Depression Therapy Quotes

I'm fine. Well, I'm not fine - I'm here." "Is there something wrong with that?" "Absolutely.

Artemis: (shocked) Why, Doctor? This is a sensitive area. For all you know I could be suffering from depression. Doctor Po: I suppose you could. Is that the case? Artemis: (head in hands) It's my mother, Doctor. Doctor Po: Yes? Artemis: My mother, she... Doctor Po: Your mother, yes? Artemis: She forces me to endure this ridiculous therapy when the school's so-called counsellors are little better than misguided do-gooders with degrees.

My films are therapy for my debilitating depression. In institutions people weave baskets. I make films.

I don't-" I shake my head. (...) "What? What were you going to say?" This is another trick of shrinks. They never let you stop in midthought. If you open your mouth, they want to know exactly what you had the intention of saying.

It's difficult. I take a low dose of lithium nightly. I take an antidepressant for my darkness because prayer isn't enough. My therapist hears confession twice a month, my shrink delivers the host, and I can stand in the woods and see the world spark.

Talking to a therapist, I thought, was like taking your clothes off and then taking your skin off, and then having the other person say, "Would you mind opening up your rib cage so that we can start?

One of the things that therapists do if you are suicidal, like a trick, is ask you about the future. They want to know what your plans are. Do you want to be the president? Do you want to be a rock star? They want to know if you want to live later even if you want to die now.

No event is depressing. I may feel depressed; if so, I take responsibility.

I feel like a violet standing alone in a vast meadow. When a cool, gentle breeze blows, I feel peaceful. If the wind turns strong and hot from the south, I plot suicide.

By masking my mental illness, I get along with almost everyone. Although the odd duck, I honor society’s rules. No one else could imagine my mind’s interior.

My therapist opens my wounds a little deeper, then picks at the scabs.

Today I hit rock bottom but didn’t busy myself with activity to take my mind off it, like I usually do. I allowed myself to sink as deep as possible. It’s like an infection: let it run its course and be done with it. Rising, I felt cleansed.

ISABEL: Sorry I missed my session Monday. DR. RUSH: Would you like to tell me why? ISABEL: I was depressed. DR. RUSH: That's a good reason to come to therapy.

I sit down on the bed, cradling her little head against my shoulder, inhaling her sweet baby scent. Someday she'll get older, and the world will start having its way with her. She'll throw temper tantrums, she'll need speech therapy, she'll grow breasts and have pimples, she'll fight with her parents, she'll worry about her weight, she'll put out, she'll have her heart broken, she'll be happy, she'll be lonely, she'll be complicated, she'll be confused, she'll be depressed, she'll fall in love and get married, and she'll have a baby of her own. But right now she is pure and undiminished and beautiful.

Until you've experienced depression, or a form of depression, you can't ever really know how strongly it controls you.

I have an obligation to help eliminate the stigma attached to mental illness. When I’m feeling despondent and someone asks in a sincere way how I am, I have a duty to tell the truth. It’s no different from saying I have a bad cold. By speaking candidly, I give others permission to acknowledge their own mental illness, talk about it, and seek help. I must break the silence instead of treating my depression like a shameful character flaw.

Most parents try really hard to give their kids the best possible life. They give them the best food and clothes they can afford, take their own kind of take on training kids to be honest and polite. But what they don't realize is no matter how much they try, their kids will get out there. Out to this complicated little world. If they are lucky they will survive, through backstabbers, broken hearts, failures and all the kinds of invisible insane pressures out there. But most kids get lost in them. They will get caught up in all kinds of bubbles. Trouble bubbles. Bubbles that continuously tell them that they are not good enough. Bubbles that get them carried away with what they think is love, give them broken hearts. Bubbles that will blur the rest of the world to them, make them feel like that is it, that they've reached the end. Sometimes, even the really smart kids, make stupid decisions. They lose control. Parents need to realize that the world is getting complicated every second of every day. With new problems, new diseases, new habits. They have to realize the vast probability of their kids being victims of this age, this complicated era. Your kids could be exposed to problems that no kind of therapy can help. Your kids could be brainwashed by themselves to believe in insane theories that drive them crazy. Most kids will go through this stage. The lucky ones will understand. They will grow out of them. The unlucky ones will live in these problems. Grow in them and never move forward. They will cut themselves, overdose on drugs, take up excessive drinking and smoking, for the slightest problems in their lives. You can't blame these kids for not being thankful or satisfied with what they have. Their mentality eludes them from the reality.

Forget about the scant hours in her brief life when Sylvia Plath was able to produce the works in Ariel. Forget about that tiny bit of time and just remember the days that spanned into years when she could not move, couldn’t think straight, could only lie in wait in a hospital bed, hoping for the relief that electroconvulsive therapy would bring. Don’t think of the striking on-screen picture, the mental movie you create of the pretty young woman being wheeled on the gurney to get her shock treatments, and don’t think of the psychedelic, photonegative image of this sane woman at the moment she receives that bolt of electricity. Think, instead, of the girl herself, of the way she must have felt right then, of the way no amount of great poetry and fascination and fame could make the pain she felt at that moment worth suffering. Remember that when you’re at the point at which you’re doing something as desperate and violent as sticking your head in an oven, it is only because the life that preceded this act felt worse. Think about living in depression from moment to moment, and know it is not worth any of the great art that comes a its by-product.

But I don't want you to keep pretending you're okay. I don't want you to keep downplaying the hurt you feel like you're not even human. You keep it up - all these lies to yourself, to other people, and soon you're not going to know who you are.

How odd that we spend so much time treating the darkness, and so little time seeking the light. The ego loves to glorify itself by self-analysis, yet we do not get rid of darkness by hitting it with a baseball bat. We only get rid of darkness by turning on the light.

