Depression? Anxiety? A Therapist’s Guide to Staying out of Therapy

Why would a therapist write an article helping people avoid therapy? For the same reason a physical therapist would write an article helping people avoid injury. It’s part of the gig.

A therapist should be interested in helping people avoid a situation that requires therapy, and I truly believe that the obvious points I’m going to cover below will help do just that for many.

These basic practices have kept human beings happy and vibrant for centuries, but in our time, in a media overload age, they have been roundly ignored.

Interestingly, when the average person becomes depressed or begins experiencing panic attacks or other anxiety related issues it rarely dawns on them to go back to the basics. Instead they seek a quick fix, a pill, a class, anything that will pull them out of the mire as fast as possible. But alas, it never works—at least not long-term.

Therapy is an obvious option, however, therapists often have their own battles to fight with the demand for quick fixes and wind up augmenting their client’s problems in the long-run. But even when a therapist has liberty to take time with a client they might still operate in a fog of theoretical orientation, which excludes giving attention to these basic principles.

So, before spending a lot of time and money on therapy it might be wise to make these things a matter of habit. If you do one of two things will likely happen: either you will eliminate your need for therapy altogether, or you will make your therapeutic journey far more effective by building a strong base with these habits.

(Note: Of course, if the nature of your situation is one requiring urgent inpatient or psychiatric treatment, getting immediate help should be first priority.)

1. Walk away from the screens

A recent study claims the average adult spends more than 11 hours per day interacting with media, 6 of those hours on video focused app/web. If one sleeps 7 to 8 hours per night that leaves a whopping 5 to 6 hours to eat, shower, get dressed, say hello to a living human, see a tree, smell a flower, pet a dog, you get the point. An existence absorbed in the act of pure information gathering is not the natural mode of a human being, hence this sort of existence is bound to cause disruptions in one’s mood and general psychic functioning.

Studies abound on the topic of media over-indulgence and its effects on mental health. One such study conducted at the University of Pennsylvania is particularly interesting. It claims to have found a causal connection (not merely a correlative one) between over-usage of social media and disturbances in mental health. The study divided 143 students into two groups: one group limited their social media use to 10 minutes per platform (Facebook, Instagram and Snapchat), per day, and the other group continued their social media use as usual for 3 weeks. The researchers state the following conclusion:

The limited use group showed significant reductions in loneliness and depression over three weeks compared to the control group. Both groups showed significant decreases in anxiety and fear of missing out over baseline, suggesting a benefit of increased self-monitoring. Our findings strongly suggest that limiting social media use to approximately 30 minutes per day may lead to significant improvement in well-being.

But, does it really take scientific research to know that your mental health is in jeopardy if you spend 11 hours of your day in front of a screen? Those in Silicon Valley didn’t seem to need it. When people like Steve Jobs and Bill Gates restrict their own kids from media usage you should know something is wrong. And the jury is still out on its actual effect on a child’s developing brain, but the recent explosion in teenage suicide should be, at a minimum, a reason for extreme caution.

What would happen if you intentionally put down your screens and simply took a walk, experienced nature, touched a leaf, looked at the stars, noticed yourself—your real self? What would change in your experience with life if you became more acquainted with actual life, with reality, rather than the images of reality projected from a screen? Can one have a vibrant life with images of real things rather than with the actual things themselves?

Can one have a vibrant relationship with the image of one’s spouse, or does it take having the actual spouse? Why is life in general any different?

But, will having a working relationship with actuality, with nature, make depression and anxiety magically disappear? No. Keep reading.

2. The Trinity of Health: diet, exercise, and sleep

The opposite of depression is not happiness; the opposite of depression is vitality.

Anyone experienced in depression knows that it is a life comparable to that of the walking dead—a lack of vitality far deeper than mere fatigue or sadness. It is a zombie’s existence, just less hopeful (at least zombies can eat fresh brains for energy).

You simply cannot—CANNOT—maintain vitality without proper diet, exercise and sleep. It is absolutely fundamental to winning the fight for mental health.

Consider the following.

