In the movie, “As Good As It Gets,” Jack Nicholson’s character – who suffers from manic-depression, or bipolar disorder – steps out of his psychiatrist’s office and says to a group of waiting patients, “What if this is as good as it gets?” 

The patients recoil in horror, realizing that he has just spoken their worst fears.  At the very heart of depression lies the terrible belief that nothing in life will improve.  However bad things may feel at the present moment, many depressed persons believe that the current circumstances are as good as it gets.  Hence, the hopelessness and despair of this terrible disorder.

Everybody Goes Down, But Some Do Not Go Up

Everyone gets depressed from time to time.  In health, it’s among our more important biological and psychological mechanisms for rest and recovery.  The beauty of the human spirit is that it eventually bounces.  Most of us recover from our bouts of dark mood and temporary despair.  After a day or two – or perhaps a week – we awaken one morning and feel ready to take on life again.  Something mysterious happens in our body, mind, and spirit to restore our hope that life will get better, which in turn boosts our internal happiness meter. 

The question is this: Why are some people capable of rebounding from depression, while others sink ever-deeper into their own dark worlds and remain trapped in despair?   

In fact, there is no clear scientific or medical consensus to answer that question.  And there may be little effort in the clinical setting to find one. Psychiatrists have all but given up on the job of actually understanding depression, much less curing it with any sort of therapy other than drugs.  All too many psychiatrists spend as little time as possible with patients before slapping a prescription on them and sending them off to the drug store. 

That doesn’t mean that the prescription drug is a cure.  Far from it.  About a third of patients report an improvement in symptoms after taking an anti-depressant.  Another third report no change at all, and still another suffer one or more negative side effects.  For many, side effects include a deepening of depression, along with intense thoughts of suicide and death through non-suicidal means.  Among the many who contemplate suicide as their only answer are thousands of children who take these medications.  And indeed, many adults and a growing number of young people have indeed killed themselves while on the meds.   

One of the more head-scratching factors in the medical picture is that the scientific research doesn’t offer a strong endorsement for the use of anti-depressant drugs.   Only about half of the studies examining the effects of anti-depressants have shown that patients experienced a positive effect from the drugs, according to a study published in the New England Journal of Medicine (358 (3):252-60.)   

An examination of all the research sponsored by the pharmaceutical industry on the six most popular anti-depressants showed that the drugs were only minimally more effective than placebo (a non-therapeutic sugar pill).  (The study was published in The Journal of Psychopharmacology

[Oxford], 22(3):223-6.)   

In fact, the failure of anti-depressants to show any benefit at all is so common that the pharmaceutical industry is routinely forced to repeat the same studies again and again in order to show positive results from a particular drug.   The U.S. Food and Drug Administration requires at least two studies that prove the drug’s efficacy before it permits the company can sell the drug to consumers.   

Nevertheless, many people absolutely need anti-depressant medication in order to function.  Moreover, the drugs do save lives.  Unfortunately, the legitimate need for anti-depressants is being used by physicians as an excuse to over-prescribe them.

Hence, the use of anti-depressants is climbing throughout the world.  They are now the most commonly prescribed drugs in the U.S. and much of Western Europe.  Children are increasingly being prescribed for everything from weight loss to hyperactivity.   Thanks to an array of factors that extend far beyond the medical and pharmaceutical industries, we are moving toward a worldwide addiction to ant-depressant drugs.    

In this article, I give my own perspective on why people become depressed, why they remain trapped in depression, and how we can begin to effectively treat this terrible disorder. 

I must say at the outset that depression can be a life-threatening disorder.  And for many chronically depressed people, medication is essential, at least for a limited period of time.   That does not mean that it should be the only means of treatment. 

Much depends on the patient’s willingness to engage in healing activities, of course.  But many who are ready to engage the process can change their brain chemistry and thereby establish the biological foundation for good health and a recovery from this dread disorder. 

Common Symptoms Of Depression

Depression emerges as a deepening malaise, which is accompanied by an array of common symptoms.  They include the following. 

  • Chronic feelings of worthlessness, hopelessness, and despair. 
  • Loss of appetite, accompanied by significant weight loss (meaning greater than 5 percent of body weight in a single month).
  • Chronic insomnia.
  • Chronic fatigue and loss of energy.
  • Decreasing ability to focus and concentrate.
  • Recurrent thoughts of suicide or death. 

