Many of the suggestions of A. Cornelius Celsus mentioned above are healthy pleasures – music, soothing sounds like that of running water, cheerful conversations, massage and travel. Whatever it is that is a source of pleasure should be sought out and developed by the depressed person because the essence of depression is the lack of capacity for enjoyment, also known as anhedonia. But even when a certain degree of anhedonia is present, some activities might still provide pleasure.
Pets, for example, can be a great source of comfort and delight even to depressed people. Many years ago I decided that it would be a useful exercise to put several of my depressed patients together in a group. I reasoned that they might be able to help one another cope with depression. In truth it was not a good idea. The group was suffused by a sense of communal gloom and despair. But I remember on one occasion when someone mentioned her dog or cat, there was an immediate change in atmosphere as each of the group members pulled out a picture of his or her pet – animals that until that moment I had not even known to exist. For some time they pored over one another’s photos, admiring the animals and discussing their various special qualities and foibles. It was a vivid demonstration to me of the power of animals to cheer people up and how even depressed people are capable of spells of happiness if they are presented with the right stimuli.
Only you know what it is that delights you most when you are feeling well and how best to seek such activities out. Ask yourself what it is that still appeals even though you may be depressed. Is it painting watercolours, growing orchids or taking long walks in the countryside? The possibilities are limited only by the imagination. Consider the question, make a list of such sources of joy and then devise strategies for how you can bring them back into your life again.
I specify healthy pleasures because some pleasures are quite unhealthy, even if they are capable of bringing you out of depression for brief periods. Such pleasures may include alcohol and addictive drugs and compulsive behaviours, such as excessive shopping, spending, gambling or sexual activity. One of my patients, for example, would regularly go and shop for clothes that she could ill afford, did not need and in fact hardly ever wore. Her cupboards were full of expensive dresses that she had never even tried on after leaving the shop. For her, all the reward came from the act of shopping itself. There was something about the process of going to an expensive shop, trying on the garment, and having the saleslady pay attention to her and compliment her that proved irresistible. Of course, the comfort was very short-lived and the cost of the habit, both financially and in the form of marital conflict, severely exacerbated her depression. There are many different varieties of this habit and they can be very difficult to break. Addictive sexual behaviour is another costly way that some people use to medicate their depressed feelings. At times I have recommended specific recovery groups for these types of problems, with fairly good results.
And how do you tell the difference between a healthy pleasure and an unhealthy one? Usually it is fairly obvious. The one leaves you feeling good afterwards; the other leaves you feeling bad. The one feels like a wise investment that continues to yield dividends over time; the other like a foolish expenditure of time, money and energy, which ends up costing more than it’s worth. And finally, the one is a source of pride that you might be pleased to share with friends and family, whereas the other is often a source of shame, cloaked in secrecy.
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