People get depressed for many reasons, but weakness of character isn’t one of them. It’s true, of course, that depressed people have “stinkin’ thinkin.'” But stinkin’ thinkin’ isn’t the cause of their depression. It’s a symptom of it. Advances in brain research have revealed that the brains of people who are actively depressed do not function normally because of reduced amounts of dopamine, norepinephrine, and serotonin, key neurotransmitters responsible for mood regulation, reward-seeking, and overall sense of well-being.
People get depressed for many reasons, but weakness of character isn’t one of them.
Nobody chooses to be depressed. Depression is a biological illness brought on by a combination of external and internal factors. It is a unique illness in that it wreaks havoc with every system of the body. It kills sleep, appetite, energy, mood, and libido. It can also cause: aches, pains, heaviness in the limbs, poor digestion, irregular heartbeats, electrical surges in the head, crippling anxiety, and feelings of guilt, shame and unworthiness.
The best known feature of depression is anhedonia, the inability to feel joy. But the worst part of depression isn’t the lack of joy. It’s the inescapable presence of dread.
According to the National Institute of Mental Health, 15% of the adult population–or 15 million people–suffer from depression each year. Forty million suffer from anxiety disorders. In older adults–especially women–these numbers are even higher. And the numbers are rising, especially among children.
Antidepressants have recently been shown to promote neurogenesis–the formation of new neurons in the brain. So don’t be a hero. Not all suffering makes you stronger.
So, if you’re suffering from depression or anxiety, there is no need to feel shame. You’re not alone, and you won’t always feel this way. I promise. There are things you can do right now to start feeling better.
- Tell someone who understands depression because they have been there and they got better. Ask them to tell you the parts of their story that make you feel more hopeful. I remember begging my best friend to “Tell me that great story about how you were rocking on the bathroom floor and thought you were going to die, but you didn’t die and then you got better.” It sounds crazy, but I loved that story.
- Read or write. Both of these activities are inherently soothing because they require concentration, a higher brain function than the fear-driven parts of our brain that make us feel like we’re out of control.
- Do anything that works (as long as it doesn’t hurt anyone).
- Don’t beat yourself up if affirmations don’t do it for you. If affirmations work for you, go for it. I remember wanting to punch people who told me I just needed to think positive thoughts. To a happy person, positive thoughts come naturally. To a depressed person, positive thoughts are lies stupid people tell us in order to make themselves feel better.
- Do watch this amazing video on depression by Robert Sapolsky. Watch it with your loved ones. It will help them understand the reality of what you’re going through.
- Use distraction all you want. Watch television, listen to your favorite music, find ways to pass the time that don’t hurt you. Sometimes, passing the time till bedtime is hard enough by itself.
- Exercise. Walk, run, do aerobics, develop a daily yoga practice. Exercise releases healthy brain chemicals and burn off the adrenaline that ruminating only perpetuates. Doing any of these activities reminds the body that it still knows how to act normal. My favorite saying was “It probably won’t help…but doing what I’m doing right now (ruminating) will definitely make it worse.” So just do it.
- Maintain normal sleeping habits. I am not a doctor, but I do know that if I don’t sleep well–and most depressed people have sleep problems–I get fragile. And , fragile means that I start to get shaky. And shaky is a trigger for my brain to start thinking I might be sliding into a dark place. So take care of your sleep. And if you’re not sleeping well, talk to your doctor about getting some help with this, ASAP.
- Unless you’re an addict, don’t be afraid or too proud to try medication. Untreated depression can be damaging to your brain (it actually shrinks the hippocampu–which is involved in regulating emotion and is involved with long-term memory) and to your heart (thought to be as hard on the heart as obesity). And anitdepressants have recently been shown to promote neurogenesis–the formation of new neurons in the brain. So don’t be a hero. Not all suffering makes you stronger.
