Better options are available than prescription drugs in almost all cases. Almost all psychiatric medicines are essentially placebos -- often with harmful side effects including psychosis and where treating side-effects lead to a treadmill of medications. See: "Deadly Psychiatry and Organised Denial"
by Peter C. Gøtzsche https://www.goodreads.com/book/show/26214735-deadly-psychiat...
"Deadly Psychiatry and Organised Denial explains in evidence-based detail why the way we currently use psychiatric drugs does far more harm than good. Professor, Doctor of Medical Science, Peter C. Gøtzsche documents that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the United States and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. Gøtzsche explains that we could reduce our current usage of psychotropic drugs by 98% and at the same time improve patients' mental and physical health and survival. It can be difficult, however, to come off the drugs, as many people become dependent on them. As the withdrawal symptoms can be severe, long-lasting and even dangerous, slow tapering is usually necessary. In his book, Gøtzsche debunks the many myths that leading psychiatrists - very often on drug industry payroll - have created and nurtured over decades in order to conceal the fact that biological psychiatry has generally been a failure. Biological psychiatry sees drugs as the "solution" for virtually all problems, in marked contrast to the patients' views. Most patients don't respond to the drugs they receive but, unfortunately, the psychiatrists' frustrations over the lack of progress often lead to more diagnoses, more drugs and higher doses, harming the patients further."
If you can only look at one resource, read or watch something by Stephen Ilardi, PhD, author of "The Depression Cure: The 6-Step Program to Beat Depression without Drugs", whose advice is built around this quote of his: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life."
Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally adapted for and what they continue to need with these six components:
* Brain Food [supplement with Omega 3s; remember your brain is mostly fat]
* Don't Think, Do [avoid excessive rumination by doing things]
* Antidepressant Exercise [aerobic exercise is medicine]
* Let There Be Light [get natural sunlight and supplement as needed with vitamin D3]
* Get Connected [engage in face-to-face social activities regularly]
* Habits of Healthy Sleep [get enough sleep by following basic guidelines]
There are many other books as like the excellent "Why We Sleep" by Matthew Walker or many on nutrition (e.g. Fuhrman, Weil, Mackey, etc.) that examine aspects of this issue -- but what makes Ilardi's book so useful is bringing so many of these ideas together in a historical context. Ilardi says his advice is general and some people with specific traumas underlying their depression may need additional specific help (such as in "The Body Keeps The Score" book on recovery from trauma mentioned below).
Other books that address specific aspects of depression and related issues of addiction, trauma, and perfectionism (and how they are at root deep cultural issues related to recent Western lifestyle changes) include:
* "Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions" by Johann Hari. From the last chapter of the book: "You aren’t a machine with broken parts. You are an animal whose needs are not being met. You need to have a community. You need to have meaningful values, not the junk values you’ve been pumped full of all your life, telling you happiness comes through money and buying objects. You need to have meaningful work. You need the natural world. You need to feel you are respected. You need a secure future. You need connections to all these things. You need to release any shame you might feel for having been mistreated."
* "Chasing the Scream: the First and Last Days of the War on Drugs" by Johann Hari
* "The Globalization of Addiction: A Study in Poverty of the Spirit" by Bruce Alexander
* "In the Realm of Hungry Ghosts: Close Encounters with Addiction" by Gabor Maté, MD
* "The Story You Need to Tell: Writing to Heal from Trauma, Illness, or Loss" by Sandra Marinella
* "Writing Hard Stories: Celebrated Memoirists Who Shaped Art from Trauma" by Melanie Brooks
* "The Gifts of Imperfection: Let Go of Who You Think You're Supposed to Be and Embrace Who You Are" by Brené Brown
* "Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead" by Brené Brown
For people dealing with the special case of a specific trauma for themselves or a loved one, consider reading "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk. As the blurb for that says, "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring -- specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy -- and a way to reclaim lives."
For those facing specific issues related to suicide for themselves or a loved one, a key book is: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations and societies can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone -- not just those who have reached a threshold where pain is very close to coping resources. Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.
As David Conroy says: "Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."
(I write this in memory of my friend from Princeton, Robin Rochlin Cooperman, M.D. Psychiatry, 1963-2010. I can wish that she was still alive to talk with about all this newly emerging information about increasing wellness in a wide variety of ways beyond prescription pharmaceuticals. And also I write this in memory of other friends I have lost along the way...)
Thanks for this post. I used to be a textbook example of "sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden" and somehow bumbled into improvement on all those fronts the hard way, one by one. Better eating, a more action-oriented outlook, exercise, and socializing with people changed my life massively and I am now very stable, and even optimistic despite the state of the world.
Sleep has taken a back seat since having kids, but not for lack of trying, and I have every confidence that a few years from now it will be in fine form again.
