While depression is a growing epidemic in western society, it remains to be one of the most treatable as well. While the medical profession looks first to medication, I believe only the most severe cases require any long-term medical treatment.

If you look at the criteria for diagnosing depression, you will notice that most of it relies on behavior and thinking. Two things that we can consciously control, even if in the pit of depression it does not seem like it.

I was clinically depressed for several years in my early adulthood, and have since worked with hundreds of people suffering from anxiety and depression. What I have seen in people who get through the depression without medication, is that they relearn how to not act and think depressed. They learn that they are responsible for their depressive thoughts and behaviors even if they do not feel great. I remember taking half an hour to roll off the couch and do a push-up when I was depressed because I knew I had to do something that went against how I was feeling.

Cognitive-behavioral therapy has always been known to be effective in dealing with most depressed people. The basis of this is to understand how your thoughts influence your feelings and behavior, then to work to change the habitual thought patterns in a beneficial way.

Some of the more common depressive thinking patterns are to: catastrophize, to attribute specific events to always and never (over-generalizing), and to argue against hope and positivity. Just these three can lead us to think that everything is always worse than it really it is and will never get better. The more someone tries to cheer a depressed person up, the more the person argues and holds onto their view, because they think nobody else can understand how bad it is for them. We get into a habit of negative perception, and exclude any evidence that it can or is getting better.

At the root of depression you will usually find anger (at self, others, and the world), feeling alone, fear, hopelessness, and helplessness. Often depressed people will have some social anxiety, causing them to isolate and be uncomfortable around others. When you talk to a depressed person they are usually trying to convince you how bad it is, so they are also looking for validation. Rather than trying to convince you that it is not as bad as you think and will get better, I would rather start where you are and agree with you. I would ask you how being this depressed and having such a terrible life benefits you and why you would want to stay there.

The truth is that most depressed people get a benefit from being depressed, and it is often that nobody expects anything of them, and they can justify their ineffective behavior. Being depressed is easier than dealing with life and taking action to improve it. We fool ourselves into believing that we are helpless and there are no options to make it better. Depression becomes a self-fulfilling prophesy that helps us prove how bad our life is because we don't do anything to change it. I have found that sometimes having suicidal thoughts can actually bring about positive change because when you get that desperate you are usually willing to see other options and maybe choose one over killing yourself.

While I know that depression can usually be helped without medication, I am not totally against taking short-term antidepressants as long as it is in combination with other things as described above. If all you do is take the meds, any improvement is attributed to the meds and you don't learn to live differently and feel a sense of personal power. However, sometimes the meds can help us just enough so that we can start making these changes and then eventually when our life looks better, we can be weaned off of them.

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