Ultimately, forgiveness is usually about one thing—“This is for me, not for you.” Hatred is exhausting; forgiveness, or even just indifference, is freeing. To quote Booker T. Washington, “I shall allow no man to belittle my soul by making me hate him.” Belittle and distort and consume. Forgiveness seems to be at least somewhat good for your health—victims who show spontaneous forgiveness, or who have gone through forgiveness therapy (as opposed to “anger validation therapy”) show improvements in general health, cardiovascular function, and symptoms of depression, anxiety, and PTSD. Chapter 14 explored how compassion readily, perhaps inevitably, contains elements of self-interest. The compassionate granting of forgiveness epitomizes this.41

Secondly, extroverts often incorrectly assume that introverts are suffering. Introverts internalize problems; we like to take things inside and work on them there. Extroverts prefer to externalize and deal with problems interactively. Because of this difference, introverts may seem psychologically burdened, while extroverts spread the burden around and seem healthier—from an extroverted standpoint. But note that I said introverts like to take problems inside. Sure, an introvert can overdo it, but so can the extrovert who feels compelled to express every unresolved thought or emotion. The former gets depressed or anxious and goes to therapy; the latter sends others to therapy.

A happy brain is a supple and flexible brain, he believes; depression, anxiety, obsession, and the cravings of addiction are how it feels to have a brain that has become excessively rigid or fixed in its pathways and linkages—a brain with more order than is good for it. On the spectrum he lays out (in his entropic brain article) ranging from excessive order to excessive entropy, depression, addiction, and disorders of obsession all fall on the too-much-order end. (Psychosis is on the entropy end of the spectrum, which is why it probably doesn’t respond to psychedelic therapy.)

I realize now that no simple, single-factor theory of depression will ever work. Depression is partly in our genes, partly in our childhood experience, partly in our way of thinking, partly in our brains, partly in our ways of handling emotions. It affects our whole being.

For some reason the word “chronic” often has to be explained. It does not mean severe, though many chronic conditions can be exceptionally serious and indeed life-threatening. No, “chronic” means persistent over time, enduring, constant. Diabetes is a chronic condition, but measles is not. With measles, you contract it and then it is gone. It can sometimes be fatal, but is never chronic. Manic depression, in other words, is something you have to learn to live with. There are therapies which may help some people to function and function for the most part happily and well. Sometimes a talking therapy, sometimes pharmaceutical intervention helps.

If you are treated like dirt long enough, you begin to fell like dirt

It takes far more strength to accept help than to reject it.

And I always feel so stupid sitting in therapy talking about my problems because, Jesus Christ, so what? I can't equate the amount of pain and misery and despair I have suffered and endured as a depressive with the events of my life, which just seem so common.

In order for therapy to be effective, a patient must be prodded and provoked, forced into confrontations, given sufficient incentive to push herself out of the caged fog of depression.

Whenever you feel down, take a long walk in nature.

When you feel sad, you are participating in a venerable experience, to which I, this monument, am dedicated. Your sense of loss and disappointment, of frustrated hopes and grief at your own inadequacy, elevate you to serious company. Do not ignore of throw away your grief

The words on the pages within this book are solely dedicated to victims of bullying, those that ever have or still do suffer from depression, mental illness, and the struggles that accompany it.   You are brave.   You are strong.   You are smart.   You are beautiful.   You are worth it.

I’m not interested in Bob Marley telling me to ‘lively up’ myself. The only music that satisfies me is Nine Inch Nails and Trent Reznor’s voice crying through industrial rhytms. In the August evenings, I lie on my bed with earphones, letting his laments roll through me like unrepentant thunderstorms. I envy the courage that carries his voice into the world. He doesn’t berate himself for pain and anger; he howls. And this delights me, even though I feel ashamed when my own rage comes to the surface. My anger doesn’t signify courage; it’s just more confirmation that I’m bad.

This is a little dirty secret of mental health economics: if you're depressed, you don't think you're worth the cost of treatment. You feel guilty enough about being unproductive and unreliable.

But these abnormal emotions feel just as valid and realistic as the genuine feelings created by undistorted thoughts, so you automatically attribute truth to them. This is why depression is such a powerful form of mental black magic.

Of course I began to see Nikki, which was strange because I was staring into Danny's eyes, and Danny is a six-foot-three black man who looks nothing like my ex-wife.

One foot, then the other. Don't look at all five feet at once. Just take a step. And when you've taken that step, take one more. Eventually you'll make it to the shower. And you'll make it to tomorrow and next year too. One step.

...sometimes they almost made me feel glad that I had a few extra years to play my depression out with therapy and other means, because I think its useful in youth- unless suicide or drug abuse are the alternatives- to have some faith in the mind to cure itself, to not rush to doctors or diagnosis's...I sometimes worry that part of what creates depression in young people is their own, and their parents, and the whole worlds impatience with allowing the phases of life to run their course. We will very likely soon be living in a society that confuses disease with normal life if the panic and rush to judgment and labeling do not slow down a bit. Somewhere between the unbelievable tardiness that the medical profession was guilty of in administering proper treatment to me and the eagerness to with which practitioners prescribe Ritalin for 8 year old boys and Paxil for 14 year old girls, there is a sane course of action.

Depression is a serious problem, but drugs are not the answer. In the long run, psychotherapy is both cheaper and more effective, even for very serious levels of depression. Physical exercise and self-help books based on CBT can also be useful, either alone or in combination with therapy. Reducing social and economic inequality would also reduce the incidence of depression.

I wanted to cheer him up, but it felt weird wanting to cheer up someone who was possibly depressed because they didn’t murder you correctly, and that’s when I thought, "This must be what love is. When you want to make it less difficult for someone to murder you.” And that’s when I realized that I was far too in love with him for my own good, and also that I probably needed therapy.

Avoidance therapy does not work. One major reason for that is because Avoidance Therapy (diversion, think yourself happy, positive affirmations) is predicated on the validity of 'Failure of Will.' Depression is not a choice.

