A new set of anti-depressants


In his excellent new book, “Lost Connections,” Johan Hari recounts the story of a Cambodian vegetable farmer who lost his leg when he stepped on a landmine. After receiving medical care and being fitted with a prosthetic leg, the farmer was still in chronic pain and could no longer work his land. He fell into a profound depression. His community gathered around him, listening to his struggles and offering support. A neighbor had the idea that although regular farming was now too difficult, he could probably be a dairy farmer. The village pooled funds to buy the man a cow. His sense of purpose was restored, and the man’s depression lifted. Later a psychologist came to the village to study the effects of living in an area littered with land mines. While conducting his research, the psychologist explained the concept of “depression” to the villagers as a sadness that does not go away. They agreed that this definition had applied to the farmer. But when the psychologist told them about anti-depressants, medicine designed to lift the depression, they told him that they already had such medicine: “The cow is the medicine.”

The cow was the medicine. So were the medical care and the community support. In isolation, each of these building blocks was not enough. Taken together, the depression lifted.

In your own life, what are your anti-depressants? One of them might be an actual SSRI, but even if that’s the case, medicine is usually just one component of managing anxiety and depression. What are the building blocks you cobble together to live as well as you can and to keep anxiety and depression at bay? If you think you need more or better supports, here are some areas to look at:

Physical needs: At bottom, we are animals. If we are denying our bodies the nutrition, exercise, and sleep we need, our bodies will rebel. People who over-restrict calories feel nervous and agitated; people who take in too many feel sluggish and low. Our bodies rely on movement to operate properly. And sleep, is crucial for all cognitive functioning – especially mood regulation.These are things we all know, yet rarely prioritize. A hallmark of our human hubris is to believe our bodies can be dominated and controlled, or conversely, ignored. Sometimes we don’t even realize we are abusing ourselves until our body pushes back in painful and debilitating ways. What would your schedule look like if it were arranged to prioritize your physical needs? If you made time each day to move your body for at least 30 minutes, whether that be dancing around your living room, weight lifting at the gym, or taking a walk during lunch. What if you made time in the evening to unwind and then slept at least 7 hours? Or took time to do weekly meal planning and prep so that your diet doesn’t crater once the week gets away from you? Seem like too much? If so, what changes do seem within reach? This might be the most impactful step you could make toward improving your mental health.

Connection: The research abounds that we are people who need people, and yet when we are feeling low we tend to isolate ourselves, under-value the connections we do have, and focus on relationships that have not met our expectations. We tell ourselves a story that we are alone, that we are not loved, that we have no one, and often that is not the case. If this sounds like you, you are going to need to start pushing yourself to connect even, or especially, when you don’t really feel like it. If you are feeling down and don’t want to reach out to talk about yourself, instead reach out and focus on what is going on for someone else. It can be a huge relief to focus on someone else’s ups and down instead of your own. And don’t disregard lower level interactions; chatting with your barista, small talk with co-workers, and even saying good morning to the people you pass everyday on your commute are all reliable mood elevators.

Purpose: We tend to venerate those who have found their PURPOSE, all caps, and so we should, usually these people are doing amazing things in the world. But if you aren’t lucky enough to know what your PURPOSE is, there is no shame in starting with a smaller purpose. Look around at your community and see if there is some small need that you could fulfill. You could take it upon yourself to keep the street you live on clean. You could take your elderly neighbor’s dog out to get some vigorous exercise. You could start and maintain a lending library at your office. Look for something that you can engage in consistently, that is important to you (not IMPORTANT, just important), and is a net positive for your community.

Awe: Take a minute to think through times in your life that took your breath away. Visiting the Grand Canyon. Listening to an amazingly talented street performer. Watching your child perform in a school event and thinking, “Look at this amazing person you’ve become.” There are two parts to injecting your life with more awe-inspiring moments. First, you can plan highlight moments. People who made an effort to watch the solar eclipse last year or who plot to visit every National Park are planning for awe. I love going to the theater, and if I hear about an extraordinary performance, I snap up a ticket and go see for myself, even if I have to go alone.The second part is lingering over moments right in front of us. Your neighbor’s brand new baby, beautiful writing in the novel you are reading, trees blossoming once it is finally spring. There are so many awe-inspiring things and people all around us, but if we rush we tend to miss them.

Take a minute to evaluate how you are doing in these four areas. Is there room for improvement? What is the next step you could take to better meet your physical needs, to feel more connected, to create more purpose and awe?