DEPRESSION IS A PHYSICAL ILLNESS

Overcoming depression needs to be dealt with on a physical level. We tend to think of depression as an ‘emotional’ problem but it’s actually also a physical illness. I remember when the doctor told me that I was suffering from depression I was horrified! After all who wants to acknowledge that they have a mental illness. Maybe you reacted the same way. I found a diagnosis of depression far more acceptable when the doctor explained that depression was a physical illness.

I found this diagram very helpful. Understanding the cycle can help you break the cycle.

Work your way around the diagram clockwise, starting in the top right corner with stress.

STRESS, stress, BIG TIME STRESS! 

Depression always starts with stress and is also associated with loss. It can be a very real loss like the death of a loved one, or the loss of a job. At times, it’s an internal loss, like a loss of self-esteem. Stress is not the same for two people. An event that one person finds hugely stressful might cause no stress whatsoever to another. We can conclude that stress is caused by the way we view the situation. It’s our perception of what is happening that can cause the stress.

Cognitive therapy is essentially a therapy of your thoughts and is regarded as the most successful therapy for overcoming depression. In my experience, I have to agree with this. In cognitive therapy, a very important premise is that it’s not the situation or event that causes stress, but rather it’s personal meaning that causes the stress.

Don’t throw your arms up yet in disbelief, or even horror! Bear with me, I’ll deal more with this as we carry on and even more in the article on PSYCHOLOGICAL ASPECTS, so hold your fire! But let me give you some examples of what I’m saying right here.

• Are you a perfectionist? Perfectionists are very prone to depression as their standards are impossibly high; they never meet them and constantly feel that they’re a failure. The motto for many perfectionists is ‘If you can’t do it perfectly, don’t do it at all.’ Recognize that thought? Often this fear of failure stops the pereson from even trying, as mistakes are a train smash. This type of thinking is very stressful. Whereas another person sees a mistake as part of life and a part of life’s learning process. It’s okay to make mistakes because you can learn from them. After all how else do you learn? Obviously the second person’s thoughts are more based in reality and this type of thinking does not result in stress or depression.
• Are you a people pleaser? People pleasers is the other group particularly prone to depression as their mood is dependent on other people’s approval. This is actually an impossible situation. You can’t please everyone and it places the responsibility for your moods outside of your control and into the hands of others. The result is that every time someone disapproves of you it pushes you into the downward spiral of depression.

Two more examples: You have two salesmen and neither of them closes a particular sale. The one salesman says ‘On, darn it, I’m useless as a salesman, I’ll never make it, I may as well just give up’. How is this man going to feel? Without a doubt he’ll feel down in the dumps. On the other hand, the other salesman might say ‘Well I can learn from that experience. I’ll polish up on my sales techniques so I’ll do better next time’. These thoughts won’t pull him into depression.
Last one! You phone an acquaintance, leave a message and the call isn’t returned. What goes on in your mind? Perhaps thoughts like ‘what did I do wrong? My so-called friend obviously doesn’t like me if they don’t bother to return my call and if they can’t be bothered to phone me – well I won’t bother either!’ These thoughts will lead to a loss of self-esteem and will make you feel down. Ask yourself if you are really sure that these thoughts are based in reality. You won’t know if you don’t check them out. Or maybe you think along these lines. ‘I wonder if he got my message. Maybe he’s busy or could have forgotten. Anyway, let me give him a ring to find out.’ These thoughts won’t lead to depression and internal stress as they are grounded in reality.

I hope you can see that it is the way we think that causes us to feel depressed and stressed rather than the event. Happy thoughts lead to a happy mood. Sad thoughts lead to a sad mood. Your thoughts determine your mood, not the other way round. The difficulty is that most of us are unaware of our thoughts and our thoughts have become automatic. This is where the article on PSYCHOLOGICAL ASPECTS should help some more for overcoming depression.

WHY STRESS LEADS TO DEPRESSION

The reason is very simple. Stress uses up the brain’s thinking chemicals, like serotonin. Let me try and give a simple explanation. Thoughts travel as an electrical impulse along one nerve and they end in what is known as a synapse. The thought now needs to ‘jump’ across to another synapse to continue its journey along another nerve. The problem is that there has to be these brain chemicals between the synapses for the thought to jump across properly. You can think of the ‘thought’ as being like a canoe on one side of the river. If there is insufficient water in the river, the canoe won’t be able to row cross properly and would possibly get stuck in the middle. Same with our thoughts. Stress depletes ‘the serotonin river’ running between the synapses and the thought cannot cross properly. These thoughts are a bit like a radio that’s badly tuned. There’s nothing wrong with the original broadcast but it reaches you all ‘cracked up’! Basically the thinking process short-circuits and the thoughts are not transferred properly.

Normally the body would replenish the brain chemicals between stressful events, with a bit of time-out or stress-free activity. But when there is no time for this and the stress never lets up, it’s time for medical treatment to restore the chemical level.