The irony of taking Anti Depressants: you take them to feel good but they also make you feel bad or worse because you worry about your purse.

psychedelic therapy creates an interval of maximum plasticity in which, with proper guidance, new patterns of thought and behavior can be learned.

When the expected occurred, never panic, by keep calming, you gain control over the situation.

In the last twenty-five years, the borderline patient, who confronts the psychiatrist not with well-defined symptoms but with diffuse dissatisfactions, has become increasingly common. He does not suffer from debilitating fixations or phobias or from the conversion of repressed sexual energy into nervous ailments; instead he complains "of vague, diffuse dissatisfactions with life" and feels his "amorphous existence to be futile and purposeless." He describes "subtly experienced yet pervasive feelings of emptiness and depression," "violent oscillations of self-esteem," and "a general inability to get along." He gains "a sense of heightened self-esteem only by attaching himself to strong, admired figures whose acceptance he craves and by whom he needs to feel supported." Although he carries out his daily responsibilities and even achieves distinction, happiness eludes him, and life frequently strikes him as not worth living.

Fear, by its depressing effect on our mentality, thus causes disharmony in our physical and magnetic bodies and paves the way for [bacterial] invasion. The real cause of disease lies in our own personality. ..

In my community, mental health isn't taken seriously enough. Therapy is replaced by prayer. Tears are a sign of weakness. When you are different, you are told to change. And really, what does that do? It isolates desperate, vulnerable people and creates victims.

How long does a recession have to last before it’s called a depression?

The attitude that depression is necessary strikes me as destructive, inhuman, and victimizing.

Happiness is not dependent on the good or bad opinion of others, but instead upon your actions.   It

The best way to overcome depression is to work it to death. Whether it be your body or your mind, just be active and some relief you’ll find.

YOU NEVER HAVE TO APOLOGIZE FOR HAVING HIGH ANXIETY.

When you use your voice, whether through speed or the written word, it has a way of healing.

I thought therapy was a sort of magic, that you just kept talking and the very act of talking unlocked some forgotten key.

The trick is, don’t give in to the grief. Instead, I let myself feel it, embrace it, learn from it. In bed by 9:30, up at 7:00, breakfast, then off to school where I spend five mind-numbing hours living by the dictates of San Diego County’s Board of Education, the Western version of Mao’s Little Red Book.

None of these things define you as a person: Your education The size of your bank account Your job title Your failures Your successes And sadly, we let so many of these things rule our lives. Obsession with crossing off the checkboxes of society's life plan leads to little other than therapy, midlife crises, and depression.

Even though I’d like to avoid the circumstance or situation, I will not. Avoidance behavior will only increase my anxiety. I will go ahead, experience the unpleasant feelings, and I’ll get through it.

Therapy helped, but it is not magic. It does not change our thoughts or behaviours. It only teaches us what they might be. It does not work unless we take from it what we have learned and put it into action.

There’s no reason, on paper at least, why I need these pills to get through life. I had a great childhood, loving parents, the whole package. I wasn’t beaten, abused, or expected to get nothing but As. I had nothing but love and support, but that wasn’t enough somehow. My friend Erin says we all have demons inside us, voices that whisper we’re no good, that if we don’t make this promotion or ace that exam we’ll reveal to the world exactly what kind of worthless sacks of skin and sinew we really are. Maybe that’s true. Maybe mine just have louder voices. But I don’t think it’s as simple as that. The depression I fell into after university wasn’t about exams and self-worth, it was something stranger, more chemical, something that no talking cure was going to fix. Cognitive behavioral therapy, counseling, psychotherapy—none of it really worked in the way that the pills did. Lissie says she finds the notion of chemically rebalancing your mood scary, she says it’s the idea of taking something that could alter how she really is. But I don’t see it that way; for me it’s like wearing makeup—not a disguise, but a way of making myself more how I really am, less raw. The best me I can be.

Human beings are hardwired for relationships. We need the stability of relationships in order to be well. Our brains know this, even when society tells us “You don’t need no one but your own DAMN SELF, playa’!” That’s some bullshit.

Beck’s three principles of cognitive therapy were: All our emotions are generated by our “cognitions,” or thoughts. How we feel at any given moment is due to what we are thinking about. Depression is the constant thinking of negative thoughts. The majority of negative thoughts that cause us emotional turmoil are plain wrong or at least distortions of the truth, but we accept them without question.

My training makes me uneasy with a happy mystery.

I've had a lot of therapists, so I've had the opportunity to approach my fear in many different ways. I've faced it head on and sideways and tried to tiptoe up behind it.

How We

I am not depressed; my life is just shit. As a consequence of my not being depressed, I am not like them. You need to know this from the very off. You need to know I, Arch Fry, will not allow myself to be neatly pigeonholed, erroneously labelled or closed off in some tidy little box - one to be shelved away and conveniently forgotten about. No, I am not depressed: NOT. DEPRESSED. You see, I’m just not stuck in some deep unassailable chasm like all the rest, like all these other poor fuckers who’ve so readily accepted that noose of a word.

Although it is important to be able to recognise and disclose symptom of physical illnesses or injury, you need to be more careful about revealing psychiatric symptoms. Unless you know that your doctor understands trauma symptoms, including dissociation, you are wise not to reveal too much. Too many medical professionals, including psychiatrists, believe that hearing voices is a sign of schizophrenia, that mood swings mean bipolar disorder which has to be medicated, and that depression requires electro-convulsive therapy if medication does not relieve it sufficiently. The “medical model” simply does not work for dissociation, and many treatments can do more harm than good... You do not have to tell someone everything just because he is she is a doctor. However, if you have a therapist, even a psychiatrist, who does understand, you need to encourage your parts to be honest with that person. Then you can get appropriate help.

And although I played along with him for a while so as not to prick his bubble, inside I felt pretty bleak indeed, because now I knew that he was going to be just as pliable and credulous as everyone else, he didn't appear to have anything close to the firepower I'd need to give me any hope of getting helped out of the trap of fraudulence and unhappiness I'd constructed for myself.

