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When his wife took his car keys so he couldn't drive to his drug dealer twelve miles away, he got on his ten-speed bicycle and pedaled, on the highway, to get his fix. When he went to play basketball abroad--no longer US material--first in Italy, then China, Turkey, even Iran, he upped his game to heroin when pills were not readily available. Stuck in despair, I tried to recall anything that might help my situation. I remembered when, years earlier, I was in a similar depression and a friend had recommended that I keep a feelings journal as a way of tracking my moods from day to day. I began that journal because, in spite of the help that I received at the counseling centers, I continued to feel emotionally shattered and unable to pull myself together. Ironically, there were some occasions when I felt slightly worse after a counseling session than I'd felt before the session had begun. Of course, this was never the intended effect of a session, and in spite of this infrequent and unintentional backlash, I was grateful for the concern those volunteers showed me, as I still am today. It seemed that since conventional talk therapy focuses on how the client, or myself, in this case, generally feels while in the session, that after spending thirty minutes focused on exactly why I felt so poorly, I sometimes left a counseling center feeling somewhat more unsettled than before I had entered it. It felt as though I had fallen into a deep, dark hole--and it eventually occurred to me that perhaps I alone, might be the only one who could help me find my way out of it. So I began writing that feelings journal as a kind of self-constructed ladder, to help me climb a path of self-discovery and betterment. If there is any mental health issue that can be said to be universal, it's depression. Among the famous people who dealt with this crippling disease were such luminaries as Edgar Allen Poe, Winston Churchill, Abraham Lincoln, and Virginia Woolf, to name just a few. But depression has been found in people of all ages and cultures and in just about every era in human history. For that matter, it may predate human history considering that depressive symptoms have been observed in numerous nonhuman species as well. We all get depressed, at least once in a while, though for most people, those "blue moods" pass quickly enough. But not everyone is so lucky. In the United States alone, mood disorders are the most common reason for children from one to seventeen years of age to be hospitalized, and more than fifty thousand Medicaid patients are readmitted to hospital for depression each year. And these grim statistics are in line with what is being reported in most other industrialized countries as well. Unfortunately, getting accurate statistics is often impossible in many countries because the stigma attached to most forms of mental illness, including depression, often encourages people to suffer in silence. In most developing nations, psychiatrists are in extremely short supply, and psychiatric help is simply not available for many patients courageous enough to ask for it.

Even in supposedly advanced nations like the United States, the long waiting lists for proper treatment can lead to depressed people having to wait months to get help, even if it's just in the form of medication. Like Tolkien, Hemingway once wrote that the world is a fine place and worth fighting for. These days, it is easier to notice the fighting rather than what is fine. It is easy to point towards the grey skies and dark clouds, but perhaps we all need to be more like Samwise the Stout-hearted (but preferably a bit less furry in the feet department) and see what is good in this world of ours. A friend of mine, Rita, grew up in Latvia during the Soviet era. It may not have been Mordor, but it was a time of fear and mistrust, a time when every window was covered with a curtain and when communities were shaped by suspicion and scarcity. Occasionally, a truck carrying bananas would arrive from Vietnam. Not knowing when bananas would be available again, my friend and her family would buy as many as they could afford and could carry. Then the waiting would begin, as the bananas would still be green and not ready to eat. They would place the fruit in a dark cabinet to make it ripen faster. Watching bananas turn from green to yellow was like magic in a city that was fifty shades of grey. As a child, Rita had thought only three colours existed: black, grey and brown. Her dad decided to change that and he took her on a treasure hunt around the city: to look for colour, for beauty and for the good in the world. We have every option available to be very clean and hygienically-friendly and responsible, but some of us aren't capitalizing on those opportunities. We're not giving strict attention to the details of our hygiene and health. When someone misses the details, you notice. If they haven't brushed their teeth, you avoid talking to them, if possible. If they haven't flossed in a while, you still smell the rotting food that's been in their mouth for days and weeks. If they're wearing clothes that came out of the dirty laundry, you know it. If YOU notice it and choose not to be direct about it, other people notice when you do it and are choosing not to say anything as well.

