I Think I'm Gonna Be Sad

I think I’m gonna be sad…Karen Carpenter sang that line in her song Ticket to Ride. I love that line because it reminds me I have choices. I can choose how I will react to a situation. I’ve recently returned from a stellar conference on depression. There were reviews of the latest medications and treatments, but the one thing that stuck with me the most was the discussion about patient self-ratings of their mood. I started wondering, what if on that particular day they chose to be a bit sadder than the day before, and how does that sway the rating? And how does that rating effect the treatment? The most difficult part of treating people with depression is figuring out its origin. Depression is a symptom. Just like chest pain is a symptom. Are you depressed because your brain neurotransmitters aren’t working right? Are you having chest pain because you are having a heart attack? Are you depressed because your spouse died? Are you having chest pain because you are about to have a job interview and you’re nervous? So maybe there are times we can’t choose. You can’t choose not to have a neurotransmitter malfunction and you can’t choose not to have a heart attack. So what’s Karen Carpenter singing about? She’s singing about perception. Who knew she was an undercover philosopher posing as a fabulous singer! Most of my depressed patients need medication, and it is often a long road to finding the right one. But I’m walking the road with you, and we are simultaneously working on the philosophy of perception. What does perception have to do with depression? Perception is the effect or product of perceiving…and perceiving is to become aware, to attain awareness. The Dalai Lama said, “Pain is inevitable, suffering is optional.” Karen Carpenter was right! She chose to be sad that day…that day she sang about her man leaving. The lesson here is simple…don’t miss your therapy appointments! The medication alone will not make you feel your best. You must work on your perceptions and reactions to outside events. You can choose to suffer, or you can choose to learn, grow and move on. Shakespeare said it best, “There is nothing either good or bad, but thinking makes it so.”