Depression Is an Addiction

The Definition of Addiction

Addiction has been defined as follows:- “Being abnormally tolerant to and dependent on something that is psychologically or physically habit forming.”

With this definition in mind, anyone who has experienced long standing depression can say without doubt that it is indeed a “psychological habit that a person has an abnormal tolerance to and dependence upon”.

How Does Someone Become Addicted to Depression?

Everyone has their own personal story and history of how their addiction began. The most likely wide ranging scenario though is as follows…

At some point in a person’s life (probably somewhere in childhood), a person’s identity became rooted in depression. If one takes into consideration the Fear-Anger-Depression link (ie: that anger is a mask for fear as it gives a person a sense of power in a powerless situation and depression is stuffed anger that a person does not feel a right to have or express), then it is easier to understand how, if that person is experiencing regular situations which are fear inducing and then do not feel they have an outlet or a right to express the anger the fear induces in them, then the pattern of stuffing the anger turns into a habit and then turns over time into depression which then turns into an addiction.

There are many factors to be considered as to why people choose or are forced long term to stay in their depression addiction:-

  • Depression is often a better alternative to anxiety.
  • People seek the familiar and if a person has been depressed for some time, this is what is now familiar even though it is painful.
  • Fear releases adrenaline into the body which a person can become addicted to and anger releases cortisol (also potentially addictive) meaning there are physiological addictions related to depression too if one remembers the Fear-Anger-Depression factor.
  • Depression is safe in that a person knows where they are with it. It is like a pair of old moth eaten slippers. They know what to expect from it and it holds no surprises.
  • Depression becomes a part of who you are – the missing link – similar in fact to a drug addict or alcoholic when a person does not feel complete without their drug of choice.
  • As with any addiction, a person knows it is a problem and harmful to them but is often powerless to stop it.
  • Any change is scary even if a person is desperate for change. Old habits will do their best to kick in if defiance is shown to the addiction.
  • There is also often the feeling that even when life is getting better on the outside and conditions change in a person’s life, a part of the depressed person does not want to embrace happiness as depression is all they know. It has them trapped in quicksand.
  • Depression is simply “comfortable” no matter how uncomfortable and painful it feels. Happiness is alien, frightening and threatening to the status quo. As a species, humans often fear change – both good and bad. Therefore every ounce of progress must be balanced up (on a subconscious level) by an act of self sabotage and in the case of depression addiction, the choice to be depressed and create more pain in the body when faced with a positive move forward of some description. Too much success must be balanced by failure.
  • The bottom line is this… people who are addicted to misery try to protect themselves against feeling bad by not feeling too good. It becomes a catch 22 situation.

How Does a Person Recover From Depression Addiction Without the Use of Drugs?

There is no one way but admitting and accepting you have the problem is probably your best first step. Depending upon what the root cause is will be your starting point in how best to proceed. In general though, there are many non-drug routes to go down which could help. For example:-

  1. Cognitive Behavioural Therapy
  2. EFT (also known as Tapping)
  3. 12 Step Recovery Programs
  4. Acupuncture
  5. Holistic Therapies

A Book called “When Misery is Company” by Anne Katherine is also a very useful resource as it discusses Misery Addiction and has a recovery program for it.

What is Depression?

It would be impossible to fully describe depression in just a few words but if you will take the time to read this informational article titled “What is Depression” I am sure you will at least leave with a general understanding of the condition as well as the overall scope of the this very real psychological concern. But before we get stated let’s take the time to review a basic definition.


The Merck Manual of Medical Information (Second Edition) described depression as the feeling of intense sadness; it may follow a recent loss or other sad event but is out of proportion to that event and persists beyond an appropriate length of time. End of definition.


The scope and breath of depression is staggering. The World Health Organization estimates that on any given day 121 people worldwide suffer the gloomy and sometimes dark condition known as depression. While so many other diseases have seen their occurrences drop, depression rates continue to escalate. Perhaps the most troubling of these rapidly escalating numbers is the fact that area seeing the most rapid increase is in children and teens. Some experts believe that the designer status of such drugs as Ritalin is fueling the phenomenon.


Medical research has yet to determine the cause of depression. Many respected experts have various ideas as to the possible cause of depression.


