3 prescriptions for lifting depression without pills

This 16 minutes talk by clinical psychologist Susan Heitler provides helpful insights into dealing with depressive and negative thoughts without the use of medication. What she proposes is looking first at what in your life may be causing you to feel the way you do.

The analogy of the common cold is helpful. While a common cold can be quite mild, in the short term it can leave you feeling quite miserable. There is also the risk of the cold developing into something more serious like a sinus infection or even pneumonia. For these reasons it is important to pay attention to when you find yourself persistently discouraged, with low energy, self-critical and irritable with others. Our modern assumption to quickly assume such feelings are due to a chemical imbalance has led to an over-diagnosis by doctors of depression, (See Is The Rate Of Depression Actually Increasing Or Not?)

The reason this is so important is the tendency in our modern world to look for a quick fix. This has become hugely important as the prescription for antidepressant medication has dramatically increased over the last few decades with no clear evidence that clinical depression has actually increased. For example from 2011 figures at least 1 in 10 Americans are on antidepressant medication and for women in their 30s and 40s this figure is around 1 in 4. (See Why Has There Been a 400% Increase In The Prescribing Of Antidepressants?) I  also write about my own experience of how your lifestyle can be leading to depressive thinking here).

Susan Heitler expands on her Conflict Resolution Theory of depression, or more simply 'Bump Therapy'!

The first step or prescription is to identify the particular hurdle or obstacle in your life that you find yourself feeling disappointed about. The more specific you can be then the more likely you are to find a solution or way through that challenge.

The second prescription is what she calls 'pump up' or identify the resources or tools at your disposal.  Dr Heitler gives an example on the video of this with a client of hers called Julie. You may also find of interest the article and video with Amy Morin called  Are You Looking For Inner Strength?

The third prescription is then by looking at potential solutions to the challenge you are facing and deciding on which is most appropriate for you. For more on this see What Fills You Up And What Drains You Down?

In combination these three steps can significantly reduce the risk 'the common cold of mental illness' does not develop into something more serious or insidious in your life.

What in your own life have you find helpful to deal with depressive thoughts and feelings?

You may also find of interest:

Could Your Lifestyle Be What Is Getting You Down?

Podcast #004: Combatting Depression

The Scale Of Mental Health Problems And What To Do About Them

What Do I Say To A Loved One Who Is Struggling With Depression?

My own personal journey with depressive thinking in my late teens at Just As I Am

How can faith and prayer enhance mental health?

Using the example of money

I was recently asked to talk at a financial institution on this subject from a Biblical perspective.

 Its a huge subject and I was given only 10 minutes along with speakers from Jewish and Muslim backgrounds! This is a summary and transcript of what I was able to say. As it was at a financial institution it made sense to use money as an important theme! Indeed as we have previously discussed there are 2350 verses in the Bible on money - more than there are on faith or prayer even!

We can summarise the question by saying faith and prayer ultimately enhance mental health when I am able to delight in God for who He is rather than what I can get out of Him. To break it down further into one word then it is to use the word grace.
Grace means undeserved mercy and favour. When I truly understand grace then that has a profound impact on my mental health.
The best way to convey that is with a simple story.
Imagine you came to my house to stay. I had to go out and left you in charge. When I returned you say to me, Sunil while you were out someone came to the door with a bill to pay and I paid it. Now there is one vital piece of information you are lacking. It is how much was the bill? If the bill was £1 then that is hardly even worth saying thank you for. But imagine it was £20 billion and you had the resources to pay. How would that make me feel? What would that do to my mental health?
But it gets even better! Not only do you pay the £20 billion bill you actually credit my account with a further £20 billion and you buy me a new house!
Sounds crazy an even ludicrous.

But that is what the Bible seeks to convey how grace impacts the mental health and life of someone who understands it.

Let’s  explore this further.....

What do I say to a loved one who is struggling with depression?

7 practical suggestions

We live in a world with a lot of negativity. Behind the smiles of the advertising and the apparent fun and laughter of social media there are many people struggling with depressive thoughts and feelings. (See The Scale Of Mental Health Problems And What To Do About Them).

