Depression Is a Choice: Winning the Fight Without Drugs by A. B. Curtiss

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About the book

In this revolutionary and provocative work, a psychotherapist with a family history of depression takes a hard look at the syndrome and how to overcome it naturally -- without medication...

Reviews

"Will rouse discussion among caregivers, patients, and drug companies."
-- Booklist

"According to Curtiss, as soon as one becomes aware of depressed or manic feelings, one must "as an act of will, replace the accidental, unchosen thoughts that have caused the problem with new, positive, neutral or commonsense thoughts or actions." Even in cases resulting from chemical imbalances in the brain, contends Curtiss, it's simply a question of learning how to employ the mind. She feels strongly that prescription drugs coupled with "psychologized thinking" (i.e. the Freudian premise that "the mind and the self... are one and the same") will only mask, not help with depression."
-- Publisher's Weekly

Curtiss, a long-time sufferer of manic depression who spent years in therapy before deciding to become a cognitive behavioral therapist, concedes that depression is caused by a chemical imbalance in the brain, but contends that will-power, not chemicals, is the way to cope with it. Depression, she asserts, lies in the lower-brain primal mind; to make it go away, simply use the upper-brain higher mind, which does not contain depression. Drawing at length from her own life experiences, but also using anecdotes from her practice, she describes how to use the higher mind to gain control over reaction to depression. She calls the process of choosing specific thoughts to switch the focus of attention from lower-brain mind to upper-brain mind "Directed Thinking," and like many self-help gurus, she advocates the use of positive self-talks. For quick help, though, in those moments when depression strikes, she recommends having some simple mind tricks on hand.
-- Kirkus Reviews

The most engaging aspects of her long book are her accounts of her experiences and of the growth in awareness that led her to "Directed Thinking," the major goal of which is to control not depression but one's reaction to depression; not to find fault (a culpable condition) but to find a remedy consisting of mental processes to employ as soon as the first twinges of depression appear. Developing such processes is a choice, hence the title of Curtiss' hortatory book, which probably will rouse discussion among caregivers, patients, and drug companies
-- Booklist, American Library Association

Curtiss is a family therapist and cognitive behavioural therapist. She also has long personal experience of the condition now known by psychiatrists as bipolar affective disorder - formerly called manic-depression - in which periods of intense despair and misery are interspersed with episodes of highly charged energy and excitement. This book is a detailed, honest and at times alarming account of her ongoing struggle with depression, which makes good use of historical, philosophical, professional and some very personal perspectives.

The book’s central message concerns the importance of what Curtiss calls ‘Directed Thinking’. She has found that it is not necessary to become a victim of depressed mood. She argues that although we cannot get rid of it directly, we do have some element of choice in the matter. It is possible for us to think our way out of the depths of despair.

She explains the technique of ‘conscious neutral thinking’, whereby we can learn to use simple repetitive thoughts - such as nursery rhymes - to counter and replace depressive thinking that can so easily hampers and cripple us. She also explains some of the cognitive-behavioural techniques used to challenge negative thinking, which are aimed to help us to see ourselves as not as failures but as ‘works in progress’. In place of the complex biochemical formulae developed by pharmaceutical companies to derive antidepressant medication such as Prozac, she presents us with her own much simpler formula for the cure of depression:

Depression + conscious neutral thinking x concentration = equanimity

Curtiss describes valuable role models from history and from literature. At the age of twenty-two Benjamin Franklin decided to embark on a regimen of acquiring what he considered to be the thirteen important virtues (including temperance, resolution, chastity and humility) and kept a diary to record his progress. She finds him a helpful example of how it is possible deliberately and explicitly to work on our health and well-being. Greater than this is the importance of locating ourselves in our life, our roles and responsibilities, and not seeing our immediate feelings as the arbiters of our fate. Ishmael, in Melville’s Moby Dick, said that ‘in all cases man must eventually lower, or at least shift, his conceit of attainable felicity; not placing it anywhere in the intellect or the fancy; but in the wife, the heart, the bed, the table, the saddle, the fire-side, the country’.

She has devised a morning meditation to use if she wakes and finds herself depressed. This includes singing children’s songs and nursery rhymes, fast counting, laughing silently (or out loud if there is nobody else around), praying for three other people, and remembering that life can have meaning without the necessity of happiness. ‘If you can’t do it for yourself, do it for the others’.

Curtiss is strongly anti-medication, particularly antidepressants such as Prozac, which she sees as taking away our responsibility and our ability to work things out for ourselves. While I agree with her concerns about the medicalisation of misery, and the relentless drive for profit maximisation of major pharmaceutical companies, I think her position here is unnecessarily antagonistic. In my experience as a general practitioner - and as the father of a child who has experienced bipolar affective disorder - I have found that medication can be a very useful support to the approaches and techniques that she is advocating in this book. I do not think that we need to make an either-or choice, but can do best with a judicious use of all relevant approaches.
-- Christopher Dowrick, Professor of Primary Medical Care, University of Liverpool

Excerpt

Journey to a Choice

The moment I felt depressed, it never occurred to me to do anything else but be depressed. The progression from a feeling of depression to being a depressed person was a foregone conclusion that I never questioned.

