What Causes Depression | Depression Facts and Help | Symptoms | Self Help

Positive non-pharmaceutical self help and professional solutions

This page has been professionally reviewed and edited by a practicing mental health professional with a PsyD in psychology.

12% percent of women (nearly 12 million women) in the United States are diagnosed with depression, as compared to seven-percent of men (over six million men) who are diagnosed with depression. Mild depression can be differentiated from clinical depression, which includes major depression, bipolar disorder, and dysthymia, although dysthymia can be considered to represent one form of mild depression. (University Health Services Tang Center Berkley, CA). At any given time in the United States, ten-percent of individuals comprising the adult population are taking antidepressant medications.

Depression Statistics - U.S.

12% women

7% men

10% adult population on antidepressants

There are many factors that can cause and contribute to what is referred to as unipolar depression. Unipolar depression is a depression without any bipolar symptoms, and this type of depression does not include both depression and mania. A genetic predisposition can contribute to the presentation of depression. While there is often much discussion about "chemical imbalances" and their role in depression, this somewhat simplistic theory has been shown to be not entirely reliable and not necessarily accurate.

Lifestyle changes and learning positive coping skills can help in overcoming depression

Good nutrition is an essential part of good mental health. Better nutrition can help you overcome depression.

Depression Self Help, Lifestyle Changes, Diet and Nutrition

While one might think of depression in terms of something akin to catching a cold, coming on for no apparent reason, there are, in reality, exogenous reasons why someone might become seriously depressed. (Note that exogenous reasons constitute environmental factors, while endogenous factors include biological predispositions or internal factors.)

Lifestyle changes can represent curative factors relating to depression for many sufferers of depression. Much has been written and stated about the maintenance of a healthy diet and giving attention to nutrition in combating depression. In doing so, one can make positive steps toward alleviating symptoms of depression, in addition to bipolar disorder and other mental health disorders.

A diet low in carbohydrates, low in sugars, and low in fat can be helpful in alleviating depressive symptoms, and elimination of alcohol from one’s diet can be helpful. Moreover, a vegetarian or a substantially vegetarian diet, in addition to an avoidance of red meats, can be helpful in maintaining a balanced body and brain chemistry that will be conducive to good mental health.

Also important in terms of diet, eating three nutritious meals per day is helpful. Some individuals with depression rarely have three nutritious meals per day. A regular, nutritious breakfast daily is essential, even if you do not have an appetite or feel hungry.

Your body can become used to eliminating breakfast, but if you do eat a good breakfast daily, your body will become accustomed to that, and you will probably start feeling some hunger pangs when waking up in the morning. Note that doing without breakfast does not help you to lose or maintain your weight. The body responds by slowing down your metabolism, which compensates for the skipped meal.

Children and teens may often skip breakfast at home, and, at times, eat breakfast in public schools (This has been true in Newark, NJ public schools.) Breakfast of this kind may be no more than a pop tart and juice. This type of diet is inadequate for a rapidly growing teen or child. Some children or teens might skip both breakfast and lunch. Moreover, lunches at school may be lacking in terms of nutrition.

For adults, eliminating habits such as smoking and alcohol consumption can also result in a positive affect on one’s mental health. Persons suffering from mental illnesses of any kind, or those that have even a tendency towards mental health difficulties, should consider seriously the elimination from their diet alcohol, which is a depressant. Marijuana use can also contribute to depression (and schizophrenia for some chronic users).

More Depression Self-Help Solutions

Green Therapy constitutes getting out in the outdoors regularly, as well as engaging in exercise. This has proven to be more effective for some individuals than antidepressants.

Green Therapy, time spent outdoors enjoying nature, positively affects depression as reported in some clinical studies

Exercise: A natural remedy for depression Exercise represents an avenue toward better mental health for individuals suffering from all forms of depression. One Duke University study indicated that, for mild and moderate depression, regular moderate exercise was more effective than medication both in terms of short term improvement and in long-term results or recurrence rates.