Some of it is because of the everyday worries and concerns of life. There are tragedies and setbacks like bereavement, diagnosis of major illness or sudden loss of a job.

For others it is more deeply rooted in questions of meaning and ultimate purpose. (See Podcast #035: What Is Life Really All About?)

Some people go onto clinical depression, but for many others life can feel like living under a continual dark cloud. There are distinct changes in their energy, optimism and motivation.

Maybe you have a close friend or loved one who is struggling with negative thoughts and feelings. You have seen a change in the way they come across. You are not sure how to handle them. What should you say or not say? How should you approach them?

Sometimes it is hard to know what to say when speaking to a loved one about how they are coming across to you. You might fear that if you bring up your concerns they will get angry, feel insulted, or ignore you. You may be unsure what questions to ask or how to be supportive. It is so easy to just say nothing and miss the opportunity to offer genuine hope, comfort and encouragement.

If you don’t know where to start, the following suggestions may help.

1. Don't feel you have to have all the answers.
Being a compassionate listener is often far more important than giving advice. It is not about immediately trying to 'fix' the person as it is about empathy and understanding of what they are feeling and going through. It is also about encouraging the person to talk about their feelings and be willing to listen without judgement. They may be holding thoughts, worries and fears they have never shared with anyone else. By creating a safe space for them to bring these into the open can bring enormous relief. (Also see 5 Levels Of Listening And Communication).

2. It is likely you are going to have to persevere and keep coming back .
Don’t expect a single conversation to be the end of it. Depressed people tend to withdraw from others and isolate themselves. It is likely this has gone on for some time. You may need to express your concern for them and your willingness to listen over and over again. Be gentle, yet persistent. In their negative thought patterns they may be questioning if you really do care about them. Your quiet dependability and reliability can make a real difference in reaching through to them. Your actions will then speak louder than your words.

3. Things you might say to start the conversation could include:
"I have been feeling concerned about you lately."

"Recently, I have noticed some differences in you and wondered how you are doing."

"I wanted to check in with you because you have seemed pretty down lately."

It's important after this to then wait and give time for them to slowly open up. You may need to become comfortable with just sitting in silence to help build their trust and confidence.

4. Here are some follow up questions it might well be worth asking:
"When did you begin feeling like this?"

"Did something happen that made you start feeling this way?"

"How can I best support you right now?"

"Have you thought about getting help?"

Being supportive involves offering with your concern and sympathy also encouragement and hope. Very often, this is a matter of talking to the person in language that they will understand and respond to while in a depressed mind frame. And that can take significantly more time than other conversations you are use to having.

5. Other things you can say at appropriate times in the silence:
"You are not alone in this. I’m here for you."

"You may not believe it now, but the way you’re feeling will change."

"I may not be able to understand exactly how you feel, but I care about you and want to help."

"When you want to give up, tell yourself you will hold on for just one more day, hour, minute—whatever you can manage."

"You are important to me. Your life is important to me."

"Tell me what I can do now to help you."

6. There are also some definite things to avoid saying:
- Be very careful about not jumping to conclusions about what the problem might be or how the person might be feeling.
- Don't put words into their mouth or complete their sentences for them.
- Don't use words like 'should' or 'ought'.
- Don't get caught up with universal blanket statements from the person like 'it's all a disaster'; 'my life is such a mess'. If they say something like this then try to break down what they are saying to find out what they actually mean.
- Don't ay anything or make promises you cannot follow though.
- Don't use cliche phrases like 'don't worry it will pass', 'I know how you feel', 'just look on the bright side', 'it's all in your head', 'we all go through times like this', 'you have so much to live for why would you want to die?', 'I can't do anything about your situation', 'just snap out of it', 'what's wrong with you?', 'shouldn't you be better now?'
- Don't be sworn to secrecy by the person as a way to win their confidence. It is important to explain there is a risk to themselves or others you may have to tell others.
- Don't pass judgement on what the person says or feels.

