By Eric Milbrandt, MD, MPH
One in five Americans will suffer from depression at some point in their lifetime. Between 2011 and 2014, one in nine Americans reported taking at least one antidepressant medication in the past month. Three decades ago, less than one in 50 people were on antidepressants. Reasons for the staggering rise in antidepressant use include greater awareness of major depression, expanded indications for use, and direct to consumer advertising.
Why are we so depressed? What is going on in our society that leads greater than 10% of the population to need a pill just to feel “okay?” Why do these medicines frequently fail to help? Have our lives become that depressing? Is this just “normal” for us today?
What really causes depression (and its cousin anxiety)?
According to a new book entitled “Lost Connections” by New York Times bestselling author Johann Hari, we are depressed and anxious because as a society we have become cut off from things we innately need but seem to have lost along the way. We are disconnected from essential people, places, and things in our lives.
These include being disconnected from:
1. Meaningful Work
2. Other People
3. Meaningful Values
4. Unresolved Childhood Trauma
5. Status and Respect
6. The Natural World
7. Hopeful or Secure Futures
But how could this be? In many ways we are the most connected society ever. With a simple handheld device, we can instantly “connect” with anyone almost anywhere on the planet. Facebook, Instagram, Snapchat, instant messaging, Facetime, discussion groups… the list of ways to “connect” goes on ad infinitum. Even so, many of us feel lonely and empty, that our lives are lacking meaning and purpose.
Meaningful contact is something we innately crave, but our society is predicated on individualism. We celebrate the “self-made man” and encourage others to “pull themselves up by their bootstraps.” Studies show that active involvement in community organizations fell sharply over the past three decades. According to Hari, “we stopped banding together… and found ourselves shut away in our own homes.” Few of us know, let alone talk to, our neighbors. Our busy lives make it difficult to share meals together. When asked how many people you could you call in the middle of the night in a crisis, the average answer just a few decades ago was five. Today it is zero.
Our work lives have changed dramatically in the “gig economy.” Jobs are frequently contracted and we can be let go with little or no notice. Often, we have no say in what we do or how we do it. Many mindlessly clock away hours doing work that doesn’t seem to directly help anyone other than those in corporate to get increasingly rich. We do this for a paycheck in order to buy the things that we think will make us happy, things that media and advertising has convinced us are the keys to a fulfilled life. When we finally acquire these things, we find they don’t fill the need at all, instead leaving us disappointed and wanting for more.
We spend very little time in nature. Most of our time is spent in climate-controlled environments with little to no fresh air under garish artificial lighting staring at computer, phone, or television screens. Science has proven that nature can have a powerful effect on our mental state. Spending time outdoors in greenspaces not only reduces blood pressure, heart disease, and diabetes, but also lowers stress, anxiety, depression, and maybe even improves memory. Yet, few of us take advantage of what nature has to offer.
Reconnection – The Road Back to Happiness
There is hope for this depressing situation. In the final third of the book, Hari describes a variety of ways we can begin to reconnect and, therefore, become more happily and usefully whole. He presents a wide range of real-life stories about people banding together for a common good and in doing so finding meaning and purpose. He goes on to suggest putting down our electronic devices, scaling back materialistic pursuits, ditching dead end jobs, finding joy in helping others, sharing meals together at home, and asking for help to work through unresolved childhood trauma.
In theory, many of these ways of reconnecting are cheap and relatively easy. However, when depression has you deep in the pit of despair, it can seem nearly insurmountable to even get off the couch, much less reach out to others, go to the gym, hike in the forest, or volunteer at a local shelter.
What then are we to do? How do we get out of this situation and begin to do the things that will make us feel better? This is the great paradox of depression. Because we feel unable to do what we need to do to get better, we don’t even try.
The answers, it would seem, are already available. Antidepressants and talk therapy, while not panaceas, can at least give us the boost that we need to get started with reconnection. Starting with small things and doing them often is another helpful tool for reconnection. By beginning with something easy and self-limited, we feel a sense of accomplishment and build confidence to tackle greater challenges.
There are times when traditional antidepressants and talk therapy are not enough. This is where new alternative treatments, such as ketamine infusion therapy, can help. Low-dose ketamine infusions, like those provided by The Infusion Clinic of Ocala, are fast-acting and highly effective for treating resistant cases of depression, anxiety, and PTSD.
You can find out more about ketamine infusion therapy in the August issue of Health & Wellness Magazine (https://tinyurl.com/OcalaKetamine), online at https://www.InfusionClinicOcala.com, or by calling The Infusion Clinic of Ocala at (352) 325-5755.
Dr. Eric Milbrandt is owner of The Infusion Clinic of Ocala, located at 40 SW 1st Ave, Ocala, FL 34471. Dr. Milbrandt is a critical care medicine specialist with over 16 years of experience providing care to the sickest of hospitalized patients, including those with severe depression. He is board certified in Critical Care Medicine, completed a fellowship in Quality Improvement and a Master of Public Health at Vanderbilt University. He is a graduate of The Ketamine Academy, a leading provider of comprehensive online training for all major aspects of ketamine therapy. The Infusion Clinic of Ocala provides low-cost ketamine infusions for the rapid treatment of depression (including depression with suicidal ideation), anxiety, PTSD, and chronic pain.