The Depression Makeover

THE DEPRESSION MAKEOVER

THE DEPRESSION MAKEOVER

DR. JAMES N. HERNDON

VALLIS SOLARIS PRESS PHOENIX, ARIZONA

THE DEPRESSION MAKEOVER Copyright © 2002 Dr. James N. Herndon First Edition Vallis Solaris Press Phoenix, Arizona [email protected] All rights reserved. No part of this book may be reproduced, stored in any retrieval system, or transmitted in any form, by any means, including mechanical, electric, photocopying, recording or otherwise, without the prior written permission of the publisher. ISBN 0-9721684-0-0 Printed in the USA

Dedicated to those who are suffering. May the suffering end. —Dr. James N. Herndon

CONTENTS INTRODUCTION 11 PART I:

THE MEANING OF DEPRESSION

What Is Depression? 17 Dominance, Submission and Depression 29 The “Big Bang” & the “Physics” of Depression 39 Our Depression “Situations” 43 PART II: NON-SCIENCE AND THE DRUGGING OF DEPRESSION Our Depression “Handlers” 53 The New Mythology of Social Science Research 59 What Does Depression Research Really Show? 67

PART III: THE TEN ANTI-DEPRESSION SECRETS (AND THE NEW PATH) The Search for Relief 85 Secret #1: Exercise Dominance Through Personal Interests 91 Secret #2: Give-Up the Word “Depression” 99 Secret #3: Focus Depression Forward 103 Secret #4: Recreate Happiness 107 Secret #5: Always Bet on the Real Chance 113 Secret #6: Become Anti-Anger 117 Secret #7: Banish Unreasonable Fear 121 Secret #8: Redeem Your Guilt 125 Secret #9: Take the True Measure of Status 127 Secret #10: Make Your Own Meaning 131 The New Path 133

APPENDIX 12 DEPRESSION TRACKING CHARTS 141 HOW TO CONTACT DR. HERNDON 156

INTRODUCTION

D

epression seems to be everywhere nowadays. Either we feel depressed ourselves, or a friend or relative is depressed, or some celebrity is telling the world about his or her depression. Statistics claim that each year one in ten Americans will suffer from depression—and that most will never seek treatment. And the number of depression sufferers keeps growing. Some call depression an epidemic. It certainly appears that way. But one thing’s for sure: Our modern psyche is under attack. And the attack is intensifying. At the same time, the media and our health care professionals are bombarding us with a message that says: “Depressed? Well, your depression can be cured. All you need is the right pill...the right anti-depressant.” Yet, with all this relief just around the corner, more and more persons seem to be suffering from the depression “disease.” For me, the topic of depression has always been shrouded in a false sense of mystery. Many of the answers have always been in plain sight, but we have persistently failed to observe the obvious. Unfortunately, “mental health” problems are also big business, so it is often highly profitable to divert attention from the obvious.

THE DEPRESSION MAKEOVER

11

But the problem of depression has reached a flash point. It is now, reportedly, the number one health problem facing primary care physicians, and reputedly, the number one health concern for women. In fact, on May 20, 2002, the U.S. Preventive Services Task Force (USPSTF), an independent panel of MDs, issued a statement recommending that primary care physicians screen ALL of their adult patients for depression. In 1996, this same task force found insufficient evidence for such a recommendation. I have spent many years conducting depression research and I have worked with many depressed persons. I have to tell you—something’s not right. The media and our mental health community are saying one thing about depression (we have no control over our depression and only anti-depressants can “cure” it). And I’m seeing another (depression is a normal, naturally controllable condition, and anti-depressants are dangerous and ineffective). Tragically, the most serious problems faced by today’s depression sufferers are often not due to depression at all. Rather, anti-depression drugs are creating a horrifying range of side-effects, frequently more excruciating than the deepest depression. And compounding the misery, attempts to stop taking anti-depressants often plunge the depression sufferer into a nightmare of terrifying withdrawal symptoms. The time has come to start asking some hard questions about the way we are treating depression. Because the depression “situation” is deteriorating. Rapidly. In fact,

12

DR. JAMES N. HERNDON

it is my belief that we need an entirely new path, one that puts control back in our own hands, where it belongs. To date, both medicine and psychology have failed us. Miserably. The truth of the matter is, overcoming depression is, first and foremost, a training problem. Simply, we must learn some new skills—skills that will lead us out of depression and prevent us from ever again becoming severely depressed. We must learn to be our own best medicine. Is this possible? And is it realistic? Yes. But first, we need to critically look at where we are right now. We need some facts. And we need the truth. A lot of hard questions are facing us and we need to demand some answers. Are anti-depressants really accomplishing anything? Or are they, in fact, some of the world’s most harmful drugs? Is depression being scientifically diagnosed? Are women really twice as depressed as men, or is this just another modern day form of discrimination? And what about socalled childhood depression? Why are we ruthlessly drugging many of the youngest, most helpless members of our society? Let’s finally get to the bottom of this thing we call “depression.” What really is it? What is its message and what does it mean for us? And let’s ask the most important questions of all: How can we get rid of our depression? And what can we do to prevent it? And let’s have some answers we can use. This book is in three parts. Part I explores the meaning of depression. Does it have a purpose? And is it actually there to “help” us?

THE DEPRESSION MAKEOVER

13

Part II explores what’s going on in today’s depression “marketplace”—the flawed research, as well as the uncontrolled, and needless, drugging of our minds and bodies. Finally, in Part III we’ll talk about “The 10 AntiDepression Secrets,” hidden strategies that my research has shown to be highly effective in subduing and preventing the feelings of depression. (If you’re looking for help right away, read Part III first, then go back and read Parts I and II.) The Depression Makeover has three objectives. First, to remake the facts about depression. Second, to “makeover” the way we react to our own depression. And, third, to learn how we can truly “make-it-over” being depressedall the time, every time. Depression presents us with perhaps today’s greatest health care challenge. Is there hope? Yes there is, but only if we’re willing to re-think our preconceptions, and then to take charge of our own mental health. I don’t just wish you success in the battle against depression, I know that success is possible. And I know that you will succeed. James N. Herndon, Ph.D. Phoenix, Arizona July 2002

14

DR. JAMES N. HERNDON

Part I The Meaning of Depression

WHAT IS DEPRESSION?

W

e need to ask a simple question right at the beginning. The question may be simple, but the answer is all-important. The question is—What is depression? Interestingly, I think your average person on the street will give you a better answer than many mental health professionals. Ask a 16-year-old, or a 60-year-old, to tell you what depression is. You’ll usually get remarkably similar, and remarkably sensible, answers. You’ll hear words like “sad” and “empty” and “blue” and “low.” Often, people will use the word “depression” to define depression. They’ll say such things as: “Depression is when you feel really depressed.” The American Psychiatric Association has its own definition of depression. This definition is the one that doctors and psychologists use to diagnose clinical depression. Here is an excerpt from the Association’s clinical diagnostic criteria for a major depressive episode (forgive the length, but I believe that everyone touched by depression needs to read this): Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at

THE DEPRESSION MAKEOVER

17

least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure. Note: Do not include symptoms that are clearly due to a general medical condition, or moodincongruent delusions or hallucinations. (1) depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful). Note: In children and adolescents, can be irritable mood. (2) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others). (3) significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. Note: In children, consider failure to make expected weight gains. (4) insomnia or hypersomnia [sleeping too much] nearly every day. (5) psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

18

DR. JAMES N. HERNDON

(6) fatigue or loss of energy nearly every day. (7) feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick). (8) diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others). (9) recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. [In addition....] The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms are not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hypothyroidism). The symptoms are not better accounted for by bereavement, i.e., after the loss of a loved one, the

THE DEPRESSION MAKEOVER

19

symptoms persist for longer than 2 months or are characterized by marked functional impairment, morbid preoccupation with worthlessness, suicidal ideation, psychotic symptoms, or psychomotor retardation. [from the diagnostic “bible” of mental illnesses, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, commonly called “DSM-IV,” published by the American Psychiatric Association] Although it gives the impression of being very scientific, do you notice how incredibly vague and imprecise these diagnostic criteria are? We’d be about as well off asking a randomly selected high school student to diagnose our depression. We see phrases like “depressed mood” (what exactly is that?), “diminished interest or pleasure” (how much is “diminished”?), “diminished ability to think” (which means…?), “excessive guilt” (how much is “excessive”?), etc. Amazingly, we are even told that a major depressive episode is characterized by a “depressed mood.” This is like saying that a “bird” is any animal that is “bird-like.” And what is so magical about at least five of these symptoms needing to be present for at least two weeks? What if you have only four symptoms that have lasted for ten weeks? Or all of the symptoms, which have lasted for 10 days? Are you automatically a “non-depressed” person?

20

DR. JAMES N. HERNDON

And to top it all off, a doctor’s or psychologist’s diagnosis of depression is encouraged to take into account things that other people say about you! For a scientist, there is also a glaring omission from these diagnostic standards. Did you notice that a diagnosis of clinical depression doesn’t require one single bit of evidence of any physiological abnormality? In fact, our depression “experts” have yet to establish even one physiological benchmark that is associated with depression. Depression is being portrayed nowadays as a medical condition, yet lacks even a single distinguishing physiological cause. Are we dealing with science? Or are we dealing with voodoo? And what does this tell you about how reliably your depression is being diagnosed? Can you imagine a doctor attempting to diagnose, say, John Smith’s heart condition, and saying to himself: “Well...John’s friend tells me that John seems a little outof-breath at times, and that the expression on John’s face sometimes looks like he may be in pain. Also, when John was in my office the last time, he put his hand over his heart a couple of times. And John also told me that sometimes he feels like he has indigestion. There’s no doubt about it. John’s suffering from congestive heart failure.” This is the careless, unscientific way your depression is being diagnosed. And this is the subjective, haphazard basis on which you are being prescribed anti-depression drugs. The American Psychiatric Association’s diagnostic criteria for depression are the “gold standard” for determin-

THE DEPRESSION MAKEOVER

21

ing whether or not you’re clinically depressed. But it frightens me, as it should you. Let’s face it, there’s enough “wiggle room” in these depression criteria to include, in any given year, just about every man, woman, and child in the United States. What kind of mental health “professional” would support such crude, unscientific diagnostic criteria for depression? I’ll tell you what kind—and the answer isn’t comforting: Individuals who are primarily interested in making money. Today’s accepted standards for diagnosing depression exemplify a gaping hole in the way depression is conceptualized. The fact is, most doctors who prescribe you antidepressants are unable to answer even the most elementary questions about depression. For example: Is depression a “disease” or a “symptom”? A cause or an effect? Virtually every person in the mental health community would answer without hesitation: “It’s a disease.” Yet not a single bit of evidence supports this position. Let’s see if we can bring a little bit of common sense to an extremely important question: Is depression really a “disease,” or merely a symptom of our lack of coping skills? Let’s begin by using pain as an example. Suppose we have a sudden pain in our hand. If the pain goes away quickly and doesn’t come back, we’ll probably ignore it. But what if the pain doesn’t go away? Then what? Most of us would think: “There’s got to be something wrong with my hand.” No reasonable person would imag-

22

DR. JAMES N. HERNDON

ine that the pain itself was the problem. The pain is a symptom. The pain is being caused by something else. But the pain is also serving a very useful function. We might call the pain a “messenger”. The purpose of the pain is to tell us that something is wrong and to encourage us to find the causeand to get rid of it. Simply, pain exists to help defend us. Our immune system is another example. When a cold virus invades our body, our immune system jumps into action. Interestingly, the cold virus is not what makes us feel bad. It is our immune system that produces our stuffy head and runny nose. It is the process of killing the invading virus that makes us feel lousy. Are we angry with our immune system for defending us and making us feel bad? Of course not. Then why are we unhappy about feeling depressed? “Now wait a minute,” someone might say. “You don’t know what you’re talking about. My depression is a disease. It’s not a symptom of anything. My depression isn’t helping me. It isn’t fighting something. I am a victim of a chemical imbalance in my brain.” “Well what’s causing your depression?” “My chemical imbalance.” “What makes you think that your depression is a disease?” “Everyone says it is.” “Who?”

THE DEPRESSION MAKEOVER

23

“Well, I hear it on TV. My doctor tells me it’s a disease. Articles I read in magazines and newspapers call it a disease. What else am I supposed to think?” “Is it possible that your depression means something else?” “Such as...?” “Could it be a message that something is wrong?” “Yeah, that I have a chemical imbalance.” “So, now you’re saying that your depression is a symptom of some other problem?” “Now hold on” “I’m just saying that if a chemical imbalance is the cause, then your depressed feelings must be a symptom. Right? I mean, a chemical imbalance and the feeling of depression aren’t the same thing, are they?” “I guess not.” “So what is causing your chemical imbalance?” “It’s just there.” “Has it been there every day of your life?” “No, just sometimes.” “Then what causes the chemical imbalance to happen?” “It just kinda happens by itself.” “For no reason?” “That’s right.” “Have you ever been happy in your life?” “Of course.” “Why were you happy?” “What do you mean?” “I mean, doesn’t being happy have a cause?”

24

DR. JAMES N. HERNDON

“Well, yeah. Good things are happening to you.” “Is there such a thing as being too happy?” “What do you mean?” “I mean, if you were too happy, would that also be a chemical imbalance?” “I don’t know.” “Should people who are too happy take a pill that would cause them to be a little depressed?” “Look, I don’t understand where you’re going with this.” “Depression is really just a bad emotional feeling, isn’t it?” “Of course it is.” “Really bad emotional feelings can have a cause, can’t they?” “Yeah.” “So it’s possible that depression can be caused by something bad in our lives?” “Sure...like a really bad situation at home.” “Why should that cause us to feel depressed?” “Because it makes us feel bad.” “Now we’re talking in circles. Let’s ask the question again: Why should a bad situation at home cause us to feel depressed?” “Because it’s a negative thing. Because it’s not something we want.” “Doesn’t our intellect tell us that?” “Yeah.” “So what is the point of this really bad emotional feeling that we call depression?”