7. Take care of yourself as well!
Caring for others who are struggling with depression can become overwhelming and exhausting. Try not to carry all the responsibility on your own. It is important to have others to talk with and share the responsibility you are feeling for the the depressed person. While you care for others, it is important you also care for yourself. (Also see What Fills You Up And What Drains You Down).

From your own experience with others who have struggled with low mood, or maybe your own life, what would you add to these suggestions?

You may also find of interest:

Why I Am Working On Becoming A Happier Person

Podcast #004: Combatting Depression

My own personal journey through depressive thinking


The scale of mental health problems and what to do about them

5 simple steps

According to the Mental Health Foundation, depression is now the leading cause of ill health and disability worldwide. Statistics from the UK indicate that 2/3 of the UK population have experienced a mental health problem at some point in their lives and that only 13% of the population are thriving with high levels of positive mental health.

Let's try to to put this in context. A recent report from the Institute of Directors state that 1 in 6 UK adults experience a common mental health disorder over any given week. To put that another way. that is 10 times the number of people who attend a professional football match - the nation's favourite sport. The most recent Mental Health at Work Report from Business in the Community also states that 3 out of every 5 employees (60%) have experienced mental health issues in the past year because of work.

It is also increasingly being recognised that mental ill health is a problem not just affecting a small minority of people, but society as a whole. 1 in 4 people are reported to be diagnosed with a mental health condition in any given year. In addition many more experience poor mental health, which disrupts our family and working lives.

Mental ill health is now the leading cause of sickness absence in the UK, with more than 15 million absence days attributed to stress, anxiety and depression in 2013, at a cost to the UK economy of £8.4bn. In 2015/2016 stress accounted for 37% of all work related ill health cases and 45% of all working days lost.

The Centre for Mental Health has also calculated that presenteeism, the practice of staying at work more hours than required, usually because of job insecurity, costs the UK economy £15.1bn per annum. In other words, people stay at work but their minds and attention is so distracted or below optimum that they take far longer to do tasks or get distracted by the unimportant or unnecessary. I am sure these statistics and figures are not much different for most of the rest of the industrialised world.

To maintain physical health, there has been a rightful emphasis on factors such as stopping smoking, losing weight, exercise, healthy eating and meaningful relationships. (For more on this also see What Is The Single Most Important Thing I Can Do To Improve My Physical Health? and What Is The ONE Essential Ingredient For Life-Long Health and Happiness?).

But what about mental health wellbeing?

Over recent years, through increased research there has began to be a greater understanding of  the contributing factors that lead to poor mental health. What this means is that many common mental health problems can be prevented. For prevention to be effective,  appropriate and relevant education is essential in order to encourage self care and our own management of our wellbeing.

Here are 5 simple ways to wellbeing:.....

Podcast #033: Practical ways to find joy through disappointment

Disappointment. We all experience it. We all know what if feels like. We have all at some time or other said and done things when disappointed with our circumstances or other people that we have later regretted. But what are healthy ways to handle disappointment in our lives?

On this podcast I continue my conversation with the author John Hindley on his book, "Dealing With Disappointment: How To Know Joy When Life Doesn't Feel Great". (Our earlier conversation at Podcast #032 is here).

Disappointment can so easily come to dominate life - the nagging thought in the back of our minds and the constant "yes, but..." colouring all our pleasures.

Do join us as we discuss practical ways to find joy through disappointment. In particular we discuss:

  • Disappointment with my circumstances.
    The power of a different perspective rather than relying on the stoicism that we tend to default to.
    Or, in other words, how to defeat those painful things that are true by looking at things that are more true.
    Finding a balance between working too much or too little.
  • Disappointment with people.
    How do I decide if it is something I should forgive and move on from or something I should forgive and then talk with the person concerned about?
    For more on this also see: Podcast #025 Is There A Difficult Person In Your Life?
  • Disappointment with my success.
    John and I confess personal examples of how easy it is to tie up our meaning and identity with things that are actually quite trivial.
    How the good things of life are a signpost to a far greater work and person we should be enamoured by.
    How "the fuel for living a truly successful life is to know that you will one day live it perfectly, and with perfect satisfaction."
    For more on this also see Podcast #002 Success.
  • Disappointment with myself.
    How facing up to the painful reality that I am not the person I wish was can be not the last word in our lives, but part of our story to greater wholeness.
    The freedom that comes from understanding, as John writes, "Your purpose in life is not to be perfect. Your purpose in life is to showcase God's grace to the imperfect."
    Balancing in my life God's gift of forgiveness with the gift of integrity.
  • Disappointment with God.
    For people of faith, this is probably the hardest disappointment to face up to. As John says, "If God is in control - and He is- then behind all your disappointments with your relationships, your circumstances, your ministry and yourself must lie disappointment with God......God could have, should have, might have....and didn't. So often, in so many small and serious ways, it feels as if God doesn't come through."
    For more on this also see Podcast #028 The God I Don't Understand.


If your life isn't perfect..... you need to listen to this podcast!

How a higher perspective empowers you to handle disappointment

One important way to get a handle on disappointment in our lives is to be able to take a higher perspective. Somebody who understood this well was the author C. S. Lewis. In 1942 he wrote the book The Screwtape Letters that has since then been continuously in print. It has been adapted into plays, made into a comic book, and recorded as an audio drama by the actor John Cleese. The Hollywood Film company Fox owns the film rights, and Ralph Winter, best known for blockbusters like “X-Men” and “Fantastic Four,” has said he will produce it.

The novel is a fictional account of a series of imaginary letters from a senior demon called Screwtape to a junior demon, Wormwood. It is a powerful perspective on the real life challenges of faith in God and handling disappointment. In the novel, God is the enemy. We eavesdrop on the schemes and strategy of  two devils in the mind of a human being, described as 'the patient'. While being fiction, it provides piercing insight into the challenges we face in day-to-day life while pointing us to a higher spiritual perspective.

Modern 21st century secular thinking tends to have no place for the realm of a higher order of evil let alone for the existence of God. However, it is worth reflecting on that most of mankind has believed in the supernatural power of evil for much of history. There is also little else available to explain the power and rise of evil regimes and forces during the course of human history from the rise of Nazi Germany to the current horrors of North Korea.

The following short excerpt provides a powerful insight into disappointment:

Understanding the 3 dangers of disappointment

Taking the bitter medicine

To be forewarned is to be forearmed. Disappointment is an experience we all go through at some time or other in our lives. While disappointment is a form of suffering, it is not the acute, dramatic, heart wrenching extreme painful form like sudden bereavement, or betrayal or torture or persecution. (For more on that type see here).

Instead disappointment is more subtle and insidious. But it is just as challenging. Like a hidden cancer under the surface it can eat away and destroy our sense of joy or wellbeing. It is linked to a general sense of frustration with life. Maybe there is a mild depression or even a root of anger, cynicism or bitterness.

Disappointment can be seen as a product of affluence and having an abundance of choices and opportunities (If you are reading this on a computer or smartphone, then that includes you!). The truth is we have privileges and possibilities that are beyond the wildest imaginations of people of previous generations. But it doesn't feel like that. We have a tendency to say something along the lines of, 'Yes I know I should be thankful, but....' It's what you say to yourself or others after that 'but' is the disappointment we are talking about.

John Hindley in his book 'Dealing With Disappointment: How To Find Joy When Life Doesn't Feel Great,' defines disappointment as "What we experience when we expect satisfaction and this satisfaction is denied." John goes on to give the almost banal example of coming home from a long day's work expecting his family to welcome him and finding that they are out somewhere. So he feels disappointed - he expected a certain satisfaction and it was denied. There is certainly nothing earth shattering about that.

Disappointment is that sense my life is ok, my marriage is ok, family life is ok..... even worse I have achieved my dreams and I am still empty and unsatisfied.

I remember in my own life how I acutely felt that in the summer of 2001. I had just been confirmed in my job as a consultant psychiatrist. I had reached the top of the career ladder after a six year medical degree and 11 years of work and study. I was happily married with the joyful arrival of our third child. I was actively involved in church leadership and ministry. On the surface everything looked so good. If you had asked me I would have said yes there is a lot to be thankful for. But (there was a but) yet the biggest thing I remember feeling at that time was a profound sense of emptiness, which was so disappointing.