These symptoms affect both men and women.  In men, however, the disorder tends to take on additional, and more dangerous, characteristics.  Depressed men are far more prone to anger and violence than depressed women.  Unlike women, men see their depression as a sign of weakness, and many men view depression as a failure of their masculinity.  Men tend to isolate themselves when depressed and are far less likely to seek help than women.  Men also self-medicate with alcohol to a far greater extent than women.  And when they attempt suicide, men typically choose more violent means.  Similarly, depression in men often leads to dangerous behaviors, such as sexual addiction, gambling, reckless driving, thrill seeking and violence. 

All of these symptoms are important in both men and women, because they offer important clues to both the cause and the recovery from the illness. 

Anger: One Of The Keys To Depression

At the bottom of depression in both men and women lies a great reservoir of anger.  Anger is an enormous source of energy.  In fact, anger can become so powerful that we can literally tremble and shake from the emotion, just as we do from fear.  This is a symptom of how powerful, and potentially destructive, anger can be.  We can literally become possessed by anger. 

The problem is not the presence of anger itself, but what we do with it.  Most women, I have found, turn their anger inward, on themselves, blaming themselves for the problems they face.  Such self-blame is often followed by intense feelings of guilt.   Both the anger and the guilt must be repressed.   The emotional tremors generated by the anger and guilt are turned back into the body, thus adding to the toxic load in the tissues. 

Men turn the anger inward, too, but unlike many women, many men eventually allow their anger to explode, often at innocent people.  I call this type of anger, which is directed more at innocent bystanders than at the actual source of the problem, powerless anger.  I also distinguish powerless anger from justified truth, which is the act of expressing one’s anger and truth at the actual source of the conflict, challenge, or disagreement. 

Justified truth is, in fact, a more honest and mature state in which a man or woman addresses the actual causes of the problems.  Such an act invariably leads to an improvement in one’s life and a restoration of one’s heroic nature.  One feels brave, noble, and stronger for having expressed one’s justified truth.  Any anger that may be expressed in the process usually blows over quickly and does not linger, because one feels better about oneself as a consequence of expressing one’s underlying feelings. 

Depression, I believe, is a form of powerless anger – or anger that is turned inward, injuring oneself with powerful negative emotions, including rage, self-blame, and self-loathing.  

In Chinese medicine, the injury is said to be held primarily in the liver and heart.  And indeed, Western researchers have confirmed that chronic anger can contribute to various forms of heart disease. 

The Reasons We Become Angry – And Depressed

Essentially, there are three reasons why we become angry.  The first occurs when our lives (or livelihoods) are threatened, either by physical violence, illness, or by job insecurity.   

The second occurs when we are told that our lives are meaningless or of little value.  (The value of every single life is beyond human comprehension; demeaning the value of your life is an affront against nature.) 

And the third arises when our needs go unmet for an extended period of time.  (This invariably causes anger and a desire to push people away in order to pay attention to our own cares and needs.) 

Any of these three conditions can arise suddenly – such as when a person loses a loved one, or is beset by a sudden illness, or loses a job.  Or they can drag on over time and erode the spirit, such as when the conditions at work demean a person, or slowly take away his sense of value or purpose.       

Anyone with any life experience has encountered these and other debilitating circumstances many times over.  Depression lingers and becomes chronic when we find ourselves believing that our circumstances will never get better.  In effect, we come up against a set of beliefs within ourselves that insist that we are powerless against the forces arrayed against us.  Under such conditions, the heart retreats.  We feel weakened, afraid, and powerless.   

In the silence of our inner lives, an even deeper crisis is occurring.   Below the surface, we start to believe that we will not become the person we always dreamed of being.  The deeper spiritual goals of your life – your dream to become an individuated, fulfilled, and successful human being (in whatever way you define success) – now seems threatened and perhaps impossible to achieve. 

And at this point, a kind of existential and even spiritual anger can take us over. 

All anger contains essential truths that must be expressed, lest they sit inside us and fester. 

One of the great mistakes people make is that they accept the training that anger is bad, or wrong, and consequently they refuse to express their underlying rage. 

