Some of the most comment causes of obesity in the world today are:

•Diet
•Lifestyle
•Metabolism
•Genetics/Heredity
•Emotions
•Lack of Sleep
•Medications
•Diseases

This domino affect allows many people to dig themselves holes; leading to weight gain and
depression. It’s not an easy task to eliminate excessive fat due to depressive symptoms.
Concurrently, the person finds him/herself having to overcome depression AND lose weight.
As challenging as a task this may sound, people still have options.

This condition that already produces several health problems that cause many to seek help via
weight-loss procedures from centers like MetropolitanMD (a Chicago liposuction and cosmetic surgery center that employs some of the best plastic surgeons Chicago has to offer). However, before consulting with a surgeon, individuals should look to natural weight loss practices, such as exercise and diet. Instinctively enough, those who suffer from depressive systems tend to be inactive, which in turn leads to weight problems. It’s important to remember to stay as active as possible; this includes more than simply going for a run four days a week. Engaging in every day conversation with friends, family, and coworkers is great way to avoid depression. This would fall directly under lifestyle, but can directly affect one’s mood.

Mood swings are common for those suffering with depression and can be caused by a lack of communication and relationships with others. Remember, the easiest way to stay healthy is to surround one’s self with healthy people, subsequently creating a much healthier environment to live in. Behavioral traits have a tendency to spread like wildfire within a group, so it’s greatly important to remove yourself from an unhealthy situation. It’s equally important to pay close attention to any type of medication that you may be on; side effects could potentially lead to disease, lack of sleep or a sudden change
in diet. Moreover, this could all lead to an increase in weight.

Emotional stability is important in any person’s life, and will directly affect their lifestyle. Combined with the above, this has the potential to be a lethal underlying cause for obesity. It’s quite easy to notice the correlation amongst the causes/symptoms of depression and obesity. The best way to avoid this growing epidemic is to take preventative action. Remember to stay healthy and help promote healthy habits by influencing others to do the same.

Rachelle Holmes of plastic surgeons Chicago, MetropolitanMD.

I know it sounds funny or even narcissistic the concept  of having a conscious relationship with yourself. But in reality, we all do, irrespective of our level of self awareness or self consciousness. That’s not say, we should be walking around all day with our heads in the clouds, consumed with every little thing regarding ourselves.

An easy way to get your head around it, is to consider that your relationship with yourself is no different from your relationship with a family member, friend or partner. From time to time there will be a degree of conflict – a degree of unhappiness or discontent. To resolve the drama we have to hold the mirror up and have a look at what we may have done, which may have contributed to the disharmony. Similarly, nobody’s perfect. There are going to be some things about the other person, no matter who was in the right or wrong, that we simply have to learn to accept.

And that’s it in a nutshell. When we’re struggling with any variety of issues, we need to consider what we may have contributed to it and also learn to accept that we’re not perfect. The big challenge, however, is knowing where to begin or kick starting this relationship if you haven’t been overly aware in past of the source of your previous happiness and contentment. This challenge or difficulty is particularly acute, if you’re suffocating under the weight of a deep dark depression.

First, if how we see and value ourselves is largely dependent upon other things, such as job or career or a relationship, and we lose this source regardless of why or how, our world can be thrown into turmoil and we can end up experiencing depression (Dr Dorothy Rowe).  Actress Emma Thompson has just spoken publicly of the depression she experienced as a consequence of her divorce from Kenneth Branagh, fashion designer Alexander McQueen committed suicide as result of the depression he experienced after the death of his mother and Billy Joel’s daughter spiralled into depression and attempted suicide after a break up.

Interestingly, a recent journal article suggested that the breakdown of a relationship is the second most stressful life event we will experience – the most stressful being the death of a loved one. And that the amount of mental and emotional energy we consume during this period is the equivalent of working two fulltime jobs. Little wonder some of us find it so difficult to function during this type of experience.

Second, and I believe probably the main reason for the significant increase of depression within the developed world – depression is expected to be the second biggest health problem and burden within the developed world by 2020 – is the ever increasing stress and pressure we encounter during our everyday daily lives. Most of us operate 24/7, with little down time, particularly with insidious cancerous growth of new technologies – mobiles, texting, emails, tweeting. Ironically, of which, are meant to make our lives ever increasingly easier to live and more socially connnected. In reality, the connection appears to be more plastic in nature, as opposed to a real, earthy, deeply rooted bond.

