The Surprising Silver Lining of Sadness

What if feeling depressed is actually a positive thing that makes you healthier?

By Ginny Graves, Prevention

Dina S.* had already been on antidepressants for a few months when she got the most devastating news of her life: Her beloved husband of 10 years had been killed on impact when the small plane he’d been piloting crashed. The next days and weeks were a tearful, painful blur, but even as she grieved, the 50-year-old was dismayed by her own response to the tragedy–it felt hollow somehow, as if she weren’t able to access the full depth of her anguish. So after 2 months, she made a decision that was squarely against her doctor’s advice: She gradually weaned herself off the antidepressants.

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As the effects wore off, her emotional agony became profound. “I was tortured by the fact that I did not get a chance to say good-bye to my husband,” Dina says. She took a leave from work and let her raw emotions take over, aware that this meant she would have to confront the pain of her husband’s death as well as the anxiety issues that prompted her to start taking the drugs to begin with. “I felt I had a choice–to take antidepressants to just get through the day, or to stop and potentially grow and learn,” she says. “I chose the latter.”

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Dina’s decision to part ways with a pharmaceutical solution puts her in an ever-growing minority. Antidepressants have become the most commonly prescribed drugs in America for adults under age 60. At any given moment, about 10 percent of the adult population is taking them, double the percentage just 10 years ago, and about twice as many of them are women as men. And at the same time, talk therapy as treatment for depression is becoming increasingly uncommon. An American Journal of Psychiatry study published last year found that among people being treated for a mental health issue, 57 percent used medication only, while just 11 percent used psychotherapy alone and about one-third used the two treatments together.

“There are lots of reasons why drugs are so popular,” says Mark Olfson, MD, an author of the study and a professor of clinical psychiatry at Columbia University School of Medicine. One of them is the widespread attitude that the easiest way to deal with whatever ails you is by swallowing a pill. “People hear about antidepressants in TV ads and ask for them by name,” he says. The way insurance companies reimburse for services only supports this easy-fix expectation. “Insurers tend to be much more generous with coverage for antidepressants than for psychotherapy, which means patients who don’t want drugs often have to pay a lot more out of pocket for it,” adds Dr. Olfson. The financial incentives work both ways: Because psychiatrists can make more money doling out meds in 15-minute office visits than seeing patients for 45-minute talk sessions, more and more of them no longer even provide talk therapy as a service. “The decline in psychotherapy is a huge loss, in my opinion,” says Dr. Olfson.

Dina’s instinct to eschew drugs, though uncommon, is supported by a provocative theory newly gaining traction that questions whether depression is really a disorder at all. According to this theory, the pain and sadness we feel when we’re blue has a purpose in our lives as a clarifying, healing force. “Depression may be nature’s way of telling you to stop and focus on what’s troubling you, so you can move past it and get on with your life,” says Paul Andrews, PhD, an evolutionary biologist at Virginia Commonwealth University. He, along with his colleague J. Anderson Thomson, MD, a staff psychiatrist at the Student Health Services and Institute of Law and Psychiatry at the University of Virginia, have become controversial proponents of an idea that actually dates back to Aristotle, that depression may lead to better mental health.

Dr. Thomson’s and Dr. Andrews’s take on it is this: Depression actually facilitates the kind of rumination that can make recovery from traumatic events such as the death of Dina’s husband possible. Although depressed people often say they find it difficult to concentrate and think clearly, Dr. Thomson says that perception isn’t exactly accurate: “The real problem is that they can think about only one thing–the issue that’s troubling them–and that gets in the way of trying to concentrate on work or anything else.” Studies have found that sadness actually promotes analytical reasoning–a type of intense thinking that allows you to break down a complex problem into smaller and more manageable parts, making it easier to figure out.

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Because we’re social creatures, our need to interact with others typically leaves little time or energy for the type of sustained concentration that analytical reasoning requires. Depression, however, makes us withdraw from others, and the solitude can provide more uninterrupted time to think.

“In studies on depressive rumination–which usually find that it’s an unhealthy habit–most people say they see it as useful in some ways,” says Dr. Andrews. “It helps them gain insight into their problems.” The ruminations could be self-incriminating (If I had been a better listener, maybe he wouldn’t have left me) or anxiety provoking (What if I have the same bad luck at my next job?), but the insights they provide can be useful. “You are thinking about ways to improve your situation–about what you can learn from it and do better next time–rather than worrying about the potential negative outcomes,” explains Natalie Ciarocco, PhD, a professor of psychology at Monmouth University who has also studied rumination.

Lara Honos-Webb, PhD, a clinical psychologist in San Francisco, actually encourages her patients to dwell on their problems. “Depression is meant to stop you in your tracks because, like physical pain, it’s a signal that there’s something wrong and you need to fix it,” says Dr. Honos-Webb, who wrote Listening to Depression: How Understanding Your Pain Can Heal Your Life. “The social withdrawal that comes with depression can help you change something in your life that’s broken–and once you’ve gone through it, you can be stronger and more resilient because of the experience.”

