Wednesday, February 29, 2012

RX for Depression

In the Tragical History of Dr. Faustus, a play published in 1604 and written by Christopher Marlowe, a contemporary of Shakespeare, I discovered my favorite quote in all of literature.  The play is about Dr. Faustus, a wealthy and successful physician who grows bored with life and makes a deal with Lucifer. The deal is that in exchange for Satan giving Faustus special powers and knowledge, Faustus agrees to surrender his soul to the devil at the end of 23 years. As part of the deal, Lucifer assigns his right hand henchman Mephistopheles to accompany Faustus on his journeys.

During their time together, Faustus finds opportunity to ask Mephistopheles a question. The question is predicated on what happened to Satan and his other henchmen who used to live in heaven with G-d. As the story goes, Lucifer led a revolution against G-d and as punishment was banishment from heaven and casting out to hell. Mephistopheles was among those dislodged from heaven.

Faustus's question to Mephistopheles is how could someone who knew the glories of heaven tolerate the misery of hell. The response represents my favorite literary line. Mephistopheles answers that "The mind can make a heaven out of hell and a hell out of heaven." I wholeheartedly agree.

Over the past couple of days, I've had occasion to spend time with a few patients that either feel depressed or are on anti-depressants. I spent considerable time listening to each patient's history so I could fully comprehend the root cause of his or her depression.

It is well known that there is an epidemic of anti-depressant prescriptions being written in the US. Its obviously a lot easier for a doctor to write a prescription then spend the time necessary to get to the root cause of the depression. (In fact, last year a psychiatrist described in the NY Times how the new economics of medicine had forced him to markedly curtail time with patients from sometimes an hour or more to a mere 15 minutes, the time he thought he needed to identify the right prescription medication for his patient.  It's a sad state of affairs. I created MDPrevent to be an old fashioned practice that gives patients all the time they need to express their concerns, worries, and needs. I find it makes a huge difference. Just yesterday as I approached the second hour of a consultation, I finally discovered that my patient had fainted two weeks earlier, and then her husband, who was in the room, suddenly reported that she had suffered recently from some hallucinations. This information would not have been identified unless I had spent the appropriate time to learn everything that was going on.  Time with patients matters.)

Numerous studies have shown that the key to a healthy, well-adjusted, and long life is a sense of meaning and purpose. The Okinawans, who enjoy the highest rates of living to 100, call it Ikigai. It is their purpose for living. The French call it the Raison D'etre, the reason for living. Living is not about existing or surviving. It is about finding purpose in one's life.

There are many ways to find purpose in one's life, which include helping others by actively participating in a community service function. The studies show that when you volunteer from a selfish perspective, you don't feel better. However, the studies also show that such selfish volunteering often leads to selfless volunteering which does improve our state of mind and overall health. Volunteering can take many forms and can have many focuses. It can include working in a soup kitchen to feed the homeless. It can include helping home-bound seniors by staying in contact, helping them shop, or providing companionship. It can involve working with underprivileged and neglected children by mentoring them and letting them know that someone cares. You can volunteer at an animal shelter, a hospital, or a nursing home. You can participate in a food drive, a blood drive, or a walkathon. There are many ways to help others and one need only open one's eyes to find them.

At MDPrevent, we have a bulletin board dedicated to community service opportunities because we believe that it is at the very core of healthy living and disease prevention. I strongly encourage anyone who feels rudderless or without purpose to keep searching until you find a community service that is engaging. In the interim, get involved in your Church, Synagogue or Mosque if you are affiliated with one. Doing something is better than sitting around feeling sorry for yourself.  It's not that you may not have a good reason to feel sorry for yourself, it's just that the sitting around wallowing in self-pity serves no purpose. As the old Chinese proverb states, "man will sit in a chair for  long time with mouth opened before roasted duck flies in." You have to make things happen. As my oldest friend Jay's mother Eleanor use to say, "G-d helps those that help themselves.")

You may say what do I know? I'm a successful physician/entrepreneur. I seem to have everything a person could possibly want. It's true. I am blessed to have what I have. I worked hard for everything I have but I was also lucky.

But three years ago, after selling my first company, I found myself without anything to do. I quickly fell into a deep depression. I couldn't get out of bed. I had no reason to do so. I walked around muttering 168. That's the number of hours in a week. I was desperate to fill them.  My mind was making a hell out of heaven. I thought that if I only ran my old company, all would be well. It turned out that I got he chance and I was wrong. As I know now, "thoughts are not facts."

It was ultimately up to me to find purpose and meaning in my life. I did an inventory of my life, my experiences, and my skills. I focused on what I was good at and what had previously given me pleasure. I started MDPrevent to be my form of community service because I felt that there could be no greater human service than helping people stay healthy, avoid preventable diseases, and live longer, happier lives.

So if you are depressed, as I was for a good year, then maybe its time to do something about it instead of depending on a pill or simply self-pitying yourself. Go out and help someone else. I promise you that your problems, regardless of what they are, will not seem so bad when you discover the less fortunate and find joy and purpose in helping them.

In addition, create an exercise routine in your life. Countless studies have shown that exercise lifts moods and markedly decreases depression.

So my RX for your depression is to help others and exercise routinely. For most people, it sure beats those little false hopes called pills that your doctor may give you.

You have but one life to live. What are you going to do with it?

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