Antidepressants are the most commonly prescribed class of medication in the United States. But Dr. James S. Gordon questions the use of drugs to treat depression:
This book will challenge the prevailing “medical model” of depression and the widespread, even epidemic, use of chemical antidepressants. This narrow model of diagnosis and treatment insists that those who feel helpless and hopeless, unhappy and uncertain, have a disease, like insulin-dependent diabetes, that requires a pharmacologic treatment. I’ll offer you evidence that strongly suggests that this model is poorly justified, largely inappropriate, limited and limiting, and, often enough, dangerous to your physical, emotional, and spiritual health.
A non-drug approach to the treatment of depression is the focus of Unstuck: Your Guide to the Seven-Stage Journey Out of Depression. In his latest book Gordon outlines his preferred depression treatment—a “healing journey” that includes “mind-body” techniques such as meditation, guided imagery, physical exercise, and acupuncture.
Gordon’s expertise in using mind-body medicine to heal depression is influenced by his work with leading physicians and researchers at the National Institute for Mental Health (NIMH) and The Center for Mind Body Medicine. Some techniques recommended in the Unstuck approach—such as the soft belly—are borrowed from those individuals.
Gordon suggests a comprehensive alternative approach to treating depression. In the first step, “The Call,” Gordon instructs the reader to acknowledge his depression and investigate its cause. This investigation begins with a trip to the reader’s primary care physician for a physical exam, complete medical history, and routine lab tests. If the “conventional workup” does not reveal the cause, Gordon suggests consulting with a naturopath.
During “The Call” the reader also examines his diet. Gordon suggests using an elimination diet to identify food sensitivities. He also offers suggestions for vitamin and mineral supplements.
In the “Guides on the Journey” stage the reader is given instructions for “meeting and choosing the men and women who can help.” Gordon doesn’t always refer to these men and women as therapists, but it is fairly clear that he is asking the reader to consider psychotherapy. “False guides”—people who “got the answers, not only for themselves but for you as well”—are identified as well.
The third stage, “Surrender to Change,” acknowledges that “the journey through and beyond depression requires a balance of action and acceptance.” During this stage Gordon asks the reader to let go of control and move forward. Movement is emphasized during this stage in the form of walking, yoga, dancing, and dynamic meditation.
The fourth stage, “Dealing with Demons” focuses on addressing the habits that keep the reader stuck. In this stage Gordon recommends meditation and Chinese medicine to address these issues.
In the fifth stage, “The Dark Night of the Soul,” Dr. Gordon addresses suicidal feelings. According to Gordon these feelings signal “a turning point, not an end point.” Readers are encouraged to seek out their guide and meditate. Gordon says he considers using antidepressants during “dark nights,” but recommends SAM-e, 5HTP, and Saint John’s Wort first.
Spirituality is the focus of the sixth stage. Gordon is careful to note the difference between religion and spirituality—“the connection between ourselves and something greater than ourselves.” Meditation and prayer are recommended.
The last step, “The Return,” is a celebration that depression has lifted. Gordon offers 10 simple suggestions to the reader to practice as they move forward with their lives: T
- be aware
- practice acceptance
- have patience
- take time out
- fear not
- ask for help
- trust your inner guide
- celebrate everything
The Unstuck approach may be a valuable treatment option for mildly depressed individuals who have the drive to exercise on a regular basis, cook healthy food, and participate in psychotherapy. Most individuals with severe depression, however, lack the kind of energy and motivation that are necessary to make Gordon’s mind-body approach effective.
Antidepressants may have side effects, but sometimes the benefits outweigh the risks. The right antidepressant produces a response fairly quickly, making them the preferred treatment option for individuals with intractable depression or suicidal ideation.
What’s missing from Gordon’s approach to depression is the acceptance that other treatment options—namely antidepressants—can work in some individuals. His opposition to the use of antidepressants is so strong that he recommends them only after trying the Unstuck approach—even with patients having suicidal thoughts. This kind of all-or-nothing thinking does little to help a patient on his journey out of depression.
Unstuck: Your Guide to the Seven-Stage Journey Out of Depression
By James S. Gordon, M.D.
Penguin Books: Reprint edition, May 2009
Paperback, 448 pages