My difficulty now is to try to get my wife to go on a similar journey of improvement. She eats well, but ruminates, doesn't exercise, works in a windowless office or leaves the curtains closed when working from home, avoids people, and sleeps terribly. She'll even lament these things, knowing they're a problem, but my encouragement (or nagging, let's be realistic) to try to improve these things falls on deaf ears. There's always some excuse, always some reason why it can't be now, why it can't be scheduled for soon, why it's not going to happen. Books I've bought her on the topic sit unread, gift cards for yoga classes go unused.
If you know of any resources for someone to try to help someone else improve without falling into the pitfalls I keep falling into, time and again, I'd appreciate it.
You're welcome. That's a tough situation (but a common one). The main things I can thing of right now are:
* continue to be a good example
* try to reduce stress in her life (without increasing yours significantly)
* be a good listener
* consider a physical hobby together like swing dancing -- or maybe walking or swimming or yoga or kayaking in the sunshine (ideally things your kids can be safely involved in too)
* consider humor (healthy humor; maybe read up on that like stuff by Joel Goodman such as "Laffirmations" or things by others)
* consider a temporary change of scenery (like an active vacation in the sun?)
Kudos on your own success though. That has to be helping your wife even if indirectly in being able to be a better parent and better spouse.
One idea is like on airlines: "Put on your own oxygen mask first before assisting others". You've already done that, but keep it in mind. As Zig Ziglar said, "People often say that motivation doesn't last. Well, neither does bathing - that's why we recommend it daily." Also, a lot of this for everyone is a spiral -- or ups and downs with backsliding. It takes practice (and mistakes) to get better at things. You might find of general interest two somewhat funny movies by Joe Cross called "Fat Sick and Nearly Dead I and II". They talk about progress and backsliding and progress again in nutrition and exercise. They might be useful in knowing you are not alone in that sense.
You can try to structure your shared environment (also to your own benefit) to make doing the healthier thing easy to do. Like maybe figuring out a better way to open and close curtains -- maybe even something automated? Maybe consider a treadmill workstation (although it requires reasonably good eyesight so works better at younger ages with more flexible accommodating eye lenses). The pandemic makes socializing harder of course, but maybe think about how you can help your wife more easily stay connected to any friends or family she already has (even one phone call a week).
Also, a gift card for yoga in a way just adds to your wife's workload (including travel to and from lessons). So how about getting a yoga mat and doing yoga together at home? Again, setting a good example yourself could help. As is the idea of making doing the healthier things easier.
Since the issue (including nagging) may affect your relationship eventually, consider pre-emptively reading a John Gottman book like "What Makes Love Last". Maybe also check out this HN discussion and story on "Beware of Being "Right"" to avoid crossing over from being supportive to being controlling: https://news.ycombinator.com/item?id=23802241
Also, rather than nag given it is not working (but still may make you feel good that you are trying and so be reinforcing to you), consider saying nothing about what you think should happen but instead providing some sort of positive reinforcement for your wife when she actually does a healthy thing -- even a small step. Look at writings or videos by dolphin trainers or positive-reinforcement-only dog trainers, like perhaps Karen Pryor. People are always doing a variety of things, so look for the positive tiniest incremental improvements and help them grow. That will also help you yourself focus more on looking for the positive things your wife is doing than the negative.
Or, at a higher cognitive level, since you are interested in influencing decisions, you could also look into books on selling, like Dan Pink's "To Sell is Human". From the blurb: "To Sell Is Human offers a fresh look at the art and science of selling. As he did in Drive and A Whole New Mind, Daniel H. Pink draws on a rich trove of social science for his counterintuitive insights. He reveals the new ABCs of moving others (it’s no longer “Always Be Closing”), explains why extraverts don’t make the best salespeople, and shows how giving people an “off-ramp” for their actions can matter more than actually changing their minds. Along the way, Pink describes the six successors to the elevator pitch, the three rules for understanding another’s perspective, the five frames that can make your message clearer and more persuasive, and much more. The result is a perceptive and practical book–one that will change how you see the world and transform what you do at work, at school, and at home."
Yoga nidra or positive visioning might also help if your wife does want to change something?
If you can address one aspect, which should it be? I'd suggest sleep. That can be a huge challenge with young kids. Try reading "Why We Sleep" by Matthew Walker. Or maybe listen to it as an audio book? What I got from that book was a sense that our brains are adapted to run overclocked (as it were) during daylight hours, building up waste products and also accumulating unstored memories. When we sleep well, channels in the brain literally widen and fluid flows to wash away the toxic buildup (which otherwise can contribute to Alzheimer's), our brain moves memories of the day into long-term storage, or brain via dreams also processes traumatic events of the day to remove the distressing emotional overtones and learn from them. But that only happens with good sleep. So, ask yourself, how can you help your wife get better sleep? You can also ask yourself if maybe she is a night owl trying to keep a schedule better for a morning lark or vice versa?
