Depressed…? You need to get out more!

IMG_0202In keeping with my lifelong passion for finding the easiest and most efficient (time saving) way of doing things, I try to find short cuts when dealing with clients. Getting straight to the point has always proved useful, as has my pathological unwillingness to pussyfoot around issues. A good therapist can quickly identify the point or points on which the case will turn. And yes, I perform better when I tell clients the truth rather than what they want to hear. If their best friends won’t give it to them straight then I have to, even though this approach is sometimes met with a look of incredulity and a sudden drop of the lower jaw.

But telling a client straight isn’t going to work in the long term – the trick is to get clients to recognise the truth themselves, even if they have to drag it kicking and screaming from the very depths of their unconscious. Once clients get the truth, there is very little else needs to be done.

People who tell me they are suffering from depression have usually overlooked the cause of their depression. I have lost count of how many times I’ve tried to get depressed clients off their sofas and interested in something they can enjoy in life. Most depressives sit at home most likely watching repeats of the Jeremy Kyle show. I suspect they do this because of an unconscious desire to convince themselves there are people in the world with worse lives than their own, but maybe that’s unkind. In any case, it’s irrelevant. The idea is to get them to want to get back into society.

The new concept of Mindfulness, now all the rage among therapists, has provided me with another important tool to pull out of the box when needs be, but the more people I see, the more I am convinced that the real key to curing depression is action rather than words. The cure is simple – they need to get out more – and can forget the Prozac

For most of the fully paid up members of the never-ending procession of those who suffer from learned helplessness, the answer really is that simple. If only I could get them to see their true reflection in a mirror. I have learned by experience that their depression is merely a symptom of isolation, an isolation born out of laziness and a can’t-be-bothered attitude. Once an individual has withdrawn from society, it takes a huge amount of effort to get back in.

Getting out of the house more often takes a certain degree of will power. A lot of clients are lazy and have developed the habit of giving in to the instant gratification constant snacking provides, which is why a goodly proportion of them are overweight. More sugar, more salt, leads to more weight gain and thus a reduced desire to partake of the world.

Nearly a third of clients do not respond to the more traditional treatments that come under the umbrella of psychotherapy. Of those who do respond positively, most will relapse. The good news is that there is a better and far more effective way to get these people up and running again without hours and hours of listening to them whine on about their dreary and unfulfilled lives. One answer is to get them to become part of a socially interactive group.

Human interaction really is the best cure – and the best protection – against depression. Any hobby group, for example pottery, photography, athletics, skydiving, music appreciation – ANYTHING will do, as long as it brings them into contact with other people. It’s not just the company other human beings provide, with membership also comes responsibility. People who join societies and clubs learn to be reliable, they learn to be supportive themselves and most important, they realise they have an obligation to their fellows. These three factors, once harnessed, can turn a lonely depressive into a contributing member of society.

Social contact with groups who have the same interests is considerably more beneficial than contact with individuals who share no common or specialised interests. Even (and I can’t believe I’m saying this, never mind recommending it!) joining a church group can sometimes offer a way out of the vicious downward spiral of depression. At least with mainstream church groups, individuals receive support from the group, something which is fundamental to human needs and the human survival strategy. People function better in groups.

Joining a group – better still, joining two or three different groups – also has distinct economic advantages. It’s certainly cheaper than paying £200 an hour to sit and talk to me and it has the added advantage of broadening one’s horizons by increasing one’s knowledge and even seeing and experiencing new places. Here’s the bottom line: human beings are social creatures and depend on each other for survival. Depressives are more often than not lonely individuals who have little interaction with other human beings. Everyone needs someone they can call in the evening for a chat.

Having said this, it is important to remember that often depression has external triggers such as loss or being forced to live alone. However, there is no longer any doubt that social isolation is the breeding ground of depression.

John T. Cacioppo, a neuroscientist at the University of Chicago who has dealt with 229 middle-aged and older adults published his own findings in 2010.

Individuals who reported being lonely at any point in a five year period were much more likely to develop depression within a year. The opposite was true of those who reported low levels of loneliness. The results were regardless and independent of age or gender.

Loneliness is also the prime factor that precedes suicide. Individuals with low levels of social support are more likely to consider ending it all – a fact confirmed in 2012 by a team at the University of Newcastle (Australia) led by psychologist Tonelle Handley. The study centred on rural communities in New South Wales where social networks and therefore the availability of social support were unusually low.

There is no doubt in my mind that depression is the result of social isolation because I have recognised it in numerous clients. It’s really not that difficult to spot because most of them tell me how lonely they are within fifteen minutes of walking through the door. If there is no sense of ‘belonging’ loneliness will spawn depression as surely as night follows day and the more protracted the loneliness and isolation, the worse the depression.

