This post is in response to Are Antidepressant Medications the Next Drug Abuse Epidemic? by Susan Heitler
(c) ferli
Source: (c) ferli

The following excerpt from my recently-released book, Prescriptions Without Pills, suggests eight ways to brighten your mood when you are feeling down.

Use one or more of the eight as needed, on their own for mild low moods, and liberally in conjunction with meds and/or therapy for a more serious depressive episode.

Rx 2.6 |  Strengthen yourself with AGGRESS-N, 8 natural antidepressants.

AGGRESS-N is my acronym for eight re-energizing factors. Use them for an emotional uplift.

Notice the similarity between the words aggression and AGGRESS-N. Getting aggressive by taking the anger route to get what you want also can prevent depression. As a young man once said to me, “When I fight, I feel good.”

Aggression in the usual sense of fighting can in fact re-energize you when you feel down. Aggression however carries the risk that you may feel better by making the receiver of your angry words and actions feel worse. While that outcome may sometimes feel tempting, hurting others is likely eventually to have unfortunate impacts on everyone involved.

If you fight for a positive cause, that kind of fighting can, in fact, give your life meaning, purpose, and an energy boost. Fight for better schools, for instance. You will feel better and the schools, hopefully, will benefit.

The eight AGGRESS-N factors, however, do not involve fighting. Rather, they infuse you with positive energies. That's why they have little to no apparent downsides, yet can bring many benefits.

c) stevanovicigor
Source: c) stevanovicigor

Rate yourself on how willing you might be to incorporate each factor into your anti-depression treatment plan. Score yourself from 0 (Not of interest to me) to 10 (I'm totally wanting to do this)

A | Attitude shift ___

Switch your view of yourself from seeing yourself as a victim to seeing yourself as a primary actor. A poor-me victim stance perpetuates depression. "Look what you have done to me" keeps you feeling powerless.

Believing that you are the victim of circumstances, of others’ misbehavior, or of anything external can leave you waiting helplessly for others to change. Instead, seize control by asking yourself, “What could I do differently to get a better outcome?”

Taking charge is vital because depression is a disorder of power. When you feel like you have less power than someone else with whom you are involved in a conflict, and talking cooperatively to find a win-win solution is not an option, you are likely to give up. Giving up on what you want triggers depression.

Beware of blaming. Blaming gives you a false sense of power, when it in fact dis-empowers you. 

Feel the power difference between the blaming "he makes me feel" stance and an empowered "I feel..." stance in the following example:

a) “He makes me mad.”

b) “I feel mad when he’s late for dinner...so I think I’ll start aiming for us to eat a half hour after the time we agree on. Then we can sit and enjoy a few quiet minutes together before dinner if he’s on time. If he’s late, we’ll be right on time.”

Keeping an empowered problem-solving attitude can help you in even the most difficult situations.

The following case, a Holocaust story, illustrates this principle.

I met Selma over 30 years ago when she attended a lecture on depression that I was giving for the staff at the hospital where my office is located. Selma exemplified dramatically the refusal to slide into a victim mode.

In the lecture I suggested a dilemma. What would you do if you stayed late at work and then discovered, as you were ready to leave, that the exit door was jammed? Most people in the group offered a suggestion or two and then gave up, succumbing to a depressive collapse. Selma, by contrast, offered one idea, then another, and another, and then yet another ingenious way to exit the building.

I was impressed. After the session, I asked Selma how or why she had learned to be so inventive, never giving up in a situation that others quickly regarded as hopeless.

“When I was growing up in Eastern Europe in the 1940s, my mother, my sister, and I lived for three years fleeing the Nazis. We hid in forests and barns, moving on each time our hiding places looked at risk. We knew that giving up meant death. Each time we faced a new danger, we found yet another option. That’s how we survived, taking care of each other and always thinking of alternatives.”

What are the costs of defining yourself as a victim?
When have you been effective at active problem-solving?

G | Gratitude ___

Remember the old saying about seeing a glass as half empty or half full? Even if you feel understandably depressed about a negative circumstance, somewhere in your life there are elements you can feel grateful for. Gratitude is empowering. Empowerment counters depression.

Here's an example.

Dana and his wife, a vibrant newlywed couple, traveled to Hawaii for a vacation. As soon as they arrived at their seaside condo, they headed to the beach where the sparkling surf lured them in for a quick swim. The first wave surprised Dana with its power. The wave pummeled him, head-first, straight into the sand. Dana intuitively protected his head by reaching out with one hand to cushion his fall. As he stood up after the wave had receded, Dana realized that the wave that had slammed him down had broken a bone in his arm.

When Dana returned from the hospital with a cast, he and his wife sat on their patio and talked over what had happened.

“At first I was so mad,” he told his wife. “I won’t be able to play tennis or swim or do any of the sports I had thought we’d be enjoying here. Then I realized how lucky I am. Good thing I’ve always done so many sports. If I weren’t so strong and didn’t have such quick reflexes, that wave could have given me a major head injury. It could even have cracked open my skull so I ended up dead. I feel so fortunate!”

