It’s been three years since the big depression episode I wrote about in the Beggar’s Fortune series. In those three years I’ve had very minor and fleeting brushes with depression. And I’ve learned a lot about what causes my depression and how to prevent and treat it without pharmaceuticals.

What Causes Depression?

The causes of depression are too numerous to list here. And everyone’s experience with depression is different. Here’s some of what’s behind my depression and how I’ve treated it.

Cause #1 – Stress

A study published in the Journal Of Neuroscience found that the hippocampus is smaller in the brain of a person diagnosed with depression. It’s theorized that stress is to blame. Stress releases hormones in the body which are believed to keep the brain from producing new neurons – or nerve cells – in the hippocampus. Antidepressants work, in part, by getting the hippocampus to produce new neurons at a healthy pace once again.

Cause #2 – Neurotransmitter Fail

Neurotransmitters are chemicals in the brain that make communication between different parts of the brain possible. In many depressed brains there is believed to be a lack of neurotransmitters. Antidepressants boost the amount of neurotransmitters in the spaces (synapses) between neurons (nerve cells). In a second, I’ll tell you about something that does this even better than antidepressants…cheaper and without negative side-effects.

Cause #3 – Too Much Cortisol

When in a stressful situation, the healthy body emits cortisol – the chemical responsible for our “fight or flight” instinct. It raises heart rate (up to five times its norm!), blood pressure climbs, we breathe harder and feel anxiety. When the stress passes, cortisol levels lower. But when some people experience prolonged stress the cortisol faucet gets stuck in the on position. The result is constant anxiety and susceptibility to depression.

Cause #4 – Anger

A study published in the Journal of Counseling And Development in 2006 is just one of many that proves the relationship between anger and some experiences of depression. The non-scientific explanation is this: If anger is not expressed (in a healthy way) and instead kept inside repeatedly, it can come out as depression.

Cause #5 – Rumination

There have been studies showing a possible link between ruminating (obsessive or repetitive thinking) and depression. Ruminators are some of history’s great inventors and artists because they will often obsess over a problem until they arrive at its solution. They are also prone to mental illness. This may be because ruminators have a hard time letting go of their own mistakes and the problems of the world. They reinforce their negative thoughts by going back to them again and again. Therapists call this “negative self-talk” and some believe this constant tearing down of oneself is linked to depression.

There are many other causes of depression – abuse, genetics, illness, allergic reactions, parasites – but the four above are the main culprits of mine. Here’s how we’ve treated them without pharmaceuticals.

Treatment #1 – Exercise

A study published in the Archives of Internal Medicine in 1999 showed that 60% of study participants diagnosed with “major depression” no longer had significant enough symptoms to be labeled “depressed” after engaging in aerobic exercise for just 30 minutes every day for one month – brisk walking, for instance. Researchers followed up with these patients six months later and found that those still exercising regularly were far less likely to have relapsed in depression than those who had stopped exercising altogether after the study.

Exercise reduces the stress hormone cortisol in the body, bumps up the immune system to fight disease, increases circulation to the brain (and everywhere else), and releases mood-boosting endorphins.

When severely depressed I don’t think I could have exercised a lick, so, for me, exercise isn’t so much a treatment while depressed as it is the cheapest preventative medicine around.

Treatment #2 – Sleep

I’m a night owl. My brain kicks on around the time the kids go to bed and my head fills with ideas. So I have to work at getting enough sleep.

To help my mind shut off and rest I don’t look at any screens at night or do any work. I take a hot shower to relax just before getting into bed. Becky no longer talks about money or schedules or to-do lists before bed – that gives me too much to stay awake thinking about. And I hit the sack an hour earlier than I need to because it’ll take that long for my mind to stop working and calm down. And I get a little natural help falling asleep too…

Treatment #3 – 5HTP

5-HTP is the amino acid Hydroxytryptophan found at any Whole Foods or at Amazon.com. While depressed I took two 100mg capsules every night before bed and one 100mg capsule first thing in the morning. When not depressed I take one 100mg capsule before bed only.

5-HTP is not a drug. It is a naturally occurring amino acid the body turns into serotonin and melatonin. Serotonin in the gut helps stimulate intestinal muscles and move the bowels. Seratonin in the brain regulates mood. The body turns 5-HTP into serotonin in both the gut and brain.

For me, 5HTP took away the lowest lows and allowed me to get out of bed and function, to take one thought at a time. I was still technically depressed but was no longer overwhelmed and completely hopeless.

I continue to take 5-HTP while not depressed because it has been proven in multiple studies to improve the regulation of neurotransmitter production. It may be a depression preventative.

5-HTP also turns into melatonin, which regulates the sleep cycle. I now sleep soundly every night because of 5-HTP.