When people refuse to express their anger, especially at the true source of their rage, they establish psychological barriers within themselves, barriers that keep them silent and fuel their anger all the more.  Depressed people are, in essence, silenced by the training they have encountered in childhood and young adulthood.  They have been educated to believe that their truths do not matter.  Moreover, they should not speak ill of their parents, or teachers, or superiors, and if they do, they should never confront these important figures, even if they did do tremendous harm to them either earlier in life, or in more recent adulthood. 

Instead of speaking their truths, they medicate their pain away.  That may work in the short run, but the long-term effect is to create even more pain – and a more deeply engrained depression. 

Everyone Self-Medicates – Much To Our Own Detriment

Given the terrible effects of depression, it’s easy to understand why everyone turns to some form of self-medication to relieve its symptoms.  What most of us do not realize is that our strategy for relieving depression can cause us to sink even deeper into the disorder. 

The drug of choice for virtually everyone who self-medicates against depression is, of course, some form of simple sugar.   For many, the most effective medium to carry that sugar is chocolate.  For others, it’s ice cream (often chocolate ice cream, though all flavors work).  Still others seek pastries, or muffins, or soda, or candy, or alcohol.   Alcohol is also a form of sugar and shares many of the same effects on blood and brain chemistry as other common forms of sugar.     

The reason we self-medicate with simple sugar – as a form of carbohydrate that is rapidly absorbed by the body – is that it raises brain levels of serotonin, the chemical neurotransmitter that relieves stress and promotes feelings of well-being, relaxation, and optimism.  When elevated, serotonin causes us to experience greater feelings of safety, confidence, and self-control.   It also increases our ability to focus on our work or concentrate on a given subject of study.   Serotonin causes deeper states of relaxation and deeper sleep. 

On the other hand, when serotonin falls, we can experience higher levels of anxiety, fear, and increasing degrees of depression. 

Many of the drugs used to treat depression focus on this same neurotransmitter.  These drugs, known as selective serotonin reuptake inhibitors, cause serotonin to pool in the gaps, or synapses, between brain cells, also called neurons.  This causes a greater abundance of serotonin to be present in the brain. 

Unfortunately, simple sugars raise serotonin levels for only for short periods.  Even worse, their net effect is to create lower serotonin levels over time.  Like most recreational drugs – as well as many pharmaceuticals – sugar gives a short-term benefit and a long-term addiction. 

Here’s how it works.

Once ice cream or chocolate or some other sweet food is eaten, the sugar rushes into your bloodstream and causes a rapid rise in blood sugar levels.  Your brain sees this as a sudden threat to your life.  The reason?  High blood sugar can cause electrolytes in your blood to drop rapidly, which can bring on potentially fatal heart failure.   Sudden elevations in blood sugar can also induce brain swelling, coma, and death. 

In order to keep such nasty things from happening, your brain tells your body to burn the excess sugar immediately, or store it as fat.  Both acts clear the excess sugar from your blood, which is a good thing from the survival standpoint, but a bad thing from the serotonin and mood point of view.   The sugar may have threatened your life, but elevated serotonin in your brain and made you feel good.  Now it’s suddenly gone, which means a lot of the serotonin in your brain is gone, too. 

As brain serotonin levels fall, so too does your mood.  The lower your serotonin, the deeper your depression.   Alcohol has similar effects.  Like ordinary sugar, it causes a temporary alleviation of symptoms, but that relief quickly falls away, leaving the person depressed and hurting, which in turn stimulates a new round of cravings.  This, of course, is the basis for addiction. 

Other Dominoes Fall, Too

Sugar causes other changes in brain chemistry that are only now being understood, but indeed contribute to the onset and maintenance of depression. 

Whenever you eat a processed food, such as bagels, pastries, chocolate, or ice cream, the sudden elevation in blood sugar causes an equally large spike in insulin.  Insulin is the hormone produced by your pancreas that allows blood sugar to enter your cells and be utilized by your cells as fuel. 

When high insulin levels are sustained over time, your cells can become insulin resistant.  That means that your cells refuse to respond to the insulin and receive new blood sugar, or fuel.   In effect, the cells close their doors and windows to blood sugar and insulin.  When that happens in your brain, it sets off a chemical chain reaction that affects a whole array of brain chemicals known as kinases

Among the more important of these kinases is a substance called brain derived neurotrophic factor (or BDNF).  BDNF keeps your brain chemistry balanced, in part by protecting brain cells from the effects of other neurotransmitters, especially those that cause your brain to race unnecessarily and eventually burn out. 