Here are a few of the plethora of suspected causes:

* Imbalance in brain chemistry

* Heredity

* Childhood experiences

* Lack of positive thinking

* Improvised environment

* Cultural experiences

* Learned patterns of behavior

* Problems with relationships

* Medications


Resent research trying to determine exactly what depression is seems to have struck out, when it comes to finding a particular cause. The conclusion was: depression is a witches brew of psychological and physical factors interacting with each other.


From a more technical point of view current research is focusing on the way neurotransmitters work in the brain. Neurotransmitters are chemicals in the brain that are responsible for communicating messages from one neuron to the next. Of particular focus in determining what is depression are the 3 musketeers of neurotransmitters; norepinephrine, serotonin, and dopamine. Some simply call them the feel good hormones. There is a very good chance that imbalances in these three neurotransmitter hormones contribute to depression in a substantial way.


In summary, there are more questions than answers when it comes to nailing down the specifics of depression. One thing is for sure depression is one of the most serious health concerns of our time and if you are one of the 121 million people who are suffering from depression today seeking profession help should not be flippantly discounted.


Additionally, many people are considering natural treatments for depression due to the side effects associated with prescription antidepressant medication such as Zoloft. These natural depression treatment options are very safe and have been shown to be effective for emotional health and well-being in mild cases of depression.

What is the Exact Definition of Depression?

How would you define depression? That must surely be a million dollar question because it is virtually impossible to define depression with only a few words. In fact, to define it properly would require several books. Having said that, most people nowadays do have a basic understanding as to what is meant by the term ‘depression’, but none the less, let’s just go ahead and say that depression is a state of mind which usually follows an event which has given rise to feelings of sadness and/or resentment. However, in the case of depression, this depressive state of mind tends to be out of proportion to the reason which caused it.

How else can we define depression?

o It is a condition which more than 100 million people from around the globe suffer from on a daily basis

o It is a mental condition which is becoming ever more prevalent in society

o It is a condition which is affecting more and more children regularly

o It is a condition which can be treated but often left untreated

Even though there are so many different forms of treatment, some more successful than others, and some with fewer side effects than others, doctors, psychiatrists, and psychologists have yet to pinpoint the exact cause of depression. However, it is known that the following factors may contribute:

o Genetics

o Medication

o Chemical imbalances in the brain

o Long-term negative mental attitude

o Immediate environment

o Established undesirable behavioral patterns

o Relationship problems

o Childhood abuse

o Sexual abuse

While these are by no means the only factors which could contribute towards a person becoming depressive, they are certainly amongst the most common factors. However, the vast majority of the medical professions are in agreement that depression is for the most part a result of several factors rather than a single factor. In other words, while a person may be capable of dealing with something, such as having been abused as a child, when another contributing factor is added, depression can often result.

Interestingly enough, there is still a phenomenal amount of research being done in which scientists are now investigating the role of neurotransmitters in the brain. These are essentially chemicals which occur naturally in the brain and which are responsible for various communication processes. The three chemicals which have been attracted the most attention are:

1. Serotonin

2. Dopamine

3. Norepinephine

Generally speaking, these chemicals are responsible for the “feel good” feeling, and this is why the vast majority of prescription antidepressants focus on altering the quantity of these chemicals in the brain. Additionally, certain antidepressants work by preventing the body of depleting these chemicals. By preventing depletion or by increasing production, it is possible to promote a feeling of well being and as such, it is possible to alleviate the symptoms of depression. However, by their very nature, many of the drugs which are used to achieve these results are known to cause dependency.

The bottom line is; rather than try to define what depression is, there is more focus on trying to determine the exact cause, so that the 100+ million sufferers in the world today can look forward to a brighter, happier future.

What is Psychological Depression?

It is one of the most common and most serious mental health problems facing people today. Psychological depression can interfere with a person’s ability to function effectively throughout the day or even to have the motivation to get out of bed in the morning and it is in fact so common that over 1 in 5 Americans can expect to get some form of depression in their lifetime.

The causes behind depression are complex and not yet fully understood but we are able to treat it much more effectively because we have a better understanding of the causes of clinical depression.

The first step in fighting depression is to understand what it is, how it affects you, and what causes it. Unfortunately, many people do not recognize that depression is a treatable illness. Most people with a depressive illness do not seek treatment; although the great majority, even those whose depression is extremely severe can be helped. This condition is so common that over 1 in 5 Americans can expect to get some form of depression in their lifetime.

