|
What
is Depression?
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%)
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!
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. 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!
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 for a consultation.
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.
Please do check back
periodically for new information. These articles will be extended
and replaced over
time with new articles and info.
|
.JPG)
