One of the reasons depression is getting worse is that even though people are seeing more psychiatrists, not all of the depression that people experience is an illness. Somewhere along the way, as a society, we started assuming that if you are depressed, then that also means that you are ill.
An illness is a malfunction in the regular function of your body. For example, our blood pressure is supposed to stay within a particular range. But if we develop hypertension, our blood pressure rises above what it is supposed to be.
Sometimes, our brain malfunctions and we end up with clinical depression. If your life is going really well, and you have a good job, are in a relationship, and you have people in your life who care about you, and at the same time you wake up every day and you feel sad and empty, that is more consistent with clinical depression. We look at this person’s life and we think “this person should be happy”. But if they are sad even though they should be happy, that implies that there is a malfunction.
Moreover, if something is broken, then there are particular ways to fix that. For example, in this person, their serotonin system might be malfunctioning so that their serotonin is low. In that case, we can try giving them medications (SSRIs). If we correct that serotonin imbalance, they start to live the normal life that they are supposed to.
However, the tricky thing is that not everyone who is depressed should be happy. In fact, a lot of people who are depressed should be depressed. That means that it is normal or “congruent” with their situation. If you are stuck in life, you don’t have a job, no fulfilling relationships, socially isolated, then it makes sense for you to feel depressed in that situation.
Unlike clinical depression, congruent depression is appropriate to your situation.
However, there is a caveat that sometimes clinical depression can come out of unfavorable circumstances. For example, if you lose your job, then you can get clinical depression that was triggered by that bad circumstance. But the key idea is that if the bad circumstance is fixed, then someone with congruent depression will start to feel better and someone with clinical depression will have episodes of depression that are independent of their circumstances i.e it becomes episodic.
Congruent depression can be long-lasting. It can last for years or even your entire life. It is related to major shortcomings in your life.
For example, if someone has been depressed every day for 15 years, then it is likely that something in their life is fundamentally lacking. People who have congruent depression often have a life that lacks purpose. They lack motivation and feel lonely and paralyzed. They feel stuck. They feel like they are living their life on autopilot. Their life can feel like a blur. They can feel behind when they compare themselves to other people.
There is a part in brain called the default mode network (DMN), which gives people the capacity for self-awareness or self-reflection. This survival mechanism allows people to change behavior and adapt to external conditions. For example, deer, who do not have a DMN, can search for 10 fields for food, not find anything, and continue to do the same thing. In contrast, humans can do the same thing and realize that they need to change their approach by creating a trap or tools to help them.
As a result, it allows
However, the DMN gives us the potential to have depression because it appears that those who are depressed tend to have overactive DMN. The those with an overactive DMN are burdened with thoughts about themselves, and, as a result, require less external circumstances to begin to draw a self-critical conclusion. For example, regular people can ask 10 girls out, not find love, and feel like an idiot. While depressed people can ask 1 girl out, not find love and feel like an idiot because the hyperactive DMN sees 1 "failure" and immediately criticize themselves.
This means that the DMN will turn any tiny thing that is external and unrelated into personal fault or guilt. As a result, depressed people will sometimes say things such as "I think my family is better off without me" because the overactive DMN observes an external unrelated situation like family arguing and immediately creating false narratives and conclusions about how they are the cause for it.
So if someone with an overactive DMN were to detach themselves from self-reflection, then their depression would actually lessen. This is clinically observed in patients that receive ketamine as a treatment for depression. Ketamine is a dissociative agent meaning that it separates the mind from its sense of self, thereby, shutting off the DMN and pausing the self reflection. In addition, it is one of the fastest acting treatments for depression, as most people under treatment see changes in depression within a few hours, while patients that are prescribed SSRIs or hallucinogens require weeks for results. However, it is also noted that this is rarely prescribed due to the dissociative property because separating a patients sense of self can cause PTSD. Therefore, all treatments for depression should be conducted under the guidance of a clinician.
