Feeling Good Again
Depression is treatable. With good diagnosis and the right help, most people can expect to recover. If you feel a loss of pleasure, reduced energy, a diminished sense of your worth, or unexplained aches and pains, you may be depressed (see Chapter 2 for more information about the symptoms of depression). Please get help (see Chapter 4 for ideas on how to find the right help for you).
Many types of help exist for depression. This book is one of them and falls under the category of self-help. Self-help does work for many people. However, self-directed efforts may not be enough for everyone. In the following sections, we briefly outline the different kinds of help that you may find useful.
You don’t have to choose just one option. You may need or want to combine a number of these strategies. For example, many people with depression find the combination of medication and psychotherapy helpful. And using more than one type of psychotherapy, usually completing one type before starting the next, can prove useful as well.
If your depression doesn’t start to lift or if you have severe symptoms such as thoughts of suicide, please seek professional help.
Cognitive therapy
Dr Aaron T. Beck developed a system of psychotherapy that he calls cognitive therapy. Cognitive therapy is based on the theory that the way you think strongly influences the way you feel. Chapter 4 explains that therapists now often combine cognitive therapy with behaviour therapy (see the following section) in the form of Cognitive Behavioural Therapy, or CBT Studies support the value of CBT compared with other approaches to the easing of depression.
Depression causes people to have pessimistic, bleak outlooks, and the cognitive part of CBT helps untangle this distorted thinking. You can find out more about this approach in Part II of this book. We encourage you to have a go. Research shows that CBT even protects you against possible recurrences of depression. Sceptical? Well, where’s the harm in trying out CBT?
If you want to know more about CBT, check out Cognitive Behavioural Therapy For Dummies, by Rhena Branch and Rob Willson (Wiley).
Overcoming depression
The behavioural part of the CBT approach to the easing of depression has also been shown to bring about effective change. Behaviour therapy is based on the theory that altering your behaviour changes your mood. The problem is, when you’re depressed, you don’t feel like doing much of anything. So, in Part III we help you work out how to take small steps and overcome this block using behaviour-therapy based tools. Also, we tell you how
Exercising can kick-start your battle with depression.
Bringing small pleasures back into your life eases the pain.
Problem-solving strategies can improve coping.
Re-establishing relationships
Depression sometimes follows the ending of a significant relationship, such as the death of a loved one, or getting divorced. But depression can also follow other types of relationship losses – which also change the way you relate to the world. For example, retirement requires you to give up (or lose) one role, that of an employee, and take on another. Major life changes or transitions sometimes lead to depression if you don’t have a way of dealing with them. In Chapter 13, we talk about handling loss and transitions.
Depression can also cause problems with important current relationships. In Chapter 14, we suggest various ways of enhancing your relationships. The process of improving your relationships may also lessen your depression.
Finding biological solutions
Perhaps you think the easiest approach to treating depression is found at the chemists or the health food shop. By simply taking the right pill or potion – you’re cured! If only it were that simple.
In Chapter 15, we look at the pharmacological therapies. There are quite a few to choose from and we help you sort through the options. We also give you strategies for making the complicated decision of whether antidepressant medication is for you, or whether you’d be better with alternative approaches.
In Chapter 16, we discuss complimentary therapies, bring you information about electroconvulsive therapy (ECT), plus other, less well-known treatments for depression.
Feeling Great
After overcoming your depression, you feel so much better. However, keeping up your improvement is vital. Depression, like the common cold, has a nasty habit of returning. But you can do a lot to minimise or prevent future occurrences – called episodes – of depression. We show you how to lessen your chances of becoming depressed again in Chapters 17 and 18. If you become depressed despite these efforts and techniques, we show you how to get on top of your depression again quickly and how to make symptoms more bearable.
So, now you feel better. You feel good. But guess what? You don’t have to settle for good. We want you to feel better than good; we want you to feel great – perhaps even better than you’ve ever felt in your life. That may sound too good to be true. However, in Chapter 19, we suggest ways of adding purpose and meaning to your life. Also, we show you the hidden keys for unlocking your potential for happiness.
Seeing the Sense in Sadness
We begin this book promising relief from depression. However, no therapy, behaviour, or medication can guard against a life free from sadness. And if such a cure existed, we’re never going to recommend it.
