I recently had the pleasure of reviewing Little Voice Mastery, and it was a very different read than most of my business book reviews. Although author Blair Singer is focused on helping people improve the bottom line, hit sales goals, and the like, this book has some real meat in it for the depressed person.

For example: on page 126, in the middle of a series of very specific techniques Singer suggests for quelling the nagging, doubting voices that echo in all of our heads, he offers a technique for shiftly one's mood quickly. It's a role play, and it will almost make anyone feeling depressed additionally feel stupid, but that's the little voice of the depression talking, so pay attention to me, not it.

In essence, the technique is one of having a dialogue with oneself, just asking questions about mood until one gets an answer. It's surprising how easy it is to get the subconscious to own up to how it feels if you just ask it a direct question or two. After you've identified your real mood (and we all know that sometimes the anger or sadness is masking something else), the exercise helps you pick another mood and try it out.

Emotions do really follow our direction. If you feel powerless to change, it's not because you're not capable - it's because that damned depression has convinced that you're impotent. Instead of dwelling on it, try a role play out. Just walk through the steps and follow the instructions carefully, so you have no choice but to succeed. You may be surprised that it was easier than you expected.

Thought Becomes Deed

I arrived at the diner and pulled my keys from the ignition with the same motion that had turned the vehicle off. As I slid out of the seat I slipped my hand into my pocket, confirming that my wallet was within. It wasn't.

I checked my other pockets, and then the spare pair of pants I had in my bag - although I hadn't worn them. I opened the glove compartment, checked under and behind the seats, and in all the pockets of my bag. The wallet just wasn't there.

Panic rose in my throat. Had I left it at work? Work was half an hour's drive, and closed for the night. Further, this was Sunday night, so they wouldn't be open again until Friday. It would really have been problematic if I had left my wallet there.

I took a breath, released it slowly. No, I decided, you left your wallet on the desk at home. I smiled, and grabbed the ten dollar bill I had discovered when I had been searching, and brought it with me. I had to be careful how much I ordered, but it was a fun time with my coworkers.

I found my wallet on my desk the next morning - it was half buried in a small pile of papers.

What am I getting at here, anyway?

Placebo: What Your Brain Can Do for You

The placebo effect is the measurable, observable, or felt improvement in health not attributable to treatment. This effect is believed by many people to be due to the placebo itself in some mysterious way.

So states this article on placebos and depression from the Skeptic's Dictionary, and appropriate resource. Like this UCLA article about placebo usage, it discusses how, when a patient is told they are receiving a placebo, the effectiveness often goes away. Is this because the treatment was all in their heads? Or that the depression was?

Many studies try to compensate for the "placebo effect." Others, more recently, have specifically studied this factor as a healing process. A study by Dr. Arif Khan showed, according to the New York Times, that:

It turns out that the more severely depressed people are, the less likely they are to respond to a placebo. And people with more mild depressions get better with just about all treatments, including placebos. Since most clinical trials enroll less severely depressed patients, the observed difference between the response to an antidepressant and a placebo can be misleadingly small.

Other studies, including one by Dr. Irving Kirsch, suggest that medications are nearly useless because the placebo effect is so high in depression treatment. Meanwhile, doctors wrestle with the ethics of "tricking" patients with placebos.

I think the point is not quite being realized by the scientific community. Depression is a disease that is has an effect upon the body as well, because the brain controls all things. Placebo is the brain's natural ability to repair damage to all the human systems. This process is easily interrupted by doubts and limiting beliefs. At this point in our development we have identified the process, and we recognize that it can be encouraged by presenting patients with a physical talisman, if you will, of healing; the pill. More severely depressed people need more than a sugar pill because they are so very sick their limiting beliefs extend deep into the unconscious, metastasizing like cancer. They need medications to bring them to the point where the placebo process can recover enough to even try to work.

I foresee a time when the scientific community will focus serious research on placebos, not to remove them as a variable or identify what is "in a patient's mind," but to determine how to harness our own healing ability and hone it. This research will not be conducted by drug companies, because it would not be advantageous to cure such a lucrative market for maintenance medications. It will be research into areas currently sidelined as psychology or superstition, and will tap into the true potential of the human brain.

The lucky depression patients have found other avenues to unlock these secrets, either through sugar pills or prayer or exercise or therapy, and they have been given a chance at true healing, y allowing their brains to overcome depression naturally. It's time the scientific community figures out a way to give the rest of the victims that opportunity.

Cleaning House

Is a messy home a caused by depression, or is depression caused by a messy home? I've heard passing references to a link between disorganization on the outside and fogginess on the inside, but I wasn't able to find any research on the subject. I know that I'm no stranger to having a bit of untidiness in my life, and there are plenty of other people I know who fall into both the categories of "depression victim" and "house cleaning challenged."

