|
Depression
- What is it? What causes it? What can we do about it?
The main criteria most usually used to diagnose depression
are as follows: -
-
Depressed
(Low or disturbed) Mood
-
Sleep
disturbance
-
Decreased
energy
-
Increased
or decreased psychomotor activity (fidgety or apathetic)
-
Decreased
concentration
-
Suicidal
ideation
-
Appetite
or weight change
-
Guilt
or feelings of worthlessness
-
Loss
of interest or pleasure in everyday life.
Of course, everybody feels some of these feelings some of
the time. This doesn’t necessarily indicate
depression….this indicates you’re human and you have ups
and downs! When we experience difficulties or loss in life it
is quite normal to experience a period where we feel the same
feelings which characterise depression. These feelings usually
pass normally with the healing passage of time. Clinical
depression though is characterised by a persistent and deeply
pervasive experience of the above difficulties with little or
no rational reason to be feeling those feelings.
What
causes depression?
It is true that depression tends to run in
families. It is also true that genetic research has failed to
identify a single defective gene which might be responsible
for creating depression, and researchers believe it is
unlikely that one will be found.
Other
studies have shown that identical twins (sharing the same
genes) will more often than not both suffer with depression,
which lends weight to the argument that there is a genetic
pre-disposition to the disorder. Interestingly though, those
twins who were separated at birth and grew up in different
environments show less incidence of twin development of
depression, arguing that there must be other factors involved,
namely of course, the effect of environment on mental and
emotional development. It is clear that depression runs in
families at least in part because families have
“atmospheres”. This is an unscientific plain English way
of saying that different families do things their own way, and
behavioural traits are passed down from generation to
generation. Thinking styles (ways of viewing the world) are
also passed down. If the general “atmosphere” of a family
is negative and oppressive, it is easy to see how this general
“gloominess” is passed on to family members. Michael Yapko
makes this case beautifully in his important book “Hand me
down blues”. When we think about it clearly, it’s not
difficult to make sense of. Did your family possess or provide
you with the coping skills you require to make a success of
life? If you were not taught how to see the World positively
in your formative years then is it any wonder that the World
feels negative, hostile, or threatening today? If you were not
taught the skills you need to interact healthily with people,
how to get your needs met in a functional way, how to have
self esteem etc, then is it any wonder that the competitive
world we live in feels overwhelming? These are all clearly
important factors in determining whether depression will
develop or not. So whilst grudgingly I am forced to
acknowledge that there is evidence to show that we can be
genetically* pre-disposed to depression, I make the point
nonetheless that a high proportion of people apparently
“pre-disposed” to depressive disorders (over 50% of
schizophrenic identical twins sharing the same genes for
example!) do not develop difficulties. I say grudgingly*
because I believe that our scientific models encompass only
biological factors, and these are insufficient as an
explanation, but that is another separate article to be
written!
In
any case, let’s conclude that what we do know for sure is
that people who grow up in unsupportive or hostile
environments are more likely to suffer from mental and
emotional disorders later in life. This is clear from the
research, as well as by using our own common sense. Let us
further conclude that even if we are “pre-disposed” to
depression that the evidence bears out that this does not
necessarily mean that we DO develop depression, and by
extension this tells us that we are not purely victims of
genetics! Genetics may be a factor. We might have to work a
little harder than someone less pre-disposed than ourselves,
but let us be clear, that we can move out of depression,
because depression at one level is a response to our
environment. If our environment is uninviting, (and this
includes our mental and emotional environment), then
depression can thrive. Conversely, a positively focused life
filled with satisfying activity and success leaves little room
for depression.
So,
having dealt with the genetics …..what does cause
depression? This can be summarised with two words:
Hopelessness and helplessness.
That’s
the core of it. Of course there are other peripheral
considerations such as diet, lack of exercise, age,
medications, addictions, illness and loss etc. It can be a
complicated picture for sure, since good health requires many
factors to be balanced, but essentially we experience
depression when it feels like we can’t be helped, and that
there is no hope for the future. At that point something dies
inside us (metaphorically speaking) and we stop trying.