Another study, published in the Archives of Internal Medicine in 1999, divided 156 men and women with depression into three groups. One group took part in an aerobic exercise program, another took the SSRI, Sertraline, (Zoloft), and a third did both. After 16 weeks, depression had been alleviated in all three groups. About 60% to 70% of the people in all three groups could no longer be classified as suffering from major depression. In fact, on two rating scales of depression, all groups were essentially the same in terms of the amount of depressive symptoms manifested by them.

This suggests that, for those who need or wish to avoid drugs, exercise might be an acceptable substitute for antidepressants. It should be noted, however, that the swiftest positive response or improvement in mood occurred in the groups taking antidepressants, and it should be understood that it can be difficult to stay motivated to exercise when you are depressed.

A follow-up to that study found that the positive effects of exercise lasted longer than those of antidepressants. Researchers evaluated 133 of the original patients six months after the first study ended. They found that the people who exercised regularly after completing the study, regardless of which treatment they received originally, were less likely to relapse into depression.

Regular exercise is proven to help depression and anxiety.

A study published in 2005 found that walking quickly for about 35 minutes a day, five times a week, or 60 minutes a day three times a week had a significant influence on mild to moderate depressive symptoms. Note that walking quickly for only 15 minutes per day, five times a week, or doing stretching exercises three times a week did not help to alleviate depressive symptoms significantly. (Harvard Mental Health Letter).

Causes of Depression - Depression and Television

Science Daily reports that there appears to be a correlation between how much time individuals spend watching television and how much depression is experienced by them. This may indicate that reducing or eliminating time spent watching television may be one positive step in overcoming depression. The authors of the study represented time spent watching television as an opiate, which provides immediate pleasure at the expense of long term happiness and good mental health.

Study: University of Maryland, (2008). Science Daily

Aric Sigman, Ph.D. a American-British psychologist, also demonstrated a link between television viewing and depression. He notes several reasons for this connection, including the following: the depressing and often pessimistic nature of the television news, and the over-stimulation of the brain from watching fast-paced television or violent content. He notes, as have other authors, that the sedentary nature of watching television, especially as a lifestyle, contributes to depression, both directly and indirectly.

One life-coach noted that, after one-half hour watching television, the brain begins to slow down into a passive mode, especially when considering the mindless nature of many TV programs. Even programs that are of greater substance, such as nature documentaries or programming from Science Channel or Discovery Channel, (Sigman specifically notes Discovery Channel), can slow down the activity of the brain, especially when these are viewed as regular and ongoing entertainment. This can be differentiated from watching a specific program or video as part of a college course or as a supplement to school work, wherein, for example, note-taking and deliberate processing of the information for assignments or testing might be required.

Television can also indirectly contribute to depression in that it displaces time that might otherwise be spent in activities which are more active, mentally challenging, strengthening or otherwise productive. It creates a type of learned-helplessness in one's thinking or a passivity which lays a foundation for depression to grow.

Cutting back or cutting out television, as a number of individuals with depression have done, is a positive step towards a more productive lifestyle and to overcoming depression. One middle-aged man who dealt with depression found almost immediate relief from most symptoms of his depression after deliberately cutting out television from his lifestyle. He recognized that television was a factor in his depressive symptoms, and made a positive lifestyle change which led to permanent relief of his symptoms. He experienced further improvement through positive changes to diet and attention to nutrition. (2010).

Types of Depression

Dysthymia is diagnosed when a person experiences a depressed mood for most of the day, most days, as well as at least two other depressive symptoms, but not enough symptoms of sufficient persistence or severity to be considered major depression. With dysthymia, there are no manic or hypomanic episodes.

Symptoms of Depression or Major Depression

One or more major depressive episodes in absence of any manic or hypomanic episodes. Symptoms consist of a prominent and persistent depressed mood or loss of pleasure for at least two weeks, accompanied by four or more symptoms such as poor appetite, insomnia, psychomotor retardation, fatigue, feelings of worthlessness or guilt, inability to concentrate, and thoughts of death or suicide.

