Depression

Depression is such a big subject and to discuss it in detail in a blog will not be possible.  I will, however, try my best to give you plenty of information without writing a book.  I have put together an Information Sheet on “What is Depression?”.  You can find it under the “What Is, When To and What If” tab on our the website.  Please feel free to print it out, share and do your part in bringing Mental Health Awareness to the forefront.

Most of us have heard the word “Depression”.  It may be from somebody close to us suffering from depression, reading about it on social media platforms or being diagnosed with depression yourself.  Unfortunately, it is not something that a person can simply “just get over”.  It is real and there are no easy cures or antibiotics that you can take to get rid of depression.

Depression is like flu or a cold, it can affect anyone.  To experience depression at certain times in your life is quite normal, for instance when you experience a loss of a loved-one or experience a disappointment or even a rejection.  You might feel grumpy or irritable, even sad, blue or down in the dumps, but it becomes a problem when it interferes with your daily functioning or persist for too long.  When sadness or irritability takes over and the feelings of giving up or hurting oneself starts to become more prominent and intense, then you know that it is important to get help.  Unfortunately, depression tends to come back even after one episode gets better and therefore it is good to learn how to deal with depression and to give attention to triggering events and your thought processes.

But what keeps our depression going?  Have you noticed that your thoughts, emotions, physical sensations, and behaviours are all connected?  When we experience negative thoughts, either we tend to view matters in a all-or-nothing way, we could start putting blame on other people, we start discounting our own successes and maximising our failures or we could even overgeneralise one bad interaction and think that it will always be that way.  People who are low or depressed are usually very critical on themselves and others and might say or think things like, “I am boring”, “I am ugly”, “No one likes me”, “Everybody is better than me” or even “What’s the point of even trying?”.  These thoughts then affect our emotions which can even manifest in bodily sensations, like stomach pain, headache or even palpitations when the feelings are unhealthy.  Other unhealthy feelings are irritability, anger, hostility, despair, despondency extreme sensitivity to things that happen or difficulty concentrating.  When we focus on these negative emotions, it leads to behaviour that reinforces negative thinking, which in turn creates a vicious cycle that gets hard to break  It clouds the way that we interpret situations and ensure a negative outlook on life.  Self-defeating behaviour like withdrawal, isolation, excessive crying, substance abuse, self-harm actions (cutting or suicide attempts) or even talking or trying to run away from home are behaviours that is seen as symptoms of depression.  Some symptoms can be risky and dangerous, and it is especially important to talk to someone that you trust right away.

Here are a few different types of depression and a short description to go with it:

• Major Depression – experience symptoms every day for most of the day irrespective of what is happening – lasts weeks or even months
• Persistent Depression – severity of symptoms can become less intense before worsening again – lasts for two years or more
• Atypical Depression – depression temporarily goes away while experiencing a positive event but returns after hype of positive event fades
• Seasonal Depression – related to certain seasons, mostly winter months as it changes your bodily rhythms in response to decrease in natural light
• Psychotic Depression – losing touch with reality and experiencing delusions and hallucinations, problems sitting still or slowed physical movements
• Secondary Depression – predominantly in individuals who has one or more pre-existing, nonaffective psychiatric disorders or an incapacitating or life-threatening medical illness which precedes and parallels the symptoms of depression
• Peripartum/Postpartum Depression – Peri-(onset within 4 weeks before childbirth). Post-(onset after childbirth).  Hormonal changes that trigger changes in the brain that cause mood swings
• Situational Depression – feelings brought on by specific events or situations such as death of a loved one, divorce, abuse, financial difficulties or legal troubles but where the feelings start to feel out of proportion to the triggering event

Even though I have written a few behavioural symptoms of depression above, it is important to note that depression is not always easy to observe.  It can be silent.  You might be experiencing it right now, but you feel it in your gut that something is wrong.  You quickly silence the warning signs and project a “perfect” life.  You are successful, you smile, communicate easily, do not express painful emotions easily, do not isolate, and you seem to have a perfect-looking life.  You might even rally forth and put a smile on your face despite struggling every day.  You are so used to coping and masking your despair and intense loneliness that your pain stays silent and you count on your coping skills and your perfect life to carry you and mask your vulnerability.

