When your tell your doctor you are depressed, the first thing they will usually do is to prescribe antidepressants.   If they have a more holistic orientation, they might ask you about your eating, sleeping and exercise.  All of these are good things to take into account when treating depression.  But it can be even more productive to look further into some of the underlying causes.  Medication can support therapeutic work by giving you a “floor” that you can’t fall through as easily–and by giving you a subtle lift so that you are more able to engage with others.

But depression, besides being a chemical imbalance, can also be a clue that something in your life isn’t working; that something needs to be looked at and perhaps changed.  I like to keep in mind the following six points and engage clients in dialogue around these things.  I developed this list from my work with teenagers, who really seem to resonate with this list.  But really, these things apply to people of every age.

1. Self-Authenticity/Integrity

I define “integrity” as acting in accordance with one’s belief system; or being true to oneself.  When you’re not acting out of integrity, when you’re just going along reluctantly with what someone wants you to do, you are undermining your own power.  Standing up for yourself is one of the best things you can learn how to do, because you gain strength by bringing your life into alignment with your purpose and value.  Removing the mask or masks you’ve been wearing to please others can be truly liberating.  Because who wouldn’t want to live a more authentic life?

2. Ability to Express Oneself

If you read my posts, you know that I’m a big believer in the power of the creative arts to help us heal.  We can’t always express how we feel with words; some of us speak better through sound, through art, through dance.  Sometimes in these alternate ways of communication, we can express more accurately how we truly feel.  I encourage people–especially teenagers and people going in a grieving process–to not only use the expressive arts, but even radical creative expression.  This is why I believe the “fringe” and avant-garde arts are so important, and why I also believe more people could benefit from knowing a wider range of what is possible, artistically.  When I was a teenager, “The Canterbury Tales” meant nothing to me, but reading Ionesco, Beckett and other “absurdists” did.  Those authors gave me a language with which I could express myself.  Chaucer never did!

3. Finding Meaning and Purpose

It’s clear to me from working with adolescents that the reason so many of them hate school is because they can find no meaning in it.  And meaning is important to humans, and teens especially.  Adults who can’t find meaning or purpose in their jobs are often miserable (though they won’t always readily admit this to others).  Meaning and purpose function as anchors in a way; without them we just drift.

4. Connecting with Others
As humans, we all need to connect with other people in a meaningful way; it is an essential part of our mental well-being.  For us introverts, this may look like having a few very close friends that we can have deep one-on-one conversations with.  For extroverts it might mean going out with a group of friends on weekends.  No matter who my clients are, I encourage them to find authentic connections with others in ways that they can feel seen, heard, and met.

5. Self-Empowerment

Every day we are making choices.  Some of these choices can lead to empowering ourselves; other choices lead to disempowering ourselves.  Creating healthy boundaries with family members and friends is an example of the former; texting the person that you know is no good for you would be an example of the latter.  There are many ways to build yourself up and reclaim your power including: getting out of toxic relationships, leaving a job you really don’t like, or doing one thing that’s out of your comfort zone every day.  And when you start doing these things, your depression may start to lift.

6. Widening One’s Perspective

I worked with one client who said that a few years ago, she was in the throes of a moderate to severe depression.  Somehow, she managed to take a trip to Italy–and while she was there, her depression lifted and stayed away.  She said it was due to suddenly being so engaged with a different culture, and I think there’s a lot of validity to that.  Depression has a way of narrowing our perspective, making our world smaller, and fooling us into believing that we’ve always been depressed and we always will be depressed.  So using whatever energy you can muster up to combat that shrinking in whatever way you can, you are helping yourself, at least temporarily, if not permanently.  It doesn’t necessarily have to involve changing physical locations; sometimes a shift in one’s thinking can be enough.

Studies show that the most effective treatment for depression is a combination of the right meds and talk therapy.  But you’ve got to be talking–to yourself and with others–about the right things.  The six things I’ve mentioned here are meant to be used as a kind of map that may help you start to get out of whatever unhelpful state you’re in!