The stress associated with our vocation – our job, study or business – relationship stress with our partner, family and friends; and finally,  financial stress – many of us are in debt up to our eyeballs – only adds increasing pressure upon us. Like being burden with a heavy weight, this pressure builds and builds with ever increasing or unrelenting stress until something has got to give – namely us – and we find ourselves flat on our back struggling with depression or being prodded and poked by a Doctor who has just diagnosed a major health problem.

Thirdly, as Dr Martin Seligman suggested many years ago in his theory of ‘learned helplessness’, depression can become a learnt response to minor or major personal setbacks, particularly if how we feel about ourself is largely dependent upon external sources.

I realise that many suggest that depression is due to a a biochemical imbalance. And, based upon my own experiences with depression, I have no doubt that some type of physiological changes occur. However, at the end of day, which causes what? Particularly when you consider the results of studies that demonstrate that placebos or sugar pills can be just as effective in the treatment of mild and moderate forms of depression. Not to mention the fact that in the USA pharmaceutical companies made almost $10 billion dollars in antidepressant sales in 2009, less than 25% of depression sufferers actually seek help and depression is an ever increasing problem within society.

In other words, I don’t believe as a society we are properly debating the causes and treatments of depression. It’s all too easy to simply suggest that depression is a condition that we as individuals cannot have any influence upon. A similiar line of argument to suggesting that obesity is simply caused by genetics, while sitting on a couch stuffing your face with a cream bun. Irrespective of what may or may not be the cause depression, improving our ability to handle everyday stress or seeking additional support - even if it’s as simple as talking about the problem – can significantly reduce the built up anxiety and tension we may be experiencing; and hopefully keep the barking ‘black dogs’ at bay.

Many of us here in Australia are only too well aware of the terrible toll the drought has had upon farmers and their families. Unfortunately the rate of depression is much higher in rural areas, as compared to the cities, not to mention the tragic suicide toll. Unending drought, financial pressures, relationship problems, a loss of identity and an expectation that a country man or woman is bred tough and can cope with all sorts of adversity and isolation have had an incredibly detrimental and demoralising impact upon individuals and communities alike.

From my perspective, based upon my wheeling and dealing with the ‘black dog’, how you see and value yourself is an important aspect to maintaining daily mental health and wellbeing. Obviously, if how you see and value yourself is disrupted with loss of a job or career, you may find yourself struggling. Which in many respects, may explain why there is a greater prevalence of depression within rural communities, as the identity of the individual is directly threatened by the potential loss of the farm and a way of life – with the extra sting in the tail of the personal crisis being the fact that that farm may have been in the family for 4 or 5 generations, and you’re the person responsible for it’s continued upkeep and profitability.

Closer to the mark, however, may be the terrible drain or burden of continued and unrelenting stress or pressure in trying to keep the farm financially afloat. Unfortunately, no matter how hard the farmer works, the weather, the markets or both, can have a devastating impact upon the profitability of the farm. This pressure would be like Chinese water torture a thousand times magnified, and regardless of how grateful and appreciative he or she may be of the life they lead, like having your head in a vice, the pressure can slowly grind you down.

Someone once said, ‘what doesn’t kill us makes us stronger’, and there is an element of truth to that statement. But the reality is, all of us as human beings have breaking points, and it’s important that we are able to recognise when we need an extra hand to cope with different situations.

Finally, hopefully despite all the recent rain, we don’t forget the plight of the farmer. For many of them, they would require  a couple of good seasons before they began to feel any respite from their particular situation. We all face challenges, but if you have a greater influence upon the potential outcome of a challenge, you’re doing pretty well. If not, which in many instances is the case for the rural man or woman with weather, banks and markets mostly dictating terms, it’s an unenviable position to be in. Hopefully, with community support and their noted resilience, they we be able to find a path through and continue to provide the much needed produce that many of us in the city may not really give a second thought to until we reach into our wallets to pay a multinational our grocery bill.

The first point to make is that people who are depressed often do not want help.  They are not motivated to do anything at all.  So you need to know up-front that helping them is not going to be easy.  Having said that, don’t give up.  You can make a difference.

The way that people experience depression can be difficult to understand.  So you can help simply by encouraging the person to talk about how they are feeling and just listen.  Often they will just be wanting someone to listen, so avoid the urge to give advice.  By listening and not being judgmental, you are likely to learn more about what the sufferer is really experiencing and will leave the door open to conversations in future.

Let them know you care.  This sounds so simple but is often overlooked.  Even during the tough times when your attempts to connect might be rejected, be patient and let them know that you care and will be there to talk when they are ready.

When the timing is right, suggest that they seek professional help.  Encourage them to read books written by others who are dealing with depression or who have been through the experience.  This will help them to see that they are not alone and that others who have been through the same experiences have found a way out.