If you have been feeling down, how might you shift your focus toward more gratitude?

G | Giving ___

Most people have heard the saying, “Pick a card, any card.” It turns out that if you pick a recipient, any recipient, and give attention, affection, or money—if you give in any positive mode to any person or cause—your body will spurt forth a quick shot of the chemistry of feeling good. Lovingly taking care of a child, elder, pet or even a stranger can help you as much as you help them.

Cole was driving in his car, feeling discouraged about his life. His girlfriend had left him. Now his work situation was showing signs of fraying. While he waited at a traffic light, a disheveled older man standing in the center of the road walked up to his car. “Can you spare some change?” Cole reached into his pocket and pulled out a five-dollar bill.

The old man’s pale blue eyes looked straight at Cole. “God bless you, sir. I’m so appreciative,” the old man said.

Suddenly Cole’s spirit perked up. He felt fortunate now. His small act of giving had led to feeling profoundly blessed.

To whom or what might you give?

R | Relationship connections ___

Feeling depressed often creates an impulse to cocoon at home. Interacting with others can feel like it would take too much energy. Isolating feels safer, less overwhelming.

Contrary to the impulse to stay at home, far from others, that you may feel when you feel down, talking with others can lift your mood. Even exchanging a few words with someone in the grocery checkout line can grant you a small energy boost.

Chatting, receiving smiles, and enjoying shared humor all stimulate positive energy. When you talk with others, your emotional state and theirs eventually will match. Moods are contagious. If yours has been low, others’ more positive moods may raise yours.

Social interactions offer opportunity also for fresh perspectives. If you feel flummoxed by a practical problem, discuss it with others. They may offer you an alternative way of seeing the dilemma.

Therapists use the term reframe for a new and more positive outlook on a challenging situation. A reframe can bring you hope.

Socializing can also have its downsides. While connecting with others re-energizes most people, even those who crave solitude, it can sometimes add to discouragement. Seeing others’ apparently comfortable emotional states can heighten your awareness of your own state of discouragement.

Do protect yourself, also, from encounters with critical folks. Criticism can hammer you further down. For the most part, though, mingling with almost anyone who is in a normal to happier-than-normal mood can lighten yours.

The following extended case example illustrates the importance of social connection as well as several of the remaining AGGRESS-N factors: exercise, sleep, and sunshine.

Teresa, an attractive woman in her mid-60s, suffered one of the most profound depressions I have treated in my clinical practice. She was the only client I have worked with whose depression was so intense that she would curl up in fetal position in my office.

When Roy and Teresa both had retired the prior year, Roy had said that he’d like to move to a larger city in a warmer state. He was bored now that he no longer went each day to work. Especially in the dark, cold, and icy winters he felt housebound and stir-crazy.

Teresa said no.The thought of moving terrified her. She felt safe and loved in her familiar, decades-old friendship group. Moving sounded totally unappealing.

Roy nonetheless scanned the Internet for houses in sunnier cities. When Teresa reiterated her strong desire to stay where they had lived for more than 30 years, Roy replied dismissively, “That’s foolish. Living in a city will be fun. You’ll make new friends there.”

Roy found a house he liked in a warmer and sunnier climate. He bought it.

Within weeks of their move, Teresa slid into a deep depression. She seldom left their new home and either slept or cried most of every day. Reeling from a decision to move for which her input had not been considered, living in a new city where she had no friends, grieving the loss of her community, and angry at her self-centered husband, Teresa descended into depths of despair.

While Roy’s dominant-submissive mode of decision-making plus the loss of her former close-knit friendship group had triggered Teresa’s profound depression, the lack of social connections in her new city perpetuated it.

If you have been feeling depressed, how might you increase your social interactions?

E | Exercise ___

If you are seriously depressed, the last thing you may feel like doing is anything that takes output of energy.

Paradoxically though, pushing yourself to expend energy in physical activity, such as walking, biking, dancing, going to a gym, or doing virtually any sport, will generate more energy. The more you apply energy to moving your body, the more energetic you will feel. Paradoxically too, the harder the workout, the more positive energy you are likely to experience at the end of your workout.

Living now in a place with warm sunshine, Roy encouraged Teresa to join him in his new morning routine of after-breakfast walks. At first, Roy had to reach out and take Teresa’s hand to ease her off the sofa. Gradually, exploring their new neighborhood together became a fun activity that helped Teresa begin to re-energize (see New below). And the more Teresa walked, the more energy Teresa seemed to have to do other activities during the day.

Want to amplify the impact of your exercise on your moods? Exercise with music. Listening to music even without exercise can boost feelings of well-being. Ever noticed that in stores that play upbeat music, your enthusiasm for buying rises? Similarly, listening to music while you exercise makes your mood more upbeat.[i]

Sexual activity, especially in the context of a loving relationship, can prove to be a particularly potently anti-depressive form of physical exercise. In addition to activating your musculature, breathing, and heart rate, sexual arousal impacts your biochemical system by increasing the flow of oxytocin and other feel-good neurochemicals.