THE DEPRESSION MAKEOVER

25

“I...uh...don’t know.” “Could it be a powerful emotional message? Could it be a way for our brains to help defend us against attack?” “You’ve lost me.” “I mean, what if your depressed feeling was trying to tell you something?” “Trying to tell me what?” “To change.” “To change what?” “To change those things in our lives that are causing the depressed feelings. And to change the way we react to those feelings. Maybe that is the meaning of depression.” I’ve used this little dialogue to help lead us to an answer to our question, “What is depression?” Here is my answer: Depression is an instinctive psychological defense mechanism that produces a powerful, persistent flood of extremely negative physical sensations. The purpose of these sensations is to cause us to change, withdraw from, or avoid factors that are threatening our psychological health and survival. The evidence is clear: Depression is a symptom. And, as we shall see, depression is a symptom of the way we react to psychological stressors in our lives. Is it therefore medically wise to attack depression symptoms with mind- and body-

26

DR. JAMES N. HERNDON

altering drugs that merely “cover-up” or “sedate” the feelings of depression? And is it wise to totally ignore the role that our own behavior plays in the creation of depression? Today’s medical community unhesitatingly tells us: “Pop a pill. That’s the answer.” But if the “drug” approach works, then why is depression raging like an epidemic through our society? And why are tens of thousands of persons who take anti-depressants on the brink of suicide?

THE DEPRESSION MAKEOVER

27

DOMINANCE, SUBMISSION, AND DEPRESSION

L

et’s explore the meaning of depression in a little more detail. All the evidence points in one direction: The feeling of depression is an instinctive response. Each of us has this response. And depression is a sensation that each of us has experienced and that each of us can understand. But why would nature provide us with this instinctive capacity for depression? Generally, the many processes going on in our bodies serve a positive, useful function. That is, they’re adaptive. This essentially means that they are there to help us survive. Depression is also plainly adaptive. In other words, it’s there for a reason. And the reason is survival. Think about all of the systems in our bodies. They are there to keep us functioning as living organisms. They are there to ensure our survival. As we previously mentioned, our immune system protects us against such things as bacteria and viruses. Why shouldn’t we also have built-in defenses against psychological attack? I am becoming increasingly convinced—this is a primary meaning of depression. All right. So how can being depressed help us survive? This doesn’t seem to make sense. When we’re depressed, we feel terrible. But, remember, we also feel terrible when

THE DEPRESSION MAKEOVER

29

our body is fighting an invading virus. But we know that we will get better and feel normal again. But when we’re depressed, we often don’t even know why. Waves of depression can engulf us for no apparent reason. If our brains are really trying to defend us against something, then what is it? The answer to this question, I’m firmly convinced, provides a critical insight into the problem of depression, and, I believe, a necessary strategy in overcoming depression. Most animals have an instinctive desire to dominate. This dominance involves controlling their territory or their environment, as well as attempting to control each other. This “will” to dominate is also adaptive. It serves a survival function. The better job an animal does of dominating or controlling its environment, of dominating other group members, of dominating outsiders who encroach on its territory—the better its chances of survival. But sometimes, chance and circumstance do not allow an animal to dominate. For example, a stronger animal may attack. In this instance, nature has provided the animal with two possible ways to respondfight or submit (often called “flight”). If the opponent is stronger, the animal is often more likely to survive if it submits or flees. Dominance and submission. We usually view one as positive and the other as negative. However, both behaviors have only one objectiveto insure survival. Yet these instinctive responses of dominance and submission don’t just apply to animals. They apply to us as well. Thousands of years ago, the problems of human beings were very much like the problems of other animals,

30

DR. JAMES N. HERNDON

namely, having enough food to survive, and being vigilant against physical attack. Human beings, like animals, would dominate where and when they could, and would submit (that is, run away, or avoid certain persons or situations) where their physical survival was at stake. Again, dominance and submission are two sides of the same coin. Both are instinctive. Both are there to help increase the chances of survival. But what happened as civilization developed and became more “sophisticated”? Our instinctive capacity for dominance and submission was often thwarted. When in a dominant mode, it was becoming less acceptable, and less necessary, to be physically aggressive. Now the instinct to dominate had to find a more social, a more psychological, form. Our submissive instincts also faced changing social and cultural conditions. As society evolved, we found less and less need to submit to a more powerful physical aggressor. Instead, we found more and more need to submit to powerful psychological attack. And more and more often, this attack would come from our own thoughts. It’s unthinkable, especially to a depressed person, that depression might actually be there to protect us. But I believe that the evidence strongly supports this conclusion. Again, we must consider that, just as dominance and submission exist in us for a reason, something now as common as severe depression must also be serving some protective or adaptive function. Well, I believe here is the key:

THE DEPRESSION MAKEOVER

31

The feeling of depression is our brain’s message for us to avoid, change, or “submit” to a psychological threat. By doing so, our chances of psychological survival will be increased. And exactly what is our brain trying to tell us to submit to? The evidence is unmistakable—depression is warning us to submit to the psychological threats that we create in our own minds. But submission doesn’t mean lying down and giving up. It means focusing our awareness on the problem— and then solving the problem. I don’t believe severe depression would be possible if it were not for another important ingredient—the feeling factor. In other words, much of our thoughts and behaviors have unique emotions, feelings, or moods. At its most basic level, depression is all about feelings. When severely depressed persons are asked to describe their depression in detail, a horrible feeling is the thing most often talked about. It is such a unique feeling, that words are virtually powerless to describe it. And, significantly, the words that are used to define the feeling of depression are always negative words: “hopeless,” “lost,” “empty,” etc. The question is: What are these feelings telling us? Do they carry a message? The answer is yes. Over the millennia, the human mind became increasingly self-analytical. We, as human beings, became accustomed to sitting around and just thinking about things. We could plan our aggression, for instance, perhaps delaying it to a later time. Or, in situations where we had to “submit,”

32

DR. JAMES N. HERNDON

we could sit around and brood and worry. We could wish evil things on our opponents, and increasingly, heap scorn and ridicule on ourselves for our weakness. So what was happening? We were taking something that was formerly very behavior-oriented, very actionoriented, and starting to intellectualize it. Whereas thousands of years ago we spent little time analyzing our problems—usually because we were too busy with the problems of mere survival—we eventually began to carry on more and more inner conversations with ourselves. In fact, the rise in our leisure time contributed to this phenomenon. But what made it particularly bad—and what makes it excruciating for a person with severe depression—is that these inner dialogues have a very powerful emotional component. They are one part intellectual, but five parts raw, churning emotions. These inner dialogues, almost always involving some form of anger, fear or self-criticism, call up the brain’s depression response. It’s almost like dialing a phone number. The brain answers the call and sends us a powerful message that it is under attack and that it wants us to survive. And this message consists of a flood of extremely powerful, negative feelingsfeelings we now interpret as being depressed. The problem is, when you’re under attack by yourself, how does the brain’s depression response know when to “disconnect” from the distress call that it is receiving? That is, how does it know when the “attack” is over? Well, it may never know, because often our attacking thoughts refuse to stop. This is how someone can spend a lifetime suffering from waves of severe depression.

THE DEPRESSION MAKEOVER

33

But what is the ultimate twist on the interaction between our intellect and the feeling of depression? Something very surprising. I have found an extremely high association between intelligence and the likelihood of becoming severely depressed. In fact, a high IQ is a good predictor of severe depression. Why? Simply because those with higher intelligence are amazingly creative with their inner dialogues. Some of the characteristics of high intelligence are an above-average imagination, superior verbal ability, and advanced analytical skills. This is the perfect recipe for developing very elaborate, and very negative, inner dialogues. And that’s exactly what happens. This helps explain the well-known phenomenon of “tormented geniuses.” Simply, their depression response is often out-ofcontrol. And, despite their genius, they don’t know how to stop it. It’s important to remember how we learn. By practicing. The more we do something, the more we practice it, the better we get at it. And the less we have to think about it. We tend to think of practice in a positive sense, like practicing a sport. But we can also practice very negative things. And we can also become extremely expert at these negative skills. The way we learn to drive a car or to play a musical instrument is exactly the same way we learn to become severely depressed. And we learn to be severely depressed by practicing, by rehearsing thoughts and feelings in our minds over and over and over again until our brain’s “depression response” is in overload.

34

DR. JAMES N. HERNDON

Depressed persons I’ve worked with often resent the idea that they have “learned” to be chronically depressed. I have frequently been told: “How dare you suggest that I have chosen to be depressed, that I have learned it. I am a victim of depression. Learning has nothing to do with it.” Right and wrong. Right because no one consciously chooses to be depressed. Wrong because we are all continuously engaged in unconscious learning. Depression is a classic example of unconscious learning. What are we unconsciously practicing? The way we speak with ourselves and the way we react to stressful situations. What are we unconsciously learning? To feel depressed. Depression is the result of the negative inner dialogues we have with ourselves. These dialogues are familiar to all of us. They may involve guilt, where we say things to ourselves like: “I’m to blame for what went wrong,” or “It’s all my fault.” These dialogues can also involve thoughts of unrealistic despair, such as “It’s no use. Things will always turn out wrong.” Or: “My job situation or my family situation is hopeless.” Or: “People are always mistreating me.” Or: “I’ll never be able to accomplish anything.” Or: “I’m of no use to myself or to anyone else.” Or, the dialogues can involve despair about the depression itself, like: “I’ll always be depressed. It’s never going to get better.” Typically, individuals believe they have strong reasons for these thoughts. A terrible family or job situation, for example, can be horribly debilitating. But by engaging in extremely negative inner dialogues, we are playing a very risky game. Simply, we are risking overwhelming our depression

THE DEPRESSION MAKEOVER

35

response and plunging ourselves into a lifetime of severe depression. Often depressed individuals have said to me: “But these kinds of thoughts didn’t make me feel severely depressed. Because first I felt depressed, then I had these negative thoughts.” However, on closer examination of virtually every case, I find that these kinds of negative thoughts, in fact, do appear first, then severe depression results. Simply put, our bad thoughts produce our bad feelings. But, like any habit, changing something we practice as much as our inner dialogues is extremely difficult, especially once we have trained our feelings of depression to activate so easily, so unconsciously. Depressed persons get very tired of hearing people say things like: “Just snap out of it. Be more positive. It’s not that big of a deal.” Well, once we have reached the stage of severe depression, it is a very big deal. And just simply telling ourselves to “be more positive” is not a strategy that is concrete enough to be very helpful. What we can do, however, is to rethink our depression-fighting strategies. Simply, we must take targeted action to subdue the feelings of depression. We must practice engaging in thoughts and behaviors that take advantage of the flip side of our depression response—our “dominance response.” Interestingly, this is what our depression is actually “telling” us. It is saying: “You must dominate this situation. I am making you feel terrible to warn you that you

36

DR. JAMES N. HERNDON

are in psychological danger. Get away from this damaging situation and re-establish your dominance.” In Part III of this book, we’ll discuss ten strategies to make this happen.

THE DEPRESSION MAKEOVER

37

THE “BIG BANG” AND THE “PHYSICS” OF DEPRESSION

M

ost of us have heard of the “Big Bang Theory.” It says, basically, that the universe existed, billions of years ago, as something infinitely small and infinitely dense. There was no good and no bad, no strong and no weak. No happiness and no depression. Then, for reasons we will perhaps never know, this unimaginably small, heavy entity exploded. As it exploded, it created the thing we call “space.” And it created “time” as well. Eventually, galaxies and solar systems formed. And something else formed—“dominance” and “submission.” When we look around us, it is fascinating to observe the similarity of “dominance” and “submission” on both very large scales and on very small scales. For example, our own solar system has a central sun, around which planets revolve. The sun, in a certain sense, “dominates” the planets, which are trapped in its gravity. We might say that the sun is the “ruler” of the planets. This same pattern is true on an extremely small scale as well. An atom, for instance, is really like a little “solar system,” with electrons revolving around a “ruling” nucleus. Thus, everywhere we look in our physical universe, we see dominance and submission. This same pattern holds true for human society. For example, the USA is a representative democracy, in which

THE DEPRESSION MAKEOVER

39

we elect “rulers” to “lead” us. We “submit” ourselves to the dominance and control of a president and a congress and to our local politicians and government authorities. In a literal sense, much of our lives “revolves” around those who are stronger and more powerful and to whom we must submit—whether we like it or not. And the pattern continues: At work, we have a boss. At home, children must submit to their parents. One sibling must often submit to another. A friend may seem to dominate another friend. The universe itself is pre-programmed to have a minority of rulers and a majority of followers. Why? Simple. Too many “leaders” leads to anarchy. And anarchy leads to death and dissolution. Survival is the essential spirit of the universe. The universe “knows” that existence itself is facilitated by leadership of the many by the few. And yet, each of us exists in his or her own self-contained universe. And each of us is pre-programmed to dominate our personal universe. Severe depression occurs when we are consistently prevented—by others or by our own actions or beliefs—from exercising personal dominance. I believe that inside each of us is a “memory” of the “Big Bang.” What is actually happening as the sickening feeling of depression rises up, swells, overcomes us, and won’t let go?

40

DR. JAMES N. HERNDON

I believe that the physical sensation of depression is the result of an extremely small, whole-body, molecular “expansion”—almost like the beginning of a mini-explosion. Many depression sufferers say things like: “I feel like I’m going to explode.” or “I feel like I’m disintegrating.” I believe that this is literally true. When we’re depressed, our bodies want to literally explode with suppressed dominance. The message is twofold: 1) Get away from (submit to) your bad “situation”; and 2) Once you are “safe” you must reassert control (dominance). Only by creating the excruciatingly unpleasant feeling of depression can our brains be assured that we have “heard” the message.