Finally, you need to keep yourself in good shape.  Supporting someone who is depressed can be exhausting, physically and mentally.  Set time aside to get rest and to exercise so that you are in the best possible condition to be an active supporter.

Dealing with depression can be tough for those closest to the sufferer.  However, your support can make a difference; sometimes it can be a very significant contribution to the recovery process. So keep faith and persist.  You will be making a difference.

From a parental point of view, it’s a difficult social problem to address. On the one hand, you know from your own experiences that bullying is a very real and troubling problem that your child or adolescent needs to learn to deal with successfully. And on the other hand, you want to step in and smite the infidel giving your kid a hard time. What’s the right approach or correct course of action? Particularly when you reflect upon your own life experiences and know all too well that as a direct consequence of the tough times or bullying you experienced, you developed the capacity to deal effectively with a variety of problems or challenges.

In many respects, this makes bullying is a double edge sword. The reality is, as human beings we need to devlop a degree of resilience within ourselves to cope with the various put downs, setbacks and tragedies we all face in life. Rightly or wrongly, many of us develop a thick skin as a direct result of the bullying and adversity we experienced during our formative years. The question is I guess, is how much bullying is too much? Or better still, how do we learn or teach people to deal effectively with bullying?

In an ideal world, we wouldn’t be on the wrong end of any type of personal harassment or humiliation. Again, the reality is, most of us at one time or another have been on the end of verbal intimidation, social rejection or even physical abuse. Ironically, many individuals become bullies as a direct result of the bullying or abuse they received. We continually hear from the “experts” that individuals bully because they feel feel insecure or lack self-esteem.

Based upon my own experiences and observations of bullying, this appears to be largely a correct assumption or truth. The great irony, however, particularly if you’ve ever experienced bullying directly, is that in the vast majority of cases the individual who is dishing out the trash or physical intimidation appears and acts in a largely cool, calm and collected manner – they are well practised in the art and are not easily ruffled. However, scratch a little deeper below the surface and the individual can end up wailing like a 3 year child who hasn’t got their way with something. The challenge is to get the bully to confront the reason or causes of their behaviour.

So where does this leave us? Particularly when you consider all the time and effort you put in as a parent to teach your child to behave in a socially acceptable way. Again, on the one hand you strive to teach your child to behave one way; and ironically on the other hand, the very behaviour that would equip a child or adolescent to deal somewhat more effectively with the bullying situation is disencouraged. At the end of the day, as well as seeking to stamp out bullying, I believe a greater emphasis needs to be placed up teaching kids to deal with it more successfully. Part of that may involve informing them as to why an individual bullies in the first instance, as well as placing a greater emphasis upon their peers to step in and stand up to the bully. Someone once said that ‘evil occurs when good men or women fail to act’.

In respect to the first point of teaching our kids to deal effectively with bullying, a psychologist who has been interviewed quite a deal during the current debate, has emphasised the art of ‘blocking’ – mentally blocking out the emotional torment and ridicule as to prevent giving the bully any power. I guess it is along the lines of the old adage of “sticks and stones will break my bones’ etc.. No doubt such an approach can work in some instances, but when someone has a go at you and then takes it to the next level by physically assaulting you, attempting to mentally ‘block’ the abuse is useless. 

I believe we need to develop a greater understanding of why an individual bullies. From my experience, it comes down to three things. First, it’s simply a case of the bully attempting to get what they want – a desire born out of a deep seated insecurity and selfishness. It could be about maintaining their position on the social ladder, improving it or even as simple as getting an emotional pay off – boosting their fragile ego and deep seated insecurity or poor self worth.

Second, just as we see on the sporting field so often, some forms of bullying is about ‘feeling’ out a potential opponent or rival, trying to figure out what makes them tick and then taking advantage of this weakness in their armour. Third, as anyone who has been in a fight will know, there are a number of physiological changes taking place during this situation – the heart pumps faster, the adrenalin surges and the mouth becomes dry. Unfortunately some individuals find this experience satisfying or rewarding – a drug if you like - which probably explains alot of the alcohol fuelled fights late at night, particularly after a rooster has been unsuccessful in attracting any hens.

As I suggested, instead of attemting to stamp out a social problem which has existed since the beginning of time, I believe as a society a greater emphasis needs to be placed on equipping people with the skills to defuse a situation, a focus on strengthening an individuals resilience - detachment without a loss of empathy – and placing a greater emphasis upon others – a child or an adolescent’s peers – to step in when an injustice occurs. The obvious problem with the last suggestion is that the conflict may escalate, but therein lies the dilemma of the bullying problem.

