Clinical Depression Quotes

sarcasm and jokes were often the bottle in which clinical depressives sent out their most plangent screams for someone to care and help them.

What I want you to know: Dying is easy. Comedy is hard. Clinical depression is no fucking picnic.

In those pamphlets that they give at mental health centers where they list the ten or so symptoms that would indicate a clinical depression, 'suicide threats' or even simple 'talk of suicide' is considered cause for concern. I guess the point is that what's just talk one day may become a real activity the next. So perhaps after years of walking around with these germinal feelings, these raw thoughts, these scattered moments of saying I wish I were dead, eventually I too, sooner or later, would succumb to the death urge. In the meantime, I could withdraw to my room, could hide and sleep as if I were dead.

Some catastrophic moments invite clarity, explode in split moments: You smash your hand through a windowpane and then there is blood and shattered glass stained with red all over the place; you fall out a window and break some bones and scrape some skin. Stitches and casts and bandages and antiseptic solve and salve the wounds. But depression is not a sudden disaster. It is more like a cancer: At first its tumorous mass is not even noticeable to the careful eye, and then one day -- wham! -- there is a huge, deadly seven-pound lump lodged in your brain or your stomach or your shoulder blade, and this thing that your own body has produced is actually trying to kill you. Depression is a lot like that: Slowly, over the years, the data will accumulate in your heart and mind, a computer program for total negativity will build into your system, making life feel more and more unbearable. But you won't even notice it coming on, thinking that it is somehow normal, something about getting older, about turning eight or turning twelve or turning fifteen, and then one day you realize that your entire life is just awful, not worth living, a horror and a black blot on the white terrain of human existence. One morning you wake up afraid you are going to live. In my case, I was not frightened in the least bit at the thought that I might live because I was certain, quite certain, that I was already dead. The actual dying part, the withering away of my physical body, was a mere formality. My spirit, my emotional being, whatever you want to call all that inner turmoil that has nothing to do with physical existence, were long gone, dead and gone, and only a mass of the most fucking god-awful excruciating pain like a pair of boiling hot tongs clamped tight around my spine and pressing on all my nerves was left in its wake. That's the thing I want to make clear about depression: It's got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal -- unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature's part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead. And the scariest part is that if you ask anyone in the throes of depression how he got there, to pin down the turning point, he'll never know. There is a classic moment in The Sun Also Rises when someone asks Mike Campbell how he went bankrupt, and all he can say in response is, 'Gradually and then suddenly.' When someone asks how I love my mind, that is all I can say too

That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorror, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

Hang me upside-down and fuck me in both ears. You pulled yourself out of a clinical depression by being a freaking hero.

Sometimes when I’ve felt despondent for several days, it helps to discipline myself by saying, ‘I’m going to think only positive thoughts.’ Enough is enough!

With all this talk about taking my life, why have I never attempted it? Answer: I have an overwhelming desire to live.

There is in fact a category of people who get unusually close to the truth about themselves and the world. Their self-perceptions are more balanced,they assign responsibility for success and failure more even-handedly, and their predictions for the future are more realistic. These people are living testimony to the dangers of self-knowledge. They are the clinically depressed.

Lately, though, he'd just been tired in general. Tired of people. Tired of books and TV and the nightly news and songs on the radio he'd heard years before and hadn't liked much in the first place. He was tired of his clothes and tired of his hair and tired of other people's clothes and other people's hair. He was tired of wishing things made sense. He'd gotten to a point where he was pretty sure he'd heard everything anyone had to say on any given subject and so it seemed he spent his days listening to old recordings of things that hadn't seemed fresh the first time he'd heard them. Maybe he was simply tired of life, of the absolute effort it took to get up every goddamned morning and walk out with into the same fucking day with only slight variations in the weather and food. He wondered if this was what clinical depression felt like, a total numbness, a weary lack of hope.

That dead-eyed anhedonia is but a remora on the ventral flank of the true predator, the Great White Shark of pain. Authorities term this condition clinical depression or involutional depression or unipolar dysphoria. Instead of just an incapacity for feeling, a deadening of soul, the predator-grade depression Kate Gompert always feels as she Withdraws from secret marijuana is itself a feeling. It goes by many names — anguish, despair, torment, or q.v. Burton's melancholia or Yevtuschenko's more authoritative psychotic depression — but Kate Gompert, down in the trenches with the thing itself, knows it simply as It. It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self's most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency — sitting or standing, doing or resting, speaking or keeping silent, living or dying — are not just unpleasant but literally horrible. It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain, a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one. The authoritative term psychotic depression makes Kate Gompert feel especially lonely. Specifically the psychotic part. Think of it this way. Two people are screaming in pain. One of them is being tortured with electric current. The other is not. The screamer who's being tortured with electric current is not psychotic: her screams are circumstantially appropriate. The screaming person who's not being tortured, however, is psychotic, since the outside parties making the diagnoses can see no electrodes or measurable amperage. One of the least pleasant things about being psychotically depressed on a ward full of psychotically depressed patients is coming to see that none of them is really psychotic, that their screams are entirely appropriate to certain circumstances part of whose special charm is that they are undetectable by any outside party. Thus the loneliness: it's a closed circuit: the current is both applied and received from within.

That’s the thing I want to make clear about depression: It’s got nothing at all to do with life. In the course of life, there is sadness and pain and sorrow, all of which, in their right time and season, are normal—unpleasant, but normal. Depression is an altogether different zone because it involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part (nature, after all, abhors a vacuum) to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

According to studies, clinically depressed individuals have a more accurate grasp of reality than the average person. We tell ourselves lies and layer falsehoods and self-assurances over one another in order to cope with a world colored by pain and suffering. We put blinders on. If we lose that illusion, we crumble into depression or we crack and go mad. So perhaps I’m crazy, but only because I see things too clearly?

Perhaps the strangest thing about this illusion of control is not that it happens but that it seems to confer many of the psychological benefits of genuine control. In fact, the one group of people who seem generally immune to this illusion are the clinically depressed, who tend to estimate accurately the degree to which they can control events in most situation.

I have been clinically depressed for most of my life. I once used drugs to fix it. Then I stopped. I stopped because I decided they were making me stupid, and I’d rather be miserable than stupid. I am what I am.

The trouble is that when we get around to solutions, it always seems to come down to Prozac. Or Zoloft. Or Paxil. Deep clinical depression is a disease, one that not only can, but probably should, be treated with drugs. But a low-grade terminal anomie, a sense of alienation or disgust and detachment, the collective horror at a world that seems to have gone so very wrong, is not a job for antidepressants. The trouble is, the big-picture problems that have so many people down are more or less insoluble: As long as people can get divorced they will get divorced; America=s shrinking economy is not reversible; there is no cure for AIDS. So it starts to seem fairly reasonable to anesthetize ourselves in the best possible way. I would like so much to say that Prozac is preventing many people who are not clinically depressed from finding real antidotes to what Hillary Clinton refers to as 'a sleeping sickness of the soul,' but what exactly would those solutions be? I mean, universal health care coverage and a national service draft would be nice, but neither one is going to save us from ourselves. Just as our parents quieted us when we were noisy by putting us in front of the television set, maybe we're now learning to quiet our own adult noise with Prozac.

I know the difference between sadness and depression. Clinical depression has no source from which it springs-it just is. Intractable sadness has nothing to do with synapses, or brain chemistry, or essential salts, it's born of something. It's the product of injustice and helplessness. It can be anesthetized, I suppose, but it's there, unaltered, when the medication wears off, like an intruder who has broken into your house and is still there every morning when you wake up. Given the choice, I would rather be depressed. I've come back from depression.

