Lift me up: coping with depression in its many forms
Graham has a long history of depression. He doesn't remember how it started, but says it runs in his family. Depression can be a natural response when something goes wrong, sometimes it strikes for unknown reasons.
He recently came out of a relationship and the break-up made him deeply unhappy. He has been finding it difficult to get out of bed and is sleeping more than usual. He feels lonely and has isolated himself from his friends and family.
Most people will feel down after a break-up. But they are usually able to keep living their lives. They take their portion of responsibility for the break-up and realise that they will be happy again someday.
But when anything happens to Graham, he responds by feeling down about himself. His thinking becomes self-persecutory. As a result of his break-up, he feels he is not good enough and that it was his fault: 'No woman will want me. This always happens and I am going to be alone forever.' Depressed people feel they have little control over their lives and that they are helpless.
There is some research to say that depression is a habit rather than a hereditary disease. That means that the depressed response is a habituated response which develops over time. It may still turn out to be a disease. But if it is a habit, it means we may have more control over it than we think. As with most mental disorders, people have a predisposition towards certain illnesses. Certain environmental factors trigger them into being.
A difficult break-up can leave a person scared of future relationships. They think they cannot handle break-ups. So whenever they enter into a relationship, the fear of it ending is always there. That can lead to them sabotaging it themselves.
If this happens, it reinforces the person's fears about relationships, and it becomes fixed at the brain level. This is the same for depression. It becomes fixed, and it becomes the common response to problems. As with the fear of a relationship ending, the brain becomes hardwired for depression.
Depression covers all experiences with a negative film that is pervasive. Reality becomes grim. Even normally positive experiences cannot be enjoyed.
Depression is usually caused by a first-time event. But it eventually doesn't need a trigger. People can become depressed about being depressed. Graham, our example, is at a loss about how to deal with his life. He endures a sense of hopelessness. Graham earns a lot of money, but he feels like a fraud.
He pretends to have fun when he goes out, but goes home feeling empty. He has been looking for a girlfriend, but ends up choosing looks over substance. There is an inability to suspend gratification, so he finds himself at the mercy of pleasure, experiencing only pleasure not joy. He tries to use relationships to fill the emptiness he feels inside.
A good way of preventing depression is to limit exposure to stressful situations. If you are confronted every day with a situation, or a person, that evokes the stress response, you should try to avoid it. This means leaving a destructive relationship or dead-end job. Depressed people often put up with bad situations much longer than necessary.
Depressed people often find it hard to make decisions. So getting better at decision making can help to prevent depression. Learn to ask, is this something I can fix? Is this something I should put up with, or should I walk away from it? Tell yourself you can cope, that you can think, that you can make good decisions and trust yourself. When you really can't cope, ask for help, or gather more information. It's important to take action and learn to let go where appropriate.
The worst thing depressed people do is isolate themselves. This is the time when you need others most. It's important to spend time with others, because it helps.
If you are depressed, analyse your thinking and try to counteract the depression. Realise that it's normal to make mistakes. Understand that you are a good person and as worthy as the next of being loved. Don't believe everything your mind tells you and don't trust your feelings. Thoughts and feelings can be conditioned responses. They don't have to control us. We can take actions to change our neural pathways.
People become depressed when their lives are out of balance, when they have little substance in their lives, or when they receive no rewarding experiences. This was the case for Graham. People cope better if they can balance the negative experiences with the positive ones.
We need social connections like friends and family, too. Depressed people need empathy, validation of their worth, understanding and love. Staying away from alcohol and drugs, eating good food, sleeping well and taking regular exercise are vital to the prevention of depression.
Having a fulfilling and secure job and doing the things you enjoy are also important. Going to a support group for those suffering from depression is immensely beneficial, and meditation can be effective.
If you are depressed, sometimes you cannot do the things you need to do until you get above a certain level. If you feel that way, or if you are having suicidal thoughts, go and see a therapist. Getting the help you need is taking care of yourself. There is no shame in it.
Depression can be debilitating. But with the right skills and help it can be managed and even cured.
Hayley Thomas is a child, adolescent and family therapist who specialises in eating disorders. Her website can be found at relatehk.com