The physical energy to move objects around, and get in close to the dusty surfaces with a cleaning cloth. Even if a doctor recommends starting on an antidepressant medication, the final decision about whether or not this is a good idea belongs to the person who is going to take them. Still, while medication can help many people with depression control their symptoms, it isn't necessarily the best solution for everyone. Before starting any medication, it is essential to do some basic research about that medication, including becoming fully aware of the potential side effects and other risks involved. Here are just a few caveats that need to be considered: First of all, it takes time for most medications to build up in the system before the benefits become noticeable. For many people, this can mean weeks before their symptoms start to subside. Medications don't work the same way for everybody who takes them. Though some people start recovering right away, many people with depression may require trying several different medications before finding one that works. For people with more than one diagnosis--depression and social anxiety, for example--a combination of different medications may be needed to get all the different symptoms under control. This can increase the risk of drug interaction effects as well as side effects. All medication needs to be carefully monitored by the prescribing doctor, including regular blood tests and frequent checkups to ensure that the medication is working as prescribed. Make small talk. Have a friendly chat. Give a compliment. Americans have mastered this art; Danes are notoriously bad at friendly chats with strangers. I try to be better at it, but sometimes I try and I fail. Two years ago, I walked into a lift at a university in Copenhagen. In it was a man who looked very much like me and dressed exactly like me: glasses, brown leather briefcase, blue trousers, white shirt, brown blazer. Also like me, his longish hair was going grey - Sometimes you swing for kindness but awkwardness hits you in the face. But sometimes you try and you succeed and, for those five seconds, the world is a better place.

It may also be the first five seconds of a longer journey towards a kinder world. Remember, big things often have small beginnings. Mark Twain once wrote that kindness is a language which the deaf can hear and the blind can see. Robert Levine has taken that literally. One day when he was six years old he saw a man lying in the middle of a crowded pavement in a busy part of New York City. The people passing by were not only ignoring the man but were avoiding getting too close to him. Many years later, travelling in Myanmar, Robert found himself in a crowded market in Rangoon. The sun was hot, the air was dusty and it was difficult to breathe. Suddenly, a young man carrying a huge bag fell down in the middle of the crowd. People quickly gathered around him. Sellers left their stands, brought him water and placed a blanket under his head while they fetched a doctor. What are your excuses for not getting up? Get rid of them. ALL OF THEM. Nothing is stopping you from you getting up. You're stopping yourself. I'm not a morning person and I'm grumpy in the morning are excuses used to dodge blame and responsibility. They're used to avoid having to suck it up and get it together. If you can't master something as easy as getting out of bed when you're supposed to, how will you master anything else? Seriously.

How are you going to consistently do anything harder than getting out of bed early if you can't even get out of bed early? You won't. You can't master the big things if you can't master the smaller things first. Getting up early, when you think about it, really isn't that hard and if, at the moment, it actually is hard, you can still program your Autonomic Nervous System to make it happen automatically. When the alarm goes off, it only involves throwing the covers off, sitting up, turning, standing up, walking to the bathroom, and doing whatever it is you do when you start your day. Yes, it's hard when you're not used to it. But the more you do it, the more it becomes an automatic behavior. Eventually, you don't even have to think about it or put any energy into it. It just happens. He needs to devote a good bit of time for deciding what goes where, and to neatly place it all into file folders. Ted will need the emotional energy with which to "let go" of items that, though unnecessary, could be of significant sentimental value. Finding new ways to use the space that had been taken up by the things he just threw out. The physical energy to move furniture and household items back where they belong. So, how "simple" did that sound to you? This is an example where someone prevents himself from taking action because what he's told himself during the previous week while at work has little to do with the real work of getting it done. The self-statement, "For once and for all, this weekend I'm going to whip my apartment into shape!" is what my father would have called "a pipe dream." While this self-statement cloaks itself in the guise of good intentions, it can actually prevent the procrastinator from taking action because it's more of a fantasy statement than anything else. As we all know, it's fine to dream of fantasies--they're a pleasant distraction, but we cannot live an adult life in a full-time fantasy world. Most importantly, it is essential that people taking antidepressant medication be alert to the possibility of suicidal thinking. Research looking at the effects of SSRIs on depression suggests that people who are already experiencing suicidal thoughts may find this kind of thinking becomes worse while on the medication. This is especially true for children and adolescents on SSRIs who seem particularly vulnerable to increased suicidal thinking and suicide attempts (but not necessarily successful attempts).