Irrational optimism can be great; it’s why only about 15 percent instead of 99 percent of humans get clinically depressed.

clinical depression is a semiregular visitor and anxiety disorder is my long-term abusive boyfriend.

The teeth of the smile evidenced a clinical depressive’s classic inattention to oral hygiene.

Doctors kept stressing that mental disease was the same as physical disease. Telling someone who was clinically depressed, for example, to shake it off and get out of the house was tantamount to telling a man with two broken legs to sprint across the room. That was all well and good in theory, but in practice, the stigma continued. Maybe, to be more charitable, it was because you could hide a mental disease.

Depression and anxiety are two of the body’s first reactions to stockpiles of hurt. Of course, there are organic and biochemical reasons we experience clinical depression and debilitating anxiety—causes over which we have no control—but unrecognized pain and unprocessed hurt can also lead there.

I never define depression, clinical or otherwise. It's the basis of most life. It seems to be the modern world: we all are depressed.

Non-clinical depression occurs when you’re not where you want to be in life, you have lost any hope to ever be, and can’t accept it.

I’ve struggled with many forms of mental illness since I was a kid, but clinical depression is a semiregular visitor and anxiety disorder is my long-term abusive boyfriend.

In 1965, a psychologist named Martin Seligman started shocking dogs. He was trying to expand on the research of Pavlov--the guy who could make dogs salivate when they heard a bell ring. Seligman wanted to head in the other direction, and when he rang his bell, instead of providing food, he zapped the dogs with electricity. To keep them still, he restrained them in a harness during the experiment. After they were conditioned, he put these dogs in a big box with a little fence dividing it into two halves. He figured if the dog rang the bell, it would hop over the fence to escape, but it didn't. It just sat there and braced itself. They decided to try shocking the dog after the bell. The dog still just sat there and took it. When they put a dog in the box that had never been shocked before or had previously been allowed to escape and tried to zap it--it jumped the fence. You are just like these dogs. If, over the course of your life, you have experienced crushing defeat or pummeling abuse or loss of control, you convince yourself over time that there is no escape, and if escape is offered, you will not act--you become a nihilist who trusts futility above optimism. Studies of the clinically depressed show that they often give in to defeat and stop trying. . . Any extended period of negative emotions can lead to you giving in to despair and accepting your fate. If you remain alone for a long time, you will decide loneliness is a fact of life and pass up opportunities to hang out with people. The loss of control in any situation can lead to this state. . . Choices, even small ones, can hold back the crushing weight of helplessness, but you can't stop there. You must fight back your behavior and learn to fail with pride. Failing often is the only way to ever get the things you want out of life. Besides death, your destiny is not inescapable.

grief is not like clinical depression, schizophrenia, or anxiety, which can be diagnosed and treated. The grieving need someone to say “I see you, I hear you, I understand you are hurting and you can tell me more.

The American Psychosomatic Society published a study showing how Michael Babyak and a team of doctors found that three thirty-minute brisk walks or jogs even improve recovery from clinical depression. Yes, clinical depression.

It is also lonely on a level that cannot be conveyed ... If a person in physical pain has a hard time attending to anything except that pain, a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell.

Imagine a society that subjects people to conditions that make them terribly unhappy, then gives them drugs to take away their unhappiness. Science fiction? It is already happening to some extent in our own society. It is well known that the rate of clinical depression has been greatly increasing in recent decades. We believe that this is due to disruption of the power process, as explained in paragraphs 59-76. But even if we are wrong, the increasing rate of depression is certainly the result of SOME conditions that exist in today’s society. Instead of removing the conditions that make people depressed, modern society gives them antidepressant drugs. In effect, antidepressants are a means of modifying an individual’s internal state in such a way as to enable him to tolerate social conditions that he would otherwise find intolerable.

There is no enough.’ Tarin flicked her indicator on, the clicking noise filling the car as she merged on to the motorway. ‘You seem to be forgetting that she’s in a clinical facility getting professional help. Which is great, obviously. Let them worry about how to deal with depression. You’re going to visit your friend, remember? Yes, she’s a patient, but she’s not your patient. So for God’s sake, don’t treat her like one.

One in two recently evicted mothers reports multiple symptoms of clinical depression, double the rate of similar mothers who were not forced from their homes. Even after years pass, evicted mothers are less happy, energetic, and optimistic than their peers. When several patients committed suicide in the days leading up to their eviction, a group of psychiatrists published a letter in Psychiatric Services, identifying eviction as a “significant precursor of suicide.” The letter emphasized that none of the patients were facing homelessness, leading the psychiatrists to attribute the suicides to eviction itself. “Eviction must be considered a traumatic rejection,” they wrote, “a denial of one’s most basic human needs, and an exquisitely shameful experience.” Suicides attributed to evictions and foreclosures doubled between 2005 and 2010, years when housing costs soared.

Postpartum depression makes you suddenly feel like a stranger to yourself, but knowing the clinical facts are the first step toward wellness.

Like most clinically depressed patients, she appeared to function better in focused activity than in stasis. Their normal paralyzed stasis allowed these patients’ own minds to chew them apart. But it was always a titanic struggle to get them to do anything to help them focus.

If you are genetically endowed with an optimistic bias, you hardly need to be told that you are a lucky person—you already feel fortunate. An optimistic attitude is largely inherited, and it is part of a general disposition for well-being, which may also include a preference for seeing the bright side of everything. If you were allowed one wish for your child, seriously consider wishing him or her optimism. Optimists are normally cheerful and happy, and therefore popular; they are resilient in adapting to failures and hardships, their chances of clinical depression are reduced, their immune system is stronger, they take better care of their health, they feel healthier than others and are in fact likely to live longer. A study of people who exaggerate their expected life span beyond actuarial predictions showed that they work longer hours, are more optimistic about their future income, are more likely to remarry after divorce (the classic “triumph of hope over experience”), and are more prone to bet on individual stocks. Of

While play-acting grim scenarios day in and day out may sound like a good recipe for clinical depression, it’s actually weirdly uplifting. Rehearsing for catastrophe has made me positive that I have the problem-solving skills to deal with tough situations and come out the other side smiling. For me, this has greatly reduced the mental and emotional clutter that unchecked worrying produces, those random thoughts that hijack your brain at three o’clock in the morning. While I very much hoped not to die in space, I didn’t live in fear of it, largely because I’d been made to think through the practicalities: how I’d want my family to get the news, for instance, and which astronaut I should recruit to help my wife cut through the red tape at NASA and the CSA. Before my last space flight (as with each of the earlier ones) I reviewed my will, made sure my financial affairs and taxes were in order, and did all the other things you’d do if you knew you were going to die. But that didn’t make me feel like I had one foot in the grave. It actually put my mind at ease and reduced my anxiety about what my family’s future would look like if something happened to me. Which meant that when the engines lit up at launch, I was able to focus entirely on the task at hand: arriving alive.

Spiritual depression presents itself in much the same way as clinical depression—but not quite. The marks of distinction are crucial, yet hard for the untrained to recognize. They make the difference between interpreting the source of depression as a problem that may require medication or as a process of transformation that is best served by reflection, discussion of the stages of the dark night, and understanding the nature of mystical prayer. I have met many people who have been treated for depression and other conditions when they were, in fact, in the deep stages of a spiritual crisis. Without the proper support, that crisis becomes misdirected into a problem with relationships, a problem with one’s childhood, or a chronic malaise. Spiritual crises are now a very real part of our spectrum of health challenges and we need to acknowledge them with the same authority as we do clinical depression.