Unchecked there are three main dangers of disappointment:

How healthy is your brain?

6 key take away implications

Dr Daniel Amen is an American psychiatrist and director of the Amen Clinics in North America. Amen's six clinics specialize in the use of brain imaging equipment (Single Photon Emission Computerised Tomography or SPECT) in diagnosing psychiatric disorders. He has also written ten books on his work that have hit the New York Times bestseller list.

Below is a 14 minute TED talk given by Dr Amen in 2013 entitled "The Most Important Lesson From 83,000 Brain Scans". He speaks candidly and openly about his own life journey along with his passion for psychiatry and mental health:

A SPECT scan is a type of nuclear imaging test, which means it uses a radioactive substance and a special camera to create 3-D pictures. So while imaging tests such as X-rays can show what the structures inside your body look like, a SPECT scan produces images that show how your organs work. Thus a brain SPECT scan can show not only how blood flows to your brain, but also which areas are more active or less active.

However, Amen's methodology has been criticized by some psychiatrists and neuroscientists on ethical and safety grounds.

Since the original TED talk above Dr Amen and his team has gone on to have done over 100,000 brain scans using SPECT. His organisation has the world's largest database of brain scans related t0 behaviour on patients from at the last count 111 countries.  He states that his work has been published in over 70 peer reviewed journals on subjects such as:.....

Podcast #031 How can I live with hope today?

Psychologists, psychiatrists, politicians and theologians may differ in their opinion on many things, But one thing they would all seem to agree on is the importance of hope.

“Human beings can live about forty days without food, about three days without water, about eight minutes without air…but only for one second without hope.”


Do join my co-host Andrew Horton and I as we discuss:

  • Why hope in the true sense of the word is much more than wishful thinking, but instead a joyful expectation about the future.
  • How we can view hope as "not the conviction that something will turn out well, but the certainty that something makes sense, regardless of how it turns out." (Vaclav Havel)
  • The dangers of basing my hope on a particular outcome that I want.
  • How the attempted suicide of a friend taught me the dangers of a secular hope.
  • 4 core beliefs in developing hope
  • A Biblical perspective on hope.
  • The forgotten part of the serenity prayer and what that teaches about hope.
  • What to say to someone who is struggling to have hope about the future.

What questions, thoughts and comments does our discussion raise for you?

You may also find of interest:

How Can I Find Hope In My Darkest Days?

Do You Need Hope Today?

Why Understanding Easter Brings Hope.

Podcast #003 Stress

Podcast#007 Religion

Podcast #013 How To Grow In Resilience

Podcast #017 The Last Taboo Subject?

Podcast #020 Baroness Caroline Cox

Podcast #021 Grit

Podcast #022 The Stories We Tell Ourselves




Podcast #030 Do you need more sleep?

“If you want to be a billionaire, sleep as little as possible.” Donald Trump.

“Sleep is a criminal waste of time. A heritage from our cave days.” Thomas Edison.

“Every important mistake I’ve made in my life, I’ve made because I was too tired.” Bill Clinton


Sleep. So easy to take for granted, but so essential – especially if you are not getting enough. And yet there is so much bravado and neglect when we think about sleep. Whatever you may think of Donald Trump and Thomas Edison, their opinions on sleep are way off the mark when it comes to what the research and even what common sense shows. And whatever your opinion of Bill Clinton there is much wisdom in his reflection on sleep and making errors of judgement.

On this podcast my co-host Andrew Horton and I discuss:

The importance of prioritising sleep in our lives.

The dangerous consequences of not having enough sleep.

How do I know I am getting enough sleep?

An embarrassing example in my life of not getting enough sleep.

How much are people in positions of authority making decisions from a place of inadequate sleep?

A Biblical perspective on sleep.

Three suggestions for those struggling to get to sleep.

You may also find of interest:

Do You Need More Sleep?

The Importance Of A Good Night's Sleep

What questions, reflections and comments on sleep do you have?