Graeme Cowan suffered through a five-year episode of depression that his psychiatrist described as the worst he has ever treated.
Part of his recovery involves helping people build their resilience and mental fitness as the Director of R U OK? In his book, Back From the Brink: True Stories and Practical Help for Overcoming Depression and Bipolar Disorder, he offers advice gleaned from interviews with 4,064 people who live with mood disorders.
He asked the respondents to rate the treatments they had tried and how much each had contributed to their recovery. Here’s what he found.
The following were the top eleven most effective treatments:
- Supportive psychiatrist
- Supportive psychologist
- Support group, emotional support of family and friends
- Vigorous exercise
- Fulfilling work, paid or voluntary
- Cognitive-behavioral therapy (CBT)
- Electroconvulsive therapy (ECT)
- Reducing intake of alcohol and other non-prescription drugs
- Belief in God, spirituality, religion
Other helpful treatments include:
- Mindfulness-based cognitive therapy (MBCT)
- Acceptance and commitment therapy (ACT)
- Hobbies, such as gardening, pets, or music
- Good nutrition
- Keeping a gratitude journal
Cowan then categorizes the effective approaches into five major themes:
1. Emotional Support
We are social creatures who crave empathy and connection. That’s why emotional support, reassurance, and compassion from psychiatrists, psychologists, support groups, and family and friends dominate the top ten effective strategies. Cowan’s findings indicate that the emotional support and reassurance provided by psychiatrists and psychologists is judged more important than their treatments, which concurs with previous studies that have shown that the quality of the relationship between a clinician and patient is the best predictor of a successful outcome.
2. Psychological Treatments
Some psychological treatments that were listed as effective: psychoanalysis, counseling, cognitive behavioral therapy, mindfulness-based cognitive therapy, interpersonal therapy, acceptance and commitment therapy, and letting go of unrealistic goals.
3. Lifestyle Strategies
Both vigorous exercise (equivalent of running for 30 minutes 4-6 days per week) and moderate exercise (equivalent of walking for 30 minutes 4–6 times per week) were rated as very effective. Other helpful lifestyle approaches include: getting a good night’s sleep, being able to relax, doing meditation or yoga, engaging in hobbies, getting massages, and reducing intake of alcohol and recreational drugs.
4. Fulfilling Work
Cowan credits his fulfilling work — offering hope to persons stuck in depression — as one of the most powerful tools he uses to stay well. “I experienced personally the benefits of doing voluntary work in my own recovery,” he writes. “My voluntary work involved placing discouraged people (new migrants or people rehabilitating from physical or mental illness) into volunteer positions with charities. I saw how the work lifted their self-esteem and confidence.”
Fulfilling work was rated more highly than cognitive-behavioral therapy, which is often considered a highly effective depression treatment. Cowan cites the Gallup poll that found that only 20 percent of employees like what they do, but that people with a high career well-being were more than twice as likely to succeed in life overall. Dan Baker, Ph.D., director of the Life Enhancement Program at Canyon Ranch, and many other positive psychologists believe that a sense of purpose — committing oneself to a noble mission — and acts of altruism are strong antidotes to depression.
5. Prescription Medications
The results of Cowan’s surveys found that, while prescription medications can play a vital role to recovery from depression and bipolar disorder, they should not be relied on as the sole strategy. Pharmacology is still in its infancy. A drug that works wonders for one person might not do anything for another except give her a dry mouth and nausea. Cowan writes: “This stresses the importance of working with a doctor who’s highly experienced in successfully treating mood disorders.”
Stay tuned for my interview with Graeme Cowan on “Getting Mentally Fit For Work.”
Originally posted on Sanity Break at Everyday Health.