Telling someone who was clinically depressed, for example, to shake it off and get out of the house was tantamount to telling a man with two broken legs to sprint across the room. That was all well and good in theory, but in practice, the stigma continued.

Depression ... involves a complete absence: absence of affect, absence of feeling, absence of response, absence of interest. The pain you feel in the course of a major clinical depression is an attempt on nature’s part ... to fill up the empty space. But for all intents and purposes, the deeply depressed are just the walking, waking dead.

Clinical depression: The print your behind makes on the doctor’s examination table. Derange: Kitchen appliance. Usually sits right next to de fridge. Bonding: What chewing gum does between your shoe and the pavement. Repressing: What you’ll be doing to your pants after a thirteen-hour car trip. Healing process: Teaching your dog to walk beside you.2

The depressed person’s therapist was always extremely careful to avoid appearing to judge or blame the depressed person for clinging to her defenses, or to suggest that the depressed person had in any way consciously chosen or chosen to cling to a chronic depression whose agony made her (i.e., the depressed person’s) every waking hour feel like more than any person could possibly endure. This renunciation of judgment or imposed value was held by the therapeutic school in which the therapist’s philosophy of healing had evolved over almost fifteen years of clinical experience to be integral to the combination of unconditional support and complete honesty about feelings which composed the nurturing professionalism required for a productive therapeutic journey toward authenticity and intrapersonal wholeness. Defenses against intimacy, the depressed person’s therapist’s experiential theory held, were nearly always arrested or vestigial survival-mechanisms; i.e., they had, at one time, been environmentally appropriate and necessary and had very probably served to shield a defenseless childhood psyche against potentially unbearable trauma, but in nearly all cases they (i.e., the defense-mechanisms) had become inappropriately imprinted and arrested and were now, in adulthood, no longer environmentally appropriate and in fact now, paradoxically, actually caused a great deal more trauma and pain than they prevented. Nevertheless, the therapist had made it clear from the outset that she was in no way going to pressure, hector, cajole, argue, persuade, flummox, trick, harangue, shame, or manipulate the depressed person into letting go of her arrested or vestigial defenses before she (i.e., the depressed person) felt ready and able to risk taking the leap of faith in her own internal resources and self-esteem and personal growth and healing to do so (i.e., to leave the nest of her defenses and freely and joyfully fly).

Misinformation about the Bible's answers to these issues has led to much wrong teaching about boundaries. Not only that, but many clinical psychological symptoms, such as depression, anxiety disorders, guilt problems, shame issues, panic disorders, and marital and relational struggles, find their root in conflicts with boundaries.

To think that melancholy--which seems a natural response to the coexisting realities of beauty and mortality--is the same as clinical depression is tragically mistaken. Words like "sad," "gloomy," and "depressed" leave no room for the rich, dark quality of melancholy, which I've always seen as a sensitive appreciation that change is happening every second of our lives, that everything and everyone we love will die, and that in knowing this we have the opportunity to share our gratitude while we still do have time.

What we have now, shall never be again. The poets of the past sit in amazement of the wanna-be's of an era long gone.

Antidepressant drugs that increase serotonin in the brain have the same modest effect, in clinical trials, as drugs that reduce serotonin in the brain.

What are borderline personalities?” she asked him. “It’s a psychiatric disorder involving problems of identity and intimacy—difficulty connecting with other people. Borderlines have higher-than-average rates of clinical depression and they’re more likely to get involved in substance abuse. Females tend to punish themselves but male borderlines can get aggressive.

I stared at the floor, my mind racing. Did I . . . did I look like the kind of person who ought to be avoided in a game of bus seat selection? I could only conclude, in the face of the evidence, that I did. But why? I would have to reason my way to the answer. I wasn’t overweight. I didn’t smell—I showered daily, and I laundered my clothes regularly. That left madness, then. Was I mad? No. No, I wasn’t. I was suffering from clinical depression, but that was an illness. It wasn’t madness. Did I look mad, then? Act mad? I didn’t think so. But then, how would I know? Was it my scar? My eczema? My jerkin? Was it a sign of madness even to think you might be mad? I rested my elbows on my knees and placed my head in my hands. Oh God oh God oh God.

Typically people with clinical depression wake up in the middle of the night and can’t fall back to sleep, whereas patients with anxiety disorders have trouble settling down when they go to bed.

But I am clinically depressed and have an anxiety disorder, which interferes with things like studying and learning and breathing and living. He thinks it’s something I can just turn off and on with willpower.

Rumination involves a repetitious focus on negative thoughts and memories of all kinds (not just related to heartbreak) that can easily become habitual and lead to elevated risk of clinical depression. They key to breaking free of rumination is to counteract its negative pull by fostering ways of thinking that are strictly nonjudgmental. The most potent and successful of these techniques is called mindfulness meditation.

As affluence and urbanization rise in a society, rates of depression and suicide tend to go up rather than down. Rather than buffering people from clinical depression, increased wealth in a society seems to foster it. Suicide

Today, our view of genuine reality is increasingly clouded by professionals whose technical expertise often introduces a superficial and soulless model of the person that denies moral significance. Perhaps the most devastating example for human values is the process of medicalization through which ordinary unhappiness and normal bereavement have been transformed into clinical depression, existential angst turned into anxiety disorders, and the moral consequences of political violence recast as post-traumatic stress disorder. That is, suffering is redefined as mental illness and treated by professional experts, typically with medication. I believe that this diminishes the person,

We are afraid of what we will do to others, afraid of the rage that lies in wait somewhere deep in our souls. How many human beings go through the world frozen with rage against life! This deeply hidden inner anger may be the product of hurt pride or of real frustration in office, factory, clinic, or home. Whatever may be the cause of our frozen rage (which is the inevitable mother of depression), the great word of hope today is that this rage can be conquered and drained off into creative channels … …What should we do? We should all learn that a certain amount of aggressive energy is normal and certainly manageable in maturity. Most of us can drain off the excess of our angry feelings and destructive impulses in exercise, in competitive games, or in the vigorous battles against the evils of nature and society. We also must realize that no one will punish us for the legitimate expression of self-assertiveness and creative pugnacity as our parents once punished us for our undisciplined temper tantrums. Furthermore, let us remember that we need not totally repress the angry part of our nature. We can always give it an outlet in the safe realm of fantasy. A classic example of such fantasy is given by Max Beerborn, who made a practice of concocting imaginary letters to people he hated. Sometimes he went so far as to actually write the letters and in the very process of releasing his anger it evaporated. As mature men and women we should regard our minds as a true democracy where all kinds of ideas and emotions should be given freedom of speech. If in political life we are willing to grant civil liberties to all sorts of parties and programs, should we not be equally willing to grant civil liberties to our innermost thoughts and drives, confident that the more dangerous of them will be outvoted by the majority within our minds? Do I mean that we should hit out at our enemy whenever the mood strikes us? No, I repeat that I am suggesting quite the reverse—self-control in action based upon (positive coping mechanisms such as) self expression in fantasy.

The fact that a patient is classified as mentally or emotionally sick prevents the psychotherapist from enquiring into the possibility of whether, or to what extent, his patient may be cognitively right. It is perfectly possible that a person with 'existential frustration', 'ontological despair', or simply 'sub-clinical depression' may, because of his abnormal condition, be in a better position to look through the camouflage of life that still is deceiving the 'healthy' psychotherapists.

