The reasons that people fall prey to depression can be quite varied but many if not most of those reasons are psychological in nature and thus need to be treated in a psychological format. What I mean by this is that something happens to the person or has happened to the person in their life such as separation/divorce, financial setback, having a baby, losing a job, loss of a loved one and other highly stressful, traumatic or anxiety provoking situations which leads them to conduct themselves in certain ways (physically and behaviourally) and to think and feel in certain ways which can lead to anxiety disorders and to depression.
Ongoing stress and anxiety releases negative chemicals such as cortisol into our bodies and this in turn can lead to a lowering of the positive chemicals that we need to feel good – such as serotonin. Whilst there has been no definitive proof that a lowered level of serotonin CAUSES depression, it is certainly a factor that cannot be ignored. Whether you can raise your serotonin levels through natural means (which you can!) or you choose to take anti-depressants is a very important and difficult consideration.
Anxiety disorders are numerous and specific in nature such as OCD (obsessive compulsive disorder), GAD (general anxiety disorder), specific phobias (of heights, confined or open spaces, animals, flying, needles etc.), PTSD (post traumatic stress disorder) and a few others. Depression, however, works on a continuum. You can be mildly, moderately or severely depressed. The symptoms tend to be the same but vary in their intensity and impact on a person’s quality of life. It is my opinion that anti depressant medications should ONLY EVER be used when someone has been identified as severely depressed and has been diagnosed as such by a psychologist, social worker or other mental health professional and not by a 10 question survey in a doctor’s office whilst the patient is in tears and feeling like their life is falling apart. Honestly, what other outcome are we to expect in that moment in asking them how they have felt in the past two weeks? Two weeks! Surely, a diagnosis of “clinically or severely depressed” needs to look at the person holistically and over the past couple of weeks if not months. Then and only then – when symptoms are occurring such as the inability to get out of bed and go to work, to shower or bath, to eat and where basic functioning in life has been impaired – should anti-depressants be prescribed.
And even then, only after other therapies, tools and exercises have been exhausted and no noticeable improvements have been seen. We may then have cause to take the risk WITH OUR PATIENTS of needing to start the journey of taking a substance that they may very well benefit from in the short term but which may prove to be very difficult to withdraw from when their crisis has past and they no longer need it.
The jury is still out on whether there is any significant relationship between genetics and depression. There is stronger evidence that there is a genetic link when it comes to disorders such as schizophrenia and bi-polar disorder but not so for anxiety and depression. One would always need to ask the question of whether it was genetics or the fact that the child grew up in an environment where a parent was suffering from anxiety and/or depression and thus the behaviour, thought patterns and general way of being in the world was picked up and learned. We learn many other behaviours and habits both good and bad from our parents and carers early on when they are our greatest reference point of what to do in the world. It is thus not difficult to understand the potential for the behaviours to be passed on in this way rather than through the genes. The further impact of an emotionally or physically abusive upbringing would add to the potential for the child to grow into an anxious or depressed teen and adult. I do understand that twin studies have shown two siblings growing up in the same environment may react very differently and one may end up with depression and the other not, ostensibly pointing to genetics as a factor in why someone gets depressed. However, isn’t it also true then that if it was pure genetics that both of the twins should develop depression?
It is true that some people develop depression when there does not seem to be any specific external reason for it and this type of depression is often very resistant to treatment both in terms of anti-depressant medications and/or therapy. A good friend of mine lost his brother through this type of intractable depression. This is known as melancholic depression. “Luckily”, very few people experience this type of depression and most depressions are caused through external events as well as psychological and behavioural habits. This (the most common) type of depression is known as non-melancholic depression.
Treating non-melancholic depression with anti-depressant medication can lead to amongst other things: blunting of emotions, lack of empathy, seemingly uncontrollable anger and outbursts, high levels of anxiety, loss of libido/sex drive, delayed orgasm (leading to difficulties in relationships as partners feel it is them not being able to satisfy or stimulate their partner anymore), memory loss (in particular, short term memory loss) and a host of other “side effects” we probably don’t even know about. And those are just the effects of staying ON the medication. Coming off them is another issue altogether and I devote a whole chapter to this in my book which is available as an Ebook on the website.
Why do people get anxious?
I believe that anxiety disorders are a combination of personality factors as well as learned behaviours from childhood and the teenage years that are carried forward into adulthood. Of course, children feel anxiety and fear and without support at the time that they experience their fear and anxiety about something (particularly if it appears to be intrusive and intractable or appears to be getting steadily worse) they may end up with an anxiety disorder that will require treatment at some point in their lives.
Anxiety becomes a way of coping in the world and responding to fearful thoughts that is automatic and deeply entrenched and healing requires learning new ways of identifying faulty thinking and fighting off recurring and sometimes obsessive thoughts about the “what if’s” of life. What if I don’t pass the exam? What if I approach her and she rejects me? What if lose my job? What if I can’t pay the rent? What if I get a serious illness? What if that pain and lump in my side is cancer? What if I can’t make it in life? What if I can’t afford to send my children to a good school and they don’t get anywhere in life? What if I don’t have enough money for my retirement? What if I fail? What if I never find a partner or have a baby? What if I end up alone? What if I left the stove on? And it goes on and on.
