Depression IS manageable: keep your rainbow paints with you by equipping yourself with 'mood management know-how:' / image courtesy of maen_cg at freedigitalphotos.net
Society is becoming aware and accepting, toward the fact that, either suffering the condition of depression is more commonplace in society than we previously thought was the case, with common estimates that 1 in 5 Australians will be affected by depression to varying degrees or lengths of time. Perhaps, it might be more accurate to propose that depression has always been present to this degree, but only now recognised to be quite a common condition, due to the increasing acceptability and validation that this condition now has in our society. Indeed, it has been suggested that the twenty percent lifetime risk of suffering a depressive episode may be quite conservative, due to a degree of stigma still surrounding the condition, and rates may be even higher than this.
Depression is by nature difficult to define in concrete terms. By its very nature, it is an ‘invisible’ affliction – there is no characteristic physical manifestation such as coughing, high temperature or a rash. For this very reason in itself, people often have trouble recognising it and very unfortunately, its manifestation in themselves or others can be thus hard for some of us to validate and recognise as a very real disorder.
Fortunately, in terms of being able to recognise a depressive episode, it is manifested and indeed characterised by diagnostic criteria, and the characteristic pattern of symptomology that defines its presence is firstly helpful because these criteria are quite clear and specific about what symptoms constitute the occurrence of a depressive episode in an individual, as are the minimum number of these symptoms as well as the time period they occur for. The fact that these symptoms form a very typical overall picture most importantly allows for the realisation that because they do form a consistent picture of characteristics, these is more than just a by-chance observation. Just as having the flu is characterised by tiredness, often sore joints, and sore throat to name a few symptoms, it becomes recognisable and a valid disorder.
So, first of all, those of you who suffer depression, or who know somebody who does, realise first that validation is still a terribly important aspect of recovery : many people still wonder if what they are feeling is ‘real’ or condition where treatment is not only warranted, but most encouragingly, treatable! It is first of all important that we recognise this condition is real, just as much as the cold or flu: otherwise the stigma of silence may prevent treatment and recovery. Recovery rates are at least as high as eighty percent. What is great news is that if one medication does not work, very often another does. This article does not intend to replace advice by a professional – the appropriate medication and other treatments should be advised by those who are educated specifically in the management of this disorder. THIS ARTICLE IS NOT MEANT TO BE A SUBSTITUTE FOR SEEING A DOCTOR, PSYCHOLOGIST OR PSYCHIATRIST OR TO DIAGNOSE DEPRESSION. IT IS ONLY HOPED TO BE A GUIDE FOR THOSE WHO MAY BE OR THINK THEY MAY BE SUFFERING FROM THE CONDITION.%%
I will briefly overview the features of depression, so that readers may have an idea whether their symptoms constitute a depressive episode, and so they can tell their clinician. It is important that sufferers choose a practitioner who they feel comfortable with, who is validating, understanding, informative and helpful. This is not only an optional extra helpful addition, it is paramount.
The diagnostic criteria for depression help to distinguish the difference between a clinical ‘depressive episode’ and what is ‘sadness’. The difference between an episode of clinical depression and the just as valid human emotion that we call ‘sadness’ is that:
They both involve a sense of loss, or grief, or a sense of helplessness – however these circumstances in themselves are recognised as eliciting feelings of sadness. In the case of sadness, these events are typically seen as situations that would evoke this emotion in themselves, there is a clear and easy to recognise precipitating event that is expected to evoke these feelings because of their very nature.
For example, it is an expected and easily recognisable emotion that may occur if a loved one dies, you lose a job or a romantic relationship ends or a close family member you care deeply for is suffering.
However, in the case of a depressive episode, the main feature that distinguishes it from sadness is that these feelings that accompany it seem to have no clear, defining cause. Or there may be a precipitating event – however the intensity or length of the depressed mood is out of proportion to what one would expect.
The symptoms of both sadness and depression are similar. ** The diagnosis of a clinical depressive episode, as distinct from transient sadness require that 5 or more of the following must be present for at least 2 weeks, and there must be a significant impairment in everyday work, relationship or leisure activities that occurs as a result.