If a person is depressed but experiences less than four of these symptoms, is not having feelings of suicide or of hurting oneself, then the depression would not be considered major depression but mild to moderate depression.

Untreated Depression

At the same time, it is also acknowledged that depression that goes untreated can carry risk factors. Depression, especially when it is deep or long-term, does need attention. What many individuals do not realize, however, is that there are options regarding treatment for serious depression.

One of the greatest needs in treating depression is represented by getting support. This can come in many forms, but some individuals do need professional support. Those who isolate themselves or don't seek any type of support can put themselves at serious risk. It is important to talk to qualified persons when one is seriously depressed. This alone can be of value, and it can be a matter of self- protection, in the event that one might be suicidal.

It should be noted that it is possible for many depressed individuals to find professional support that does not necessarily include pharmaceutical treatment. A non-pharmaceutical approach can be effective for many people.

Most persons feel sad at times, but in major depression, it is intense and of long duration, causing difficulties in functioning day to day.

What Causes Depression - Multi-Faceted Factors

The University of Arkansas Medical Department states that, as is true for most mental disorders, research indicates there is no single cause of depression, but that it results from the synergy involving complex interactions among multiple factors.

Biological, genetic, neurophysiological and hormonal related aspects of depression represent physical factors that can be involved with depression.

Psychological factors for depression can include the following:

Cognitive distortions, poor coping skills, problematic interpersonal relationships, poor social support, and stressful life experiences are some psychological factors that can contribute to depression.

A history of abuse can also contribute to depression.

Summary of some of the factors that can contribute to depression:

Stressful life events
The loss such as the death of a loved one, or, similarly, the early loss of a parent can contribute to a predisposition towards depression for some.
Romantic losses
A promiscuous lifestyle can contribute to depression in some individuals.
Current or former substance abuse
Some studies suggest that "chronic strains" or ongoing relatively low-key stressful situations may lead to depression
Several stressful situations involving a series of circumstances can also lead to depression. These may include, for example, a loss of a romantic relationship, doing poorly on a test, losing one's job, a major family crisis, etc.
A thwarted, major goal can contribute to depression for some individuals.
Child abuse can contribute to a predisposition towards depression for some people.
Some physical conditions can lead or contribute towards depression.
Having an abortion can result in depression for women, and, perhaps surprisingly, for men as well. See Psychology Today, May/June 2004. Note that sometimes grief that comes as a result of abortion can be long-term.
Situations that lower self-esteem be a contributing factor
The need for a more healthy diet and exercise is an aspect of depression
A genetic predisposition can also be a factor for certain persons experiencing depression, in conjunction with any of the above stressors or other, stressors.

"A warm caring relationship with a parent or caring adult acts as a protective factor against depression. Young adults who have lost a parent before the age of 16 experience more depression and suicide attempts than those adults who came from intact families. Consistent nurturing from another adult, however, can lessen these negative reactions." Lillian M. Range, PhD. Children's Health.

Major Depression in a child: Major Depression in a child: The symptoms involving the diagnosis of Major Depressive Disorder, (MDD), or major depression, in a child or teen must include having experienced one or more major depressive episodes. This might include a time-span from two weeks to one year in duration, and it can be characterized by extreme sadness or hopelessness, thoughts about death or dying, loss of energy, inability to sleep, or an inability to concentrate. This same psychological and behavioral presentation is true in adults as well.

Experience of childhood depression symptoms: Roberto is eight years old, he has lost interest in playing with his friends, he only sleeps after school. It is difficult to get him to eat a complete meal. His grades have slipped, his teachers say he doesn't talk or play with the other children and often looks sad. He has trouble sleeping at night and this has been a pattern for several months.

Many of these self help skills referred to on this site can contribute to a positive effect on depressive symptoms for adults, teens and children.

