Depression, how doctors deal with it

My second question usually provokes a smile…

I get to meet many depressed patients in my job. I say get to because I love helping them. I will greet them, introduce myself and sit down next to them. Some of them smile back, some do not, some glance at me quickly and turn their gaze back to the floor. A sign of deep depression.

My second question to them usually provokes a tiny smile. Most of the time just a hint of a smile, just one corner of the mouth turns upward. They make eye contact just for a brief second as my unexpected question sinks in. In that brief second I can see the spark that once gave them hope.

My first question is always, why do you think you are depressed?

Most of the time they are not sure. There are a few who became depressed after losing a job, a loved one or some other life stress. The majority with long term depression cannot give me a clear answer and that’s okay.

The BIG question,

If money wasn’t an issue, what would you do with your free time?

What?

Usually unexpected, at first a puzzled look, then it sinks in, and then, that moment that I love so much. That memory of what excites them. From the deep dark dusty storage room in the back of their brain comes a small spark, a hint of enjoyment.

The responses I have gotten are very interesting.

I would do voiceover work for cartoons that make kids happy, a young guy in his twenties told me. I would start a nonprofit to help abused teenagers, a young lady in her thirties told me. I would open a beauty salon to help women look pretty. I would make travel documentaries. I would play sports and coach kids. No joke, these are actual responses from actual people I’ve met!

I find this interesting. Look at these responses again, what do they have in common? Most of them deals either with a creative task, creating something new, desiring passion in something they would like to do or helping someone.

So why the smile?

This may be a stretch, but some argue the answer lies in the difference between humans and animals. Humans possess the ability to create, animals do not. Creativity is our unique ability and it happens to bring pleasure. Helping each other on the other hand is a universal phenomenon of any living thing. Animals do it for survival. This may explain why we find pleasure in community.

Now that your head is spinning with questions, like what could animals possibly have to do with feeling depressed, let me explain.

Animals are born with certain instincts or talents. For example. A baby fawn is born and as its mother licks it clean, it opens its eyes and starts moving its legs. Something miraculous happens. The baby deer gets its legs underneath it and attempts to get up. It takes its first steps!!!

It took roughly a year for my kids to learn to walk, scavenge the kitchen for their own food and feed themselves. At just a few minutes old a baby deer will get up, stumble over to its mother and find a teat for its first sip of warm milk. As a father of three, it is such a relief when my kids can finally reach up, grab an apple and eat, it just took a while to get to that point.

So the question begs, what instincts do humans have, what are we able to do naturally that animals do not? Asking for help is one of the first things we do. A baby cries and gets nice warm milk. Some will argue that we have other instincts. For example, when a mother’s breast touches the baby’s cheek they will turn their head towards it. This is called the Rooting reflex. It is not an instinct or a talent but merely a primitive reflex.

So do humans have an instinct, a unique characteristic that sets us apart from animals? Maybe, we are born with the ability to think creatively, to fashion tools, to make and build things. We have the capacity to think into the future of what a possible outcome may be. The ability to recall memories. We are not sure if animals possess these, some studies try to answer this question but we haven’t really seen any apes launching themselves to space. One example of creation denovo in nature is of Chimps going termite fishing.

How does this relate to depression and the spark I see in my patients eyes?

When we engage in a creative task, we find joy in the process. When we exercise our only gift we feel happy. The happiness emerges from the struggle of making something new and the accomplishment of success.

Humans have this unique ability, is it true that exercising this creative thought will give us joy? From my own experience I believe so, but I can’t speak for every person out there. I can speak for my dog Shaka though. You see, dogs have an inborn instinct to hunt, to chase their prey, this is how they survive. Hunting is a natural talent for a dog. My dog Shaka loves to chase after a stick or a ball. He will go to the ends of the earth to retrieve his ball, he will swim, jump, turn circles, anything just to go chase after his ball. You can see his tail wagging, his ears flapping, a sparkle in his eyes. This is because he is exercising one of his inborn abilities, to hunt and chase after his ball.

So what is the treatment for depression? Depression is very common today. Many people suffer from it on a daily basis. Luckily there are a variety of really good medicines that help. It usually takes a few tries to find the right one, but here is what I’ve discovered. My patients who are not on any medicine, do wish to try some. My patients who are already on medicine still seem depressed. This is very unfortunate. They put their heart and their hopes in me to help them. I feel as if, by just giving them a pill, I do them a disservice.

That is why I came here to write today’s blog, to give a little different perspective, to help you see it from another angle. We tend to get stuck in the daily grind, wake up, get to work, get home, sleep, repeat. We get tunnel vision and forget to look up from our phones every once in awhile and enjoy this amazing thing called life.

I have nothing against medicine, I do find that my patients say it helps a little. But I want to encourage you today, take some time and think. What would you do if money wasn’t an issue? What would you do with your free time if you had an unlimited amount? If you could do that activity. How can you use it to serve others? By using the thing you would enjoy to serve others you would satisfy both happy-providing activities. Then ask yourself, why aren’t you doing that right now? What is holding you back? Is it fear of failure, not having time, money?

What is down must come up

Do not fear failure, for it is only the universe trying to tell you to try again. Make sure you learn from your failures though, otherwise they serve you no purpose. Here’s the trick though, you have to keep trying. Keep trying to find a way to exercise your passion, your creative thoughts. Start today, take one step toward making something new. Take something old, be bold, and create your mold.

Use what you love to do to help another. If you are believer use your god given gifts to serve. If you are an atheist use your genetically derived ability or your environmentally created unique skill set to create something new that may give an ounce of pleasure to someone else.

When you engage in an activity that captivates your time and mind, when nothing else seems to matter because you are so focused, you enter a state of flow. This is a state of true intrinsic reward. It is one of the happiest forms of activity for humans.

Humans are pack animals. We need connection with others. Depression causes isolation and isolation fuels depression. I referenced the film Yes Man starring Jim Carrey to a patient with depression. I told him to start saying yes to invites from friends. He also happened to used to play guitar which I encouraged him to do again. I saw him a month later and he was a new man. He walked in with his shoulders back like a man on a mission. I could see the weight was lifted off. The pride beaming from his eyes. He told me he started going out more, reconnecting with friends and playing guitar. He was happy again.

Engaging in meaningful activities rather than bland time wasting activities seem to help as well. Instead of watching endless TV use your time wisely. Time is very precious. It is something that most people do not realize until they are over 60 years old. Don’t be that.

Small accomplishments add up to great happiness. Learning to cook a new recipe. Reading a new book. Clean one room. Writing a poem. Learning a new song. Wash the car. Crafting a new piece of art. Now the lawn. All these are small accomplishments and result in a small dopamine burst.

These are some ways to help your happiness journey. Good luck my friends.

This is your life, your one life here with your loved ones. Make it count.

Flow by Mihaly Csikszentmihalyi

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