If
you’re reading this and feeling low, you might have been
moved by that last line. “Something dies inside”. Sure
does feel that way doesn’t it? I’d like to reassure you
that you’re still very much alive…..your life (and the
self you know yourself to be) is just in hibernation mode.
This is what hibernation mode feels like…exhaustion,
disinterest, paralysis even. This will make much more sense
when you understand what is going on here.
Let’s
have a quick look at the cause of depression and its purpose.
Depression is a physiological response to certain conditions;
namely hopelessness. Our ancestors were hunter-gatherers. They
gathered their food on a daily basis. They relied heavily on
natural crops and game for survival. Without agriculture, and
the subsequent storing of surplus food, drought and famine
would have been a common occurrence. Nature generally favours
survival, and we find ourselves therefore equipped to deal
with such emergencies. So, if the rains had failed to fall on
a particular year and consequently food had become scarce then
the best way to ensure survival is to conserve energy, since
when starvation threatens every single calorie saved equals a
better chance of long term survival. In a famine, with no
immediate chance of food, the situation becomes temporarily
“hopeless!” So, what would be the best way to make sure
that a human being conserves energy? Feelings of exhaustion,
lack of interest, lack of hope, and low motivation will fit
that request nicely! Then we are much more likely to turn
inwards, become intensely reflective, and cease physical
activity. The brain learned that to survive, it was necessary
to inhibit energy use in times of crisis (hopelessness). So,
we can see then that the feelings depression creates are very
“real. The unpleasant feelings of lethargy and disinterest
that depressed people experience are in fact powerful shifts
in internal chemistry. The brain and body go into an “opt
out” mode of existence, which quite literally “grounds”
a person. It sends us into an inward looking trance like state
of external disinterest and exhaustion. This is what
depression is. A physiological response designed to save lives
when conditions become temporarily “hopeless”. It can be a
relief to sufferers of depression to learn that these feeling
are a response and are not indicative of their core being. Our
culture favours the view that we are helpless victims of
depression; that if we are depressed, then we are
fundamentally medically broken. We are told our brain
chemistry is faulty. This view, perhaps more than anything
else, is likely to keep you depressed! This view assumes that
you have no say in whether you are depressed or not, and it
gives permission to remain in victim mode, which is the same
as saying “helpless”. This needs to be challenged! You are
NOT your depression. You are NOT a “depressive”. It is
very important to remember this fact. You are a human being
suffering an inappropriate physiological response to stress
and negative environment. Depression lifts when we change the
incoming signal….when we change the environment. There is
ALWAYS something you can do to make things better.
That
is very interesting…. but we’re not in a famine!
No
famine I agree….but are you starving? I’m not meaning to
be clever or dismissive here. This is a serious point. The
feelings of hopelessness we might experience in our complex
lives today are every bit as fraught with angst and
seriousness as those our ancestors will have experienced in
the absence of food. The depression response too is every bit
as powerful. It didn’t just disappear because we started
living in houses and shopping at the supermarket. So follow
the logic and you can see that this powerful response pattern
can be activated just as powerfully by today’s modern
“emergencies” as it has always been by floods, famines or
warring tribes.
So,
what are today’s modern “emergencies”?
Well,
we have the obvious of course, being immediate emergencies;
divorce, bereavement, losing a job etc. These emergencies can
trigger depression, but again they don’t necessarily. If we
have good coping skills, low stress levels generally, and a
strong constitution, we can ride these things out without
going into depression. But, there are longer term emergencies
too. I used the phrase earlier “are you starving?” It’s
long been recognised in solution focused psychology that as
individuals, as human beings, we have needs. This is a fact.