One of the causal factors for depression in children can be child abuse. This can take many forms, including verbal, physical and sexual abuse. These types of abuse are possible causal factors in both childhood and adult depression. Adults who have been abused as children should talk about these symptoms with a sympathetic and non-judgmental listener, even if these events have taken place in the past. Healing and comfort is needed for the emotional wounds of child abuse, probably more than any other alleviating factor in the treatment of prior child abuse in adults.

Anxiety and depression are much more common in those who have been abused as children. Some teen depression can be attributed to abuse or neglect. Individuals who have been abused as children can experience relief from depression after being able to talk to sympathetic listeners about their experiences over an extended period of time. There needs to be healing from abuse, and this is true of adults or teens who may be abused by spouses or others.

Additionally, for anyone who has suffered from any form of child abuse, watching violent scenes on the news can reawaken feelings of helplessness and exploitation, and make it difficult to heal from the wounds of child abuse. This can especially true of the evening news or some more-sensational TV news magazine programs, where accounts of various types of abuse are related in graphic detail.

For those who have experienced any form of abuse as a child, it might be better to do without television news and news magazines, in favor of keeping current on the news through reading, making an effort to focus on more-positive news stories, rather than reading about violent occurrences, especially as they relate to any form of abuse, rape, etc. Reading is gentler on the mind and emotions that watching television, in terms of the news. Even for some who may never have had experienced abuse, watching the news regularly can contribute to depression.

As stated previously, diet plays a role in depression. A healthy, nutritious diet, low in sugar and low in refined carbohydrates is needed for children and adults. Children should eat breakfast. Breakfast in schools is often high in sugar and refined carbohydrates. Children should receive a healthy breakfast at home, before going to school. Note that some adults suffering with depression might eat only one meal a day, and this meal may not necessarily be nutritious.

American culture is high on both media time and media violence. Violence is evident in most movies that we have grown accustomed to, from Rambo and Jaws, Star Wars to Chucky. Television, including fast-paced cartoons and TV sports, often focuses on active violence, which can produce elevated moods in conjunction with a lowering of moods. That is, when watching such programming, the mind is over-stimulated, and, afterwards, the mind can suffer from a corresponding low.

Excessive television, movies and video games can be a corresponding factor for some children and some adults, in terms of depression, ADHD, and other mental health disorders. As

indicated previously, for some people experiencing mental health problems, it might be better to do without TV and movies completely. This may represent a measure that can be implemented for six months in order to determine whether TV does or does not contribute to better or worse mental health in individual children or adults. It should be noted that the stimulation of many action movies and the fast pace of television commercials can correspond to a plummeting in levels of key neurotransmitters, resulting in depression or even contributing to bipolar disorder. For some children, cartoons and children's movies, Disney, etc, can contribute to depression.There is much violence on television that is regularly viewed by children and young people today. Even the Disney channel has some rather intensely violent (non-cartoon) programming for children and young teens.

This can be true of music as well. For some, a steady auditory consumption of radio music is not compatible with their well-being. Dr. Joel Robertson’s advances the idea that music effects brain chemistry. This means that the type and intensity of the music one listens to can lead to depression and other disorders in some persons, including some children.

Why Television Can Contribute to Depression in Teens
and probably adults as well.

Mental activity can prevent both depression and dementia. Engaging in mentally-challenging activities can be therapeutic for depression. Studies have shown that the amount of time spent watching television can be correlated with symptoms of ADHD, and it can be correlated with depression in teens, most notably in males. Just 2.3 hours of TV watching per day has been shown to result in significantly greater rates of depression in TV viewers. For every hour of TV watched by a teen, there was a correspondingly greater risk of depression.

Television often causes one’s mind to revert to a passive mode; it is fast-paced and creates artificial, but temporary stimulation. When that stimulation is later absent, it can result in a corresponding lowering of one’s mood, and this is thought to be a reflection of brain chemistry. Paradoxically, TV can then cause difficulty in overcoming feelings of depression. In terms of the various factors, TV can become something like a drug.

