Mindfulness in Turbulent Times
In the past few months I have witnessed tremendous increases in anxiety, irritability, depression, and fear about what’s happening in our country and the world, in my mindfulness students and therapy clients (as well as among friends, family, neighbors and most everyone I interact with). At the same time, I’ve heard more people questioning the value of mindfulness practice in these crazy, chaotic times.
How can we make sense of the current political climate in the U.S., and particularly the constant assault on our Democratic institutions and dedicated public servants, from a mindfulness perspective? And more importantly, how can mindfulness help us to manage the anxiety we’re feeling? Here are some thoughts:
1) Mindfulness is not an escape from reality, but rather an embracing of reality that offers true refuge, as the American Buddhist teacher Tara Brach’s book of the same name explains. It gives us a solid ground to stand on, unlike the false refuge of our various addictive behaviors and ways we all have of numbing ourselves or checking out. When we are truly mindful, we can see clearly what is happening, without getting overwhelmed, and we’re less likely to be fooled by those who seek to manipulate our emotions.
2) When we learn to stop, take a breath, and observe what’s happening, both around us and within us, before we act/speak, then we begin to see the full range of choices available in how we respond, to any situation we face. We can choose our response carefully, rather than act/speak reactively. This is a fundamental freedom that no one can take from us, as Viktor Frankl, the Austrian psychiatrist and concentration camp survivor, said so eloquently in his book, Man’s Search for Meaning. Mindfulness practice teaches us response-ability.
3) Mindfulness asks nothing more, and nothing less, of us than deep and honest self-reflection. While the guiding principles of mindfulness are fairly simple, it is not easy to practice, because it requires that we acknowledge all of our thoughts, emotions, actions, and reactions, even the ones we’re not so proud of. It holds us accountable for our words and deeds, asking that we speak wisely, and choose skillful action, in ways that are not harmful to ourselves or others. In other words, the opposite of what’s been playing out in the political arena over the past months!
4) Mindfulness increases our capacity to tolerate strong negative emotions and difficult situations. Another of my favorite American Buddhist teachers, Pema Chodron, says, in her book When Things Fall Apart, that things are always falling apart and coming back together again, that much of our suffering comes from our resistance to this inevitable process of change, and that “the healing comes from letting there be room for all of this to happen: room for grief, for relief, for misery, for joy.”
5) There are two opposing forces in the universe, chaos and rigidity. We can see rigidity in how the current occupant of the White House tries to impose his will on others: that’s authoritarianism. We can see chaos in the impulsive and cruel actions of his unelected hatchet man: that’s nihilism. Neither extreme is good. And all of humanity’s struggles can be understood as a quest to find balance between these two forces, both in the world and within our own minds. Dan Siegel, the interpersonal neurobiologist, discusses these ideas in his book, Mindsight. Mindfulness meditation practice can lead us to that balance, a “middle way.”
6) Finally, Mindfulness invites us to acknowledge our common humanity, to recognize the fundamental truth that most people want the same things – to be able to take care of themselves and their loved ones, to have financial security, to enjoy basic rights and freedoms, and to be happy. As the television producer Norman Lear used to say, “I am just another version of you.” When we look for the common humanity in each other, we build bridges to understanding and compassion, rather than building walls and more hatred.
In closing I would like to offer a couple of mindfulness practices for these challenging times. The first one is called The Mountain Meditation, adapted from the Mindfulness-Based Relapse Prevention curriculum, and originally published by Jon Kabat-Zinn in his book, Wherever You Go, There You Are. The second one is a brief practice, borrowed from my colleague Renee Burgard, LCSW, called the Mindful Self-Compassion Break. Both can be found on this website, on the Guided Meditation audio files page. Password is “patience”.
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Alcohol Is Not a Health Food
Here’s yet another reason for “Dry January,” if not “dry indefinitely”: US Surgeon General Vivek Murthy says alcohol consumption causes cancer, that it is responsible for 100,000 cases of cancer and 20,000 cancer deaths annually.
“The direct link between alcohol consumption and cancer risk is well-established for at least seven types of cancer including cancers of the breast, colorectum, esophagus, liver, mouth (oral cavity), throat (pharynx), and voice box (larynx), regardless of the type of alcohol (e.g., beer, wine, and spirits) that is consumed. For breast cancer specifically, 16.4% of total breast cancer cases are attributable to alcohol consumption.”
