An integrative approach to depression ~ from one Aspie / autistic perspective [Mental Health Monday]

I can slowly feel my inner wheels beginning to catch on and take hold.  The only way I know this is happening is because I feel more constructive.  I’m processing less and pro-acting more.

So, it’s time to get proactive.

I’m writing this post for three reasons.

1. I’m pretty sure I’m not the only one suffering a Low Point right now; it seems to be happening among several of my lovelies, which means that it’s probably not just me; it’s a Thing, and that means people out there might be able to use this information.  Thus, there’s always the possibility that this might help someone. ❤
2. I promised this post as a follow-up to a post I had written waaaaay back when, and I want to make good on my promise to follow through when I say I’m going to write a post on something in the future.
3. I like being proactive.  Meditate on that word for a minute – isn’t the word “proactive” awesome?  It’s a fun, liberating, empowering word.  It stacks the cards in your favor.  It shows the world who’s boss (you).  It gives you your life back.  At least, that’s how it feels to me.
4. (Bonus) – I like ending the day on a happy, upbeat note if I can, particularly if I’ve been deep-sea diving in the emotional abyss for a while and hadn’t had the good sense to stay quiet during that time 😉

I also like the concept of integration, and this applies to health, too.  I love the idea of reaching out for the floating options around me and pulling them into my basket of goodies, stowing them in my toolbox.

When I last wrote about depression, my Wiser Older Sister, the ever-lovely Unabashed Autist, and I were jointly building proverbial “First-Aid Kits” for depression (for those who haven’t yet seen this, here are links to her post and my post on this subject).

Those posts each detail excellent options and ideas for a DIY (Do-It-Yourself) Depression First-Aid/Survival Kit of sorts, which can be a perfect antidote to mild-to-manageably-moderate episodes of depression.

But what about moderate depression?  Or even severe depression?  Or grief?

There are so many different kinds and root causes of depression that I can’t possibly cover them–or remedies for them–in one post.  There are several research-backed nutrients involved, in any one or combination.  There are literally dozens–if not hundreds–of medicinal herbs that have been studied and found to be effective in clinical trials, published in medical journals.  There are several toxic chemicals in our environment known to be linked to depression (I know that correlation isn’t the same as causation, but the evidence is pretty strong).  There are literally dozens (if not hundreds, or even thousands by now) genetic mutations known to contribute to aberrant brain function, which can predispose one to depression.

And of course, there are some experimental therapies that have been around a long time, that other cultures have known about for centuries and have been anecdotally effective (I know that anecdotes and individual case reports do not a randomized controlled trial with a large sample size make, but individual case reports are indeed where many of the ideas for larger trials come from.  Pile up enough case reports, and you begin to think of a hypothesis to be studied.  Pile up enough case reports, and, with your hypothesis in hand, you’re one step closer to securing funding for a larger study.  And so it goes).

So anyway…

Most people are well aware of the various medications out there that are designed to treat various types of depression.  So, that’s where I’ll start.  I won’t name specific meds (that’s for your specific healthcare providers to do), but since we know that they exist and they can be highly effective, I’ll mention that first.  Since it’s the most familiar treatment route, however, this part of the discussion will also be the briefest.  I’d rather expand on what people are less likely to be aware of, in order to offer ideas for other options.

A couple of disclaimers before I get into this any further.

1. I’m a doctor, but unfortunately I’m not your doctor, so definitely go with the options that you and your healthcare providers decide are best for you.  I also don’t know your body and mind like you do; you know yourself best.
2. While people ultimately have dominion over their own healthcare and they have the right to act as their own healer, I do recommend consulting with a licensed professional about which of these might be options for you.
3. My specialty is in chronic disorders/conditions, and although that does include depression and I’ve successfully helped many people with depression, none of this is intended to be actual medical advice or any substitute for professional advice/guidance.
4. The route of post-doctoral training I chose to take is not in pharmaceuticals (although I’m not against them and I do recognize their necessity and value in many situations); my training is in integrative medicine, a paradigm that considers all possible avenues of healing.  There are tons of various interventions to be gleaned from a variety of different cultures; mine center mostly on Chinese/Japanese, Indian/Ayurveda, North American Native/Indigenous, and Western American/European, in addition to contemporary therapies.  Don’t laugh; when used properly, they work. 🙂