You might be asking what causes depression.  Depression is usually caused by a combination of things (triggers), such as chronic illness, chemical imbalance in the brain, loss of a loved-one, divorce or even a breakup or rejection from a boyfriend or girlfriend.  Stressful life events or changes can also lead to depression.  People who have a close family relative who suffers from depression are also more likely to experience depression, as it seems to run in families.

In the COVID-19 pandemic that we currently live in, depression could be triggered by being separated from someone that you care for or value  Reading about other people’s problems in the world could also serve as a trigger.  Other triggers could be:

• Not getting what you want or what you worked for
• Being disapproved or disliked by people that you care about
• Discovering that you are helpless or powerless
• Being with somebody that is sad or in pain
• Feeling rejected or excluded
• Feeling lonely
• Stopped doing something that you used to enjoy (practising a hobby or socialising with friends)

Now for the part that, most probably, drove you to read this blog.  Here are a few suggestions on how to deal with your own depression or how you can help somebody else with their depression.

How you can help somebody who is Depressed:

Do not judge your loved-one or friend for the depression that they are experiencing.  This will only lover their self-esteem and push them away from you.  Also avoid telling them to “snap out of it” or “get over it”, it is not so easy otherwise they would have done so at the beginning when they started to feel drained and down.  Pushing them too hard will also serve as discouragement.  Rather praise them for the effort that they are putting in and help them along through the small steps that they are managing to take.

• Recognise Depression as an Illness. As mentioned earlier, just like flu or a cold, a person cannot simply decide or choose to “get over it” or “shake it off”.  It affects people from all walks of life and it is real.

• Be supportive and reach out. Encouragement is one of the most important things that you can do.  Tell the person that you are there for them and that you are willing to participate with them on their journey.  Tell them that things will get better if they keep on working on themselves and reassure them that better days will come.  It might seem to them as if they are in a dark hole, but with your support, encouragement, and reassurance, they will feel the motivation to work towards a better life.  Check in regularly and encourage them to talk.  Should they wish to talk to you, listen attentively, respect their feelings and acknowledge that their feelings are real to them.  You might not always understand what they are feeling or what they are going through, but your support can give them the strength that they need.

• Offer to help. Try not to bombard the person with offers to help as this could cause the person to feel incapable of taking care of themselves which can lead to anxiety.  Once a day should be sufficient.  Ask what they might need or how you can help.  The important message here is that you are showing them your support and willingness to help them if there is something that they cannot do for themselves.

• Meals and Snacks. Most people with depression suffer with a poor appetite and very low energy levels.  Sometimes it could be an effort for them to get up to make something to eat.  You could offer to cook dinner or to get take-out.  Encourage the person to eat regular meals or to enjoy light snacks.  It is important not to force feed, but rather encourage small mouthfuls a few times a day until their appetite is back on track.

• Research.  I love researching various subjects that interest me and to stay abreast of the latest therapeutic material.  We have often solved various conundrums by typing in a few words in the search bar.  Ask your friend or loved-one if they will mind if you do a bit of research on their diagnosed depression and how to effectively help them at home.  This will make them feel that their feelings are being validated and that you are showing interest in their well-being.  The internet is full of wonderful information but read a few articles and papers to get a bigger picture of their diagnosis.

• Support Groups. Introduce them to support groups that you know about in your area.  The aim here is to let the person feel less isolated and more understood.  Support groups are wonderful when people who went through similar situations talk about their struggles and victories as they went along their journeys.  Social interaction also helps combat depression and contribute towards mental health.

• Activities.  Motivate the person to get a bit of fresh air and sunshine.  Ask them to take a walk with you around the block or up and down the street.  You could even ask them to sit with you on the patio for a half hour.  Exercise is also a great mood-booster and a few yoga stretches or a few silly dance moves could do the trick.

• Sleep.  You might have notices that your friend or loved-one is sleeping a lot.  Discourage naps and sleeping to much.  Get them out of the bed.  Give them the tools on how they can improve their sleeping habits to form consistent sleeping patterns.