Depression is partly a nocebo effect, in the sense that it can be produced by negative exceptions about oneself and the world. The way in which these negative expectations develop and produce their negative effects provides some clues as to how they can be reversed. Expectancy effects grow, feeding upon themselves. One reason this happens is that our subjective states - our feelings, our moods and sensations - are in constant flux, changing from day to day and from moment to moment. The effects of these fluctuations depend on how we interpret them, and our interpretations depend on our beliefs and expectations. When we expect to feel worse, we tend to notice random small negative changes and interpret them as evidence that we are in fact getting worse. This interpretation makes us actually feel worse, and it strengthens the belief that we are getting worse, leading to a vicious cycle in which our expectations and negative emotions feed on each other, cascading into a full-blown depressive episode. .. Positive expectancies have the opposite effect. They can set in motion a begin cycle, in which random fluctuations in mood and well being are interpreted as evidence of treatment effectiveness, thereby instilling a further sense of hope and countering the feeling of hopelessness that are so central to clinical depression.

I’d walked to school like it was any other day. Like my heart wasn’t breaking. Like my head wasn’t reeling and my feet weren’t weighted down by the sudden and tragic onset of clinical depression, making each breath a trial, each step a struggle. I totally needed a car.

I guess there are different kinds of depression. There’s the kind that just crushes you for no reason, what Mom calls the clinical kind. But this isn’t that. This is the other kind, the kind that comes because the things that have happened to you are actually just unbelievably, heartbreakingly sad.

Bryde looked cool enough, but he sure didn’t act cool. He was silent for long stretches, looking windblown and put-upon with his hands in the pockets of his jacket, and then when he did talk, it was in the long blocks of words that usually involved vocabulary Matthew had never memorized. He and Matthew would be talking about something entirely different and then suddenly Bryde would break off and be all consciousness is a map to every place we have ever been and ever will be and yet no one here will consult it and thus is lost and Matthew would ask, “Have you ever read anything about clinical depression?

I call it your source-fracture wound, the original break in your heart from long ago. It may have happened in an instant--a little rejection, a shocking abandonment, or a slight misattunement that suddenly made you realize how alone you were in this world. Or perhaps it was a bit-bu-bit splintering as over the years you met with an intermittent meanness, an unpredictable but repetitive abuse, or a neglect that stole your childhood inches at a time. Wherever, however, or whenever it happened, one thing we can assume is that no adult helped you make accurate meaning of your confusing and painful experience. No grown up sat you down and lovingly said, "No, honey, it's not that you're stupid. It's that your big brother is scared and insecure." "It's not that you don't matter, angel. It's that Daddy has a drinking problem and needs help." "It's not that you're not enough. It's that Mommy has clinical depression, dear, and it's neither your fault nor yours to fix." Without this mature presence to help explain to you what was happening to your little world, you probably came to some pretty strong and wrong conclusions about who you were and what was possible for you to have in life. And those conclusions became a habit of consciousness, a filter through which you interpret and then respond to the events of your life, making your grief all the more complex.

It is a level of psychic pain wholly incompatible with human life as we know it. It is a sense of radical and thoroughgoing evil not just as a feature but as the essence of conscious existence. It is a sense of poisoning that pervades the self at the self’s most elementary levels. It is a nausea of the cells and soul. It is an unnumb intuition in which the world is fully rich and animate and un-map-like and also thoroughly painful and malignant and antagonistic to the self, which depressed self It billows on and coagulates around and wraps in Its black folds and absorbs into Itself, so that an almost mystical unity is achieved with a world every constituent of which means painful harm to the self. Its emotional character, the feeling Gompert describes It as, is probably mostly indescribable except as a sort of double bind in which any/all of the alternatives we associate with human agency—sitting or standing, doing or resting, speaking or keeping silent, living or dying—are not just unpleasant but literally horrible. It is also lonely on a level that cannot be conveyed. There is no way Kate Gompert could ever even begin to make someone else understand what clinical depression feels like, not even another person who is herself clinically depressed, because a person in such a state is incapable of empathy with any other living thing. This anhedonic Inability To Identify is also an integral part of It. If a person in physical pain has a hard time attending to anything except that pain, 282 a clinically depressed person cannot even perceive any other person or thing as independent of the universal pain that is digesting her cell by cell. Everything is part of the problem, and there is no solution. It is a hell for one.

I could’ve quit long ago, but there wouldn’t be nothing to quit to, unless I was ready to commit suicide.

Optimists Optimism is normal, but some fortunate people are more optimistic than the rest of us. If you are genetically endowed with an optimistic bias, you hardly need to be told that you are a lucky person—you already feel fortunate. An optimistic attitude is largely inherited, and it is part of a general disposition for well-being, which may also include a preference for seeing the bright side of everything. If you were allowed one wish for your child, seriously consider wishing him or her optimism. Optimists are normally cheerful and happy, and therefore popular; they are resilient in adapting to failures and hardships, their chances of clinical depression are reduced, their immune system is stronger, they take better care of their health, they feel healthier than others and are in fact likely to live longer. A study of people who exaggerate their expected life span beyond actuarial predictions showed that they work longer hours, are more optimistic about their future income, are more likely to remarry after divorce (the classic “triumph of hope over experience”), and are more prone to bet on individual stocks. Of course, the blessings of optimism are offered only to individuals who are only mildly biased and who are able to “accentuate the positive” without losing track of reality. Optimistic individuals play a disproportionate role in shaping our lives. Their decisions make a difference; they are the inventors, the entrepreneurs, the political and military leaders—not average people. They got to where they are by seeking challenges and taking risks. They are talented and they have been lucky, almost certainly luckier than they acknowledge. They are probably optimistic by temperament; a survey of founders of small businesses concluded that entrepreneurs are more sanguine than midlevel managers about life in general. Their experiences of success have confirmed their faith in their judgment and in their ability to control events. Their self-confidence is reinforced by the admiration of others. This reasoning leads to a hypothesis: the people who have the greatest influence on the lives of others are likely to be optimistic and overconfident, and to take more risks than they realize.

For the past twenty-five years, the psychiatric establishment has told us a false story. It told us that schizophrenia, depression, and bipolar illness are known to be brain diseases, even though—as the MindFreedom hunger strike revealed—it can’t direct us to any scientific studies that document this claim. It told us that psychiatric medications fix chemical imbalances in the brain, even though decades of research failed to find this to be so. It told us that Prozac and the other second-generation psychotropics were much better and safer than the first-generation drugs, even though the clinical studies had shown no such thing. Most important of all, the psychiatric establishment failed to tell us that the drugs worsen long-term outcomes.

Psychotropic drugs have also been organized according to structure (e.g., tricyclic), mechanism (e.g., monoamine, oxidase inhibitor [MAOI]), history (first generation, traditional), uniqueness (e.g., atypical), or indication (e.g., antidepressant). A further problem is that many drugs used to treat medical and neurological conditions are routinely used to treat psychiatric disorders.