- Find a doctor with a steady hand and a kind heart. I can’t stress this point enough. If you don’t like your doctor, find another. If you don’t like that one, take a deep breath, and put the energy in to finding a good one. A good one will talk to you about all of the above, but will also talk to you about medicatioin. That way, you can make an informed decision about what the best all-round program is going to be for you.
- If you’re trying medication, give one medication a fair trial before adding another. With medication, it’s easy to give up too soon, either because the initial side effects are bothersome, or because you think you should be able to handle your depression without it. Some side effects are bothersome, but transient. Some are intolerable. Talk to your doctor if you start something and are worried about any side effects you may be experiencing. One medication may be well-tolerated by one person, but cause weird side effects for another. If you hang in there, and you’ve got a doctor who is paying attention and is competent to tweak, change, or add something, you are very likely to find something that works for you. But don’t expect any medication to work fast. Generally, they take weeks to work.
- Find a therapist who really understands depression. Before you choose a therapist, talk to her on the phone. Ask her about her experience treating depression. Ask her if she’s ever been depressed. If she asks you why that’s important to you, tell her. Tell her you’re looking for someone who has been through a depression and has successfully come out the other side. Some therapists will be honest with you about this, many won’t. My belief is that therapists need to be the first ones to combat the stigma surrounding mental illness. If they ask, I always tell clients the truth.
- Use Dip-Shifting to exit negative patterns of thinking and acting. The Dip-Shift Process is a mindfulness practice that develops your ability to recognize, interrupt, and disengage from disabling thoughts, so you can redirect your attention whenever and wherever you choose. Click on the link above to download the free instructions on my website.
- Ask a good friend to call you every morning. Depression is a lonely, alienating experience. One of the reasons is that your inner suffering is often misinterpreted by those around you as stand-offishness, disinterest, grumpiness, or selfishness. Find someone you trust and ask them to check in with you every day. Morning is a good time because it reminds you that you are not alone, even though you may feel alone in your suffering.
- Call a Helpline or Suicide Hotline if you feel at risk of harming yourself. The link here gives you lots of options. The bottom line is that you won’t always feel this way. When my husband used to say, “Let’s see what your doctor has to say,” my response was always: “What’s she gonna say?” And then we’d go, and more often than not, my doctor would have something to say that I hadn’t thought about. If nothing you’re doing is working, it might be time to find another doctor. Sometimes, we’re so exhausted that it feels like too much work. But it could just be that the well-meaning doctor you trust has run out of ideas. It happens. And if worse comes to worse, check yourself into a hospital. I know it’s a last resort, and it should be, especially if you’ve got loved ones around you at home. But if you’re really desperate, go to the ER. Thinking about hurting yourself is a medical emergency and should be treated that way. Seriously.
The last thing I want to say is that if you’re someone who suffers from recurrent depression–meaning it comes and goes–there is a program that’s been proven to cut the relapse rate in half. It’s called “MBCT,” which stands for Mindfulness-Based Cognitive Therapy. It’s a highly structured, 8 week (1X week for 8 weeks) class that helps you develop a daily practice of simple yoga, sitting meditation (a non-religous form of meditation that helps you steady your mind), and cognitive therapy (a type of therapy that teaches you how to exit negative thought loops and challenge distorted thinking).
The program works best for people who have had 3 or more episodes of major depression, so that’s the great news. The not as great news is that it’s hard to meditate in a shit-storm. Meditation is a practice that’s easier to learn when your mind is relatively healthy. It’s still worth trying. But if you’ve got an anxious depression that makes it impossible to sit still without feeling like you’re going to explode, it’s best to start with a yoga practice, tai chi, or a walking program. All of these allow you to move and require a fair amount of concentration. When your mind is steadier, meditation will be easier to tackle. Then the challenge is to keep it up.
Good luck, fellow travelers.
If you’re looking for mindfulness-coaching or therapy in Minnesota, contact Betsy through her website at BetsySansby.com.
Photo credit: Abigail Keenan