Understanding and Overcoming Depression

What Is Depression?

People often say that they are depressed. Everyone feels down now and then, especially after suffering a stressful experience, such as the loss of a job or the death of a favorite pet. People usually go through a period of mourning and then recover with the support of family and friends. Grieving over the loss of a loved one, although heartbreaking, is different from clinical depression. The following traits characterize clinical depression:

• An unrelenting sad mood.
• An absence of energy and vitality.
• Problems concentrating or remembering things.
• Loss of interest in activities that you once embraced and enjoyed.
• Difficulty sleeping and changes in appetite.

“Depression is a thief that steals from people, robbing them of energy, vitality, self-esteem, and any pleasure that they might previously have enjoyed.”

Depression is more than just a low mood that taking part in a pleasant activity or receiving nurturing from others can lift. People suffering from depression feel isolated and often withdraw from friends and family. They also feel terrible about themselves and believe that life will never be good again.

Depression’s Common Signs

“Depression is a state of profound psychological suffering that reduces a person’s sense of physical well-being.” It undermines the victims’ eating and sleeping patterns, and saps their energy. Most people suffering from depression exhibit symptoms in the way they “think, feel, behave and in their physical state.” These symptoms are interrelated; one feeds off another. The areas of concern include:

• Thoughts – For depressed people, thoughts are enemies, characterized by a constant stream of self-criticism, hopelessness, and negativity.
• Feelings – Fear, guilt, anxiety, loss of confidence, and worry are common manifestations of depression.
• Physical symptoms – Sleep disruptions, changes in appetite, and the loss of interest in sexual activity can all be symptoms.
• Behavior – Children and adolescents might become disruptive or exhibit other behavioral problems when depressed. Adults might seem irritable, inattentive, and lethargic, and have vague physical complaints. They might also use drugs and alcohol in an attempt to medicate the pain of depression.

Depression Takes Many Forms

People experience depression in different ways. Some people suffer from “dysthymia,” a low-level form of depression lasting for a long period. Dysthymia often goes unnoticed. Severe depression lasts for at least two weeks with strong symptoms and even thoughts of suicide. The terms “bipolar” or “manic depression” refer to a pattern of mood swings from elation and hyperactivity to severe depression.

“In spite of its frequency – depression has been called the common cold of psychiatry – only one in 10 of the people who become depressed seek help professionally.”

Depression can affect anyone, including children, adolescents and men, but the majority of sufferers are women between the ages of 25 and 65. Research confirms that women are more likely to suffer from depression than men.

The Causes

The three main factors that contribute to depression are “negative early life experiences, rigid rules for living, and stressful social pressures.” You develop your self-image during your childhood. An unresponsive or abusive parent, a parent’s harsh, controlling behavior, or a lack of affection can prevent a child from developing a positive self-image. The trauma from a bad experience, such as the loss of a parent, also can cause depression later in life if the child does not receive proper care and attention at the time of the event.

“Depression makes one self-centered, but not selfish. As with a throbbing toothache, it’s hard to think about anything except your own personal hell when you are depressed.”

People develop “rules for living” as a means of coping and controlling their lives. In most cases, these rules work toward fostering a sense of belonging and high self-esteem. However, if these rules are extremely rigid, a perceived mistake can bring on depression. For example, if your rigid rule for living is, “To feel good about myself, I must make sure I’m liked by other people,” you will feel successful only when you feel well-liked. When you don’t feel liked, you lose self-confidence and become vulnerable to depression.

“Perhaps the most common evidence of depression is this obsessive negative thinking from which depressed people cannot extract themselves.”

Your social circumstances can cause depression. Social factors that cause stress include poor housing, low income, feelings of isolation, and unsupported single parenting. However, research shows that if you have even one close friend to lean on during rough times, you are four times less likely to experience depression than someone who does not have this support.

“What hurts most when you are depressed is your compelling feeling that there will never be an end to your suffering.”

Many studies indicate that biochemical changes in the brain cause depression. These changes can be “genetic” or “evolutionary.” The genetic theory suggests that some people are more “genetically sensitive” to depression. The evolutionary theory states that the brain reacts to certain stimuli in specific ways. For instance, people become anxious when they feel threatened. When biological factors cause depression, doctors can prescribe specific medications to counteract the resulting neurochemical imbalances.

Hopelessness: a Roadblock

People suffering from depression feel that nothing is ever going to change. This feeling of hopelessness is self-fulfilling and self-defeating. However, if you are the victim of this feeling, you can take steps to overcome it. Instead of becoming overwhelmed by the enormity of your problems, break them down into actionable steps. Take one small step at a time and focus on getting that one thing done. Keep your expectations modest so that you are likely to be successful. Every small accomplishment acts to combat your feelings of uselessness. Try to think about things that made you happy in the past and imagine having them in your life again. Foster the thought that you are a worthy human being and do not deserve to be in pain. Lastly, remember that life can surprise you. Trust that you might catch a break now and then.