Though our needs are somewhat subjective, there are certain
needs which we all have to some degree; the need for physical
safety and security for example. Most (though not all) people
have a need for positive human interaction. Other needs
include having a purpose in life, being financially secure,
employment, peer recognition, friends, interests, to love and
be loved. For each individual there will be certain areas
which stand out more than others as being critically important
to that individual’s sense of okay-ness with the world. If
that need is very important and is not being met, and it
appears to that individual that there is no way that need will
be met any time soon, then this constitutes a crisis or
emergency as far as the mind is concerned. To put it simply
then, if our needs are not being met then emotionally speaking
we are starving. To the mind, the feeling of hopelessness is
exactly the same as that feeling our ancestors experienced! So
the antidote to this starvation then is to go to find food.
Finding food means getting our needs met.
Where
do I find food?
The first thing to consider here is whether you
have actually stopped looking for it. Human beings at one
level, particularly when suffering anxiety and depression
operate in a fairly primitive way, much like animals, in that
once we have learned that a situation is hopeless we often
stop trying. This is called “learned helplessness” and is
a well established psychological concept. One well known
experiment is that conducted by psychologist Dr. Martin
Seligmann. His research programme involved giving dogs a mild
but inescapable electric shock. The dogs made the mental
connection (learned) that the shock was inescapable. When they
were later placed in a cage with two inter-joining
compartments, one of which contained shocks, they failed to
respond or to try to escape the shocked side, despite the fact
that the other side of the cage was shock free. Dogs not
subjected to the initial shocks simply jumped to the shock
free side. The trained dogs had “learned helplessness” and
learned that the only thing one can do with a bad situation is
to tolerate it. There have been other experiments showing the
same results. It’s an animal trait. We also have an animal
brain (the limbic system) and it has more control when we are
angry depressed or anxious, so we are operating at that level
when in the trance of depression. So, what’s the message
here? The drought or famine has passed. There is food outside
to be collected, but are you still holed up in the dark cave?!
Leaving
the safety of the cave
(Ok...enough
with the metaphor!)
In
some weird way depression can become a safe place to be,
miserable as it is. I know this makes no logical sense. Why
would anyone choose to stay miserable? Often that choice is
made unconsciously. Meaning that no-one actually sits down and
says “Yes I think I prefer being depressed to living my
life!” But, what happens in practice is that depression has
become the devil you know. At least it’s predictable. At
least you can’t fail any more if you’ve already failed!
The mind, being now only familiar with the walls of the cave
and having had such a long time to introspect about the
terrible dangers lurking outside the cave has become
increasingly convinced that the outside world is too dangerous
to engage with. Indeed that failure will seem inevitable, and
therefore too much to bear. Part of the problem with
depression is that it is very convincing. It’s supposed to
be. In a famine, it will save your life. It means business,
and its job is to STOP YOU ENGAGING with the outside
world…to stop you using your energy, and that means that the
very thing that you most need when you are depressed is the
very thing that the depression is telling you to
avoid…connection and integration with the outside world.
So
the very first thing to recognise is that the feeling that
everything is hopeless and that you are helpless, is an
illusion. It is not an established fact. It may present as an
established fact but if you want to live your life again then
it is crucial to recognise that the feelings, however
pervasive they may be, are not reflective of the facts. If
you’ve been in the cave for a long time, it will have been
easy to create a picture of the outside world in your mind
which appears to be very threatening. This is part of the
cause and the effect of depression. When we are depressed we
necessarily see the worst in things, and seeing the worst in
things sustains depression. Remember, this is part of the
action of depression. It makes life look unappealing and even
impossible. That’s what its job is. If we make the mistake
of taking that to be an objective truth, especially once the
difficulty has passed, then we can see why life looks so
difficult! It may well be that your negative experiences in
life so far have taught you that certain areas of your life
are hopeless, but in truth that is because you have either had
a run of bad luck/negative experiences, or that you currently
lack the resources to make a success of those areas. If the
latter is true, then you can know that resources (knowing HOW
to do things) can be learned…no matter how late in life you
are!
