Newsletter June

Depression is no respecter of statues or fortune. Indeed, many famous people throughout history have suffered from it, King Solomon, Abraham Lincoln, Winston Churchill, and the Finnish composer Jean Sibelius.

What is important to remember is that depression is not about human weakness.

What do we mean by Depression?

This is a difficult question to answer because a lot depends on who you ask. The word itself can be used to describe a type of weather, a fall in the stock market, a hollow in the ground and, of course, our moods. It comes from the Latin deprimere, meaning a ‘press down’. The term was first applied to a mood state in the seventeenth century.

If you suffer from depression, one thing you will be aware of is that it is far more than just feeling down. In fact, depression affects not only how we feel, but how we think about things, our energy levels, our concentration, our sleep, even our interest in sex. So depression has an effect on many aspects of our lives.

When you feel depressed that last thing you want to hear is that ‘it’s all psychological’ or ‘only a state of mind’. After all, you probably feel tired and aimless, you may not be sleeping well compared to your normal self. This is because when we become depressed there are very real changes in our bodies and brains. The fact is that our brains are working differently when we are depressed. Depression is as much a physical problem as a psychological one. Although we sometimes still tend to think of the mind and body as separate, they are not.

The brain is affected by depression in many ways. The sleep system is disrupted; the area of the brain controlling positive feelings and emotions are toned down; and the areas controlling negative emotions are toned up. In other words, when we are depressed, not only does life stop being enjoyable, but we are also more anxious, sad, irritable and bad tempered. These changes in our feelings happen because there are changes in the way messages are relayed between one nerve cell and another in the brain.

One of the things that many people notice as they become depressed, is that small things, or things they would formerly have done easily, like calling the garage to have the car fixed, or having friends over for differ, get very hard to do. They start putting these things off, and at the same time worrying because they have not been done. Suddenly, small things become big things. If this happens, then try as best you can to do those small things and not let them build up and get on top of you. You will feel better for it, even though it may take a lot of effort; whereas if you do put things off, you may then start to brood on them and that will increase the stress on you. Also, recognize that your experience is a common one, and not evidence of your being ‘personally useless’

Thoughts and feelings about yourself as a person usually become very negative in depression.

Sometimes depression can be triggered by conflicts and splits in families or other important relationships. The depressed person may feel very defeated and trapped by these relationships but not to blame for them. Sometimes depressed people feel bad about being depressed and the effects this is having on them and others around them, but they do not feel that they are bad or inadequate as people: they blame the depression.

All the negative, self-directed thoughts a person with depressions feels are a form of bullying. The inner bully observes the self and passes judgments ranging from mild criticism to hatred.

The inner bully sets up a self-defeating spiral, and causes many of the problems that it attacks you for. It’s like hitting a man when he’s fallen down, just because he’s fallen down!

The ten key steps that can help to control depression:-

Seek help if you need it - don’t suffer in silence

Go step by step

Break problems down into smaller ones, rather than trying to do everyting in one go.

Introduce more positive activities into you life

Become more attentive and aware of your thinking and the ideas that go through your mind when you are depressed

Try to identify your typical thinking styles (e.g. all-or-nothing thinking, discounting the positive aspects of your life). Note especially what you think about yourself, and how you label and treat yourself. Look our for your internal bully. Remember that this can drive you further into, rather than out of depression.

Try writing down your thoughts to aid clarity and to focus your attention

Try to identify the key themes in your depression (e.g. Your need for approval, shame, unhappy relationships unrealistic ideals, perfectionism) This will allow you to spot more easily your personal themes when they arise, and to challenge them,

Learn to challenge your thinking with the use of your rational mind. The more you treat yourself with compassion and give up thinking of yourself in terms of inferior, worthless and so one, the easier it will be for your brain to recover.

Try challenging negative thoughts and developing new ways to behaving. However, also expect setbacks and disappointments from time to time.

Finally - remember

Your depression may be a state of mind you are in, but your depression is not you

Your anxiety may be a state of mind you are in, but your anxiety is not you.

