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Depression & Mood Disorders

What is Depression?

I’m not going to try to put a ‘rosy spin’ on this – Depression is a serious mental health problem that if left untreated can become potentially fatal (it can lead to self-harm or suicide).  Depression also affects relationships and health: A recent 2016 study of Australian women who were followed over an 18-year period, found that depression was a significant predictor of Coronary Heart Disease (CHD). Although there are many reasons why a person might become depressed, people who have had depression are more likely to have depression again, and unfortunately depression rarely resolves on its own – you need to do something about it. But there is hope. There are many things you can do for depression. Read on.

 

Depressive Symptoms:

  • A persistent flat, depressed or ‘low mood’, or persistent agitation and irritability (particularly in children and teens)
  • A loss of pleasure in normally enjoyable activities
  • Feeling constantly fatigued or easily exhausted / no energy
  • Persistent, troubling thoughts (‘rumination’) about being worthless, ‘not good enough’, or ‘not being able to cope’
  • Feeling hopeless – like things are never going to change
  • Sleep disturbances: difficulty falling asleep, broken sleep, early-morning waking, over-sleeping
  • Difficulty concentrating and decision-making
  • Problems with motivation
  • Reduced appetite and libido
  • Some people may also experience suicidal thoughts
  • Some people experience Panic Attacks and other types of Anxiety with Depression

 

What Maintains Depression?

Behaviour – what you do (and don’t do) -Most importantly, as with most mental health problems, the behaviours that people often engage in to ‘cope’ with the symptoms often make things worse. For instance, people who are depressed often ‘feel so bad’ that they often stop doing things that make life meaningful. They may withdraw from or stop doing personally important, and even potentially helpful activities (like soothing and nurturing activities, like getting out into nature). This is completely understandable because having depressive thoughts and feelings can feel absolutely overwhelming to the sufferer.

However, In terms of withdrawing, one consequence is missing out. This may lead to feeling guilty or ashamed, which then makes you feel worse, gives your mind more to agitate over, and again makes you feel even worse. Now you are depressed about being depressed… and the downward cycle continues: This makes engaging in future helpful behaviours even harder.

On the other hand, a depressed person may drink or use substances to try to change / distract from / forget how they are feeling – Again, this is completely understandable because having depressive thoughts and feelings can seem absolutely overwhelming to the sufferer. However, in terms of using alcohol or substances, even if this behaviour provides some temporary relief – substance use can ultimately leave you feeling more depressed because of its depleting effect on serotonin and dopamine. In certain people, substance use with a depressive illness may trigger psychotic symptoms, mania (as in Bi-Polar disorder) or may increase hopelessness and lead to suicidal ideation.  

Thoughts – what you think (and how you respond to your thinking) – Depression can lead you to have thoughts that if left unattended can trap you into a further spiral of depression. The following are examples of common thinking styles that are typical in Depression:

  • “What’s the point?” (Catastrophizing),
  • “Nothing ever works out for me” (Overgeneralization),
  • “Why should I bother going – I probably won’t enjoy ‘X, Y, Z’ anyway” (Predicting the Future)
  • “I just don’t feel like I can” (Emotional Reasoning)
  • “Everything’s shit” (Black and White Thinking)
  • “I’m so depressed I am just going to bring other people down” (Personalising, Mind-Reading, Predicting the Future)
  • “I’m such a looser” (Labelling, Black and White thinking, Catastrophizing)

 

How Thinking Makes us Feel

If we were to blindly accept exactly what our minds’ are telling us– that is, if we accept any of our thoughts to be literally true – we are going to feel emotions that are consistent with our thoughts. No exceptions. This is also true of positive thoughts and images too (eg, daydreaming is a perfect example of when it can be pleasant to blindly accept whatever thoughts, images and stories your mind is telling you). 

Now, understand that thinking is not necessarily the problem – it is the accepting of your thoughts to be true that is the problem. I have written about this here.  Because of the feedback-loop between your brain and body, painful, self-critical, and pessimistic thinking can flood our brains with stress hormones and can trigger our threat system which can lead to changes in our bodies. So – thinking is a complex mental activity that can make us feel certain emotions.

There are two main ways to address the thought-feeling connection when it comes to problematic or distressing thoughts: To try and change our thinking (see traditional Cognitive Behaviour Therapy (CBT), or to change our relationship to our thoughts (see Acceptance & Commitment Therapy (ACT).