In
any case, making the initial determination that it’s worth
engaging with life, even if you need to learn new skills to do
so effectively, is step one. The important thing to understand
here is that you will need to do this even if your feelings
are telling you it’s not worth it, or even that it’s too
scary, or too much effort. If you feel unable to do it alone
then get help. Depression might tell you that you really
shouldn’t bother anyone with your problems…this is more
illusion…more negativity…more “I can’t be helped”.
To overcome these blocks we need courage, and determination.
Remember that courage is not the absence of fear but the
decision that something else is more important than the
fear…in this case …your life!” In my article “When the
gloves come off”, I mention that depression is fighting
talk. Remember…depression is a bully. Deciding you are going
to overcome your depression whatever it takes is a pivotal
moment. I believe that when you do this, you’ve as good as
won the fight. It might take time, but that’s the spirit
that makes stuff happen!
The
Science of Depression-
So now you have decided to create wellness, how are you
going to do it? Well, before we get to the practical in this
regard it’s useful to know a bit about the science of
depression. To understand this we’ll borrow the brain from
our “science of anxiety” article, which gives detailed
information on the brains’ actions.
The
principles are the same whether we are talking about anxiety
or depression. The problem is due to continued over-arousal of
the emotional brain (this is the pink area in our diagram).
What causes over-arousal? Well, basically, in a nutshell,
negative perspectives. This should make sense. Since we know
that the emotional brains' job is to protect us, it follows
logically that it is always therefore on the look out for
potential threats. When we are healthy, the mind has a healthy
balance. Most of what we notice and do is positively focused.
Some aspects of our life may not be, but the mind can cope
with a bit of negativity. Life’s not perfect perhaps, but
it’s certainly okay. When we are depressed however, we
become increasingly negatively focused, too much so in fact,
and we begin to notice (only) the worst in things….a lot!
The worse things look generally, the more aroused the
emotional brain becomes, because continually perceiving that
things look terrible sends a message to that brain that some
form of evasive action is or will be required. The emotional
brain of course, doing its job perfectly will gladly oblige
with one or a mixture of the three main action responses…..anger, anxiety, or depression.
The
emotional brain is a primitive mind. It is not logic based. It
is an INSTINCTIVE and EMOTIONAL mind. The emotional mind,
primitive as it is, does not perceive a great deal of
difference between what is past, present future, real, or
imagined. In other words, to the emotional mind, it’s all
the same. It doesn’t matter whether it happened yesterday,
today or tomorrow, it is still emotionally arousing. It also
doesn’t matter to the emotional mind whether it is really
happening or if we are only imagining that it is happening. It
is still emotionally arousing. This is crucially important to
understand. 99% of what we imagine/worry might happen never
does. The emotional mind doesn’t know that though. It takes
everything as probable or fact.
Depressed
people introspect a lot. In plain English this means they
think too much. Specifically, they think about themselves and
about their lives. Their focus is mainly inward looking, and
it is mainly negative and repetitive. What this means is that
fifteen of the sixteen hours in a depressed persons day is
spent thinking intensely about how terrible everything is, how
there is no way out, how bad the past has been, how
hopeless and helpless they are, and how the future will be no
different. This is referred to then as “negative
introspection”. So even though a depressed person appears to
be “doing” very little, at the mental and emotional level
there is in fact masses of activity, and mostly it is all
miserable. It is exhausting for sure. But, as well as being
exhausting it is also extremely damaging, because the
emotional mind witnesses every bit of that negative
introspection, and if you follow the understanding explained
above, the emotional mind becomes highly aroused by what it is
witnessing, even though it is not ACTUALLY happening. Since
it perceives little difference between what is past, present,
future, real, or imagined, the emotional mind perceives these
introspections as essentially real. The emotional mind
concludes that the negative introspections, as pervasive as
they are, must indicate how things really are, and it then of
course steps in with a response to remedy the situation. So
depression is the response which says “If things are THAT
bad, then we need to just opt out…it’s safer to not engage
at all”, and there you are duly supplied with feelings of
lethargy, lack of interest and so on. This leads to less
interaction with the world as one withdraws and more time to
think about one-self and how terrible everything is……and
so on it goes! It’s easy to see how this cycle creates
depression. There is more to this story too.
