I have a calling but I don't know what it's called

I'd like to help depressed people with diet and exercise

Published September 15, 2009 10:15AM (EDT)

Dear Cary,

I feel like I have stumbled upon a calling, but I don't know how to qualify myself for this job, or even if it actually exists.

My inspiration comes from my own life and that of my mother, but first and foremost from the experiences of my brother who, at the age of 12, was diagnosed with clinical depression and put on the first of many drugs. Over the years the diagnosis changed from depression to attention deficit disorder (ADD) to bipolar to attention deficit hyperactivity disorder (ADHD) to an anxiety disorder and back to depression, in a never-ending loop. The prescriptions changed with it every time.

The drugs rarely if ever had the intended effects. The side effects often compounded his problems. As he passed through high school, two things did have a positive impact. The first was when he got involved in sports and changed his sedentary ways. The second was the diagnosis and treatment of a hormone imbalance. Even then, the diagnostic merry-go-round kept spinning until, fed up, my brother took himself off of all medications except for his thyroid hormone replacement. The first time I saw him after that -- a brief few minutes in a gas station parking lot -- will stand out in my mind forever. I know it's irresponsible to suggest that going off his meds without a doctor's supervision was a good thing, but it was like the sun coming out from behind the clouds. I barely recognized the laughing, animated young man who stood in place of my withdrawn, angry brother. I cried the whole way home and for much of that night, for the years that I still feel were stolen from him and from our family. This isn't to say he's lived happily ever after, or even that his life has been easy. Rather, he's been able with the help of our family in the past three years to gradually pull himself out of the hole he'd slid down into, and is now doing well as a full-time student while holding down a part-time job. Every single day he makes me proud.

This experience, along with my own much less dramatic struggle with depression, and the experiences of too many friends and family members to list, led me to the epiphany that many people are being treated for neurochemical imbalances when they really suffer from a desk job and too many Doritos.

(Please believe me when I say this is not to discredit in any way the very real suffering that these people endure, nor do I disbelieve that there really are people who need medication for mental and emotional problems. Far from it.)

I also think that the current approach to treating depression ignores the possibility that, maybe there are things going on in your life that you should be unhappy about. Maybe your road to contentment requires you to deal with the things in your life that are making you unhappy. I feel like this is often ignored in a medical culture where depressed people are given a prescription and shown the door.

I acted on this insight and started going to the gym, eating healthier. Making myself and my own health a priority in this way eventually led to a self-awareness that allowed me to really think about the situations I put myself in on an everyday basis -- which ones are beneficial to me, which are toxic, and what I need to do to eliminate or at least reduce the toxic. While the changes this caused might not be apparent to everyone else, to me they are monumental: While sometimes things happen in life that make me feel sad or defeated, these are normal emotions instead of the soul-killing bleakness that used to threaten to consume me.

So what I want to do, what I really think is the best thing I could possibly do with my life, is to work with people who have worn themselves down into the same dark place I used to live, where my brother used to live, and show them how to take care of themselves to climb out.

I think what is called for, for many people, is something like a combination of a trainer, a nutritionist and a life coach, someone who can address both the physical aspect of caring for the body and the emotional underpinnings that make a person feel that they do not deserve that sort of concern in the first place.

I want to send my patients home from counseling sessions with doctor's orders to hit the gym three times a week. I have done some research on cognitive behavior theory, thinking that might be a place to start, but I haven't come across anyone else doing this sort of thing. Osteopathic or holistic medicine also seem like paths to this, but there are barriers there as well (accreditation in certain medical specialties is an issue with a non-M.D. background, and I don't want to be written off as an unqualified quack). Can you point me in the right direction?

Blindly Seeking My Calling

Dear Blindly Seeking My Calling,

What you say makes perfect sense to me. I think your caveats are wise and your experience is genuine.

It sounds like you would do well working as a therapist, life coach or counselor, perhaps one who specializes in using diet and exercise to combat depression. More generally, it sounds like what you have discovered is the kind of thing that underlies somatic psychology.

As far as degrees and accreditation go, you might look at something like the California Institute of Integral Studies' Somatic Psychology Program.

Out here in California many people without medical degrees work in a variety of ways to help others improve their lives and their mental health. While some very important work is being done, and while much improvement can be had through common-sense lifestyle changes, there will always be those who scoff at anything that doesn't come in a bottle prescribed by an M.D.

So I think it will be useful for you to think deeply about what your most powerful motives are. Your experience with your brother was an "Aha!" moment that started you into action. It was also emblematic of a wider problem. But what is most important to you: to change the prevailing medical system, or to work directly with individuals and help them in a therapeutic setting?

I get the feeling what really attracts you is helping people. Yet you obviously have a very individual and original approach. So you will want to think carefully about how you present yourself, and how you distinguish yourself from those who may make outsize claims about the effectiveness of this or that remedy. New ideas usually meet opposition from more established fields that they threaten to supplant. So you will need to be clear about what you are doing.

But I think you have a marvelous idea for a field of work. Perhaps you can ally yourself with a personal trainer and a nutritionist, so that these disciplines come together in a practice and so you do not have to try to become an expert in all fields.

Incidentally, I do particularly like your suggestion that while true clinical depression exists, we may at times be too quick to "pathologize" unhappiness. We may indeed be unhappy for good reasons. There may indeed be better ways to live. Sometimes it's as if, wandering through a concentration camp, we were surprised to find the inmates feeling a little down.

Feeling a little down? Yep, there's stuff in here about that.

Makes a great gift. Can be personalized for the giftee of your choice. Signed first editions on sale now.

What? You want more advice?


By Cary Tennis

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