One youth with bipolar disorder reported that the only time his symptoms improved was when he watched TV. The TV calmed him while he was watching it, but afterwards, his symptoms returned in an exaggerated way. Encouraging teens to greatly cut back on the time spent watching TV is valuable. For some individuals, this can mean eliminating or tempering TV in the home, and certainly eliminating it in the bedroom. It is contended that parents should not allow children or teens to have a TV, video games or internet access in the bedroom. TV often can be an avenue for problems and issues which can contribute to anxiety, loss of sleep and may ultimately contribute to depression or other mental health issues for children and teens.

Dr's Primack, Georgiopoulos, MD; Land, Ph.D., and others associated with a clinical study on adolescent depression concluded: "Television exposure and total media exposure in adolescence are associated with increased odds of depressive symptoms in young adulthood, especially in young men."

Music is a powerful influence for many youths. Some children and youths listen to music for hours every day, on the school bus, during breaks at school, at lunch or at recess and at home. Some do their homework to music or music videos. To some teens who are of driving age, their first car seems to be a night club on wheels, and music is turned on from the moment they enter the car to the moment they leave. Note that much of the music today is "supercharged"; it's not mellow or relaxing; rather, it is pumped up.

Too much time spent listening to today's music can affect the mental health of a child or teen. It is one area where parents, educator' and professionals can give consideration to the emotional needs of children or teens with depression. Joel Robertson, Ph.D. of Saginaw, MI, in his book “Natural Prozac”, documents the effect that music can have on mood. Music that is intense, of any type, can contribute to a roller-coaster effect of mood in some persons.

Regularly viewing pornography can contribute to depression for some. Additionally, isolation or too much time spent alone, in itself, can have the same result for some. We all need loving attachments, meaningful relationships with others, as well as a purpose in life and purposeful work. This contributes to good mental health and the absence of values can contribute to depression. Cognitive Behavioral Therapy and Depression Solutions

Cognitive behavioral therapy proves to be as effective as medication in terms of both short and long term results regarding depression. When combined with other lifestyle changes, it can prove to be all that is needed for the majority of those persons suffering with depression.

Psychology Today, July/Aug 2007 also recently contained writing on the subject of depression and cognitive-behavioral therapy. This publication summarized a study on CBT and its positive effects on depression. The study demonstrated that cognitive-behavioral therapy to be more effective than antidepressants for both the short and long-term benefits in treating depression.

Cognitive Behavioral Therapy works from the "top down”. This means that it results in elemental changes to one's thinking. Medication, however, works from the bottom-up. It is addresses symptoms by medicating symptoms, rather than helping to address serious underlying issues that need to be addressed for recovery. Medication for depression is like the proverbial Chinese "handing a man a fish." It feeds him for the day, but you haven't necessarily provided anything towards self-sufficiency for the long-term.

Medication may treat depression, but it is only superficially curative because the problems and reasons behind the depression have not been solved, and psychiatric medication generally only addresses symptoms.As alluded to previously, an analysis of major studies on the effectiveness of medication and cognitive-behavioral therapy in treating depression revealed that, in the majority of cases, cognitive therapy was as effective as medication in the treatment of major depression; moreover, some studies indicate a slight advantage of cognitive therapy over medication. DeRubeis, R. (1997, May). A second group of researchers reached similar conclusions. (Cris-Cristoph, 1996).

Cognitive-Behavioral Therapy emphasizes the effects of thoughts on behavior, implicating a performance-oriented focus. Two main themes in cognitive-behavioral therapy are as follow:

Therapy sessions are often accompanied by techniques, such as homework sessions and assignments. The therapist and the client work together to evaluate and adjust changes that these techniques have on thought patterns. Faulty reasoning on the part of the client is challenged in real-life experiments, as the therapist guides the client in adjusting his view of himself. As a result, the client realizes that his negative assumptions and cognitive errors are faulty. One might sum it up as a “way-of-thinking” readjustment.