Your anger may be a state of mind you are in, but your anger is not you..

These states of mind are to do with how your brain was designed over millions of years. They are part of human nature.

Whatever judgments of ‘you’ that your emotions come up with, they are about as reliable as the weather. They more compassionate you are with yourself, the less you will be a ‘fair-weather friend’ to yourself. If you can stay a true friend to yourself, even though depressed, you are taking a big step forward. You’re on the way up!

Anxiety affects your whole being. It is a physiological, behavioural and psychological reaction all at once. On a physiological level, anxiety may include bodily reactions such as rapid heartbeat, muscle tension, queasiness, dry mouth or sweating. On a behavioural level, it can sabotage your ability to act, express yourself, or deal with certain everyday situations.

Psychologically, anxiety is a subjective state of apprehension and uneasiness. In its most extreme form it can cause you to feel detached from yourself and even fearful of dying or going crazy.

The fact that anxiety can affect you on a physiological, behavioural and psychological level has important implications for your attempts to recover. A complete programme of recovery from an anxiety disorder must intervene at all three levels to

Reduce physiological reactivity

Eliminated avoidance behaviour

Change subjective interpretations (or self-talk) which perpetuate a state of apprehension and worry.

Anxiety can appear in different forms and at different levels of intensity. It can range in severity from a mere twinge of uneasiness to a full-blown panic attack marked by heart palpitations, disorientation and terror. Anxiety that is not connected with any particular situation, that comes ‘out of the blue’ is called free-floating anxiety, or, in more severe instances, a spontaneous panic attack. The difference between an episode of free-floating anxiety and a spontaneous panic attack can be defined by whether you experience four or more of the following symptoms at the same time -

Shortness of breath

Heart palpitations (rapid or irregular heartbeat)

Trembling or shaking

Sweating

Choking

Nausea or abdominal distress

Numbness

Dizziness or unsteadiness

Feeling of detachment or being out of touch with yourself

Hot flushes or chills

Fear of dying

Fear of going crazy or out of control.

If your anxiety arises only in response to a specific situation, it is called situational anxiety or phobic anxiety. Situational anxiety is different from everyday fear in that it tends to be out of proportion or unrealistic. If you have a disproportionate apprehension about driving on a motorway, going to the doctor, or confronting someone, this may qualify as a situational anxiety. Situational anxiety becomes phobic when you actually start to avoid the situations.

The main ways in which to overcome any anxiety disorder can be summed up as follows:-

Physical Breathing exercises (learning to breathe from your stomach rather than your upper chest.

Regular practice of deep relaxation

Regular exercise

Nutritional improvements (reducing sugar intake etc)

Behavioural Imagery desensitization

Real-life desensitization

Emotional Learning to identify and express feelings.

Mental Countering negative self-talk

Countering mistaken beliefs

Interpersonal Developing an assertive interpersonal style

Whole Self Developing self-esteem by cultivating a relationship with your inner child.

It is simply not possible to change or grow in any area of your life unless you are willing to take some risks. To recover means being willing to experiment with new ways of thinking, feeling and acting that may be unfamiliar to you at first. It also means giving up some of the payoffs for not changing. If you are dealing with phobias, the way to overcome them is simply to face those situations you’ve been avoiding - gradually an in your imagination at first. If you are dealing with panic attacks, it may be necessary to risk relinquishing some control and learning to flow with unpleasant bodily sensations instead of resisting and fighting them.

Resisting or fighting initial panic symptoms is likely to make them worse. It’s important to avoid tensing up in reaction to panic symptoms or trying to make them go away by suppressing them or gritting your teeth.

Face the symptoms - don’t run from them

Accept what your body is doing - don’t fight against it.

Float with the wave of a panic attack rather than try to force your way through it

Allow time to pass

Recovery can take a long time, depending on how long you’ve been suffering, and there will be setbacks, but eventually you can and will succeed.

Our next Newsletter is due out in September. If there is anything specific you would like included, then please let me know, either by writing to the registered address, or e-mailing me at anxietyalliance@tiscali.co.uk