Dueling with Depression
Those who know me well know I struggle with clinical depression. I have good weeks. I have bad weeks. Then I have those devastating weeks where putting on my shoes feels equivalent to summiting Mount Everest.
It sounds ridiculous, I know. I even tell myself how silly it is, sitting on the edge of my bed in the dark, staring down at my inert Vans. “It’s just a pair of goddamn shoes,” I tell myself. “Put them on! Lace them up! Get out of the apartment!”
And I do — most days. But it takes an enormous amount of energy to walk out that door. And the entire week I feel excruciatingly empty, a suffocating void in my chest threatening to collapse my ribcage.
Depression is not synonymous with sadness. There’s no “snapping out of it.” Andrew Solomon, writer and LGBT activist who lectures about his own struggles with mental health, defines depression as the inverse of vitality.
I sometimes equate depression to swimming in a river against the current with lead weights fastened to my ankles. I can stay above the surface of the rushing water if I kick my feet hard enough. But constantly fighting to keep from drowning and performing simple, everyday tasks (such as doing the laundry) is bafflingly and frustratingly exhausting.
I’ve tried numerous medications with negative results. Zoloft did nothing but make my mouth dry and truncate my libido. A generic form of Prozac made my entire body achy all the time. And lithium made me feel obstinately ambivalent about everything.
And I’m not alone. Dr. Stephen Ilardi, Associate Professor of the Department of Psychology at the University of Kansas, has spent the last 20 years researching depression.
“One in nine Americans over the age of 12 is currently taking an antidepressant,” says Ilardi in a 2013 TED Talk lecture he gave at Emory University, emphasizing the rate of antidepressant use over the past 20 years has increased by more than 300 percent. “And what’s happened to the rate of depression in the interim? It’s continued to increase.”
That’s not to say that antidepressants (and psychotherapy) haven’t helped others. But what about those like myself where medication has only resulted in insufferable side effects?
And as a writer living alone in an overpriced Denver apartment, are there any complementary, inexpensive treatments? Do they actually work? Are there studies demonstrating their efficacy?
Exercise
Exercise sucks. There, I said it. I know some live for the gym, but I’d much rather smoke pot and binge watch Star Trek: The Next Generation. But I cannot ignore the numerous studies which demonstrate exercise being just as effective against depression as some medications.
Even as little as 30 minutes of aerobic exercise three days a week has shown positive results. As Dr. Ilardi puts it, “Exercise is medicine.”
One often-referenced classic study showed that “although antidepressants may facilitate a more rapid initial therapeutic response than exercise, after 16 weeks of treatment exercise [they were] equally effective in reducing depression among patients with MDD [Major Depressive Disorder].”
So how exactly does working out help with depression?
“Of course there are lots of theories, and we don’t know for sure,” says Dr. Dana Steidtmann, Senior Instructor and Licensed Psychologist at the University of Colorado Depression Center. “One of the findings we see is what appears to be an important chemical in the brain called Brain Derived Neurotrophic Factor (BDNF). There’s some thinking that this may be implicated in our mood and mood functioning.”
Steidtmann worked with Dr. Ilardi in developing lifestyle treatments for depression, with exercise being one of the most potent strategies. “There are only a handful of ways that we can get more BDNF, and one of the ways appears to be through aerobic exercise.”
But when merely brushing your teeth for two minutes feels like an impossible task, how do you find the motivation to bike around Cheesman Park for 30 minutes dodging inattentive drivers?
“Like any new habit we’re trying to start or get back into, starting small is pretty important. People just telling themselves ‘I just have to go for five minutes. If I want to go longer I can, but I just have to do five minutes today.’”
In addition to starting with small goals, Steidtmann adds that “having a workout partner or a spouse that you commit to walking daily can be really helpful for people.”
Or in Star Trek parlance, find yourself a “Number One” and “Make it so!”
Bright Light Exposure
In the words of Lord Eddard Stark, “Winter is coming.” This means shorter days with fewer days of sunlight.
“Our daily body rhythm, what we call our circadian rhythm, appears to be regulated through the way light is taken in through the eye,” says Steidtmann. “Light is essentially the way we keep our daily rhythm in check. Sometimes those cycles can get off a little bit, and bright light can help reset them.”
Not only do special receptors in the back of the eyes affect our body clock, they can also regulate serotonin levels in the brain which can potentially trigger what’s commonly referred to as Seasonal Affective Disorder (SAD).
And for those like myself who already struggle with clinical depression, the condition is exacerbated.
Studies have demonstrated positive results using light exposure for those struggling with SAD, and one pilot study used light therapy for cystic fibrosis patients suffering from depression. “There was a significant decrease in depressive symptoms for all subjects receiving light therapy … and [it] resulted in improved depressive symptoms and quality of life.”
Steidtmann recommends bright-light exposure on sunny days without wearing sunglasses. “Or you can buy specialized light boxes that you sit in front of for 20 or 30 minutes a day.”
Of course the variables in the studies supporting these claims must be taken into account (such as sample size, possible report bias, or the limited types of antidepressants tested). But exercise and light exposure are inexpensive, supplementary approaches which I myself use to manage my own depression.
I plan on writing about additional strategies which have scientific backing, such as Omega-3 intake, sleep hygiene, or even (to my surprise) acupuncture. Until then, I’ll continue kicking my feet and fighting the river from carrying me off into that distant horizon.
If you’re struggling with your mental health and need help, contact the Colorado Crisis and Support Line at 844-493-TALK (8255) or visit their website at ColoradoCrisisServices.org
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Greetings. I’m Mike. People call me Mike. I’m just a gay guy trying to be creative before I’m kicked off this spinning, planet-sized spaceship hurdling through the void of space. Writing and photography are the creative outlets I spill my brain into when mental monsters start clawing at the back of my eyes. I only hope these articles provide readers with a few insights I’ve carefully gathered in cupped hands, cracked hands that have dueled for decades with these nebulous shadows that haunt so many lives. Plus, writing is a great way to pass the time on this planet-sized spaceship hurdling through the void of space.