The therapist helps the client to identify logical errors in the client’s thinking and to challenge the validity of negative thinking. If a person feels they are totally worthless, they need to regain a balanced view of themselves, and they must attempt to eliminate “all-or-nothing thinking” that can be crippling to the extent of culminating in suicidal thoughts.

The cognitive behavioral therapist works with a client to develop real-life situations to allow the client overcome faulty thinking in a stepwise fashion. Also, the therapist might help a client schedule his daily activities, which allows the client to have a structural framework with less "down-time,” during which the client might become depressed.

Additionally, Interpersonal Therapy, which relates to, but is less directed than cognitive-behavioral therapy, has been found to be effective, especially with teens, who often need simply to talk to someone. Anyone who is dealing with depression can benefit from talking about their circumstances with a sympathetic listener, whether it is a friend, a mate, a minister, or a professional. This can be, and often is, a necessary element in process of healing from all manner of child abuse, as well as for other traumatic life experiences.

Sometimes, social workers in the public schools, are trained in cognitive, interpersonal, or talk therapy, and, because clinical psychologists are not always available in the public school system, social workers sometimes take on a more serious role as therapists for children who need to talk to a concerned adult. See School Psychology page

Attention to spiritual and emotional needs are of importance in treating depression

Spiritual and emotional needs are important for good mental health and in overcoming depression.

Spirituality and Psychology Giving attention to our spiritual needs is also vital for our mental health. If we guard ourselves from things that can damage us emotionally or spiritually, then the mind can heal and function in a more healthful way. Attention to our spiritual needs can be an overlooked part of our mental health. This can true for adults, teens and children.

Reading the Psalms, as an example, is a stabilizing and comforting activity. The deep emotions of human beings who have experienced inner turmoil, culminating in profound emotional expressions, often reflect our own inner sentiments. We can find our own identities in these deep poetic and heartfelt expressions. This may represent a gentle and soothing part of the healing process. Reading and writing poetry can also be therapeutic and is used as a form self-initiated self help, and it can also be used in a professional context as form of therapy.

There is much that can be done to overcome depression before resorting to antidepressant medications. Many thoughtful psychologists and even psychiatrists have stated that they recommend medication only as a very last resort, rather than a first-line treatment. Moreover, it is naive to believe that the marketing and lobbying efforts of multi-billion dollar pharmaceutical industry has not influenced the current practice of using pharmaceuticals as the first-line treatment for millions who suffer from depression. (Valenstein, Ph.D., 1988)

In considering the role of a "chemical imbalance" in terms of depression, what is being measured is the chemical nature of the mind itself after problematic thought patterns have been established. In other words, we are considering and perhaps treating the effects of depression as much as we are considering and treating the cause.

It is generally agreed by serious psychiatrists and those in the mental health professions that medications are, in general, treating and addressing symptoms, but they are not in any way curing an "illness". This thought is well documented.

Martin S. Willick, M.D., a practicing psychiatrist in New Jersey, USA, and a co-host of a recent (April 2009) meeting on mental health at Columbia University stated that we know that psychiatric "medicine addresses the symptoms but does not treat the disease." This is a statement reflective of the current evidence on the limits of psychiatric medications. This is a statement reflective of the current evidence on the limits of psychiatric medications.

Antidepressants help about 45% of those who take them, at least for the short term. There is also evidence that there is a strong placebo response, which some interpret as evidence that SSRI's are statistically comparable to placebos in their positive effects. In all likelihood, antidepressants do help some individuals to make short term gains. However, over half of those people who take antidepressants do not make significant gains from taking antidepressants alone. Further, approximately 60% of those who take antidepressants do not respond to the first antidepressant they are prescribed.

