The four questions

A couple of years ago, I went to my doctor for a yearly physical. This was at the height of my drug use, so needless to say, I wasn’t in very good shape—physically, mentally, or emotionally. During the exam, I told the doctor that I’d been very depressed lately and wondered if I should seek professional help or some kind of medication.

He then told me something I’ll never forget. He said, “You know, I see lots of young people like yourself who are struggling with similar issues, and I always ask them the same four questions about their lives.”

Here are the questions he asked me:

  1. Are you exercising on a daily or at least regular basis?
  2. Are you eating an (at least somewhat) healthy/balanced diet?
  3. Are you getting good, regular sleep?
  4. Are you moderating your use of drugs and alcohol?

After I had (rather sheepishly) said ‘no’ to all of these, he told me, “Anytime someone answers ‘yes’ to three or four of those questions, I advise them to explore options for treating their depression…. but almost none of the 18-25 year-olds answer ‘yes’ to even one or two.”

Now the argument can obviously be made that those suffering from chronic depression are very unlikely to be doing any of those four things precisely because they are depressed, and that’s a fair point. However, it seems equally plausible that lack of exercise, a poor diet, insufficient/sporadic sleep, and drug & alcohol abuse will almost certainly cause depression in those who would otherwise be quite content with their lives.

Something I learned in rehab is that more and more people in the medical profession are realizing that if someone is abusing drugs and alcohol, it’s nearly impossible to accurately diagnose them with a mental disorder. I was convinced I was bipolar before I got sober. It made total sense at the time; I checked all the boxes. However, I was completely ignoring the fact that turbulent and unpredictable mood swings and heavy cocaine use go together, as the philosopher Gump would put it, “like peas and carrots.”

I suppose my point is this: if you are suffering from depression, if you are as mired in that thick, suffocating fog of apathy and dread as I once was, try your absolute damnedest to get to a point in your life where you can answer ‘yes’ to at least two of the questions above, and see if you don’t feel a bit better…. or maybe just not quite as bad. Then try for three, and then four. Will it be easy? No. I’m still working on the diet part, and my sweet tooth is fighting me every step of the way. But no one said it was going to be easy, or that it’s supposed to be.

But I’ll tell you what I do know: it’s easier than wanting to die. It’s a hell of a lot easier than waking up every day and having your first thought be, “Well, fuck—I’m still here.”

Wouldn’t anything, no matter how challenging, be easier than that?

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