THE DEPRESSION MAKEOVER

41

OUR DEPRESSION “SITUATIONS”

H

umans have a built-in capacity for depression. It serves a survival function. In that sense, depression is normal. But is severe depression normal? Again, the answer is “yes.” Severe depression is an early warning system. We might even call it a “code red” alert. We are under massive psychological threat and the chronic feelings of depression are continually telling us to either “dominate” the threat— or risk a psychological meltdown. My experience and research have established something else about depression—something specific and something negative is causing it. Let’s make a simple, but true, observation: Happy people don’t become severely depressed. This might sound self-evident, but frequently people tell me: “There’s no such thing as a totally happy person.” I agree. Nobody I’ve ever met (or heard about) can avoid some occasional bad experiences and the bad feelings that go along with them. But this doesn’t invalidate my claim that there really is such a thing as a “happy person.” Some people, because of their specific “situation” in life are more “immune” to de-

THE DEPRESSION MAKEOVER

43

pression than others. I don’t believe they are more immune genetically, but simply that they have developed coping mechanisms that tend to make the possibility of severe depression far less likely. I have lost count of the times I’ve heard individual depression sufferers (as well as members of the mental health community) claim that depression can just “come out of nowhere.” I’ll say it flat out—this claim is false and I have never seen one bit of evidence, or seen a single individual example, that would support it. One thing is clear: Chronic depression can run like an unconscious river through our lives. We can begin to feel that depression is as much a part of us as eating, drinking and sleeping. And depression can, indeed, seem as if it were a disease, relentlessly attacking us for no apparent reason. But when put under a microscope, depression sufferers’ lives are full of problems. Simply, a careful analysis will not support the depression-as-disease paradigm. Frankly, I am still looking for that mythical “totally happy” person who suffers from chronic depression. Something is going wrong in a depression sufferer’s life. Pure and simple. And the fact is, severe depression develops because depression sufferers do not know how to deal with 1) the feeling of depression itself; and 2) with those people, situations, or events that produce the depressed feelings. Don’t get me wrong, I am not condemning the disease model of depression or those who espouse it, and I’m particularly not condemning depression sufferers themselves.

44

DR. JAMES N. HERNDON

The reason, though, that depression-as-disease has become the accepted wisdom is simple, but powerful: Money. And the marketing and propaganda clout that money can buy. But here’s the point: Something in our lives is causing us to feel depressed. And, something about the WAY we react to the initial onset of depressed feelings produces chronic depression. “But,” you might say, “if the feeling of depression is instinctive, how can we ever overcome it?” My answer: By listening to, instead of ignoring, the message that depression is sending us. And then, by taking action. Let’s step back for a moment. Imagine a young couple about to be married. The invitations have been mailed. Everything is set for the happy day. One night, the bride-to-be receives a phone call from her future spouse. “We need to talk,” he says. When he arrives, she knows something is wrong. “Let’s sit down,” he says. Then he begins. “You know, I’ve been doing a lot of thinking.” “About what?” “About us.” There’s a long pause. “I’m sorry, Michelle, but I don’t think it’s going to work out for us.” Michelle gets a sinking, tight, nauseated feeling in the pit of her stomach and a rush of adrenalin. Her entire body feels as if it had just received a shot of some powerful drug.

THE DEPRESSION MAKEOVER

45

“What are you talking about?” she says. “It’s over, Michelle,” he says. “I’m really sorry. I’ve decided we’re really just not right for each other.” “Who is it?” she asks. “You’ve found somebody else, haven’t you?” He looks away. Michelle has just received a devastating psychological blow. All of this information was processed through her intellect. Her reasoning power alone tells her that this is a “bad” situation in the truest sense of the word. And yet…she also has this feeling of depression. Why? We get the feeling of depression because our brains want to “emotionally” reinforce our “intellectual” assessment of a negative situation. The message of the depressed feelings is that we must regain a position of dominance, or we will suffer harm. We might call the feeling of depression a “redundant” psychological system. Our intellect understands that something has happened to us that we do not like. Then the overpowering emotional sensation of depression slams us, with the purpose of powerfully reinforcing our intellectual conclusions. But few of us know how to interpret the message of this horrible feeling. What do we usually think instead? We think that something must be wrong with us. That we

46

DR. JAMES N. HERNDON

have failed. That we are weak. That we are vulnerable. That we have lost control. That we are going to be humiliated. What happens is that we interpret the feeling of depression in precisely the opposite way in which it was intended. It’s like being told that we must take immediate action to avoid disaster, but instead we go to sleep. There’s a good chance that Michelle will misinterpret her feelings of depression as well. And chances are, her depressed feelings will linger on. Her depression keeps trying to tell her: “Do something.” Instead, Michelle begins to fear the messenger—who won’t go away. She becomes more terrified, more anxious. More depressed. Unfortunately, there’s a high probability that she will sink into severe depression. And she may even develop a lifetime “habit” of chronic depression. Was this necessary? Or inevitable? No. Chances are, Michelle is not only horribly hurt, but suffering from excruciating humiliation. She believes that people are thinking: “What’s wrong with her? How could she have chosen such a loser?” But embarassment fades quickly, usually faster than we think. Michelle was in fact lucky to have avoided many years of suffering with the man she almost married. She actually came out the winner. Yet in the midst of broken spirits and shattered emotions, perceiving oneself in a “dominant” position is difficult at best. A new mindset in our relations with others is critical—one that gives top priority to our own emotional equilibrium.

THE DEPRESSION MAKEOVER

47

This is far from being a cold, self-centered philosophy. Because only by maintaining our own balance and selfconfidence can we ever truly be prepared to properly nurture our relationships. But my main point is simple: Let’s not mislead ourselves into believing that our depression has merely dropped out of the sky. Because it hasn’t. Something in our lives (or perhaps many things) is causing it. And just because the reasons may not be obvious—or we are unwilling to admit them—does not mean that they don’t exist. Most critically, something about the way we react to stressful situations in our lives is what is really causing our depression. Are some “situations” more likely to cause depression than others? Yes. I have found the following to be the top 10 “producers” of the feeling of depression, in no particular order of importance: 1. Guilt or shame 2. Self-doubt and the fear of failure or humiliation 3. Anger 4. Fear and worry 5. Interpersonal conflict (especially at home) 6. Money problems

48

DR. JAMES N. HERNDON

7. Feeling trapped in one’s life 8. Bad job situations 9. Loss of someone close 10. Fear of the future or dwelling on the past This list is obviously not all-inclusive, and there can be a good deal of overlap among the 10 items. And no doubt each of us could add to this list many times over. On the other hand, most of us can probably point to one or more of the items on this list and say, “Yeah, that’s been a problem for me.” Defeating depression is a function of realistically identifying its causes—and then taking corrective action. The important question then becomes: “What kind of action should I take?” Increasingly, our corrective action is no action at all: We are taking anti-depressants to “deaden” and “coverup” our feelings of depression. But is this truly effective? And is it safe? And is there a better way? Let’s answer these questions.

THE DEPRESSION MAKEOVER

49

Part II Non-Science and the Drugging of Depression

OUR DEPRESSION “HANDLERS”

F

or many years now, depression has been considered to be primarily a medical condition. Yet psychologists as well as medical doctors treat depression. Psychologists who treat “patients” typically have a Ph.D. in clinical psychology. They can engage in the treatment of every imaginable sort of psychological problem, with one important difference: Unlike medical doctors, psychologists are not allowed, by law, to prescribe medication. Psychological organizations like the American Psychological Association, of which I am a member, are now lobbying state legislatures to also grant prescription privileges to psychologists. Currently, only psychologists in New Mexico can write prescriptions. (I am not in favor of these expanded privileges.) Then, there’s another issue. A medical doctor who specializes in psychology is called a psychiatrist. In theory, psychiatrists have an advantage over psychologists due to their medical knowledge and training, something psychologists generally lack. Psychiatrists should be positioned to bring to their treatment strategies an understanding of the human body and the diseases to which it is prone. They should then be able to forge an alliance between the “physical” and the “psychological,” all to the benefit of the patient.

THE DEPRESSION MAKEOVER

53

There has always been a certain mutual dislike between psychologists and psychiatrists. Psychiatrists look down on psychologists as unqualified to treat the “wholebody” issues of mental illness. And psychologists typically find psychiatrists to be insufficiently trained in purely psychological issues. Both sides have a point. To talk about depression, for example, as if it were separate from the body is clearly wrong. Our feelings and our emotions do not exist as separate entities from our bodies. In the truest sense, our very thoughts have a physical component. On the other hand, we cannot view emotional problems as if they were the flu (a common complaint against psychiatrists). One hundred years ago, mental illness was almost entirely within the realm of medical doctors, simply because “pure” psychologists were so rare. However, great pioneers like Freud and Jung (both of whom were medical doctors) helped shift the treatment emphasis away from the purely medical approach to what has become generally known as “talk therapy.” Freudian psychoanalysis eventually became the prototype for our image of the psychiatristthe patients on the “couch” pouring out their souls to the ever-probing “analyst.” Simultaneously, university psychology departments began producing more psychologists, trained strictly in the “higher” issues of the human psyche. Thus a sort of battle beganpsychiatrist versus psychologist. Then, a funny thing happened. Pharmaceutical companies began to discover that certain chemical compounds

54

DR. JAMES N. HERNDON

could often “stabilize” a person’s schizophrenia, or psychosis, or depression. Suddenly, psychiatrists found that they could dispense with all that messy psychotherapy. A pill seemed to work just as well. And they hardly even had to talk with the patients anymore! Psychologists had to compete. Over the years, a couple of dozen “scientific” psychotherapies were developed: behavior therapy, cognitive therapy, rational-emotive therapy, problem-of-the-month therapy. The psychologists didn’t seem to be bothered by the fact that these psychotherapies represented extremely loose sets of overlapping common-sense concepts, which each psychologist implemented in a totally different way. No matter. The mantra from the mental health community eventually became: “What works best is a combination of antidepressants and psychotherapy.” Psychiatrists and psychologists were both happy. Each side got a piece of the pie. But no one was in any real doubt about who had really won. The psychiatrists (and the drug companies and insurance companies) had won. The medical side had won. The treatment of psychological problems had come full circle...from medical to psychological and back to medical. Soon, every kind of MD was prescribing antidepressants, from the eye doctor, to the plastic surgeon, to the general practitioner. Isn’t it interesting that so many different doctors from so many different medical specialties feel themselves to be expert psychologists, qualified to

THE DEPRESSION MAKEOVER

55

prescribe anti-depressants? It’s like asking a dentist to perform open heart surgery. Would it surprise you to learn that most pharmacists know more than your family doctor about the drugs that are being prescribed to you? And would it surprise you to learn that the doctor who is prescribing you antidepressants has been largely educated on these drugs by drug salesmen? So, if one were to ask the question—“Who is more qualified to treat depression, psychiatrists or psychologists?”—the answer often involves a bleak choice. For me, it’s like being asked, “Would you prefer to be stabbed or shot?” Both are going to hurt, and neither one is going to do you much good. Essentially, there’s a great big family secret that nobody wants to talk aboutpsychiatrists and psychologists both do an equally bad job of treating your depression. Simply, the success rate is extremely low for both drug therapy and psychotherapy. And it would not be this low if the mental health community knew what it was doing. We might as well come right out and say ittoday’s treatments for depression are about as scientific as your typical fortune teller. In fact, it’s probably safe to say that most fortune tellers are more sophisticated students of human nature than the vast majority of our psychiatrists and psychologists. And yet we’re continually led to believe that our mental health experts possess some magic carpet that will carry us to the promised land of inner peace and tranquility. But more and more of us are becoming depressed. And more

56

DR. JAMES N. HERNDON

and more of us are saying: “How come once the insurance money ran out, he suddenly tells me that I’m cured?” And more and more of us are saying: “If my anti-depressants are supposed to cure my depression, then why do they make me feel so lousy?” It makes you wonder: Is today’s depression marketplace really all about curing our depression—or is it really all about making money?

THE DEPRESSION MAKEOVER

57

THE NEW MYTHOLOGY OF SOCIAL SCIENCE RESEARCH

T

he whole idea of “science” intimidates most people, including me. When I think of science, I think of nuclear physicists, or astronomers, or people in lab coats holding test tubes. Science is supposed to be something complex, something rigorous, something where a lot of “experimenting” is going on. I remember a time when my greatest wish was to get a “chemistry set” for Christmas. In fact, there was a period in the early 1960s when chemistry sets were all the rage. Most little kids I knew just had to have one, and on a particularly memorable Christmas morning, I got my wish. These chemistry sets were not exactly toys. Mine had about three dozen small bottles containing exotic “chemicals.” It also had a large number of test tubes, an “alcohol lamp” (guaranteed to burn down the house) and other niceties designed to strike fear into the heart of any sensible parent. Nonetheless, I learned a few things about science from my chemistry set. Such as, that science meant that you had to investigate things carefully. That you usually dealt with quantities instead of qualities. That science involved factors you could control (usually). And that science arrives at meaningful results.