Sleep
and Depression.
It
has long been noted that people with severe clinical
depression will tend to massively over-sleep, sometimes 13 or
14 hours a day. This is extreme, but certainly we note sleep
disturbance of one kind or another usually exists alongside
depression and anxiety. Joe Griffin and Ivan Tyrell (authors
of “Human Givens”) explain this process in their books and
monologues, and put forward a modern explanation of depression
as a sleep disorder.
In
the course of an ordinary nights sleep, we cycle between two
distinct phases of sleep.
·
Slow wave sleep – This is the sleep cycle
where the body undertakes physical relaxation and repairs.
(75%)
·
REM (Rapid Eye Movement)-
During this sleep cycle dreaming takes place. It is
physically non-recuperative (it’s not relaxing!) and
mentally is MORE active than being awake. It is believed that
during this stage of sleep the brain is re-processing mental
information and de-arousing emotional arousal (through
dreaming) from the previous day. (25%)
Non-Anxious/non-Depressed
Persons Sleep Distribution
|
Slow
Wave (Restful, recuperative) 75%
|
In
a non anxious person, we will cycle into a period of REM
followed by slow wave, followed by REM, followed by slow wave
etc, and by the end of the nights sleep approximately 75% of
the night would have been spent in slow wave (recuperative,
healing relaxing rejuvenating) sleep, whilst 25% would have
been spent in REM (highly active) sleep, de-arousing the
emotional mind.
Studies
have shown however that in depression, this balance shifts,
and we see much more REM sleep and less slow wave. In fact the
whole cycle can invert meaning that we get only 25% restful
slow wave sleep, whilst spending 75% of the night wrestling in
the realms of the archetype...dreaming....and if we're anxious
or depressed, they're probably not good dreams either!
Anxious
or Depressed Persons Sleep Distribution
|
REM
(Dreaming) As much as 75%
|
Slow
Wave (Restful, recuperative) 25%
|
Now,
when you consider that REM uses more energy than being awake
then as far as the brain is concerned, if we sleep 75% REM (as
people with severe depression will) and only 25% slow wave,
then we have a problem. We are simply not getting the rest
(the slow wave sleep) we need, and in fact it’s worse than
that; we are actually becoming even more stressed out because
we’re working harder at night than we are during the day. Is
it any wonder there is a sense of hopelessness?!
So
what is causing this? Well, basically, again, “negative
introspection”. Think about the last time someone really
upset you. Think about it. Remember it. Do you now feel a
twinge of annoyance/tension in your gut? That’s an emotional
arousal. You have just added to your stress level today
(sorry…necessary to make the point!). In the “science
of anxiety” page, the first diagram shows stress
(emotional arousal) containers. Every time you negatively
introspect about something that happened or something negative
that you are thinking might happen, you can add a scoop to the
stress container! If you spend all day doing this, how full is
your container by the end of the day?
In
practice what is happening is that your body is readying
itself for a fight because you used your mind to show it a
threat. So there is a literal sense of arousal in the nervous
system. That arousal does not go away unless it is actually
discharged. It sits in your system, leaving you feeling more
tense than you were before you had the thought. It might not
be noticeable since it was tiny but it is stored nonetheless.
There are two ways that the emotional arousal can be
discharged from the system; either by taking action (engaging
the situation), or through the process of sleep. Since there
are many false alarms in life, nature takes care of
unnecessary (and therefore un-discharged) emotional arousal
through sleep, where it is discharged “virtually” through
the process of sleep. When we sleep the mind metaphorically
replays the scene of concern (dreaming) and discharges the
associated anxiety.
So
what happens in depression, is that our negatively focused
person is spending all day providing scoops of emotional
arousal through the process described above. Now the stress
container is filled with masses of emotional arousal but there
is no action to discharge it (this is one reason exercise is
good for helping depression…it burns nervous energy!).