Anyway, some ideas to get you started. Now that you are thinking more about this, all sorts of ideas might come into your attention. Still, in the end, no one is perfect (if such a thing is even definable given conflicting -priorities). So take time to enjoy your imperfect relationship with your imperfect wife and imperfect kids -- and try to be thankful every day for how lucky you are given you are imperfect too (as is everyone in some way). That might help reduce some of the stress of the situation for everyone -- which might have its own beneficial effects.
For people facing psychological issues, see the resources I've collected in the "Health and Wellness" section of this reading list I have put together: https://github.com/pdfernhout/High-Performance-Organizations...
If you can only look at one resource, read or watch something by Stephen Ilardi, PhD, author of "The Depression Cure: The 6-Step Program to Beat Depression without Drugs", whose advice is built around this quote of his: "We were never designed for the sedentary, indoor, sleep-deprived, socially-isolated, fast-food-laden, frenetic pace of modern life."
Dr. Ilardi prescribes an easy-to-follow, clinically proven program that harks back to what our bodies were originally adapted for and what they continue to need with these six components:
There are many other books as like the excellent "Why We Sleep" by Matthew Walker or many on nutrition (e.g. Fuhrman, Weil, Mackey, etc.) that examine aspects of this issue -- but what makes Ilardi's book so useful is bringing so many of these ideas together in a historical context. Ilardi says his advice is general and some people with specific traumas underlying their depression may need additional specific help (such as in "The Body Keeps The Score" book on recovery from trauma mentioned below).Other books that address specific aspects of depression and related issues of addiction, trauma, and perfectionism (and how they are at root deep cultural issues related to recent Western lifestyle changes) include:
For people dealing with the special case of a specific trauma for themselves or a loved one, consider reading "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma" by Bessel A. van der Kolk. As the blurb for that says, "Trauma is a fact of life. Veterans and their families deal with the painful aftermath of combat; one in five Americans has been molested; one in four grew up with alcoholics; one in three couples have engaged in physical violence. Such experiences inevitably leave traces on minds, emotions, and even on biology. Sadly, trauma sufferers frequently pass on their stress to their partners and children. Renowned trauma expert Bessel van der Kolk has spent over three decades working with survivors. In The Body Keeps the Score, he transforms our understanding of traumatic stress, revealing how it literally rearranges the brain’s wiring -- specifically areas dedicated to pleasure, engagement, control, and trust. He shows how these areas can be reactivated through innovative treatments including neurofeedback, mindfulness techniques, play, yoga, and other therapies. Based on Dr. van der Kolk’s own research and that of other leading specialists, The Body Keeps the Score offers proven alternatives to drugs and talk therapy -- and a way to reclaim lives."For those facing specific issues related to suicide for themselves or a loved one, a key book is: "Out of the Nightmare: Recovery from Depression and Suicidal Pain" by David Conroy. By reconceptualizing suicide as an involuntary action that occurs when total pain exceeds resources for coping with pain, David Conroy provides a morally neutral way for organizations and society to think about suicide prevention in a productive way. Rather than focus mainly on intervening in a crisis, organizations and societies can rethink their operations to reduce participant pain and to increase coping resources. This helps everyone -- not just those who have reached a threshold where pain is very close to coping resources. Aggregate pain includes physical pain, emotional pain, and social pain. Reducing pain in any area by even a small amount may bring a person below a threshold for suicide. Similarly there are many types of coping resources from interacting with a friend, to going to a funny movie, to receiving adequate health care, to interacting with a pet. There are also some short-term coping strategies like denial or drinking which may have long-term negative consequences that become new sources of pain when done to excess.
As David Conroy says: "Suicide is not chosen; it happens when pain exceeds resources for coping with pain. That's all it's about. You are not a bad person, or crazy, or weak, or flawed, because you feel suicidal. It doesn't even mean that you really want to die - it only means that you have more pain than you can cope with right now. If I start piling weights on your shoulders, you will eventually collapse if I add enough weights... no matter how much you want to remain standing. Willpower has nothing to do with it. Of course you would cheer yourself up, if you could. Don't accept it if someone tells you, "That's not enough to be suicidal about." There are many kinds of pain that may lead to suicide. Whether or not the pain is bearable may differ from person to person. What might be bearable to someone else, may not be bearable to you. The point at which the pain becomes unbearable depends on what kinds of coping resources you have. Individuals vary greatly in their capacity to withstand pain. When pain exceeds pain-coping resources, suicidal feelings are the result. Suicide is neither wrong nor right; it is not a defect of character; it is morally neutral. It is simply an imbalance of pain versus coping resources. You can survive suicidal feelings if you do either of two things: (1) find a way to reduce your pain, or (2) find a way to increase your coping resources. Both are possible."
(I write this in memory of my friend from Princeton, Robin Rochlin Cooperman, M.D. Psychiatry, 1963-2010. I can wish that she was still alive to talk with about all this newly emerging information about increasing wellness in a wide variety of ways beyond prescription pharmaceuticals. And also I write this in memory of other friends I have lost along the way...)