Depression
What is it?
Everyone feels a little low from time to time. Sometimes, though, an experience of 'feeling down' hangs on and is reluctant to let go; that's when ordinary feelings of sadness can turn the corner into depression.
Depression impacts how we feel, how we think, how we act, how we experience our body physically, and how we relate to others. Because all these parts of who we are are powerfully interconnected, depression can build momentum quickly.
Depression negatively affects the way we see ourselves and others, it diminishes our ability to experience joy, robs us of energy, impacts our ability to concentrate and make decisions, affects sleep and appetite, and interferes with our ability to function effectively in our lives.
Multiple factors can contribute to our susceptibility to depression and/or be triggers for depressive episodes:
family history of depression
major losses or grief
history of trauma/abuse/neglect
social isolation
interpersonal problems
family of origin issues
unresolved emotional conflicts
major life stressors
physical/chronic health issues
poor sleep and nutrition
post partum factors
lack of life direction/purpose/meaning
Depression can have serious consequences to our lives including loss of productivity or inability to work, disintegration of important relationships (partners, friends, family), and physical health concerns. Unaddressed suicidal thoughts or feelings (sometimes an associated feature) can even make depression a life threatening condition.
Loops of negativity and avoidance
Depression comes in many shapes and sizes. No two people experience it exactly the same way. Some cases are mild, some more severe. Some are chronic, others are more episodic.
What seems to be a common element of depression, though, is the way in which it is maintained and reinforced when loops of negativity and avoidance start to crowd out our normal, healthier ways of being in the world. These loops of negativity and avoidance evolve something like this:
I have negative or self-critical thoughts. These simmer inside and create feelings of sadness, low self worth, worry, guilt, or shame. Feeling vulnerable, I keep these thoughts and feelings to myself. I worry people will judge me if they know how I'm really feeling. Unfortunately, this leads to increased feelings of isolation. As a result, I become more preoccupied with my own negative thoughts and feelings. This, in turn, leads me further away from reaching out to my friends/family/partner (the same people who actually might be able to help).
As negative feelings intensify, I begin to pull away from life. I don't want people to see me at my worst. I don't want to bring others down. Over time, I stop engaging in the normal day to day, life giving activities I used to engage in. Trying to 'feel better' I may turn to over-eating or excessive drinking to help manage my mood. I might sleep all the time or I might not be able to get much sleep at all. My mind begins to feel less sharp and focused, more fatigued. Neglecting my physical needs, my body starts to betray me with aches and pains, less energy, more lethargy. Feeling badly about my body, I have even more negative thoughts and feelings and retreat even more from the activities and relationships in my life that I used to love (the same activities and relationships that might be able to pull me out of this funk).
If this pattern continues long enough, I'll find that I won't have the physical energy I need to be active, work productively, or get out of the house. I won't have the mental energy I need to see things clearly and to challenge or understand all the negative thoughts I'm drowning in. I won't have the emotional energy I need to be more kind and compassionate toward myself -- so I'll feel worse, think more negatively, and avoid and retreat more. On and on the pattern goes...
Most of us have some experience with smaller versions of this negative cycle. When emotionally healthy, though, we are more resilient and are able to keep these loops from pulling us down. We intervene early -- addressing our feelings or thoughts, reaching out to others, staying involved and engaged in our lives in meaningful ways, and taking care of our physical needs.
Some of us, however, are more susceptible to getting stuck in these loops. When these loops stick around too long, they develop well worn pathways in the brain, in our habits, and in our self concept making recovery difficult.
getting Better
The good news is that your depression can be treated. Intervention for depression requires taking a deep look at how you think, feel, behave, relate to others, and care for yourself physically. It requires understanding and disrupting these loops of negativity so you can approach your life again instead of turning away.
In order to loosen depression's isolating grip, you'll need to make emotional contact with an understanding, knowledgeable, and compassionate other. This is an important first step and why a good therapy relationship is crucial.
A careful assessment can help determine what's unique to your depression and how to treat it. How do you experience your depression? How did it evolve? What are some likely causes and triggers? Is there a family history? How does the depression impact your thoughts, feelings, and actions? What seems to get in your way of getting better? Has anything helped in the past? What makes it worse? Do you have a support network? How do your loops of negativity and avoidance work? Is a medical evaluation needed to rule out physiological factors or look at possible medication options?
Once we have a clear idea of what your depression looks like, we can start working to treat it. Here are five important steps in recovering from depression.
Step 1: Learning to Relate to Suffering with Compassion
One of the hardest but most important parts of your recovery from depression will be learning how to move toward and not away from thoughts, feelings, and actions that are uncomfortable. You'll need to learn how to relate to the pain you experience differently. Instead of constant judging and criticizing, you'll need to learn to tend to yourself with compassion, kindness, and acceptance. Learning to accept yourself just as you are has a paradoxical effect of freeing you up to feel something different.
Step 2: Making Sense of the Story of Your Life
You'll need to look at, understand, and work through hurts from your past -- not wallow in them or play the blame game, but truly understanding and making sense of your life story so it so it doesn't control or define you. Mending hurts in present relationships too will be important.
Step 3: Developing a Comprehensive Self Care Plan
You'll need a self care plan that involves exercise, good nutrition, and good sleep hygiene. You'll need to understand depression comprehensively; addressing the feeling parts, the thinking parts, and the behavior/habit parts. You'll need to look at how they all work (or don't work) together.
Step 4: Rediscover Your Life's Meaning and Purpose
You'll need to remind yourself (or maybe discover for the the first time) what is important to you, what is meaningful, what gives your life purpose. Treating depression isn't about 'removing negative feelings'-- it's about understanding them, learning to live with them, and about giving you something to live for.
Step 5: Building and Leaning on a Support Network
You'll need to bolster and lean on your support network. If you don't have one you'll need to work to create one. This may involve risk and discomfort in allowing yourself to need others, so we will work on this together. Learning how to identify what your needs are and then work to get them met is a crucial part of immediate and ongoing healing.
change through Patience and Persistence
All of this requires commitment to the process of getting better, a willingness to change, and patience with yourself. Change doesn't happen in a day. Getting better is a process, not an event.
With persistence and with support, depression doesn't have to keep you from living the kind of life you want. In time, understanding and working through your depression can give you a greater appreciation for life, a unique sensitivity to the suffering of others, and a greater sense of life purpose.
How can I help? Schedule your first session or set up a free phone consultation.