THE DEPRESSION MAKEOVER

59

I don’t know exactly when it happened, but one day I became aware of something called the “social sciences.” They had names like “sociology” and “psychology.” The social sciences seemed to be basically interested in how human beings behave, both individually and in groups. And I started to wonder how this was a “science.” I thought back to my chemistry set. I remembered in one experiment that we were told to mix one gram of chemical “A” and one gram of chemical “B” and to heat it up in a test tube. Then we were told to observe the color of the smoke that was produced. Then we were told to add chemical “C” and to see if that changed the color of the smoke. Little did I know at the time that I was actually conducting a real-life, honest-to-goodness, scientific experiment. And it wasn’t until I was in graduate school that I truly understood what I was doing when I was 10 years old. What is an experiment? Well, an experiment is research. But...not all research is an experiment! Confused? All right, let’s straighten it out. (And trust me—there’s a point to all of this.) If I ask you to fill out a survey form, I’m conducting research. I can ask a thousand people to take this survey, then I can analyze this information. We’re used to hearing about this kind of research all the time. For instance, we might hear that 65% of the country supports a particular politician and 35% oppose him. That’s survey research. Then there’s research that’s called associational research. For example, we might ask: “What is the likelihood that a runaway teen will also abuse drugs?” In other words,

60

DR. JAMES N. HERNDON

are being a runaway and abusing drugs “associated”? We could interview a sample of runaway teens about their drug use, crunch the numbers, and come up with a result. But, so far, we have not conducted an “experiment.” Now...what if we wanted to know if a particular antidepressant drug is effective. Well, we’ve got to do an experiment. But what does an experiment involve? An experiment’s got to have at least one independent variable and at least one dependent variable. OK, stick with me. Drug companies that want to find out if their new anti-depressant pill is effective must conduct an experiment. First, they have to choose an independent variable and a dependent variable. Independent variables are those things you can “vary” and dependent variables are your results. You might say that your dependent variable “depends” on what you do with your independent variables. So, suppose that a drug company chooses a group of, say, 100 depressed people (our “subjects”) and randomly splits them into two groups. Then they “vary” what they give each group (this is the “independent” variable). Fifty subjects get a pill that does nothing (a placebo). And the other fifty get to try the new anti-depressant. (Of course, none of the subjects knows which pill he or she is getting.) Before they begin their “treatment”, the subjects rate their level of depression on a scale of one to ten. The subjects then take their pill for, say, 60 days, then rate their depression again. Rating their depression is the “dependent” variable because the subjects’ level of depression “depends” (supposedly) on which pill they were given.

THE DEPRESSION MAKEOVER

61

In theory, we have just conducted a scientific experiment. Obviously, the drug company hopes to find that the group that took the new anti-depressant has significantly lower depression than the group that took the placebo— and I know of few instances where the drug company doesn’t reach this result. But, was this experiment just as “scientific” as the kind I used to do with my chemistry set? No, it was not. Why? Because it’s a social science experiment. By now, you’re probably saying: “So what does all this independent and dependent variable and social science stuff have to do with anything? And what does it have to do with depression?” Here’s what it has to do with depression: The drug companies are conducting social science experiments. The social science experiments done by drug companies use qualitative dependent variables. And this kind of research can’t be trusted. “Here we go again.” That’s right. Here we go again. And here’s our next lesson in research: Depression is a quality, not a quantity. Let’s put it another way: Depression research can never be considered “hard” science because we can’t count our depression. Stop and think about it. Depression is an emotion. It’s a feeling. I can’t know about your depression except what you tell me about it. You may look depressed, or act depressed. But the bottom line is, I don’t really know anything about your inner emotions unless you tell me about them.

62

DR. JAMES N. HERNDON

If we want to conduct an experiment about your depression, we have to be able to put a number to it. Because, generally, if we can’t crunch some numbers, it’s pretty hard to talk about scientific research. So, if you’re part of an experiment on depression, the researcher has to have faith that you’re telling the truth about your level of depression. And that your “level” means the same thing for every depressed person who is participating in the research. If on a given day, you say that your depression is an “8” on a scale of 1 to 10, the researcher has to not only believe you, but has to believe that under exactly the same conditions, you would rate yourself an “8” over and over again. Are these reasonable beliefs? Of course not. I’ve been around the research block a few times. And I’m telling you, there’s no way that any of us can reliably “rate” our level of depression and then meaningfully compare it with someone else’s rating. At a certain time on a certain day, someone who has been severely depressed for years might rate himself a “6”. Is this the same “6” that someone suffering from severe depression for the first time would rate himself? I can tell you from experience—it is not. A “6” for a “seasoned” depression sufferer would be more like a suicidal “10” for a “first-timer.” The bottom line? Depression research is never all apples. It’s apples, oranges, grapefruit and bananas. There are hundreds of factors (both qualitative and quantitative) that have an impact on the outcome of any

THE DEPRESSION MAKEOVER

63

given piece of depression research. And these factors are never taken into account. Age, family history, educational background, health, income, philosophical and religious beliefs, daily mood, the personalities of the researchers—sometimes even the buildings and rooms where the research takes place. The list is truly endless. For a depression experiment to be really scientific, all of these factors would need to be taken into account. (And even then, you would overlook something.) But they never are. As you may have guessed, there’s a name for this problem. It’s called “confounding of variables.” Simply, this means that things may be influencing the results of your research that you’re not even taking into account. You can take my word for it. Depression research is a shambles of confounded variables. Do the drug companies and research communities know this? Certainly. Do they care? Why should they, when so many are profiting? Welcome to the glories of “social science” research, and to the spider web of depression research. It’s qualitative quicksand. But the beauty is, researchers nowadays can “prove” just about anything they want to prove—and there is nobody to challenge them. The news media and the general public are too uninformed about research design and analysis to decide whether or not a piece of research is credible. And other researchers are too protective of their own research funding to rock another researcher’s boat.

64

DR. JAMES N. HERNDON

But when it comes to depression, it’s imperative that we become informed research “consumers.” Because we aren’t just playing with a chemistry set anymore. If we allow ourselves to be misled by flawed depression research—and by those who cynically support it—we may be placing our health, and perhaps our very lives, in jeopardy.

THE DEPRESSION MAKEOVER

65

WHAT DOES DEPRESSION RESEARCH REALLY SHOW?

F

or me, the advances made in the field of medicine are one of the (few) glories of our modern era. In recent decades, radical breakthroughs have occurred in the diagnosis, treatment, and prevention of an incredible variety of medical conditions. Concerned, diligent researchers around the world have provided hope for thousands of victims of disease for whom no hope previously existed. Many of the most important recent advances have been made in the field of genetics. I believe that the current “genome” project, which is mapping the human genetic code, will one day result in the cure and prevention of virtually all disease. There’s no doubt that drugs have also played a crucial role in helping all of us to lead longer, better lives. The last few decades have seen an explosion of new drugs for dozens of conditions. Never before have physicians had access to such an array of drug options for their patients. You name a medical condition. Chances are, there’s a drug available to treat it. Given this drug explosion, doctors’ responsibilities in prescribing medications to their patients are at an all-time high. Not only are physicians required to carefully monitor a patient’s reactions to a drug, but they are often called on to prescribe multiple medications simultaneously. The

THE DEPRESSION MAKEOVER

67

threat of side-effects or unwelcome drug interactions is always present. And given that drug company guidelines are intended for the “average” patient, doctors must frequently remind themselves that the “average” person we hear so much about doesn’t really exist. Among our modern era’s new “wonder” drugs are drugs intended to combat depression. There have been countless survey, associational, and experimental research studies conducted on depression. And much of the recent research involves the effectiveness of anti-depression drugs. Let’s take a look at some of this latest research, with two primary questions in mind: 1) Do anti-depressants actually work? and 2) What are the risks of antidepressants? And let’s also examine two pressing issues: Do women really suffer from depression twice as often as men? And, why are we drugging our children to change their behavior? DEPRESSION BECOMES A “DISEASE” Recent survey research convincingly demonstrates the victory of the “disease” model of depression in the public perception. In a January 2002 issue of The Journal of the American Medical Association, researchers tell us that whereas 37% of patients received drugs to treat their depression in 1987, 74% were prescribed drugs in 1997. Is it a coincidence that the first “modern” anti-depressants, the selective serotonin

68

DR. JAMES N. HERNDON

reuptake inhibitors, or SSRIs (such as Prozac), were introduced in 1987? I think not. Interestingly, during this same 10 year period, the number of persons seeking treatment for their depression tripled (from 1.7 million to 6.3 million), while antidepressant use doubled. The shift from the “couch” to the “pill” was steadily progressing. This same study reports that as much as 10% (about 28 million persons) of the U.S. population is depressed in any given year, yet only half of these persons ever seek or receive treatment. Despite these troubling statistics, the awareness of depression is greater than ever, and the vastly greater numbers seeking treatment suggests that depression does not possess the stigma of former times. How do we account for the increased awareness of depression? For me, it is plain: marketing and publicity. But by whom? Primarily the pharmaceutical industry. “Managed” health care also plays a part. Increasingly, primary care physicians, with little or no training in psychology, are being pressured by the insurance companies to treat “mental illnesses.” And what is the cheapest way for them to do so? By prescribing medication. Simply, the pressure to conceptualize depression as a “disease” is intense. In fact, we are bombarded from all sides, most insidiously from television. Why would a drug company spend money to advertise a prescription drug to non-physicians? And on television? Imagine…consumers are being pressured to self-medicate with substances that can only be prescribed by a doctor! The drug companies are telling us: “We want you to use this

THE DEPRESSION MAKEOVER

69

drug…and we want you to tell your doctor that you want it—now.” That this practice is not illegal shows us how far we have descended into the “money-is-everything” mentality. Given the drug companies’ staggeringly expensive campaign of marketing prescription anti-depressants directly to depressed persons, what are current perceptions about the control we have over our own depression? A survey conducted in 2001 by the National Mental Health Association (NMHA) revealed the expected results: In 1991, only 38% of us thought of depression as a medical condition or disease. Ten years later, nearly 60% of us do. Again…coincidence? Hardly. Formerly, two out of three persons believed that our “attitude” or our “outlook” might be associated with our depression. Now, only one in three believe this. But guess what? Depressed persons in the NMHA survey whose depression improved the most were those who played the most active part in trying to overcome their depression. Very interesting. It is a self-evident fact that our thoughts, actions, and beliefs can positively (or negatively) impact our depression. Each of us can quote examples from our own lives or from the lives of friends or relatives that would support this fact. Yet the onslaught of brutal, misleading marketing and propaganda continues. “You’re suffering from a disease.” “There’s nothing you can do about your depression.” “Just face it…you’re a victim.” “It’s a medical condition you have no responsibility for and no control over.” “Your

70

DR. JAMES N. HERNDON

brain chemistry just needs some adjusting.” “Antidepressants are the only answer.” On and on it goes. Drug companies spent $2.8 billion in 2001 on consumer advertising. A depression sufferer is entitled to ask the reasonable question: “How are today’s standards for the treatment of depression being set?” The answer is not a comforting one: “By television commercials.” And where is all the research evidence proving that depression is an actual “disease”? It doesn’t exist. In all likelihood, the doctor treating your depression is nothing more or less than an obedient, uninformed proxy for those actually practicing medicine—the drug and insurance industries. The sooner we face this shocking truth, the better our chances of overcoming our depression. THE EFFECTIVENESS OF ANTI-DEPRESSANTS Not surprisingly, the drug companies are on a vendetta against not only psychotherapy, but against any and all “alternative” approaches to the treatment of depression. Among the most popular of these alternatives has been the herbal remedy St. John’s wort. Although many depressed persons I’ve worked with have reported some results with this treatment, I have not found it to possess any real ability to lessen depression symptoms. A study published in an April 2001 issue of The Journal of the American Medical Association compared St. John’s wort

THE DEPRESSION MAKEOVER

71

to a placebo (a pill that does nothing). The findings? No difference between the two treatments. Interestingly, the researchers deliberately neglected to directly compare St. John’s wort with a popular anti-depressant such as Zoloft (manufactured by Pfizer Pharmaceuticals). But guess who provided the money to conduct this St. John’s wort research? Pfizer Pharmaceuticals, of course. But how does the research evidence stack-up for three of our current anti-depression “stars”…Paxil, Zoloft and Prozac? Unconvincingly. Another study in The Journal of the American Medical Association (December 2001) found these three drugs to be equally “effective” in combating depression. Yet patients often must try all three drugs before finding one that seems to work. Why? Researchers use the current convenient explanation: “genetic” differences among individuals. But most research studies on the question of antidepressant effectiveness are rife with confounded variables. Most researchers are also at a loss to explain the grotesque range of side-effects frequently produced by these supposedly effective drugs. The National Depressive and Manic-Depressive Association commissioned a study on patients’ reactions to their anti-depressants, the results of which were released in early 2001. While 85% of the 1,000 study participants with severe depression thought their anti-depressants were helpful, surprisingly, less than 25% of them thought their depression was under control. Then, the real shocker: Nearly 50% of these persons reported that their antidepressants produced unwanted side-effects. Because of

72

DR. JAMES N. HERNDON

these side-effects, 25% stopped taking their medication completely. And 17% skipped doses to avoid the sideeffects. Does this prove to you that anti-depressants are effective? It doesn’t to me. BRIBING THE FAMILY DOCTOR In 2001, we spent almost $208 billion on prescription drugs, up 17% from the previous year. And the top-selling class of drugs for 2001? Anti-depressants, accounting for sales of $12.5 billion. Over seven million persons took anti-depressants in 2001, an increase of more than 700,000 from 2000. The statistics are clear: We’re getting on the antidepressant bandwagon in a big way. Given the increasingly prominent role that these drugs are playing in our lives, don’t we have a right to expect that these drugs 1) actually “cure” depression; 2) are without significant short- or long-term side-effects; and 3) can be meaningfully and knowledgeably prescribed by our doctor? You’d think so. Instead, there’s a profound silence, and a profound ignorance, from the very persons pledged to faithfully protect our health—our family doctors. Do you think that the Food and Drug Administration (FDA) will protect you? Research reported in The Journal of the American Medical Association (May 2002) finds that 20 percent of the 548 drugs approved by the FDA since 1975 have serious, and potentially life-threatening, side-effects.

