My thoughts on depression

Every year one in four people suffer with a mental health issue. Consider the number of people you know – friends, colleagues, relatives – one in four of them are struggling each year – I guess that with some of them you know about their struggles and with some you don’t.

If we are physically ill we usually get sympathy – people understand if you have a broken leg or the flu, if you are in hospital for an operation people bring flowers and grapes and yet somehow with mental illness we are often treated differently.

Certainly there is much less stigma than there was even 25 years ago when I started in private practice as a Psychotherapist, but it’s still there. We still don’t fully understand the brain and how and why it goes wrong; however we do understand a lot more. We know that, like any other area in the body it can go wrong, it is very common and that generally we can recover from it. There are many things that we know help.

It seems to me that we take much more responsibility for our physical health (whether or not we do anything about it) than we do our psychological health. We can do things to take care of our psychological health and we can do things that are detrimental to it.

Someone in the world commits suicide approximately every 15 seconds and many of those have depression. Depression can be a hugely disabling and distressing experience for people.  There are various degrees of depression and most people who are depressed do not take their life and the majority of people either recover fully or lessen the symptoms of depression.

Depression is a change in chemical makeup in the brain that affects the brain’s function. This change affects people differently and so depression is not one thing. One of the major problems with depression is that we lose our motivation and that’s what makes it hard to overcome.

Symptoms of depression can include loss of pleasure and interest, worthlessness, guilt, inadequacy, helplessness, weakness, sadness, despair, self-hatred, irritability, loss of memory and concentration, indecisiveness, suicidal thoughts, fatigue, lethargy, sleep disturbance , restlessness, agitation, headache, muscle pain, back pain, weight loss or gain, loss of sexual desire, no enjoyment. It is also often associated with anxiety.

We all feel bad some of the time. Our lives are not quite how we want them. We go through painful bereavements, heartbreak, stressful times at work and home, financial worries and a whole host of other things. It is important for us to feel the losses and experience those bad feelings as they are indicators to us that either things need to change in our life or we are going through a natural process of grieving. If we medicate those feelings away we can lose our perspective and motivation.

In my 25 years of working as a Psychotherapist, I have worked with many people who have been prescribed anti-depressants who I don’t think were depressed – I have also worked with many others who clearly were depressed. I think GPs have a very challenging task – they are generally not experts on the brain, they have limited time and patients go in wanting to feel better. My sense is that often depression can be misdiagnosed and drugs given out too readily – this does not mean that people are not suffering but that I don’t think that medicating our suffering away is good for our human systems. It is also not to say that medication would not be the appropriate treatment in some cases where depression is accurately diagnosed. There are some towns in the UK where one in every six people are on anti-depressants.

We humans are meaning making creatures; we create narratives or stories for ourselves and call it reality. Depending on our early life experience we will have more or less of a propensity towards stress, depression and/or creating negative narratives.

The left hemisphere of the brain has a bias towards positive feelings, social behaviour and assertiveness, all of which help us to connect with others and find safety in groups. The right hemisphere has a bias towards suspiciousness and negativity to keep us vigilant and alert to danger. Both are useful but people who are depressed have too much right brain activity going on and need to find a way to stimulate the left brain – it’s like a muscle and therefore we need to use it.

What can be done?

If you think you or someone you know may be depressed then know that people can come through this and feel good again. We will never feel happy all of the time.  That does not mean people are depressed, it means we are human. People’s efforts will pay-off if they are willing to let go of feeling bad (sometimes we are unconsciously invested in feeling bad because it’s familiar, we get taken care of, and/or it means we can avoid things we don’t want to do).

Anti-depressants can help some people but they don’t address the root cause. It’s like taking a headache pill: I think we need to address what it is we are doing to give ourselves a headache.

Counselling and Psychotherapy have been found to be very helpful for a range of reasons. Choosing a therapist is a very individual thing, different counsellors/psychotherapists suit different people. Studies show that therapists from different theoretical trainings come out equal in terms of positive outcomes. Good therapy is not about the model someone uses but about the relationship between therapist and client, the client’s willingness to engage and it needs to be long term. In my opinion 6 sessions of CBT (or any theory) is unlikely to address the issue. For therapy to work I believe it needs to be in an attached empathic relationship and it’s in that relationship that the brain changes.

Mindfulness meditation has been found to be very helpful if people practise it regularly. Lots of studies show the beneficial impact on us, our brains and our psychological health, when practiced regularly it helps with a whole range of mental health issues including depression. It creates that left hand shift in our brain and encourages a feeling of wellbeing.

Studies show that self-awareness improves self-esteem, relationships, ability to manage stress, all sorts of things and it can be fun too. People who are depressed could help themselves by doing things such as counselling, psychotherapy, workshops and courses, coaching and reading self-help books.

What we eat impacts how we feel and how we function. Looking at our nutrition can be an important way to take care of our physical and psychological health. It’s good to educate ourselves about what it is we are really putting into our body and the effects that has on us. If people are feeling low then it would be useful to consider increasing their omega 3 and eating more fish, nuts, eggs, bananas.

We already know that exercise is important for our physical health but it also impacts our psychological health. People who are suffering with depression or low mood should make sure that they get some exercise every day, even if it’s just ten minutes per day and even if they don’t feel like it: It increases your serotonin levels and being out in nature creates a feeling of wellbeing.

There are many other things that have been found to be helpful like social contact, improving sleep, light boxes, St John Wort, acupuncture, and anything you enjoy doing. There is a lot we can do to improve our mood and there is a lot we can to lower our mood. It sounds simple and in some ways it is and at the same time when people are feeling low and unmotivated doing these things can be very challenging.

Prevention, as ever, is better than cure so even if you don’t have mental health issues it’s a good idea to do things to take care of your psychological health and so more likely to ensure you do not suffer in the future

Happiness is not about others, it’s not about our life situation, how much money we have or what car we drive, it is about us, it’s about how we feel about ourselves our internal state.

Things that will help people are to have a realistic expectation of themselves, life and their feelings. To learn to forgive themselves for mistakes and to value themselves as they are. To take time each day to focus on what people do have and be grateful for that.  Often we spend time on what we are lacking or don’t have and that, of course, impacts the way we feel.

Nic Parks, happiness researcher and founder of the Centre for Well-being at the UK think tank New Economics Foundation, says to be happy we need

  •             To connect with others
  •             To give to others,
  •             Be active,
  •             Take notice of the moment and what’s going on,
  •             Keep learning

Good luck with your journey and if I can help let me know.

Leilani Mitchell Dip Couns, CTA (P) UKCP Reg Psychotherapist. TSTA (P) Sen Acc. Supervisor BACP. Chair of Trustees of UKATA (United Kingdom Association for Transactional Analysis). She is co founder of The Link Centre, a centre for counselling and psychotherapy training based in Newick, near Haywards .

These are my random ramblings of today, tomorrow I may change my mind

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