Hygienic red flags are embarrassing, hard to forget, and burn horrible opinions about you into people's minds. They talk about it and remember when you don't have your hygiene squared away. I love Matthew McConaughey. He's one of the nicest and likable guys you'll ever meet, a skilled actor, and I'm not personally bashing him, but people, magazines, and websites talk about his questionable hygiene A LOT. So much that it leads you to believe he probably has some problem areas. I can't stress enough how important it is to have good hygiene because it affects your health as well. Not just everyday hygiene like brushing, flossing, and wearing deodorant, but going for regularly check-ups with doctors and specialists. Dentist checkups and cleanings get what a toothbrush, floss, and Listerine miss. They do preventative maintenance, take x-rays, and help you avoid big problems. The difference between going to the dentist and not going can mean keeping your teeth or them rotting and falling out. He had been to rehab a few times, in college and the pros. I have learned no one ever knows when the lifelong process of recovery will "take"--when the repetitive relapses will transform into days, weeks, months, and years of sobriety. For people with addiction, families, and my fellow clinicians, the message is never give up. We may not be able to predict when it will happen, but it does, more often than we imagine. Just as it happened with Chris Herren. He was blessed with a loving and enduringly supportive family. He had not only the gift of being a great ballplayer, but he had (has) the gift of being amiable--the kind of person you want to succeed, almost no matter how much he has hurt you and others. He received good treatment and used it. It was Daytop, a drug-treatment program in the New York area, founded in the 1960s, and the unbending demands of its counselors, that helped Herren find his heart and soul once again. The man has emerged from the drug.

Chris Herren is the father of three children and still married to his childhood sweetheart. He is now years into his sobriety and coaching youth basketball. His smile warms your heart. You want him to win. He tells his story with humility and with the hope that someone, some youth or aging person with an addiction, or person at risk for a life too full of ruin, will find hope, treatment, and the road to recovery. One day at a time. One of these reminders in particular clearly stood apart from the others: it was an unpaid bill from a warehouse back in the U.S. that was storing my belongings. Paradoxically, seeing this reminder unleashed on me a torrent of self-anger for not having dealt with the task, while at the very same time, I still didn't want to deal with it! I was frozen in place and felt paralyzed, like a rabbit caught in headlights. If that weren't enough, I couldn't find a better reason for not paying the bill other than, "I didn't feel like it." After all, it wasn't like I didn't have the money to pay the bill--I was working. It had more to do with the fact that I hadn't balanced my U.S. checkbook in several months, and I didn't know what my bank balance was. So, my burden from procrastination was greater than I'd originally thought, because there was just no way that I was going to deal with balancing that checkbook. You might think I had a relatively simple choice to make here by either dealing with it then and there, or deciding to continue suffering in misery. However, I found neither of these two options viable, because I simply didn't want to deal with it at all. So, I did the only thing that I knew would work for me: I distracted myself by turning on the television in my hotel room and channel-surfed until bedtime. Meanwhile, the storage bill waited for the next time I happened to stumble upon that reminder. Much of the stigma surrounding depression stems from a basic misunderstanding of what depression actually is. Even for people with mild depression, the failure to "just get over it" often leads to feelings of guilt or shame due to not being able to handle the symptoms on their own.

And for the ones dealing with more severe symptoms, getting help means months, or even years, of experimentation to find the right treatment. For that matter, horrifying stories of depression being treated through exorcisms or spurious local remedies, which often do more harm than good, are disturbingly common, even in countries where better options exist. Along with psychotherapy, use of various herbal remedies to treat depression has a very long history, but now that we are in the "Age of Prozac," is it any surprise that antidepressants are the most commonly prescribed medication of all? With an estimated sixteen million people on antidepressants in the United States alone, the sheer demand for better and stronger antidepressants has provided a permanent and growing source of revenue for pharmaceutical companies. And the demand for newer and better drugs has soared over the past few decades. Still, despite the various treatment options now available, depression continues to be a major health issue worldwide. Whether it leads to suicide, substance abuse, destroyed marriages, or lost jobs, the physical and economic toll of depression cannot be underestimated. Unfortunately, while depression is something that everyone has experience with, there are far too many misconceptions on what it is and how it should be treated. For example, many people confuse depression with the feelings of sadness that we all experience from time to time, and they often think that overcoming depression is just a matter of "snapping out of it" through sheer willpower. Nothing could be further from the truth. Yes, of course happiness is subjective, and it should be. To me, that is not an issue. What I care about in my research is how you feel about your life. That is what counts. I believe you are the best judge of whether you are happy or not. How you feel is our new metric - and then I try to understand why you feel that way. If you are happier than your neighbour, who has the bigger house, the fancy car and the perfect spouse, by our measures, you are the one that is doing something right. Working with subjective measures is difficult, but it is not impossible. We do it all the time when it comes to stress, anxiety and depression, which are also subjective phenomena. At the end of the day, it is all about how we as individuals perceive our lives.