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Areas › Low mood and hard feelings › When everything feels flat
Head to head, the differences in how much they lift mood are modest. Where they really differ is in everything else they do to you, and in how well they suit the particular shape of your low mood. A switch is therefore mostly a change of side-effect profile rather than a step up in power, which is useful to know before pinning a great deal of hope on the next one.
'Do not look longingly at the good things We have given some to enjoy' (Quran 15:88). Comparing your treatment with someone else's tells you very little about your own.
الحجر
لَا تَمُدَّنَّ عَيۡنَيۡكَ إِلَىٰ مَا مَتَّعۡنَا بِهِۦٓ أَزۡوَٰجࣰ ا مِّنۡهُمۡ وَلَا تَحۡزَنۡ عَلَيۡهِمۡ وَٱخۡفِضۡ جَنَاحَكَ لِلۡمُؤۡمِنِينَ
Do not look longingly at the good things We have given some to enjoy. Do not grieve over the [disbelievers], but lower your wings over the believers
Qur’an 15:88read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A meta-analysis of randomised trials found that behavioural activation, which means systematically getting back into meaningful activity, outperformed control conditions for depression and did as well as full cognitive behavioural therapy. The same pattern keeps turning up: credible treatments land near each other. That evidence comes from talking therapies rather than from drugs, so take it as a general shape and not as a claim about any two tablets.
Ekers, D.; Webster, L.; Van Straten, A.; Cuijpers, P.; Richards, D.; Gilbody, S. (2014). Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis. PLoS ONE doi
BA comparable to full CBT protocols.
Strength of evidence: one line of research. A single study, or a theoretical account.
Treatments that work through the same route tend to finish in a similar place.
Heaviness in the body, aching, and a tiredness that sleep does not touch are part of low mood. They are not a separate complaint to raise another time.
When someone says they react badly to normal doses of almost everything, take it as information about their body rather than as a personality trait.
If pain is part of what you are carrying, bring it into the same conversation as the low mood. They are not two separate appointments.