Do we need warning labels on every bottle, as he’s proposing? Setting aside the fact that it won’t happen due to pushback from the alcoholic beverage industry, I think it would probably be a waste of time and money, because it’s not likely to change anyone’s behavior. Most people who drink already know that alcohol can be harmful to the body, because they’ve had one or more harmful experiences, or “negative consequences” as we say in healthcare, and yet they keep drinking anyway. But that’s the cynic in me talking.
The optimist in me says, Yes, even if it only moves the needle 10%, that could save 200 lives! More, given the many ways that drinking can lead to death. While most people don’t heed warning labels, some do, and although it won’t help the folks who are committed to drinking regardless of risk, it may get the attention of those who are concerned about their health and want to increase their chances of living a long and healthy life.
His advisory has already got our attention – I’ve seen half a dozen news articles on the topic in the past week – and talking about it could lead to behavior change. We can’t change that which we are unaware of, so the first step in change is awareness.
If you’re skeptical of this news, that’s not surprising. After all, hasn’t the medical community been telling us for decades that moderate drinking is safe, even a healthy habit?
Here’s what I know, based on my training as a substance abuse counselor, over 40 years of experience counseling adults who drink too much, and my own personal experience. In a nutshell:
* Alcohol is both an intoxicant and a toxin
* Its addictive potential is strong
* In small amounts, it produces some pleasant benefits, like relieving social anxiety and stress
* But it comes with serious risks, including painful illness and death, which are not always proportionate to the amount consumed.
* It is so ubiquitous in our society that if you don’t drink you’re considered odd, and if you do, it’s very easy to consume too much.
How much is too much? That’s a key question. Do you know that before the 1980’s, a standard drink was considered to be 1 oz of spirits, or 4.2 oz of wine? You could get six drinks from one bottle of wine. But drinks, like food, got supersized, so that now the standard drink is 1.5 oz spirits, 12 oz beer and 5 oz wine. Many restaurants offer 6 or 8 oz pours of wine, while craft beers and hard seltzers have a higher alcohol content. Right there you can see how easy it is to overdrink, and how common it’s become. (Here’s a standard drink chart for reference.)
The notion that moderate drinking is healthy originally came from Scandanavian health survey data, which showed a correlation between “moderate” alcohol consumption and low rates of disease. First, correlation is not causation. Moderate drinkers might have good genes, or a healthy lifestyle, or get health checkups more often. Second, it turns out that “moderate” drinkers in those surveys were those who drank “more than none,” anywhere from 1-2 drinks a year up to 1 drink a day. From this data, our American healthcare experts extrapolated that it must be healthier to have a drink a day than none at all!
To be clear, alcohol is not a health food, and there is no universe in which it’s healthier to drink alcohol than to abstain. Doctors who have “prescribed” a drink a day, or assured their patients that “moderate drinking is perfectly safe” are either uninformed, afraid to offend their patients, or in denial about their own alcohol consumption. But we can’t just blame doctors; most people want to believe that 1 to 2 drinks a day is okay.
In reality, for most people most of the time, drinking is a pleasant experience. Alcohol is an effective mood enhancer, at least initially, and it can anesthetize physical pain as well as numb emotional pain. Because it lowers anxiety and inhibitions, it serves as a “social lubricant” for many people. Many people like the taste, and enjoy trying different drinks.
Can something be both good for you and bad? Sure, consider acetominophen (Tylenol). It’s available over the counter, so it must be safe, right? Yes, if you take 325 – 1,000 mg every 4-6 hrs, as the label directs. But wait – just 4,000 mg over 24 hrs can cause liver damage! The same is true of ibuprophen (Advil), which is safe for pain relief if taken as directed, but can destroy your stomach lining if you take it in large quantities. There’s a fine line between a safe amount and a risky amount, just as with alcohol. (And fentanyl, which I had for a recent surgery, but obviously wasn’t given a 12-pack to take home!)
The comparison with fentanyl is more apt than with acetominophen, because of the potential for addiction. Nobody gets addicted to Tylenol. Why? It’s not an intoxicant, it doesn’t give you a buzz or mellow feeling. So understanding the addictive potential of alcohol is also an important factor in deciding whether it’s safe for you to drink.
For many years, people thought it was perfectly safe to smoke cigarettes, and they smoked in restaurants, offices, airplanes, even hospitals! We now know that for many years the tobacco companies spent lots of money to suppress the research that showed smoking causes cancer, and that nicotine is addictive. Now these are well-known facts, and yet, some people still choose to smoke. (Another US Surgeon General warned about smoking and cancer back in 1964, but smoking behavior didn’t change for decades.)