Symptoms of major depression include at least five of the following symptoms (at least one must include the first and second listed below) and they must be present nearly every day, all day, for 2 weeks: Persistent depressed mood, including feelings of emptiness or sadness, loss of interest or pleasure in activities, feelings of hopelessness or pessimism, feelings of guilt, worthlessness and helplessness, insomnia, early morning awakening or oversleeping, change in eating (either loss or increased appetite), decreased energy, fatigue or feeling slowed down, restlessness and irritability, difficulty concentrating, remembering or making decisions, thoughts of suicide or death, persistent physical symptoms, such as headaches, digestive disorders or chronic pain. A less severe type of depression, Dysthymia, involves long-term, chronic symptoms that do not disable, but keep one from functioning well or from feeling good.

The most important thing anyone can do for the depressed person is to help him or her get an appropriate diagnosis and treatment. The guidelines for diagnosis of major depressive disorder and dysthymic disorder are found in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM IV). The depressed mood must persist for greater than two weeks in order to warrant this diagnosis.

The first step to getting appropriate treatment for depression is a physical examination by a physician. Without treatment, symptoms can last for weeks, months, or years. Appropriate treatment, however, can help most people who suffer from depression. If a diagnosis of depression is made, treatment with medication and/or psychotherapy will help the depressed person return to a happier, more fulfilling life. Most do best with combined treatment: medication to gain relatively quick symptom relief and psychotherapy to learn more effective ways to deal with life’s problems, including depression.

Psychological depression is not something you can just “snap out of”, it is a serious medical condition that affects the chemistry of the brain. With the appropriate medical treatment the vast majority of people of suffer from its effects can live depression free lives.

What is Depression, How to Change it and Can NLP Help?

Opportunities are all around us, every second of the day. I wonder why so many people don’t see them. Do you ever feel that life is dull and boring, that you never get the chances that those around you seem to get? There are the same chances or opportunities around us all, but of course we see them differently because each one of us has had a unique life which colors or alters the way we see things. I wouldn’t expect a teenage boy to think about planning a surprise picnic for friends in the same way that I would plan it. And the reason is obvious, let me see now.

Our perception is unique to each of us. How come some people get depressed and others don’t? My experience in Social Services and Mental Health services has shown me how our state of mind dictates our level of happiness. There is no doubt our bodies respond to our thoughts as clearly seen every day.

At age 54, having been female all my life, married, work, school, education, disappointments, achievements have just got to be so very different that to think that I can think like a teenage boy, for example, or that a teenage boy can think like me is silly. Our perception is totally different.

Life is what you make of it, you can see the worst or see the best. I know that life can be very hard at times but what I also know is that the only person that can change how you feel inside is you. No one else can get inside your emotions and alter them although that is what we say all the time. And what do we say? ” You made me so mad. You ruined my life. You did this to me. It’s your fault I failed. You made me do it.”

Now you have to stop this blaming other people because that means they are running your life. When you can say, honestly that OK I made that mistake because I did what you told me to, only then can you start to own your own life. Even better if you can say to yourself when things have gone wrong ” I did that, I wish I hadn’t, next time I will do it another way because everyday I learn from my mistakes and become a better, happier person because of it.”

Only when we are running our own life will we be able to see and use the chances that come our way. The price we have to pay is to accept that we make mistakes, we all do. That mistake may be big or small. Can you change it? Can you travel back in time and alter it? No. So what to do about it? Be certain to ask about NLP. Here you will find simple, practical and highly effective methods of changing your perception.

Changing the way you view your circumstances is such an incredible experience. Having seen it happen and with first hand experience myself, let me urge you to try it out. Don’t hesitate too long, begin living a greatly improved life style very soon.

I wish you all the luck and courage in the world.

Understanding Depression – What Is Depression?

Depression is the most common mental health problem in the United states. It affects 17 million each year of all ages, groups, races, and background. Depression is a serious illness and everyone need to have some understanding of it whether you’re suffering from depression, or have a friend or loved one suffering from it, or whether you’re just hearing of it. Even if you’re not suffering from the disease or know someone suffering from it, it’s still good to familiarize yourself with it so that you can recognize its symptoms at any point in time, get diagnosed immediately and get the help you or your friend or loved one needs.