Someday she'll get older, and the world will start having its way with her. She'll throw temper tantrums, she'll need therapy, she'll grow breasts and have pimples, she'll fight with her parents, she'll worry about her weight, she'll put out, she'll have her heart broken, she'll be happy, she'll be lonely, she'll be complicated, she'll be confused, she'll be depressed, she'll fall in love and get married, and she'll have a baby of her own. But right now, she is pure and undiminished and beautiful.

When people recover from depression via psychotherapy, their attributions about recovery are likely to be different than those of people who have been treated with medication. Psychotherapy is a learning experience. Improvement is not produced by an external substance, but by changes within the person. It is like learning to read, write or ride a bicycle. Once you have learned, the skills stays with you. People no not become illiterate after they graduate from school, and if they get rusty at riding a bicycle, the skill can be acquired with relatively little practice. Furthermore, part of what a person might learn in therapy is to expect downturns in mood and to interpret them as a normal part of their life, rather than as an indication of an underlying disorder. This understanding, along with the skills that the person has learned for coping with negative moods and situations, can help to prevent a depressive relapse.

If you have not resolved your grief, it will affect your future relationships including the one you have with yourself. Including the one you have with me. It will keep us all in a holding pattern, putting a straightjacket on your love and chaining you to the past instead of moving you forward into the future.

I didn’t want to be abandoned, alone, isolated and feeling all of this on my own. He was all I had. All I even could get from this world. But I was a horrible human being, and that was just the start of it all.

It's one of these juvenile therapy scams,” he went on, sprinkling a pinch of the Golden Virginia tobacco along the rolling paper. “They advertise help for your troubled teen by staring at the stars and singing ‘Kumbaya’. Instead, it’s a bunch of bearded nutjobs left in charge of some of the craziest kids I’ve ever seen in my life—bulimics, nymphos, cutters trying to saw their wrists with the plastic spoons from lunch. You wouldn’t believe the shit that went on.” He shook his head. “Most of the kids had been so mentally screwed by their parents they needed more than twelve weeks of wilderness. They needed reincarnation. To die and just come back as a grasshopper, as a fucking weed. That’d be preferable to the agony they were in just by being alive.

We must realize that mental problems are just as real as physical disease, and that anxiety and depression require active therapy as much as appendicitis or pneumonia,” wrote Dr. Howard Rusk, a professor at New York University who penned a weekly column for the New York Times. “They are all medical problems requiring medical care.”12

In his seminal book, Man’s Search for Meaning, the psychiatrist Victor Frankl described the essence of what has come to be known as an existential approach to the human condition with this metaphor: “If architects want to strengthen a decrepit arch,” he wrote, “they increase the load which is laid upon it, for thereby the parts are joined more firmly together.” It is similarly true, he said, that therapy aimed at fostering mental health often should lay increased weight on a patient, creating what he described as “a sound amount of tension through a reorientation toward the meaning of one’s own life.

It’s all very well learning why I behave in the way that I do. That doesn’t stop me behaving in those ways. I am just more conscious of them.’ Consciousness is where therapy stops and we begin. Therapy can only give us knowledge. It is up to us to use it.

One of the depressing things about depression is knowing that there are lots of people in the world with far more reason to feel depressed than you have, and finding that, so far from making you snap out of your depression, it only makes you despise yourself more and thus feel more depressed. The purest form of depression is when you can give absolutely no reason why you’re depressed. As B says, in Either/Or, “A person in sorrow or distress knows why he sorrows or is distressed. If you ask a melancholic what it is that weighs down on him, he will reply, ‘I don’t know what it is, I can’t explain it.’ Therein lies melancholy’s infinitude.

When clients relinquish symptoms, succeed in achieving a personal goal, or make healthier choices for themselves, subsequently many will feel anxious, guilty, or depressed. That is, when clients make progress in treatment and get better, new therapists understandably are excited. But sometimes they will also be dismayed as they watch the client sabotage her success by gaining back unwanted weight or missing the next session after an important breakthrough and deep sharing with the therapist. Thus, loyalty and allegiance to symptoms—maladaptive behaviors originally developed to manage the “bad” or painfully frustrating aspects of parents—are not maladaptive to insecurely attached children. Such loyalty preserves “object ties,” or the connection to the “good” or loving aspects of the parent. Attachment fears of being left alone, helpless, or unwanted can be activated if clients disengage from the symptoms that represent these internalized “bad” objects (for example, if the client resolves an eating disorder or terminates a problematic relationship with a controlling/jealous partner). The goal of the interpersonal process approach is to help clients modify these early maladaptive schemas or internal working models by providing them with experiential or in vivo re-learning (that is, a “corrective emotional experience”). Through this real-life experience with the therapist, clients learn that, at least sometimes, some relationships can be different and do not have to follow the same familiar but problematic lines they have come to expect.

In recent years, “psychiatry has gone from being brainless to being mindless,” as one psychoanalyst has put it. If psychedelic therapy proves successful, it will be because it succeeds in rejoining the brain and the mind in the practice of psychotherapy. At least that’s the promise.

Absolutes do not exist in this universe. If you try to force your experiences into absolute categories, you will be constantly depressed because your perceptions will not conform to reality. You will set yourself up for discrediting yourself endlessly because whatever you do will never measure up to your exaggerated expectations. The technical name for this type of perceptual error is "dichotomous thinking." You see everything as black or white—shades of gray do not exist.

For people who are depressed, and especially for those who do not receive enough benefit from medication of for whom the side effects of antidepressants are troubling, the fact that placebos can duplicate much of the effects of antidepressants should be taken as good news. It means that there are other ways of alleviating depression. As we have seen, treatments like psychotherapy and physical exercise are at least as effective as antidepressant drugs and more effective than placebos. In particular, CBT has been shown to lower the risk of relapsing into depression for years after treatment has ended, making it particularly cost effective.