Irrespective of what you might think of the antics, there’s little doubt it’s probably had a devastating impact upon Mrs Woods and the young children. Not too mention the fact that Tiger’s probably doing it pretty tough right now or may be at some point in the future - if and when he begins to contemplate certain issues or adverse consequences.

As the saying goes, “it takes a lifetime to build a reputation, and a moment to destroy it”. If the latter is the case, there’s only one thing to do, get back to building!

Recently, it’s been alleged that Tiger’s behaviour is the result of being a sex addict. While others have argued that Tiger’s exploits are not a problem or a behavioural issue; but rather it’s part and parcel of the life of an elite sportsman or celebrity. At the end of the day, only Tiger really knows.

However, regardless of whether it’s viewed as sexual prowess or is diagnosed as an addiction, the behaviour was a problem as it’s appears to have destroyed a marriage and a family and potentially a career. Even potentially Tiger Woods the person, if he is coping poorly and is not getting the necessary help and support. And that’s probably all that needs to be said on the matter, since most of us aren’t exactly saints ourselves. Although, admittedley, our vices may be a somewhat different.

What this present situation does highlight, however, is the various challenges faced by top flight sportspeople.

Some may laugh at this comment. But consider for a moment their lives and I’m not talking about when they’re receiving the winning trophy, the big fat winner’s cheque, the endorsements, the cheers and the public adulation and respect. The reality is, many of them - at a relatively young age - have dedicated themselves to reaching the top in their respective sports. This means sweating it out for hours on the “training paddock”, maintaining a high degree of discipline and experiencing a fairly isolated life - a difficult task at the best of times, especially if you’re young and eager to explore the world and live life.

Due to this spartan-like existence, some sportspeople don’t get the opportunity to make the same mistakes that you and I did during that great transition period between adolescence and adulthood. Thereby, obtaining the necessary life experiences - learning about yourself, others and the world we live in - and hopefully developing a little bit of inner wisdom or common sense. Today, many top sportspeople live in a fish bowl, with the time, money and trappings to get into a whole lot of mischief.

Also, if they do make the same or similar mistakes that we did, it’s made in full view of the public eye, unlike the relative anonymity we enjoyed. It’s bad enough making a serious blue – you feel terrible and are filled with regret. Imagine doing it in front of the eyes of the world. Modern technology and a gossip styled news broadcast with a salacious appetite, beams the latest piece of malicious news or innuendo onto our screens twenty-four seven. This is a bitter, hard pill that people with a public profile have to learn to swallow. Little wonder Tiger so ferociously guarded his privacy, but perhaps to his own detriment.

Finally, you often notice sportspeople who have reached the top - after a long hard road of blood, sweat and tears - begin to relax and let their hair down a bit. In many respects, well deserved. In many instances, a recipe for disaster. Since in reality, the really hard work only begins once you’ve made the grade. Unfortunately, all the previous good work can be quickly undone, not only affecting their on-field performance, but critically their marketability and endorsements.

However, the greatest challenge a sportsperson may have to grapple with is the development of his or her own sense of self or self identity. Particularly, as much of it occurs under the watchful, waiting eye of the media and general public.

Like many of us, the self-identity of an elite athlete can become pretty heavily dependent upon their careers, a great part of which is forged during our late teens and early to mid twenties. In other words, how they see and feel about themselves can be strongly associated with their respective roles and success as a sportsperson. Consequentley, if their career stalls or disappears due to injury, poor form or retirement – it can have an adverse impact upon how they feel about themselves in general, and in turn lead to behavioural issues, depression and anxiety.

Ironically, a similar situation can occur once a sportsperson has reached the top in their respective field. Despite achieving everything that they’ve worked so hard for over many years and all the trappings of success - status, fame and wealth - some may feel a little empty inside – somewhat unfulfilled. Success isn’t all what’s it’s cracked up to be. Subsequently, some may seek to fill this void, this emptiness or inner turmoil through other means. Hence, the life and challenges of an elite sportsperson can be somewhat different or unique from the rest us.

For example, when an athlete is injured, not only do they have to overcome the injury and work hard to re-find their past form once they return to the playing field; but the injury also poses a serious test of character. Since how they see and feel about themselves, unknowingly in many instances, has become dependent upon their sporting career, sporting performances, the cheers of the crowd, the acknowledgement of the backslappers and the euphoria of competition or hard physical training. Subsequently, some sportspeople may begin to question who they are, what they are doing and why they are doing it. Or they may attempt to fill their inner emptiness with parties, the booze and the pills. Or some may experience varying degrees of depression. In reality, it’s probably a combination of all three scenarios at various times.

