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Your Do-It-Yourself Guide to Fighting Depression – Part 4

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In the first three articles in this series, I have explored three basic changes you can make to fight depression. These changes were to increase depressed_personphysical, social and pleasurable activity. The behavioral changes are difficult because depression makes its victim want to decrease physical activity, withdraw from others, and avoid previously pleasurable activities.

I used the analogy that depression is like an ugly, mean troll that gets inside the victim’s body and makes him want to do the very things that feed it and make it grow. When a depressed person decreases physical, social and pleasurable activity, his depression worsens.

Today, we will consider the fourth do-it-yourself depression fighter, which is: question your perceptions. Yes, when you are depressed, you cannot trust your perceptions. Depression distorts our perceptions in several areas, and those distortions are fairly predictable.

Depression distorts our perceptions of ourselves, our current circumstances, our past events and our future. We’ll look at each of these in turn.

The most powerful negative perceptual distortion is the victim’s view of himself. The depressed person sees himself as inadequate, unimportant, unlovable and a burden to others. He believes that others would be better off without him. He focuses on his failures and mistakes and dismisses his positive attributes and successes. This distortion of self often contributes to suicidal thinking.

Such thinking is truly a distortion. As I listen to a clinically depressed person describe himself or herself, I am amazed at the differences between the person’s real self and perceived self. These negative perceptions are deep and strongly believed. Nevertheless, they are wrong.

The victim’s perceptions of his current circumstances are usually distorted as well. The depressed person focuses attention on the negative aspects of life, while seeming to totally ignore the positive aspects. He will acknowledge the positives when they are pointed out, but they soon fade from awareness.

Depression also distorts one’s memories. Past mistakes feel more dire and unforgivable. They stand out in the victim’s mind. They are analyzed and replayed over-and-over. Past successes are forgotten or ignored.

Finally, depression creates a painful and hopeless vision of the future. Expectations are negative and pain seems permanent. The future looks bleak.

All of these perceptions are distortions of the truth. The distortions are predictable. So is the impact.

To fight depression, the victim must understand that his perceptions are not real. He must not trust his thinking or his feelings. He must remind himself daily that those perceptions are inaccurate. He must listen to and trust supportive friends and family who assert that his negative perceptions are wrong.

Imagine that you participated in a research study for a new drug. The researchers were very clear that this drug would temporarily distort your perception, but that this distortion would appear very real. You would have to remind yourself constantly that the drug was making you see things that were not real. By not trusting your perceptions, you would be able to function fairly normally. Depression’s distortion of perception is very similar. Depression is a chemical imbalance and this imbalance distorts perception in the same way as the experiential drug.

You can take positive steps to conquer depression by increasing physical, social and pleasurable activities, and by questioning your negative perceptions. Take the first steps today. You’ll feel better for the effort!

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Your Do-It-Yourself Guide to Fighting Depression – Part 3

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This is the third article on do-it-yourself tools to fight depression. In the first two articles we began with the metaphor that depression is like a troll_3mean, parasitic troll that influences you to do the very things that will make him grow. He makes you decrease your physical activity and your social activity because doing so makes you more depressed, thus feeding the troll and making him grow.

The do-it-yourself techniques involve making yourself do the opposite. You make yourself do more physical activity and more social activity. You won’t enjoy it, of course. In fact, you will probably resist it with every once of energy you’ve got. But if you can make yourself do it. If you can get up and move. If you can reconnect with the people who care about you, you will feel better.
In this article, I want to explore a third tactic of the depression troll, as he attempts to grow stronger. He makes you decrease pleasurable activity. He does this in two ways. First, he saps your energy so you don’t feel like doing anything, even something you think you would enjoy. But worse, he takes away any pleasure you experience when you do previously pleasurable activities. Activities you used to enjoy, no longer feel pleasurable. There is a word for this in psychology; anhedonia – the inability to experience pleasure. The depressed person just doesn’t seem to enjoy anything.  Does that sound familiar?
Not surprisingly, the absence of pleasure worsens the depression, thus feeding the troll. So, what are we to do? How can we experience pleasure if the activities we used to enjoy no longer feel pleasurable?
I’m afraid the answer sounds a little like “fake it till you make it.” You have to make yourself do activities that were pleasurable before you became depressed. You identifying activities that you previously enjoyed, and you try to make yourself do them again,
You won’t enjoy them at first. You won’t look forward to them. In fact, you might dread having to do them, but doing them does help you in your fight against depression.
Of course, doing previously pleasurable activities won’t make a noticeable difference at first, but if you persist in doing those activities, you will gradually experience pleasure in them. Then they will serve to fight the depression and starve that mean ole depression troll,
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The Power of an Attitude of Gratitude

