Natural help for chronic depression

Natural help for chronic depression...

Natural Help for Chronic Depression

This paper focuses on Out of the Blue: Six Non-Medicating Ways to Relieve Depression, a presentation given by Bill O’Hanlon in which he describes how his experience with debilitating depression earlier in life helps inform his practice. He describes six ways to interrupt, externalize, accept, interject hope, become mindful, to “reduce suffering in the midst of suffering”, and jolt one into new brain functioning. Although a beginning counselor wants to know exactly which intervention to use and when, Bill says try one or all—a client who becomes a scientist and researcher in their own experiment, is one who is most likely “psychotically optimistic” that their situation will change-- if they just keep trying something new.

There is a myth that depression is caused by body chemistry or genetics and can only be treated by medications which change that chemistry. Bill says counselors can intervene in the process of depression. He played a tape of a man describing his downward spiral which began with mild depression, and then grief from a death of a family member. From here it sank in to his thinking, turned to immobility, and then to dread of being in a bottomless pit. He forgot how to relate to others, couldn’t figure out how to put his shoes on as he was imploding. He became anxious as he realized he had become other than who he was, and became afraid of this thing which had descended upon him and made its way inside as if he had opened the door…he could not live, nor could he die.

In his presentation Bill O’Hanlon begins with marbling, or a way of interweaving facts about the client’s present state, with times when they had functioned well in the past, with good or funny moments…anything to get the brain out of the entrenching groove it is digging. He cites the Seligman studies where participants who were asked to write positive things daily, expressed being "happier" at the six month follow up. In another study, writing three good things every day for 15 days showed 94% of participants no longer severely depressed. Counselors need to be cognizant that talking about problems can be depressing; simple, positive interventions can enhance well-being.

Bill’s next suggestion is called undoing depression. The counselor can look for patterns. Where is the person stuck, how can these patterns be influenced to change? Ask the client about anything that has worked in the past; how can we help change? By doing. Being out in nature has been found to be a catalyst for healing—through viewing or doing. Hypnotherapist Milton Erickson once told a patient to “go be depressed in the library”. The patient begins to read about his interest in spelunking. One day he meets someone in the same section and they strike up a conversation…soon they were going on their first field trip to the caves. The patient has made a friend, and they are doing activities. Dr. Erickson didn’t know what would work, he just knew that any new environment may make something happen.

The third application is shifting relationship to depression. This I practiced myself. I knew that the emotion was just that—an emotion, which had no power over me, or who I was. Seeing depression as an intruder, or something that has descended upon the person, the client can build self-efficacy by not becoming overpowered—or even throwing the effect of depression out! Narrative therapy depersonalizes depression. The application changes the language around depression to I am depressing, or I am responsible for taking this in to myself (Corey, 2013). I would have the client ask if they can be depressed and do what they need to do for themselves anyway. Mindful Behavioral Cognitive Therapy helps people to learn new thinking and actions so that their recovery time far outweighs that of medication therapy. Bill says there is a reason for depression, and the client should attach meaning to it—it is possible that depression helps one to think more deeply about their current struggle or position in life, and is a pre-cursor to change.

Next is challenging isolation. A disconnect from others is a vicious cycle that comes from and leads to depression. Others may find it impossible to be with someone who is depressed, so they might be left, or they may withdraw due to feelings of low self-worth and that others would be better without them. The more a client connects, the quicker they will come out the other side. Bill notes that there may be more depression in modern society due to disintegration of the family unit, social media contraptions, and the sheer number of people who live alone. The average American has two friends. Upon my recovery from multiple organ failure in 1993, I found that my physical foundation had to come first, and then from inside I had to re-build a pathway out of self and from a place that appeared to be like a very deep depression. I found that same pathway Bill mentions: First to inner self, then to social resources. Mine were animals, then therapist, then friends—and then continuing to build connections to outside of self. Research says that being in nature helps this process of coming out of self, and to create personal meaning for life, and finally find the higher purpose for our being here. Bill says the therapist can help the client to investigate where they lost connection along this pathway, and discover how to work to restore function.

The future with possibilities application is another I experienced. Bill says anything that looks like a hopeful possibility can keep someone from suicide. Depression is a stuck, one dimensional mode, without hope of change. He says hope can be restored through a future pull, or bringing the future to the client. Victor Frankl projected himself into a future, seeing himself alive after surviving the death camps in World War II. In my own experience as I re-gained physical life, I realized that I had to choose to live as if I were going to live. I had to begin to do in order to build a foundation on which life could be sustained, and of which memories are made, one day at a time. I saw my Everest vision as a ranch for recovering people who would learn to live naturally, and where I would have much to offer others. Bill suggests exercises such as writing a letter from your future self, that will help your now self to reach beyond this time.

And the last suggestion—and the greatest in my opinion—restart brain growth. Because the brain has become flat and non-reactive, and stuck in a groove, they have died from lack of integration and movement. As a teen I used to have a counselor who said, "use it or lose it" (or was it "move it or lose it"?) A friend of mine was a Viet Nam veteran who was blown up in a landmine explosion, and decided after 11 years of fighting the VA for benefits he wanted his 100% disability benefits. He sat on the couch and would do little for himself. Two years later he was worse in his PTSD, his range of motion, in everything. After sitting for so long, he could hardly get up again. Bill cites stress as suppression of neurogenesis in the hippocampus--much like depression. Studies have shown that experiences and body sensations change brain pathways, and that exercising certain behaviors such as internet gaming (Lortie & Guitton, 2013) causes reinforcement of that pathway (and only that pathway)--in detriment to other pathways and functions, which then begin to disintegrate. My friend's TV watching pathway was the only strength left in him and he did get a 90% rating by the VA after all.

Anything which shocks the brain into action will cause a reaction of the body to attempt to heal, possibly causing a strengthening such as what happens to the bones of joggers. There are brain hormones which encourage growth, and depressed persons have less of these hormones. But medications, exercise, healthy living, learning new things, music, and novel physical movements help to stimulate the production of these hormones. It is possible that this is why medications work—not that they are controlling certain neurotransmitters, but that they are causing damage the brain seeks to heal. Studies have shown that exercise has major effects on depression. The amount of exercise is proportional to the amount of change seen in the brain. For every 50 minutes of exercise per week, there is a correlated 50% drop in depression. The counselor has the option of taking what I call "walk and talk" sessions—something I could not get my own counselors to do with me 20 years ago—or suggesting the client get an exercise buddy. The counselor has an in wherever the client has another motive for exercise, such as they want to walk their dog, they want to improve memory or lose weight.

We may search for patterns that work for the client, and begin to include family and friends in the therapy also, creating a circle of support. But most of all, as counselors we need to convince the client at times that they should build a repertoire of self-administered skills, just in case they find themselves alone on a desert island without a soccer ball named Wilson on which to project.

References

Corey G. (2013). Theory and practice of counseling and psychotherapy, 9th ed. Belmont, CA: Brooks/Cole, Cengage Learning

Lortie CL, Guitton MJ. (2013). Internet addiction assessment tools: Dimensional structure and methodological status. Addiction, 108:1207-1216

O'Hanlon B. (2016). Out of the blue: Six non-medication ways to relieve depression. [Presentation, 1/15/16]. Irvine, CA: California Southern University