The secret to treating and overcoming depression in time lies in the early diagnosis of it. When you can recognize its symptoms in time, and seek treatment you can easily beat it.

What is Depression Really?

Depression shouldn’t be mistaken for the usual feeling of bad moods, sadness or feeling down. Such feelings are normal reaction to day to day events, and they are often overcome within a short time.

When someone is depressed or have mood swings consistently for weeks, months, or longer and it limits the person from going about his or her daily activities, then that could be depression.

There are different types of depression, there is major depression, dysthymia, adjustment disorder, seasonal affective disorder and bipolar disorder or manic depression.

Causes of Depression

Causes of depression ranges from genetic causes to significant life events. That is if some members of a person’s family has suffered from depression, it increases the person’s chances of developing depression. And if a person experience a sudden change of events such as losing a loved one or moving to a new area or the person someone is in a relationship with breaks their heart, can lead a person to become depressive.

Other possible causes could be chronic illness or side effects from some types of medicine or infections.

Diagnosing Depression

For an accurate diagnosis see a mental health professional for a detailed clinical evaluation. To qualify for a diagnosis, you should have been experiencing at least 5 of the following symptoms consistently for a period of at least 2 weeks.

Signs and Symptoms of Depression

Having little interest or pleasure in doing things

Feeling down, depressed or hopeless

Trouble falling or staying asleep, or sleeping too much

Feeling tired or having little energy

Poor appetite or overeating

Feeling bad about yourself – Or that you are a failure or have let yourself or your family down

Trouble concentrating on things

Moving or speaking so slowly that other people could have noticed, or the opposite – Being so fidgety or restless that you have been moving around a lot more than usual

Thoughts that you would be better off dead, or of hurting yourself in some way

Recognizing Depression

If you think you or loved one may be suffering from depression, take the necessary steps to get treatment. Do not overlook it especially when you notice such symptoms in children. Untreated depression can pose a threat to human life.

Treating Depression

If you suspect depression, your first stop should be to see your regular doctor so that physical illness can be ruled out. If your doctor suspects depression, he or she can then refer you to a psychiatrist, psychologist, or licensed clinical social worker who will then give you a proper diagnosis for depression.

Do not put treatment off, early detection and diagnosis are the key to quickly overcoming depression. There is nothing to be afraid of, more than 80% of the people who become depressed are treated successfully.

A psychiatrist or psychologist can perform a complete evaluation and start a treatment plan with you which may include counseling, medicine or both.

Depression: Create A Crisis Plan

HALT: Advice From Recovering Heroin Addicts

There are four things recovering heroin addicts watch out for to prevent them from feeling so bad that they decide to shoot up heroin again. To successfully beat the habit of using heroin they must train themselves to ask one question when they are at a point of crisis: Am I hungry, angry, lonely, or tired? HALT. If they are going to beat the drug they must learn to stop and become aware of what is going on right now in their life before they make a really bad choice.

If you are spiraling down into deep depression you can ask yourself the same question. Before you use some unhealthy way of managing your hurt, make sure that you haven’t ignored basic self-care. Life is overwhelming and time can easily slip away. Forgetting to eat, not getting enough rest, not connecting with friends, or dealing with your unwanted emotions in a unhealthy way can make you vulnerable for a major crash. Just take a moment and see if you might be dealing with one of the HALT symptoms.


Food for me can be quite a dilemma. I obviously need to take in nutrients but I take much joy in food and a lot of comfort in eating. When depressed I make very poor choices. Being a guy I tend to ignore my irritation and sadness and I disconnect from my body’s needs. After I stress eat (damn you pizza and chocolate), I feel tons of guilt. So I then skip the next meal to make up for all those calories I ate earlier. Now, not only am I full of carbohydrates and junk, but I am also purposely refusing to feed myself nutritious food. Later I become really hungry and reach for the easiest thing around, which is usually snacky food with sugar in it. And the crazy loop continues.

WARNING: Eating sugary food erratically throughout the day, without any protein or exercise to soften the blow, causes massive spikes in blood sugar levels and your mood gets tossed around. Put down the sugar snack and caffeine and look for some fruit or nuts.

