When you think of depression treatments, odds are, your mind immediately goes to medication. After all, you can’t watch TV for more than 30 minutes without seeing a commercial advocating the life-improving benefits of one pharmaceutical or another. And certainly, medication is a common, very visible, and often quite effective treatment for depression.
However you may be surprised to learn that in a survey of 4,064 people who have lived with depression or bipolar disorder, most respondents didn’t rate medication among the most effective treatments that contributed to their recovery. In fact, the highest-rating medication came in at number 23!
“While the ‘most effective’ treatment regimen for depression is different for each patient, it’s clear that a multipronged approach that goes beyond ‘just’ medication often works best,” says Graeme Cowan, who conducted the aforementioned survey and is the author of Back from the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder (New Harbinger Publications, Inc., 2014, ISBN: 978-1-608-82856-2, $16.95, www.IAmBackFromTheBrink.com).
“Unfortunately, you may not receive that information from your healthcare provider(s)—depression recovery research is heavily biased toward areas where more money can be made, with minimal attention to lifestyle and alternate approaches. And to further complicate the situation, doctors and counselors often rely on the tools they’re familiar with. If you’re holding a hammer, everything looks like a nail.”
Cowan’s interest in exploring a wider range of depression treatments stems from his own experience. In Back from the Brink, he tells the story of his multiple suicide attempts and five-year episode of severe depression. The book is filled with real stories of hope and healing, information about treatment options and medication, and tools for putting the book’s lessons into practice. With a foreword by Glenn Close, the book also features interviews with people from all walks of life, including former U.S. Representative Patrick Kennedy, Google’s Director of Public Policy Bob Boorstin, former NFL player Greg Montgomery, and more. A free excerpt from the book, which contains Cowan’s full research results, can be downloaded from www.IAmBackFromTheBrink.com.
“My approach to recovery became extremely holistic,” Cowan shares. “It involved dietary changes, meditation, exercise, intimacy with others, fulfilling work that relied on my strengths, therapy, and more—yes, including medication. While I would never discount the value and effectiveness of medication in treating many cases of depression, I do want others to know that there’s much more you can do to control this disease than just getting prescriptions refilled.”
Here, Cowan shines a light on 10 of the most effective depression treatments (out of 60 total options) from his 4,064-person survey:
1. Emotional support from a psychiatrist and/or psychologist. Interestingly, the reassurance and support from mental health professionals was rated more important than the specific treatment they provided.
“I know that during my horrendous five-year depressive episode, the reassurance and support of my psychiatrist, Dr. Fisher, was paramount,” Cowan shares. “This finding highlights the importance of having a good relationship with your clinician. In fact, scientific literature indicates that the quality of the relationship between clinician and patient is the best predictor of a successful outcome. So if you don’t sense your professional cares about you and your recovery, no matter how technically brilliant he or she is, I recommend finding another.”
2. Peer support groups. These groups are run by people who have all lived with depression, bipolar disorder, or anxiety. The members are at different stages of recovery and encourage each other to take small steps each week that assist in recovery.
“I helped run Bounce, a support group for people with mood disorders, for eight years,” says Cowan. “The main benefit members reported was meeting people who really understood what they were experiencing. Like me, they learned that suffering in silence just doesn’t work. And many even reported that the emotional support and insight they received from the group was the most important element of their recovery.”
3. Moderate and vigorous exercise. In this survey, moderate exercise was defined as 30 minutes of brisk walking four to six days per week, or the equivalent. Vigorous exercise was defined as running for 30 minutes four to six days per week, or the equivalent.
“The fact that exercise placed so highly as a treatment option isn’t surprising,” Cowan comments. “Research shows that a 20-minute brisk walk, or the equivalent, significantly improves mood for up to 12 hours. Exercise also boosts energy, confidence, and perception of sexual desirability. Remember, you can’t control the slings and arrows that come your way each day, but you can control your habits—including whether or not you’re active.”
4. Other psychotherapy. Cowan’s survey defined “other psychotherapy” as “involving a process whereby the therapist helps you explore and resolve issues related to past experiences and/or your personality style.”
“The causes of depression can often be traced to personality and aspects of social functioning in areas like work, relationships, and other social roles,” he explains. “The goal is to understand how these factors are operating in the patient’s current life situation and how they are involved in his or her depression.”
5. Fulfilling work—paid or voluntary. This surprising finding reinforces a study by Gallup, which revealed that work is essential to our well-being. In fact, people with high career well-being are twice as likely to be thriving in their lives overall.
