Moments of sadness are usually triggered by experiences where things go wrong, people let us down, we lose something we valued or we fail to achieve something we wanted. It's normal for everyone to feel sad from time to time and these are normal responses to life's setbacks. These occasional moments of sadness are not usually a problem and with time, they will pass.
On the other end of these fleeting moments is depression - what can be a debilitating condition that interferes with every aspect of daily life. From interacting with others to experiencing joy; from restricting your ability to perform your role at work or home to getting through the most basic activities in your day to day life. Unlike sadness, depression can last for months or even years. When diagnosed and treatment is sought, it is possible to make a full recovery where you can get back to enjoying the little things in life again.
This guide will help you understand the many faces of depression and the combination of factors which may contribute:
Historical - eg: early parental loss or neglect; history of family conflict
Biological - eg: inherited condition where there is a disturbance in neurotransmitter functioning
Psychological - eg: personality and cognitive style; habitual negative thinking and low self-worth
Environmental - eg: stressful life events with significant impact (loss of loved one, loss of job, illness, divorce etc)
Psychosocial - eg: social isolation; lack of close confiding relationships
Depressed Mood - This is a normal state of sadness that we all experience at times. We may see our work situation, home life or key relationships in a more negative light than usual. More than likely, this is a temporary depressed mood which is likely to resolve within a few hours, days or weeks.
Major Depression - In Australia, the DSM-5 (Diagnositc and Statistical Manual of the American Psychiatric Association) is widely used as a guide to diagnose major depression. It is said that a person is experiencing major depression if they have at least 5 of the following symptoms over a period of 2 weeks, including at least one of the first two symptoms listed:
Depressed mood for most of the day
Reduced interest in usually pleasurable activities
Changes in appetite or weight
Changes in sleep patterns
Lack of energy
Feelings of guilt or worthlessness
Agitation or slowing down of physical movements
Inability to concentrate or make decisions
Recurrent thoughts of death or suicide
Depression Triggered By Stressful Life Events - The majority of depressions are triggered by stressful life events including: death of a loved one, breakdown of a relationship, loss of employment, business failure, onset of serious illness, loss of reputation, stressful work environment, chronic physical or mental illness or being a caregiver to a family member with serious illness.
Postnatal Depression - More than the common "baby blues" this can arise within 3 months of childbirth and can last for a few weeks through to years.
Other types of depression can include psychotic depression, melancholic depression and bipolar disorder - all of which have strong biological underpinnings.
It's important to understand that people 'wear' their depression in many different ways. Some people may look unhappy, become irritable or withdrawn easily and cry frequently. In contrast to this, others may try to put on a brave face to hide how they are really feeling. Once we start to feel depressed, the loss of motivation and negative self-talk that accompany this low mood can often cause a downward spiral into deeper depression. For example: idle time makes us feel bad for not being productive; this in turn allows the mind to roam and these thoughts can create despondency. The more we withdraw, the more we become inactive and even more negative self-talk is generated. This in turn causes people to take a negative view of themselves, the world and the future:
The Self - I am no good, I am useless, I am worthless.
The World - People are uncaring, people are so critical, people are too harsh.
The Future - Things will never improve, things will be this way forever, there is nothing to look forward to.
Depression generates plenty of negative thoughts where topics such as personal failure and past errors tend to dominate the themes. For this reason, although the thoughts are incorrect and unreasonable, it is helpful to notice their presence in our mind.
Try this exercise. Create a table with two columns - on the left, name this "Negative Self-Talk" - on the right, name this Reasonable Perspective. It may look something like this:
Disputing negative self-talk is one cognitive way to directly manage depression. Other ways are via behavioural strategies - these are particularly powerful as they have both direct and indirect effects on mood. Direct effects are things like exercise, listening to music, meditation and spending time with friends have mood enhancing effects, where our mood is lifted. An indirect effect is communicating with a friend about how we are feeling. This challenges the belief that we un-cared for creating a psychological boost, lifting our spirits.
There are two types of activities which are particularly helpful in overcoming depression - these are activities which create a sense of achievement and pleasure.
Achievement: get out of bed before 8am; spend some time in the garden; finish an incomplete job; make an appointment; make the bed; do a routine chore; initiate some social contact; go to work; clean a cupboard /spare room; pay a bill; help someone else.
Pleasure: go for a walk; have a bath; watch a funny movie; have a massage; write in a journal; play with your pet; do some stretching; listen to music; read; cook/bake; colour in or do some art work; go shopping; dance; spend some time in the sun.
Although everyone finds different activities to be helpful, there are some behaviours which can exacerbate depression. These include: staying in bed for hours during the day; inactivity - sitting around unoccupied or watching TV for hours; avoiding contact with people and isolating yourself; short term comfort activities - drinking alcohol, taking drugs or snacking on unhealthy foods.
Strong and supportive relationships are one of the best safeguards against depression, hereby protecting your health on a psychological and physical levels.
Creating a lifestyle that is both meaningful and satisfying can also protect you from future depression relapses.
DEVELOP MEANINGFUL INTERESTS! FIND YOUR PASSION!
Ask yourself "What do I love doing?" If at this stage, the answer is "nothing", this is the ideal time to consider the endless possibilities of options. It can take months to find something that we truly love doing, the key is to enjoy exploring. Most community centres have groups and classes available on weekdays or weekends and there is plenty of variety:
Join the Gym
Learn a Foreign Language
Join a Walking Group
"When we commit ourselves, particularly with other people, we become part of something larger than ourselves. And we are distracted from the despair of a life lived in solitary, obsessive fixation on ourselves. Our headlights again are turned outwards, illuminating the wonder of the world around us, instead of inward, blinding us to everything but our own unhappiness"
- Penelope Russianoff, When Am I Going To Be Happy?
If you or someone you know need assistance with depression, there are many helplines available and ready to talk with you.
Lifeline Australia: 13 11 14 / 24 hours per day
Beyond Blue: 1300 22 4636 / 24 hours per day
Kids Helpline: 1800 55 1800 / 24 hours per day
Love & Light
xx Sandra Stoitis xx