Crisis Prevention – Keep healthy snacks and finger foods available at home and work. Be careful of “healthy” nutritional bars, most are just one step above a candy bar. Check the ingredients label to see if sugar or high fructose corn syrup is at the top of the list. If it is find something else.

Fruit is always a great idea. Nuts, trail mix, dried fruit, peanut butter, yogurt, a can of beans for protein. Go to your local health food store and look around for easy-to-make snacks and meals. When you are cooking, make enough for two or three meals and freeze the extras.

Dehydration can disguise itself as hunger. You need to drink lots of water every day. Soda doesn’t count, and though coffee is mostly water, the caffeine doesn’t do you much good as it actually restricts blood flow to the brain. Try drinking a glass or two of water before you eat to see if that helps your food cravings at all. If you’re feeling thirsty you are already getting dehydrated.


Anger can do a lot of damage to your body and to your relationships with others if you let it sit and fester. Usually the person you’re angry with doesn’t even know or care about your feelings and your anger does nothing to them. As the old saying goes: Anger is like drinking rat poison and expecting the other person to die.

Anger is considered one of the “bad” emotions, but I believe there is a place for it. It’s a great brain signal that some issue needs major attention. The problem come when you hang onto it. As a society, though, we are not allowed to express anger appropriately, so many of us bury our anger until it explodes inappropriately. With depression, since you tend to blame yourself for everything going wrong in your life, anger tends to turn inward. It can evolve into self-hate and build up until you’re a mess of physical ailments and mental anguish.

The stuck emotion of anger needs to be released. It needs to get out of the body. Often people like to hold onto anger and other emotions so that they can analyze them and figure out a solution, or at least find the reason why they are so angry. But the emotion, and the intensity that surrounds it, blocks any intelligent reasoning and your ability to find a way out.

If you bury your anger you will need to start practicing becoming aware of your physical state and your emotions. If you are feeling disjointed, irritable, hateful, annoyed, antagonistic, exasperated, impatient, or feel the need to be violent, you need to determine whether you’re holding onto anger.

Crisis Prevention – Here are some ideas for discharging the emotional energy of anger: use the CBT exercises in chapter 12; release your anger physically but safely by going to the batting cages or golf driving range, kick a soccer ball, punch a pillow, run as fast as you can; drive in your car and yell, curse, or scream; scream into a pillow; write it down (just let it flow without regard to spelling, grammar, or punctuation); draw your anger; play drums or other instrument and express your emotions musically.

When the emotional intensity is gone then the source of the anger can be looked at. If the anger is resentment based, maybe it will be gone and you won’t need to do any soul searching. But if you are constantly getting angry at the “little” things in life, or raging at your loved ones, then there is probably some deep-seated trauma, humiliation, or abuse that is blocked in your memory and body.

Anger comes from feeling resentment and powerlessness to change a situation in your life. If you have long-term anger issues that may have resulted from childhood trauma or abuse you should seek out someone who can help you resolve the memories and emotions. Whether talking with someone, doing cogitative therapy, or hypnotherapy, this is where a coach and your team come into play. They are there to help and support you, just like an athlete needs a coach for maximum physical performance, get someone on your side.


One side effect of depression is isolation, but being around other people, especially people who seem happy and have it together, can feel discouraging and hopeless. You may feel that they have it together and you never will. Isolation may also have been used back in childhood as a defense against emotional or physical abuse at home or bullying at school. If you learned isolation as a way to survive as a child it can be difficult to reach out to other people as an adult.

Even if you prefer the company of only yourself, there can be times when you are lonely. Having fun while hanging out with friends will fire all sorts of “feel good” hormones and neurotransmitters in the brain. The trick is finding good friends.

If you don’t have any good friends you can turn to, you need to start building a network of people who can support you. I know, easier said than done. Try finding people at work or where you live. Find some organizations you care about and volunteer, the food bank, animal shelter, or go outdoors with the Fish and Game Department. Work with an arts organization like your local community theater, symphony, or concert promoter.

Search the website which lists all sorts of different, fun social groups in your city like gourmet foodies, dog lovers, music fanatics, film aficionados, every kind of sports, hiking, yoga, meditation, gardening, UFO’s, pretty much anything you want. And if you don’t find anything you’re interested in, start your own group. Know that with 7 billion people on the planet, you are not alone.

