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Young Adults’ Experiences of Depression in the U.S.

Holistic and integrative approaches to depression

In the United States, integrative or holistic approaches to addressing depression are common. Some people use these approaches on their own, while others do so in the context of seeking help from health care providers or other clinicians. Integrative approaches take into account many different parts of a person and his or her life rather than focusing on depression just by itself. Integrative or holistic approaches focus primarily on “healing” -- that is, improving overall well-being and focusing on spirit, mind, behaviors and community as well as the physical body. This is different from a focus on “curing” -- that is, eliminating disease with a targeted treatment*. 

Most people we interviewed talked about holistic approaches to healing or coping with depression. And the majority of those who tried these approaches found one or more specific strategies that helped.
 

Maya says holistic models of mental health work best to help her feel safe and comfortable in her own body.

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Age at interview: 27
Sex: Female
Age at diagnosis: 15
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And I think that for people with depression, people with anxiety, people who have a history of either physical, emotional, or sexual trauma, finding a way to be safely embodied is very important and I think that it’s difficult in the western model to find those therapies that help you find safety in yourself and feel like your body is a safe place to be.

And I think that Eastern models of mental health always include the body and always include, you know, being safe in the body and feeling grounded which is a lot of my work. I work with a meditation teacher. 
Holistic mind and body approaches

Exercise, nutrition, supplements, yoga, meditation, mindfulness, and acupuncture are all techniques for treating depression. Research supports several of these approaches with the best data showing benefit for exercise and mind-body therapeutic approaches*1,*2,*3. More information about these complementary health approaches and the evidence behind them can be found on the National Center for Complementary and Integrative Health website.

Young adults around the country that we talked to were trying these holistic approaches to address their depression. This was even more pronounced for people on the West Coast. Some people focused on training their minds and outlook in order to change their depression patterns. As Sara put it, “I did a lot of reading and that is what really got me to be able to control my brain by myself… I have control over my own thoughts. Nobody else does, I do. And realizing that helped a lot.” Others tried mindfulness classes or meditation in groups, or with a teacher one on one. Some used these techniques instead of medication, while others used them alongside medication.
 

Meditation calms Devin and he is glad his girlfriend understands what it means to him.

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Age at interview: 21
Sex: Male
Age at diagnosis: 16
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Let’s see in 10th grade, I started going along a more natural path I guess with the way I dealt with things. I guess with the way I ate. And that seemed to have a “inaudible” I always put off things just like meditation because I was in, I was in on the east coast and, and it wasn’t much of an area for meditation or anything really natural there it’s a at least where I lived. But I found out that things like meditation really helped me out, it calmed me down. You know, afterwards I would always feel less stressed, more happy and I’ve continue meditation to this day because it’s always, always helped me during my extremely stressful times and I enjoy that and I’m glad that the person that I am with now actually understands and is able to deal with my extremely hippie ways [laughter]. 
 
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Maya benefits incredibly from her meditation community, where she engages in deep work with other people from all walks of life who “do the work.”

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Age at interview: 27
Sex: Female
Age at diagnosis: 15
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I actually moved here mostly to join this meditation community, because I found so much incredible benefit from being around people who are doing the work and like, that’s the thing that I like about meditation and mindfulness communities, that like, when you are talking about people who are doing internal work, people who regularly are going to a meditation community are doing the work… And I think surrounding myself with people who are doing the work and whatever flavor that is, whether or not, that’s people who dance at a [unknown] and who sing and play music at the center for conscious learning. Or, you know, people who dance and sing in the gospel choir at this Baptist church or people who chant, you know, or sit in silence or go on silent retreat for weeks or months or years, you know what I mean. Anybody who does the work, that is where I feel at home and I guess I’m sort of like a universalist. I’m not going, regardless of what the sign says on the door I’ll go in if it suits me. 
A number of people focused on exercise and/or diet as a strategy for addressing their depression or preventing it from recurring. One person aptly summarized common experiences by noting “Any type of exercise feels great when you’re depressed, because it makes you feel less depressed afterwards.” Some people “… just sort of figured out what worked better” on their own, while others had doctors, therapists, teachers, or others help them. A few people talked about lack of self-motivation as a significant down side of “self-help” approaches of any kind (holistic or not). (See also ‘Depression and strategies for everyday life.’).
 

Jeremy wants to meditate more and try other things, but sometimes just doesn’t feel like it.

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Age at interview: 22
Sex: Male
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So you talked about, you like being natural and you said you like, you’re an excerciser in the summer, and you look to spirituality, and do you do anything like meditation or…

Sure, I.

…or diet or herbs or?

I tried it, I try meditation stuff sometimes, I just don’t feel like it. I wanna do it more. It’s one of those things where it’s like where you know you want it, it’s something you should be doing, but you don’t, I’ve meditated before like it’s really, transient is really good, or like listening to tones, certain tones, like, resonance, I don’t know if you know what that is, it’s like earth’s natural frequency. 
The arts and creativity

For many people, focusing on creative work is a crucial way to improve overall well-being and alleviate depression-related suffering. Making music or art, writing, or drawing on nature as a source of inspiration – these things were described over and over as relaxing; calming; a satisfying way to be expressive. Several people talked about art helping them “gain control of my feelings and reflect on things.” Ryan says his poetry, rap and music are healthy ways to put himself out there and maybe even be helpful to others. Meghan notes that her a cappella group in college provided an automatic community, which prevented her from being isolated and more depressed.
 

Myra’s music gives her strength and makes her depression instantly better.

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Age at interview: 28
Sex: Female
Age at diagnosis: 27
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Even if no one's listening. It, even if it just seems like no one cares, it, it's just so helpful. I can't explain the power I feel when I, when I'm singing or if I have a tambourine or something in my hand, you know. It's just, wow. Like I said, I can't really explain it. I just love it.

What happens when you're in a really, really down spot and you, you perform or you jam or you, you get together with your, your group, your band?

I'm just instantly better. And I can come in and I can be upset, I can be crying, you know. And I just throw myself into it and I'm just instantly so much better. It's just instantly like I have this strength to rely on. The, this is helping me see that there -- that tomorrow is another day. And that, you know, I need to stick around to see what's going to happen, you know?
 

For Nadina, creating art helps her face fears and understand bad drams.

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Age at interview: 23
Sex: Female
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I feel that illustration has really helped with me to face what, what exactly is troubling me and, and kind of torturing me in some ways, you know a lot of my nightmares that I have, I have really bad insomnia, but when I do sleep I usually have some nightmares that are pretty scary so I try to kind of illustrate what happened in there because I, instead of like fearing it and running away from it or whatever it is even if it’s like horrifying I try to pinpoint what I saw and maybe try to figure out why I saw what I saw in my dream. That you might be suppressing and if you keep suppressing that, it’s just going to keep coming back and back until you just face it head on. 


References
* Rakel, David. Integrative medicine. Elsevier Health Sciences, 2012.
*1 Cooney, Gary M., et al. "Exercise for depression." Cochrane Database Syst Rev 9.9 (2013).
*2 Crane, Catherine, et al. "The effects of amount of home meditation practice in Mindfulness Based Cognitive Therapy on hazard of relapse to depression in the Staying Well after Depression Trial." Behaviour research and therapy 63 (2014): 17-24.
*3 Weitz, Erica S., et al. "Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy: an individual patient data meta-analysis." JAMA psychiatry 72.11 (2015): 1102-1109.

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