Also, all the following symptoms may be symptomatic of sadness. However, they are defining features of depression: however in general the symptoms in sadness are generally of identifiable cause(s), are in proportion in terms of intensity and duration to the precipitating event and are ultimately finite – depending on the circumstance(s) that initiated the emotion.
1. In depression, the low mood may seem to have no precipitating event or may be, individual differences accounted for, out of proportion in terms of duration, length or both to the triggering event.
The experience of low mood may be experienced as feeling ‘flat’, or feeling like you want to cry or generally feeling negative, or pessimistic.
2. A loss of pleasure in activities once found enjoyable or interesting – in depression this is one of the defining features. This is probably easier to help one to recognise depression in oneself or others that ‘low mood’ – which is by its nature, subjective, open to interpretation, and also the general questions that accompany this symptom make it hard to identify clearly such as ‘what is normal?’ and ‘we all feel down sometimes’ and ‘how low is low enough to be depressed?’.
However, it might be hard to think up, but we all have some thing(s) we do enjoy doing, consistently and reliably – even if that’s eating chocolate, or shopping! For example, I love Zumba. It is what I am most passionate about doing. I know that if I don’t have interest in going, it may be a sign of a relapse for me.
3. Another objective symptom that lends itself well to easier recognition of depression is that of sleep disturbance – snoozing too much or too little – this takes into account individual differences and needs to be interpreted in terms of what is normal for you. This is thus helpful to hopefully identify depressive symptomology earlier so that it can be treated promptly.
4. There may be a personally uncharacteristic loss or increase in appetite, along with accompanying weight loss or gain.
5. A feeling of unwarranted worthlessness or guilt. For example, you may start dwelling on mistakes that everyone makes, and find yourself ‘beating up on yourself’ about them, and interpreting them as though it somehow makes you a bad person. If anyone else were to tell you they have done the same thing, you would tell them it was not a big deal, and anyone could have done the same. With depression, one often sees their lives through the lens of failure…successes and positive factors in your life may likewise seem insignificant.
6. Physically you may have a feeling of tiredness, a loss of motivation and being slowed down. What you could normally do in half an hour seems to take you a lot longer, and it takes a lot for you to feel like doing it. This is something that you must not beat yourself up for. If you have the other symptoms present that are objective and you can’t say “I’m not sleeping, don’t feel like eating” and you know very well these are things that do not have another reason for them, DON’T go and tell yourself you are lazy or entertain other negative thoughts. Recognise it for what it is.
And if you don’t have other symptoms of depression, and you usually do have energy to physically engage in activities, this also does not mean you are lazy!! Most often, you could be coming down with a physical illness. Even subtle medical issues like an underactive thyroid or iron deficiency may cause these manifestations. Besides, we all have off days, even if it’s not this. But please please, be your own best friend.
7. This is the most serious symptom and should NEVER BE IGNORED, OVERLOOKED, AND YOU SHOULD NOT HOPE IT ‘WILL JUST PASS. YOU NEED TO TALK TO SOMEONE ALWAYS IF YOU ARE HAVING THOUGHTS OF SELF-HARM OR SUICIDE. If this is happening for you, make an appointment to talk to a professional as soon as possible. Remember lifeline is available 24 hours a day and trained counsellors are always on the line who are compassionate, trained in understanding depression and are non-judgemental, and who can help you get through these feelings until you can talk to a doctor or someone who can practically get you the more urgent help that you do need.
LIFELINE’S 24 HOUR LINE IS 13 11 24. SUICIDE CALL BACK SERVICE IS 1300 659 467.
Suicide is a temporary action with a permanent result. You life is precious. Particularly if you are depressed, you may not realise the number of people who love and care for you and whose lives would be devastated if they lost you.
Depression is treatable. Please if you are experiencing these symptoms, get professional help immediately.
It is up to professionals to give you the kind of help you need. However, here are some activities that I can personally say as a follower sufferer have helped me, and I will mention a few of these, not as a substitute for professional help, but that I can say have helped me, and also others I know.
1. Eating healthily from the five food groups: dairy, wholegrains, nuts and cereals, meat or legumes or soy products, fruit and vegetables. Also drink plenty of water. This may seem minor and not that important, but believe me, diet plays more of a role than I gave it credit for until I noticed my mood improved consistently by at least two thirds, when I regularly at this way. This includes drinking plenty of water.