NEGATIVE THINKING

We’re still on the right hand side of the diagram in the second button. The symptom of depression is negative thinking. Feelings of being worthless, unlovable, guilty are common. Because the symptom of negative thinking is common to all depressed people, it really does indicate that these thoughts are really the result of insufficient serotonin, rather than a genuine worthlessness as the thoughts would have you believe. These thoughts are not based in reality and are caused more by a lack of serotonin. The negativity showed by a depressed person often seem uncharacteristic and this in itself should alert one to the fact that the person is ill.  The brain is ill. The brain is just an organ of the body like every other body organ and can get ill. Somehow we accept that all the other body organs get ill, but not the brain. We expect the brain to work perfectly all the time. However, overcoming depression is so much easier when we just accept that the brain gets ill and can need treatment. So, my advice is, swallow your pride, go to your doctor and get treatment!

IN THE PIT

A person experiencing severe depression often refers to being in the Pit or in a dark tunnel.  It’s a pit that seems to take an all-consuming hold on you. Life feels impossible and that is when suicidal thoughts become a problem. And before you even think that your family would be better off with you dead, throw that dreadful thought out of your head! That type of thought is not based in reality and is part of the illness. You can check out the truth of that thought with your family if you like!

Story of ‘In the Pit’. I wrote this story to help anyone unfamiliar with the ‘Pit’ to get a greater understanding. Share it with your loved one or a friend who is wondering what is going on with you and wants to help. But tell them to first switch off the TV! Ask them to close their eyes while you read so they really get the picture.

‘Imagine yourself in a dark pit, you don’t know how you got there. You just seemed to land on a slippery slope and down you went. It’s very scary, nothing makes sense, and you can’t see anything. Thoughts bombard you from within, a bit like bats flying round you in a dark cave … you’re worthless, you’re guilty, you’re unlovable, life’s hopeless. You become restless and irritable. You can’t sleep. You’re tired but sleep doesn’t come. Your appetite is gone and you can’t eat. Things that you used to enjoy hold no appeal now you’re in the pit. You try to claw your way out, it’s such a battle … maybe death would be a welcome alternative. It’s very scary and you realize you will need help to get out. But this thought is also scary because it’s difficult to trust anyone … you’ve learnt to be so self-sufficient, people can hurt. You get a grip on the edge of the pit and hope someone will give you a hand and pull you out. Someone does come along and your hopes rise. People peer over the edge and you hear comments like:

• What’s your problem?
• I’m surprised, I thought you were stronger than that.
• No one ever said life was fair.
• Pull yourself together.
• Stop feeling sorry for yourself.
• There are lots of people worse off than you.

You feel yourself loosing your grip on the edge of the pit.

• You have so many things to be thankful for, why are you depressed?
• You think YOU’VE got problems…!
• Cheer up!
• You need to get out more.
• Well, everyone gets depressed sometimes.
• You never think of anyone but yourself.
• You’re just looking for attention.
• You don’t LOOK depressed.
• Maybe you should take some vitamins, or chamomile tea for your stress.

All these comments hurt you so much, maybe you were right not trusting people.

Then some other people come along and hear you struggling to get out of the pit. Maybe these people will help. You hear these words.

• I love you, let me give you a hand.
• I do care, let’s go out for a cup of coffee.
• You’re not alone in this.
• I’m not going to abandon you.
• Hey, you’re not crazy.
• I can’t fully understand what you are feeling, but I’ll try.
• You’re important to me.
• All I want to do now is give you a hug and a shoulder to cry on.
• When all this is over, I’ll still be here and so will you.
• It will pass. We can ride it out together.

MEDICATION

You’ve seen the doctor and the doctor has prescribed medication. That’s terrific, you’ve started your journey out of the pit! You’re on your way to overcoming depression. Getting treatment is the wisest decision you could make.

Anti-depressants aren’t ‘happy pills’. They don’t take away the knocks that hit you, but they will keep your serotonin level normal, giving you back a normal mood. This gives you the chance to work out your problems, especially your thinking. Sorting out the emotional side is very stressful but worth it in the long run.

You really don’t need to tell everyone you’re on anti-depressants. You don’t tell the world about your blood pressure tablets or most other tablets. Let’s face it there are many unsympathetic people out there who might say hurtful things. By all means tell a friend who is sympathetic and is going to help you through your journey in overcoming depression.

It will probably take at least two weeks before you start feeling a bit better, with your thoughts becoming a bit more normal. You might feel so relieved that you throw out the pills. Big mistake! It’s the pills that are making you feel better and without the pills, it won’t be long before you slip down that slippery slope again. It’s a bit like being thirsty. A sip of water might take away your thirst for a short time but you need a glass of water to quench your thirst. Likewise your brain needs a full dose of medication for at least 6 months to ‘quench its thirst’.