Therefore, the only other option is to discharge it through
the sleep process. Dutifully, the REM process starts working
overtime to de-arouse all the extra emotional arousal that has
been created. Of course it is exhausting since the brain has
now not only had to deal with a day filled with negativity,
but is also now having to work overtime to discharge that
negativity through the dreaming process. So our depressed
person oversleeps to compensate. It is however fruitless
because what happens is that the REM function is being
over-used and is exhausting the brain. So even having slept 12
or 14 hours, our depressed person is still waking up
completely exhausted. Sometimes, it will go the other way and
our sleep will be broken or we will suffer with insomnia. This
is more often an anxiety response, but essentially here, the
brain is waking us up to save REM. Since REM is also used as
an “alerting mechanism” during the day, the brain will
sometimes opt to try to conserve sleep rather than over use it
based on the assumption that sleep is so exhausting it’s
better to be awake, and life is so dangerous through the
daytime that we better save some alerting mechanism to deal
with the next big threat. Both are strategies caused by
over arousal of the emotional mind and both cause and maintain
exhaustion! Mild depression might mean that a person gets 8
hours sleep a night but still wakes up tired. The same process
is taking place. The REM function is being over used. So,
it’s not all about how many hours one sleeps, it’s also
about the quality of that sleep too.
So,
if you’re following this? The answer?
“Negative
Introspection” and “Emotional Arousal” must be reduced!
Then the whole process can reverse. By ceasing continued
negative introspection and creating positive perspectives, you
stop adding scoops of unnecessary arousal to the stress
container and you can give your REM mechanism a chance to get
on top of things. Essentially, your REM function can take care
of the stress in your stress container when you stop filling
it up with unnecessary stress! Then you start waking up with
more energy, more zest, more hope, and more positive focus.
This may be easier said than done I know, but we have to start
somewhere, and just understanding the science of this
mechanism should give you a powerful tool in understanding why
it’s worth doing and exactly what you need to do in order to
help yourself. It takes discipline to do this, but again, when
you put your mental health and well-being first it’s got to
be worth the effort!
Brain
Chemistry
-
Cause or Effect? - Placebo or Medicine?
We
looked at genetics earlier as one of the possible causes of
anxiety and depression. Faulty brain chemistry is often cited
as a cause of depression and is therefore obviously also an
important area to understand. Here again, it seems we have a
similar picture to the one we find when considering genetics.
Some people may have brain chemistry which is pre-disposed
towards depression. We have to concede the point that
physiology varies from person to person, and in the same way
that some people are blessed with very strong constitutions
physically, then the same will also be true with regards to
mental and emotional constitution. Persons with poor physical
constitution will need to eat well and exercise daily to stay
well, but they can lead a good life still.
We
also have to make some distinction with regards to the type of
depression experienced. Most depressions are what we might
call an "ordinary" (non-medical term!) depression.
Anyone can experience ordinary depression, and it usually
follows a roughly predictable (albeit unpleasant) pattern. An
ordinary depression can come and go. Then we have Bi-Polar
disorder (formerly known as Manic Depression). Bi-polar is
really a lifelong medical condition with no known cure (though
it is manageable and sufferers can lead satisfying lives once
they have the right support). This condition is characterised
by severe emotional swings between extreme lows, and manic
highs. During the "mania" phase, a sufferer can
become dangerously carefree and will often behave in a manner
which they later regret. Clearly there are other depressive
disorders which need different handling. These disorders occur
much less frequently than common depression. For the
purposes of this work here today, please assume that we are
discussing the brain chemistry issues noted in
"ordinary" depression.
So
research indicates that Serotonin levels in depressed people
are generally low. Serotonin is a chemical neuro-transmitter
within the brain, which is responsible for carrying signals
between one brain cell (neuron) and another. We have
approximately three trillion brain cells firing signals from
one to the other at any given time. The brains computing power
is vast indeed! There are many different neuro-transmitters
active in a brain but Serotonin is believed to be the most
prevalent and also the most important in regulating our
overall level of well-being. So Serotonin is often referred to
as the "feel-good" neurotransmitter. When Serotonin
exists in balanced levels within the brain, then
generally we feel good.