In America, Rousseauism has turned Freud’s conflict-based psychoanalysis into weepy hand-holding. Contemporary liberalism is untruthful about cosmic realities. Therapy, defining anger and hostility in merely personal terms, seeks to cure what was never a problem before Rousseau. Mediterranean, as well as African-American, culture has a lavish system of language and gesture to channel and express negative emotion. Rousseauists who take the Utopian view of personality are always distressed or depressed over world outbreaks of violence and anarchy. But because, as a Sadean, I believe history is in nature and of it, I tend to be far more cheerful and optimistic than my liberal friends. Despite crime’s omnipresence, things work in society, because biology compels it. Order eventually restores itself, by psychic equilibrium. Films like Seven Samurai (1954) and Two Women (1961) accurately show the breakdown of social controls as a regression to animal-like squalor.

The first thing you need to know if you are a survivor is that parts of you have probably been trained to create a variety of symptoms and behaviours. Abusers actually train child parts to cut the body, to make other parts cut, to attempt suicide, to create flashbacks by releasing pieces of visual or auditory memories, to create body memories of pain or electroshock, and to create depression, terror, anxiety, and despair by releasing the emotional components of memories to the rest of the personality system. The front person and most of the rest of the system do not know that this is the source of these feelings and behaviours. p126

Happiness" alone does not guarantee mental health and well-being. A tempering dose of disappointment- an occasional taste of frustration and learning that you do recover from it- goes a long way toward producing long-term contentment. Indeed the ability to ride out the bad times without feeling doomed is essential to survival. When happiness is not taken for granted, and when one is acquainted with its opposite it is more easily savored and has more lasting effects.

My other client, whom I will call Teresa, thought Lorraine had MPD and hoped I could help her. Almost no one recognized this condition in those days. Lorraine was forty years old and had been in and out of psychiatric hospitals since she was thirteen. She had had various diagnoses, mainly severe depression, and she had made quite a few serious suicide attempts before I even met her. She had been given many courses of electric shock therapy, which would confuse her so much that she could not get together a coherent suicide plan for quite a while. Lorraine’s psychiatrist was initially opposed to my seeing her, as her friend Teresa had been stigmatized with the "borderline personality disorder" diagnosis when in hospital, so was seen as a bad influence on her. But after Lorraine spent a couple of months in hospital calling herself Susie and acting consistently like a child, he was humble enough to acknowledge that perhaps he could learn some new things, and someone else’s help might be a good idea.

The hamster friend said being able to do front rolls didn't make the hamster as good as Bruce Lee, which was not a true statement and not an untrue statement, because the word 'good' is meaningless until defined within a context and a goal, and hamsters when enjoying the company of other hamsters rarely define or think about contexts and goals, because to do so would make them aware of certain things about the universe that would make them feel a kind of emptiness or 'neutrality of emotion' that is usually desirable only in situations where the hamster wants to stop his or her self-perpetuating cycle of negative thinking, in order to fight severe depression or crippling loneliness. In a situation of severe depression or crippling loneliness caused by a period of time of uncontrollable negative thinking this 'kind of emptiness'--effected by an understanding (of the arbitrary nature of the universe) that is attained by thinking comprehensively about context, goals, and meaning--can be used to neutralize the hamster's automatic and self-perpetuating pattern of negative thoughts, at which point the hamster can form new thoughts, that will cause new behaviors, that will cause new patterns of thought, with which the hamster can better function in life and in relationships with other hamsters.

Although the idea has been around for ages, most depressed people do not really comprehend it. If you feel depressed, you may think it is because of bad things that have happened to you. You may think you are inferior and destined to be unhappy because you failed in your work or were rejected by someone you loved. You may think your feelings of inadequacy result from some personal defect—you may feel convinced you are not smart enough, successful enough, attractive enough, or talented enough to feel happy and fulfilled. You may think your negative feelings are the result of an unloving or traumatic childhood, or bad genes you inherited, or a chemical or hormonal imbalance of some type. Or you may blame others when you get upset: “It’s these lousy stupid drivers that tick me off when I drive to work! If it weren’t for these jerks, I’d be having a perfect day!” And nearly all depressed people are convinced that they are facing some special, awful truth about themselves and the world and that their terrible feelings are absolutely realistic and inevitable. Certainly all these ideas contain an important gem of truth—bad things do happen, and life beats up on most of us at times. Many people do experience catastrophic losses and confront devastating personal problems. Our genes, hormones, and childhood experiences probably do have an impact on how we think and feel. And other people can be annoying, cruel, or thoughtless. But all these theories about the causes of our bad moods have the tendency to make us victims—because we think the causes result from something beyond our control. After all, there is little we can do to change the way people drive at rush hour, or the way we were treated when we were young, or our genes or body chemistry (save taking a pill). In contrast, you can learn to change the way you think about things, and you can also change your basic values and beliefs. And when you do, you will often experience profound and lasting changes in your mood, outlook, and productivity. That, in a nutshell, is what cognitive therapy is all about. The theory is straightforward

When people call it that I always get pissed off because I always think depression sounds like you just get like really sad, you get quiet and melancholy and just like sit quietly by the window sighing or just lying around. A state of not caring about anything. A kind of blue kind of peaceful state.’ She seemed to the doctor decidedly more animated now, even as she seemed unable to meet his eyes. Her respiration had sped back up. The doctor recalled classic hyperventilatory episodes being characterized by carpopedal spasms, and reminded himself to monitor the patient’s hands and feet carefully during the interview for any signs of tetanic contraction, in which case the prescribed therapy would be I.V. calcium in a saline percentage he would need quickly to look up. ‘Well this’—she gestured at herself—‘isn’t a state. This is a feeling. I feel it all over. In my arms and legs.’ ‘That would include your carp—your hands and feet?’ ‘All over. My head, throat, butt. In my stomach. It’s all over everywhere. I don’t know what I could call it. It’s like I can’t get enough outside it to call it anything. It’s like horror more than sadness. It’s more like horror. It’s like something horrible is about to happen, the most horrible thing you can imagine—no, worse than you can imagine because there’s the feeling that there’s something you have to do right away to stop it but you don’t know what it is you have to do, and then it’s happening, too, the whole horrible time, it’s about to happen and also it’s happening, all at the same time.