“My 15 years of experience in recruitment, outplacement, and career management fully confirm this finding,” Cowan comments. “And it’s important to note that when it comes to the psychological benefits of fulfilling work, a paycheck doesn’t matter. In fact, an important component of my own recovery was volunteer work. The important thing is to utilize your inherent strengths. This will boost your self-esteem, give you a reason to get out of bed, and help you make fulfilling connections with others.”
6. Counseling. This type of therapy is not about exploring unresolved themes; instead, it’s a practical process in which the counselor may take an educational approach.
“Counseling involves you and the counselor discussing strategies for dealing better with day-to-day life,” says Cowan. “Often, that will include exploring specific problems with which you’re dealing and identifying preferred solutions.”
7. Emotional support from family and friends. Even if you’re reluctant to discuss how you’re feeling with those closest to you (and many, many people are due to depression’s undeserved stigma), chances are, they’ve noticed changes in your mood and demeanor and would like to play a larger role in supporting you.
“Even though loved ones often feel that they are pushed away by the depressed person, this result highlights how essential their compassion and care actually are,” Cowan notes. “In my experience, the vast majority of people react with genuine compassion (and often, relief!) when a loved one asks for help. And again, I simply can’t overstate the value of not isolating yourself and of receiving support.”
8. A good night’s sleep. One of the common symptoms of depression is early wakening or a disturbance to normal sleep patterns. And for people who are depressed, getting a good night’s sleep can feel like hitting the reset button.
“Regular exercise, diet, and tools like meditation can help you to experience a better night’s sleep,” Cowan comments. “However, you may need to seek professional help to address this issue. When I was in an acute stage of my illness, the medication that helped me to sleep was a godsend after spending so many nights staring at the ceiling.”
9. Cognitive behavioral therapy (CBT). People who are suffering from depression often have an ongoing negative view of themselves and the world around them. Whether they are in the midst of a depressive episode or not, many or all of their experiences are distorted by a negative filter.
“Cognitive behavioral therapy, which is normally conducted by a psychologist, focuses on changing those negative thought patterns,” explains Cowan. “It shows people how their thinking affects their moods and teaches them to think less negatively about life and about themselves. Usually, it involves doing structured homework tasks.”
10. Reducing intake of alcohol and other non-prescription drugs. Many people with depression self-medicate with alcohol and other illicit drugs in order to alleviate symptoms.
“Ironically, while there can be short-term relief, excessive consumption of these drugs is ultimately unhelpful, and will spark many more problems than it solves,” Cowan states.
“After trying 23 different medications, my personal view is that they can ease symptoms, but they aren’t the key to long-term well-being,” Cowan concludes. “So while I’m glad medication is on the survey, I’m also glad that the survey results confirm how essential it is to consider other lifestyle and treatment options.
“If you or someone you love is battling depression, I encourage you to take a holistic view of treating depression. When you integrate medicine, therapy, and lifestyle changes, you increase your odds of experiencing recovery.”
About the Author:
Graeme Cowan is the author of Back from the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder (New Harbinger Publications, Inc., 2014, ISBN: 978-1-608-82856-2, $16.95, www.IAmBackFromTheBrink.com). He is also a speaker who helps people build their resilience, well-being, and performance. Despite spending most of his career as a senior executive in Sydney, Australia, with organizations like Johnson & Johnson, Pfizer, and A.T. Kearney, Graeme had struggled with depression for more than 20 years. Graeme reemerged with not just a best-selling Australian book series to his name but a new attitude toward the way individuals approach recovery.
He is also the author of the report “The Elephant in the Boardroom: Getting Mentally Fit for Work,” which highlights that 86 percent of people with a mood disorder in the workplace would rather suffer in silence than discuss their illnesses with colleagues. Cowan is one of Australia’s leading speakers and authors in the area of building resilience and mental health, and has appeared regularly on national Australian television and radio and had articles written in the Australian Financial Review on workplace health. He is also a director of the R U OK? Foundation, whose slogan is “A Conversation Could Change a Life” (www.ruokday.com), and was supported in its launch campaign with video promotions from Australian actors Hugh Jackman, Simon Baker, and Naomi Watts. Cowan is passionate about sharing his journey and helping others to find hope, know they are not alone, and find a way back from the brink.
Sign up for his free 30-Day Mood Challenge at www.IAmBackFromTheBrink.com.
About the Book:
Back from the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder (New Harbinger Publications, Inc., 2014, ISBN: 978-1-608-82856-2, $16.95, www.IAmBackFromTheBrink.com) is available at bookstores nationwide and major online booksellers.