ACT differs from CBT in that it teaches you to respond differently to our inner-experiences in ways that allow us to notice and ‘have’ difficult thoughts and emotions without being ‘pushed around’ by the meaning of those thoughts or  emotions. A third approach which shares many features of ACT is Compassion Focused Therapy (CFT). CFT was designed to help people who experience difficulties with intense self-criticism and shame, as a result of their developmental and emotional learning histories, to behave in caring and self-compassionate ways towards one’s self.

 

Depression & Emotions

Quite often the emotions that accompany Depression are very powerful and are energy and motivation robbing: Guilt, shame, anger, grief, sadness, self-loathing, numbness, and hopelessness are all common emotions that can co-occur with a depressed mood. One of the most common responses to having difficult emotions like these is to try and ‘get rid’ of these difficult emotions. This may involve temporary distractions (like seeing a close friend), or more harmful distractions that make things worse: Social withdrawal; Drug / alcohol use; risk-taking behaviours; self-harming.

Strategies that do not address the underlying primary emotion are usually going to make things worse in the long term and lead to regret (secondary emotion). Now you have depression and regret. This can lead you to feel depressed about being depressed. Remember this formula: Suffering = Pain + Resistance. Pain = the primary emotion. Resistance = The struggle with trying to ‘not have’ the primary emotion. This leads to secondary emotions and suffering.

‘Primary emotions’ – the stuck, difficult, painful emotions driving all of the unworkable attempts to ‘get rid of’ them – are often the result of unexpressed needs. But figuring out these needs and accepting yourself for having these emotions is the only way forward to being able to truly change the emotions without making things worse. This is challenging work and requires a willingness to ‘have’ these emotions in the first place – it requires courage. It helps if you have someone to do this work with.

Therapy is very useful for helping you realise your unmet needs, accept yourself, process your Primary emotions, and understand how your unwillingness to ‘have’ primary emotions is influencing unworkable behaviours. Quite often ‘unwillingness’ to have these ‘primary emotions’ is what is maintaining the unworkable behaviours that are resulting in so much pain.  Click here to learn more about evidenced based therapies that can help you. 

 

“I think I’m depressed – What should I Do?”

If you are depressed, you should seek professional help. As you can appreciate, Depression is a complex and often recurring problem that has many possible causes and many maintaining factors. Working on changing your thoughts, behaviours, and processing your emotions is complex for anyone. This is made even more difficult if you are depressed. Although self-help articles are useful, they are not a treatment, per se. If you could have gotten better on your own, you would probably already would have! Because depression affects information-processing and reduces motivation, the best advice is to seek out the help of a qualified therapist with whom you feel safe and supported by, who can draw upon the latest treatments such as those listed above. Your mental health deserves the best care. 

For Self-help resources, visit my blog. To read about stress and stress management, click here. To get in touch with me, let’s talk.

 

Please note: If either you, or someone you care for, needs to talk to someone right now please phone Lifeline – 13 11 14, Kids Helpline – 1800 55 1800, or Beyond Blue – 1300 22 4636, or the Mental Health Access Line – 1800 011 511. If life is in danger call 000. All of these services operate in Australia 24 hrs/day.  

 

Further Resources:

About Me 

I am a PhD Clinical Psychologist with over 15 years of psychotherapy experience. Whether you are seeking an assessment and diagnosis, or are searching for integrative research-backed tools to help you heal past wounds, break reactive-patterns and achieve long-lasting change, my aim is to provide a safe space for you to feel seen, understood, and empowered so you can make meaningful progress on your healing journey.


To learn more and to get in touch, please:

CONTACT ME

I endeavor to reply to all enquiries within 24 hrs.

About Me

I am a PhD Clinical Psychologist with over 15 years of psychotherapy experience. Whether you are seeking an assessment and diagnosis, or are searching for integrative research-backed tools to help you heal past wounds, break reactive-patterns and achieve long-lasting change, my aim is to provide a safe space for you to feel seen, understood, and empowered so you can make meaningful progress on your healing journey.

To learn more and to get in touch, please:

CONTACT ME

I endeavor to reply to all enquiries within 24 hrs. 

Let’s Talk.

    Mindfulness & 

    Clinical Psychology Solutions

     

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    Po Box 1028, Newtown NSW 2042