OK, moving on some more… 😉

Possible Option #1: “Special Interests” / Primary Interests / Niche Interests / Favorite Topics / Specialties (etc):

My first approach is to use what I already have.  Since I’m already aware of the topics I’m interested in, then I already know what tends to make me happy and relax my system.  Thus, I’m going for that first.  Bonus:  I don’t even have to leave the house, so I can do it any time, I don’t have to travel anywhere, and I don’t have to interact with anyone.

Possible Option #2: Nutritional Supplementation or Herbal Formulas:

An overwhelming number of nutrient deficiencies can cause depression.  Insufficient levels of Vitamin B-complex (which includes like seven different vitamins, Vitamin D, Magnesium, Selenium, Iron, Copper, and certain amino acids like Tryptophan, Phenylalanine, Tyrosine, and several others, all include depression in their symptom profiles.  (My recommendation is to, ideally, have your nutrient levels tested by a lab that knows what they’re doing so you know which nutrients to target; a multi-vitamin or all-purpose protein powder might not suffice here.  Professional guidance is likely crucial.  But these lab tests do exist and the supplementation can help immensely, possibly even resolving the issue completely.  I’ve lived that scenario!)

Herbal formulas might provide relief, too.  Herbs actually work like mini-medications; throughout history, pharmaceutical companies have manufactured prescription drugs from the alkaloids and other phytochemicals of certain herbs.  No kidding.  Even today, fully 25% of all pharmaceutical drugs are extracted from the active properties of herbs/naturally-occurring plants.  And the scientific research community–and pharmaceutical companies–are beginning to step up these efforts, because they’re beginning to realize how much more potential the herbal family has to offer.  Again, because they upregulate and downregulate various pathways in the body just like medications do, you’ll want to work with a properly-trained professional on this one.  But these have worked well for me, too.  Just like medications, different herbs/herbal combinations will work for different people, because everyone’s brain chemistry is different and all that.

Possible Option #3: Meetup Groups and Other Social Events for Asperger’s/Autistic People:

This option obviously does involve leaving the house and traveling, at least a short distance.  It also requires research to find a Meetup (or similar) group near you.

And of course, there are a few other potential barriers.  They’ll probably meet in a public place, with at least several other people, people whom you may not know.

But here’s a way to make physical connections, to sit or stand physically close to someone who operates the way you do, or at least similar.  Here’s a way to make friends in your own region, and maybe feel less apprehensive about going out.

I haven’t done this option yet.  However, I’ve heard from many who have, and they swear by it.  It relieved their loneliness/isolation, which helped lift their depression.

What I plan to pay attention to while I’m in the planning stages of implementing this option are aspects like day, time, location, size, the general personality of the group, and how often they meet.

Possible Option #4: Acupuncture (The Proper Points):

Like Option #2 (Nutrients and Herbs), this can work absolute wonders.  But just like that option and conventional medications, it’s important that the acupuncturist matches up the right points with your specific needs at that moment.  This is both harder and easier than it sounds.  A good practitioner will question you thoroughly, including physical and mental/emotional symptoms.

One thing I really like about Traditional Chinese Medicine (TCM) is that it’s very non-judgmental.  Mental illness and other mental/emotional/psychological issues are not stigmatized in TCM.  The mind-body connection (i.e., the connection between various emotions and various physical functions/symptoms) is well-recognized and thoroughly understood by TCM providers.  A good TCM provider understands that dysfunction in various areas will impact both the associated physical and mental factors.  It will give rise to emotional imbalances, mental impairments like foggy or forgetful thinking, and so on.  Thus, mental/psychological/emotional issues are intertwined with physical issues, and they’re treated as such.  The mind and body are inseparable, which is really appealing to me.