THE DEPRESSION MAKEOVER

73

More than 56 of these drugs were actually given a “serious-side-effect” warning or even taken off the market. Few of us are aware that many “new” drugs are only slight molecular modifications of drugs that are decades old. These changes are made by drug companies to reinstate expiring patents and thus continue the gravy train. Naturally, doctors are encouraged by drug salesmen to prescribe these latest “improvements.” And just how are doctors encouraged to prescribe drugs? Among other ways, by being invited to lavish meetings and banquets (all at the expense of the drug companies, of course). These get-togethers are nothing more or less than thinly-veiled bribery sessions, wining and dining medicine’s “best and brightest” in the hope of financial gain. How many of these “events” were held in 2001? Over 370,000. (See if you can get your family doctor to admit how many of these drug company “information seminars” he or she attended in the last year.) How many times have you sat in your doctor’s office waiting room and watched as a drug salesman (briefcase bulging with free drug “samples”) was quickly ushered in to see the expectantly waiting doctor. And you waited. And waited. Well…there are about 82,000 drug salesmen prowling doctors’ offices these days, an increase of almost 50% in the last four years. How is it possible that an industry’s sales force could grow so rapidly? The answer is simple: Because doctors are falling for these drug company sales pitches hook, line and sinker. Apparently, the prospect of a few free drinks is enough to

74

DR. JAMES N. HERNDON

entirely overcome many doctors’ already meager medical judgment. The Serotonin Syndrome alone should be sufficient to cause doctors to exercise the most extreme caution in prescribing anti-depressants. But my own research has found that most doctors have never even heard of the Serotonin Syndrome. THE SEROTONIN SYNDROME The research literature, as well as drug company propaganda, is relentless on one issue: Anti-depressants, especially the “new” ones, don’t have significant sideeffects. At least half of the persons taking anti-depressants would disagree. The Serotonin Syndrome is characterized by a terrifying range of symptoms, including sleep disorders, mood swings, hostility, seizures, dizziness, nausea, fever, tremor, abdominal pain, suicide attempts, fatigue, panic, anxiety, massive rebound depression, and even death. The list goes on and on. The newer classes of anti-depressants work by artificially increasing the levels certain chemical transmitters, primarily serotonin. Serotonin plays an important role in regulating such processes as pain, appetite, motor control and nervous system functioning. Since only about 2% of our body’s serotonin is found in the brain, decisions to tamper with the delicate levels of this chemical can have profound and disastrous consequences for our entire systems. Do most doctors pass

THE DEPRESSION MAKEOVER

75

along this critical information to their patients? No. Do most even know about it? Unfortunately, not. Can artificially increasing serotonin make us feel better? Sure. But other drugs besides anti-depressants do this too, drugs such as cocaine and amphetamines. Why don’t doctors prescribe you cocaine for your depression? The immediate answer: “What…are you crazy? Cocaine is not only illegal, it’s addictive.” But anti-depressants are addictive, too. And the evidence can no longer be denied. Many brave researchers are starting to speak out. Dr. David Healy, director of the department of psychological medicine at the University of Wales College of Medicine is one of them. The British newspaper, the Independent on Sunday (September 30, 2001), quotes Dr. Healy as stating that “all SSRIs are addictive” (SSRIs include such products as Paxil, Zoloft and Prozac). He finds that 50% of persons who take these drugs will eventually experience withdrawal symptoms and that “severe, lasting problems may occur in up to 20% of patients.” In this same article, Dr. Ben Green, senior lecturer at the University of Liverpool, is quoted as saying that “the effects of SSRIs reverberate through the nervous and hormone systems in the body…for weeks, even months after ceasing to take the drug.” He has found patients experiencing “involuntary muscular movements, dizziness and slurred speech many months after withdrawing.” The long-term consequences of the wanton, wholesale prescribing of these drugs are unknown. But it is beginning to look like the “cure” for depression may be worse

76

DR. JAMES N. HERNDON

than the “disease.” Simply, it’s time for our medical community to begin behaving responsibly when it comes to anti-depressants. Before it is too late. WOMEN AND DEPRESSION No doubt the most well-established “fact” about depression is that women are twice as depressed as men. Let me put it delicately: This is a damned lie. And it’s time to stop repeating it. In October of 2000, the American Psychological Association (APA) sponsored a “Summit on Women and Depression.” The results of this summit were published by the APA in April 2002 and are available on its web site (www.apa.org). The summit findings reveal that such factors as genetics, sex hormones, life stress and trauma, and interpersonal relationships and cognitive styles all uniquely combine to double the rate of depression in women compared with men. In other words, women are, once more, portrayed as biologically flawed, with a unique capacity for emotional imbalance. Enough is enough. I just wish every woman would read the complete text of this publication and then ask the question: “Upon exactly what scientific basis are women portrayed by all of these experts as genetically flawed victims of uncontrollable emotions, prone to a lifetime of psychological instability?” If all of the “experts” on women’s depression were to honestly answer this question, it would go something like

THE DEPRESSION MAKEOVER

77

this: “Portraying women as an inferior, second-class gender, prone to unending mood swings, helps attract funding for my research. After all, it takes a very long time to solve a problem that doesn’t really exist.” That’s the real reason we’re continually told that women are twice as depressed as men. Women represent a huge market for drugs and mental health services. The livelihoods of tens of thousands of persons depend on the myth that women are inherently predisposed to emotional problems. The bottom line: If it makes money, it must make sense. But the facts present a different story. Do you want to know the single reason why women are supposedly twice as depressed as men? OK, here goes: Women ADMIT that they’re depressed twice as often as men do. In other words, because women tell the truth more often than men, they are branded as emotionally unstable! Let this sink-in for a moment. We’ve got a multibillion-dollar-a-year women’s emotional health industry that WANTS women to believe that they’re BORN DEPRESSED. And it’s all based on women’s honesty! Isn’t it interesting that men commit suicide four or five times more frequently than women? Yet we’re asked to believe the ridiculous inconsistency that women are twice as depressed as men! These “women’s researchers” (and their drug company taskmasters) are laughing all the way to the bank. Do you know what my research has found? Exactly the opposite. My research indicates that WHEN MEN

78

DR. JAMES N. HERNDON

TELL THE TRUTH, they actually suffer from depression about one and a half times more frequently than women. It is obvious that depression is an increasing problem for women. It is an increasing problem for men, too. But to falsely stigmatize women as being genetically predisposed to depression is not only brutal, it is false. Once again, in the world of big business, ethics takes a back seat to profit. I want my message to women to be unmistakable: Do not tolerate being portrayed as inferior and emotionally flawed. Your depression is not biologically inevitable. And it can be defeated. CHILDREN AND DEPRESSION When you were a child, did you ever try to get out of going to school by claiming to have a stomachache? Did you do it more than once? Well, if you’re a kid nowadays, you’d better watch out. Because the “Depression Police” just can’t wait to diagnose you with depression. And guess what else is waiting for these troubled little tykes? A good strong dose of anti-depressants. It was to be expected that the profit-vultures in our drug and mental health communities would zero-in on the youngest, most vulnerable members of society (and their worried, credulous parents). And this is exactly what has happened. The National Mental Health Association reported in 2001 that about one in thirty of America’s children suffers from clinical depression (exactly how such a determination

THE DEPRESSION MAKEOVER

79

can be made is beyond me). And it gets even better: The University of Pittsburgh, in collaboration with other researchers in the USA, Canada, and Europe, is proposing that “childhood depression may have its roots in faulty regulation of emotional excitement.” This sounds like a description of every eight-year-old in the country. More than 5,000 children and adolescents commit suicide each year. Is depression a problem for today’s youth? Undoubtedly. Is this a problem we must fight with all of our resources? Certainly. But we’re dealing with children. And when dealing with children, the most extreme care and judgment must be exercised. Do most children become sad and despondent at times? Every parent can attest to this. At what point does sadness become depression? This is a difficult issue for persons of all ages. For now, we do not have cut-and-dried answers. But just as we must not err on the side of inaction, neither must we be too quick to label a child as “depressed.” And only when the most extreme need has been demonstrated should we prescribe a child anti-depressants (which does little more than sedate the child). Would you send your child off to school with a shot of Tequila? Or a snort of cocaine? Many parents, criminally misled by their family doctors, are doing something just as damaging— shoving a behavior-changing, mind- and body-altering pill down their child’s throat. The long-term health consequences for the child? Highly questionable. Would it surprise you to learn that children as young as seven are being prescribed Prozac? Or that university

80

DR. JAMES N. HERNDON

psychiatric departments are conducting anti-depressant experiments on children under ten years old? I’ll say it bluntly: The cold, vile, beastly, profit-driven cynicism of this research lacks even a shread of human decency. This horrid experimentation with our children’s mental and physical health must stop. Now. My advice: Look for signs of chronic, debilitating sadness in your child. Seek help. And make yourself part of the solution. Most importantly, ask questions. And take note: Drugs will not “cure” your child’s sadness. THE FINAL VERDICT Research with which I have been involved has consistently shown the same results: When individuals believe that they are taking a pill that will help their depression, they will typically report, in the first 30-120 days, that their depression has improved. These findings hold true whether the pill was a real anti-depressant or a placebo. I believe, simply, that when anti-depressants are perceived to be effective, the anticipation of relief, in and of itself, is what produces the feeling that the depression has improved. The anti-depressants themselves are largely ineffective. This finding is consistent with some of the latest research. For example, Dr. Joanna Moncrieff, a senior lecturer at University College London’s department of psychiatry and behavioral sciences, recently found (as reported in The Daily Telegraph of February 12, 2002) that the

THE DEPRESSION MAKEOVER

81

difference in response rates between anti-depressants and a placebo is only around 10%. I believe the emerging evidence is clear: 1) Antidepressants are almost entirely ineffective; and 2) Antidepressant side-effects represent an unacceptable health risk to patients. And most significantly, anti-depressants don’t cure anything. They only sedate, or cover-up, the depressed feelings. Despite the mounting evidence, many persons “swearby” their anti-depressants, just as others feel their need for a six-pack of beer each day. But this is not evidence that the beer (or the anti-depressants) is more helpful than harmful. In the public’s mind, the jury is in on anti-depressants. Not only have anti-depressants been found innocent— they are the new holy grail of happiness. But for me, they have already demonstrated their guilt. There’s no need to mince words: Anti-depressants are a significant threat to the public health.

82

DR. JAMES N. HERNDON

Part III The Ten AntiAnti-Depression Se Secrets (And the New Path)

THE SEARCH FOR RELIEF

W

hen we are depressed, we really only want one thing: We want the feelings of depression to stop. There are many things we do to deaden or escape from these feelings. Some of us might have a few glasses of wine each evening. Some of us might take illicit drugs. Some of us might become addicted to gambling or sex or even the Internet. Many of us just sit and suffer in silence. And an increasing number of us anxiously prays that somewhere out there is an effective anti-depressant with no side-effects. Most of us are looking for anything that can help. And our greatest wish is for the pain to go away. When we’re experiencing a major depression, it’s very hard to imagine that we may have the inner resources to become the architects of our own improvement. We’re physically and spiritually exhausted. Our personal lives are often a mess. And we’re continually propagandized with the lie that only by popping an anti-depressant can we hope to improve our condition. Is it realistic to expect that we can pull ourselves out of severe depression? Without drugs? Or is this just more self-help pie-in-the-sky? Well, my research and my personal experience prove to me that we can. But we need to be shown some specific things we can do to make it happen.

THE DEPRESSION MAKEOVER

85

Situations that call forth our instinctive feelings of depression will always be with us. And it is important to remember that totally eliminating these instinctive sensations of depression is impossible. Our objective must be to train ourselves to quickly and effectively react to these depressed feelings. That is, we must “listen” to the depression, decipher its message, and take action. The feelings of depression will then be “trained” to quickly vanish. As strange as it may sound, we must make a friend of the feeling of depression. We must make it work for us. Why? Because that is the reason for its existence—to help us. Depression is attempting to send us perhaps the most important of all survival messages—“Watch out!” We should welcome these warnings. And we should respect this admittedly unpleasant, but incomparably valuable, warning system that nature has given us. Yet the greatest problem encountered by depressed persons is not knowing how to react to these depressed feelings. Exactly what are we supposed to do? As we have previously discussed, depression is situational. Something, or more likely a combination of things, is causing us to feel depressed. Our task is to identify those situations that are “triggering” our depression response. Then we must decide what actions to take to become psychologically more “dominant.” As we become more “attuned” to our depression, as we increasingly analyze our lives, our minds, and our bodies, it will become easier and easier to “condition” our depressed feelings to subside just as quickly as they arise.

86

DR. JAMES N. HERNDON

Depression is really a complex juggling act. The more we practice positive, dominant techniques for reacting to it, the more expert we will become at “depression management.” What follows are ten “secrets” for managing our depression. These strategies represent things I have discovered in my research. They also represent ideas and feedback I have gotten from the many depression sufferers I have worked with one-on-one. These 10 strategies are not based on some academic theory. They are real-world techniques that have been proven to work. For each of the ten anti-depression secrets, I will first give you some background information, then provide you with some activities that you can pursue to put the specific strategy into practice. I recommend that you attempt all of the activities from these ten secrets. See which of them work best for you. Often, just one or two of them will provide you with the breakthrough that you need. And then, persist. As with most things in life, failure will only occur if you stop trying. In the Appendix at the end of this book, you’ll find twelve depression tracking charts (as well as a sample chart to show you how to do the tracking). Each chart represents one month, and you can track your level of depression for each day of the month. Rate your depression on a scale of 1 to 10, with 1 being “no depression” and 10 being “suicidal.” If you want to give yourself a “half” rating, like 7.5, you can (see the sample chart).