Depression always ends. Not because of Prozac. Not because of psychotherapy. Not because of psychoanalysis or shock treatments. Depression always ends because it is in the very nature of depression to end. The only question is, how can we get it to end sooner, the way we want it to, instead of later, which we hate?

The answer is that we have to learn to think about depression in a different way. But it is not going to be enough to simply consider new ideas from a safe distance. We have to get down on our hands and knees with a magnifying glass and crawl around inside of the beliefs we have for so long relied on. It is not going to be enough to consider what we think. We have to consider how we think because the problem of depression lies in the very gears of our thinking process.

To do this we must entertain some rather esoteric ideas that we cannot so easily dismiss with our ready-made answers. There are wonderful clues in ancient paradoxes, like koans: What is the sound of one hand clapping? These clues can reach beyond our normal considerations to some un-invented part of us that we are not normally in touch with They help us learn to think sideways, intuitively, restructuredly–all the better to match wits with our depression

Depression makes us fearful that we will never be truly happy because we see how our happiness can be blown away in an instant, like straws in a hurricane, and absolutely nothing remains to comfort us in our anguish.

We need not be afraid. We do not need comfort. It is not true that all our happiness has fled and what we are suffering is the pain of its loss. Our essential capacity for happiness is not something we can "get back" or acquire no matter how hard we try because it is our natural state. What happens is that depression covers over our natural state and tricks us into thinking that we don’t have it anymore. When we properly address our depression, it relinquishes its hold upon us, and we find ourselves once again in the bedrock of our infinite okayness. Practically speaking, happiness is unlearned depression.

Our essential happiness is not conditional. Conditional happiness can not pass for essential happiness anymore than being serially grateful for disparate things can pass for a state of infinite and abiding gratitude. Conditional gratitude, where we see something that causes us to be grateful, is not the same as essential gratitude, where being grateful causes us to see something. Conditional happiness, the temporary excitement of having what we want, is not the same thing as essential happiness, the transcendent awareness that we can want what we have. Conditional happiness is a feeling that comes and goes. Essential happiness is our original state of well-being that is always available to us. It is not quantitative despite the fact that we think it depends upon some quantity of things or feelings we "must have."

Depression is not quantitative either despite the fact that psychiatrists have labeled it a disease and divided it up into various classifications and diagnoses. Depression, like essential happiness, is qualitative. But depression is not our natural state, it is a state of alarm. When I began my career as a psychotherapist in 1987, I was as deeply afflicted with depression as anybody else who walked through my door looking for help. But no more. I have come to see depression in a revolutionary way that has totally eliminated the whole idea of it as a disease in my life. After suffering with it for decades; after watching my brother struggle with the same ravages of manic depression that killed my father, I know, now, that it doesn’t have to be that way. There are 17 million people suffering with depression who are all seeking an answer to their hurt and pain. Ten years ago, as a result of my work as a cognitive behavioral therapist, my struggles with my own severe mood swings and my experiences with patients who came in for therapy, I discovered the real cause of depression. I haven’t "been depressed" since that time.

This book is not an orthodox book on depression. The trouble with orthodox books is that we agree with them. We seldom do things we agree with because agreement makes us feel so comfortable that it is easy to substitute our knowledge for our action. There is simply no movement without resistance, as physics tells us. That’s why we bounce a ball on the hard floor instead of a pillow. That’s why we do exercises. Because we seldom agree with them. Exercises make us feel so uncomfortable that we end up doing them out of some kind of spite, and they take us galaxies beyond anything we intellectually agree with.

There’s a good chance you won’t agree with even the title of this book. You may find it uncomfortable, annoying, confronting, outrageous, even dangerous. How can depression be a choice? You may want to argue with this book, fight with it, wrestle it to the ground. Good. The quickest path to change is through our resistance to change. And there is nothing we less want to change than our own long-held opinions, and the process of how we think. It is human nature. But sometimes the very act of defending some deeply-held idea causes us to look at it more closely. We see a flaw. I have sat down at my desk in a furious rage to write down all the one, two, three points that "prove I am in the right;" only to find, as I read over my own words, the surprising clue to my culpability.

The other problem with orthodox theories about depression, in addition to the fact that we agree with them, is that at some point they all depend upon some faulty but hidden premise that no one thinks to ferret out because everyone is so caught up in the admiration of the excellent logic employed. We are all subject to this touch of intellectual arrogance.

Last modified: July 29, 2002