I chose 5-HTP over an antidepressant because it’s cheaper, just as (or more) effective, and has no harmful side-effects. There have been several double-blind studies (here’s just one) conducted comparing the effectiveness of 5-HTP to antidepressants (SSRIs) and 5-HTP fared as well or better than SSRIs in all of them I’ve read. The only 5-HTP side-effects reported by study participants were regular bowel movements and vivid dreams (I enjoy both of those, thank you very much). While with antidepressants you get to deal with the the possibility of nausea, agitation, dry mouth, headache, reduced sexual desire, permanent impotence, rash, increased sweating, weight gain, drowsiness, insomnia…

NOTE: Do not take 5HTP while taking an SSRI. Doing so can cause the brain to create too much serotonin and lead to “serotonin syndrome” and even coma.

Treatment #4 – Tulsi Tea

I buy Tulsi Tea from Whole Foods but you can get from Amazon.com as well. It’s been proven in multiple studies to lower cortisol levels quickly and increase immunity. Both of these effects are thought to decrease the feelings of stress and the damage stress does to the body. (Here’s just one study.)

Treatment #5 – Talk

“I’m never angry but sometimes I get annoyed,” I told the therapist three years ago. “Different names for the same thing,” he said.

But good boys and girls don’t get angry right? Turns out, there’s a lot for even good people to get annoyed angry about.

Angry at myself for a mistake made. Angry at poverty and its causes. Angry when I come back from a trip to the developing world and hear my kids complain about what’s on the dinner table or hear a friend say she has nothing to wear. I’m not saying my anger is justified but it’s there and I’ve had to start dealing with it. Even when I don’t think it’s a big deal. Small things build up until the dam breaks…or the brain.

I talk with close friends and my wife. I pray some painfully honest prayers and journal every morning. And all this helps.

I do not deal with anger by putting it on the internet – that spreads negativity like a virus. I deal with anger in close community and with God – privately. These people, I’ve learned, won’t think I’m a bad guy for being angry. And just talking about how I’m feeling and figuring out why allows me to get past it, to learn from it, to anticipate what situations might make me angry in the future.

Treatment #6 – Meditation

Every day that I’m home, sometime before lunch, I get alone with my bible, blank paper and a pen. Then I do four things: Pray, Read, Write, Pray.

First, I offer myself to God and tell Him I’m open to anything He wants to do with our time together. Then I pray that God will illuminate the scripture I’ll be reading.

Then, I read a small section of the bible. Right now I’m reading one Psalm each morning. I keep reading it over and over again, slowly, mindful of every word, until something sticks out to me – something convicting, encouraging, beautiful, challenging.

Next, I write down the part that stuck out to me. Let’s say it’s a couple of verses. Then, I may underline a word I don’t understand or a sentence I want to study in more depth. I write down any questions I have. Then I find the answers and write them down too. Those answers may be a definition of a word I didn’t know before, or a quote from a commentary that clears up some of my confusion about the passage, or it could be a cross-referenced verse that sheds more light on the verse I’m spending time with.

Last, I pray in writing. I write down a prayer only God and I will know about. This is not a prayer for a friend in the hospital or that meeting I’ll be having later this afternoon. That comes later. This is a prayer about what I’ve just read. I’ve taught my kids to have a “quiet time” in this way by explaining that time with God is a conversation. He speaks to us through the bible and then we respond in prayer.

I read in Psalm 8 just this morning that when children praise God it silences God’s enemies. And that’s exactly what spending time each morning meditating on God and scripture has done in my life. It’s kept the enemy (and my own negative thoughts) quiet(er). Morning devotion time, for me, is a conversation starter I need so that I can be mindful of God and talking with Him all day.

Treatment #7 – Gratitude

If one of my kids says “I’m so stupid” I put them in time-out because we don’t call people names – even ourselves. But I can’t put myself in time-out.

I’ve been saying mean things to myself all my life. Some of the most successful people you know work hard to achieve because their own inner monologue has been telling them “you can’t” all their life – they have a chip on their shoulder and something to prove. That’s certainly me. And that’s not healthy.

Only two things have helped me be nicer to myself over the last three years. First, when I realize I’m putting myself down I tell myself to shut up. Second, I make a point, all day long, to say (in my head or out loud) what I like. It becomes like a form of all-day praying. “This guacamole is amazing.” “You have the prettiest eyes I’ve ever seen.” “That sure smells good.”

This doesn’t seem all that profound but I find it keeps me fully present and experiencing what’s happening around me instead of staying inside my own head thinking about myself. I know a therapist who tells patients to look in a mirror and say nice things about themselves but I couldn’t do that with a straight face. What works for me is redirecting my thoughts away from myself and out into the world around me so full of things to be thankful for.

Treatment #8 – Food

I left this out originally because every kid who’s ever seen a food pyramid knows the importance of a good diet right? But maybe we need the reminder: When we eat junk we feel like junk. Fruits, veggies, nuts, water, healthy meats – all good. Stuff that comes from a bag or a box or a drive-thru window – probably not good. When I put good stuff in my body it works the way God designed it too – pretty dang well. We don’t need a study to prove this right?