For instance, consider the unfortunate stories surrounding the former Olympic swimmer Scott Miller, the former heavyweight boxing champion Frank Bruno and the former soccer star Paul Gascoigne. Sadly, there may be other fallen stars. Ironically, the same traits or qualities that made these individuals great sportspeople, can also get in the way of them getting help. Their absolute single-mindedness or focus, determination or resolve, and ability to overcome pain and adversity, may prevent some individuals from admitting that they’re doing it tough and drive them to try and fix the problem by themselves - ”I’ve done before by myself, and I can do it again!”

What they perhaps need to realise and accept is, yes, you did overcome and achieve much. But no, it wasn’t all by yourself - your parents, coaches and team members made signifcant contributions along the course of the journey. Subsequently, yes, you can overcome your present personal predictament. But no, you’re not weak or a failure if you need to access the help of others, just as you needed to do at various times during your sporting career.

Another big sticking point that may hamper an elite athlete from obtaining help could be the inner conflict associated with their personal reality and their public image. Over many years their public image, and in turn a large part of their self identity, has been developed and directly related to their own unique talents, ability to overcome adversity and personal success on the various sporting battlefields.  Hence, due to these attributes and past achievements, it may be very difficult for some individuals to reconcile with themselves, that they are indeed struggling and in need of help and support. Let alone risk the fact, that the general public (and sponsors) may become aware of these various personal difficulties; and that in reality the athlete, despite their sporting qualities and achievements, is not any different from the rest of us. They too put their pants on one leg at a time.

Encouragingly, Mr John Eales has instigated a program called the “Captains Forum”, whereby sporting leaders from a wide variety of sports will examine and seek to address a range of personal, social and community challenges faced by sportspeople and the general public at large. Hopefully, in the years to come, some of the recommendations and initiatives developed, will help assist athletes and the broader community, to avoid some of the pitfalls of 21st century life and living.

Unfortunately, in this day and age, due to the hectic work, family and social lives we all lead, not too mention the constant interruptions of modern technology, many of us implement sleep deprivation upon ourselves. New parents, especially the mums of the world, are all too familiar with this experience. Gradually overtime, we begin to feel tired and fatigued, restless and irritability, and may even sink into a mild or severe depression. At least this is what I have experienced at different times. Not too menton the fact, that we are also more susceptible to the various colds and flus floating around, as our immune system becomes run down.

Our susceptibility towards depression is highlighted in a recent study of about 15, 000 college and high school students. It found that adolescents and young adults who consistently failed to get to bed before midnight had a 24% greater risk of depression than those who turned in before 10pm. Also, night owls were a 20% higher risk of battling suicidal thoughts. Even more concerning were the results that showed that adolescents that slept 5 hours or less per night were 71% more likely to suffer depression and 48% more at risk of becoming suicidal. Obviously, this study examined adolescents and young adults; but I think most would identify with it’s implications for us older folks and recognise that there may have been times when we haven’t been the best company for ourselves or others.

Another potential adverse side effect of sleep deprivation, is that it affects our judgement and decision making. Similar to the effects of alcohol when we drink too much. As a result, our ability to come up with the “right play” at home, or at work or within our life in general is somewhat diminished; with the consequences of our poor choice leading to greater problems within our lives.

What’s the moral to the story? Well, just as we have to be mindful of what we eat or how much we drink – we need to be mindful that we’re getting the proper rest, relaxation and critically, the proper amount of restorative sleep. Otherwise, just like the adverse results of the study, we could end up experincing depression. Again, lifestyle factors, such as sleep or exercise, are integral components or building blocks in our relationship with ourself. Put simply, if we don’t look after ourself, it can have dire consequences on our immediate health, relationships and career.

Unfortunately some of us struggle to accept this and fail to get the proper rest and relaxation we need because we are too busy trying to keep up with “Jonses”, or we see sleep as a personal weakness or self indulgence. ”I don’t need to sleep, I can push myself through this and get the job done!” Whatever it is. In many instances, we do manage to do this successfully. However, one day, a lack of sleep may eventually catch up with us. And when it does, it hits like a tsuami, particularly if you haven’t really experienced it before. It literally knocks you off your feet, and it may take days, weeks or even months to fully find your feet again.

Ironically, another challenge, if you are tired and wired is actually getting to sleep and staying asleep. The reality is, strangely, you do actually have to consciously work at slowing down. We simply can’t flick a switch and return to normal homeostasis. We have to consciously focus on doing less at home and at work and socially. (Don’t let your boss know though!) Also, I find exercise, such as a brisk evening stroll, despite the tiredness and lethargy, helps burn off that pent up physical energy and agitation. Unfortunately today, most of our jobs don’t require too much physical exertion. Keep in mind though, feeling normal and being in a good sleep routine doesn’t happen overnight. Hence, it’s very worthwhile getting professional advice if you’re not feeling 100% or not sleeping all that well.

