As a therapist I often meet with individuals who are dealing with depression but I’m no stranger to it myself. Winston Churchill described his bouts with depression as a visit by the “black dog.” My experience is more of a grey fog. I’m probably more accurately diagnosed as having occasional dysthymia – a low grade depression – one that allows me to function for the most part – not super high, not super low – just ok, but usually feeling just a little blah. The fog analogy works well for me – imagine a grey thickness hovering close to the ground that sometimes reduces visibility, blocking out the sun, leaving you feeling sluggish and weighed down.
One winter a couple years ago I had a particularly bad week. It was dark and cold (as winters often are) and I experienced several frustrating encounters with a coworker, but mainly I just felt bad, weighed down and lacking energy. It felt like I was covered in a heavy x ray protective apron – but instead of protecting me from radiation, I felt as if it exposed me and all my inner turmoil for everyone to see. I knew that I was experiencing a more acute moment of depression. (And, surprise, surprise, depression can make you more sensitive to others remarks and more liable to misinterpretation.)
My experience that year brought into focus what is helpful when we find ourselves feeling depressed. Sometimes it is difficult to find the right words to say to someone when they are experiencing depression. Sometimes the grip of depression can feel and be very powerful. But there are things that can help in a very practical way. Wherever you or a loved one might be on the depression spectrum, there are several things you can pay attention to – I call them the P’s of depression – that can be instrumental in helping you or others navigate depression with integrity and health.
SymPtoms
Depression (which is much more than sadness, something we all experience at different times) can show up with many symptoms including: loss of interest in typical activities, loss of energy and appetite, a ‘closing in’ or ‘closing down’, sleep changes (including difficulty going to sleep, staying asleep or wanting to sleep much more), a physical sensation, a weight, anger and irritability, feeling helpless and hopeless.
Depression is personal and unique. Though there are common causes and symPtoms, depression can affect each of us in different ways. Thus I believe that the treatment of depression will also be personal and unique, though there are some general ideas and solutions to pay attention to that may be helpful.
Precipitators (Common Causes)
PROBLEM – There can often be a very real and specific problem that is affecting your mood and emotion. This can be a PHYSICAL health issue or a PERSONAL relationship or PARTICULAR situation that is causing PAIN and pain is very real. Any loss can lead you in the direction of depression
PURPOSE – Depression can occur when you don’t feel like you have a PURPOSE – whether that is because of a change in your family, job or a variety of other reasons. If you feel like your PRESENCE is not valued or you don’t know your PLACE anymore this can affect your purpose in life.
PRECIPITATION – You may laugh, but once I left the gray and cloudy Pacific Northwest and moved to the East Coast, my overall countenance improved. My wife and I joked that we literally saw the light. I was never officially diagnosed with Seasonal Affective Disorder (SAD), but having more sun helps and I don’t miss the gray!
Depression – The P’s that can help (in no order of importance)
1. Psychologist/Psychiatrist/TheraPy – This might be the most readily encouraged solution and there’s a reason for that. Talking to someone can help. Talking to someone who is trained in the ways of the human mind and heart and knows how to be helpful is even better. And if that helpful person is also a medical doctor he or she can do a physical evaluation to assess if hormones and chemicals are in balance and prescribe medication if it is needed. (see #2)
2. Prescription – I’m not a pill pusher, but I’m also not a pill avoider. We are probably over diagnosed and overprescribed in this country, but medication can be very helpful in many situations. Don’t discount it, but do know that it might take some time and adjusting to find the right medication and dose for you.
3. Purpose – Losing your sense of purpose can quickly take you to dark places. I find that when I start to sink, it’s because I feel like I don’t have a purpose. I can quickly spiral down wondering what I am doing with my life. Do you need to make a change as a result of a circumstance that has changed? Or do you need to pay attention to #4 and #5 – ways that you can be reminded what your purpose is.
4. People – Often when depression occurs, you might not want to spend as much time with others. You may feel annoyed by them, you may feel you are only going to bring them down, but whatever the reason, you still need to spend time with people, perhaps now more than ever. Friends are there to walk beside you and sing your song when you can’t sing it yourself. Having some alone time is fine, withdrawing from everyone is not and may make things worse.
5. Perspective – One of the first things that depression can affect is our perspective. It’s not as easy to see or interpret situations when we are depressed. So it is important to pay attention to your perspective and actively pursue a healthy perspective so you can make healthy choices. # 1, 2, and 4 can all be incredibly helpful in ensuring you have a healthy perspective.
6. Practice the Practical - I’m not for pretending that things are ok, but sometimes acting like you are not depressed can help – go out to dinner, go for a walk, buy flowers, go to the gym or yoga class even though you don’t want to go – even if you don’t feel like it. It’s possible to sometimes ‘trick’ your body into feeling better. Sometimes it is good to stay in bed, but sometimes it is good to power through. What small, specific things can you to today that will help you navigate the day better? Check in with a friend. Put a hopeful message on your phone screen saver. Find a texting buddy that you can text one thing you are grateful for to each other every day.
7. Physical – Closely linked to #6 is paying attention to your physical body. If your depression has not been brought on by a physical condition/injury and you are able to, try and ensure that you get some exercise, go for a walk, or practice deep breathing. This will help. Remember to eat well and keep your fluid intake up.
8. Presence – Choose to be present. Sometimes distractions and busy work are helpful ways to cope, but sometimes they get in the way of being truly present. (The same is true for any sort of substance use.) Choose to engage with the present moment, even if it is painful. I recently heard someone struggling with alcohol addiction say, ‘Feel the feelings, they are not going to kill you.’ Too often we avoid our true feelings because we think we will be undone by them. Feelings may be very painful, but there’s usually a reason for that, so instead of pretending they aren’t there, acknowledge them – and if doing that by yourself is too painful, see #1 and #4. On the flip side, if you encounter a day that brings you some measure of joy and a lightening of the load, enjoy it. (And if you are someone trying to help someone who is depressed, your presence with them will usually go much farther than any wise words you might have.)
9. Prayer – for some prayer or meditation will be helpful. Knowing that you are connected to something bigger than you and that you are part of a bigger plan is helpful to many people. Prayer may also be a safe place to acknowledge how you are truly feeling! Taking time to be still and focus may also help focus your perspective.
10. Patience – Be patient with others – remember your perspective might be a little off and you may be overly sensitive. And be patient with yourself. Depression is a very real struggle and sometimes it takes more time than you would like to work through it or to learn how to live with it. I tell my clients all the time to be kind to themselves. There are plenty of people who will try to keep you down and often we are our own worst critic. We can’t control the behavior of others but we can choose to be kind to ourselves instead of beating ourselves up even more. Be patient and hold on to what gives you life and strength.
A helpful link with more information:
http://www.helpguide.org/articles/depression/depression-signs-and-symptoms.htm
Duncan
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