As discussed by Michael Yapko

This essay is mostly a transcript of a talk I found online.

Highlights

• Depression is a mood disorder that spreads its tentacles into every aspect of a person’s life
• Each person’s depression is different
• For some people it even develops into a lifelong quality of their character
• Being depressed affects one’s physical health, quality of thinking and leads to bad decisions – following your feelings with decisions can often be a recipe for disaster
• Prevalence of depression is growing rapidly resulting in human suffering and disability
• Children of depressed parents are at a significant risk to likewise become depressed
• Antidepressants do sometimes help, but they are not critical
• Professional help is important

Some people cope better with depression than others. It is as if they are insulated from it, even when they have experienced terrible things in their lives that could definitely leave anyone else deeply scarred and depressed.

Biology matters but not as much as one would think. Indeed, there are genes that make people vulnerable to depression, but significance of biology is often overstated.

So many risk factors towards depression stem from social aspects. As one of the most significant risk factors, it is mostly about how you react, perceive and attribute, as well as interpret the significance of events in your life. Person’s habitual attributive style is one of the big things resulting in depression.

Technology and smartphones represent some of the most significant risk factors. They are so ingrained in the quality of life that they're causing addiction. It’s an epidemic of loneliness out there and people are in a way more disconnected than ever.

Each person’s pathway into depression is unique, and each person’s pathway out of it is likewise unique. Is there a best method to get out of depression? Absolutely not. There is no standardized way of treating it.

You have to identify and learn about your own risk factors and vulnerabilities. Learning about yourself is one of the most important things you can do.

There is probably never going to be a drug that treats depression, just like there will never be a drug to treat racism or poverty. Looking at it through the lense of biology is a very limited perspective. Drugs help with some of the vegetative symptoms like sleep deprivation while raising the floor on depression, but drugs do have the highest rate of relapse. Alone by themselves, drugs are not enough as none of them helps to develop effective coping strategies or stress management skills. They won’t help develop realistic explanatory styles, build or maintain positive relationships, develop flexible and discriminating cognitive skills, build sophisticated problem-solving skills, learn effective decision-making strategies, or build a support network. Drugs won't help you with transcending your adverse personal history and neither will they show you how to build a realistic and motivating future.

People who can focus on the future deal better than people who dwell on the past.

If you are vulnerable to depression, alcohol is a very bad idea. Given susceptibility to depression, alcohol consumption should be zero. Alcohol is a bad drug and that is an understatement.

The unexamined life isn’t worth living

-Socrates

Well...