“People who survive misfortune tend to be mentally stronger and more well adjusted.”

So while swallowing a pill may forestall psychological suffering, it also may rob you of your brain’s ability to reconfigure pain into wisdom and grit–both of which will serve you well for the rest of your life. When several psychologists recently asked nearly 2,400 people about their history of adverse experiences–everything from whether they’d been through a divorce or natural disaster to if they’d ever lost a loved one–they found that those who had faced some misfortune were actually more well adjusted than those who’d had no bumps in the road at all. “Having to deal with challenges may toughen us up,” says Mark Seery, PhD, lead author and assistant professor of psychology at the University of Buffalo, “and leave us better equipped to deal with subsequent challenges.”

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None of this is to say that medication should never play a role in the treatment of depression. For some people–especially those who are clinically depressed–it can be necessary, even lifesaving. “People with more than mild to moderate illnesses–those who are debilitated by their low mood and can’t do their job or take care of their kids, or who no longer enjoy anything in life–need medication,” says Paul Keedwell, PhD, a psychiatrist at Cardiff University in England and the author of How Sadness Survived: The Evolutionary Basis of Depression.

Even Dr. Thomson acknowledges that “in some cases, depression can be so severe that medication is required.” But he says it’s also true that putting a pharmaceutical bandage over an emotional wound can interfere with true recovery–which calls for discovering the source of your misery and thinking deeply about how to get through it.

Sandra T.*, 40, an artist in Chapel Hill, NC, went to a therapist and instinctively began to exercise and meditate when she was felled by a bout of depression last year. “Through a lot of soul-searching, I saw that part of the problem was that I was too isolated and didn’t have enough social support,” she says. She also realized that her negative thoughts–I’ll never be successful…Nothing will ever change–were perpetuating the problem and were completely inaccurate: “The whole episode was incredibly painful, but now that I’m on the other side, I feel like I have tremendous insight about what keeps me emotionally healthy and what throws me off balance.”

While medication can help in the short term to treat depression, talking to someone about your problems has one distinct advantage–it may actually help protect you from a repeat bout of the blues. “Antidepressants are like aspirin for a headache: They work only as long as you’re on them,” says Steven Hollon, PhD, a professor of psychology at Vanderbilt University who has studied the effectiveness of both drugs and talk therapy. “But certain types of therapy seem to have enduring effects. People who do therapy alone or with pills have half the relapse rate of those treated with medication alone. The most plausible reason is that you learn skills that help you deal with your negative thoughts, and you learn to deal with stress and challenges more effectively.”

Dr. Thomson agrees that therapy is an effective way to work through problems, so long as the approach encourages people to ruminate. “Therapists need to help patients focus on the content of their rumination–that’s the window through which you can see what’s really troubling you,” he says. “By paying closer attention to what it is you’re brooding about, you can identify the problem and then help patients come up with solutions.”

Even those not interested in therapy–or who can’t afford it because their insurance will not reimburse for it–can benefit from trying to uncover the source of their woes. It takes effort, though. One technique that can help: writing, which is a kind of formalized thinking. Studies in 2006 and 2008 found that when people suffering from depression engage in expressive writing, which forces them to focus on their troubles, their depression tends to lift sooner than that of people who don’t write about their problems.

That’s one of the key tools that have helped Dina cope with her anguish since her husband died. She’s continued seeing her therapist, who helps her talk through the range of emotions she feels surrounding the tragedy, but she’s also started blogging about her experience. “That’s been better than any medication or any therapist,” she says. “It’s extremely therapeutic because I can express all my feelings, and I examine them and work through them as I’m writing. They just spill out on the page. It’s such a release. I don’t think I could write like that if I was on medication, because the emotions that come out are so intense. But they’re real–and that’s a step in the right direction.”

*Names have been disguised.

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Judith awaynomail

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Excellent article. I think the part regarding when going through a loss or grieving, that the benefit of spending more time alone, that they have increased time to evaluate and analyze the situation and other situations for that matter. That was after the article stated that being social beings we spend most of our time interacting with others. The best thing that happened to me while working was the long drives from Seattle to Bellingham, WA. My radio broke and I did wasn't sure if I was going to replace the car of get a different radio. So I rode in silence with only my thoughts. That is when I started questioning everything in my life, things that I generally accepted. And I questioned politics. I had a lot of 'What if' questions, playing the devils advocate and now more than twenty years later cannot stand listening to the radio in the car, only on rare occasions. I do not like the intrusion into my thoughts. We spend a great deal of time letting the television, friends, and the radio doing their commentaries. When do we have time to examine our own lives.
And grieving is a time to that we can examine what is bothering us and why, and examine if whether the grieving is related to another loss, as often it is. A loss of a neighbor might connect you to the loss of a loved one, such