This is why doctors need to be careful in screening their patients for suicidal thinking or previous attempts before prescribing antidepressant medication. If you or someone you know starts experiencing suicidal thoughts more frequently after starting on a new medication, seek help immediately. Ironically, the greatest danger for suicide in people who are dealing with depression isn't when the symptoms are at their worst, but when they are starting to feel better. Though this sounds like a contradiction, it really isn't. People dealing with severe depression are usually too despondent and immobilized to make any suicide plans. But when those symptoms ease, whether due to medication or some other treatment, many people may consider suicide out of fear that their condition will eventually get worse. This is another reason why doctors need to screen patients for suicidal thoughts before and after prescribing a new medication. Today, Robert is a professor of psychology at California State University and is researching what makes people care for each other and why cities are so different when it comes to their approach to kindness. Robert has conducted three different experiments, all on busy streets, to test the kindness of strangers. The experiments involve creating a situation in which a stranger needs help. In the pen scenario, a pen is dropped on the pavement, apparently without its owner noticing. In the hurt scenario, an experimenter wearing a leg brace and walking with a limp drops a magazine and is obviously struggling to pick it up. In the blind scenario, the experimenter feigns blindness and approaches the kerb of a busy junction and waits for someone to help him cross the street. What the researchers discovered was that the main predictor of how much people help others in cities is how crowded the city is. If there are more people, individuals feel more disconnected and less responsible for others and are therefore less willing to help. When they looked at twenty-four cities in the US, the researchers found that the lowest level of help was in New York City and the highest was in Knoxville, Tennessee. It also helps if you have a powerful reason for getting up early each and every day instead of being lazy and staying in bed. Eric Thomas says, My WHY wakes me up every single morning! What is your reason for waking up early? If you don't have one, get one because it will motivate you more than anything else.

Personally, I get up early because it's tough and I'm not looking for life to cut me slack. I get up early because it's uncomfortable and I aim to get comfortable being uncomfortable. I get up early because I'm tired of sleeping when I could be improving my life. I get up early because the more I get done, the more income I generate, and the more comfortable I am. I get up early because my competition is still sleeping and when they get started, I've already been at it for hours. Squeeze every minute out of your day and make things happen. Sleeping past the time you're supposed to be up is unacceptable. Although there are some individuals who can order themselves to whip their apartments into shape in almost warrior-like frenzy, not everyone is like this. Habitual procrastinators like us can inadvertently order ourselves to become still and frozen in our tracks, because we communicate with ourselves in the wrong way. Our mission is not to become "warriors" or to "stop acting like lazy jerks," as some procrastinators have said to themselves. Instead, our goal is simply to gain a more balanced life. You've probably seen the manager of a major league sports team face reporters after losing a crucial game, and then praise his team for their effort by saying something like, "Well, we did our best." We can learn a great deal about positive self-talk from observing how others handle difficult situations. If, instead of putting ourselves down, we objectively examine our behaviors with the aim of finding the cause-and-effect relationships for our inaction, we'd then realize the opportunity to see our negative behaviors in a new light. With this approach, we can begin separating our past from our future by communicating with ourselves in better ways, learning to be patient with ourselves, giving ourselves better instructions, and acting in new ways. There is also some controversy whether certain kinds of antidepressant medication may actually cause suicidal thinking, especially in people who are taking these medications for reasons other than treating depression (such as social anxiety). While this controversy is far from settled, people considering going on medication need to stay alert to new mental health issues that may arise. Though newer medications have fewer potential problems, it is still essential that people who have been prescribed an unfamiliar medication do their research and make certain they are aware of all the potential risks. Though the doctor prescribing the medication will be monitoring your condition as well, the symptoms you are experiencing are an important clue to determine how well this medication is working. Again, though, medication isn't necessarily the answer for everyone dealing with depression. We will explore a few alternatives in the next section.