Possible Option #5: Engaging In–Or Even a Break From–Social Media:

Social media, at least for me, seems to be a two-sided coin.  On one hand, engaging with my fellow Facebook and Twitter peeps brings senses of peace, unity, connection, harmony, bonding, kinship, validation, and so many other concepts, to my world.

On the other hand, the drama can get out of hand.  The self-censorship out of fear of objection or rejection can become excessive.  Sometimes, it’s hard to feel free to speak.  Sometimes, simply interacting with or creating a friendship bond with a certain person or group of people can result in ostracism, criticism, and shunning or exclusion.  Or maybe one might feel a sense of pressure to keep checking in, keep responding, keep up with everyone and everything, lest they miss something or offend someone.

In the latter case, a break might be in order, and it might be quite healthy.  For me, when I need a break, taking one can feel like the release of a pressure valve, a restoration of balance, and a sense of re-ordering my life.  It might be temporary–short-term or longer-term, or it might be even longer-term than that.  Maybe the change in time spent on social media eventually becomes permanent, as one restructures their time and engages in new activities, effectively constructing a new routine.

Social media is double-edged, and it all depends.  What might be healthy at one point might become unhealthy at another, and vice versa.

Possible Option #6: Creative Catharsis/Release:

In my experience, frequently, there is no better outlet or depression lift than calling upon my creative muses and extracting their juices (OK, that sounded really creepy, but it wasn’t meant to be).  I’m blessed to have several outlets: writing (most common, right now), art (painting, drawing), and music composition (the least frequent right now, due to my difficulties with my increasing hearing loss).  Journaling is an excellent variation on the writing theme.  Digital art is an amazing variation on the art theme (I might just get into that (!), since I face so many barriers to doing non-digital art).  There’s even digital scrapbooking (!).

The writing is awesome because it doesn’t do more harm than good; i.e., I don’t need my ears to work in order to write.  The same goes for painting and drawing, although that option involves digging out art supplies, finding old clothes to wear, and setting up an art area–which, in our limited-space apartment, can be challenging.  Writing is obviously more attractive an option for me because it involves only my mobile, laptop, or desktop, and there’s no potential mess involved. 🙂  The only down-side is that technology and I do engage in fist-fights….frequently.

Other people’s creativity might take on different forms; crafts like crocheting, knitting, beadwork, sewing, embroidery, stained glass, scrapbooking, photography, making masks (the real ones, not the Aspie/autistic masking that I often talk about), making clothing, making purses, doing needle-point, or some other similar activity.

The really cool part about crafts is that it involves one’s hands, and it also involves repetitive movements.  Hello “stim”!  This can provide an extra element of relaxation, calming, and focus.

Possible Option #7: Mindfulness Methods:

These include anything from Qigong to meditation to Tai Chi, to yoga, to repeating a mantra or a saying, to whatever.  Anything that accomplishes the amazing benefits I’m about to talk about.

Basically, anything that calms your mind and brings it mind to a focal point will work here.  This can even be activities like prayer, contemplation, you name it.  It can be calming and uplifting.  It doesn’t have to take much time.  It doesn’t have to take much effort.  It doesn’t have to take much ability.  You can tweak this for pain levels, mobility issues, even mood and stress levels.

There’s no “right” way to do these, really.  Any way that gets the job done and doesn’t cause you any harm is indeed the right answer.  If it involves physical movement, the movements don’t have to be perfectly choreographed.  The mind can be allowed to wander some, so long as it doesn’t wander into dark corners and crannies.  If you see a brightly-colored mental butterfly, chase it.

Possible Option #8: Physical Activity:

Physical activity is one of the most effective, scientifically-validated methods of uplifting one’s spirits.  In one of my conferences, it was recently stated that if one is depressed, the depression simply cannot be lifted if the person doesn’t move some.  That leaves me wondering about the fate of quadriplegic people, but maybe their set-point is different.  I’m not sure.