Jane W.
Jane Warren7 years ago

something to think about

Ro G.
Ro G.7 years ago

True depression is an epidemic and I find it unconscionable that therapy is being slowly abandoned courtesy of big pharma and big insurance. The reality? only about 15% that take anti depressants fully recover. Also, not all depression is the same and not everyone responds to the same treatment. Visit Dr. Richard Brown's website, he is prof. of psychiatry at Columbia U. Read Dr. James Greenblatt's "The Breakthrough Depression Solution" I have been through the wringer with depression and it's treatment...meds put me in complete remission for a short time--that is 2 out of 25 different trials. SAMe also put me in complete remission but also stopped working. TMS is a good option for many as well as Neuroreplete. I believe that for me the biggest breakthrough has been having first a rEEG then a qEEG, as well as. being prescribed Neurofeedback. I do not know where I would be today if the last Dr. I went to did not suggest the was very revealing.

Judith Corrigan
Judith Corrigan7 years ago

If tablets are needed then this article may encourage people to stop taking their medication.Speak to your doctor and see if you are able to lower your dose but please do not stop suddenly.

Faith Purdy
Faith Purdy7 years ago

as someone who is on a low dose of lexapro and wants to wean off of it soon, this article really supplies some great advice. especially the writing, i find writing letters that i don't intend to actually send out is very thereapeutic
thank you for the article :)

Carina Engstrom
Carina Engstrom7 years ago

My earlier comment was unfortunately interpreted as an insult and I'm sorry for that. I didn't mean that antidepressant is bad and that everyone can walk out from a hell by them selves. I know the difference between depression and DEPRESSION ( clinical ) and I'm really sorry if someone got hurt, it wasn't my intention. In my country it is unfortunately a common thing that doctors prescribe antidepressants without consulting psychiatric doctors or nurses and the patients are left with lots of questions. It's seems to be cheaper to prescribe a pill than to prescribe 10 or more sessions at a psychiatrist. And I still see that many actually believe that it is something wrong with them selves when the problem is outside them selves. I really sorry if I made someone angry and hurt with my comment. In the future my comments will be more clear and complete.

Ainsley Chalmers
Ainsley Chalmers7 years ago

I suffered depression for a few years. ADs helped but a book i read by david burns called "feeling good" (ISBN 0 7318 1036 8)showed that my thoughts needed to be changed (called cognitive behavior therapy). readjusting my thinking to a more positive region resulted in less depressive episodes and me giving up ADs. being a christian also helped me greatly. as the bible says "a cheerful heart doeth good like medicine" and to be "renewed in the spirit of your mind" . in other words think more positively.

Lynn C.
Past Member 7 years ago

Very good article! Also some great comments. Thank you.

Scott Freewheeler

Many experiences in life leave scars. Some grief will be taken all the way to our grave. For some things there are no cures; this is just life. It is not just for enjoying and for being happy.

We must not let these trials destroy us or make us mean and moody. We must still be generous and kind, even loving. It is not so important how bad it is; it matters which direction you are headed – either you are getting closer to God/self realisation or you are not listening to your heart or conscience.

If your life is awful or your mind is in misery then make someone else’s life a little better with charity and kindness. Perhaps some quadriplegics don’t have a great deal of power to change their practical life but our focus is our choice.

God doesn’t require us to worship Him or to be grateful for His sake; it is for our own sake. The forbidden things are not restrictive of our fun; God is protecting us from them (intoxication, gambling, etc). Clean up your life, exercise if you can, be loving or just be nice and you will cope. Don’t wait for someone/thing else to fix your life for you; get started and they are more likely to come.

People get stuck by wishing it was much better instead of accepting where they are presently and working on small improvements. Struggle is sometimes inevitable by suffering is optional.

CarlaJeanne V.
CarlaJeanne V.7 years ago

My grandmother was prescribed antidepressants every single time she left the hospital after her many, many angina episodes. My mother and I knew that my grandmother used her angina as a way to say "I can't handle this anymore." After my grandmother's death, one of the things that was revealed was my grandmother's long, long history of untreated depression. At times it would get so bad that she would no longer know her children's names. Her self-treatment was always to just lay in bed or on the couch, telling everyone that she was too sick to do anything else. I tell you this story to illustrate a point. Some people simply WILL NOT do what is needed to help themselves, as far as thinking about what they could have done to change their circumstances, etc. I've learned to do that through therapy. I've met a lot of people in therapy and most people j.u.s.t d.o.n.'.t g.e.t i.t. no matter how hard the therapist tries. Those people need drugs to keep them from killing their coworkers or eventually dying early because of complications.