Depression goes through stages, but if left unchecked and not treated, this elevator ride will eventually go all the way to the bottom floor. And finally you find yourself bereft of choices, unable to figure out a way up or out, and pretty soon one overarching impulse begins winning the battle for your mind: “Kill yourself.” And once you get over the shock of those words in your head, the horror of it, it begins to start sounding appealing, even possessing a strange resolve, logic. In fact, it’s the only thing you have left that is logical. It becomes the only road to relief. As if just the planning of it provides the first solace you’ve felt that you can remember. And you become comfortable with it. You begin to plan it and contemplate the details of how best to do it, as if you were planning travel arrangements for a vacation. You just have to get out. O-U-T. You see the white space behind the letter O? You just want to crawl through that O and be out of this inescapable hurt that is this thing they call clinical depression. “How am I going to do this?” becomes the only tape playing. And if you are really, really, really depressed and you’re really there, you’re gonna find a way. I found a way. I had a way. And I did it. I made sure Opal was out of the house and on a business trip. My planning took a few weeks. I knew exactly how I was going to do it: I didn’t want to make too much of a mess. There was gonna be no blood, no drama. There was just going to be, “Now you see me, now you don’t.” That’s what it was going to be. So I did it. And it was over. Or so I thought. About twenty-four hours later I woke up. I was groggy; zoned out to the point at which I couldn’t put a sentence together for the next couple of days. But I was semifunctional, and as these drugs and shit that I took began to wear off slowly but surely, I realized, “Okay, I fucked up. I didn’t make it.” I thought I did all the right stuff, left no room for error, but something happened. And this perfect, flawless plan was thwarted. As if some force rebuked me and said, “Not yet. You’re not going anywhere.” The only reason I could have made it, after the amount of pills and alcohol and shit I took, was that somebody or something decided it wasn’t my time. It certainly wasn’t me making that call. It was something external. And when you’re infused with the presence of this positive external force, which is so much greater than all of your efforts to the contrary, that’s about as empowering a moment as you can have in your life. These days we have a plethora of drugs one can take to ameliorate the intensity of this lack of hope, lack of direction, lack of choice. So fuck it and don’t be embarrassed or feel like you can handle it yourself, because lemme tell ya something: you can’t. Get fuckin’ help. The negative demon is strong, and you may not be as fortunate as I was. My brother wasn’t. For me, despair eventually gave way to resolve, and resolve gave way to hope, and hope gave way to “Holy shit. I feel better than I’ve ever felt right now.” Having actually gone right up to the white light, looked right at it, and some force in the universe turned me around, I found, with apologies to Mr. Dylan, my direction home. I felt more alive than I’ve ever felt. I’m not exaggerating when I say for the next six months I felt like Superman. Like I’m gonna fucking go through walls. That’s how strong I felt. I had this positive force in me. I was saved. I was protected. I was like the only guy who survived and walked away from a major plane crash. I was here to do something big. What started as the darkest moment in my life became this surge of focus, direction, energy, and empowerment.

The opposite of play isn’t work. It’s depression.”6 When we’re depressed, according to the clinical definition, we suffer from two things: a pessimistic sense of inadequacy and a despondent lack of activity.

If left untreated, depression can become serious. It can rob people from many hours of effective functioning—and sometimes rob them of life itself. At any given time, it is estimated that up to 20 percent of the population have disturbed daily functioning due to clinical depression. If you find yourself in this category and have experienced any of these symptoms for longer than two weeks, seek professional help.

People who are clinically depressed have their own disturbances with food. For some, it’s as if hand to mouth were an involuntary reflex, as if food could fill the abyss. Which it can’t, and they grow fat, which does nothing good for their state of mind. The others are rarely hungry or else they are never hungry. They emaciate, become insubstantial, a manifestation of the wish to disappear. Bunny is one of the thin ones.

Logan looked at her and wondered how someone so beautiful could be so oblivious to their own beauty, how someone so smart could be so foolish to the extent of their own intellect and how someone so loving and compassionate could ever think she wasn’t worthy of love? It was like watching a blind man trapped and wandering aimlessly and helplessly in a scorching hot desert unable to see the small puddle of water that lay just a foot away. The only difference was that she had eyes. Two beautiful ones, yet she could not see. Is that what madness was? Was it to be able to view and appreciate every form of beauty but to be blind to the value and exquisiteness of one’s own? Logan believed in many forms of insanity but he knew in that instant watching her trembling frame on the train tracks that hers, that her illness, surpassed any clinical or psychological term known. Maybe she did suffer from depression or bipolar or schizophrenia. Who knew? All he was certain of in that moment that she suffered from no greater illness than the blindness of the heart.

While play-acting grim scenarios day in and day out may sound like a good recipe for clinical depression, it's actually weirdly uplifting. Rehearsing for catastrophe has made me positive that I have the problem-solving skills do deal with tough situations and come out the other side smiling. For me, this has greatly reduced the mental and emotional clutter that unchecked worrying produces, those random thoughts that hijack your brain at three o'clock in the morning.

While play-acting grim scenarios day in and day out may sound like a good recipe for clinical depression, it's actually weirdly uplifting. Rehearsing for catastrophe has made me positive that I have the problem-solving skills to deal with tough situations and come out the other side smiling. For me, this has greatly reduced the mental and emotional clutter that unchecked worrying produces, those random thoughts that hijack your brain at three o'clock in the morning.

Religion has used ritual forever. I remember a famous study led by psychologist Alfred Tomatis of a group of clinically depressed monks. After much examination, researchers concluded that the group’s depression stemmed from their abandoning a twice-daily ritual of gathering to sing Gregorian chants. They had lost the sense of community and the comfort of singing together in harmony. Creating beautiful music together was a formal recognition of their connection and a shared moment of joy.

It’s normally agreed that the question “How are you?” doesn’t put you on your oath to give a full or honest answer. So when asked these days, I tend to say something cryptic like, “A bit early to say.” (If it’s the wonderful staff at my oncology clinic who inquire, I sometimes go so far as to respond, “I seem to have cancer today.”) Nobody wants to be told about the countless minor horrors and humiliations that become facts of “life” when your body turns from being a friend to being a foe: the boring switch from chronic constipation to its sudden dramatic opposite; the equally nasty double cross of feeling acute hunger while fearing even the scent of food; the absolute misery of gut–wringing nausea on an utterly empty stomach; or the pathetic discovery that hair loss extends to the disappearance of the follicles in your nostrils, and thus to the childish and irritating phenomenon of a permanently runny nose. Sorry, but you did ask... It’s no fun to appreciate to the full the truth of the materialist proposition that I don’t have a body, I am a body. But it’s not really possible to adopt a stance of “Don’t ask, don’t tell,” either. Like its original, this is a prescription for hypocrisy and double standards. Friends and relatives, obviously, don’t really have the option of not making kind inquiries. One way of trying to put them at their ease is to be as candid as possible and not to adopt any sort of euphemism or denial. The swiftest way of doing this is to note that the thing about Stage Four is that there is no such thing as Stage Five. Quite rightly, some take me up on it. I recently had to accept that I wasn’t going to be able to attend my niece’s wedding, in my old hometown and former university in Oxford. This depressed me for more than one reason, and an especially close friend inquired, “Is it that you’re afraid you’ll never see England again?” As it happens he was exactly right to ask, and it had been precisely that which had been bothering me, but I was unreasonably shocked by his bluntness. I’ll do the facing of hard facts, thanks. Don’t you be doing it too. And yet I had absolutely invited the question. Telling someone else, with deliberate realism, that once I’d had a few more scans and treatments I might be told by the doctors that things from now on could be mainly a matter of “management,” I again had the wind knocked out of me when she said, “Yes, I suppose a time comes when you have to consider letting go.” How true, and how crisp a summary of what I had just said myself. But again there was the unreasonable urge to have a kind of monopoly on, or a sort of veto over, what was actually sayable. Cancer victimhood contains a permanent temptation to be self–centered and even solipsistic.

