Death, loss, grieving, and depression

Dear Jim,

A rule is, if something works, do more of it. If it doesn't work, do something else instead. If you are still suffering after 30 years of Prozac, then it hasn't worked.

You are not alone. Antidepressants like this are barely better than placebo at relieving depression. Their greatest advantage is for the drug companies: the myth of depression as a chemical imbalance is very profitable. Research since about 2004 has shown the same brain changes from therapy as from drugs. The difference is the effects of therapy last, while drugs can only work while you take them. And there are terrible withdrawal effects with drugs. I suggest you find a psychologist to work with you, and in the meantime request your doctor to gradually and slowly wean you off the Prozac.

Depression is not something you are, or something you have, but something you do. That's why therapy can be effective. But it is not necessarily so either. Here are the requirements:

1. You need to believe that it works. The power of belief is enormous. Many people who fail at any treatment do so because they start by doubting whether it'll work. Go into it full blast, with strong commitment to make it succeed.

2. The most important factor in the success of therapy is the personal bond between two people. Read up on the work of Carl Rogers. It is valid, and there are many articles on the internet about it.

3. My approach, which is supported by a great deal of research, is Cognitive-Behavioral Therapy, with a Buddhist/Mindfulness approach. Various other therapies, like Narrative Therapy and Acceptance and Commitment Therapy, are based on the same principles and work.

Have a good life (you can),

Bob