So,
this great scientific discovery appeared to offer a solution
to why we "get" depression. It was, we were told,
because we were unlucky, and had been cursed with poor brain
chemistry...not enough Serotonin. Pharmaceutical companies
went hurriedly about the business of finding a way to get the
brain to create more Serotonin, thus allegedly alleviating
depression. They came up with Selective Serotonin Re-uptake
Inhibitors (SSRI's). These are substances which inhibit the
re-absorption of Serotonin into the brain. You see Serotonin
is released and then re-absorbed, and then more Serotonin is
manufactured by the brain and released and so on. So by
slowing down the rate of re-absorption, it is possible to make
the Serotonin go further by having it stay in the brain
longer. The net effect of this should be that you feel happier
since more Serotonin in play=More feel good factor. SSRI's are
the most common types of anti-depressant medication in use
today, though there are other types of anti-depressants
available too (MAO inhibitors/Tricyclics). Most people have
heard of Prozac. Prozac is the brand name for Fluoxetine. This
is still in very common use today, and there are many other
different anti-depressant drugs available from your GP which
have a similar action to Fluoxetine. Some of these drugs have
courted widespread controversy. Seroxat (Paroxetine) for
instance has been in the news a lot over recent years because
of it's addictive qualities, and difficult side effects such
as suicidal thoughts, and uncontrollable aggression.
Panorama (BBC investigation team) investigated over a two year
period and found that there had clearly been a cover-up along
the way. Users were not informed of the risks despite the fact
that the pharmaceutical companies were aware of potential
problems. With millions of people using these drugs,
anti-depressant drugs are big business. Many of these
drugs have strong side effects in some users.
I
have met many clients who are using anti-depressants
successfully. Many people do not suffer noticeable side
effects and for some there is clearly a marked improvement in
their overall state of well-being. The picture therefore is
complicated. I should make clear that I am NOT
anti-medication. It is clear that in some cases medication
helps. This is for you to decide and for you to discuss with
your Doctor. However, I do have a point to make, and that is
that one should be informed of the facts when deciding a way
forwards. Trials have shown that anti-depressants often have
little more effect than placebo. When drugs are being tested,
one test group is given sugar pills whilst the other is given
the drug. This highlights how much of the effect of a drug is
the drug and how much is the persons expectation of what the
drug will do. I borrow here in paraphrased form (paraphrased
purely to avoid copyright restrictions-all figures are
correct) from an article published in the Guardian in 2002:
A recent
$6m 5 year study found that St John's Wort cured 24% of cases
of moderate to severe depression whilst the anti-depressant
Zoloft cured only 25% of cases. The placebo (a sugar pill)
cured 32%.
Seattle
psychiatrist Arif Khan analysed 96 anti-depressant trials
between 1979 and 1996 and found that the effect of the drug
could not be distinguished from the placebo (sugar pill) in
52% of the trials.
Following
the above 5 year study, Leuchter told his healed placebo test
subjects that they had only taken sugar pills. Nearly all
relapsed immediately demanding to be given the real drug! Only
one subject had the good sense to spot the faulty logic and
decide that if he'd been able to make himself happier without
a drug, then so much the better!
You
can view the full article (which is a very worthwhile read) by
clicking below:
http://www.guardian.co.uk/medicine/story/0,11381,740638,00.html
Isn't
that very telling? Especially the last paragraph! Wow.
Everybody but one relapsed when they found out that they
didn't get the drug! That really tells us a lot. Perhaps you
are beginning to see just how important a role ones approach,
expectation, and attitude is when making the decision to
overcome depression?!