Follow your doctor’s orders. For me that means antidepressants and behavioral therapy. Exercise thirty minutes a day, six days a week. Get sunlight, or if you can’t, use light therapy. Do not overuse your light therapy lamp even though you want to. Treat yourself like you would your favorite pet. Plenty of fresh water, lots of rest, snuggles as needed, allow yourself naps. Avoid negativity. That means the news, people, movies. It will all be there when you’re healthy again. The world will get on without your seeing it. Forgive yourself. For being broken. For being you. For thinking those are things that you need forgiveness for. Those terrible things you tell yourself? Can you imagine if the person you love most were telling themselves those things? You’d think they were crazy. And wrong. They think the same about you. Those negative things you are thinking are not rational. Remember that depression lies and that your brain is not always trustworthy. Give yourself permission to recover. I’m lucky that I can work odd hours and take mental health days but I still feel shitty for taking them. Realize that sometimes these slow days are necessary and healthy and utterly responsible. Watch Doctor Who. Love on an animal. Go adopt a rescue, or if you can’t, go to the shelter and just snuggle a kitten. Then realize that that same little kitten that you’re cradling isn’t going to accomplish shit but is still wonderful and lovely and so important. You are that kitten. Get up. Go brush your teeth. Go take a hot shower. If you do nothing else today just change into a new pair of pajamas. It helps. Remember that you are not alone. There are crisis lines filled with people who want to help. There are people who love you more than you know. There are people who can’t wait to meet you because you will teach them how unalone they are. You are so worthy of happiness and it will come.

In fact, the same intervention or response may even have the opposite effect on two different clients with contrasting developmental histories and cultural contexts. For example, if a client’s parent was distant or aloof, the therapist’s judicious self-disclosure may be helpful for the client. In contrast, the same type of self-disclosure is likely to be anxiety-arousing for a client who grew up serving as the confidant or emotional caregiver of a depressed parent. Greater sharing with the therapist may help the first client learn that, contrary to her deeply held beliefs, she does matter and can be of interest to other people. In contrast, for the second client, the same type of self-disclosure may inadvertently impose the unwanted needs of others and set this client back in treatment as, in her mind, she experiences herself back in her old caretaking role again—this time with the therapist. This unwanted reenactment occurs because the therapeutic relationship is now paralleling the same problematic relational theme that this client struggled with while growing up.

Like many fellow travelers who’ve crossed the Styx and returned, I view the itinerary as transformational. On the one hand, I won’t join that cohort claiming gratitude for their time in hell; on the other, I can say that in the wake of my depression, I’m pierced by other people as I wasn’t before, that I waste less time entertaining myself, and that I hear my thoughts with a useful attention to their tenor, fairness, and sanity. I feel equanimous most of the time, and have a strong impulse to give. My life has become, if you will, intentional, in a way it might not be if I hadn’t made my plummet. William Styron died in 2006. During the last third of his life, after the publication of Darkness Visible, he became a mental health advocate. I’m among those aided by his account, who found in it succor, but I’m also mindful of complaints such as those in Joel P. Smith’s essay “Depression: Darker Than Darkness”—that Styron was depressed for months, not years; that he was never alone; that he had the best of treatment; that he stayed in a hospital “as comfortable as they come”; and that he didn’t have to rely on radical remedies like electroshock therapy: all of this to say that Styron didn’t plumb the depths and can’t represent the depressed, and neither can I. Others have and have had it worse. For them, depression never yields or lessens. For them there’s no rising into the light of day, no edifications, and no gains, nothing but the wish to be dead, which is, after a marathon of untenable suffering, granted. “E

Robin Carhart-Harris’ theory of the entropic brain represents a promising elaboration on this general idea and a first stab at a unified theory of mental illness that helps explain all three of the disorders we’ve examined in these pages. A happy brain is a supple and flexible brain, he believes. Depression, anxiety, obsession and the cravings of addiction are how it feels to have a brain that has become excessively rigid or fixed in its pathways and linkages—a brain with more order than is good for it. On the spectrum he lays out in his entropic brain article, ranging from excessive order to excessive entropy, depression, addiction and disorders of obsession all fall on the too much order end. Psychosis is on the entropy end of the spectrum which is why it probably doesn’t respond to psychedelic therapy. The therapeutic value of psychedelics, in Carhart-Harris’ view, lies in their ability to temporarily elevate entropy in the inflexible brain, jolting the system out of its default patterns. Carhart-Harris uses the metaphor of annealing from metallurgy: psychedelics introduce energy into the system, giving it the flexibility necessary for it to bend and so change.

Even harder to admit is how depressed I was. As the social stigma of depression disappears, the aesthetic stigma increases. It’s not just that depression has become fashionable to the point of banality. It’s the sense that we live in a reductively binary culture: you’re either healthy or you’re sick, you either function or you don’t. And if that flattening of the field of possibilities is precisely what’s depressing you, you’re inclined to resist participating in the flattening by calling yourself depressed. You decide that it’s the world that’s sick,, and that the resistance of refusing to function in such a world is healthy. You embrace what clinicians call “depressive realism.” It’s what the chorus in Oedipus Rex sings: “Alas, ye generations of men, how mere a shadow do I count your life! Where, where is the mortal who wins more of happiness than just the seeming, and, after the semblance, a falling away?” You are, after all, just protoplasm, and some day you’ll be dead. The invitation to leave your depression behind, whether through medication or therapy or effort of will, seems like an invitation to turn your back on all your dark insights into the corruption and infantilism and selfdelusion of the brave new Me World.