What I often amuse myself with is wondering why we humans seem to have been wired to think about and look for the dangers that seem to be all around us just waiting to pounce on us around the next corner. And I guess I have used “waiting around the corner” and “pouncing” purposefully here because in the days of our early ancestors they HAD TO be fearful and prepared to fight or run away (super fast) in order to survive or they would be eaten, maimed or killed by animals or other humans at any moment. And so, part of my own theory about why we naturally find ourselves imagining the worst outcomes is because we are looking for the tiger that is going to eat us. Our stress response is still the same as it was when we were cavemen but the causes of our stressors are now mental events and very seldom the actual physical threat to our lives. And so we sit in our offices or doing what we do for our work and in our personal lives and we have triggers (not tigers) that set off our stress response and we cannot literally run away or punch our bullying boss in the face. Or could we? J Maybe more people should actually punch workplace bullies in the face and then claim it was their stress response and they were acting in self defence!
Of course, there are many other potential contributors to stress and anxiety. Some of these include actual stressors such as financial strain, relationship difficulties as well as prolonged health conditions such as chronic pain. There are also contributors such as caffeine and a diet that is high in sugars as these will both play with someone’s moods and ability to think clearly. Lack of sleep is also a very close contributor to stress and anxiety, effectively lowering our resilience and ability to cope with life’s ups and downs. It is important to ensure that if you are someone who struggles with stress and/or anxiety that you ensure you do not have more than one caffeinated drink per day and preferably early in the morning and certainly nothing beyond 2 or 3pm latest.
My book and the work I do is about understanding stress, anxiety and depression as well as what causes our moods to change from day to day and week to week. It is also about all the tools and strategies that I have used and shared with my clients over the past 15 years that can assist you to start to take your life back. To learn how to get yourself into a different state of mind and level of focus and energy to allow you to be the person you were meant to be.
What is depression?
For people who have never experienced it, it can be very hard to describe to them what it feels like being deeply depressed. The feelings of helplessness and of being trapped in a deep, dark hole are debilitating to such an extent that the depressed person finds him or herself unable to even get out of bed in the morning. I am not talking about your everyday Monday morning blues here. We all experience that from time to time and hit that snooze button in winter a few times too many. Feeling comfortable and warm in our beds and not wanting to get out is one thing. However, feeling like getting out of bed is an unbearable and terrifying thought because you cannot face the day and are playing mental war games with yourself to try and get moving is a very different psychological state to be in. It is pure torment. I know because I have been there. I have counselled people who have been there too.
There are many triggers that may lead someone into a depression including: loss of a loved one, divorce, loss of a job, loss of health, monetary concerns, abuse of alcohol, gambling and relationships difficulties. In and of themselves, these triggers do not always cause someone to become depressed. People are very different in how they respond to such things. Some people appear to be more resilient than others. Having said this, there is usually an underlying level of negative and faulty thinking patterns and suppressed emotions in the person who then falls into a depression after such events. The other thing to note is that anxiety over a prolonged period of time can be its own catalyst and trigger for someone to become depressed. More about this in the next chapter.
We also need to understand that there is a major difference between sadness and depression. We can feel sad for the loss of something or someone important in our lives but it is usually more of a fleeting emotion and we can within a short period of time move through to experiencing the other range of human emotions such as joy and hope for the future. With depression, the negative rumination continues for days, weeks, months and in some cases even years.
Some additional signs include people finding it difficult to enjoy things that they used to enjoy; they lose motivation and energy to do some of the simplest things. They start to isolate themselves from friends and family because they feel they cannot handle having to hold a normal conversation and they will often fear that people will think less of them. So, they stay away. Being around happy people who seem to have their lives in order can be extremely difficult for the person going through the mental torment of depression. Unfortunately many of the people who could support the depressed person don’t really know how to help or what to do when the depressed person isolates themselves. When I run seminars on anxiety and depression I often get friends and family members of depressed people asking how they can get the depressed person to engage socially, exercise or go for counselling. I will say that they obviously cannot force someone to do any of those things but to be there for the person and consistently and gently encourage them to take the steps they need to take to heal their depression. There are other tips and support available for concerned friends and/or family members of someone who is suffering with depression that can be found on the Beyond Blue website (This is a not for profit Australian organisation with the aim for educating the public and supporting people with anxiety and depression).
My goal as a psychologist is to help all my clients in the most holistic way possible to find their way out of anxiety and depression and to begin to live their lives in a more calm, happy and peaceful manner. Working through your past is important as part of this process to understand why you think and act the way you do as is learning tools like cognitive behaviour therapy and acceptance and commitment therapy. I will also teach you about mindfulness and how to meditate effectively. I don’t leave a stone unturned when it comes to understanding my clients and working with them to lead happier, healthier and more fulfilling lives.
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