Taking antidepressants may increase the rates of suicidality (suicidal ideation) in individuals within the population ranging in age from childhood until the age of 24. They do not seem to increase the rate of suicidality in those from the age of 25 to the mid-50s. The rate of increase in suicidal ideation doubles with use of antidepressants from 2% to 4%. For this reason, the FDA requires that antidepressants carry the strongest warning possible, other than removing the drug from the market, a black box warning, so that those using antidepressants can be aware of this possible affect from antidepressants. (FDA off-site link) This risk is most noted during the initial weeks of antidepressant use, or when switching medications.

Overall, there may be a potential for healing from depression that can be equated or correlated with a number of factors other than the use of medication. These include (1) catharsis, or emotional expression of one’s feelings (2) based on the examination of one’s thought processes (3) and attention to healthy habits (4) with any concerned and empathic individual (5) who may be either a concerned friend or a professional treatment provider.

Anyone who is attempting to come off antidepressants or other psychiatric medications should do so gradually rather than abruptly. Note Dr. Joseph Glenmullen's book, The Antidepressant Solution

1. Carson, R.C., Butcher, N. J., Mineka, S. (2000). Abnormal Psychology and Modern Life. 11th Edition. P. 662-668.

3. DeRubeis, R. (1997, May). Cognitive therapy IS as effective as medication for severe depression. A mega-analysis. Paper presented at the meeting of the American Psychological Society. Washington.

4. Exercise and Depression (Retrieved August 3, 2009). Harvard Mental Health Letter. https://www.health.harvard.edu/newsweek/Exercise-and-Depression-report-excerpt.htm

5. Graves, G., (July 2011). The Surprising Silver Lining of Sadness. Prevention Magazine.

6. Kimberly Goldapple, MSc; Zindel Segal, PhD; Carol Garson, MA; Mark Lau, PhD; Peter Bieling, PhD; Sidney Kennedy, MD; Helen Mayberg, MD, (January, 6004). Arch Gen Psychiatry. 2004;61:34-41. Treatment-Specific Effects of Cognitive Behavior Therapy. off-site link. https://archpsyc.ama-assn.org/cgi/content/abstract/61/1/34

7. Kirsch, Irving (1)*, Deacon, Brett J. (2), Huedo-Median, Tania B. (3), Scoboria, Alan (4), Moore, Thomas J. (5), Johnson, Blair T. (5)
(1) Department of Psychology, University of Hull, Hull, United Kingdom, (2) University of Wyoming, Laramie, Wyoming, United States of America, (3) Center for Health, Intervention, and Prevention, University of Connecticut, Storrs, Connecticut, United States of America, (4) Department of Psychology, University of Windsor, Windsor, Ontario, Canada, (5) Institute for Safe Medication Practices, Huntingdon Valley, Pennsylvania, United States of America. (February 2008). PLoS Medicine, Public Library of Science. Initial Severity and Antidepressant Benefits: A Meta-Analysis of Data Submitted to the Food and Drug Administration - off-site linkhttps://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0050045

8. Marano, Hara Estroff, (July/Aug 2007). Talk Therapy vs. Drugs. Psychology Today https://www.psychologytoday.com/articles/pto-20040316-000004.html

9. Sigman, A., (2007). Remotely Controlled: How television is damaging our lives and what we can do about it. Ebury Press.

10. Watching Television, Channeling Unhappiness, (November 14, 2008). Science Daily. https://www.sciencedaily.com/releases/2008/11/081113080006.htm

11. Valenstein, E., Ph.D., (1988). Blaming the Brain – The Truth About Drugs and Mental Health. New York:The Free Press.

Childhood Depression - When Your Child's World Collapses: Kids & Depression Part I, by James Lehman, MSW

Depression Experiences - A couple of positive stories of overcoming depression through lifestyle changes.

Ann Reitan, PsyD is practicing therapist and former associate professor of psychology. She received her Doctoral degree at California Professional School of Psychology and her Masters degree from Pepperdine University.