The risks associated with alcohol consumption are also known, and the alcoholic beverage industry has also tried to hide that research, but mostly, it just spends millions of dollars every year on marketing campaigns to convince you that everyone drinks (not true), and that drinking alcohol will make you happier, sexier, and a lot more popular!
These days, it’s a safe bet that most people who drink are drinking too much, and should drink less or quit, for their own good. So why don’t they? The most common reason people have trouble changing their drinking habits is simply that a habit can be difficult to change, especially when there’s so much encouragement for drinking in our society, and when it’s so readily available and relatively inexpensive.
Most people can drive over the speed limit without getting a ticket or having an accident, and we usually don’t even think of that as “risky” behavior. In the same way, we don’t tend to think about drinking as risky, and any negative consequences from drinking may seem so rare or unlikely to happen that they’re easy to dismiss as “it’ll never happen to me.” (By the way, that’s the title of a classic book about children of alcoholics, and ironically, if you have a parent who is or was an alcoholic, your odds of developing alcoholism increase by 50%.)
Another reason some people drink too much is they believe “everyone drinks like this, and that’s just how it is.” They think of drinking as a super fun activity to do with friends, which makes them feel sexy and no longer shy, and so what if they black out or have a terrible hangover the next day, doesn’t everyone? This thinking is common among people who may have started out with binge drinking in high school or college, and don’t know any other way to consume alcohol. (Binge drinking is defined as 5 or more drinks on one occasion.)
I have counseled hundreds of adults who have experienced “negative consequences” (blackouts, DUIs, relationship problems, health issues, job jeopardy) from drinking, and would like to learn how to avoid future negative consequences. None of them have wanted to quit completely, and most didn’t believe they needed to quit, because “I’m not an alcoholic, I just enjoy [the taste, the way it relaxes me, the social aspect]”. So we start with a treatment goal of drinking less, not quitting.
My experience has confirmed what the research shows: indeed, some people can learn to drink less, so that they lower their risks of negative consequences. Usually it’s younger people, who have been drinking for fewer than 10 years, who don’t have a family history of alcoholism. Occasionally it’s an older person who just needed to learn a few tips, like to drink only occasionally, not drink on an empty stomach, alternate alcohol with drinking water, stick to 1 or 2 drinks, and to say a firm “no thanks” to another one.
But most of my clients who have experienced one or more negative consequences from drinking haven’t been successful at moderation. They quit counseling instead, or in some cases, come to the decision that it might actually be easier to abstain completely, because it seems to require too much self-discipline to drink less.
Frankly, one major reason some people continue to drink too much despite negative consequences is that they’re already addicted and just don’t know it, because alcohol use and abuse exist on a spectrum, where the lines between “moderate drinking,” “risky or problem drinking,” and “alcoholism” are difficult to discern. If addiction has already taken hold, chances of learning to drink moderately are slim, no matter how much willpower a person has.
I believe it’s still worth trying to reduce a dependence on alcohol, so I support “Dry January,” and “Sober Curious,” and encourage you to consider other experiments in abstinence. Keep a log or journal of thoughts and feelings that arise when you’re choosing to not drink, and pay attention to what your mind and body tell you – it might be very informative!
If you’d like help figuring out your relationship to alcohol and whether it needs to change, please feel free to reach out to me. I’m not taking new patients for long-term therapy, but I am available for short-term consultation, assessment, and referral. I also recommend checking out the ReThinking Drinking website.
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Did the Election Kill Our Hopes and Dreams for a Better World?
“Hope is being able to see that there is light despite all of the darkness.” Desmond Tutu
Well, I was hoping to retire in 2025, but after the election, it looks like my services are needed more than ever, and may be for years to come. So this is my first post in a long time, but it won’t be the last.
These are challenging times. The emotions people have described to me run the gamut, including afraid, angry, anxious, despairing, disillusioned, grieving, heartbroken, and sad. I tell them, these are all normal reactions to an abnormal set of circumstances, and it is entirely appropriate to feel like mourning, or crawling under the covers, or seeking a way to numb yourself. If you are having thoughts of harming yourself or others, however, it is imperative that you let your therapist or me know right away.
It is also a very strange time. Many of us are feeling like we’re at a funeral, or sitting shiva, while on the other side of the street, people are shouting for joy and turning cartwheels. It feels surreal. It’s hard to be on social media right now, let alone out in the world. You may not feel safe, and you may in reality no longer be safe, if you’re a member of one of the groups that the incoming administration despises.