Because without sadness, what is happiness? In order to recognise and experience great happiness, you must also feel sadness, it is an indispensable part of happiness. Sorrow is the basis of the great plays or emotionally powerful works of art, and of songs that strike a chord in the depths of the soul.
So in writing this book, we wish you a life of happiness that’s inevitably woven with moments of pain, so that you know when you are truly happy and living life to the full. Flowers need the sun and the rain, and no life is complete without sadness.
Chapter 2
Detecting Depression
In This Chapter
Looking at the symptoms of depression
Discovering depression’s many forms
Connecting ill-health to depression
Keeping track of your moods
Depression takes many forms, and develops in different ways. Sometimes it deepens slowly but surely, gradually taking over your whole life. At other times depression overwhelms you, giving little, if any, warning. Some people don’t realise that they have depression, but others fully recognise the signs. And sometimes depression has no obvious cause, often masquerading as a set of physical complaints including fatigue, sleeplessness, changes in appetite, and even indigestion.
Depression is a disorder of extremes. It can destroy your appetite – or make you insatiably hungry. It can deprive you of sleep – or make you overwhelmingly fatigued, confining you to bed for days at a time. When you are depressed you find yourself pacing to and fro frantically – or frozen with fear. Depression may last for months or years, but it can also lift within a very brief time.
In this chapter, we help you recognise if you or someone you care about is suffering from depression by identifying the effects depression has on individuals. We outline the major types of depression and their symptoms; explore the relationship between illness and depression; discuss when grief crosses the line into depression. We explore the causes of this disorder. And finally, we tell you how you or a loved one can monitor and track your moods if you suspect that you may be battling depression.
Recognising the Damage of Depression
Everyone feels low at times. Financial setbacks, health problems, loss of loved ones, divorce, or failure to meet work targets – events like these can make anyone feel upset or sad for a while. But depression is more than a normal reaction to unpleasant events and losses. Depression is more intense and goes well beyond sadness, affecting both mind and body in disturbing ways.
Depression can affect all areas of your life. There are a several types of depression (see ‘Examining the Six Types of Depression’, later in this chapter), and they can all affect four main areas of your
life. But although depression appears in different forms, they all can disrupt:
Thoughts
Behaviours
Relationships
Your body
In the following sections, we consider how depression affects each of these areas of your life.
Dwelling on dark thoughts
When you get depressed, your view of the world changes. The sun shines less brightly, and the sky’s covered by dark cloud. Those around you seem cold and distant, and the future looks black. Your mind may focus on recurrent thoughts of worthlessness, self-loathing, and even death. Typically, depressed people experience difficulty in concentrating, remembering, and in making decisions.
For Margaret, depression starts about a year after her divorce. She finds herself thinking that all men can’t be trusted. Margaret is attractive, although when she looks in the mirror, she only sees the beginning of wrinkles and an occasional blemish. She decides that even if any good men exist out there, they are going to be repulsed by how awful she looks. She feels tense. Her concentration goes, and she starts to make mistakes at work. Her boss is understanding, but Margaret sees her mistakes as proof of incompetence. Although she believes that she’s in a dead-end job, Margaret doesn’t see herself as capable of doing anything better. She begins to wonder why she bothers to go into work each day.
Does your mind dwell on negative thoughts? If so, you may be suffering from depression. The following ‘Depressive Thoughts Quiz’ gives you a sample of typical thoughts that go with depression. Tick each thought that you often have:
Things are getting worse and worse for me.
I think I’m worthless.
No one would miss me if I were dead.
My memory has gone to pieces.
I make too many mistakes.
Overall, I think I’m a failure.
Lately, I find it impossible to make decisions.
I don’t look forward much to anything.
I’ve been feeling down and pretty hopeless over the past month.
The world would be a better place without me.
Basically, I’m extremely pessimistic about things.
I can’t think of anything that sounds interesting or enjoyable.
I’ve found little interest or pleasure in the things I used to do and enjoy.
My life is full of regrets.
Lately, I can’t concentrate, and I forget what I’ve just read.
I don’t see my life getting better in the future.
I’m deeply ashamed of myself.