As Jim Rohn said, “You are the average of the five people you spend the most time with.” So pick friends who model the person you’d like to be. Pick people who are above you on the Emotional Guidance Scale (see Chapter 2 – The Dark Contract). They will help you reset your emotional set point just by being around them. Make sure they are people who are willing to listen to you and what is going on with you. Be sure and give back to them and listen with an open heart to what’s going on in their life.

If you’re having trouble making peoplefriends, then how about a pet? Dogs and cats are great at giving unconditional love but any pet, hamsters, fish, or parakeets can be wonderful companions. You also get the extra added bonus of taking care of another living being and giving them love.

Crisis Prevention – Create a list of places you can turn to when loneliness hits. List the friends and family members who will support you in positive ways. Have a directory of some organizations you can volunteer with, such as playing with the dogs at your local animal shelter. If nothing else connect with people on Facebook, Twitter, or online forums in subjects you like, and if that doesn’t work find a way to get busy with a project to focus your mind on something else.


Fatigue can grind you down. You can become irritable and self-care ends up going down the drain. However, fatigue doesn’t necessarily mean lack of sleep. You may have low blood sugar, be over stressed, lack exercise, or be emotionally overloaded.

Our body is made to get 9 hours of sleep a night. The average most people get is 7, consequently the majority of us are running on a sleep deficit. Add stress to the mix and your body may need extra sleep to help reboot.

Some of us like to push through our tiredness, as if that shows strength of character, bragging about staying up all night like it’s a badge of honor. Being tired is not something to ignore. Your body is telling you something important. It needs rest to recharge; otherwise it will start to fall apart.

Crisis Prevention – Take a break and rest. And rest doesn’t mean switching to a less busy activity, it means relax and reboot. Read a fun book, nap, do some yoga, or watch a funny movie to recharge. If you miss too many nights of sleep, schedule in an early bedtime to make sure you can have at least 10 hours. If your body doesn’t need 10 hours it will wake up when it’s good and ready.

Developing A Crisis Plan

Depression can fog the brain with low energy making it difficult to come up with positive ways to reduce your suffering. By creating a plan with ways to deal with a spike in your depression you will be able to literally change the chemistry in your brain.

A Crisis Plan is an organized list of reminders, activities, and friends to help you when you start sliding into deep depression. This is a list of positive things you can to do instead of waiting for the world to change for you, which only leaves you feeling stuck and lethargic.

The plan is made up of things you like to do that will increase the positive feelings in your brain or at the very least divert yourself from dwelling on a negative thought loop. These are activities that will redirect your thoughts towards something fun you like to do. The activities can be simple things or things that takes massive involvement. It doesn’t matter.

Your plan doesn’t have to be formalized in one sitting. It may take a few days or weeks to come up with the perfect set of actions. Write down fun stuff you like to do, hobbies, creative projects, enjoyable ways you like to get exercise, friends to call, online social web sites to engage in, places you can go, organizations to volunteer with. Nothing is disallowed – as long as it’s not illegal or could hurt someone else. Also, leave drugs, alcohol, sex, and smoking off the list. This list is for you and won’t look like anyone else’s, so be creative with it.

On a piece of paper draw three columns. The first will be for feelings and a list of friends to call. The second column will be for activities you love to do. In the third column you will compile a list of things to do right away when you realize you’re slipping into depression.

Make a few of copies of your plan and keep one next to your bed, on your desk, in the glove compartment of your car, and one at work. Shrink one down using a copy machine and put it in your wallet. Continue to change it and update it with new stuff you like to do and new ways you find to deal with your depression.

You might use your Crisis Plan a lot at the beginning but then you’ll notice that your favorite things to do and recharge hobbies become automatic. As you become more aware of how you’re feeling and the best ways to deal with it, you won’t need to look at the list anymore. When you put your plan into action and start using the techniques in this book, you grow in emotional strength. You will then find that you won’t fall down as much and you’ll get up much faster.

If you feel comfortable doing so, show the plan to a trusted friend, someone on your list. When you call them in need of help they can go through the list with you and help walk you through what you need to do next. If you’re seeing a therapist, show the list to him or her. They should be in on your plan of action and they’ll help you if you’re having trouble with some of the third column/recharge ways of dealing with your depression.

And don’t forget to celebrate yourself for taking the time and effort to do something about your depression!

