According to the World Health Organization depression affects 300 million people globally*.

I have grappled with the experience on many occasions including two in which it was prolonged, and I was suicidal. It has affected family members and many friends.

In our teens, I confess I thought my sister should really just get over it when she experienced depression. A common view was that depression was a lack of character or a weakness to be overcome by will and determination.

In coming to view depression as a medical condition a huge stride has been made in recognizing it is not a lifestyle choice, it may have physiological origins or at least correlates, and effects all manner of people, including those we would regard as successful, strong, reliable and of good character.

Through the lens of depression being regarded as a medical condition stigma and shame are perhaps reduced. We might also hope that compassion is increased and the space to talk about the experience and possible remedies expanded. The advantages of such a movement from ‘character defect’ to ‘illness’ cannot be understated. Yet is it true to say it is a medical condition? Many think so.

Those selling physical treatments for depression claim that depression is a consequence of faulty brain chemistry and that their pills will fix this faulty brain chemistry. In Emperors New Drugs: Exploding the Antidepressant Myth by Professor Irving Kirsch we learn that this simply marketing rather than as statement of scientific fact.

An individual experiencing depression might find solace in the idea that they have an illness entirely beyond their control and responsibility and that a pill will fix it.

I watched a documentary on mental health in which a young woman compared her depression to diabetes ‘you wouldn’t judge someone for continually having low insulin would you?!’ she reasoned. I empathise with her experience yet to compare the two is categorically false.

The idea that depression is an illness and that its cause is faulty brain chemistry is a questionable hypothesis and one built on a faulty philosophy. Unlike diabetes or cancer or heart disease there is no biomarker for depression. In this way the marketing of SSRIs is built on an unproven hypothesis.

If it had been proven that depression was a consequence of faulty brain chemistry, we might expect that on visiting a doctor and explaining depressive symptoms a test of brain chemistry would result. Hopefully having first prescribed exercise and meditation, time in nature, dietary considerations, actions to support connection, community and contribution.

From the neurochemical testing they would then deduce which pill is evidenced to work most effectively with this specific imbalance of brain chemistry, if one were found. Then after a month of use the neurochemical test could be repeated to determine efficacy. The truth is far from this ideal. Pills are prescribed, dosages increased, or new pills tried based not on any data or evidence but doctor’s habit, whim or intuition. This will likely be influenced by which pharmaceutical sales agent was most recently in their ear, or which ghost written ‘research paper’ piece of pharmaceutical marketing they may have somehow had time to read within their ludicrously busy life. Bad Pharma; How Medicine is Broken and How We Can fix It by Ben Goldacre details the extent to which pharmaceutical companies have corrupted the medical system at every level. In America at least, the only developed country* to permit advertising of medicines, it may simply be which ad has most spend and has thus manipulated the patient or doctor into believing in its efficacy.

The results of this societal experiment are in. Economically they are superb. Yearly profit is x billion*, one of countless examples proving GDP as a meaningful measure to be absurd. For therapeutically they are awful. Metanalyses indicate that SSRIs are no more effective than placebo in 95% of cases. Another series of studies indicates that 4-6 people in 10 will actually benefit from these pills. Many will suffer immensely from these medicines though the stats on suicide, increased depression, anxiety and psychosis, worsened brain chemistry are largely unavailable because we do not measure or record such data. And if we did the predictable drug industry defence would be they were depressed to start with so surely it was their existing illness rather than the dice roll of the brain chemistry altering pills that is to blame?