A leading study explains how a healthy digestion tract not only does wonders for your bodily health, but serves to “guide your emotions.” This section of the article is worth quoting in full:

 Serotonin is a neurotransmitter that helps regulate sleep and appetite, mediate moods, and inhibit pain. Since about 95% of your serotonin is produced in your gastrointestinal tract, and your gastrointestinal tract is lined with a hundred million nerve cells, or neurons, it makes sense that the inner workings of your digestive system don’t just help you digest food, but also guide your emotions.

What’s more, the function of these neurons — and the production of neurotransmitters like serotonin — is highly influenced by the billions of “good” bacteria that make up your intestinal microbiome. These bacteria play an essential role in your health. They protect the lining of your intestines and ensure they provide a strong barrier against toxins and “bad” bacteria; they limit inflammation; they improve how well you absorb nutrients from your food; and they activate neural pathways that travel directly between the gut and the brain.

The bit about limiting inflammation is key according to vast amounts of research indicating that inflammation is a major contributing factor in depression. One study in a recent issue of Psychology Today claims that over 30% of documented cases of depression are directly linked with some form of inflammation in the body. If you are one of these cases you may spend a great deal of time in a therapy room or a yoga studio attempting to get ahold of your depression with very little long-term benefit if you don’t also address the inflammation.

According to the above article a great place to start is by adopting more traditional diets, like the Mediterranean and traditional Japanese diets, as opposed to a typical “Western” diet. These diets demonstrate a risk of depression 25% to 35% lower compared with our mainly processed Western diet.

Many more studies could be brought into the discussion concerning proper sleep and exercise, but suffice it to say (what is easily verified with a quick online search) that they play an equally critical role in mental health and work in tandem with a good diet. Get these right and you’ve accomplished a major victory in your fight for mental health.

But, will proper diet, exercise and sleep make depression and anxiety magically disappear? No. Keep reading.

3. Enjoy the silence

Here is where things can get really scary, really fast for many people. Many of us are so accustomed to noise and distraction that when we finally find ourselves in a place of peace and quiet our system, being utterly unacquainted with such, goes haywire.

I experienced this phenomenon many times when I worked as a psychotherapist in an inpatient hospital. I interviewed several dozen patients over the course of a couple of years asking them what their most difficult experience in the facility was. Without fail they routinely answered, “During off-talks.” Off-talks was period in the day when the mental health techs, worn out by either noise or fights on the floor, would demand no talking for 5 to 10 minutes. These brief moments of silence were torturous for the vast majority of patients.

Why? I theorize because silence is a stark and immediate reminder of our true selves, a reminder of our true existential situation—of being alone in the world. For a person who is already experiencing psychic disturbance this reminder is less than welcomed. It is instead treated as an enemy and fought with extreme earnestness by way of endless mental distraction.

This behavior is repeated by culture at large, not just by those in a serious battle for mental health. Silence, or, the term I find far more appropriate, “stillness”, is a difficult state for anyone to achieve. As an Orthodox Christian I have spent years studying the desert fathers, monks, and ascetics of the Church and have found endless examples of men and women who have spent several decades cultivating the practice of stillness through prayerful meditation. This, along with my own therapeutic education and practice of prayerful meditation, have settled the issue for me—stillness is difficult to achieve, difficult to maintain, but by far the single most important element in mental health.

This is a vast topic which I have no intention of pretending to cover in a short article, but rather intend only to use as a point of encouragement. Similar to the preceding two point, this third point is one that requires more action than discussion; one will not realize the benefits without action no matter what the degree of intellectual agreement one might have with them.

For further exploration on this topic see my article on “Beating Anxiety” through mindfulness, where I discuss how mindfulness can literally alter one’s brain structure (known as neuroplasticity) in favor of decreasing anxiety. A quick online search will reveal several thousands of articles on the subject, if the reader is so inclined.

But, will mindfulness make depression and anxiety magically disappear? No.

None of these points will in themselves be THE solution to depression and anxiety, but without these one faces awfully desperate odds. Similar to the parable of building one’s house on the sand and the rock, attempting to overcome mental illness without these things is equivalent to building a house on the sand. It will look good and feel good for a time, but when the storms come the house will fall apart. The practices discussed above provide one with a solid support for doing the work of building a house—a peace of mind—that will last.