Depression

Depression

In the absence of hope we must still struggle to survive, and so we do - by the skin of our teeth , - quote taken from Darkness Visible by William Styron

Key noticeable symptoms of depression are (these must be present for at least two weeks):

  • A lowering of mood
  • Tearfulness
  • Lack of interest or drive
  • Inadequacy
  • Feelings of guilt and shame
  • Loss of concentration or memory lapses, forgetfulness
  • Loss of energy, noticeable lethargy and fatigue
  • Loss or increase of appetite and weight
  • Insomnia or excess sleeping
  • Loss of self esteem and confidence
  • Self hatred
  • Worthlessness - no sense of purpose
  • Regretful thoughts
  • Loss of feelings or an inability to identify feelings
  • Joylessness
  • Negativity

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We can all at times feel low or depressed, life tends to throw us curve balls which lead to disappointments and failures which can lead to feelings of hurt, misery, loss or despair. Most people are depressed from time to time, roughly 1:10 will suffer from depression to a varying degree in their lifetime some may experience ‘situational depression’ which is a short-term form of depression that can occur in the aftermath of various traumatic changes in your normal life, including divorce, retirement, loss of a job and the death of a relative or close friend, menopause, post operative states, trauma, but can overcome depression with some support or a period on anti depressants and can become quite resilient in managing negative feelings and can get through these hard times to enjoy life again.

However some people are unable to shake off these feelings of gloom and despair, no amount of trying to’ cheer up’ or ‘shake themselves out of it' makes any difference at all. Depression does not discriminate between race, creed, age or class and can affect anyone of us at any time. People suffering from depression can start to feel disconnected from others and may want to isolate to hide that they feel different to others round them. At times it is difficult for someone with depression to talk and communicate with others, they struggle to articulate their feelings and their needs, which can isolate them further. Depression interferes with sleep causing sufferers to be fatigued and unable to motivate themselves to get on with life. Depression can feel worse in the morning and individuals may wake up dreading the day and results in them being unable to get up out of bed. Others can see this as laziness as they are unable to imagine the inner torment and the indescribable pain that accompanies depression. As they day moves on, sufferers may feel a little better only to dread fitful sleep to awaken to the same hopelessness the next day

Friends and family can become quite irritable and exasperated that their attempts to help you snap out of it - have no effect whatsover and their ability to empathise with you dissipate. They are unaware of the unimaginable emotional pain, which can be felt physically - as they have never experienced it. Women are considered to be at higher risk for depression but statistics are often thwarted as men rarely seek professional help because of the shame and stigma associated with the condition. Many people hide their problem and pretend they are ok - however keeping depression a secret does not help to resolve the problem and can have a detrimental affect on your mental health.

Depression can occur as a result of a life event that may cause depression such as a loss of a close friend or family member, a loss of a job, moving house, breakdown of a relationship, etc. But depression can also arise from other issues which may not be evident to yourself or others. Childhood attachment issues, traumas, abuse etc. may have triggered depression in childhood which may never have been addressed.

Symptoms can be accompanied by more physical features such as:

  • Loss of appetite
  • Constipation
  • Measurable loss of weight
  • Early morning wakening - as depression affects the circadian rhythm
  • Tearful when awakening
  • Loss of sexual drive or libido
  • Intolerant of noise, conversations, bright lights
  • Physical slowing down of movement and speech
  • Confusion and an inability to focus

The impact of depression is highly distressing which often has physical sensation which can become unbearable. Sufferers may try to adapt their mood by using negative methods like using alcohol, drugs, overeating, eating disorders, self harm, sex or other self defeating methods can invariably make the problem worse. Alcohol is a depressant and therefore drinking to feel better is counterproductive. Drugs such as ecstasy give rush of euphoria as the serotonin in the brain is released - however this leaves the brain depleted of serotonin and therefore will be preceded by low moods until the serotonin level adjusts. The more the drug is used the more difficult it is for the body to catch up with serotonin production creating long term low mood. Using food whether overeating or under eating interferes with the blood sugar level which creates mood swings. This also interferes with serotonin production.
Rewarding yourself with substances such as these increases your dopamine levels and may make you feel better in the short term. However when you do not address the underlying problem which is causing the depression it is impossible to feel good, and the props used such as drugs, alcohol, sex and food will stop giving you the feel good factor and the depression will remain. Working through problems past and present with a therapist who can help you to process your feelings and to understand why you are feeling how you are can help you to work through your problems.

