Is It Really Depression?
Depression vs. Unhappiness
Jody Stanislaw, ND
Depression. As a holistic practitioner, you certainly have worked with this condition. Without a universally agreed-on standard protocol, natural treatment options vary widely and can include a change in diet, blood glucose level balancing, exercise, more sleep, light therapy, 5-hydroxytryptophan, Saint-John’s-wort, fish oil, S-adenosylmethionine, dehydroepiandrosterone—the list goes on and on. Before jumping to prescribe any of these, an important question should be asked that is often ignored: “Is this really depression?”
A patient may have a loving family and friends, a good job, and a nutrient-dense diet and may care for the body through regular exercise and adequate sleep but still feels depressed. This situation likely necessitates the diagnosis of depression and a biological intervention to enhance the mood.
Other patients may be unhappy because they do not like their job, are unhappy with their spouse, do not feel a sense of purpose in life, are unable to identify what they love and appreciate about themselves, or do not have a supportive community. These conditions themselves are not depression. Such situations do not support a feeling of well-being for anyone and should not be labeled as depression.
In these latter cases, the best treatment plan is to underscore to the patient the importance of creating an action plan to change the unhappy situation. Of course, it would take less time to prescribe Saint-John’s-wort, for example. However, as holistic practitioners, we seek to treat the root cause, and clearly Saint-John’s-wort would not suffice.
Taking a pill would be an easier option for the client too. Again, however, the patient most likely would not get the relief he or she is looking for and eventually will schedule a return visit to report continued unhappiness.
This is not to say that any of the typical herbs or vitamins prescribed for depression would not at least have some part in helping to improve the patient’s mood. The main point is that we must ask ourselves the important question: “Is my patient truly depressed or just unhappy with life?”
Uncovering the answer may sound like a potentially over-burdensome and time-consuming undertaking, but I have a simple solution. On the last page of my intake form for new patients, I have a “wheel of balance,” a circle cut like a pie with 8 slices. The 8 areas are labeled as follows: health, friends and family, career, significant other and romance, money, personal growth, fun and recreation, and physical environment. The directions explain to start at the center of the circle of each slice and shade in the area in relation to how much satisfaction the patient has with that area of his or her life. Any areas that are less than half filled in will serve as a significant obstacle to cure; therefore, I make certain to address these during the patient’s appointment.
The most effective way to uncover the best course of action to improve patients’ situations is to simply ask them. I usually have many of my own ideas, which I become tempted to suggest. However, the most powerful source of action always comes from the patient’s own mind. So, I encourage you to let go of thinking you need to find the answer yourself and instead simply pose the following question to your patient: “What ideas do you have for ways in which you could improve this area of your life?” Then, just listen and support the patient in taking action on what he or she came up with.
I also often give my patients a 10-step process, which helps move them from the feeling of being stuck in their unhappy situation to action to create a life they love. As part of their treatment plan, I give them a list of questions, which take them through all 10 steps. I explain that spending time answering these is an absolute key part of their “prescription” for improving their mood.
The 10 questions are as follows:
- What intention do you have for your life? (For example, joy, service, family….)
- Are you living in integrity? (Living out of integrity does not coincide with happiness.)
- What purpose do you want to fulfill in your life?
- To feel satisfied with your life, what things do you feel you must do before you die?
- What does your doubter voice say about obstacles to creating change, and are they truly realistic? (The knee-jerk answer is usually yes, so one must dig deep here.)
- Do you believe you can make change? (If the answer is no, change likely will not happen.)
- Can you see the growth gained from failure? (Being able to see this is key because otherwise, when the first obstacle is encountered, it is easy to take it as “proof” that one should give up.)
- Write a list of as many action steps you can think of that would bring more joy into your life. (Be creative here; reach beyond the doubter voice, and tap into the fun of what might show up.)
- Who can support you in making change? Who can you ask for help?
- How can you support yourself in staying committed to your plan of action for creating positive change in your life, even when you feel like it is too hard and want to give up?
Sometimes, I just give this out as a handout. However, I also encourage my patients to enroll in ongoing support to truly incorporate the answers into their life. My program includes an initial 90-minute appointment, plus a 30-minute phone appointment with me each week and a workbook with exercises that dig deep into helping them uncover their answers to each of the 10 questions. Patients who go through this 10-week program enjoy the fruits of lasting and positive transformation in their life that results in true health and well-being from their core.
My patient Pam was a 40-year-old mother of 2 young boys. She came to me feeling depressed about not having a life outside of being a mom (which is not a diagnosis of depression), describing herself as stressed and tired, and wanting to lose 40 lb. She signed up for the 10-week program and enjoyed diving into the weekly exercises in her workbook.
She not only became clear on what changes she wanted to make in her life, but she also discovered a clear plan of action for how to make positive change in her life. By the end of the program, Pam had created an inspiring business plan for starting her own gluten-free bakery, and she had gone from rarely exercising to not feeling right if she even missed one day. In addition, she had removed sugar from her diet, and she became an avid lover of vegetables. As a result, she had lost 20 lb.
The transformational process described herein was developed by Marcia Wieder, CEO of Dream University. This process is a result of her 30 years of working with clients, in the United States and abroad, to support them in moving from feeling stuck in their life to having the clarity and motivation to create a prosperous and successful new reality.
If you would like to learn more about this process or have patients you believe would benefit from the 10-week program, please feel free to send me an e-mail.
The next time you have patients coming to see you for “depression,” I encourage you to have them fill out the wheel of balance. Then, simply ask them what they feel is necessary to improve any of the weak areas of their life. You will be truly treating the root cause of disease and serving as a powerful catalyst for them to create a life full of joy and happiness.
Jody Stanislaw, ND received her naturopathic degree from Bastyr University, Kenmore, Washington. While working in Thailand in 2008 with patients from all over the world, she realized the universal need for simply supporting patients in healthy living and its powerful influence on improving health. Her practice is located in Sun Valley, Idaho, where she offers programs for lifestyle optimization via wholesome nutrition, regular exercise, adequate sleep, and emotional well-being. She also works with out-of-town patients over Skype. To contact Dr Stanislaw, please visit www.DrJodyND.com or send an e-mail to DrJody@DrJodyND.com.