
  • Mood Disorders: Depressive Disorders - A listing of different mood disorders bearing the label of "depression".
• Major Depression | PubMed Health - Information about depression and its causes, symptoms, treatment, and prevention.
• Depression - National Institute of Mental Health - A fairly in-depth page about depression, with extensive discussion and citations.
• Depression - Mayo Clinic - A page on major depression on this health-focused website, which I find to be a consistently high-quality source of information.
• Depression - American Psychological Association - I find this page's explanation of depression to be particularly easy to understand; this site also offers some deep and interesting advice that goes beyond what is found on most other places.

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