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.

I can see every day that a squirrel's perfectly at home in a world of trees. But imagine taking that squirrel and plunking him down in the middle of the desert. This wonderful animal will suddenly feel depressed, anxious, confused, completely at a loss. There are plenty of animals who make a home in the desert, but not the squirrel. There's nothing really wrong with that downcast squirrel in the desert. He's perfect. But he's only perfect when he's at home, in a place with lots of trees. In the desert a squirrel is an unhappy misfit. Now imagine doing something stupid: taking that squirrel to a therapist so he'll feel better... You could do squirrel therapy forever but as long as the squirrel's in the desert, he's going to be miserable. But if you just pick him up and bring him to a place with trees, now he's at home and he's happy. There are so many people who are miserable because they are squirrels in the desert. They think there's something wrong with them. They endlessly try to fix themselves but the fixing doesn't work. Yet they keep trying because it's hard to face the ways they're not at home in the world. And yet how simple it would be if they could see there's nothing wrong with who they are, there's just something wrong with where they are. But they can feel more at home than they ever imagined. They just have to look for ways that events in their lives are showing them the way home.

I believe the perception of what people think about DID is I might be crazy, unstable, and low functioning. After my diagnosis, I took a risk by sharing my story with a few friends. It was quite upsetting to lose a long term relationship with a friend because she could not accept my diagnosis. But it spurred me to take action. I wanted people to be informed that anyone can have DID and achieve highly functioning lives. I was successful in a career, I was married with children, and very active in numerous activities. I was highly functioning because I could dissociate the trauma from my life through my alters. Essentially, I survived because of DID. That's not to say I didn't fall down along the way. There were long term therapy visits, and plenty of hospitalizations for depression, medication adjustments, and suicide attempts. After a year, it became evident I was truly a patient with the diagnosis of DID from my therapist and psychiatrist. I had two choices. First, I could accept it and make choices about how I was going to deal with it. My therapist told me when faced with DID, a patient can learn to live with the live with the alters and make them part of one's life. Or, perhaps, the patient would like to have the alters integrate into one person, the host, so there are no more alters. Everyone is different. The patient and the therapist need to decide which is best for the patient. Secondly, the other choice was to resist having alters all together and be miserable, stuck in an existence that would continue to be crippling. Most people with DID are cognizant something is not right with themselves even if they are not properly diagnosed. My therapist was trustworthy, honest, and compassionate. Never for a moment did I believe she would steer me in the wrong direction. With her help and guidance, I chose to learn and understand my disorder. It was a turning point.

When you are depressed, you may have a tendency to confuse feeling with facts. Your feelings of hopelessness and total despair are just symptoms of depressive illness, not facts. If you think you are hopeless, you will naturally feel this way. Your feelings only trace the illogical pattern of your thinking. Only an expert, who has treated hundreds of depressed individuals, would be in a position to give a meaningful prognosis for recovery. Your suicidal urge merely indicates the need for treatment. Thus, your conviction that you are "hopeless" nearly always proves you are not. Therapy, not suicide, is indicated. Although generalizations can be misleading, I let the following rule of thumb guide me: Patients who feel hopeless never actually are hopeless. The conviction of hopelessness is one of the most curious aspects of depressive illness. In fact, the degree of hopelessness experienced by seriously depressed patients who have an excellent prognosis is usually greater than in terminal malignancy patients with a poor prognosis. It is of great importance to expose the illogic that lurks behind your hopelessness as soon as possible in order to prevent an actual suicide attempt. You may feel convinced that you have an insoluble problem in your life. You may feel that you are caught in a trap from which there is no exit. This may lead to extreme frustration and even to the urge to kill yourself as the only escape.

depression in its major stages possesses no quickly available remedy: failure of alleviation is one of the most distressing factors of the disorder as it reveals itself to the victim, and one that helps situate it squarely in the category of grave diseases. Except in those maladies strictly designated as malignant or degenerative, we expect some kind of treatment and eventual amelioration, by pills or physical therapy or diet or surgery, with a logical progression from the initial relief of symptoms to final cure. Frighteningly, the layman-sufferer from major depression, taking a peek into some of the many books currently on the market, will find much in the way of theory and symptomatology and very little that legitimately suggests the possibility of quick rescue. Those that do claim an easy way out are glib and most likely fraudulent. There are decent popular works which intelligently point the way toward treatment and cure, demonstrating how certain therapies—psychotherapy or pharmacology, or a combination of these—can indeed restore people to health in all but the most persistent and devastating cases; but the wisest books among them underscore the hard truth that serious depressions do not disappear overnight. All of this emphasizes an essential though difficult reality which I think needs stating at the outset of my own chronicle: the disease of depression remains a great mystery. It has yielded its secrets

