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As a psychiatrist, I have treated many people who have . The primary tools I've used are and .

In addition to these, I’ve prescribed several self–administered techniques, that can have a very positive effect on treatment response.

In clinical research, one uses the scientific method and studies just one treatment alone in order to assess its effectiveness. But in clinician mode, I am convinced that a combination of effective techniques increases the probability of a strongly positive result – and I don’t really care which of them did the most good.

Here are five simple yet powerful treatments I recommend because they are both scientifically valid and clinically effective.

Exercise

This is my number one recommendation. Scientific experiments as well as clinical observations show its efficacy in treating depression. In less severe depression, some studies have shown exercise alone to be equal in effectiveness to medication.

In my book The End of Miracles - a novel of psychological suspense about a woman who unravels into deep depression and shocking, though understandable behaviors after severe stressors overwhelm her ability to cope - I put my advice about exercise into the mouth of her psychiatrist. Here it is: "Try and do a little every day. Whatever you can do, just walk ten steps in place if that's all you have the energy for. Exercise is like fertilizer for the brain and improves its biology. It has a strong anti-depressant effect, so take it like a medicine."

Start with however far you can walk, and add a few more steps every day.

Stimulating the Brain’s Pleasure Centers

Deep in our brains are small regions specialized to experience pleasure. In depressed people, brain imaging shows that these regions are less activated by pleasurable stimuli compared to the non-depressed. So the common experience that depressed people have: that they get less pleasure out of things then they used to, has a very strong biological underpinning. Because of this dampened experience of pleasure, people may come to believe it’s not worth the effort to engage in activities no longer as rewarding as they once were. But it is important not to give up on being exposed to these stimuli. It’s necessary to keep the pleasure centers stimulated and activated. For example, keep listening to your favorite kinds of music, adding some new pieces for novelty to the old standbys.

Morning Light

This is a well-validated treatment for depression, especially of the seasonal type. Our circadian rhythms of and other biological components are regulated by light. Being outdoors in the morning is clearly ideal. But for many, tasks that need to be done indoors or winter weather make this impractical.

There's no need to give up on getting morning light, however. Just open a window in the room where you need to be working, put on a winter jacket to stay warm, and glance out the window as frequently as possible.

Hugs

There is scientific evidence that our physiology is regulated in a positive direction by pleasant touch.

Hugging is a quick and easy way to experience this. In addition, asking for and receiving hugs is experienced as social support. And social support is known to be one of the strongest contributors to reducing in difficult situations.

Using your Eyes to Decrease

Anxiety often accompanies depression, and makes the experience even more difficult to endure.

Throughout the day when needed, a simple technique with your eyes can quickly reduce anxiety.

First, look up with your eyes open. Then, keep looking up as you slowly close your eyelids. Next, let your eyes - under the closed eyelids - relax into their normal position. Then, take three deep breaths, inhaling deeply and exhaling. (This last step automatically triggers the autonomic responses that foster calm and relaxation.) Finally, slowly open your eyes.

Putting It All Together

Your primary care provider or psychiatrist will evaluate with you whether you need medication, psychotherapy, both, or neither. Whatever the decision is as to the primary treatment, you can add in some or all of the techniques mentioned here.

In this way, you actively participate in your own recovery. And that is not only a good feeling, but it contributes to that recovery as well.

Quote from: The End of Miracles: A Novel