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thanksgiving_photoOnce more, scientific research has confirmed something that our parents and grandparents already knew; that counting our blessings will make us happier. In fact, practicing this one habit seems to improve our sense of emotional wellbeing more than any other behavior.

In the mid-1990’s, a branch of psychology began to emerge, called “Positive Psychology”. Rather than focusing on emotional illness or difficulties, this group turned their research toward increasing understanding of the factors that made some people exceptionally positive or mentally healthy.

We’ve all known some individuals who seem to handle life’s difficulties with exceptional grace, and just appear more happy, joyful or satisfied. They clearly experience their share of life’s up’s and down’s, but do with more peace and hope than most. The researchers in Positive Psychology studied such individuals to identify those traits, attitudes or habits they shared that allowed them to do this.

First, let’s look at the factors that did not predict happiness. The researchers found that material wealth or standard of living had very little to do with happiness. While the United States has the highest financial standard of living, we are clearly not the happiest people. Many people who have much less than us report that they are much happier.

The research also found that negative life events did not necessarily lower a person’s level of happiness on a long-term basis. Of course, one’s happiness does go down immediately after experiencing a negative life event, but the research found that the person’s level of happiness usually returns to their pre-event level within two years. This was even true when the negative event was extreme, such as spinal cord injury resulting in permanent paralysis. Interestingly, the same was true for positive life events. Immediately after the event, the person’s level of happiness did go up, but usually returned to their pre-event level within about two years.

The studies did find, however, that exceptionally positive people all share an attitude of gratitude. They report that they pay attention to the blessings in their lives. Most of them consciously and deliberately cultivate this feeling of thanksgiving in each day. Most report that, with practice, the attitude becomes more natural and automatic.

We can all learn to be more grateful. Make the decision to cultivate an attitude of gratitude starting today. Count your blessings. Write them down. Before your feet hit the floor each morning, make yourself think of five things you have to be thankful for. Thank those you love. Thank them for the things they do for you, but more, thank them for loving you and sharing your life. Look for opportunities to be thankful today. You just might find yourself feeling happier!

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Your Do-It-Yourself Guide to Fighting Depression- Part 2

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In the last post, we looked at depression as being similar to a mean, ugly, parasitic troll, which had gotten your body andtroll_2 mind. This destructive troll wants to grow stronger, so it makes you do the very things that feed it. Unfortunately, as it grows stronger, you grow weaker. Such is the course with all parasites.

This troll makes you feel fatigued, weak, heavy, and drained so you decrease your physical activity. When you’re depressed, you just want to sit, or worse, stay in bed. You almost yearn to be still and move as little as possible.

The depression troll makes you decrease your physical activity because this worsens the depression. To fight the depression you must make yourself do as much physical activity as possible. While this can be difficult, and seem impossible, you can do little bits of activity at a time. Then you can gradually increase the amount of activity.

Today, will cover the second do-it-yourself tool to fight depression. While the depression troll works to make you decrease your physical activity, he also works to make you decrease your social activity. He makes you want to withdraw from others. He makes you isolate yourself.

The depression makes you uncomfortable being around other people. You feel that you don’t fit in. You imagine that they are thinking negative things about you. You perceive that they are judging you. You feel more comfortable when you are alone.

Even when you are around others, you don’t talk as much or share as much. You feel a distance, even when others are in the same room as you. You feel disconnected. You may perceive that others are backing away from you, but it’s more likely that they are simply responding to your distance.