One thing should be clear, but apparently it is not: if this were indeed our nature, we would be living in paradise. If pain, humiliation, and physical injury made us happy, we would be ecstatic. If being sold on street corners were a good time, women would jam street corners the way men jam football matches. If forced sex were what we craved, even we would be satisfied already. If being dominated by men made us happy, we would smile all the time. Women resist male domination because we do not like it. Political women resist male domination through overt, rude, unmistakable rebellion. They are called unnatural, because they do not have a nature that delights in being debased. Apolitical women resist male domination through a host of bitter subversions, ranging from the famous headache to the clinical depression epidemic among women to suicide to prescription-drug tranquilization to taking it out on the children; sometimes a battered wife kills her husband. Apolitical women are also called unnatural, the charge hurled at them as nasty or sullen or embittered individuals, since that is how they fight back. They too are not made happy by being hurt or dominated. In fact, a natural woman is hard to find. We are domesticated, tamed, made compliant on the surface, through male force, not through nature. We sometimes do what men say we are, either because we believe them or because we hope to placate them. We sometimes try to become what men say we should be, because men have power over our lives.

Therapist and writer Lori Gottlieb wrote an article for the Atlantic questioning why so many of her twentysomething patients were unaccountably depressed, even though they had great parents and on the surface great lives. This category of patients stumped her until she discovered the right questions to ask. “Back in graduate school,” she wrote, “the clinical focus had always been on how the lack of parental attunement affects the child. It never occurred to any of us to ask, what if the parents are too attuned? What happens to those kids?”2

I was already an atheist, and by my senior year I had became obsessed with the question “What is the meaning of life?” I wrote my personal statement for college admissions on the meaninglessness of life. I spent the winter of my senior year in a kind of philosophical depression—not a clinical depression, just a pervasive sense that everything was pointless. In the grand scheme of things, I thought, it really didn’t matter whether I got into college, or whether the Earth was destroyed by an asteroid or by nuclear war. My despair was particularly strange because, for the first time since the age of four, my life was perfect. I had a wonderful girlfriend, great friends, and loving parents. I was captain of the track team, and, perhaps most important for a seventeen-year-old boy, I got to drive around in my father’s 1966 Thunderbird convertible. Yet I kept wondering why any of it mattered. Like the author of Ecclesiastes, I thought that “all is vanity and a chasing after wind” (ECCLESIASTES 1:14) . I finally escaped when, after a week of thinking about suicide (in the abstract, not as a plan), I turned the problem inside out. There is no God and no externally given meaning to life, I thought, so from one perspective it really wouldn’t matter if I killed myself tomorrow. Very well, then everything beyond tomorrow is a gift with no strings and no expectations. There is no test to hand in at the end of life, so there is no way to fail. If this really is all there is, why not embrace it, rather than throw it away? I don’t know whether this realization lifted my mood or whether an improving mood helped me to reframe the problem with hope; but my existential depression lifted and I enjoyed the last months of high school.

I have this theory that everyone is a little mentally ill,” Letty said. “No such thing as perfectly normal. You’ve got all these branches extending out of some kind of theoretical normalcy. You’ve got the schizophrenic branch, the paranoid branch, the psychopathic branch, the sociopathic branch, the manic-depressive branch, the clinically depressive branch, the OCD branch, and so on. Nobody is dead center. Everybody is out on one of those branches. Or more than one. If you’re too far out, you’re nuts. If you’re just a little way out, you’re fine, but you have a tendency.” “Where

I'd been so tired of 'strong female characters' for so long by then. I was so tired of the way female strength was made to look cold and humorless; the way it was characterized as deviant and 'unnatural' and always lonely and exceptional. I was tired of the grim undertone of tragedy that lurked under its surface. 'Strong female characters' were never funny, and they never had any fun, either. More often than not, they were celibate, friendless, and clinically depressed. Their monomaniacal devotion to crime fighting made them lean, cranky, and impatient. Naturally, they had axes to grind: they were avenging brides, poker-faced assassins, gloomy ninjas with commitment issues. Who were these characters? What were they trying to tell us? Why didn't they ever say goodbye before hanging up the phone? And why were they always being reborn or remade as killing machines after losing everything they held dear? ...I don't want to see another symbolic woman start all over again. I want to see the symbolic world change to acknowledge her existence. I don't want to see a young girl get a makeover or go shopping with her boyfriend's credit card. I want to watch her blow up the Death Star - metaphorically, of course.

Physiological stress, then, is the link between personality traits and disease. Certain traits — otherwise known as coping styles — magnify the risk for illness by increasing the likelihood of chronic stress. Common to them all is a diminished capacity for emotional communication. Emotional experiences are translated into potentially damaging biological events when human beings are prevented from learning how to express their feelings effectively. That learning occurs — or fails to occur — during childhood. The way people grow up shapes their relationship with their own bodies and psyches. The emotional contexts of childhood interact with inborn temperament to give rise to personality traits. Much of what we call personality is not a fixed set of traits, only coping mechanisms a person acquired in childhood. There is an important distinction between an inherent characteristic, rooted in an individual without regard to his environment, and a response to the environment, a pattern of behaviours developed to ensure survival. What we see as indelible traits may be no more than habitual defensive techniques, unconsciously adopted. People often identify with these habituated patterns, believing them to be an indispensable part of the self. They may even harbour self-loathing for certain traits — for example, when a person describes herself as “a control freak.” In reality, there is no innate human inclination to be controlling. What there is in a “controlling” personality is deep anxiety. The infant and child who perceives that his needs are unmet may develop an obsessive coping style, anxious about each detail. When such a person fears that he is unable to control events, he experiences great stress. Unconsciously he believes that only by controlling every aspect of his life and environment will he be able to ensure the satisfaction of his needs. As he grows older, others will resent him and he will come to dislike himself for what was originally a desperate response to emotional deprivation. The drive to control is not an innate trait but a coping style. Emotional repression is also a coping style rather than a personality trait set in stone. Not one of the many adults interviewed for this book could answer in the affirmative when asked the following: When, as a child, you felt sad, upset or angry, was there anyone you could talk to — even when he or she was the one who had triggered your negative emotions? In a quarter century of clinical practice, including a decade of palliative work, I have never heard anyone with cancer or with any chronic illness or condition say yes to that question. Many children are conditioned in this manner not because of any intended harm or abuse, but because the parents themselves are too threatened by the anxiety, anger or sadness they sense in their child — or are simply too busy or too harassed themselves to pay attention. “My mother or father needed me to be happy” is the simple formula that trained many a child — later a stressed and depressed or physically ill adult — into lifelong patterns of repression.

No death, no suffering. No funeral homes, abortion clinics, or psychiatric wards. No rape, missing children, or drug rehabilitation centers. No bigotry, no muggings or killings. No worry or depression or economic downturns. No wars, no unemployment. No anguish over failure and miscommunication. No con men. No locks. No death. No mourning. No pain. No boredom. No arthritis, no handicaps, no cancer, no taxes, no bills, no computer crashes, no weeds, no bombs, no drunkenness, no traffic jams and accidents, no septic-tank backups. No mental illness. No unwanted e-mails. Close friendships but no cliques, laughter but no put-downs. Intimacy, but no temptation to immorality. No hidden agendas, no backroom deals, no betrayals. Imagine mealtimes full of stories, laughter, and joy, without fear of insensitivity, inappropriate behavior, anger, gossip, lust, jealousy, hurt feelings, or anything that eclipses joy. That will be Heaven.