Back
to chemistry then. Serotonin we know is necessary to good
mental health. It appears that when Serotonin is depleted
within the brain that this must be the cause of depression and
that depression must therefore be a chemical problem to be
rectified at the chemical level. All reasonable
enough....except for one missing fact. Serotonin is a mood
regulator, but it is also regulated by mood. The
production of serotonin in the brain is increased and
stimulated by positive living. Every positive thing that
happens in your life can lift your mood. Knowing you have
something fun to look forward to can lift your mood. Knowing
that you will get better soon (or any light at the end of the
tunnel) will lift your mood. Deciding you are going to beat
your depression (maybe with a baseball bat!) will lift your
mood. Getting a sense of humour....going to the
theatre...having dinner with friends....making something (a
website for example...why do you think I'm doing this?!),
helping someone, volunteering perhaps, finding a part time
job, studying, teaching. It all lifts mood, and it all
stimulates Serotonin production. So if you are following this.
YOU are the most powerful anti depressant known to Wo/Mankind!
So,
chemistry? Cause or effect? Placebo or Medicine? You decide.
Conclusion
You are not powerless.
Yes, you have a fight on your hands. Yes, it will take time.
Yes, you have to want it, and yes, depression will argue it's
not worth the effort (what's the point?). If you want
reminding, the point is life is short and it can be fun. I
know that's hard to believe, but it's all subjective. If you
want to see life as fun there's no one stopping you...there's
no rule book says that's not allowed except the one in your
own mind. So dig deep and fight for it. Know that it CAN
be done. You can visit the "help" section on this
website for practical ideas and inspiration. This website is
still under ongoing construction. I have a lot to say and it
takes time to get it all down on paper (bytes!). I intend to
update this section of the website with a very full
description of what you can do. For now however, I'll
summarise. I hope the point is clear. Your job is to stop
introspecting, to find something inspiring to DO...that means
trying new things...being brave...being daring etc. I recently
bought a power kite. It has changed my life! Figure out
what you want in life and find ways of working towards making
that so. Eat well. Make sure you are enjoying good nutrition.
Lay off the recreational drugs/alcohol and cigarettes. None of
these help in the long term even if they appear to offer
immediate short term relief. If you need help from someone, a
friend, a therapist, or a family member, then enlist it. Think
ONLY about solutions. Any thought pattern which is not
contributing to solution is probably negative. Learn to
recognise which thoughts give you a sense of hope and follow
those through to conclusion. Use a pen and paper if it helps
to remind yourself which thoughts help and which are to be
ignored. Then start putting your foot down. Get tough on this
point! You can visit my article here
on how to self help using CBT. Clean your home. Make it a nice
place to be. Buy some flowers. Clear out your drawers. Go for
a walk somewhere pretty. Some exercise? Plant some flowers, a
herb garden, or a window box. Bring some brightness into your
life. Volunteer. Take a course. Learn a language or a new
skill. Book a short break. Join a club. Write a blog. Connect!
Anything that feels positive will help. Keep at it. You might
not see the benefits immediately but the landscape of your
life...the backdrop to the depression if you like will begin
to look different as you make these changes, and the fact is
depression simply cannot thrive in a bright environment. Don't
let depression tell you it's not worth it. Do it and then
decide if it was worth it. Only someone determined to remain
depressed will be able to say it wasn't!
There's more on depression available
here too:
http://www.hypnotherapyforlife.co.uk/anxiety-depression-bristol-bath.htm
Of course it should go
without say that you can also contact me if you are in this
area for one to one help. I am a trained and certified anxiety
disorders specialist with plenty of experience in helping
people successfully overcome depression and anxiety. If you
would like to meet me to discuss your difficulty and a way
forwards please do feel free to
make
an appointment here.
This article is copyrighted (except for the Guardian
link/article which remain the property of the Guardian) and
may not be copied without my express permission.
Disclaimer: This article is given
for information purposes only. The author cannot be held
responsible for any effects arising from the use of the
information contained herein, and any use of the information
in this article is used entirely at the risk of the user.
Persons with poor mental health should not consider
using these exercises but should refer themselves to their GP
for assistance.
|