You may be feeling alone right now. It’s as if the majority of the country has turned in a totally different direction than the one you had believed we were all heading toward. And maybe your friends, the ones who believe in what you believe in, are too distraught to even talk about it. But you’re not alone, I assure you. There are millions of Americans who still believe that a kinder, more tolerant, more equitable and more socially just world is possible.
I am not an economist, historian, or political analyst, so I’m not going to try to explain what happened, or why. I intend to stay in my lane here, by speaking from both personal and professional experience about pathological narcissism and its toxic effects. In my family of origin, I was the one who first confronted mistreatment, and called out the lies and distortions of reality, and for that I was scapegoated. So I have always supported the victims of bullying behavior, and I learned at an early age to judge people’s character by their actions, not their empty promises.
I am a psychotherapist by training, a social worker by education, and a lifelong observer of people, so I’ve learned a lot about human nature, both its positive or “prosocial” side, which I believe is our true nature, as well as its dark, antisocial side. I’m not religious, but have come to believe in the existence of evil.
And while I’m not a Buddhist, I am a student of Buddhism, which refers to those darker impulses of human nature as “greed, hatred and delusion.” So I will say that it looks like greed, hatred and delusion have won this time, vanquishing the benevolent forces of generosity, kindness, and tolerance of differences. But if they’ve won the battle, I refuse to believe they’ve won the war, because there are simply too many of us on the other side.
So if you’re having a hard time coping right now, if your anger or fear or sorrow or despair are getting the best of you, please, please, please reach out. I am here and I want to help, whether to take you on as a psychotherapy patient, or as a member of one of my mindfulness groups, or by finding another therapist or support group for you. Together we can help you get grounded, find your voice and inner strength, and perhaps then figure out what role, if any, you want to play in what I’m going to call “the resistance movement.”
Thank you for reading – may you be safe and free from harm.
As another astute observer of human behavior once said, this wannabe dictator’s ideology is “purposeful, vindictive chaos,” and “it is going to take relentless stamina, vigilance, and every institutional check and balance this great country can muster” to stop his destruction. “No one action will be adequate, all actions will be necessary.” (Jon Stewart on the Stephen Colbert show, 1/31/17)
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Living with Loneliness
Loneliness, a normal part of the human condition, has reached epidemic proportions in recent years. Amplified by the social isolation that the COVID pandemic imposed (and continues to demand of the elderly and the immune-compromised), loneliness as a social issue was already on the rise. As I wrote in a 2017 post on social support (1), a national survey revealed that 25% of Americans said they had no one in whom they could confide or share a personal problem. (A similar survey in 1985 had reported that most people had at least 2 – 3 trusted confidants.)
The highest reported rates of loneliness are among seniors, who are more likely to be living alone, retired from the workforce, and needing to protect themselves from the risks of catching not only COVID but all of the other viruses circulating out there. One of the most unfortunate consequences of our modern society, particularly in this country, is the sidelining of elders, who in earlier generations were considered a necessary part of a family, whether as caregivers for grandchildren and keepers of the home fire, or as sources of wisdom and familial history and traditions. Now, many elders are left feeling superflous, invisible, not belonging anywhere.
Right behind seniors in reported rates of loneliness are teens, who are developmentally still learning social interaction rules and skills, and who were hit hard by the closing of schools during the lockdown. Some still have not returned, or have dropped out. Teens lack the perspective that “this too shall pass,” giving more urgency to current distressing circumstances. And they are more reliant on their smart phones and social media, which create a false sense of being connected while not requiring any direct social interaction at all.
And in between are the rest of us, who may be experiencing loneliness for a variety of reasons, and to a greater degree than before. Everyone feels lonely sometimes, but as a recent article in The Atlantic says, “emerging evidence suggests that we are in the midst of a long-term crisis of habitual loneliness, in which relationships were severed and never reestablished.”(2)
According to Vivek Murthy, US Surgeon General, this is a public health issue.(3) Indeed, research has shown that loneliness is a risk factor for several kinds of health problems, including cardiovascular disease and dementia, as well as mental health, especially depression and suicide.(4)
While other nations (Japan,England) have created governmental agencies tasked with finding solutions to loneliness (5) the US has tended to regard it as an individual problem rather than a societal one, leaving Americans to cope with loneliness on their own. Ironic, but not surprising!
So if you are experiencing loneliness, you’re not alone! Know that this is a common condition in today’s world, caused by many factors over which we have little or no control (including the pandemic, political polarization, and over-reliance on smart phones and social media) so you are not to blame. I repeat, it is not your fault.