Another source of depression is that the brain is designed for a simpler survival lifestyle, but the current problems that society faces are more complex in mental need. In the past, survival was the only challenge that society faced, and family profession influenced the direction of your future career path. As a result, there was little need to find purpose and meaning in life. But now that most of our survival needs are met, the only thing people are missing is purpose. But there is little direction or no clear answer as to how you find purpose. Like the rich kings, despite having your needs met, you are simply left unhappy, and can turn to religion or spirituality.
The challenge is that as we medicalized depression, we stopped looking for answers to all these questions.
If you're sad then that's kind of okay, it's a natural part of the human experience. But if you're so sad that you can't go to work, if you're so sad that you can't be the person that you need to be for your spouse, your kids, or the people around you, then we call that depression.
The best way to get treatment for depression is by seeking help from mental health professionals. An important aspect of getting proper treatment is finding the right mental health professional.
When depression becomes so severe that an individual cannot get out of bed, then it becomes especially important to seek help from a mental health professional.
DO NOT USE THE FOLLOWING SUBSTANCES BY YOURSELF TO CURE YOUR DEPRESSION
All dissociative agents mentioned, ie Ketamine, SSRIs, and hallucinogens, should all be used under prescription from a medical professional.
FRACTURING/SEPARATING YOUR SENSE OF SELF CAN GIVE YOU PTSD AND LEAVE YOU WITH DEPRESSION AND PTSD.
Individuals with depression often have certain vulnerabilities that can be triggered by the world, which can further facilitate depression. Due to the mind-body connection, eating healthy food and getting physical exercise can help combat depression.
There is a profound connection between mind and body. In fact, the field of psychoneuroimmunology explores the connection between mind, brain, and immune system. This field has discovered that your body’s response to a vaccine is blunted if you are depressed and that people who are grieving are more susceptible to viral infection.
Mental problems are not caused by physical problems — but the mind is connected to the body. When the circadian rhythm is off, the body is in a pro-inflammatory state, and as a result, the body feels lazy and people do not want to do anything.
This is also observed when people have the flu because having the flu means that all you want to do is lay in bed. Do not blame yourself for being lazy when you have an irregular sleeping schedule. Instead solve the inflammation by doing yoga or exercise or eat anti-inflammatory foods like leafy greens and berries. Research has demonstrated that there is an important link between diet and depression. Make sure to stay properly hydrated, eat fruits and vegetables (e.g. bananas and pineapple), and avoid processed foods.
There are also studies to suggest that anti-inflammatory medication can be used to treat the effects of depression, but its not recommended and strongly advised against.
Talk with your doctor about these things. Do not just get a blood test and draw conclusions from that.
Depression is not a binary state and is actually a spectrum of feelings. So when severe clinical depression gets better, the severity of depressive episodes will decrease, and can even be manageable. As a result, people often feel like they can avoid addressing their sadness because it is lower in severity. However, you do not want to stop your self-care practices because they are keeping your from falling into a more active or severe episode. Like a sinking boat, you can plug up the holes to stop water from coming in, but the boat can still be sinking because there is still water in the boat. It is just sinking at a slower rate because there is no water coming in that is dragging the boat down. So keep bailing water out of your ship, keep taking care of yourself, and keep seeking help because your depression became a waiting game. Every day that you do not give into the depression makes the future episodes smaller and smaller, and with time, the depression will also shorten in duration and frequency.
One can deal with self-doubt by failing in a safe manner. Failing with survival is the path to overcoming that feeling. You need to keep failing.
For example, Dr. Kanojia got about 140 rejections from medical school before he finally got accepted into one. Obviously, the first couple of rejections hurt, and the next few hurt as well, and then the next couple hurt as well, but eventually they finally started to hurt less. The solution to the fear of failure is exposure therapy and managing your fear.
Generally speaking, the fear of a thing is worse than the thing itself.
Sometimes, people face self-doubt because they have set up unrealistic overconfidence and anything can cause that overconfidence to topple over and shatter. Basically, they have high peaks and very deep slumps.
To solve this problem, people need to be a bit more even. They need to deal with their complex, cognitive biases, or Samskaras of overconfidence. People can focus on the fear and self-doubt caused by this complex, but it is even better and more effective to take care of the root cause itself.