THE DEPRESSION MAKEOVER

87

As you begin your activities contained in the ten antidepression secrets, I suggest that you immediately begin to track your daily level of depression. At the end of each day, before you go to bed, give yourself an “average” level of depression for the entire day. Mark it down on your chart. A critical part of taking charge of our depression is “objectivizing” it. We must begin to view depression as something that is not genuinely a “part” of us. Depression is a “system,” just like pain. We cannot define ourselves through any of our body’s systems, especially not one as potentially damaging as depression. The fact that depression has a strong emotional component is what typically misleads us into falsely believing that depression has somehow become part of our very souls—and that we are therefore flawed as persons. For this reason, we need to tightly control this “system” we call depression. One way to do this is to track it. By actually “charting” our depression on paper, we increasingly begin to feel that depression is something that we are capable of controlling—and that doesn’t control us. So, I encourage you to make this daily tracking a part of your life. When you examine your “charts” and see the level of depression going progressively lower and lower, it’s a great feeling. This feedback tells you that what you’re doing is working. And when you feel you no longer need to do the tracking, stop. Each of these ten “secrets” helps to reinforce dominant thinking and behavior. Dominant does not mean that we become aggressive and unpleasant toward others. It

88

DR. JAMES N. HERNDON

does not mean that we must “control” others. It means that we must never again feel that we have lost control of ourselves. It also means a new confidence, a new stability in our own personal universe. And this new confidence and stability represent a new understanding—of ourselves and of depression. It is an understanding that few of today’s depression sufferers ever achieve—that we can conquer our own depression.

THE DEPRESSION MAKEOVER

89

SECRET #1: EXERCISE DOMINANCE THROUGH PERSONAL INTERESTS

I

began my own research into depression by asking a large sample of individuals some survey questions. About half of these persons had never had a major depressive episode and about half had suffered at least one. My objective was to see if I could pinpoint any meaningful differences between the two groups. And so I asked questions about a lot of different areas: age, gender, lifestyle, attitudes, interests, occupation, education, diet, family history of depression, family problems, and on and on. It was my prediction that somewhere there had to be some common factors that might provide at least a partial clue to the mystery of depression. When I began to analyze the results of my first group of surveys, many patterns emerged. But one, in particular, really struck me: Individuals with the fewest episodes of major depression had developed personal interests, and actively pursued those interests, in all of the following six areas: 1) objects, 2) activities, 3) places, 4) people, 5) skills, and 6) beliefs. And these individuals spent, on average, over 90% of their leisure time pursuing these interests. Guess how much of their leisure time depressed individuals spent pursuing their personal interests? Less than

THE DEPRESSION MAKEOVER

91

20%. And a great deal of the rest of the time, they were thinking about being depressed. My latest research continues to support these findings, and I am confident in stating that: The lack of comprehensive personal interests in these six areas strongly contributes to the development of severe depression. We could summarize it this way: Persons with a comprehensive set of personal interests have more dominant, confident personalities and so are less likely to engage in negative inner dialogues. In such cases, feelings of depression are less likely to be triggered. Thus, these persons are less likely to become severely depressed. Ironically, “keeping busy” with something that interests us is one of the oldest pieces of advice for a depressed person. It seems that nowadays, we’re much too “sophisticated” for such grandmotherly wisdom. But guess what? That advice just happens to be right. And virtually no severely depressed person follows it. One of the most fascinating areas of psychology is personality psychology. Psychologists have debated for years about exactly what defines a person’s personality. In particular, volumes of research have been written on the so called “trait” terms that we label ourselves and each other with. For example, if I were to say that I’m “assertive” and “self-confident” or that I’m “shy” and “withdrawn,” I would be using trait terms. We all use trait terms con-

92

DR. JAMES N. HERNDON

stantly. And we think we know what they mean. But what happens when we try to match specific behaviors with specific trait terms? For instance, exactly what behaviors is the word “shy” supposed to describe? Well, no two individuals seem to agree. In this case, as in others, the real value of the trait term is questionable. One of the interesting outcomes of my depression research is that individuals actually seem to define themselves—in effect, to define their personalities—not through “trait” terms, but through their personal interests. Most significantly, our personal interests seem to be areas that we perceive as our “strengths,” as our “power,” as our control over our environment; in other words, as our ability to feel dominant. Simply, our personal interests represent those behaviors in which we feel strong, secure, and in control. And by doing so, we also tend to feel more free from threat— most importantly, the threat of negative inner dialogues. We all have at least one thing we are very good at or know a lot about or are really interested in. These things then become the means through which we can exercise a positive kind of strength, a positive kind of dominance. Those of us, however, who have the most personal interests are also the most resistant to the sort of negative inner dialogues that help trigger our feelings of depression. Let’s briefly look at these six areas of personal interests. The first is objects. All of us define themselves very strongly through the objects we possess. For instance,

THE DEPRESSION MAKEOVER

93

clothes, jewelry, antiques, family mementos, a CD collection—and literally thousands of other objects—can become possessions we not only value highly, but enjoy “spending time with.” Second is activities. These are the things we like to do: exercise, read, watch TV, pursue a hobby, build something, create something, cook, or be with friends or family. Activities also play a critical role in the way we define ourselves. In fact, when most of us think about personal interests, we are primarily thinking about activities. Third is places. We all have places that mean a lot to us, such as a favorite vacation destination, a certain city, favorite buildings, and, of course, our home. Fourth is people. Most of us know persons who mean a lot to us, most often friends or family members. People we’ve never even met can also exert a powerful, positive influence on us, such as well known persons in history or sports or entertainment. Fifth is skills. Skills includes anything we’re really good at or know a lot about. Someone might know a lot about history, or be a great skier, or an outstanding chef, or know a lot about music or antiques. The development of skills, and actively pursuing these skills, strongly contribute to our self-confidence and our ability to feel “dominant.” Finally, sixth is beliefs. Personal beliefs are also important components of the way we define ourselves. Whether it’s a religious or philosophical perspective, our belief systems have a major impact on our success in coping with stress and disappointment. Considerable research suggests

94

DR. JAMES N. HERNDON

that persons with a well-established belief system are significantly more resistant to depression. Not surprisingly, most of us who are prone to severe depression simply do not have interests in all of these six categories—especially interests that we actively pursue. When we are undergoing a severe depression, there is a tendency to become extremely passive. The feeling of depression is so agonizing, that the last thing most of us care to do, or care to think about, is pursuing an interest. In fact, the opposite usually occurs. Ironically, feeling depressed and thinking about our depression can become our most consuming personal interest. I’m often told: “You must think it’s easy for me to stop thinking about my depression. My depression is so bad, that I think about it almost every waking moment.” No, I don’t think it’s easy to stop thinking about something that’s slamming us in the face. But one of the most powerful techniques for helping us to stop thinking about our depression is to force ourselves to engage in an activity involving a personal interest. I once tried a simple experiment. I took ten severely depressed persons I knew and randomly assigned them to one of two groups. I asked five of them in the first group to each dig a large hole in the ground. When they were finished, I asked them to cover it over, then dig it up again. They were to repeat this process for two hours each day for one week.

THE DEPRESSION MAKEOVER

95

The five persons in the second group were asked to sit and watch TV for at least two hours a day for one week, and to avoid all physical activity. Which of these two groups reported less depression one week later? The “hole diggers.” Despite the fact that their task was utterly meaningless, and achieved nothing, they didn’t feel as depressed one week later. There are, of course, many factors at work here. The strenuous physical activity is certainly one of them. Physical activity is almost always associated with a decrease in depressed feelings. Primarily, however, I believe that these daily two hours of back-breaking work significantly diminished these depression sufferers’ tendency to think about their depression. The simple act of digging a hole contributed to a partial “un-learning” of their depressed feelings. This same process will work for you, too. But obviously don’t engage in something meaningless. Use your interests to help pull you out of your depression. The evidence is overwhelming: Depression feeds on inactivity. When we sit, when we do nothing, when we think and think about our depression, it gets worse. This is why I often call depression a “leisure time activity.” This is literally true. An extremely active person, even one who lives under difficult, stressful circumstances, will rarely suffer multiple episodes of severe depression. The relationship between activity level and the severity of our depression is also demonstrated by a little-known fact: Severe depression in third-world countries is far less common than in the United States.

96

DR. JAMES N. HERNDON

Simply, I believe that as the struggle for economic survival increases, our opportunities to become depressed decrease. When we’re fighting to put food on the table, we rarely have the “time” to become severely depressed. And this is what we have to keep reminding ourselves—severe depression feeds on free time. ACTIVITIES: 1. NEVER, EVER sit down, or lie in bed, and think about your depression. The moment such thoughts begin, immediately engage in ANY type of activity. 2. If you do not already have them, develop significant personal interests in each of the six areas identified above. 3. Immediately begin spending at least 50% of your leisure time in a positive, meaningful personal interest. Increase this percentage as quickly as possible. [Actively engaging in personal interests is one of the most powerful means of decreasing and controlling feelings of depression. FORCE YOURSELF to take advantage of this strong, natural anti-depressant.]

THE DEPRESSION MAKEOVER

97

SECRET #2: GIVE-UP THE WORD “DEPRESSION” (OR, THE JOYS OF COGNITIVE DISSONANCE)

T

here’s a famous phenomenon in psychology that was first described in 1935 by a man named J. Ridley Stroop. The “Stroop effect,” as it’s now called, can be demonstrated with a simple test and it’s a great example of how words play a “dominant” role in our brains. What if the word “blue” were printed in RED ink? What if the word “yellow” were printed in GREEN ink? Imagine, say, 20 of these word/color mismatches on a piece of paper—and you were asked to quickly “read” the color of the ink for each word? Sounds easy, doesn’t it? Well, just for fun, take out some colored pens or pencils and try it. I guarantee you something. You’ll feel like you’re back in first grade. What you quickly see is that your brain is preprogrammed to read words, not name colors. The word “purple” written in “orange” ink creates a major conflict in our brains. It creates what’s called “cognitive dissonance.” The Stroop effect causes our brains to slow down— really slow down. It forces us to literally stop and think. In fact, if you’re like most people, it probably took you at least twice as long to name the color of the ink than to read the words.

THE DEPRESSION MAKEOVER

99

What this tells us is that words exert incredible power over us. And that when something comes into conflict with a word, the whole system slows down. Suddenly things aren’t automatic anymore. For a depressed person, there’s nothing more automatic than the word “depression.” And for someone who is severely depressed, depression has become an unconscious behavioral and verbal “habit.” Depression. Depression. Depression. Depression. Look how automatic it is. It’s easy to read. It’s easy to say. Do you notice how you don’t even have to think about it? We’re totally “depression-pre-programmed.” And most importantly, the word “depression” conjures-up just the right emotional associations. When we see or hear the word, we even know what it “feels” like. Pretty powerful. Now…what if “depression” suddenly had another name? What if they passed a law forbidding us to use the word “depression”? And what if the law also said that we must now call depression “bliss”? Just think…we’re chronically depressed, and we have to rename one of our oldest “friends.” Then we have to call “him” something that seems totally wrong. I mean, after all, depression isn’t exactly “bliss.” Suddenly we’d be faced with some real cognitive dissonance. But guess what? When you’re depressed, cognitive dissonance is a GOOD thing. Why? Because it helps us to breakdown the unconscious negative associations surrounding our depression. It

100

DR. JAMES N. HERNDON

forces us to slow down and to think about a quality (bliss) that is exactly the opposite of depression. We want to begin to associate something ridiculously positive with our depression. Does this sound weird (and maybe just a little foolish)? Yes. But does it actually help to reduce the feelings of depression? Yes. ACTIVITY: Pick a word that represents a totally positive quality. For 90 days, whenever you’re tempted to think about or speak the word “depression,” use your new word instead.

THE DEPRESSION MAKEOVER

101

SECRET #3: FOCUS DEPRESSION FORWARD

D

epression is not an abstract concept. It is not a condition concocted by our intellect. It is a horrible physical sensation. And it is a feeling. Although depression is almost impossible to accurately describe in words, the physical sensations and the accompanying feelings are so uniquely unpleasant, and so instinctive, that everyone instantly knows what we’re talking about when the word “depression” is mentioned. But the feelings produced by depression aren’t just ordinary feelings. Pain and exhaustion, for example, are feelings, as well as physical sensations. However, when we use the word “feelings,” we’re also talking about emotions. And in the case of depression, we’re talking about very intense, very negative emotions. Thus, depression presents us with a unique phenomenon: An indescribably unpleasant set of physical sensations, combined with a range of highly negative emotions. Over the years, I’ve spent a lot of time having individuals describe to me the physical sensations they are experiencing when they are severely depressed. “Emptiness,” “disintegration,” a whole-body “tension,” “nervousness” and “nausea,” and a variety of violently unpleasant sensations in the head and neck are frequently mentioned.

THE DEPRESSION MAKEOVER

103

Generally, the hideous feelings in the head and neck area become the sensations that depressed persons wish to escape from most. I’ve found that much of the head/neck distress occurs in the back and top of our heads, and in the back of our necks. Over the years, I have conducted many informal experiments in which I asked severely depressed persons to attempt to “focus” their physical sensations of depression. In other words, I asked them to attempt to gather all of their unpleasant physical feelings of depression—and to focus them into a single, smaller “place.” The analogy I was searching for was simple: It’s better, for example, to have pain “just” in your hand than all over your body. I have seen some fascinating results from this exercise. So far, the most effective “focus” activity has been: Intensely concentrate on focusing your feelings of depression into an area slightly in front of your nose and mouth. Strangely, and inexplicably, this exercise, when practiced over time, can significantly reduce overall feelings of depression—especially in the head and neck. The mechanism at work here is unclear. I do know, however, that I continue to find increasing evidence that we are more capable than we realize of exerting control over our bodies—even over processes that are seemingly automatic.