I work with clients in a holistic way offering them the therapy that will best suit their condition and their ways of processing. There is no quick remedy for depression and it will not disappear overnight . However regular sessions can feel supportive and offer solutions and skills to help you through the dark days. You may need to take medication and I will refer you to a doctor to help with this or to a psychiatrist if we need to determine there is an underlying issue such as asperges or personality disorders that will help our work together.

Depression is often named The Black Dog a phrase coined by Winston Churchill who suffered from depression. The World Health Organisation have published an animation by Mathew Johnstone on the Black Dog



The animation is not to trivialise the condition but is quite an ingenious way to describe depression for the sufferer as well as for family and friends to understand what it is like.

There can be many causes for depression such as a genetic predisposition, a loss or a bereavement, a disappointment that you find difficult to cope with, a breakdown in a relationship - which can instigate the low mood associated with depression.
Biochemical processes changes the balance of the brains neurotransmitters causing the brain to become depleted of chemicals such as norepinephrine and serotonin which makes it difficult to cope with the low mood and increases in the levels of cortisol increases stress and insomnia. Serotonin is a neurotransmitter that stabilises mood, it is produced by nutrients consumed in food which contain tryptophan an amino acid which is converted into serotonin on the brain. Depression often lowers the appetite and sufferers lose interest in food - however regular meals including complex carbohydrates essential fatty acids and proteins are essential to maintain serotonin in the body. People who diet consistently or have eating disorder are often prone to depression due to the lack of complex carbohydrates they consume. The body struggles to transport and convert the tryptophan to the brain on low carbohydrate diet and therefore does not convert tryptophan into serotonin, therefore it is unable to uplift the mood and individuals remain depressed.

Some medications SSRI can be effective in the short term and are used for social anxiety, OCD, premenstrual tension, panic disorders and phobias. Further information can be found on
http://www.nhs.uk/conditions/SSRIs-%28selective-serotonin-reuptake-inhibitors%29/Pages/Introduction.aspx

MAOIs are used when there are atypical features evident such as heightened anxiety, increased sleep and appetite and the marked presence of anxiety.
Other medications can cause further problems with dependency or addiction.. Medications such as Valium, Ativan Alprazolam or Xanax are addictive and can have severe withdrawal symptoms.

Although Medications can help to rebalance the serotonin levels in the brain and make you feel better, they do not address any underlying problems which may have caused the depression. Problems will not miraculously disappear and therefore addressing problems with a therapist will help you to recover from depression, resolve the situation and help prevent a relapse into the former state.

There are many ways to treat depression:
Many issues can trigger depression and seeking professional help can aid recovery.
Therapy can help you to seek support and direction for your current state as well as identify possible triggers or sources that have instigated the depression. Depression like many other mental health issues affect up to 1:10 people during their lifetime.
Medication may be necessary for some people but at Hope Therapy we try different approaches such as :
  • Encouraging clients to be open and honest about the condition helps to let the depression out - Depression does not need to be a secret - acknowledging your problem will help you to start looking for solutions in a comfortable confidential environment.
  • Meditation or mindfulness can counteract stress and fatigue
  • We can direct you towards activities such as Yoga which can help you to physically de-stress the body and mind
  • Exercise can help in the production monoamines - neurotransmitters including serotonin (a mood enhancer that can decrease symptoms of depression) and increase dopamine (which is known to improve mood and long term memory and stimulates pleasurable feelings).
  • Keeping a mood and activity journal can be useful to track your depression and if there are any days in which you feel better than others. A journal will help you to identify whether you have specific triggers that make you feel better or worse.
  • Help you to identify whether work, a relationship, bullying or other issue are getting you down? we can help support you through any changes you need to make? Talking through difficult life events with a therapist can give you a different perspective on the problem and many therapists can teach you new skills to try and manage the problem.
  • Writing a gratitude list to connect with the good things you have in your life.

You are not alone remember life is full of ups and downs and although it might not feel that it will get better there are many ways that you can get through.

Books - Willian Styron. - Darkness Visible
- Sally Brampton - Shoot the Damn Dog
- Spike Milligan & Anthony Storr - Depression and How to Survive it


If you are feeling suicidal please contact your GP immediately or contact The Samaritans
www.samaritans.org . You can contact me to make an appointment to start managing your depression lizzyhopetherapy@gmail.com or call me on 07910284089 or landline 01932 85859.