However, it is up to you to do something about it. The best remedy for loneliness is to reach out to other people – not to ask for help, but rather to offer it, either as a volunteer or a friend. There’s truth to the old adage, “get busy helping others and you’ll soon forget your own troubles.” As I have written previously,
It is easier to give than receive. Most people find it much easier to offer help, than to be the one asking for help. Research on the health benefits of social support shows that while giving support is correlated with health and living longer, receiving support conveys no longevity benefit. Perhaps this is because it’s stressful to ask for help, or because those who receive support are already suffering more ill-effects of stress. (6)
Find something you can do that will force you to get out and interact with other people. Make an effort to be kind and friendly to others. Look for opportunities to interact in person, from taking a walk with a friend to signing up for a class at a senior center or community college. Don’t be afraid to call someone you haven’t spoken to in a while – there’s a good chance that they may also be feeling lonely! And finally, if you’re not already seeing a therapist, consider contacting one. It can help just to talk about it.
NOTES
1. Here’s the blog post I wrote in 2017 on social support, that includes this startling statistic: Social Support – The Survey
2. “How We Learned to be Lonely,” by Arthur C. Brooks, The Atlantic, 1/5/23 (if you can’t access this online, let me know and I can send you a copy of the article from the print edition)
3. “The Pandemic of Loneliness,” article on the California Health Care Foundation website, published 8/2/21
4. “How Loneliness is Damaging Our Health,” by John Leland, New York Times online edition, 4/20/22
5. Vivek Murthy speaking at online international conference on loneliness, sponsored by the UK’s Campaign to End Loneliness (2/8/23)
6. Quote from my second blog post on social support in 2017
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Depression Treatment News
Reported rates of depression have increased dramatically in the last few years, possibly related to the COVID-19 pandemic and its associated stressors, like social isolation (1). However, it seems that many people who report depression symptoms are not getting treatment (2) while others are questioning whether antidepressant medications are as safe and effective as we’ve been told (3). And while there have been some new and promising treatments, they are not widely available due to cost and lack of access. That’s the bad news, in a nutshell. The good news is that there are many proven effective non-medical alternatives for treating depression. This article will briefly summarize current medical treatments for depression as well as alternative treatment options.
New(ish) medical treatments include Transcranial Magnetic Stimulation (TMS) and Psychedelic-assisted therapy, of which ketamine or Spravato is the most well known. TMS and Spravato have both been approved by the FDA for “treatment-resistant” depression, which simply means depressive symptoms that haven’t responded to conventional treatment with a medication like Prozac or Zoloft, the selective serotonin reuptake inhibitors (SSRIs).
TMS involves having your brain “zapped” by electromagnetic charges. While that may sound scary, it is painless and relatively risk-free, with a fairly good success rate. The downside: it must be administered at a doctor’s office in a series of sessions, usually about 30 over six weeks, and it’s expensive if your insurance plan doesn’t cover it. Recently, researchers at Stanford University School of Medicine have developed a new version that can be completed within five days, which could be a game-changer if it’s approved by the FDA and covered by insurance (4).
Ketamine has been around for a long time. Originally developed as an anesthetic, it became popular as a party drug due to its hallucinogenic properties. Some doctors have been using ketamine infusions on an experimental (“off label”) basis to treat depression, which again is fairly costly and not covered by most insurance plans. I have a few patients in my practice who’ve had this treatment; while one experienced remarkable results, the others did not. In 2019, the FDA approved a nasal spray version of ketamine, Spravato (5). I don’t know anyone who’s used Spravato, so I can’t speak to its effectiveness, but at $3000 to $6000 per month, and with no research on its long-term effects, it’s simply not a viable option for most people. If you’d like to learn more about ketamine treatment for depression, see the notes below for a link to a fairly readable scientific article (6).
Another psychedelic drug currently being studied as a depression treatment is psilocybin, the active ingredient in “magic mushrooms” (7). A recent study found that just 2 doses could relieve depressive symptoms for up to 12 months (8). Psilocybin is classified by the federal government as a controlled substance, and therefore cannot be prescribed by a doctor nor obtained over-the-counter, though a number of states and cities have recently passed legislation to decriminalize it. There’s a lot of money being poured into psilocybin research right now, and many universities have established centers for psychedelic research, so one way to get this treatment may be to join a clinical trial (9).