104

DR. JAMES N. HERNDON

It is strangely fascinating that we are able to successfully practice “forcing” our depression out of our bodies. And that this can produce a reduction in depression symptoms. Most individuals who have had success with this strategy tell me that they concentrate on “positioning” their depressed feelings in an area two or three inches in front of their mouths and noses. As they do this, they can literally feel the depressed sensations decrease over their entire bodies. Does this strategy produce lasting results? I can’t give a scientific answer to this question (there are too many confounded variables!). But based upon what I’m told by persons who have used this strategy over the long-term (over 90 days), it seems to be of significant value. Naturally, I’ve received many raised eyebrows from members of the mental health community to whom I’ve described this technique. All I know is, it is frequently effective. And that’s all that really counts. ACTIVITY: When you feel depressed, use this focusing technique in a single, uninterrupted 10-minute session each day for two weeks. After two weeks, gradually increase the time to 20 minutes. Continue for a total of six weeks. On your depression tracking chart, see if you note any significantly lower depression trends during this period.

THE DEPRESSION MAKEOVER

105

SECRET #4: RECREATE HAPPINESS

I

often ask depressed persons: “Tell me about the last time you were happy.” When we are in a severe, long-lasting depression, our state of mind is so negative, that it’s almost as if we had never, ever been happy. And yet, no depressed person has ever told me: “Every moment of my life has been unhappy.” It usually doesn’t take too much digging into our memory to recall happy times and happy experiences. But for a depressed person, past happiness is often like an extremely distant memory, and often seems to have happened to another person. Most of the depressed persons I have worked with tend to associate their greatest happiness with times of innocence, security, and family stability—in other words, with childhood. Ironically, I have found that most of our greatest psychological traumas typically occur in childhood. Yet when asked to recall our happiest moments, most of us will name childhood experiences. A particularly memorable Christmas, or summer vacation, or time spent with favorite relatives, or with mom or dad—these are the sorts of memories we tend to recall when speaking of happiness.

THE DEPRESSION MAKEOVER

107

So, when I ask depression sufferers about their happiest moments, experiences emerge that tend to focus on a condition that we all crave—to be surrounded by loving, stable, dominant persons. Once again, by “dominant” I do not mean domineering. I mean persons who are capable of providing us with a sense of safety and security. And it just so happens that such conditions are more often found in childhood than adulthood. Think about a moment in your childhood that would satisfy your idea of happiness. Then ask yourself: “What is it that makes this happy moment different from my feelings of depression?” On the surface, this sounds like an absurdly obvious question, with an obvious answer. But actually, this is an extremely difficult question to convincingly answer. What are the things, conditions, factors, situations, feelings, or moods that separate happiness from unhappiness? Is happiness an “either/or” phenomenon? Or does happiness exist on a “sliding scale”? And is there an easily definable point at which happiness becomes unhappiness? This is part of the problem with depression. The physical sensation of depression is so painful that it often paints us into a philosophical corner. When we’re depressed, we believe that we have reached a condition of total unhappiness. We therefore naturally crave its opposite—total happiness. Yet even when a depressed person experiences something that would provide a non-depressed person with a sensation of happiness, the depressed person will frequently not perceive that anything “happy” has occurred.

108

DR. JAMES N. HERNDON

Simply, we have “unlearned” our ability to easily experience happiness. The deepest depths of depression are the most critical time for our intellect to be in charge. The time when our emotions are most raw, most on-edge, is the time for us to most strongly deny our emotions their power to influence us. Depression is the most important time to ask ourselves: “What would it take—right here and right now—to recreate—and to live—my happiest moment?” And we must force ourselves to provide an answer that would satisfy the scientific logic of an Einstein. Our first impulse is to deny the possibility that such a question can be answered. But are we telling ourselves the truth, or are we simply under the domination of our own oppressive emotions? The truth is, happiness is a self-directed condition. A memorable birthday party at age 10 was not happy because other people made it happy. Our tenth birthday party was a day of bliss because we decided we would be happy. We decided that certain conditions satisfied our own personal criteria for generating a feeling of happiness. For a depressed person to categorically claim that depression renders happiness permanently out of reach is untrue. This is part of the passive, actionless philosophy created out of the despair of depression. It is a false phi-

THE DEPRESSION MAKEOVER

109

losophy. And it is a deadly philosophy. And it must be rejected. Can happiness and unhappiness coexist? Can we feel miserably depressed and at the same time experience happiness? Can we truly recreate conditions of happiness in the midst of depression? “Yes” to all of these questions. But we must first remake our childhood notions that happiness is always associated with the security provided by other people. Although there is perhaps no loneliness like the loneliness of depression, we must not feel that our salvation remains at all times in the guiding hands of others. It does not. Today’s false, highly propagandized message to depression sufferers demands that we remain passive, dependent, and submissive: “Re-enter the womb of childhood. Mother and father figures [mental health professionals] and their magic potions [anti-depressants] will make everything better again.” This would be nice if it were true. But it isn’t. What is true? Depressed persons have the strength, the power, and the resources to reclaim a sense of happiness. By themselves. ACTIVITY: Pick a happy moment in your life. Write down specific reasons (and I do mean specific) in which this past happiness is different from the unhappiness of depression. Objectively compare the differences. Then decide what it would require for

110

DR. JAMES N. HERNDON

you to experience happiness right now. Force yourself to develop three ways that this would be possible. Write them down. Do not include ways that would involve the intervention of other persons. Put these three ways into action. [Nearly 80% of the depressed persons in my research who tried this activity reported it as helpful in decreasing symptoms of depression.]

THE DEPRESSION MAKEOVER

111

SECRET #5: ALWAYS BET ON THE REAL CHANCE

T

oday’s world of social science research requires statistics—a lot of statistics. In experimental research, if you can demonstrate that there is less than a 5% probability that your results are due to pure chance, then the scientific community “allows” you to claim that your results are “significant.” To determine this requires something called inferential statistics, which is a fancy statistical technique that permits you to make predictions with a certain degree of confidence. People who live in the real world of course rightfully couldn’t care less about such meaningless things, which are typically used by researchers to impress each other. But it’s interesting how anxious we are—especially when we’re depressed—to assign statistical probabilities to things in our lives. But we almost always deal with only two probabilities: 0% and 100%. How often have you said to yourself: “Yeah, there’s no chance at all I’m gonna get that job.” or “He’ll never call me back.” or “She will hate me forever.” We’re either totally sure something is going to happen. Or we’re totally sure that something isn’t going to happen. I’ve found that this sort of negative categorical thinking

THE DEPRESSION MAKEOVER

113

has a major impact on the intensity of our depression as well as on our ability to reduce depression symptoms. Perhaps most importantly, this sort of thinking is one of the primary causes of chronic depression. I’ve done some simple research on this issue. I asked 100 persons with depression to track five of their negative categorical predictions for 120 days. For example, is the prediction, “my depression will never improve,” actually correct? The results? Nearly 85% of the zero probability predictions were proven wrong! And when these same 100 persons decided to eliminate negative categorical thinking from their inner dialogues, 92 of these 100 persons reported significantly less depression within 90 days. Again, what does this tell us about the influence our inner dialogues have on our depression? Very simply, they are critical. By constantly telling ourselves that something will assuredly turn out badly, we’re feeding depression’s long-term submissive tendencies. And how tragic that we torment ourselves in this way when most of our predictions turn out to be wrong! The message? When you predict a zero probability, chances are, you’re 100% wrong! Reject and eliminate this sort of thinking. ACTIVITIES 1. Totally eliminate negative categorical thinking from your life. Always predict success from a

114

DR. JAMES N. HERNDON

situation. Then let your positive predictions be proven wrong. 2. Pick three things for which you have predicted failure. Track them for at least 120 days. How right were you?

THE DEPRESSION MAKEOVER

115

SECRET #6: BECOME ANTI-ANGER

H

ow often have you been angry in your life? 100 times? 1,000 times? 10,000 times? Of course, nobody counts such things. And anyway, with something as common as anger, we’d probably lose count real fast. We don’t often stop to think about the role anger plays in our lives. For most of us, anger is interwoven in subtle (and not so subtle) ways throughout our everyday existence. Most of our anger involves petty, insignificant things: We’re angry at another driver in traffic. We’re angry because we invariably find ourselves in the slowest checkout line. We’re angry because we think someone has insulted us. We’re angry at the frustrating stupidity of a friend or family member (something, of course, we are never guilty of). And then, a smaller, but significant, part of our anger often involves years of barely suppressed rage against persons and situations we feel have somehow conspired to make our lives a perpetual hell of struggle, frustration and regret. And the regret mostly consists of our self-anger at having failed to effectively “get back” at our tormentors. What are the results of all this anger and frustration? Depression, for one thing. Anger and depression. How

THE DEPRESSION MAKEOVER

117

strong is the relationship? It’s actually the perfect match. In fact, the wedding of depression and anger is a ceremony presided over by the devil himself. For me, anger is one-third of the “Big Three of Depression,” with fear and self-doubt as its other two partners. These three “buddies” are on the rampage in virtually every person with severe, chronic depression. Anger has a special place among our emotions. It arises more quickly, and can last longer, than any other feeling. And most critically, anger is the most starkly negative of all emotions. And it is the emotion most conducive to physical violence. The classical world of Greece and Rome produced some of our greatest philosophers, many of whom were also extremely insightful psychologists. Among these thinkers, anger was often a topic of interest. The Stoic Roman philosopher Seneca wrote a fascinating essay called “On Anger” which should be required reading in every school on earth. Seneca’s premise was simple: Given anger’s self-destructive potential, we must reject the possibility of ever becoming angry. For many of us, this is like someone suggesting that we stop breathing. As with many things in our lives, anger is a habit. It’s rare for a day to pass without finding at least one small excuse to feel anger and frustration. In fact, our anger response is unconscious and automatic. Yet little by little, our anger can eat away at us. Seneca argued that anger arises when we feel we have been injured. This injury is usually to our egos, our feelings, or our “status.” We falsely believe that our anger will

118

DR. JAMES N. HERNDON

“avenge” the “damage” that we believe has been inflicted upon us. The problem with anger is that it is an effect completely out of proportion to its cause. It is like washing dishes with a fire hose. Something’s going to get broken. And what usually gets broken is our own spirit. Our self-justification for anger is that “it’s not right for someone to get away with that.” But why can’t we simply ignore it? Again, because we feel that those who injure us should not escape punishment for their misdeeds. Anger is the quickest, surest way to let someone know that we’re displeased. And a startlingly effective way to “punish.” But let’s think for a minute. Was your anger ever the deciding factor in achieving one of your objectives? Did expressing anger to a stranger ever solve a situation? When and how did anger ever turn the tide in your favor? And when did anger ever really, truly make you feel better? If a man walks out on his family, most likely his family feels intense sadness, anxiety—and anger. Typically we reserve our profoundest hatred and our profoundest anger for family members. This sort of anger can simmer within us for decades, slowly eating away at our souls. This is the kind of anger that is tailor-made for depression. Seneca believed that a wise person is incapable of being truly injured or insulted. He looked deep into the human psyche for this insight. And he arrived at a critical philosophical milestone to which all of us can aspire. Learning to manage our anger is at the top of my list of ways to control and eliminate depression. It is a learned

THE DEPRESSION MAKEOVER

119

skill like any other, and improvement requires a conscious, persistent effort. Few things will rejuvenate your life as much as givingup your need for anger. When closely analyzed, situations involving anger almost never turn-out well. Instead of defending our “honor,” we usually achieve nothing but inciting pointless conflict, tormenting ourselves, and damaging our mental and physical health. Remember the saying “Don’t get mad—get even”? It really should be: “Don’t get mad. Get healthy.” ACTIVITY: Make a resolve to stop wasting your emotional resources on anger. This does not mean “turning the other cheek” or failing to stand up for your rights. And it doesn’t mean hesitating to express your opinion. It means that your life will be easier without anger’s added emotional complications. When you feel anger rising—stop it cold. Think about what the feeling of anger is doing to you, versus what it will achieve. Begin solving problems without recourse to anger. Simply, it is much easier to get your way when anger is not part of the equation. Make a conscious anti-anger effort for at least 120 days. Decide how this has impacted your depression.