Unfortunately, insulin resistance in brain cells causes BDNF levels fall.  Low BDNF causes the brain to brain experience higher levels of anxiety and fear, which eventually leads to increased depression.  And sure enough, when researchers examine the brains of people with depression, they find lower-than-normal-levels of BDNF levels.  This condition arises, of course, by chronically high consumption of sugar, processed foods, soft drinks, and alcohol. 

Cooked Grains, Pulpy Vegetables – Serotonin Without The Fall

Unlike the simple sugars found in chocolate and ice cream, the more complex carbohydrates found in whole grains and pulpy vegetables (such as sweet potatoes, yams, squash, carrots, parsnips, and onions) are slowly absorbed by the body.  These carbohydrates are long chains of sugars, wrapped fiber.  They must be worked on and broken down in the intestinal tract, which takes hours to accomplish.  The result is that carbohydrates are dripped into the blood stream at a slow and steady pace, providing hours of energy, along with prolonged and gentle elevations in serotonin levels.  

Rather than create a rapid rise and an equally rapid fall in serotonin levels, these pulpy vegetables and cooked grains (such as brown rice, millet, quinoa, and barley) cause serotonin to gently rise and remain high for hours at a time.  Those steady elevations in brain chemistry cause lasting states of optimism, confidence, the prolonged ability to focus and concentrate, and feelings of safety and well-being. 

Cooked grains and pulpy vegetables can lower weight and take a person out of insulin resistance. 

Another enormously powerful tool for achieving both of these goals is to exercise daily.  Exercise lowers insulin and blood sugar levels, improves circulation, and elevates serotonin. 

The Destructive Cascade

The long debate over which came first, the chicken or the egg – or in this case, the anger or the biology of depression – is important.  Anger arises even in young children whose needs are chronically unmet, but do not have the awareness or the language skills to express those needs and the pain they feel.  Instead, they turn to the array of anesthetics that the food industry offers children today – the never ending flow of fast food, fried foods, fake foods, sugary snacks, candy, and soda pop. 

Adults do the same thing.  Many add alcohol and recreational drugs, which only increase the rates of insulin resistance, depression, and other disorders.   

Yes, these foods, drinks, and drugs dull the senses and makes children and adults less aware of their pain.  But there is a big price to pay: overweight, metabolic syndrome, diabetes, obesity, heart disease, cancer, attention-deficit, hyperactive disorder, Alzheimer’s and Parkinson’s Disease, along with many other degenerative illnesses. 

The Western diet has become the antidote to emotional and psychological distress.   But the price is a growing depression over the conditions of our lives and the state of our world. 

What We Can Do About It

All of this points directly to a set of solutions.   If you are depressed, and especially suffer from chronic depression, try the following healing steps. 

  1. Stop processed sugar and processed foods for all the reasons mentioned above. This does not mean that you must give up sweet foods.   There are plenty of tasty snacks and desserts that do not contain sugar.  Eat foods sweetened with rice syrup, barley malt, maple syrup (preferably the darker, grade B varieties), apple juice, and other sweeteners that do not cause an insulin spike.  Cook fruit and learn to make desserts.  (More dessert recipes will appear in a future Tom Monte Monthly.) 
  1. Eat cooked whole grains and lots of fresh vegetables. Ideally, we should have at least two to three servings of grain per day, along with three servings of green and leafy vegetables, two or three servings of pulpy vegetables (such as sweet potato, squash, beets, and onions), and two or three servings of roots (such as carrots, parsnips, burdock, turnips, and rutabaga).

    The grains and pulpy vegetables will provide lasting elevations in serotonin.  If this diet is maintained over six months, a new baseline brain chemistry can be established.  The brain will view those higher levels of serotonin as the norm and thus will maintain those levels habitually.

    We must first train the brain to adapt to these elevated serotonin levels for an extended period of time with the use of diet, exercise, and other tools, some of which are listed below. 