I dial her mum's number, then sit down cross-legged, facing the wall. When she comes on the line, she sounds uncertain, hesitant. 'Hey! Guess where I am?' I ask, my voice loud with false cheer. 'Rami told me. The Wellesly Hospital in Worthing. What's it like?' 'For a loony-bin it's actually quite decent,' I reply. 'I don't have Sky or an en-suite, and the menu isn't exactly à la carte, but you know...' I tail off. There is a silence. 'Do you have your own room?' Jenna asks, 'Oh yeah, yeah. I have a lovely view of the sea between the bars of my window.' She doesn't laugh. 'Have you started' -there is a pause as she searches for the right word -'threatment?' 'Yeah, yeah. We had group therapy today. Tomorrow we'll probably have art therapy - maybe I'll draw you a hourse and a garden. I know, perhaps they'll teach us to make baskets! Isn't that why they call us basket cases?' 'Flynn, stop,' Jennah softly implores. 'And we'll probably have music therapy the day after. Maybe I'll get to play the tambourine. Or the triangle. I've always wanted to play the triangle!' 'Flynn-' 'No, I'm serious! I'll ask for some manuscript paper and see if I can write a composition for tambourine and triangle. Then I can post if off to you to hand in for my next composition assignment.' 'Flynn, listen-' 'Hold on, hold on! I'm making a note to myself now: Find fellow insane musician and start composing the Flynn Laukonen Sonata for Tambourine and Triangle.' 'Flynn-' 'And then, when they let me out, if they ever let me out, perhaps you could pull a few strigns and organize for me and my tambourine buddy to give a recital. I'm not sure where though -how about the subway at Marble Arch tube? Nice and central, good acoustics-' 'What are the other people like?' Jennah cuts in, an edge to her voice. I notice she doesn't use the word patients. Clever Jennah. For a moment there you almost made me forget I was locked up in a mental institution. 'Round the bend, just like me,' I reply. 'I'm in excellent company. We'll be swapping suicide tips in no time at all!' I give a harsh laugh.

I began to see that the stronger a therapy emphasized feelings, self-esteem, and self-confidence, the more dependent the therapist was upon his providing for the patient ongoing, unconditional, positive regard. The more self-esteem was the end, the more the means, in the form of the patient’s efforts, had to appear blameless in the face of failure. In this paradigm, accuracy and comparison must continually be sacrificed to acceptance and compassion; which often results in the escalation of bizarre behavior and bizarre diagnoses. The bizarre behavior results from us taking credit for everything that is positive and assigning blame elsewhere for anything negative. Because of this skewed positive-feedback loop between our judged actions and our beliefs, we systematically become more and more adapted to ourselves, our feelings, and our inaccurate solitary thinking; and less and less adapted to the environment that we share with our fellows. The resultant behavior, such as crying, depression, displays of temper, high-risk behavior, or romantic ventures, or abandonment of personal responsibilities, which seem either compulsory, necessary, or intelligent to us, will begin to appear more and more irrational to others. The bizarre diagnoses occur because, in some cases, if a ‘cause disease’ (excuse from blame) does not exist, it has to be 'discovered’ (invented). Psychiatry has expanded its diagnoses of mental disease every year to include 'illnesses’ like kleptomania and frotteurism [now frotteuristic disorder in the DSM-V]. (Do you know what frotteurism is? It is a mental disorder that causes people, usually men, to surreptitiously fondle women’s breasts or genitals in crowded situations such as elevators and subways.) The problem with the escalation of these kinds of diagnoses is that either we can become so adapted to our thinking and feelings instead of our environment that we will become dissociated from the whole idea that we have a problem at all; or at least, the more we become blameless, the more we become helpless in the face of our problems, thinking our problems need to be 'fixed’ by outside help before we can move forward on our own. For 2,000 years of Western culture our problems existed in the human power struggle constantly being waged between our principles and our primal impulses. In the last fifty years we have unprincipled ourselves and become what I call 'psychologized.’ Now the power struggle is between the 'expert’ and the 'disorder.’ Since the rise of psychiatry and psychology as the moral compass, we don’t talk about moral imperatives anymore, we talk about coping mechanisms. We are not living our lives by principles so much as we are living our lives by mental health diagnoses. This is not working because it very subtly undermines our solid sense of self.

The Blue Mind Rx Statement Our wild waters provide vast cognitive, emotional, physical, psychological, social, and spiritual values for people from birth, through adolescence, adulthood, older age, and in death; wild waters provide a useful, widely available, and affordable range of treatments healthcare practitioners can incorporate into treatment plans. The world ocean and all waterways, including lakes, rivers, and wetlands (collectively, blue space), cover over 71% of our planet. Keeping them healthy, clean, accessible, and biodiverse is critical to human health and well-being. In addition to fostering more widely documented ecological, economic, and cultural diversities, our mental well-being, emotional diversity, and resiliency also rely on the global ecological integrity of our waters. Blue space gives us half of our oxygen, provides billions of people with jobs and food, holds the majority of Earth's biodiversity including species and ecosystems, drives climate and weather, regulates temperature, and is the sole source of hydration and hygiene for humanity throughout history. Neuroscientists and psychologists add that the ocean and wild waterways are a wellspring of happiness and relaxation, sociality and romance, peace and freedom, play and creativity, learning and memory, innovation and insight, elation and nostalgia, confidence and solitude, wonder and awe, empathy and compassion, reverence and beauty — and help manage trauma, anxiety, sleep, autism, addiction, fitness, attention/focus, stress, grief, PTSD, build personal resilience, and much more. Chronic stress and anxiety cause or intensify a range of physical and mental afflictions, including depression, ulcers, colitis, heart disease, and more. Being on, in, and near water can be among the most cost-effective ways of reducing stress and anxiety. We encourage healthcare professionals and advocates for the ocean, seas, lakes, and rivers to go deeper and incorporate the latest findings, research, and insights into their treatment plans, communications, reports, mission statements, strategies, grant proposals, media, exhibits, keynotes, and educational programs and to consider the following simple talking points: •Water is the essence of life: The ocean, healthy rivers, lakes, and wetlands are good for our minds and bodies. •Research shows that nature is therapeutic, promotes general health and well-being, and blue space in both urban and rural settings further enhances and broadens cognitive, emotional, psychological, social, physical, and spiritual benefits. •All people should have safe access to salubrious, wild, biodiverse waters for well-being, healing, and therapy. •Aquatic biodiversity has been directly correlated with the therapeutic potency of blue space. Immersive human interactions with healthy aquatic ecosystems can benefit both. •Wild waters can serve as medicine for caregivers, patient families, and all who are part of patients’ circles of support. •Realization of the full range and potential magnitude of ecological, economic, physical, intrinsic, and emotional values of wild places requires us to understand, appreciate, maintain, and improve the integrity and purity of one of our most vital of medicines — water.