The True Cause of Depression

About two years ago a patient of mine, Mr. Burndt, committed suicide. When his wife, who was also my patient, told me the news at one of her visits, I was shocked. Fully aware that 40% of older patients who are suicidal visit their primary care doctors within one week of killing themselves, I found myself wondering over and over how I’d missed recognizing the severity of his distress. I’d known he’d been suffering from depression but had thought it mild.

But even more shocking than the news of his suicide was the reason his wife gave for it: six months earlier, he’d been involved in a car accident and had inadvertently killed a pedestrian. In the end, he simply couldn’t live with the guilt.


The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) classifies depression into the following types (there are even more, but these cover the basics):

  1. Dysthymia. In essence, having a depressed mood on most days for at least two years.
  2. Major Depressive Disorder. In addition to feeling “down” as in dysthymia, other characteristics may include excessive feelings of guilt and suicidal ideation, as well as various physical symptoms like loss of hunger and fatigue. It can be mild, moderate, or severe.
  3. Adjustment Disorder with Depressed Mood. This is grief due to a loss of some kind (which itself can be classified as normal or complicated).
  4. Depression NOS (not otherwise specified). Includes things like premenstrual depression and seasonal depression (SAD).
  5. Secondary depression. Depression due to an underlying medical disorder like Cushing’s disease or hypothyroidism.

Though not in DSM-IV, some practitioners further classify depression into two broad types:

  • Endogenous (or chemical) depression to denote depression that arises without an obvious identifiable cause, thought to reflect some kind of “chemical imbalance” in the brain.
  • Exogenous (or external) depression which is thought to arise from a specific, identifiable external cause.

Given this confusing and non-parallel classification scheme it’s astonishing doctors don’t become depressed themselves as they try to figure out into which bucket their patient’s depression fits!

How can we make sense of all this and, more importantly, understand the real cause of depression in order to augment the effectiveness of currently available therapies?


First, we need to recognize the distinction between chemical and external depression has become outdated. Many neuroscientists have suggested that the mind arises from, and is actually caused by, the physical brain, meaning chemical and electrical reactions somehow give rise to thoughts and emotions. Evidence in support of this theory can be found in numerous studies that show altering brain chemistry with anti-depressant drugs (chemicals) can make depressed people feel better emotionally. The same is true for anxiolytics (like Valium) and their effect on anxiety.

But recently, with the advent of functional MRI scans (fMRI), we now have proof the opposite is equally true, that changes in thinking cause significant, measurable changes in brain chemistry and functioning. In one study, patients suffering from spider phobia underwent fMRI scanning before and after receiving cognitive behavioral therapy aimed at eliminating their fear of spiders. Scans were then compared to normal subjects without spider phobia. Results showed that brain function in patients with spider phobia before receiving cognitive behavioral therapy were abnormal compared to subjects without spider phobia but then changed to match normal brain patterns after cognitive behavioral therapy. This may represent the best evidence to date that changes made at the mind level are able to functionally “rewire” the brain, and that the brain and the mind are more mutually influential than we’d previously thought. It certainly supports the Buddhist view that brain and mind are in fact only two sides of the same coin, or different ways of viewing the same single thing.


Where, then, does the true cause of depression lie? I would argue that depression arises at its core from a belief that we’re powerless to solve our problems.

This is clearly true with people who know why they’re depressed: invariably, once they figure out how to solve their particular problem, their depression lifts. But I would also argue this holds true for people who are depressed for no reason they know. Why? Because thoughts can trigger feelings that remain stirred up long after the thoughts themselves have been forgotten. Some studies have suggested people think upwards of 12,000 thoughts per day. How could we ever remember them all? Yet a fleeting thought we might have had this morning about the possibility of losing our job can and often does leave an emotional residue that lasts hours, days, weeks, or even longer. I would argue, therefore, any depression that appears to be “chemical” is more likely caused by a thought that simply isn’t remembered–a thought about a problem we don’t believe we can solve.

Further, sometimes what appears to be a “chemical” depression is caused by a thought that isn’t directly or consciously recognized. These thoughts are often about problems that seem so unbearably awful and unsolvable we literally don’t want (and often refuse) to think about them (such as our becoming jobless or the prospect of our own death).