Neither is the over-examined life

-Yapko

Some of the biggest risk factors leading to depression are

1. Internal orientation
2. Stress generation
3. Ruminating about negative past events
4. Global thinking
5. Unrealistic expectations
6. Depressed people use themselves as the reference point. They use their feelings to make decisions. They are driven inward. According to some writers depression is the most “narcissistic state”. This speaks to the quality of self-absorption. When you make feelings serve as indicators of what to do, you will make mistakes. The problem is that feelings inherently deceive you. People can think that things are worse or better than they are. By internal orientation we talk about subjectivity and perceptions of how things really are. One needs to go outside oneself to do a reality check and see what is actually going on. The key problem of depressed people is that they “think things up” and then make themselves believe in them. It’s a trap. Thinking is dangerous. One becomes a prisoner of his thoughts. This is why a social environment is so important. How can you train yourself to generate multiple explanations of what is happening?
7. Depressed people make decisions that complicate their lives further. Depressed people keep saying “I don’t feel like it”. Which is usually a bad decision already just by itself. Getting in touch with a professional they say “No”. A bad decision. Mood influences what and how you remember things. The mood influences the quality of choices you make. Your mood's state influences your perceptions and, again, the quality of decisions you make. Filtering the mood out of all of it is one of the most important things psychologists do. Feelings come and go, but consequences last. Essentially it all keeps generating and compounding stress.
8. Analyzing, analyzing, analyzing at the expense of taking action. It affects sleeping because people can’t stop their brains from working. If you keep analyzing but never take action, namely effective, good action then you are ruminating. Drinking alcohol in this case is not a good way of acting either. Past is a big thing people use as an excuse. People use the past to predict the future. “I won’t be happy until my parents treat me better when I was a kid”. You are more than your history, your title, your job, your income, body size or how many likes you get on social media. None of this matters and it cannot be the basis of defining yourself. The last thing you want to do is to define yourself by your history. You need to create possibilities. In life there are no guarantees but you need to create possibilities. It is plain dangerous to think too much. It is crticial to draw a distinction between useful analysis and useless rumination. If it doesn’t lead to timely and effective action it is all useless rumination.
9. Global cognitive style means that a person engages in over-general thinking. When someone has a bad day they say: “Why is life so unfair?”. People say “All I want is to be happy”. But they have no clue of what happy life actually means concretely. They don’t know what it takes or cannot break it apart into smaller pieces that would concretely and clearly lead to this outcome. Global and loosely defined terms and over-generalization is mostly about something we don’t know much about, but worse, it often leads to a defeated mentality. A good exercise is called a “flow of steps”, to make thinking more linear and stepwise from the earlier global one. Yapko tells about the shower example. Ability to be specific and problem solve instead of being too global and broad is a critical skill. If you forget one step in going to a shower you think: “Oh look, I can’t even take a shower like everyone else can, I’m such a loser, what’s wrong with me?”. If you can’t sequence what you are trying to do it is not going to happen. Over-generalization is poisonous. It’s a training process in the specific parts where you need help.
10. Our expectations are a filter of how we judge everything. How do you know whether your expectations are realistic? For many, a pathway to depression is that expectations are unrealistic and they don’t know about it, so they walk around miserable and defeated. It’s a good idea before you do anything like walking into an interview, going to an appointment, or before you ask for what you want, to think first if that person can realistically deliver upon that ask. How often do people get into relationships with other people and keep pulling on them? Lay it out. What are your expectations and how do you know if they’re realistic or not?

When people learn these skills, their vulnerability to depression drops significantly. This is scientifically proven and Prof. Yapko has studied this a lot. In fact people had less than half the prevalence of depression when they went through learning these skills.

• Getting professional help is important because you don’t know your own blind spots
• Get help before you make big decisions, e.g. marrying a person. You don’t want to make these through the filter of depression. It’s a good idea to have someone to reality test these decision
• You don’t need to wait until things get worse
• You owe it to the people around you. Every depressed person affects negatively at least three other people around himself
• It’s important to shop for a therapist, just like you would do in any field. There are people of varying experience and skill
• How experienced are they with depression? What is their approach? Are they available, what do they charge, how long are their sessions?

Some critical advice

• Get a thorough physical exam. This is a good starting place to see if there is something physical that gives rise to depression
• Avoid alcohol (yes, you)
• Strive to learn about your vulnerabilities and develop ways to manage them
• Learn to distinguish facts from feelings, beliefs from facts
• Sleep is absolutely critical. Insomnia leads to fatigue. These are all serious complaints to be taken seriously
• Learn to challenge yourself and reality test (“How do I know?”)
• Strive to exercise regularly
• Do fun things and do them often. Follow the model and dare to be superficial
• Get and stay connected to others
• Learn to relax. Visualization, hypnosis, meditation, turning your mind off
• Being goal-oriented in important areas. Realistic goals. If you don’t know or have steps then it is just wishing and you’re stuck
• Prioritize and problem-solve
• Get support, get help. Don’t wait
• Don’t dwell on the past. It’s gone, but tomorrow hasn’t happened yet
• Don’t compare yourself to others. It’s a guaranteed pathway to feeling lousy, particularly when you don’t have any information
• Don’t catastrophize. Understand probability
• Don’t leave important things unsaid or unresolved
• Don’t analyze too deeply. Move on
• Don’t ignore reality. Get the facts!
• Don’t ignore your own needs. Self-care is not the same as being selfish
• Don’t give up or be passive. Try again, but do something different!!!
• Don’t isolate yourself. Find good people to be with
• Don’t leave time unstructured

Depression cannot be cured. The goal is not to cure depression, the goal is to manage your moods. You need to manage your moods every day of your life. For this you need skills. Everyone can get depressed. If you are capable of moods you are capable of mood disorders. Learning to manage this is absolutely integral.