My early view of depression was expanded via my own experience of an intensely dark period of hopelessness, pointlessness, physical pain, lethargy and despair. After a year or so I decided to commit suicide for I felt I could no longer endure. That was 20 years ago. What saved me was the sobering realization that my suicide note would not spare my family much suffering, if any. I was unwilling to inflict that on them. The common thought of the suicidal mind, that I am a burden and everyone better off without me, was thankfully trumped by reasoning that my family would certainly see it differently. I resolved to find a way beyond my dysfunction and misery. Aware of the scam of healthcare, its infiltration at every level by pharmaceutical companies and of the false philosophy upon which it is built – ontological materialism – I was restricted to holisitic and integrative approaches. Rather than perceiving an illness – a most depressing idea! – I saw an opportunity for self-discovery and growth. And so it has been. Depression still presents however I no longer suffer it and nor has it prevented my living a life of considerable success, by my own values and measures.

The secrets of my success are well researched and evidenced. Plenty of good quality sleep, meditation, emotional integration work via various modalities, a whole foods diet ensuring certain elements – zinc, magnesium, good oils, pure water free of neurotoxins – are given particular attention, plus connection, community and a sense of purpose or contribution in my work or daily activity. If I have found a magic pill, the closest thing to a silver bullet, it is gratitude.

The practise of gratitude is proven to improve physiological, psychological and sociological functioning. Just taking the time to reflect on and feel thanks for 3 things each morning and each evening will have predictable benefits in all areas of your life, including mood and wellbeing. These benefits are lasting. The Greater Good Science Center website offers rich resources. You will find both research papers to convince your mind of the efficacy and power of such a practice, and simple tools with which to begin such a practise.

Gratitude is a practise, just like exercise, meditation, speaking a foreign language or learning to play the piano. We need to learn, invest time and in so doing expand our capacity. Accepting we don’t know everything and bringing a beginner’s mind, open and malleable, best places us to experience the benefits for yourself. It is perhaps this openness of mind that best readies the brain to be neuroplastic, to be responsive to our attempts to alter its functioning.

We can alter our brain chemistry through practice and intent.

This understanding is key to effecting wellbeing. It also reveals the partiality of ontological materialism or the idea of the primacy of matter, and the harmful downstream effects of this belief system within healthcare. Looking at the data across many fields including the placebo effect, psychoneuroimmunology, parapsychology, physics, spontaneous remissions and neuroscience to name a few – it is clear that mind effects matter. The ‘hard problem’ of how something immaterial (mind or consciousness) arise from something material (brain) is resolved when we drop the assumption that this relationship is one way.

How do I put the power of my mind over my grey matter into practise?

Let’s say I want to create a more grateful and less depressed brain but I am not sure if I can think of 3 things every morning and night.

This is a common thought and one that will be revealed to be ludicrous by the following exercise:

Grab a pad of A4 and begin writing what you feel grateful for. When you get stuck keep going.

Friends, family, sunshine, leaves, chocolate brownies, raw chocolate brownies, people making raw and organic food, taste buds, my tongue, my body, the way it digests, breathes, performs all manner of extraordinarily intricate and beneficial functions, without my input and in spite of my choices that might make it more challenging, the way I feel when I see leaves, light and water create the experience of beauty, art, John Steinbeck, reading, my sight, writing, my computer, Liverpool football club…..you get the idea. Allow yourself 30 minutes and discover the infinite array of things to be grateful for.

Failing that, try my advanced beginners practise – appreciating being, breath or awareness. In my book The Gratitude Prescription, I define them as following: Being – the embodied centredness of experience; I am. Breath – The movement in and out, happening all by itself, that can be played with and directed; I am breathing. I am breath. I am being breathed. Awareness – the background of all experience. That which is right now aware of these words, aware of the reading, the thoughts, the page, the text. The noticing; I am aware. I am awareness.

Try appreciating Being. How about appreciating breath? Can you appreciate awareness?

Whether I am being diagnosed with brain cancer or being given the all clear, taking my first or last breath, feeling the greatest joyful optimism or despairing fear, these gifts are present. They are ever present. I am grateful for this.

* www.who.int/news-room/fact-sheets/detail/depression

1. Emperors New Drugs: Exploding the Antidepressant Myth – Professor Irving Kirsch
2. Bad Pharma; How Medicine is Broken and How We Can fix It – Ben Goldacre