If you Google search ‘what causes depression’, approximately 28 million search results become available. Who’s got the time and energy to trawl through all that information, especially if you’re already depressed or you’re anxious about helping a loved one or a friend who is struggling with depression.

In many respects, the research itself can be quite depressing or the cause of great anxiety, as the vast amounts of information can be somewhat overwhelming - realms of information on the different causes of depression, different risk factors of depression, different signs and symptoms of depression, different types of depression and different depression treatments. 

Out of necessity, I come from the school of ‘keep it simple stupid’. Fortunately, it appears the World Health Organisation (WHO) employs a similar approach. Hence, in order to provide a basic outline of what causes depression, I will utilise WHO’s explanation, which simply and succinctly reflects what the vast majority of other mental health and well-being organisations from around the globe are suggesting.

Despite 50 years of extensive research and the tremendous enhancements in technology, WHO states that there is no single cause of depression. WHO employs a biopsychosocial model to provide a picture of depression; whereby biological (genetic and biochemical), sociological (stressors) and psychological (development and life experiences) factors interact to cause depression.

Unfortunately, in recent times, there has been alot of conflicting data surrounding the causes of depression. Just as the scientists appear to be getting closer to the root of the problem, another research study proposes that a previously considered fact may indeed be fiction. For instance, a recent meta-analysis published in the Journal of the American Medical Association, suggests “a gene variation that has long been thought to increase the risk of depression in combination with stressful life events may have no effect after all” (Serotonin Gene, Even When Combined With Life Events, Has No Effect on Depression; Source: Medscape).

Also, a recent report published in the Journal of the American Medical Association suggested that there was no real difference between effectiveness of antidepressants and a placebo in the treatment outcomes of mild or moderate depression. In other words, treating mild or moderate depression with a sugar pill was just as effective! Furthermore, in the treatment of patients with severe depression, there was only a 4 point difference on the scale used to measure the severity of an individual’s depression between the effectiveness of the antidepressant and a placebo (Antidepressants aren’t the only remedy for milder forms of depression: Robert DeRubeis).

Concerningly, an earlier study suggested that there is little scientific evidence to support the commonly reported theory that depression is caused by a biochemical imbalance (Caspi et. al., 2003). According to the researchers of the study; “The chemical imbalance theory, which was formulated in the 1960’s, was based on the observation that mood could be artificially altered with drugs, rather than a direct observation of any chemical imbalances. Since then there has been no direct evidence to confirm the theory and a significant number of findings cast doubt on the theory.” In other words, it would be like suggesting that since an aspirin may cure a headache, then headaches must be caused by an aspirin deficiency.

Another observation is, if depression was purely and simply due to a biochemical imbalance, why is talk therapy (cognitive behavioural therapy) scientifically proven to be just as effective in the treatment of depression as antidepressants? To me, this fact alone calls into question the commonly stated explanation that depression is due to a biochemical imbalance or gentic factors. How can talking about something overcome a medically defined illness or a disease?

From my experience with depression, there can be no doubt that some sort of physiological change takes place. Just like when we experience happiness, joy, fear or anger. However, which causes what? Did the biochemicals cause the joy you experienced from playing in a winning grandfinal or at the birth of your first child? Or did the actual experience cause the joy? In other words, did the actual experience shape how you sensed or perceived things (thoughts) and in turn, influence your mood or feelings, and at a molecular level there were the the associated biochemical changes? Or did you experience joy purely and simply because of biochemical changes?

It really can be a bit of a grey area. For instance, exercise has positive benefits on your state of mind and general wellbeing. But do you feel good about yourself due to the physiological changes related to exercise – the increase in endorphin levels? Or do you feel good about yourself as a consequence of exercise developing or maintaining a fit, strong and healthy body? And as a result, you like what you see in the mirror, the number on the scales and you’re feeling fit, strong and healthy. There’s a strong likelihood that it’s a combination of both possible explanations.

For the sake of the argument, let’s suggest that feeling good as a result of exercise is purely and simply because of a rise in endorphin levels. However, this explanation still requires that you exercise. And exercise is an actual event or experience. In other words, you had to do something or had to experience something before that physiological change took place. So in reality, feeling good after exercise is not only because of an increase in endorphin levels, but rather because you got off your backside and did something – an experience - as well as the consequences of that action or experience – you’re looking and feeling fit, strong and healthy.

