The most effective way to relieve depression

There is no "universal relief method" that applies to everyone. A three-dimensional combination of "medical standard intervention + low-burden active adjustment + benign social support" that is individually matched is the most effective way to alleviate depression.

First of all, we must draw a boundary: the depression mentioned here refers to a depressive disorder diagnosed by a regular psychiatrist, which is different from ordinary low mood and bad mood. If you’ve just been working a lot of overtime recently and have fallen out of love, you can probably get over it by going out to eat your favorite hot pot or complaining to your friends for half the night. There is no need to use rigid clinical intervention methods.

Last month I received news from Xiaoxia, a case I followed up on before. When she was diagnosed with moderate depression last year, she tried all the "self-healing methods" posted on the Internet: forcing herself to run 3 kilometers every day, reading the Heart Sutra, and forcing herself to participate in social gatherings. After half a month, she was so collapsed that she couldn't even get out of bed, and she didn't even have the strength to brush her teeth. In the end, I still managed to go to the mental health center to register as a specialist. I took antidepressants for two months as prescribed by the doctor. First, I suppressed the suicidal thoughts that popped up every now and then. I then cooperated with weekly cognitive behavioral therapy. I also quit my Internet operation job that required all-nighters. Now I can go hiking with friends in the suburbs once a week.

The debate on whether to take medication has never stopped in the academic community. The anti-psychiatry school has always believed that psychotropic drugs are "emotional shackles" concocted by capital. They will only blunt perception and cannot solve the fundamental problem. However, you have to recognize objective clinical data: for moderate and above depressive episodes, the effective rate of standardized use of antidepressant drugs is stable at 60%-70%, which can quickly reduce the extreme risk of self-injury and suicide. This cannot be replaced by any Internet celebrity self-healing method. Of course, it does not mean that you have to take medicine as long as you are diagnosed. If you are only mildly depressed and your normal eating, work, and social life are not greatly affected, the doctor will not prescribe medicine for you casually. This should be controlled by a professional person. Don’t do some research on your own and just refuse to take it, or just buy medicine recommended by others and take it blindly.

To put it bluntly, the role of drugs is to pull you from the quagmire of emotions to the shore. The rest is to find a method that suits you, how to clean the mud on your body and how to avoid accidentally stepping in it next time. I once had a client who was doing back-end development. The doctor recommended mindfulness meditation to him to relieve his mood. He sat for two minutes and his mind was filled with unfixed bugs and unfinished needs to go online. The more he sat, the more irritated he became, and he almost smashed his phone. Later, he came up with a low-tech method: pick up plastic bottles in the community for 10 minutes after get off work every day without using his brain. After picking up, he threw them into the recycling bin and exchanged them for two yuan to buy a bottle of iced Coke. This small thing helped him get through the most uncomfortable withdrawal reaction smoothly. You see, it doesn’t have to be a high-end method to be effective. The cognitive behavioral school emphasizes adjusting distorted negative cognitions, the psychodynamic school advocates repairing past trauma knots, and acceptance and commitment therapy advocates not confronting emotions head-on and learning to live normally with symptoms. There is no distinction between high and low methods in these schools. The one that is comfortable for you and can make you better a little bit is the one that is best for you.

Many people will deliberately ignore the role of "helping others" on the road to fighting depression, always thinking that they have to "come out on their own" to be powerful enough. In fact, the role of this part of support is often much greater than you think. There was a male visitor in his 30s who did not dare to tell his family after he was diagnosed. He was afraid of being told, "Why is a grown man so pretentious?" He endured it for three months, and his condition got worse and worse. Later, he couldn't bear it and confessed to his wife. His wife didn't say "you want to be more cheerful" or "what a big deal". She just sat with him on the sofa for half an hour after dinner every night. We didn't need to talk, and we just played with our mobile phones. He said that during that period, he felt that "even if the sky fell, I wouldn't be able to bear it alone." His subsequent recovery speed was twice as fast as before. Of course, not all care can be called support. If the people around you will only preach and deny your feelings when they hear that you are depressed, then it is better to stay away temporarily and find a reliable counselor or a friendly stratospheric patient group. The "care" that is forced out will be more hurtful than nothing at all.

I have been following up cases of depressive disorder for almost 6 years. I have seen students who completely improved after taking medicine for half a year, full-time mothers who gradually smoothed their emotions by learning pottery, programmers who quit their jobs in large factories and returned to the countryside to grow oranges to recover, and patients who have tried all methods but still keep coming back. There is really no unified standard answer. Many people always like to ask "how are you doing well?" and then copy other people's methods. If it doesn't work, they blame themselves for not working hard enough. This is actually the most unnecessary internal friction - everyone's disease causes are different, the severity is different, and their living environment is also different. Someone else's good medicine may become a poison that increases your burden.

To put it bluntly, there is no essential difference between depression and fractures or pneumonia. If you have a fracture, you won’t go around asking “What is the most effective treatment?”. You must first go to a doctor to set the bone and put a plaster on it, and then slowly do your own rehabilitation. There will be someone around to help you hand you a crutch or get you a meal, right? The same goes for depression. Don't engage in "hard-core self-healing" heroism. Instead, find a doctor. If you don't want to move, just lie down and rest. It's good to have someone to accompany you. Don't force yourself to hold on if there is no one to accompany you. It really doesn't matter if you move slower. As long as you are moving in a good direction, you have already won over many people.