2. Enough sleep and rest. As your depression gets treated professionally, this will be easier to maintain. Never fall into the trap of being too busy, or not feeling its important enough to ignore. These building blocks form the basis of a ‘house of bricks’ that’s easier to stand upright when the harder winds of mood crashes fall.
3. Social support from those who love and support you. Stay away or end toxic and abusive relationships.
4. Exercise regularly. This is brilliant. I have to say this does more than antidepressants or any of the other ‘health pointers’ for me. Endorphins are the body’s natural antidepressants. You need to get your heart rate up for at least twenty minutes three times per week to see results. Of course, it goes without saying that particularly if you are over 35 or have a medical disorder get your doctors input first.
5. If it is your ‘thing’ do include watching or reading or being with people who are funny, positive and uplifting. Laughter has been shown to lift endorphins as much as exercise!
6. Smile! It has psychological scientific support that the notion of the body perceiving itself to be happy by adopting a positive facial expression actually then causes us to believe we are, and feel that way – the same goes for an upright posture.
7. Do what you enjoy as part of your day. Don’t feel guilty about it. In fact, one of the reason google is such a success is that employees are actually made to have fun as part of their job. Science has shown we need to enjoy ourselves, or we do lose productivity when it comes to the ‘have to’ activities.
8. Engage in volunteer work, or help someone in a way that is meaningful for you. Research shows meaningful work does increase life’s meaningfulness.
I have no doubt you have many more activities and ideas that are personally uplifting for you.
These ideas are adjunctive only to personal recommendations by your health care professional. They are not as a replacement for medication or other treatment if your doctor/specialist feels it is necessary. However, medication is just one part of a much more holistic management of depression, and the above offer some other pointers that you may find helpful. They might not all be for you, or you may have others - for example, some people are particularly creative, or musical and involving themselves in these pursuits is also healing.
A final idea. At first I thought this would take too much time, and I could figure things out in my head. However, if you suffer depression as a condition that afflicts you regularly, you need to know your illness, yourself, what works for you. This idea involves
Keep a diary specifically for:
1. Monitoring your mood.
2. Writing down what triggers mood changes. If you find something causes a low or happier mood, you might not have even been aware of it, or know if this is a characteristic pattern that you might not be aware of. This can be powerful, for when you know yourself, your triggers, your patterns, you have the control to engage in what you know works, and avoid or manage what worsens your condition.
3. Write down who your therapists are, what they suggest, what has worked, what doesn’t. It’s about what’s best for you. Take charge as your prime therapist. Write down what has worked in terms of medications or suggestions and what hasn’t.
You can make this documentation of your personal journey pleasurable and personal by adding drawings, colour, photos, cut-outs, stickers, or by wrapping it in special paper...
You may notice patterns, such as mood changes with dietary changes, work changes, anniversaries that may have happy or sad memories, financial worries, seasonal changes.
The idea of this diary is to take charge. The nature of depression is not as random and uncontrollable as we may think. To the extent that we can know ourselves and know our personal profile is, we can empower ourselves.
Remember, depression is common, you are not alone.
Remember, depression is treatable. If one therapy does not work, do not give up. More and more treatments are becoming available.
Accommodate your illness into you life. Don’t see it as an enemy, something to be afraid or ashamed of. Think of it as even something that as you become aware of your mood profile and triggers, not only may your depression have longer periods of healing, you may empower yourself so that you have an even happier life had you not been aware of ‘how you ticked’. Always, always, seek help for thoughts or feelings of self-harm or suicide. You are in a position because of what you have been through to enjoy the good times more, help others and have empathy for them, where as people who have never suffered depression may not be able to do this.
IT IS TREATABLE AND MANAGEABLE. MOREOVER SELF-AWARENESS MAY MAKE YOUR LIFE MORE POSITIVE AND ENABLE YOU TO HELP OTHERS IN WAYS YOU MAY NOT HAVE BEEN ABLE TO BEFORE.
Most of all, remember you are NOT your depression. It is just one part of your life, a condition that comes and goes to an extent, but you are you, so important and different and precious because of every unique part of you that no-one else shares. Use the depression to empower yourself, to become stronger..
As you finish this article, SMILE, knowing you have automatically released endorphins in your brain because of it