First agriculture, and then industry, changed two fundamental things about the human experience. The accumulation of personal property allowed people to make more and more individualistic choices about their lives, and those choices unavoidably diminished group efforts toward a common good. And as society modernized, people found themselves able to live independently from any communal group. A person living in a modern city or a suburb can, for the first time in history, go through an entire day—or an entire life—mostly encountering complete strangers. They can be surrounded by others and yet feel deeply, dangerously alone. The evidence that this is hard on us is overwhelming. Although happiness is notoriously subjective and difficult to measure, mental illness is not. Numerous cross-cultural studies have shown that modern society—despite its nearly miraculous advances in medicine, science, and technology—is afflicted with some of the highest rates of depression, schizophrenia, poor health, anxiety, and chronic loneliness in human history. As affluence and urbanization rise in a society, rates of depression and suicide tend to go up rather than down. Rather than buffering people from clinical depression, increased wealth in a society seems to foster it.

And all that time I was lying to my support group. I told the ladies, "Sure! I'm writing!" when I wasn't. Yes, I could have filled all those newfound minutes with actual work, but I had no confidence in myself. I was a fraud. Who was I to pick up a pen and expect anything good to come out of it? I expected perfection as soon as the pencil hit the paper, and since that's impossible, I couldn't get myself to start. Then I felt guilty about not starting, which made me want to start even less. And with no game to bury the feelings, I got very depressed. No wonder I didn't book any acting jobs in the last half of 2006. No one wanted to hire a clinically depressed person to sell snack foods.

Consider the hypothetical case of a man who can have anything he wants just by wishing for it. Such a man has power, but he will develop serious psychological problems. At first he will have a lot of fun, but by and by he will become acutely bored and demoralized. Eventually he may become clinically depressed. History shows that leisured aristocracies tend to become decadent. This is not true of fighting aristocracies that have to struggle to maintain their power. But leisured, secure aristocracies that have no need to exert themselves usually become bored, hedonistic and demoralized, even though they have power. This shows that power is not enough. One must have goals toward which to exercise one's power.

That question became even more salient to me as I began my clinical work with troubled children. I soon found that the vast majority of my patients had lives filled with chaos, neglect and/or violence. Clearly, these children weren’t “bouncing back”—otherwise they wouldn’t have been taken to a child psychiatry clinic! They’d suffered trauma—such as being raped or witnessing murder—that would have had most psychiatrists considering the diagnosis of post-traumatic stress disorder (PTSD), had they been adults with psychiatric problems. And yet these children were being treated as though their histories of trauma were irrelevant, and they’d “coincidentally” developed symptoms, such as depression or attention problems, that often required medication.

What’s more, an ever-increasing amount of clinical research correlates screen tech with psychiatric disorders like ADHD, addiction, anxiety, depression, increased aggression and even psychosis. Perhaps most shocking of all, recent brain-imaging studies conclusively show that excessive screen exposure can neurologically damage a young person’s developing brain in the same way that cocaine addiction can. That’s

Many of the benefits of CBT (cognitive behavioral therapy) can be obtained without going into therapy. There are a number of self-help books, CDs and computer programs that have been used to treat depression and some of these have been tested in clinical trials with positive results. I can particularly recommend these two books. One is 'Control Your Depression', the lead author of which is Peter Lewinsohn, a Professor of Psychology at the University of Oregon. ... The other book that I can recommend with confidence is 'Feeling Good' by the psychiatrist David Burns. 'Control Your Depression' emphasizes behavioral techniques like increasing pleasant activities, improving social skills and learning to relax. 'Feeling Good' puts greater emphasis on changing the way people think about themselves. But both books include both cognitive and behavioral techniques.

It is for such reasons that I always ask my clinical clients first about sleep. Do they wake up in the morning at approximately the time the typical person wakes up, and at the same time every day? If the answer is no, fixing that is the first thing I recommend. It doesn’t matter so much if they go to bed at the same time each evening, but waking up at a consistent hour is a necessity. Anxiety and depression cannot be easily treated if the sufferer has unpredictable daily routines. The systems that mediate negative emotion are tightly tied to the properly cyclical circadian rhythms. The next thing I ask about is breakfast. I counsel my clients to eat a fat and protein-heavy breakfast as soon as possible after they awaken (no simple carbohydrates, no sugars, as they are digested too rapidly, and produce a blood-sugar spike and rapid dip). This is because anxious and depressed people are already stressed, particularly if their lives have not been under control for a good while. Their bodies are therefore primed to hypersecrete insulin, if they engage in any complex or demanding activity. If they do so after fasting all night and before eating, the excess insulin in their bloodstream will mop up all their blood sugar. Then they become hypoglycemic and psych​ophys​iologi​cally unstable.

It's scary, and downing, that I make my best music when I'm going through my depression... At that moment, all i can see is black, darkness and shadows, but in the bigger picture.. it's a blessing. When I look through all my work, my art, I wouldn't change or take away my depression and anxiety for ANYTHING.. because when i get those days of rainbows, and colors.. i know deep down, i'm only honest when i'm at the deepest of the oceans.. so it's like listening to a different side of my mind, that i never realize exists, until i get that little peek through the blinds, and finally see the sunlight.. THEN on those simple moments, even if they only last a few minutes, i know deep down... maybe i do have a talent. Maybe I have got something, a "gift", that some people call... So really, if it wasn't for my depression, i would never, truly believe I have anything worth giving. So I will NOT sit back and wish i wasn't clinically depressed, I will learn to embrace it, live with it, and talk my brain into believing, and fully knowing, I HAVE A GIFT. I AM WORTHY. I DO HAVE SOMETHING TO GIVE THE WORLD. I will not let my depression or anxiety control me. They can live here(in my mind), but they best know, I AM STILL, AND WILL ALWAYS BE IN CONTROL. .. BUT This is my home, and you're just living under it.

If you were allowed one wish for your child, seriously consider wishing him or her optimism. Optimists are normally cheerful and happy, and therefore popular; they are resilient in adapting to failures and hardships, their chances of clinical depression are reduced, their immune system is stronger, they take better care of their health, they feel healthier than others and are in fact likely to live longer. A study of people who exaggerate their expected life span beyond actuarial predictions showed that they work longer hours, are more optimistic about their future income, are more likely to remarry after divorce (the classic “triumph of hope over experience”), and are more prone to bet on individual stocks. Of course, the blessings of optimism are offered only to individuals who are only mildly biased and who are able to “accentuate the positive” without losing track of reality.

If you asked me, I’d tell you I’m a fundamentally happy person, someone whose heart is capable of big leaps in the air. Which is a weird thing to say, actually, considering how much of my life I’ve spent depressed. It’s not just that so many shitty things have happened to me, it’s that for the longest time I didn’t know how to make my life better. Finally, as if I were someone discovering a secret door in a secret garden, the future revealed itself to me. But now that I’m here, I still feel the weight of the past. Sometimes it’s like my legs have been bound with anchor chains, and I’ve been thrown off a ship into the cruel ocean, and all I can do is sink. I guess there are different kinds of depression. There’s the kind that just crushes you for no reason, what Mom calls the clinical kind. But this isn’t that. This is the other kind, the kind that comes because the things that have happened to you are actually just unbelievably, heartbreakingly sad.