  1. Exercise daily.  Walk, play a game, dance, do a martial art, or Chi Gong – but get at least 30 minutes of exercise every day of the week.  Exercise alone takes us out of insulin resistance, boosts brain levels of serotonin, and balances brain chemistry overall.   Thirty minutes of exercise a day – all by itself — has been shown to alleviate moderate depression. 
  1. Express your anger in a safe environment and find its true source.  We must express our truths and the anger that surrounds those truths.  Powerless anger arises from a belief that you cannot fulfill your most cherished ambitions and dreams; that you cannot love and be loved in the way you long for; and that you cannot be fulfilled in this lifetime.  All are false beliefs that form the basis for depression.

    Write your anger, sadness, fears, and experiences of betrayal and loss in a dairy or journal.  Express your deepest feelings and experience compassion for all that you have been through.  

    Get help.  Seek out healers, counselors, and therapists who can guide you into the deeper levels of your experience of life.  These people can also help you discover and express those long-denied truths whose very expression can free you from self-limiting beliefs that help create depression.

    Meanwhile, refuse to act from powerless anger and do not take out your anger on innocent people, especially those who love and care about you. 

  1. Increase consumption of Omega 3 fatty acids.

    Researchers have shown that consistently eating omega-3 fatty acids in fish oils, flax seed oils, walnuts, canola oil, and olive oil will optimize insulin function and have an anti-depressant effects.

    Israeli scientists recently reported that the brains of depressed laboratory animals contain far higher levels of omega 6 fatty acids, especially arachidonic acid, common in corn oil, soy oil, safflower oil, and processed foods.  

    Conversely, laboratory animals that experienced more positive mood and more optimal brain function had higher levels of omega 3 fatty acids in their brains.   Researchers found that although the depressed animals did indeed have omega 3 fatty acids in their brain, the proportions were low in comparison to their omega 6 levels.

    “The finding that in the depressive rats the omega-3 fatty acid levels were not decreased, but arachidonic acid was substantially increased as compared to controls, is somewhat unexpected,” the scientists reported.  “But the finding lends itself nicely to the theory that increased omega-3 fatty acids intake may shift the balance between the two fatty acids in the brain.  It has been demonstrated in animals studies that increased omega-3 fatty acid intake may result in decreased brain arachidonic acid.”

    The Mediterranean diet is rich in fish and seafood – excellent sources of omega-3 fatty acids – and low in processed foods, thus offering lower levels of omega-3 fats and specifically arachidonic acid.   Also, Mediterranean people use olive oil for cooking, as opposed to safflower, corn, and sunflower oils, all rich in omega-6s and specifically arachidonic acid.  Researchers have consistently found that people who follow a more Mediterranean-like diet have more stable and brighter moods than those who eat a diet rich in processed foods and oils rich in omega-6s.  The dietary program described in this book can raise your omega-3 levels and lower your omega-6s, thus elevating your insulin sensitivity, elevating your mood, and enhancing your brain function. 

  1. Research and begin a regimen of any of the following: St. Johns Wort, Sam-e, vitamin D, and other natural anti-depressants. St. Johns Wort has been shown to be effective against mild to moderate depression.  So, too, has Sam-e and other natural anti-depressants.   (More about all of these natural remedies in a future Tom Monte Monthly.) 
  1. Seek out practitioners of healing touch, such as acupressure, shiatsu, Jin Shin Jyutsu, Rosen Method, Therapeutic Touch, and other forms of bodywork.  Healing touch has been shown to promote greater circulation, relieve stress, and relieve muscles and other tissues of longstanding tension, spasm and trauma.  All of these changes can combine to create greater optimism and feelings of well-being.  In short, they promote increases in brain levels of serotonin.   
  1. As your condition improves, consult your doctor about creating a plan to gradually wean you of the medications. Do not change your medication regimen, or go off medication, without your doctor’s guidance.  Moreover, have a team of healers in place even as your doctor gradually weans you off your anti-depressants.  You’re going to need support.  Healers of many different kinds can provide that support and help as you regain your emotional and psychological equilibrium again.

    In order to heal depression, we must seek our own inner truths and learn to express those truths with growing compassion and love for yourself and others.  This alone will bring about the healing of your own heart.

    Healing depression is a spiritual journey, one whose gifts include greater self-acceptance and self-love.  Such a path cannot help but heal you.