I began my psychological schooling in a behavioral and social learning theory undergraduate program. I completed cognitive and psychodynamic studies in my doctoral program, and, finally, psychoanalytic training in post-doctoral training. I strongly believe that each of these psychotherapies offers tremendous benefits for dealing with depression. My practice style comes from the field of psychotherapy integration. I'm a trained psychoanalyst and operate from that theoretical framework but borrow from the fields of behavior and cognitive therapy when I work with children and adults. Personally speaking, I use many techniques from the varying schools. Of course, some days are better than others. When a bad day knocks me down, I'm not down for the count. I tap into my insight, change my negative thinking to more positive thoughts, and behave in ways that reinforce feeling good. I do this hoping to get back on my feet--and if I don't readily bounce back, I keep at it. Pharmacotherapy , the oldest of the traditional therapies for mental illness, has been practiced for thousands of years. Pharmacotherapy treats emotional illness through the use of medication. Long ago, plants and flowers were sourced for their medicinal purposes. Nowadays, scientists in the medical field of psychopharmacology create bioactive compounds. Sometimes referred to as drug therapy, pharmacotherapy changes the neurochemistry in your brain and body to prevent and treat illness. In this treatment, you meet for a consultation with a trained medical professional who specializes in the management of psychiatric and psychological disorders. Professionals that perform pharmacotherapy include psychiatrists, certified nurse practitioners, and psychiatric nurse practitioners. Though any medical doctor or certified nurse practitioner can prescribe medication, I champion the belief that you should seek highly specialized professionals who work in the field of mental illness. Pharmacotherapy is one of the most rapidly developing fields in modern science. Adding medication to your treatment regime requires confidence in the professional with whom you are working.

So, having someone who knows the latest research, trends, and side effects is critical. The pharmacotherapy process involves a thorough medical history, one that will take up your entire first consultation. While you're there, the specialist will match your symptoms with relevant medications and begin you on a small dose. At first, you will have scheduled appointments within weeks of starting your medication. As time progresses, dosage may remain the same or increase based on your reported symptoms. If side effects are intolerable, a change in medication may be necessary. However, once you are stabilized on your medication, you won't need to be seen as often. A person may use very harsh words for others, yet sometimes still act with compassion and kindness. In spite of her words, her deeds may be good. The Buddha compared this kind of person to a pond covered by moss. In order to use that water, you must brush the moss aside. Similarly, we sometimes need to ignore a person's superficial weaknesses to find her good heart. But what if a person's words are cruel and her actions too are unkind? Is she rotten through and through? Even a person like this may have a pure heart. Imagine you have been walking through a desert. You have no water with you, and there is no water anywhere around. You are hot and tired. With every step, you become thirstier and thirstier. You are desperate for water.

Then you come across a cow's footprint. There is water in the footprint, but not much because the footprint is not very deep. If you try to scoop up the water with your hand, it will become very muddy. You are so thirsty, you kneel down and bend over. Very slowly, you bring your mouth to the water and sip it, very carefully so as not to disturb the mud. Even though there is dirt all around, the little bit of water is still clear. You can quench your thirst. With similar effort, we can find a good heart even in a person who seems totally without redemption. The meditation center where I most often teach is in the hills of the West Virginia countryside. When we first opened our center, there was a man down the road who was very unfriendly. I take a long walk every day, and, whenever I saw this man, I would wave to him. He would just frown at me and look away. Even so, I would always wave and think kindly of him, sending him metta. I was not phased by his attitude; I never gave up on him. Whenever I saw him, I waved. After about a year, his behavior changed. He stopped frowning. I felt wonderful. The practice of loving friendliness was beginning to bear fruit. After another year, when I passed him on my walk, something miraculous happened.

He drove past me and lifted one finger off the steering wheel. Again, I thought, "Oh, this is wonderful! Loving friendliness is working." And yet another year passed as, day after day, I would wave to him and wish him well. The third year, he lifted two fingers in my direction. Then the next year, he lifted all four fingers off the wheel. More time passed. I was walking down the road as he turned into his driveway. He took his hand completely off the steering wheel, stuck it out the window, and waved back to me. One day, not long after that, I saw this man parked on the side of one of the forest roads. He was sitting in the driver's seat smoking a cigarette. I went over to him and we started talking. First we chatted just about the weather and then, little by little, his story unfolded: It turns out that, several years ago, he had been in a terrible accident--a tree had fallen on his truck. Almost every bone in his body had been broken, and he was left in a coma for some time. When I first started seeing him on the road, he was only beginning to recover. It was not because he was a mean person that he did not wave back to me; he did not wave back because he could not move all his fingers! Had I given up on him, I would never have known how good this man is. One day, when I had been away on a trip, he actually came by our center looking for me. He was worried because he hadn't seen me walking in a while. Now we are friends. We see a particularly large number of female clients who have suffered from recurring yeast infections, often after taking antibiotics; the vast majority have never had a health care professional link this routine to their depression.

If you've ever had a yeast infection, that's just one very common sign that your body has suffered from an imbalance in the gut microbiome. And it's possible--in fact, likely--that you've never fully recovered. If we accept that taking antibiotics can lead to a gut imbalance, then we have to account for this and be much more proactive whenever we take these medications. It's fairly common for doctors to alert patients to potential digestive side effects like diarrhea, but they don't often take the conversation further. The latest research linking gut imbalances to mood disorders will, I hope, change that soon. Until it does, you can become more vigilant about your use of antibiotics, taking them only when absolutely necessary, and supporting their use with prebiotics and probiotics. Prebiotics are substances that support the growth of certain microbiota, while probiotics are made up of the microorganisms themselves. Just one probiotic supplement contains billions of good bacteria. Introducing probiotics to resolve issues means you're attempting to restore proper levels of intestinal microflora for proper digestion and absorption of nutrients. In turn, prebiotics and probiotics help rein in harmful strains of bacteria that would otherwise overpopulate if growth were left unchecked, even preventing and inhibiting infections. Unlike probiotics, prebiotics are not microorganisms--they are nondigestible and typically nonabsorbable nutrients that help good bacteria grow and flourish. Most prebiotics are fibers or carbohydrates that can be taken as supplements or found occurring naturally in foods. When it comes to balancing the gut, you can't do it quickly. Remember, we're talking about living organisms. It may be helpful to think of the gut as a garden of sorts--we want to cultivate more of the bacteria we need and weed out the kind we don't want. Just like with a garden, first you have to create an ideal environment that supports healthy growth of whatever it is you're planting. In this case, we're talking about prebiotics as the "good soil" with lots of rich fertilizer, and probiotics as the "good seed." It's important to understand how probiotics are absorbed in the body. First, not all types can survive the journey through your stomach and large intestine. And second, others tend to "leak" out into the bloodstream. For probiotic treatment to be useful, the microbiota must get where they're intended to go.