In relation to depression, I have experienced similar scenarios over the years. Little wonder WHO suggests that  ”the assumption that depression is the direct result of a biochemical imbalance may be an oversimplification”.

Also, according to WHO, psychological factors such as ”how and what a person thinks may determine the onset of depression. If people have distorted thinking by which they view everything around them including themselves and their future as negatively and pessimistically, then their mood also becomes sad, completing the picture of depression”. The obvious dilemma with this explanation is the question of what to actual think. Or, if it was as simple as changing how you think about something then everyone would be doing it, and there wouldn’t be any unhappiness, discontent or depression in the world. Not too mention the fact, that before you can change how you think about something, you first need to get to know something – you need to develop a knowledge and an understanding of something.

Subsequently, as you begin to develop a knowledge and understanding of something, how you think and feel begins to change as well. Hence, in my experience with depression, it’s not simply a matter of changing how you think, particularly as the depression lessens or slightly lifts, it’s more about developing an understanding of yourself, and critically an acceptance of yourself, warts and all. Self-acceptance is key, especially as many people who struggle with depression do have a fairly realistic view of themselves and the world around them. But despite life’s foibles, and our own for that matter, we need to strive to accept this and make the best of varying personal situations and life challenges.

The final significant cause of depression, according to WHO, are 3 types of social stressors, and include traumatic life events such as the death of a loved one, a cancer diagnosis, a divorce or losing a job; chronic stress such as work, family and financial pressures and lastly, daily hassles. WHO suggests that “different events or stressors have different meanings for individuals, and in fact it is the perception of the event that is more important than the event itself”.

At the end of the day, it’s a similar philosophy to ”it’s not what happens to you, but how you deal with it”, or “it doesn’t matter how many times you get knocked down, but rather what matters is how many times that you get up”. Obviously, easier said than done at different times in our lives, but something we have to strive to develop – our perception of reality and our ability to bear pain and suffering. In fact, this concept or philosophy is similar to Dr Seligman’s theories of ‘Learned Helplessness’ and ‘Emotional Resilience’.

Also, we need to keep in mind that is okay to experience periods of sadness and melancholy, especially after a traumatic event. Since these thoughts and feelings are a natural human response to recent or past adversity or personal tragedies. Similar to the weather, there will be days when it is grey and overcast outside and we will just want to have a day in bed or on the couch to reflect and recharge our batteries – we don’t have to be up 100% of the time. In fact, if that is our expectation of life, it places undue pressure on ourselves, especially when we are confronted with or are battling through a personal crisis.

Other risk factors associated with the onset of depression include gender, age, marital status, family history, parental deprivation and finally, a lack of social supports. These are but a few of the numerous possible risks related to the onset of depression.

Interestingly, a recent Australian survey of people who had overcome depression, sought to rate how effective different therapies and lifestyle factors were in helping them overcome their depression. The top 10 most beneficial lifestyle factors or therapies in descending order of effectiveness included exercise, support of family and friends, counselling (CBT, IPT, etc.), fulfilling work, relaxation/meditation, nutrition, alcohol and drug avoidance, prescription medication, support groups and religious or spiritual beliefs (depressioNet).

Why do I find this survey interesting? I find it interesting because antidepressants ranked only 8 out of 10 in overall effectiveness towards overcoming depression; whereas other lifestyle factors and therapies which directly and indirectly influence the state or condition of our relationship with our self, appear to make a more significant contribution.

Today, ever increasingly, the cause of depression is being simply defined as a biochemical imbalance. I’m not sure why. Perhaps health authorities do this in an attempt to encourage more people to put there hands up and get help. The aim may be by suggesting that depression is no fault of your own – it’s a result of a biochemical imbalance which is out of your control – that this will de-stigmatise the disorder, resulting in more people accessing professional help.

However, I believe that society would be better served, especially when you consider the increasing prevalence of depression, that the overall message suggested that if you’re struggling with depression, not only do you need to get help. But equally, you also need to consider that depression may be a natural consequence to adverse life events or that there may be other lifestyle factors or life pressures that may be contributing to the condition. You need to hold the mirror up and have a good, long hard look at yourself. A somewhat difficult pill to swallow, especially when you’re struggling with depression.

Why? I believe that this message empowers people. It normalises the depressive experience and provides hope. You may be down, but you not out! Rather than suggesting that there is nothing you can do about depression – it’s a biochemical imbalance - it suggests that we need to consider other aspects of our life that we could adjust or improve upon, which may very well make a significant contribution on the road to recovery from depression. It’s a similar scenario confronting the overweight. Irrespective of whether there is a genetic influence in obesity – eating healthy, reducing alcohol consumption and exercising all make significant contributions to weight loss.