The need to be part of a group is paramount. Soldiers see the regiment as a family. For example, bonds established between members of one regiment are stronger than those between soldiers from outside the regiment. Another example is when disenfranchised and socially awkward young Asian men run off to join terrorist groups – these groups offer them something better than second-class citizenship in a country they do not feel is their own. The plight of these young men is exacerbated by the fact that they have usually been brought up in isolated communities that do not interact with the rest of society and where there is little or no integration. Little wonder than that they perceive the opportunity of becoming a fighter attractive. Maybe the thought of owning an AK47 and having sex with young girls means they will at last be treated with some respect. It would certainly seem more rewarding than stacking shelves in Morrisson’s.

So the moral of the story is that it’s not just membership and social interaction with a group that staves off depression, but the sense of connection that makes it work. My experience is that once people get off their backsides and start taking part in something, they start to enjoy it – slowly but surely the shackles of depression begin to fall away. The more groups, societies or clubs they join and the more they go out in groups – to eat or to watch a movie – the more likely it is that depression will be staved off in the long term, and the less the likelihood of falling back into depression.

A 2013 study at the university of Exeter proves the point. Of a study of 4,000 individuals, those depressives who did not join a group or engage in any social interaction had a relapse rate of 41%. Of those who joined one group, the relapse rate was 31%; two groups, 21%, and those who joined three or more groups, the relapse rate fell to just 15%.

There is however a caveat with all this. For the group to represent an effective therapy, it must reflect the interests of the person joining it. This is a matter of common sense, but its importance must not be overlooked. It is important that the individual truly feels a connection with the group; they must have a common interest (yoga, photography, amateur theatrics etc.) and must get on well with the other members. Individuals who feel strongly connected to the group recover twice as well as those who feel only weakly connected to it. So it’s necessary to find something that genuinely interests and excites them.

So, how does all this work in practice?

Research has shown that sharing an experience with other people (and the more the merrier) makes the experience more intense. It makes no difference whether the experience is good or bad, funny or frightening. More than that, shared experiences are intensified even if they happen in silence. The same is true when an experience is shared with someone they have only just met.

A recent study carried out by psychologist Erica Boothby of Yale University in New Haven, Connecticut shows that people who share experiences with another person rate those events as more pleasant (or unpleasant) than those who undergo the experience by themselves.

We know that humans are social creatures – what matters however is not just simply being together with others but taking part in activities that involve the whole group. When all the group are focused on a pleasurable activity such as watching a live comedy show, listening to a concert or watching their team play football, the experience is enhanced for each member. It’s true – I have carefully watched audiences at my shows for over 35 years – and the groups always have the best time. It worries me if I see someone sitting by themselves, which occasionally happens. They are, I’m sure, laughing inwardly, but they are not having the same experience, and therefore not sharing the same bonding, as the groups.

Boothby and her colleagues have explored the relationships between members of the group when experiences are shared. In their first study, 23 female college students were given chocolate to taste. Some of the chocolates were tasted by all the members of the group at the same time, while some were tasted by students in isolation. Just to make the experiment more interesting, all the chocolates were exactly the same.

By now, I think you can probably guess where this is leading, and you’d be right. Although the chocolates were identical, the tendency was for the students to report the ‘shared’ chocolates as being tastier.

The researchers suggest that sharing an experience with someone else, even silently, such as listening to music or looking round an art gallery, suggests that the mere act of sharing may influence how things are sensed or perceived. To find out whether sharing an experience really does make it more pleasant or unpleasant, the researchers tasked another group of students to taste some ‘chocolate substitute’ – in reality a square of dark chocolate the researchers hinted would taste unpleasant.

On this occasion, the students reported they liked the ‘shared’ chocolate less. They also reported feeling more involved in the tasting experience and more in tune with the other participant when they tasted the chocolate at the same time.

When human beings take part in shared experiences, the mind makes an association with social interaction with others, something that most humans need. The extent we are influenced by people around us, even people we don’t know and aren’t even communicating with, has yet to be measured in more detail. But while individuals are glued to their mobile phones, texting friends, checking Facebook and Twitter and so on, normal social interaction, the result of hundreds of thousands of years of evolution is being swept aside. The result is more isolation and thus more cases of depression.

We evolved to be part of a group. Groups give people a sense of belonging and meaning to life. Research has also shown that membership of a group can not only increase one’s sense of life being worthwhile, it can also help boost an individual’s immune system and make them less likely to lose their temper.

So this is what I do with my clients. During the hypnosis part of the session I employ suggestions that encourage the client to get out more. And it works. Nine out of ten of my clients report an improvement within a very short space of time. In short, the answer is… tune in, turn on, and get yourself a life!

Copyright Andrew Newton 2015. All rights reserved.