However, as my mother would say, "Dull women have immaculate homes."

There might be some wisdom to the axiom linking an orderly environment with an orderly mind, but until someone does a study I'm not making any pronouncements. However, I think it's fair to say that a messy home feeds really well into the cycle of I'm-not-good-enough that depression creates and builds upon. If you don't have the energy or focus to clean, it's pretty certain you'll put it off. As the mess builds, so does the guilt. The problem gets bigger as the guilt feeds the depression, which diminishes the energy levels and reinforces how impossible the task is. You know the drill, you've probably done it to yourself. Charming little cycle of self-recrimination and self-fulfilling prophecies. You expect that you can't clean the place up, and your mind works overtime to make sure that it doesn't make a liar of you. Didn't think you had that much mental energy, did you?

As with everything depression-related, small victories add up. Commit to not adding to the mess today. You will not create another dirty dish without washing it. One dish isn't so tough. And those socks? Just force yourself to put them in the hamper; you'll be glad you did. Keep up on not adding to the mess, and you'll see you can control your world after all. Then you'll be ready to take a step or two towards the bigger mess.

I would keep making small victories. Don't try to clean every dish in the kitchen, but do try to wash all the ones in the sink. Maybe picking up all the dirty laundry is a bit much right now, but how about just the stuff that you piled on your bed? Each time you succeed you're teaching yourself that you are capable and you are in charge.

Medical Reinforcement (sort of)

Dr. Neubauer has located some studies that support what I have stated previously, namely that there are steps you can take to improve your mood and your sense of accomplishment, including caring for pets and exercise. I understand that his training is scientific and so he will only support any treatment option so far as the scientific method can document its success, but I take exception of his downplaying the value of these treatments, as well as herbal remedies like St. John's Wort, which I will discuss more in detail in a future post. For now, suffice it to say that there have been studies that demonstrate this herb's efficacy, just not, apparently, published in any journal the doctor respects.

I'm also not surprised that he does not include such vehicles as prayer and self-affirmation, as these are exceedingly difficult to document in a laboratory. Being unverifiable is not the same is being unsuccessful, however. Expectation is often half the battle.

You Deserve Better Than Hope

Hope implies that we have a chance, even a small one, of getting what we hope for.

Hope is a funny construct - it can pull people out of the pits of despair, giving them the power to survive and succeed, but when dashed it can shatter a soul.

Hope is a passive, yet passionate, state.

Hope does not lead to action. In many cases it is a substitute for action.

Hope is somewhat optimistic, and largely dangerous.

If you're emotionally vulnerable and have a desire for a better turn of events, I don't think hope is the best way to go. Yes, there is a chance that things will turn out as you hope they will. But only a chance.

Because hope doesn't do the work, and for a depressed person it just becomes an excuse.

"Nothing ever goes right for me. I should just give up."

If I hope to win the lottery and don't buy a ticket, whose fault is that? That one might be too obvious. If I apply for a job, and hope I get it, but I never call to follow up on the application, whose fault is that? The hiring manager's? Mine, maybe?

It's really easy to be passive about life when you've got the thousand-pound weight of depression on your soul. You hope for good things to happen, but you expect those hopes to be dashed. When they are, you can easily confirm your suspicion that your life sucks, your luck is terrible, the Universe is against you, and you smell funny.

Okay, that last one is just your imagination, unless you have another issue.

But actually that last one is just like the rest of them - they're all things that you can change, but only when you stop being passive about them!

Hope is a dream killer. Sure, sometimes things work out as we hoped they would. But then we are robbed of the satisfaction of accomplishing them, because they just . . . happened. And if those good things didn't happen through our actions, then we have not learned how to make them happen again. Dreams that come true through the random action of the Universe don't turn into phenomenal stories of personal transformation any more often than single-celled organisms evolve into sentient primates with language and culture.

I'll let you look up the odds on that for yourself.

If you feel the need to hope for an outcome, do yourself a favor and find out what it would take to get yourself there. Does it seem too big a goal? No worries. Find a smaller goal, one that you can achieve, that will move you closer. Is your goal to be free of depression? Maybe the best goal you can achieve for yourself is calling a counseling center. Doesn't seem like much, but if you make that call, you have taken action. You are teaching yourself that you refuse to allow yourself to drift aimlessly through life. You are empowered to make decisions that will affect your fate.

Personal responsibility is washed away by hope; hoping absolves us the obligation for our own lives.

Don't let depression suck you down into that hole where you believe all that claptrap about not having power. You do. And you can start using it as soon as you realize that there are much better tools out there than hope.