Physical activity doesn’t need to involve going to the gym.  It doesn’t have to be strenuous.  One doesn’t need to set aside hours every day or week in order for it to do some good.  It can actually be worked seamlessly into one’s daily life, such as while running errands, or simply taking a walk around the block when you get home.  Walking outdoors has some pretty incredible, positive side-effects, such as breathing fresh, non-indoor air, getting sunlight, listening to the birds, walking on less-than-perfectly-even ground, being around trees and plants, and so on.

Physical activity can be super-gentle, such as gentle and gradual stretching.  More intense activity can be done in extremely short bursts, like maybe 30 seconds (no, I’m not kidding).  Activities involving standing on one foot or what-have-you provide extra benefits like balance and coordination.  Adding a twist, such as juggling, playing hackey-sack, or something similar, can make it fun and give one something to focus on besides the activity itself.

I also love physical labor.  Helping remodel a house or something like that is relaxing for me.  My movements are all natural and three-dimensional, meaning that they’re not numerous repetitions of a single one- or two-plane movement.  When I engage in natural activity, I don’t tend to develop repetitive strain injuries or imbalance in muscle tone between different muscle groups.

Possible Option #9: Spiritual/Philosophical Study:

One of my most powerful antidotes for depression is to read books on spirituality, philosophy, and/or world religions.  I can’t describe how incredible uplifting it can be.  Talk about a life-shift!  I find it optimal to read this kind of material just before bed, because then it can sink into my brain and “install” itself where it wants to, integrating seamlessly with what’s already there, and setting the stage (and my mood) for peaceful, complete sleep.

Lately, however, since my sleep cycles have been disrupted and I haven’t slept in bed for years (yep–years.  At least four), then I find that what works better for me right now is to visit spiritual/religious websites.  This does not have to center on Christianity or Bible material.  No way is that a requirement.  In fact, I don’t study much of that at all.

Instead, what I gravitate toward are websites about Pantheism, Buddhism, Hinduism, Wicca, Paganism, and other religions.  I might read some stuff on the Abrahamic religions (Judaism, Christianity, and Islam) for educational purposes, simply to be well-rounded.  My reading up on each of these takes a more ethereal, esoteric flavor, such as Esoteric Christianity, the Kabbalah, and Sufi Islam (the more mystical aspect of Islam).

All of these are quite peaceful, unifying, and uplifting for me.  Even though I’m not of any Abrahamic faith, studying these helps me to expand my knowledge of other perspectives and feel more diverse as an individual.  When interacting with those who are more devoutly dedicated to these faiths, I can certainly use the reading I’ve done on the more esoteric “versions” in order to find common ground.

Possible Option #10: Cleaning/Organizing:

Although I don’t do this activity nearly often enough, I definitely derive a certain calming satisfaction when I do, even if it only begins to set in once I’m already well into it.  I think that the reason I don’t get that sense of peace any sooner in the process is because it actually causes me stress when I’m first starting out.  And I think that the reason for that involves my executive function issues, such as planning, sequencing, motivation, initiation, and so on.  If I’m able to sort through all of that and throw myself over those hurdles, then I can gain momentum and inertia (in a positive way) and make real progress that I feel good about.

The sense of satisfaction I derive from the later stages of cleaning/organizing probably comes from several factors:

1. Physical activity (again)
2. The fact that I’m doing something I can see and feel–something tangible for me
3. I’m doing something highly constructive and positive
4. The activity involves routine, repeated motions and lots of little details–mundane, ordinary things that often prove relaxing to me.
5. The room (or the apartment) looks dang good when I’m done!

Possible Option #11: Talking To Myself:

Of course, it’s crucial that I monitor what I say, only in that I approach myself as a neutral referee.  This means that the only rule I impose on myself is that I don’t talk down to myself or treat myself with cruelty.  I establish a judgment-free zone and then speak to myself in neutral, non-inflammatory terms.  I act like I’m talking to my best friend, and I don’t say anything to myself that I wouldn’t say openly and honestly to my best friend.