Defeating Depression

You might find that certain activities relieve the feeling of depression, at least temporarily. These strategies include taking a walk, listening to music, spending time with a dear friend, playing with a pet, resting, sleeping, and seeking comfort in your religion. However, if these activities are not enough to alleviate your sadness, you need an approach to recovery that “attempts to integrate physical, psychological, emotional, and interpersonal strategies for overcoming clinical depression.” Since everyone experiences depression differently, you may find some methods are more appropriate for you than others.

“People do change. They face difficult times and they grow stronger in themselves as a result.”

If an imbalance in the physical chemistry of your body is causing your depression, medication might be the answer. Medication can help relieve some of your physical symptoms so that you can find the underlying emotional cause of your depression. Although some doctors believe that you can treat depression solely with medicine, others feel that a more holistic approach is necessary. The majority of experts agree that the combination of medication and psychotherapy is the most effective strategy for overcoming depression. In addition to medication, you also can use exercise, diet, meditation, and sleep to combat the physical effects of depression.

“Counseling offers a space where you can be listened to with respect and explore ways to help you find your way through the darkness.”

A counselor or qualified therapist can help you work through the core reasons for your depression. With the support of a professional, you can safely explore the painful memories and experiences that might be at the root of it. As one patient wrote, “I would like to say to anyone who feels as I felt, that there is hope. You are as good as anybody else and the only one you have to prove that too is yourself. So get whatever help you need now.”

“Recovery takes a step forward each time we become aware of negative, distorted thoughts, and find a more compassionate way of talking to ourselves.”

The elements of a holistic approach to overcoming depression include:

• “Reduce stress” – A small change in your schedule often can make a big difference in your stress level. Try to cancel unimportant commitments, schedule time off, or ask for help to relieve day-to-day stress.
• “Challenge your negative thinking” – Pessimistic thinking patterns develop over time. Begin to notice these patterns and counteract them.
• “Keep a recovery journal” – Chronicling your thoughts can help you recover.

Taking the First Step

Depression makes you feel paralyzed, unable to accomplish even the simplest tasks. Your mind tells you that it is useless to try to do anything because everything is pointless. Taking action is the best way to break this negative cycle of thinking. Often, “action precedes motivation.” Small tasks, such as making a salad, tidying up a room, or paying a bill, can begin to alleviate your pain. Try to add structure to your day. Set one or two modest goals to accomplish and note how this makes you feel. Make a point of spending time with other people.

Taking Back Your Thoughts

When you’re depressed, your mind plays a continuous loop of negative thoughts, filled with self-loathing and criticism. The first step toward healing is to become aware of these destructive thought patterns. When you become upset, tune in to the circumstances that are making you feel that way. Listen to your body. Is your heart racing? What triggered this reaction? Next, identify and record your “negative automatic thoughts.” Once you identify the conditions that exacerbate hurtful thought patterns you can begin to “talk back to your negative thoughts.” Be kind and forgiving to yourself. For instance, you might cope better if you think:

• “I’m doing OK; this isn’t easy for me but I’m hanging in there.”
• “OK, so this didn’t quite work. I wonder why. It actually had very little to do with what I did.”

“We all need friendship to lighten the burdens we carry, to restore our trust in ourselves when we lose it, and to break the grip of loneliness that can so easily overtake us when we become depressed.”

People who suffer from depression have a negative self-image. Holding on to destructive beliefs about yourself prevents you from being who you genuinely are. This, in turn, prevents you from relating honestly to other people. When you are able to be yourself, you will begin to be free from needless anxiety, strain and frustration, and this will open the door to intimacy and friendship.

When Someone You Love Is Depressed

You may be in a situation where someone you love suffers from depression. You also may feel frustrated because you are not able to help. You might not recognize the behavior as clinical depression. You may blame yourself for not being able to change your loved one’s bad mood, particularly if nothing you do helps, and the person begins to seem self-centered and unwilling to change.

“Recovery from depression is a journey rather than a destination.”

Once you both understand that clinical depression is the culprit, you can seek external help together. Your role then becomes clearer. Try to avoid feeling hurt by your loved one’s seeming rejection. Remember that rejecting help from others is a symptom of depression. Give the depressed person the space to heal. Keep participating in activities you enjoy without feeling guilty. Finally, try to understand that you can’t make everything all better.

Recovery

The road to recovery does not run in a straight line. At times, you might suffer setbacks. Here are some things to keep in mind as you work on your recovery:

Remember your past successes.

• Understand that no one is happy all of the time.
• Take action whenever possible.
• Police your thoughts and be aware of negative patterns.
• Talk openly with those you can trust.
• Don’t take the blame for all the problems in the world.
• Make taking care of yourself a priority.

Bentley Moore Executive

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About the Author

Dr. Tony Bates treats people with depression in his role as senior clinical psychologist at St. James’s Hospital in Dublin, Ireland.