The quadruple positive synergies from combining exercise, music, sexual activation, and relationship connection offer especially significant energy enhancement. Of course, like socializing and exercising, starting to engage in sexual activity when you are depressed may feel like it would take too much effort. Still, the payoffs once you get past the starting gate can be high.

What kinds of exercise could you engage in to increase your energy levels if you have been feeling down?

S | Sleep ___

Sleep rejuvenates your body’s energies. Getting adequate sleep therefore merits top priority if you want to sustain your physical and emotional health.

Depression can cause sleep loss. The reverse also can be true. Loss of sleep can cause depression. Beware of a cycle in which insufficient sleep leads to depression, depression blocks adequate sleep, and you get caught in a downward spiral.

For my Ph.D. dissertation, I studied postpartum depression. Insufficient sleep proved to be the single strongest predictor of which 40 women in the study would fall prey to a depression in the first weeks after their baby’s arrival. The single best cure: getting more sleep.

Interestingly, both too little sleep and too much sleep can increase vulnerability to depression. When you feel extremely depressed, you may not want to leave your bed. Excessive sleeping, however, can leave you drowsy instead of more energized.

Teresa had been staying in bed until almost lunchtime. With her agreement with Roy that they would breakfast together then take walks, Teresa found that less sleep time seemed to leave her with more energy.

How might you improve the amount of sleep you get?

S | Sunshine ___

With the current and well-merited attention to the dangers of sunburn as a precursor to skin cancer, the benefits of sunshine can be overlooked. Yet vitamin D turns out to be a surprisingly strong antidepressant. Absorbing vitamin D straight from the sun boosts your physical health much like vitamin C does, and at the same time boosts your mood.

Sunshine has all the more potent an antidepressant effect if you can access a natural setting. Green grass, leafy trees, and colorful flowers utilize sunshine to grow and then transfer that positive energy into your emotional state.

When natural sunlight is not available, an antidepressant sunlamp can substitute. Seasonal affective disorder (SAD) is a tendency to get depressed in the winter when there is less sunshine. During the months of short, dark days, sit under a depression-relieving lamp while you read, watch TV, or check your favorite websites. You can order lamps for this purpose via the Internet.

Teresa’s morning walks outdoors with Roy energized her as much because of the sunshine as because of the exercise and the social interactions. The morning walks improved Roy’s mood as well. Relaxing into a happier mode, he became a more enjoyable companion. His better mood increased his openness to listening to his wife’s perspectives, adding yet another boost to Teresa’s emergence from depression. Walking with Roy each morning, Teresa appreciated the relaxed kindness that had replaced her husband's former grumpiness, dismissive listening, and do-it-my-way bossiness.

How might you increase your quantity of exposure to sunlight?

N | Newness ___

New anything tends to be energizing. Are you reluctant to embrace change, fearing it rather than looking forward to it? That tendency could work to your disadvantage. Even small doses of newness can engender an emotional uplift.

Try a new flavor of ice cream or a new restaurant. Go to a part of town you haven’t visited before. Take up a new activity, anything from knitting to bowling to volunteer work. Make a new friend by inviting someone different to join you for dinner. Plan a trip and travel.

The move to a new city initially overwhelmed Teresa. Over time, however, as she launched new activities and met new friends, bit by bit her depression lifted.

One morning, as Roy and Teresa walked together, Teresa smiled. “Good thing you decided on this move. I would never have made this decision. Now though, I can’t imagine being stuck in the dark cold winters we used to suffer through. My new friends are interesting. My study groups and exercise classes here are great. The volunteer work I do at the preschool in the shelter for homeless families feels worthwhile and makes me laugh; the kids are always saying funny things. Life feels more full and more fun. I even enjoy being married to you,” she said, teasing Roy affectionately as she squeezed his hand.

How might you add new elements to your life? 
________________________
Summary

Life is not meant to be an endurance contest. Use AGGRESS-N as needed to feel more upbeat, and to enjoy your work, your loved ones, and your life.

________________________

For more prescriptions for countering depression, check out my TEDx talk, "Lift Depression With These 3 Prescriptions-Without-Pills" and further resources—free videos and handouts—here.

(c) Susan Heitler, PhD
Source: (c) Susan Heitler, PhD

To learn more about self-help treatments for depression, and also for anger, anxiety, addictions, relationship difficulties and more, check out the latest book by Denver clinical psychologist Susan Heitler, PhD, Prescriptions Without Pills.

References

[i] J. Alpert and M. Alpert, “Music Influences on Mood and Purchase Intentions,” Psychology and Marketing Psychology (2006): 109–133, DOI: 10.1002/mar.4220070204.

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