Your do-it-yourself tool is to make yourself do the opposite of what the depression troll makes you want to do. You approach others. You identify those in your life that have been the most supportive and positive toward you, and you approach them. You call them on the phone. You write an email. You invite them to lunch or a Saturday shopping trip. You make yourself spend time with others.

Then you try to make yourself connect. You make yourself talk, even when you don’t feel like it. You make yourself talk, even when you don’t think you have anything to say. You force yourself to make and maintain eye contact. You connect.

This will be uncomfortable at first. Every fiber of your being will want to run away, find an excuse to withdraw and go back to bed. That’s normal. Connect anyway.

Even if you don’t enjoy this increase in social contact, it helps significantly in fighting the depression. It starves that parasitic depression troll, until he just decides to leave you. I don’t know why it works, despite the fact that you don’t enjoy it, but it does work.

Do it now. Call that old friend or family member. Send a re-connection email. Just come out of your room and spend time with your family. Look them in the eye. Smile. You’re not alone.

Question: What do you feel contributes most to the depressed person’s tendency to withdraw, even from those who love them?

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Your Do-It-Yourself Guide to Fighting Depression (Part 1)

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Are you suffering from depression? Is someone you love suffering with depression? Suffering is the operable term here, because depression is trolltruly painful. People with both chronic physical pain and clinical depression have told me that they would rather have the physical pain than the depression. The pain of clinical depression is hard to describe, but you’ll know it if you get it.

The most effective treatment for depression is a combination of medication and cognitive psychotherapy, but sometimes those treatments are unavailable or may not be working well enough for you. Whether or not you are getting professional treatment, there are several do-it-yourself actions you can take to fight your depression.

Sometimes it helps to have a different way of perceiving depression. Think of your depression as a parasitic, mean, ugly troll that has gotten into your body and mind. This troll wants to grow, and it doesn’t care what it does to you. It is truly a parasite. The depression troll grows by making you do the very things that will feed it. It makes you yearn to do the things that make it grow and become stronger. By resisting these tendencies, you can weaken your depression and starve that mean, ugly, parasitic troll and make him go away.

There are four areas where the depression troll influences your behavior. To fight the depression and starve the troll, you have to do the opposite of what he makes you want to do. In order to give each area proper attention, we’re going to consider the four depression fighters in four consecutive blog posts. This is the depression fighter for today:

DEPRESSION FIGHTER NUMBER ONE:

INCREASE PHYSICAL ACTIVITY

Your depression troll makes you decrease your physical activity. You feel tired all the time. You don’t feel like doing anything. You don’t want to move. You feel heavy and drained of energy. The troll makes you feel this way because it feeds the depression, making it grow. The less you move, the more depressed you become. In contrast, the more you move, the less depressed you become.

Any activity or movement helps. Even getting up from the couch and walking around the house helps some. Any activity that makes your muscles move and speeds up your heart and breathing fights depression. Walking is a very effective depression fighter. A 20-30 minute walk every day would be great, but any amount helps. It seems to help the nervous system’s balance the neurotransmitters (the chemical foundation of depression).

I do realize that getting up off the couch or out of bed can feel like a monumental endeavor. It can feel totally impossible if your depression is severe. You may have to begin with very small increases in physical activity. Take a shower and get dressed. Walk from one room to the next. Step outside for a little while. Try to push yourself, but don’t chastise yourself if you can’t. Just try again later. Keep trying. Persistence is often the key to defeating depression.

You might also recruit a family member or friend to help you increase your physical activity. Tell them to push you, without fussing at you. This can be a fine line, so they will have to be careful, but the benefits of a supportive friend can be enormous.

Next week, we’ll look at the second step in your do-it-yourself guide to fighting depression, but for now try to increase your physical activity as much as you can each day.

Question: Share some actions that have helped you or a loved one fight depression.

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What My Dog Taught Me About Marriage

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In my outpatient practice, I often do marital therapy. Couples come in to work on improving, or perhaps saving their Poo_Dogrelationship. By the time they take this step, they have often experienced years of conflict or distance. Sometimes they are close to calling it quits and calling the divorce attorney.