• Drugs and Alcohol. Discourage the use of alcohol and drugs as it disturbs their ability to cope and their sleeping patterns.  You might want to monitor their intake of these substances as a precaution.

• Help.  Get them help.  Should you notice that things are deteriorating, get help, especially when you see that their comments and gestures are deteriorating instead of improving.  Suggest that they seek professional help from a therapist, psychologist or counsellor.  You could offer to make the appointment, but it is always good if the person takes that step as it is the first step that they are taking to take back control over their lives.

How you can help yourself if you suffer with Depression:

• Understand.  Understand how depression affects your feelings, physical symptoms, thoughts and behaviour patterns.

• Challenge.  Challenge your unhealthy and unhelpful thought processes to help you see your situations in a clearer and more realistic light.

• Active.  Find healthy and practical ways to become more active and make good use of your time.  Get out in the open air, feel the sunlight on your skin and do a bit of exercise by walking, stretching or working in the garden for a while.

• Acknowledge.  Notice and acknowledge your good qualities and strengths.  Give yourself credit for what you have achieved up to now, no matter how small it seems to you.

• Sharpen your skills. Improve your problem-solving skills.  Set up goals, break them down into smaller steps and work diligently towards your ultimate goals.

• Look after yourself. Eat nutritious meals, even if it is only a few bites at a time.  Give attention to your sleeping patterns and cultivate a healthy sleeping pattern.

• Socialise.  Socialise with people that you trust and care for.  Even if you talk to a support group, interaction with others in an uplifting and positive manner can enhance mental health more than you would think possible.

• Time.  Make good use of your time.  Do something that you love, like a hobby or another interest that you are passionate about.  Remember to also make space for some down-time where you allow yourself to relax, ground yourself and spoil yourself between your other activities.

• Treat yourself. Treat yourself by spoiling yourself on something that you really enjoy.  You might want to reward yourself for achieving a goal by buying something nice that you saved for.

• Be flexible. Work on how flexible our mind really is.  When you work on a problem and the solution is not working, become flexible in the way that you work towards finding another solution.  You can even come up with different solutions to see which one will work out the best in the situation.  Remember to acknowledge what you have control over and can change and what you do not have control over and cannot change.  There is no need to worry about something that you do not have control over, it will only drain you and put you in a downward spiral.

• Reach out. If you do feel that you are not coping or want to prevent your depression advancing to a more serious phase, please reach out to a therapist, psychologist or counsellor for professional help and support.

It is important for all of us to have support systems in our lives, especially when depression becomes part of a draining cycle.  Some situations you might know how to handle, but others not and that is where you can take the steps towards learning, development, growth and mental wellbeing.  Examine your own emotional health, your own capabilities, time and patience to make sure that you do not forego your own wellbeing.

As always, I like to end my blog with a quote or two and the following really enforces what I am trying to say in this blog.  The first one if from John Green who said, “There is hope, even when your brain tells you there isn’t.”, and this one from Brooke Davis who said, “Sometimes, life will kick you around, but sooner or later, you realize that you’re not just a survivor.  You’re a warrior, and you’re stronger than anything life throws your way.”.  As a little bonus, here is an extra quote from Anonymous who said, “I have endured pain and loss.  I have felt broken.  I have known hardship, and I have felt lost and alone.  But here I stand, trying to move forward, one day at a time.  I will remember the lessons in my life because they are making me who I am.  Stronger.  A warrior.”.

As a reminder, GEM Mental Health Therapy and Coaching has decided to offer Skype Video Calls, Zoom Video Meetings, WhatsApp Calls and WhatsApp Video Chats in order to reach as many people as possible.  I have also decided to incorporate Counselling via Email, which seems a bit unorthodox, but some clients do not have the freedom and privacy to discuss heart matters in the enclosed environment that they find themselves in at this time.  Please do not hesitate to reach out so that we can work together on your mental health as we face these challenging times.

Thank you very much for reading my blog.  I truly hope that it helped somebody, somewhere.  Please send any feedback or comments to info@gemtherapy.co.za and remember to have a look out for a new blog every week.