120

DR. JAMES N. HERNDON

SECRET #7: BANISH UNREASONABLE FEAR

I

suspect that most of us have heard the famous saying by FDR: “The only thing we have to fear is fear itself.” Tell that to someone being robbed at gunpoint. If I were to revise this statement, and my audience were depression sufferers, I’d say: “Always fear unreasonable fear.” What do I mean by this? Well, let’s talk about fear for a moment. Remember our “Big Three of Depression”? For many of us, fear takes top billing in this trio. It can not only cause depression to develop, but can easily throw an already existing depression into the tailspin of severe depression. Fear is also an instinctive sensation. And by playing the “fear card” once too often, we can become tied in a nearly inextricable jumble of emotional knots. Fear can also easily lead to panic, one of the most psychologically and physically unnerving experiences imaginable. Is fear, then, something we should fear? Yes, but only when it is unreasonable. Unreasonable fear is a fear that has little basis in reality—and only a small probability of becoming a reality. Unfortunately, this is the kind of fear that plagues most

THE DEPRESSION MAKEOVER

121

depression sufferers. It becomes a sort of generalized dread, a sense of impending doom, a feeling that something disastrous will happen. And as FDR suggested, we can even begin to fear the feeling of fear itself. There are many things in our modern world that would cause a normal person to be fearful. However, in order to avoid psychological overload, we must avoid continually fearing that the many potential hazards in our environment represent a clear and present danger to us. Let’s face it. Every time we get into an automobile, we face a small, but real, statistical probability that we will be killed in an accident. By unreasonably dwelling on this possibility, soon we might find ourselves unwilling to drive. We might then choose to remain indoors at all times to avoid coming into close contact with cars. Worry about our friends and family becoming involved in an auto accident might then confine us to bed, where we could engage in further fearful ruminations. This scenario is not as farfetched as you might think. Thousands of depression sufferers have followed it. They have incapacitated themselves with unreasonable fear. But it is not necessary to go to such extremes for fear to radically alter our lives—and to deepen our depression. Often, we have been traumatized by some shocking event—the death of a loved one, a major financial setback, or a romantic loss. And it can take little for us to begin to fear that our trauma might recur. What started as a tremendously stressful situation can evolve into an unreasonable fear that a similar situation

122

DR. JAMES N. HERNDON

might once again befall us. Are such fears probable? Are they reasonable? Very rarely. The risk of generalizing our fears is high. Soon, we may not even be able to identify any specific fears at all. We just know that something out there is lying in wait for us. And that we are in grave danger. When such a feeling is linked to depression, we are in a hole that is very difficult to climb out of. The goal? Try to strip the emotion from your fears and reveal the logic behind them. If the logic isn’t there, decide why you are holding onto the fear. Fear is also a survival mechanism. If your fear isn’t helping you to survive, you don’t need it. ACTIVITY: Take an immediate inventory of your fears. Take the fears you identify and decide which of them are unreasonable. Refuse to ever again think about these fears. When thoughts of them arise, remind yourself: “These fears are groundless. I will not be pulled down by them again.” Make your logic overpower the fear. Attack a generalized sense of fear by intellectually refusing to be ruled by a foe you cannot identify. Continually remind yourself: “I will only be afraid of factors that actually threaten my survival. Other fears do not exist for me.”

THE DEPRESSION MAKEOVER

123

Attempt to link a decrease in fear with a decrease in your depression.

124

DR. JAMES N. HERNDON

SECRET #8: REDEEM YOUR GUILT

E

ven when depression is not involved, few psychological conditions can tear us apart like guilt. Yet guilt remains one of depression’s most frequent, and intractable, co-conspirators. Most of us have done things in our lives—or failed to do things—for which we feel deep guilt. Most often we feel responsible for having caused another person to suffer. Guilt can be so gnawing and so persistent that it is capable of becoming the sole cause of chronic depression. And the difficult part is, we may be totally justified, both logically and morally, in feeling guilty. Often we have done something so awful and so disgraceful that it would be difficult not to feel guilt. Where does that leave us? Must we do endless penance? And must we believe that our depression is a fitting punishment for our guilt? I believe that there is an ethical way to overcome this issue—and to relieve our guilt-related depression: We must redeem our guilt. Redemption has many connotations. It can take on qualities of religion, morality, ethics, and philosophy. Each of us will interpret it in her or his own way.

THE DEPRESSION MAKEOVER

125

Once again, we must act. We must take steps to heal the injury that has occurred. If we can, make peace with those we feel we have victimized. Or seek out those who crave the comfort of friendship. Visit a hospital. Help a child. Console those who are grieving. Be a force for positive change in another person’s life. Each of us carries guilt, whether small or large. We can only begin to undo this guilt by becoming a source of healing, a source of help for others. Where possible, we must seek the forgiveness of others. And often, we are most in need of forgiving ourselves. Depression cannot become our own self-punishment for our guilt. Because then, we have accomplished nothing. An earthly redemption of our guilt is possible. But we must actively seek it. ACTIVITY: Identify a way that will allow you to step outside of your guilt. Become the opposite of your guilt by helping another person. If possible, heal wounds with those whom you may have harmed in the past. No longer accept the feeling of guilt as a meaningful, ethical method of atoning for your past actions. Track your level of guilt-related depression.

126

DR. JAMES N. HERNDON

SECRET #9: TAKE THE TRUE MEASURE OF STATUS

I

f we told the truth, most of us would admit that we’d love to have our 15 minutes of fame. After all, TV, movies, magazines and newspapers are full of persons with no perceptible talent, skills, or personality. Why shouldn’t we have a chance, too? What we’re really dissatisfied with is our “status” in society. We see all these people, with all their money and fame. And we see how much attention all of them seem to receive. Deep down, we’re just unhappy with where we are in life. We should be further along in our careers. We should be making more money. We should have fun, glamorous friends. We should be living life as it’s meant to be lived! And we should be getting a lot of attention. From everyone! And what is the reason for our unsatisfying status in life? Why are we being ignored? Why are we always in the slow lane, while others (always far less deserving, of course) speed by us in the exciting, and ever-so-sexy, fast lane? It’s enough to cause a person to have some really big self-doubts (the final member of our depression “Big Three”). So, we stop and we think about it. And then we

THE DEPRESSION MAKEOVER

127

decide: “That must be it. The reason I’m not where I want to be in life…the reason I’m not a superstar…is because I just don’t have what it takes. I guess I’m really just a…loser.” In our media-frenzied age, most of us are experts at this sort of twisted logic. First, we sentimentalize our existence (we believe we should be objects of pity because everyone else gets all the breaks). Then we decide that our dreams were never realistically obtainable anyway (because we were born inadequate and we will die inadequate). For many of us, self-doubt is the alpha and omega of our problems. Simply, it is the crux of our unhappiness. And it is at the center of our depression. Faulty logic and raw emotion are magnetic opposites. That is why they attract each other like crazy. They’re like those free refrigerator magnets that have been on the refrigerator for 10 years—and the businesses don’t even exist anymore. But we never ask ourselves: “Why keep something that’s worthless?” We’ve got to calm down. And we’ve got to think. Let me give you a personal example that comes to mind: I’ve spent a lot of time working with successful, well-known people in the entertainment industry. Many of them are very depressed. Why? Don’t they have it all? Don’t they have all the self-confidence in the world? Aren’t they beautiful? Aren’t they rich? Don’t people everywhere love them? Exactly what human foible leads us to believe that famous movie stars are exempt from the stresses, passions, and problems that you or I must face every day? Because

128

DR. JAMES N. HERNDON

they are not exempt. If anything, fame and fortune amplify the likelihood of problems such as depression. And yet, we remain painfully envious of “the high and the mighty.” What is the one thing that usually separates the “successful” from the “unsuccessful”? Successful people persist in the face of resistance. Are people famous by accident? Very rarely. Are rich people smarter than we are? Not very often. Are the “movers and the shakers” somehow immune from the psychological insecurities of everyday life? Never. We are frustrated, we seek empty status, we seek attention, because too often we simply hesitate to “go for it.” And we become depressed because of our own unwillingness to risk the little failures that occur along everyone’s path to success. We do not take the true measure of status, because we are placing high value on something of limited utility. Status cannot make us happy. And status cannot cure our depression. Do what you want to do. And welcome the struggle that it will take to achieve it. And do not measure yourself against others. Be your own measure. ACTIVITY: Do a little research. Pick any 10 famous persons. Study their lives. In what ways have they had an “advantage” over you? In what ways have their lives been more difficult than yours? Do you be-

THE DEPRESSION MAKEOVER

129

lieve that their lives have been “happier” than yours? What have you wanted to accomplish that you have failed to accomplish? What are the realistic reasons for this failure? Have you met with impossible odds, or has your attitude hindered your chances for success? Design a long-term plan to achieve one of your most desired goals. Implement this plan.

130

DR. JAMES N. HERNDON

SECRET #10: MAKE YOUR OWN MEANING

T

here has been a persistent thread among many of the depression sufferers I have worked with. It goes something like this: “My life has been a failure. It has been meaningless. I don’t know what to do anymore. I don’t know what to believe.” Call it an “existential crisis.” Call it “spiritual exhaustion.” Call it “depression.” This is often what depression boils down to— meaninglessness. It is a difficult area, an area bounded perhaps only by religion and philosophy. When we have lost a purpose, we truly have reason to feel depression. Meaninglessness is the ultimate attack on our self-definition, the ultimate attack on our very existence. The feeling of depression then screams for us to stop the assault—and to find an answer. To find a meaning. The meaning will come. But the process is painful, because we despair that any answer exists at all. But the quest must begin. And you must not stop until you have found your answer. When you find the answer—and you will—it is a key that will unlock many doors.

THE DEPRESSION MAKEOVER

131

ACTIVITY: Amid the pain of depression, pause and reflect. What meaning can you bring—not to yourself—but to others? This, then, is your meaning. (Do not accept a temporary inability to answer this question. Persist until you find one.)

132

DR. JAMES N. HERNDON

THE NEW PATH

D

epression is designed to warn us—and then to leave. It is not designed to stay and stay, like a tiresome

guest. What do we do when guests won’t go home? Here’s what we think: “I’m tired. You’re boring. I wish you’d leave.” But, we do nothing. Instead, we’re hyper-polite. We sit there. We nod. And we smile the sort of smile that is really just a pained smirk. Yet certain people take a really long time to get the message. So we continue to sit. And to pray. Most of us do the same thing with depression. We desperately want it to leave. But we continue to feed its insatiable appetite for attention. But it’s not really depression’s fault. It’s our fault. Because guess what? We can tell depression to “get the hell out!” And we won’t even hurt his feelings! And he’ll even be back, ready to help us, the next time we need him! But we always treat depression like the town bully. We’re afraid of him. And we have no idea what he’s going to do next. Come on. Who is depression? Are we depression? Is this what we’d say in a job interview if someone asked us to describe ourselves? Would we say: “Well, I’m a highly

THE DEPRESSION MAKEOVER

133

skilled engineer. I’m a great team player. I’m a conscientious worker. And I have this other quality—depression!” I think we now know a few things about depression. It’s a survival mechanism. It’s situational. It’s not a disease. It’s not a moral flaw. In varying degrees, it strikes us all. And we can make depression a habit—or we can take some directed actions to allow it to function normally. Or…we can cover-up the problem with antidepressants. For me, the most frightening aspect of antidepressants is that they are an unreasonably simplistic solution to a complex problem. Simply, our inborn logic and common sense tell us that solving the problem of depression cannot be as easy as popping a pill. We might as well claim that depressed persons are possessed by demons who can only be exorcised with a magic potion. And yet, most depressed persons have been misled into unquestioningly accepting the premise that they are possessed by forces beyond their control…and that the miracle of modern pharmacology can cure them. I’m sorry to break the bad news. But it just ain’t so. At least not yet. Mental health has always been the most difficult part of health care. It is the part we really know the least about. Truly, the puzzles of the human psyche are not easily solved. We are thus bound to never seek the easy path or to provide easy answers. Anti-depressants are very easy answers. Can a pill cure our anger, or our fear, or our self-doubt? And are we supposed to accept the absurd idea that our depression arose out of nowhere—and created our anger, fear, and self-

134

DR. JAMES N. HERNDON

doubt? This is not only ludicrously nonsensical, but is without a shread of supporting evidence. And it is a prescription for chronic depression. Is there hope? Certainly. In fact, I hope we’ve established that we DO have a great deal of control over the way we think and feel. And that controlling our depression can become a reality. Pain isn’t something I look forward to, but it’s sure something I’d hate to be without. The feeling of depression is also not a sensation that I wait for with open arms, but it’s also one of our body’s critical warning systems. Simply, depression is a message we need to listen to—and to act on. Why is depression raging through our society like some biological epidemic? Several reasons. We live in an increasingly passive culture. We live in a culture that wants us to believe that mental health is a consumer item. That we can buy our way out of depression—without effort and with little responsibility to ourselves. We also live in a society that creates stresses at every turn. And we live in a culture with an ever-increasing number of choices. Which way do we turn? And how do we get there? A sense of stability, and a sense that we possess some intrinsic value as individuals, are vanishing perceptions. Today’s world creates a sense of uneasiness. We think and we think and we think about our vulnerability—and we become depressed. In the truest sense, depression is a medical issue. Depression is inseparable from our physical bodies. The feeling of depression is, after all, something essentially physi-

THE DEPRESSION MAKEOVER

135

cal. But we often have difficulty in realizing the degree to which we can positively control our own bodies. And we forget an old, but still true, maxim: “Mind over matter.” At the same time, we must be rigorous about regular medical check-ups. There are many, many medical conditions that mimic depression, but are not true depression. Hormone imbalance is one such condition. Sadly, women with hormone imbalances are often casually, and wrongly, diagnosed with depression. The consequences of such misdiagnosis can be disastrous. It is important to remain attuned to our bodies and to our emotions. If we find ourselves experiencing emotional turmoil for no reason, we should seek medical attention immediately. And another thing: We must NEVER attempt to withdraw from anti-depressants without extremely close medical supervision. And don’t be afraid to question your doctor. Doctors are our health care partners. They are not infallible, godlike creatures. Remember: It is your body. And your life. It’s OK to feel depressed. This is a message we seldom hear. The reason it’s OK is because depression is a normal, instinctive part of human existence. But we often must put controls on our own instincts. Depression demands such controls. There’s an important lesson I’ve learned about depression: We can change ourselves and our whole world changes. How do I know we can makeover our depression? Because I, too, have been depressed. And I now know that I will never become severely depressed—ever again.

136

DR. JAMES N. HERNDON

I want you to believe this, too. And to know it. I want you to make it a reality. You can and you will. The new path is action. Take the new path.

THE DEPRESSION MAKEOVER

137

Appendix 12 Depression Tracking Charts

THE DEPRESSION MAKEOVER

141

142

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

143

144

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

145

146

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

147

148

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

149

150

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

151

152

DR. JAMES N. HERNDON

THE DEPRESSION MAKEOVER

153

NOTES

NOTES

HOW TO CONTACT DR. HERNDON

Dr. James N. Herndon [email protected]

Dr. Herndon is available for private consultation. Please inquire for more details.