A book is open in front of me and this is what it has to say about the symptoms of morphine withdrawal: '... morbid anxiety, a nervous depressed condition, irritability, weakening of the memory, occasional hallucinations and a mild impairment of consciousness ...' I have not experienced any hallucinations, but I can only say that the rest of this description is dull, pedestrian and totally inadequate. 'Depressed condition' indeed! Having suffered from this appalling malady, I hereby enjoin all doctors to be more compassionate toward their patients. What overtakes the addict deprived of morphine for a mere hour or two is not a 'depressed condition': it is slow death. Air is insubstantial, gulping it down is useless ... there is not a cell in one's body that does not crave ... but crave what? This is something which defies analysis and explanation. In short, the individual ceases to exist: he is eliminated. The body which moves, agonises and suffers is a corpse. It wants nothing, can think of nothing but morphine. To die of thirst is a heavenly, blissful death compared with the craving for morphine. The feeling must be something like that of a man buried alive, clawing at the skin on his chest in the effort to catch the last tiny bubbles of air in his coffin, or of a heretic at the stake, groaning and writhing as the first tongues of flame lick at his feet. Death. A dry, slow death. That is what lurks behind that clinical, academic phrase 'a depressed condition'.

Overall, depression is considered “clinical” when symptoms are severe and include difficulty getting through a daily routine, sleeping too much or too little, disturbance of concentration, excessive negative or pessimistic thoughts, severe guilt, and an inability to connect with or be around others. Secondary symptoms include diverse aches and pains, headaches, or other uncomfortable physical symptoms. Depression can make you feel overwhelmed, anxious, worthless, and hopeless, and you might even have thoughts about ending your life.

Medications used to treat psychiatric disorders are commonly referred to as psychotropic drugs. These drugs are commonly described by their major clinical application, for example, antidepressants, antipsychotics, mood stabilizers, anxiolytics, hypnotics, cognitive enhancers, and stimulants. A problem with this approach is that these drugs have multiple indicators. For example, selective serotonin reuptake inhibitors (SSRls) are both antidepressants and anxiolytics, and the serotonin-dopamine antagonists (SDAs) are both anxiolytics and mood stabilizers.

Of course people still feel gnawing anxiety, depression and despair. But these do not trigger religiousness, being increasingly dealt with by 24/7 distraction provided by the mass media, interpersonal communication and quick transportation; any dysphoria (mild depression or otherwise unpleasant feelings) is dealt with by mass medication with tranquillizers and emotionnumbing ‘antidepressants’, ‘antipsychotics’ or ‘mood stabilizers’ (these words are placed in ‘scare quotes’ because they are all marketing terms with negligible scientific or clinical rationale).

S-adenosyl-methionine (SAMe) is a natural derivative of an amino acid normally produced by the body, and it plays a role in methylation (see Chapter 5). Levels of SAMe in the body often become depleted by middle age. Multiple clinical trials have shown that SAMe provides substantial benefit for patients with depression. This effect occurs relatively quickly, unlike the requirement to build up levels in the bloodstream that accompanies some prescription drugs for depression. It is, therefore, an effective, natural, and quick-acting treatment for mild depression. Human trials have also shown benefits for strengthening the liver and for relief from osteoarthritis.

In 2004, the FDA urged drug companies to adopt a 'Don't ask, don't tell' policy with respect to their clinical-trial data showing that antidepressants are not better than placebos for depressed children. If the data were made public, they cautioned, it might lead doctors to not prescribe antidepressants. The FDA believed that the jury was still out on antidepressants for children. Even if the clinical trials show negative results, an FDA spokesperson was reported to have said to a Washington Post reporter, it doesn't mean that the drugs are ineffective. The assumption seems to have been that doctors should prescribe medications that have not been shown to work, until it has been proven that they don't work.

Dr. Zackson’s is a licensed clinical psychologist in Greenwich, CT and New York City, and her practice is in a private, confidential, therapeutic setting. She has modeled her practice in the style of an ‘old-time’ family practitioner, with the goal of getting to know you beyond presenting issue taking into account family, work, and financial constraints. She will customize therapy to best suit your needs, and will ultimately help you to become your own therapist by learning how to better deal with the challenges that come up in your life. Services:- * Therapy Trauma * Therapy social anxiety * Therapy Depression * Therapy for anxiety * Therapist Nyc Judith zackson * Psychologist Nyc Judith zackson * Psychologist Greenwich * Therapist Greenwich

What are the health effects of the choice between austerity and stimulus? Today there is a vast natural experiment being conducted on the body economic. It is similar to the policy experiments that occurred in the Great Depression, the post-communist crisis in eastern Europe, and the East Asian Financial Crisis. As in those prior trials, health statistics from the Great Recession reveal the deadly price of austerity—a price that can be calculated not just in the ticks to economic growth rates, but in the number of years of life lost and avoidable deaths. Had the austerity experiments been governed by the same rigorous standards as clinical trials, they would have been discontinued long ago by a board of medical ethics. The side effects of the austerity treatment have been severe and often deadly. The benefits of the treatment have failed to materialize. Instead of austerity, we should enact evidence-based policies to protect health during hard times. Social protection saves lives. If administered correctly, these programs don’t bust the budget, but—as we have shown throughout this book—they boost economic growth and improve public health. Austerity’s advocates have ignored evidence of the health and economic consequences of their recommendations. They ignore it even though—as with the International Monetary Fund—the evidence often comes from their own data. Austerity’s proponents, such as British Prime Minister David Cameron, continue to write prescriptions of austerity for the body economic, in spite of evidence that it has failed. Ultimately austerity has failed because it is unsupported by sound logic or data. It is an economic ideology. It stems from the belief that small government and free markets are always better than state intervention. It is a socially constructed myth—a convenient belief among politicians taken advantage of by those who have a vested interest in shrinking the role of the state, in privatizing social welfare systems for personal gain. It does great harm—punishing the most vulnerable, rather than those who caused this recession.

The issues of antidepressant-associated suicide has become front-page news, the result of an analysis suggesting a link between medication use and suicidal ideation among children, adolescents, a link between medication use and suicidal ideation among children, adolescents, and adults up to age 24 in short term (4 to 16 weeks), placebo-controlled trials of nine newer antidepressant drugs. The data from trials involving more than 4.4(K) patients suggested that the average risk of suicidal thinking or behavior (suicidality) during the first few months of treatment in those receiving antidepressants was 4 percent, twice the placebo risk of 2 percent. No suicides occured in these trials. The analysis also showed no increase in suicide risk among the 25 to 65 age group. Antidepressants reduced suicidality among those over age 65. Following public hearings on the subject, in October 2004, the FDA requested the addition of “black box” warnings—the most serious warning placed on the labeling of a prescription medication—to all antidepressant drugs, old and new.

Bipolar II disorder is a highly misunderstood form of bipolar illness. By its very designation as type II, clinicians, patients, and the public often assume it is less impairing than bipolar I, “the real thing.” When we examine the diagnostic criteria for bipolar II, they sound very mild. Who doesn’t get sad and happy? Who doesn’t have mood swings? Why would a four-day period of excess energy, which does not affect the ability to function, be of any clinical importance? Several longitudinal studies have found that bipolar II is far more impairing than we once thought. It is characterized by lengthy and recurrent periods of depression, comorbid anxiety disorders, and high rates of substance and alcohol misuse. The occasional hypomanias of bipolar II—in which people experience elation and irritability, exuberance, increased energy, and reduced need to sleep—are not as impairing as the full manic episodes of bipolar I, but they can certainly have a negative impact on family members and friends. Moreover, for the person with the disorder, these high periods are often short-lived, and they do little to alleviate the suffering caused by depressive phases. The hypomanic periods may even overlap with the low phases, resulting in an agitated, anxiety-ridden, and highly distressing period of depression. People with bipolar II often have difficulty maintaining jobs and relationships, and, like people with bipolar I, they are at high risk for suicide.