Depression

Please Note These Articles are meant for information purposes only and are not a substitute for Medical or Psychological treatment.

Clinical depression is one of the most painful mood states that can be experienced. There is a vast difference between feeling down in the dumps and depressed. The symptoms can be both physical and emotional and seriously affect a person’s ability to function. Depression has often been described as anger turned inward. This is often the result of people blaming themselves for not living up to their own expectations or the expectations they believe others have of them.
People commonly think of depression as a sign of weakness and label themselves as useless. It can be especially painful to be told“ Pull yourself together” - because that is exactly what the depressed person wishes they could do. The fact is that clinical depression is a serious condition that requires medical and psychological evaluation.

The symptoms of depression include:

•   Feelings of hopelessness.
•   Lack of motivation.
•   Low self-esteem.
•   Feeling guilty.
•   Negative thinking
•   Suicidal thoughts and feelings
•   Sleep disturbance.
•   Appetite or weight changes
•   Loss of sex drive
•   Loss of interest in life
•   Fatigue

How to cope with depression.

Identify what may have caused your depression. It is important to identify what may have triggered your depression. Have you recently suffered a loss? Moved home? Are you isolated from your family and friends? Do you think of your self as a failure? Once you have identified the possible reasons for your depression you will be in a better position to do something about it.
Exercise on a regular basis. Swimming, walking or riding a bicycle are all good forms of exercise and will release endorphins, the body’s natural anti-depressant hormone.

Put some structure into your day. Include activities that you would normally find pleasurable. You may think that in order to achieve something you have to feel like doing it. In fact the reverse is often true; it is the doing that will give you the feeling of accomplishment and will spur you on to achieve your goals.

Talk to someone you trust. When you are feeling depressed communication is important. Express how you feel by talking to friends and members of your family.

Challenge your negative thinking. You may have noticed that when you feel depressed your style of thinking is pessimistic. You may have thoughts such as “I shouldn’t be feeling like this” or “I am weak person for feeling depressed”. Identify your irrational thinking and challenge it. Stop defining yourself as incompetent and useless.

Seek professional help. Sometimes depression is the result of a chemical imbalance and may need to be treated by medication. Counselling and psychotherapy can be helpful for most types of depression. Whatever the cause of your depression it is important to seek professional help.
The distortions in your thinking.

The psychiatrists Aaron Beck, who developed cognitive therapy, and David Burns an innovator in the field have identified specific forms of distorted thinking. Called cognitive distortions they can lead to feelings of depression and other negative emotions. Some of the most common types of cognitive distortions are:

All or nothing thinking. This involves looking at things as either black or white, good or bad, leaving no room for middle ground. You might believe “Either I succeed at everything I attempt or else I am a total failure.” Jim had successfully stopped smoking for three months but then experienced a stressful event resulting in him smoking one cigarette. Jim thought, “That’s it, I’ve blown it completely!” This thought upset him so much that he went on to smoke an entire packet of cigarettes.

Predicting the future. Without evidence you predict that things will turn out badly. After being ill for three months Penny thought “I will never have the energy to work again” Happily Penny returned to work the following month. Whenever Penny starts to worry she now asks herself. “Am I jumping to conclusions?”

Mind reading. Again without evidence you believe you no what other people think about you. At a social gathering Sandra accidentally dropped a glass of wine, she thought to herself “People will think of me as totally incompetent.” Moments later someone she had never met told Sandra that only the previous week she had dropped a drink in a similar situatiation. That was the start of a new friendship.

Labelling. When you have done something wrong or made a mistake you label yourself a “failure” “stupid” “weak” etc. When Richard failed to complete his exam paper he thought, “I’m a failure” Labelling is irrational because you are not the same as what you do. You are therefore not a failure but a human being that will sometimes fail.

Mental filter. You filter out all the positive aspects of a situation and focus only on the negative details. Despite four newspapers giving excellent reviews to Michael’s performance in an amateur play, one paper was very critical. Michael ignored all the positive feedback and focused exclusively on the negative review. When people focus exclusively on the negative they greatly reduce their happiness.

Personalising. When something bad happens you may see it as totally your fault. Even though you may have little if anything to do with the situation you blame yourself and overlook how others might be involved. Patrick’s thirteen-year-old son was caught stealing sweets from a shop. Even though Patrick had always tried to teach his son right from wrong he thought, “This proves what a poor role model I am.”

How to lift yourself out of depression.

Dr David Burns has suggested a powerful way of transforming your mood.
This is how it is done:

1. Take a pen and paper and draw a line down the middle of the page.
2. In the left-hand column write down all of your negative thoughts about an upsetting situation.
3. Look at each thought and begin to challenge them by asking yourself the following questions.

What errors am I making in my thinking?

Am I looking at things as either black or white leaving no room for middle ground?

Am I predicting the future, thinking that things will turn out badly without the evidence to support my conclusions?

Am I mind reading, believing that people are thinking badly of me without evidence to back it up?
Am I labelling myself?

Am I focusing exclusively on the negative and ignoring the positive?

Am I personalising - seeing the situation as totally my fault?

4. In the right hand column substitute more realistic thoughts that counteract the negative ones.
This straightforward technique is a very helpful way of changing your feelings and lifting you out of a depressed state.

An Example

In my work as a therapist I have found a frequent cause of anxiety is Performance anxiety.
This includes public speaking, asking for a pay rise, going for an interview, meeting someone for the first time, and taking an exam. The common attitude that leads to performance anxiety can be summed up in this way. “In this situation whatever terrible thing can go wrong will go wrong and if it does I could not possibly stand it”. Dr Albert Ellis has called this catastrophizing. People commonly believe that in order to be able do what they fear they first have to overcome their anxiety. In reality the reverse is true; the key to conquering anxiety is to actually do whatever makes you anxious. Recognise that whatever is worrying you is unlikely to happen and even if it did you would probably be able to cope.

How to cope with anxiety.

Remind yourself that feelings of anxiety always pass.
Distract yourself by focusing your attention on someone or something in your surroundings.
Practice relaxation and deep breathing.
Visualise somebody you trust offering you words of encouragement.
Remind yourself that whatever you fear happening is unlikely to happen, and if it does tell yourself that you will find a way to cope.
Take some physical activity such as brisk walking, running or swimming.
How to cope with worry.
Set aside ten minutes every day to worry. Worry as much as you can for that period of time and then tell yourself that you are not going to worry again till tomorrow.
Think of an amusing scene. For example picture Corporal Jones from the popular television comedy Dads Army running around shouting “Don’t panic don’t panic”.
Write down what is worrying you. Make a list of all the things you would like to do about the situation. Study this list and then tick all of those that in reality you can do something about. . Act on those - and let go of the others.
Picture yourself coping.
Negativity feeds off itself. So if you are always thinking the worst then you may actually talk yourself into more than your fair share of bad experiences. You can use visualisation to cope with a situation that you fear. This is how it is done:

1. Sit in a comfortable position and close your eyes.
2. Vividly imagine the situation you are anxious about.
3. Feel your anxiety rise.
4. Now picture yourself coping with the situation.
5. Imagine that you are using a breathing technique and talking to yourself in a calm reassuring way. Use coping statements such as “This is just anxiety it will soon pass” “I know I will be OK” “This is not as bad as I think”
6. When you feel your anxiety decrease, open your eyes.
Practice the exercise unhurriedly two to three times each day allowing five to ten minutes each time. If you have a stressful situation coming up, allow as much preparation time as possible. You should start to notice a change in your anxiety after about 30 days.