Work with your doctor and say how the medication is affecting you. That is the only way the doctor will know if you’re getting better. You might be lucky with the first medication you get but if you have side effects talk to your doctor, as there will definitely be one that agrees with you. The doctor might not suggest therapy, but I think this is also very important.

Oh, and I must mention that anti-depressants are NOT addictive. Tranquilizers are and should be taken with care. You will NOT get addicted to your anti-depressants and your doctor will advise you on the best way of cutting down your dose when you are better.

• How long must I stay on medication?

The first time you’re on medication stay on it for between 6-9 months so that the serotonin level can be properly restored. The second time you’re on medication you’ll probably need to stay on for about a year. After a third breakdown you’ll possibly need to be on a life long maintenance dose. Don’t despair; rather be thankful to the huge advancements in medical science. There is a large number of anti-depressants, there will be one that will suit you. for medication that can keep one normal. Listen to your doctor’s advice.

• Can I mix homeopathic and pharmaceutical medication? 

To put it bluntly, the answer is no! Do not mix homeopathic or naturopathic medication with pharmaceutical medication as they can have an allergic reaction. I heard of someone who died from taking a combination of Prozac and St. John’s Wort. I cannot emphasise too much the importance of working with your doctor for overcoming your depression. The doctor will also assess any other meds you might be taking to ensure no adverse effects. Read the instruction list inside the box of pills. Something like St. John’s Wort is only suitable for very mild depression.

• Self-medication – good idea or bad idea?

Many people use alcohol, drugs, and flirting with the opposite sex to self-medicate. All of these are a substitute for real psychological health and it’s really a bad idea to replace depression with one of these other problems.

• What about alcohol to make me feel better!

Another bad idea!  Many people with an alcohol problem are actually self-medicating for depression. Alcohol initially increases the serotonin level in the brain resulting in a ‘happy’ mood. The downside is the next day when the serotonin level drops to an all time low. How do you remedy this? More alcohol is needed to boost up the serotonin level again. Who really wants to be treat for alcoholism as well as depression. Rather seek out therapy.

SELF ESTEEM

I think one of the biggest blow during depression is the loss of self-esteem and sense of self worth. One’s confidence takes a down ward plummet. This very unfortunately is part of depression, a result of a lack of serotonin and the negative thinking associated with it. Don’t buy into this idea of having no worth because then you just let it take root which makes the situation worse. So the next time the thought comes into your head that you are worthless talk back to that voice. Listen to the ‘best friend voice’ in you rather than believing that ‘worst enemy voice’ to be the truth. Be kind to yourself as you would be to a friend. We can be very hard on ourselves.

• Our behaviour matches our self-esteem

If you think you’re worthless you’ll behave in a way that matches this. It’s called a self-fulfilling prophecy. Think about it. Turn the tables by acting self-confident. People will then respond to you as if you were a confident person and that boost will help your self-esteem spiral go up.

Let’s think a moment about worth. Everyone has the same worth just because we’re created beings with a place on this planet. In this world we so often get our sense of esteem from our looks, our wealth, our status, the type of car we drive or our job position. This really makes no sense. We don’t judge a baby as being worthless because it has a nil bank balance. Nor do we judge someone like Mother Teresa as worthless. She too had none of these worldly things. We just need to look at superstars like Elvis, Marilyn Munroe and Freddy Mercury. They had all the material things the world could offer them but they died lonely, unhappy people.

Don’t link your self-worth or the worth of others to material things. The Bible speaks a lot about this.  Your looks will fade as you grow older and your bank balance may diminish through no fault of your own. Some people have their sense of worth so tied up with their work that their sense of purpose is lost when they retire. Statistically it has been shown that some people even die within 6 months of retirement because they have lost their purpose in life. They give up the will to live.

If you’re a Christian, base your self-esteem in Christ and what He says about you. You know what it’s like when you are so in love with someone that you would rather die than be separated from your loved one? How often do we hear young lovers say they can’t live without their loved one? This is the kind of love that God has for each one of us, a love so deep that Jesus, God the Son chose to die rather than be separated from us for eternity. All we have to do is accept this love gift. Who am I to say that I am worthless, when the Son of God was prepared to die for me? Believing that you are worthless will obviously make you feel depressed. God wants you to live life to the full. See more in the article on SPIRITUAL ASPECTS.

DEALING WITH STRESS

As I’ve mentioned several times, the basic principle in cognitive therapy is that depression or anxiety are caused by your thoughts. By learning to change how you think and learning to deal with stress, you can stop the depression cycle from reoccurring or at the least stop it before you fall into the pit again. Want to do this? Click on the article page called PSYCHOLOGICAL ASPECTS.

A word of encouragement from me to you! Well done! You’ve read this far and I can see that you are obviously taking overcoming depression seriously. Best wishes from me as you continue in this exciting journey called life!