Finally, I believe the commonly accepted idea that some forms of depression like depression NOS and secondary depression (#4 and #5 above) are caused by chemical or hormonal abnormalities overstates the case. I’d suggest an alternative explanation, that these forms of depression have a chemical or hormonal influence–reducing our ability to believe we can solve our problems but not entirely eliminating it. At first glance this might not appear to be a significant distinction given how incredibly difficult it is to believe in our ability to solve problems, for example, when experiencing premenstrual syndrome. But knowing intellectually we can win even if we’re having a hard time believing it can help to sustain the most valuable thing depression tends to reduce: hope.


None of this is by any means to say we can simply decide to believe we can solve a particular problem when no solution is obvious or forthcoming. Changing any belief, whether consciously recognized or not, is literally one of the hardest things to do. But armed with a clearer understanding of the true cause of depression we can consider the following steps to help ourselves:

  1. Find a way to raise your life-condition. Your inner life state has more to do with your ability to believe you can solve your problems than anything that may be actually going on in your life. If your thoughts are swirling in despair, take action to break free of them and attain a fresh perspective. Become immersed in a great book that moves you or watch a movie that transports you. Exercise. Go where it’s warm. Chant nam-myoho-renge-kyo. In short, do what you know from experience bounces your thinking to a more optimistic place.
  2. Identify the problem or problems you don’t think you can solve. It’s amazing how often you don’t know why you’re depressed and how helpful it can be to figure it out. Making a list of everything that’s bothering you–a sort of stream-of-consciousness rant on paper–can be a fantastically helpful exercise. Or if you do know why you’re depressed, recognizing the cause isn’t that you have a problem per se but rather that you have a problem you don’t believe you can solve can be remarkably empowering. Also, sometimes we become depressed not because we have one problem we believe we can’t solve but because we have multiple problems we believe we can’t solve. Handling challenges can be likened to balancing a “plate” of a certain size: if we pile too many problems onto it, not only do we risk having it topple over, we often find ourselves wanting to pitch the whole thing on purpose. When this is the case, allow yourself to only worry about and focus on solving one problem at a time.
  3. Identify the reason a problem seems unsolvable. As I pointed out in a previous post, Changing Poison Into Medicine, many things erroneously cause us to conclude we’re deadlocked, chief among them our inability to identify a solution to our problem right now.
  4. Recognize that your thoughts are profoundly influenced by your mood. Once depression has established itself, it takes on an insidious life of it’s own, further diminishing your belief in your ability to solve problems, your ability to plan, and your ability to have hope for the future. In this way the cause of any depression always reinforces itself.
  5. Remember that your depressed self is not your true self. Whatever life-condition you find yourself in at any one moment always feels like the only life-condition you’ve ever had or will have. But your life-condition can and often does change literally from moment to moment.
  6. Understand that anti-depressants only treat the symptoms of depression. None of the foregoing has been intended as a denial that anti-depressant medication plays a critical role in the treatment of depression. In the right patient, anti-depressants reduce the symptoms of suffering exceptionally well and can be literally life-saving. But they can’t make anyone actually happy because happiness isn’t merely the absence of suffering. The best approach, in my view, is to treat the symptoms of depression with anti-depressants (or cognitive therapy or even electroconvulsive therapy) at the same time you address the underlying cause of the depression itself.

I fully recognize that as a means to battle depression – especially a deep, all-consuming depression – these suggestions are inadequate. My point in making them, however, is to emphasize that the single most effective means to resolve a depression is to find a way to tap into our immense power to solve problems.

In a sense, we’re all on a journey to find just such a way. For me, the practice of Buddhism has been a consistently effective means by which to win over obstacles I didn’t believe I could, a tool that has enabled me to manifest wisdom, courage, and most importantly concrete solutions I don’t believe I would have stumbled upon had I not been practicing. If you have a different means that your experience has demonstrated works, stick with it. If not, spur yourself on to explore other paths until you find one that proves it has real power.

In retrospect, I wish I’d suggested to Mr. Burdnt that he think about his guilt over the death of the pedestrian he caused as a problem to be solved – and more importantly as a problem that could be solved. Perhaps had I also begun him on an anti-depressant medication to stave off what were obviously strong suicidal thoughts, he might have had time to work through his guilt. Perhaps he could have shaken loose from its grip in time to forgive himself, and his depression might have lifted. But I’ll never know. And that’s a problem I have to solve for myself.

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