My first task in marital therapy is an assessment of the situation. What are the issues? What are the patterns of communication? What are the trigger points of conflict? What are the personalities and motivations of each participant?

After this initial assessment, I will sometimes surprise the couple by telling them that they remind me a lot of my dog. This statement is met with some very strange looks, but at least I know that I have their attention. I go on to explain.

Several years ago, I was sitting on my front porch and my little white dog was playing in the yard. He never went into the road, but on this day he did. He ran into the road just as a car approached. The car hit him and ran over him. I watched helplessly as he rolled under the body of the car. The car drove on and my dog sat in the middle of the road, twisting and yelping.

I jumped off the porch and ran out to the road, while calling to my wife to get the car so we could take him to the vet. I reached down to pick up my dog to put him into the car, and he bit me on the hand.

It never entered my mind to be angry at my dog. I knew why my dog bit me. He bit me because he was in pain. I doubt that he even knew that he was biting me. He was just snapping at anything close because of his intense pain. His response was a reflex.

Most couples experiencing marital problems have been biting each other for some time. They didn’t bite because they were mean or because they didn’t love. They bit each other because they were in pain. They had been hurt by the other one and responded by biting back.

Unfortunately, each individual was aware of their own pain and their feeling that they had been bitten, but not aware that their responses had inadvertently bitten their partner. Not realizing that they had also bitten, they concluded that the partner bit because she was mean and critical or because he didn’t care.

My first task in doing marital therapy is getting each member of the couple to focus more of their attention on what they have done to hurt the relationship, rather than focusing on what the other partner has done. By realizing that they have also contributed to the problem, they can begin healing.

By the way, my dog recovered completely, and lived many years after the accident. By learning from my dog, many couples have recovered as well!

Question: Please share any experiences where you have recognized that you were not the only one being hurt in a relationship difficulty, and what you did about it.

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The single biggest problem in communication…

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I couldn’t agree more with this post by Otrazhenie. We assume we know that the other person is thinking or their intentions or their feelings. So often we are completely wrong, but don’t believe we are wrong. We then act on our mistaken assumptions, hurting the relationship and the other person. Don’t assume. Don’t do mind reading. Ask for clarification. Tell them your assumption and ask them if it’s correct. Notice how many times you are wrong. Your relationships will be better for the effort!    Terry Ledford, Ph.D.

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Story!

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You may be surrounded by wonderful, well-meaning people, but only you can know your needs, feelings and purpose. You can listen and learn from others, but you can’t allow them to direct your life. Live your life deliberately!

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Life’s Roller Coasters

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roller_coasterRoller coasters are fun because we know we will get off soon. We can thrill to the ups and downs and unexpected curves because of the flat part at the end, where we slow down, stop, raise the bar, and get off. The experience is pleasurable because we know that it is temporary.

Life sometimes feels like a roller coaster, with its own ups and downs and unexpected curves. Unfortunately, we often can’t see the flat part at the end where we slow down and return to normalcy. We imagine that our present chaotic ride will go on forever. We dread the next fall and anxiously await the next unexpected turn.

It does seem that negative life events often come in clusters. Just when we’re recovering from a jab in life, we’re struck with a right hook, and we find ourselves reeling and unsteady. Our only goal is to stay on our feet, or to put one foot in front of the other.

When you find yourself in the middle of a cluster of negative life events, you have to hang on tighter and realize that you’re not alone.  When life is unstable, we need to lean on others for assistance, advice, support or just their presence.

We also have to recall past negative clusters and remember that they eventually ended and that we survived. There is a lot of wisdom in the phrase, “This too shall pass.”

Most importantly, remember that the roller coaster had a creator, who knew each twist and turn long before you purchased your ticket. Trust that creator to bring you home to the flat part, where you can slow down, step onto stable ground and breathe a sigh of relief.

 

Question: When you’ve experienced the ups and downs of life, what steps have you taken to hold on and stay the course?