Unlike many of the questionnaires you see in magazines or newspapers, there is no specific score in this one to identify your level of depression. Merely ticking a few items doesn’t necessarily mean you’re depressed. But the more items you tick, the greater possibility of depression. And if you tick any of the items related to death or suicide, it may well be cause for concern, and a signal to take action.
If you’re having suicidal thoughts, you need immediate assessment and treatment. If the thoughts include a plan that you believe you may actually carry out either now, or in the very near future, go to your GP, the local Community Mental Heath Resource Centre, or a hospital Accident and Emergency Department. They have trained staff who can help. If you’re not able to get yourself to any of these places, phone 999 for an ambulance.
For more information about depressive thinking and what you can do about it, see Chapters 5 to 8.
Dragging your feet: Depressed behaviour
Not everyone who’s depressed behaves in the same way. Some people find themselves speeding up and others find themselves slowing down. While some people can’t stay awake, others suffer horribly from lack of sleep.
Douglas drags himself out of bed in the morning. Even after ten hours’ sleep, he still feels exhausted, with no energy for anything. He starts being late for work, and frequently takes sick leave. He stops going to the gym, an activity he used to enjoy. He tells himself he’ll go back when he finds the energy. His friends ask him what’s going on, because lately they hardly see him. He says that he doesn’t really know. He’s always just so very tired.
Cheryl, on the other hand, has about three and a half hours of sleep a night. She wakes around 3 a.m. with thoughts racing through her mind. When she gets up, she feels a frantic pressure and can’t seem to settle to anything. Irritable and bad-tempered, she snaps at her friends and colleagues. Unable to sleep at night, she starts drinking too much. Sometimes she cries for no apparent reason.
Although everyone is different, certain behaviours are typical of depression. Depressed people can feel like they’re wading through treacle, or running full speed on a treadmill. Do you feel concerned about your behaviour? The following ‘Depressed Behaviour Quiz’ can tell you if your behaviour points to a problem. Tick each item that applies to you:
I’ve been having unexplained crying spells.
The few times I force myself to go out, I don’t have much fun.
I can’t make myself exercise like I used to.
I haven’t been going out nearly as much as usual.
I’ve been skipping work quite a bit lately.
I can’t get myself to do much of anything, even important projects.
Lately I’ve been fidgety and can’t sit still.
I’m moving at a slower pace than I usually do, for no good reason.
I haven’t been doing things for fun as I usually do.
All these items are typical of depressed behaviour or, in some cases, a health problem. On a bad day, anyone is likely to tick one or two items. However, the more items you tick, the more likely it is that something’s wrong, especially if the problem has been around for more than two weeks.
For more information about depressed behaviour and what you can do about it, see Part III.
Struggling with relationships
Depression affects the way you relate to others. Withdrawal and avoidance are the most common responses to depression. Sometimes depressed people get irritable and critical with the very people they care most about.
Tony trips over a toy left on the living room floor and snaps at his wife Sylvia, ‘Can’t you get the kids to pick up their damn toys for once?’ Hurt and surprised by the attack, Sylvia apologises. Tony fails to acknowledge her apology and turns away. Sylvia quickly picks up the toy and wonders what’s happening to her marriage. Tony hardly talks to her any more, other than to complain or tell her off about something trivial. She can’t remember the last time they had sex. She worries that he may be having an affair.
Have you or perhaps someone you care about been behaving differently within one or more of your relationships? The following ‘Depression and Relationships Quiz’ explores some of the ways in which depression affects relationships. Tick the items that describe your situation:
I’ve been avoiding people more than usual, including friends and family.
I’ve been having more difficulty than usual talking about my concerns.
I’ve been unusually irritable with others.
I don’t feel like being with anyone.
I feel isolated and alone.
I’m sure that no one cares about or understands me.
I haven’t felt like being physically intimate with anyone lately.
I feel like I’ve been letting down those who are close to me.
I believe that others don’t want to be around me.
Lately, I don’t seem to care about anyone the way I should.
When you’re depressed, you tend to turn away from the very people that may have the most support to offer you. You feel that they don’t care about you, or perhaps you can’t find any positive feelings for them. You may avoid others or find yourself irritated and snappy.
Overcoming Depression For Dummies Page 5
