Relationships - Beating depression
There are various ways to tackle depression
Depression is becoming increasingly common. Apart from its popular connotation to sadness, never before have antidepressants been prescribed as much as today. Yet depression can mean a lot of things and clinically there are many variations too. The World Health Organisation identifies major depression, dysthymia, bipolar disorder, cyclothymia, and seasonal affective disorder among some others. Identifying the difference can be tricky, especially for the untrained. Common symptoms of depression include low mood, loss of interest, loss of pleasure, appetite changes, sleep changes, feelings of worthlessness, and hopelessness, which is known to be the symptom highly implied in suicide. A wish to die can be another symptom of depression.
Suicide is a risk in depression and clinicians always look out to make a good risk assessment. Suicidal behaviour is very complex and risk depends on many factors including age, gender, class, personality, and to make things worse, change over time. Other major risk factors in suicide include impulsivity, adverse life events, a family history of mental disorder or substance abuse, a family history of suicide, family violence, physical or sexual abuse, a precedent suicide attempt, a firearm in the house, incarceration, exposure to the suicidal behaviour of others including news or fiction stories.
Research abroad shows that about 90 per cent of people who commit suicide had depression. It is not true that if a person talks about suicide they will not attempt it. More than 58 per cent of those who commit suicide speak about it in the previous week. Taking these remarks seriously is paramount and helping the person seek professional help is often vital. The persons in crisis are often not aware that they need help and are not able to ask for it on their own.
In some cases, taking medication is a must if one wants depression to subside. A high level of depression often hinders the work of the psychologist or psychotherapist because the person can't process information properly. However, medication on its own is often not enough either as it does not help the person change mental processes which are normally associated with depression.
Here are some hints to help you out of your depression thinking.
Do more and think less: Ruminating is a great pitfall in depression. Two types of thinking are particularly unhelpful. First come the dwelling and brooding over problems. Second comes "introspection", excessive thinking about what one might be doing wrong. Excessive thinking doesn't do any good in life anyway. Action, on the other hand, is helpful. Doing things of any sort seems to work better for depression than ruminating. Doing things like work, a hobby, walking, meeting people and crafts all help improve one's idea about oneself. So think less and do more.
Envision a future you want: Whether you think in the short term or long term, whether the future means next weekend or next holiday or the next 10 years doesn't matter. To look forward to the future is a powerful antidepressant. You need to have a clear picture of what you want. If you don't have one, think of one, draw it or write it down, talk about it with whoever. Then work out the steps you need to take to achieve it. Future thinking is very helpful so this will also get you into a different thinking pattern.
The way one thinks is definitely a primary factor in depression. Some people are "programmed" to think negatively all the time. It's like they have been instructed to make a catastrophe out of every event that happens to them. Even a positive experience is turned into a negative one. Some actually believe that thinking about the possible bad actually prevents the bad from occurring. Others falsely believe they are unlucky. Negative self talk has a powerful impact on the way people think about life. Instructing yourself to be happy and relaxed is essential. Talk to yourself using nice and positive language.
You can do this exercise in front of a mirror, say to yourself "I am happy and relaxed" or "I am a happy person". Because you have been through some tough experiences doesn't mean you have to be miserable about them. Get yourself into the habit of speaking nicely to yourself and to others as well. The language we use when we talk with others is very important. Use a positive tone of voice and avoid moaning or grumbling. Sweeping statements like never or always are also unhelpful. As the late Steve de Shazer used to say: "Nothing happens always".
Getting yourself into a good routine of exercise, sleep, and good nutrition is essential to beat depressive phases. The human body likes routine and establishing a good circadian rhythm is very important. Exercise helps release endorphins in the brain, those chemicals which are implicated in one's sense of well being. Some people lose or gain appetite when they are feeling low. Make sure you stick to your normal diet. Avoid self medication and consult a professional. The popular drugs like alcohol, cigarettes, and coffee can make things worse.
Acting as if you are happy and relaxed has been found to be very helpful. The way we walk, sit, talk, stand, and so on give messages to the brain about how we are. It is therefore a good idea to send non-depressed messages to the brain.
Posture is also very important. Putting a smile on your face, even a forced one, releases helpful chemicals in the brain.
