Antidepressants are the second most commonly prescribed class of drugs in the United States (after statins, to regulate cholesterol). This is concerning for a couple of reasons. The evidence shows that SSRIs are no more effective than placebo for those with mild to moderate depression. (However, SSRIs are significantly more effective for major depressive disorder than placebo.) Unfortunately, side effects are not equivalent to placebo – while SSRIs (selective serotonin reuptake inhibitors) are well-tolerated by some patients, some of the most common side effects include sexual dysfunction, weight gain, and sleep disturbance, as well as aggravation of depressive symptoms, including suicidality.
So before you try meds to help regulate your mood, here are a few approaches to mood regulation that are free, and carry no side effects at all (except perhaps better overall health!)
- Exercise. Understandably it can be hard to start a new routine, particularly if you feel depressed and hopeless. But if you can find a buddy to help keep you accountable and motivated for those first 21 days (which is about the length of time necessary to create a new habit), regular exercise is probably the very best thing you can do to improve your mood. The endorphins released with vigorous exercise are very similar chemically to morphine, which can decrease sensitivity to pain and even induce euphoria – hence the idea of the “runner’s high”. Exercise also promotes better blood flow throughout the body, including the brain – improving your overall sense of well-being, and bringing the necessary precursors the brain needs to build mood-enhancing neurotransmitters.
- Smile and Laugh! There is always the “chicken or the egg” question when it comes to mood – are you sad because your “happy” neurotransmitters are low, or are your neurotransmitters low because you are sad? Either way, the evidence shows that your facial expression not only reflects your mood, but also influences it. Smiling and laughing make you feel happier – even if at first you only do it out of sheer willpower. (Caveat here, though: this does not mean you should suppress your negative emotions, as suppression can be dangerous. It just means you should not wallow in them.)
- Breathe Deeply. Sufficient oxygen is (do I even need to say this?) one of the key ingredients for life. But so many of us chronically deprive ourselves of the amount of oxygen we really need. This can lead to confusion, fatigue, lethargy, and sleepiness (which are also some of the hallmarks of depression). Breathe deeply, from your belly, with conscious awareness.
- Make a Decision. Indecision is one of our biggest sources of stress. As far as I can tell, it’s very difficult for an analytical person to deal with the pressure of potentially making the wrong choice on a big decision without some concept of a higher power to guide and protect you. My approach to this one, and the approach I teach my patients, is a step-wise process based on biblical teaching. Here it is.
- Envision the Future You Want. Thoughts have a physical structure (they look like trees in your brain), and they can trigger emotions, which set off a cascade of hormones that cause physiologic changes in your body. If you meditate on negative things (“I’m a failure, I will never succeed in (blank), the universe is against me,” etc), this will influence your words; your words will influence your choices; your choices become your actions; and your actions will determine many of your life circumstances. So instead of meditating on what you fear, or on what you currently have (and don’t want), picture what you do want to happen in your life. Create a vision board and put it somewhere you can see it on a regular basis. Make it detailed. See yourself there; picture it; feel the emotions you expect to feel when you get there. Before long, this will influence the way that you feel, which will produce your thoughts, words, choices, and actions that will help to get you there. If you believe that you will always be stuck where you currently are, then guess what? You will be.