This gives me a chance to air my thoughts and feelings.  It also gives me an exercise in diplomacy.  It also gives me freedom to be me.  It gives me the opportunity to process something more fully, whether that “something” is an aspect of myself, a conversation I had with someone else, a decision I’m struggling to make, or an event that has transpired.

Talking itself can be a neat release, and when I do it to/with myself, there’s no one else’s feelings to have to consider, no social rules to have to follow, no other variables in the encounter.  I don’t have to worry about whether or not they’re getting bored or craving a snack or feeling the pressure of something else on their to-do list.  I can talk to myself until myself’s heart is content.

Possible Option #12: Practicing Gratitude:

One of the more powerful anti-depression methods I have is to stop, look around, take inventory, and catalog everything it is that I have going for me.  The fact that I have the physical ability to do what I want to do.  The fact that I have the mental ability to do my job and engage in my creative interests.  The fact that I have strong, close bonds with a loving family and a (very) tolerant, adaptive, and understanding partner.  The fact that WordPress has provided the world with a way to speak to the world without any cost out of pocket.  The fact that I have a broadband connection that is active 24/7, via which I can write these blog posts.

The fact that my region is coming out of a 50-year drought and our water tables are up to par once again (which we never thought would happen in our lifetime–even the science/meteorological experts were saying that wouldn’t happen, and we were starting to worry about water supply).  The fact that I have access to organic food, and just enough traffic flow at work to pay for it.  The fact that our current apartment doesn’t have cockroaches in it.  The fact that I live in a region I love.  The fact that I’ve traveled far and wide across this continent.

The fact that I’ve had the opportunity to go to specialized training.  The fact that I’ve been able to turn one of my most intense “special interests” into a career field.  The fact that I have no boss standing over me, micromanaging my every move (I’m my own boss).

The fact that I’ve finally discovered I’m an Aspie and have finally found the words to explain the concepts that I’ve been experiencing all this time.  The fact that I’ve found that I’m not alone, and that there are other people out there who truly understand me (and vice versa) in our own ways.  The fact that I’ve found a whole community with which to interact, and a potently miraculous handful of them have emerged as particularly good friends.  The fact that they make me roll with laughter while staring at my mobile phone screen on a Saturday afternoon.

The fact that my parents lived through their near-fatal car wreck.  The fact that we all have our health mostly intact.  The fact that even though I have EDS, I live relatively pain-free.  The fact that at this time, my healthcare providers haven’t seen a legitimate need for me to be on any medications, especially those with horrible side-effects.  The fact that I was able to resolve my own clinical depression (which did require medication, for years).  The fact that I haven’t developed a lot of other conditions that run in my family.  Sure, I have a crap-ton of health issues, but as far as I can tell, they haven’t had as much of an impact on my life (at least, not yet…fingers crossed!).

And so on…

When I stop to think about it, I have a metric tonne to be grateful for.  Seriously, I could fill entire college-ruled notebook pages with the list of items, both the “little things” and the grand, big things.  Just taking stock of the little miracles one does already have going for them can be absolutely huge in helping someone feel better.

Final Words:

Now… this is not to say that simply “thinking positive” or getting up and walking around or painting a picture or writing a journal entry is going to “cure” depression.  Engaging in some of these activities can definitely pull me out of a funk.  But there have been (many) times when either my crap diet caught up with me, or I was stricken by grief, or I was an unwanted participant in a conflict, or some unknown/unseen factor rained down on me, etc, etc, that none of these 12 Possible Options were even going to make a dent in.

I’m not going to engage in the mindset that we’re to blame for depression, nor am I ever going to place the responsibility (burden) on the person with the depression to “just snap out of it”.  I won’t even go there for one second.  Because we all know that it’s not that easy.

But maybe, just maybe, I’ve given a glimmer of support to someone who might need it and might could benefit from it today.  🙂

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(Image Credit: Leonid Afremov)

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