Mindful recommends that anyone with depression or mood disorders consult a mental health professional before beginning or altering any course of treatment. Our articles do not constitute professional medical advice for your precise circumstances.
“Depression is not a disease,” says Dr. James Gordon in his book Unstuck: Your Guide to the Seven-Stage Journey Out of Depression. “It is a sign that our lives are out of balance, that we’re stuck. It’s a wake-up call and the start of a journey that can help us become whole and happy, a journey that can change and transform our lives.”
For anyone who has experienced depression firsthand, this view may come as a surprise—and a relief. For anyone who’s had a doctor hand over a drug prescription at the slightest sign of the blues, Gordon’s take may seem like heresy.
And it’s about time.
Depression ranks as the “most disabling of nonfatal conditions in the United States and around the world,” according to Gordon. It is, he says, “the defining disorder of our times.”
The statistics in Unstuck underscore the point. One in five Americans will have an episode of either major depression or dysthymia (defined as a “disordered and depressed mood”) during their lifetime. More than 13 million Americans will have a major episode of depression this year, and countless others will experience symptoms that don’t quite reach the threshold for clinical diagnosis. Depression makes people more likely to suffer from a host of other problems, such as heart disease, alcoholism, and diabetes. The annual cost of lost productivity is more than $50 billion a year.
Increasingly, the most common way to treat depression of any kind is by prescribing pharmaceuticals. Gordon sees antidepressants as a reasonable—and sometimes necessary—last resort, if no other treatments are found to help. But, he argues, drugs are by no means the place to start.
Gordon takes a more positive and empowering look at depression, but this is no Pollyanna approach. Depression can be serious, so do consult a doctor. But also take the time to consult yourself. If you are navigating any level of depression, you may be feeling miserable and disoriented, but, in Gordon’s words, “that doesn’t mean you don’t have intuition. People have a sense of what’s right for themselves.”
As for the rest of the journey, there’s no magic bullet. Personal effort is required. Whether Gordon is counseling patients or training other health care practitioners to take a more mindful approach, it’s the active involvement of tuning in to your body, exercising and eating well, and digging more deeply into the bigger questions of life that is called for. And on the other side of that journey? There lies the possibility of living a more enriched life with greater resilience, health, appreciation, and balance.
Mindful sat down to talk about the Unstuck approach with Gordon, who is the founder and director of The Center for Mind-Body Medicine in Washington, D.C. He’s a graduate of Harvard Medical School and a clinical professor in the departments of psychiatry and family medicine at the Georgetown University School of Medicine.
The hallmarks of depression are hopelessness and helplessness. My approach is grounded in hope and helping people help themselves.
Mindful: Why do you think it’s a bad idea to define depression as a disease?
James Gordon: When you’re in the midst of depression, you don’t know where your life is going, you’re feeling unhappy and pessimistic, and you don’t feel like interacting with others. When you’re trying to navigate that kind of condition, I don’t think it serves you best for someone to describe that as a disease.
Mindful: Why not?
JG: First of all, it’s inaccurate, because depression doesn’t have a regular pathological set of symptoms or signs. They differ from person to person. The broader implication is that this is something that needs to be treated, almost always with medication. When we call depression a disease, we define it as something chronic and essentially out of the realm of one’s own understanding. We treat it as an enemy. In that view, depression is something to reject and suppress, rather than a situation where we have the possibility of learning what’s going wrong in our lives and how to put our lives back into balance.
Mindful: What kind of imbalance are we talking about?
JG: It may be physical, emotional, mental, conceptual, social, spiritual, or all of them at the same time. They’re all connected, so the idea is to look at the ways you’re not in balance at this moment. When I work with a patient, I know that sooner or later I will need to address all of these dimensions. Each is part of who we are, and they have a profound effect on each other.
Mindful: Can you give an example of being out of balance?
JG: Say you feel an overwhelming yearning for a man or woman who’s left your life. You can’t stop thinking about him or her—you’re totally focused on that person. That’s understandable, but it’s also a kind of imbalance. You have already set up the script, so you’ve got to watch your mind—watch how it’s creating that kind of imbalance.
Mindful: What are some first steps to regain balance?
JG: Healing is based on hope, connection, and taking a more meditative approach to our lives. It starts with knowing you can make a difference in how you feel and how you live.
Recovery happens in small ways. Feeling connected to your body is important. When you move your body—even if you can only walk a few blocks—you generally feel a little better. It helps to appreciate the things you do have, even while grieving what you’ve lost. Beginning a meditative practice can help you gain some perspective. That’s important because the more perspective you have regarding your imbalances, the less they can throw you out of balan