The good news is, regardless of what may cause depression, is that it can be overcome. However, the biggest challenge faced right now by society, is getting individuals to access help. Presently, less than 25% of people with depression obtain professional care. In reality, the biggest challenge may indeed be de-stigmatising the disorder. Hence, by suggesting that depression is largely a natural human response to different personal trauma/s or pressure/s in our lives – albeit a potentially dangerous consequence - people may feel less embarrassed or ashamed, and more encouraged and motivated to seek help and address the problem of depression and the surrounding issues or lifestyle factors.

The reality is, no matter how you want to try and gift wrap a ’shit sandwich’, it will still taste terrible. Likewise, if you’re struggling with depression and anxiety, not only do you feel terrible as a consequence of the condition/s, but you will feel embarrassed, humiliated or weak to be feeling that way – especially when you hold the mirror up and look at the great things you may have in your life or observe the great adversity other people have to battle on a daily basis.

At the end of the day, it doesn’t really matter what others may say, especially if they are encouraging with the best of intentions that you shoudn’t feel embarrassed or humiliated – the reality is, this is exactly how you are feeling, and in my experiences, you simply have to bear those uneasy humiliating feelings and strive to do something about it.

Once you accept that these disconcerting feelings are in fact par for the course, just like that pain that shoots through your finger when you prick it with a needle or through your little toe when you stub it on the coffee table, then you’re in a better position to act upon your situation.

In many respects, if how you have felt about yourself, knowingly or unknowingly, was dependent upon your relationships with others or your achievements within life and living; and then suddenly a big chunk of it gets taken away from you – you lose your job, experience a divorce, or do plenty of doe in the latest stockmarket crash – all of a sudden, there’s not much left of what you thought you were – you’re a shell of your former self.

Similarly, if you’re burning the candle at both ends – working 12 hour days, under financial pressure or stress, experiencing relationship difficulties with your partner or kids – eventually the old ‘foofer valve’ begins to wear down and wear out. You begin to feel flat and tired – you gradually become fatigued and exhausted - you get to a stage where inside you don’t have any mental, physical or emotional petrol left in the tank – and you can slip quite easily into a deep dark black depression. At least this is what I have found at different times.

Additionally, like a dog that’s been beat too much, some of us can get to stage whereby we automatically sink into the toxic sewer of depression. In fact, Dr Seligman first proposed this reaction back in the 1950’s or 60’s when he first proposed the theory of learned helplessness.

Irrespective of what path you were on when you stumbled and fell into the ugly black morose of depression, one of the key characteristics of the condition from my experience, is that once the heavy dark black clouds of depression lift slightly from your conscious mind – you can suddenly breathe again, albeit somewhat laboured – you begin to feel like such a weak, crazy fool for feeling the way you do.

You start to feel embarrassed and humiliated by your condition and situation. How did I end up here? I should be feeling great now that I’m retired, or it’s not that big a deal that I missed out on the promotion or I’m only a little run down or burnt out, why can’t I get it together and get my life back on track. The fact of the matter is, as a consequence of your life experience and in particular, the depressive condition itself, you do feel embarrassed and humiliated, BUT the key thing is, WHAT ARE YOU GOING TO DO ABOUT IT?

The sooner we recognise and accept that feeling embarrassed or humiliated is normal, natural response to what life may have thrown at us and is related to our present battle with depression and anxiety – the sooner we can pick ourselves up to some extent and begin to do something constructive about our situation. It’s similar to be being caught red handed with our hand in the cookie jar. Of course we are going to feel embarrassed and humiliated about the present situation, what is critical is what we decide to do next.

So I believe, instead of publicly stating, admittedly with the best of intentions, that we shouldn’t feel embarrassed and humiliated – we should be publicly advocating that this is how you will feel – it’s a normal, natural response to our present plight. Just as our first kiss or honeymoon night may have turned out to be an embarrassing or humiliating experience, we need to be advocating that the uneasy thoughts and feelings surrounding our depressive experience, although uncomfortable and disconcerting, are in fact part and parcel of the great human experience.

I believe tackling the problem of depression and anxiety would be better served by this approach. Similar to be being aware of and accepting of the nervousness and mistakes of a young player making their top grade debut in footy, tennis or golf - I believe that if it was publicly emphasised that people will feel embarrassed and humiliated by their depressive condition and life circumstances - that this is a normal, natural expected response - then I feel people in general would feel much more comfortable with putting up their hands and getting help. What do you think?