Meanwhile, as doctors are prescribing more antidepressant medications than ever, others are questioning the efficacy of these medications, and whether their risks outweigh any benefits. A recent analysis in a respected medical journal concluded that “the real-world effect of using antidepressant medications does not continue to improve patients’ health-related quality of life over time.” (10)
We have been taught to believe that SSRIs (selective serotonin reuptake inhibitors) are safe and non-habit forming, so they can be taken indefinitely, and also discontinued easily. This is only partially true. SSRIs do have fewer harmful side effects than the older generation of depression meds. They are not addictive in the same way that opiates or benzodiazepines are, meaning you won’t develop cravings. However, their effects and side effects are definitely not harmless, quitting them abruptly can have negative consequences, and many people have found that even a tapered withdrawal may cause unpleasant effects, which can last for months or years in some cases. A study published in The Lancet, the British medical journal, in 2019 demonstrated that withdrawal from standard antidepressant medications is much more protracted and difficult than most doctors believe. (11)
I just watched a very interesting webinar on Antidepressant Drug Withdrawal Syndrome, which is a real problem for many people, so whether you are on an SSRI, thinking about taking one, or wanting to get off one, you might want to watch it too!
So what can we conclude from all of these studies? First, the mechanisms of how antidepressant medications work are still poorly understood. The theory that depression is caused by a chemical imbalance, specifically a lack of serotonin, has not been scientifically proven, in fact there’s very little evidence for it.
Second, depression is not like getting the flu or strep throat. There’s often no clearly identifiable cause, such as a virus or bacteria that can be tested for. There isn’t a predicatable course of illness. It shows up differently in different people, and even in the same person at different times. There’s debate about whether it should be considered an illness, for these reasons. Maybe it’s just part of the human condition? And third, we need to keep in mind that research on new treatments is usually funded or sponsored by pharmaceutical companies, who routinely sacrifice scientific rigor in their drive to push a new product to market, putting profits before people’s health and well-being.
There are many alternative treatments for depression, most of which are cheaper and have few or no side effects; many have been scientifically proven to be effective. Let’s start with dietary changes. Did you know that 95% of the body’s serotonin is produced in the gut? As Leslie Korn writes in Nutrition Essentials for Mental Health, “the standard American diet, consisting of overly processed foods containing refined sugars, leads to chronic inflammatory states and neurotransmitter imbalances. Inflammation is now understood to underlie most mental illness, including depression. Chronic low-level inflammation contributes to depression and cognitive decline.” (12) Read my blog post about how dietary changes can improve mood here.
Other effective approaches for treating depression include behavioral changes, especially improving sleep quality and increasing exercise; herbal remedies (St. John’s wort, tryptophan, 5HTP); nutritional supplements (Omega 3 fish oil, vitamin D, and B vitamins, especially folate); self-help groups (the Depression and Bipolar Support Alliance); social support networks, and various forms of psychotherapy, including cognitive-behavioral therapy (CBT and ACT) and of course my favorite, Mindfulness-based Cognitive Therapy (MBCT). MBCT has been proven to be at least as effective as antidepressant medication in preventing the recurrence of depression (13).
That’s the real news about depression treatment: if you start with improving sleep, exercise, and nutrition, then add social support, CBT, and mindfulness, it’s possible to achieve better and longer-lasting recovery from depressive symptoms, at least for many people. So rather than keep chasing after that elusive “magic pill” (which I don’t believe exists) doesn’t it make more sense to try some of these alternatives?
NOTES
- According to the most recent National Survey on Drug Use and Health, taken prior to 2020, depression rates were already rising among teens and young adults
- Trends in U.S. Depression Prevalence From 2015 to 2020: The Widening Treatment Gap, published in the American Journal of Preventive Medicine, 63(5)
- Antidepressants Don’t Work the Way Many People Think, by Dana G Smith, New York Times online edition,11/8/22
- The short timeframe Transcranial Magnetic Stimulation developed at Stanford University School of Medicine, NPR 2/6/22
- FDA approves Spravato (esketamine), a nasal spray for “treatment-resistant” depression, New York Times online edition 3/5/19
- A fairly readable scientific article to learn more about Ketamine treatment for depression
- This is a good overview of Psychedelic-assisted therapy
- Recent study on Psilocybin treatment for depression at Johns Hopkins University
- If you’re interested in How to find Psychedelic therapy, including how to enroll in a clinical trial
- Analysis concluding that antidepressants don’t improve quality of life
- The seminal study in The Lancet demonstrating the antidepressant withdrawal syndrome is real
- Korn, L (2016) Nutrition Essentials for Mental Health
- Kuyken, W., et al. (2016). Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials.