Mind Matters -- September 2004
Written by Ron Sterling, M.D. and Published in Northwest Prime Time Magazine

The Power of Programming
by Ron Sterling, M.D. -- September 2004


    Dear Dr. Ron:

      It seems to me that there is a lot of information published about clinical depression and how it may relate to a biological problem. Isn't it possible that depression can come from a way of thinking and not necessarily always from malfunctioning brain cells? Can depression be a choice? -- Signed: Choosing Happiness.

    Dear Choosing Happiness:

      Thank you for writing! This is a complex question about which entire books have been written. However, I think it is possible to discuss some of the most significant psychological and biological aspects of depression in this short column.

      The short answer is that there are belief systems and styles of thinking that can set us up for clinical depression. However, these are not what I would call "choices" until we become aware of what we are doing and gain knowledge about alternatives. The power of our programming cannot be consciously dealt with until we have adequate self-knowledge.

      We all have had learning experiences that have set us up primarily for happiness or depression. For those of us who may have gained beliefs and styles that set us up primarily for happiness, until we are aware of the dynamics of our happiness, we cannot say we are "choosing" happiness. We can only say we are happy, but we may not fully understand why.

      Depressions range from mild to severe. What most professionals call "clinical depression" has certain neurobiological characteristics that have lasted longer than two continuous weeks, such as early morning awakening with difficulty returning to sleep, severe loss of motivation, energy, or interest in life (suicidal feelings, ideas or plans, constant sadness), and loss of appetite with weight loss.

      Although it is possible, in some exceptional circumstances, to "think our way out" of a clinical depression, it takes a huge restructuring of our lives, learning how to effectively reduce our emotional baggage, and a lot of support. For most of us, the most efficient way to fix the neurobiological elements is with an appropriate anti-depressant. However, anti-depressants only help the neurobiology. The particular stresses, belief systems, and environmental factors that may significantly contribute to a clinical depression are not fixed by anti-depressants.

      What are the psychological factors that can set us up for clinical depression? On a simple level, the answer is "stress." However, stress comes in all sizes and flavors -- what is stress to you is not stress to me. And, stress does not always come from external sources. We all have what I call "background noise" in our brains. The burden that background noise places on our brain is based on how much unfinished emotional business has built up in our lives and upon how much "negative" programming we have endured.

      Unfinished business is an easy concept to understand, but taking care of emotional business as it happens can be a skill that is difficult to learn. Stress-inducing belief systems consist of any beliefs that produce more stress than necessary, such as a belief that "we will always be criticized for what we do." If we grew up in a situation where we received a lot of put downs and severe criticism, we may learn to expect them. When we expect that a bad thing will happen, we automatically switch into a state of fear that sets off fight-or-flight responses. Relatively constant internally switched on fears often lead to clinical depression.

      We each have our own sets of programming -- what we have been taught to believe about ourselves, life, and relationships. If we take the time to contemplate or consult with someone about our programming, we can learn what controls our stress levels and get to a place where we can make more conscious choices about happiness.

      I hope this is helpful. For more information about programming, please visit AllAboutPsychotherapy.org. -- Best wishes, Dr. Ron.

        Author Bio:

        Ron Sterling, M.D. is a 64 year-old General and Geriatric Psychiatrist with a private practice in Seattle. He invites you to e-mail him at with any questions about mental wellness or emotional, relationship, or aging concerns. He is the only person who reads e-mail sent to Dr. Ron. Please be assured that your questions and identities are completely confidential and protected. Dr. Sterling has no financial interests or investments in any entities, whatsoever, that would benefit from the sale or distribution of melatonin products. For more information about Dr. Ron and for resources related to senior mental health, please go to SeniorMentalHealth.org. Read our Disclaimer. If you wish to understand more about Dr. Sterling's potential biases in health care advocacy, please check his Conflicts of Interest Disclosure Statement

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General Psychiatry with Specialization in Adult Attention Deficit Disorder
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