Sort out your problems: Sometimes, people with depression fall into a lethargic mode and do little or nothing to resolve the problems that are spiralling down their depression. Worse than that, solving problems by creating others is also to be avoided. If you are unhappy about work and drink alcohol "to forget about it" you will only create another problem. As much as having financial difficulties and resorting to gambling creates further debts and financial problems. It is especially important to sort relationship problems with intimate partners and relatives, or with friends. If you are unsure about how to resolve certain problems consult professionals whose job it is to help out in such circumstances.
• Mr Azzopardi is a systemic family therapist.
Suicide is a risk in depression and clinicians always look out to make a good risk assessment. Suicidal behaviour is very complex and risk depends on many factors including age, gender, class, personality, and to make things worse, change over time. Other major risk factors in suicide include impulsivity, adverse life events, a family history of mental disorder or substance abuse, a family history of suicide, family violence, physical or sexual abuse, a precedent suicide attempt, a firearm in the house, incarceration, exposure to the suicidal behaviour of others including news or fiction stories.
Research abroad shows that about 90 per cent of people who commit suicide had depression. It is not true that if a person talks about suicide they will not attempt it. More than 58 per cent of those who commit suicide speak about it in the previous week. Taking these remarks seriously is paramount and helping the person seek professional help is often vital. The persons in crisis are often not aware that they need help and are not able to ask for it on their own.
In some cases, taking medication is a must if one wants depression to subside. A high level of depression often hinders the work of the psychologist or psychotherapist because the person can't process information properly. However, medication on its own is often not enough either as it does not help the person change mental processes which are normally associated with depression.
Here are some hints to help you out of your depression thinking.
Do more and think less: Ruminating is a great pitfall in depression. Two types of thinking are particularly unhelpful. First come the dwelling and brooding over problems. Second comes "introspection", excessive thinking about what one might be doing wrong. Excessive thinking doesn't do any good in life anyway. Action, on the other hand, is helpful. Doing things of any sort seems to work better for depression than ruminating. Doing things like work, a hobby, walking, meeting people and crafts all help improve one's idea about oneself. So think less and do more.
Envision a future you want: Whether you think in the short term or long term, whether the future means next weekend or next holiday or the next 10 years doesn't matter. To look forward to the future is a powerful antidepressant. You need to have a clear picture of what you want. If you don't have one, think of one, draw it or write it down, talk about it with whoever. Then work out the steps you need to take to achieve it. Future thinking is very helpful so this will also get you into a different thinking pattern.
The way one thinks is definitely a primary factor in depression. Some people are "programmed" to think negatively all the time. It's like they have been instructed to make a catastrophe out of every event that happens to them. Even a positive experience is turned into a negative one. Some actually believe that thinking about the possible bad actually prevents the bad from occurring. Others falsely believe they are unlucky. Negative self talk has a powerful impact on the way people think about life. Instructing yourself to be happy and relaxed is essential. Talk to yourself using nice and positive language.
You can do this exercise in front of a mirror, say to yourself "I am happy and relaxed" or "I am a happy person". Because you have been through some tough experiences doesn't mean you have to be miserable about them. Get yourself into the habit of speaking nicely to yourself and to others as well. The language we use when we talk with others is very important. Use a positive tone of voice and avoid moaning or grumbling. Sweeping statements like never or always are also unhelpful. As the late Steve de Shazer used to say: "Nothing happens always".
Getting yourself into a good routine of exercise, sleep, and good nutrition is essential to beat depressive phases. The human body likes routine and establishing a good circadian rhythm is very important. Exercise helps release endorphins in the brain, those chemicals which are implicated in one's sense of well being. Some people lose or gain appetite when they are feeling low. Make sure you stick to your normal diet. Avoid self medication and consult a professional. The popular drugs like alcohol, cigarettes, and coffee can make things worse.
Acting as if you are happy and relaxed has been found to be very helpful. The way we walk, sit, talk, stand, and so on give messages to the brain about how we are. It is therefore a good idea to send non-depressed messages to the brain.
Posture is also very important. Putting a smile on your face, even a forced one, releases helpful chemicals in the brain.
Sort out your problems: Sometimes, people with depression fall into a lethargic mode and do little or nothing to resolve the problems that are spiralling down their depression. Worse than that, solving problems by creating others is also to be avoided. If you are unhappy about work and drink alcohol "to forget about it" you will only create another problem. As much as having financial difficulties and resorting to gambling creates further debts and financial problems. It is especially important to sort relationship problems with intimate partners and relatives, or with friends. If you are unsure about how to resolve certain problems consult professionals whose job it is to help out in such circumstances.
• Mr Azzopardi is a systemic family therapist.