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  • BPS Staff

Understanding Depression

By Laura Miller, LMSW


In a recent blog, Understanding Anxiety, we discussed the impact of the coronavirus pandemic on mental health. In fact, since the pandemic began, the number of adults who reported symptoms of anxiety more than tripled in comparison to the number of adults who reported symptoms prior to the pandemic’s start. Sadly, this is only one statistic among many, which testifies to the unrelenting crises of an incredibly challenging year.


As 2021 begins, it’s natural to reflect on the typical feelings that occur related to the start of a new year; renewals of hope, commitment to change and optimistic views of new beginnings. However unfortunately, the start of this year has already been met with significant political unrest and continued coronavirus related challenges. At some level, the continuation of hardship is to be expected; there is little evidence to suggest that difficult times respect arbitrary calendar perimeters. However, at the same time, people need separation from difficulty. So, how do you continue to move forward and hold on to hope for the future and new beginnings?


Well, first, recognize that it’s totally understandable and okay, to not be okay. In addition to anxiety, symptoms of depression have also increased significantly since the pandemics start. In comparison to typical new years, often offering "new beginnings" and "fresh starts," the rocky beginning to 2021 may lead to experiencing a more (or continued) pessimistic outlook, and worsening in mood. Keep reading for more information on depression as well as learn ways to cope.


What is Depression?

Everyone experiences times of “bad” mood. For example, feeling sad, unhappy, irritable, cranky or even very bored. However, typically, one is able to “bounce back” pretty quickly with their mood changing in a couple of hours or a couple of days. However, sometimes, these moods last a long time; two weeks or even more. This longer length of time is indicative of depression and one cannot just “snap out of it.” Depression is a mood disorder that affects the way one feels, thinks, behaves and relates to others. See below for a list of common symptoms and click here for more information on how depression may present in different age groups.


Emotions:

● Sad or irritable

● Hopeless about the future

● Guilty


Thoughts:

● Difficulty concentrating, remembering information, making decisions

● Self-blame or criticism

● Loss of interest in activities once enjoyed

● Thoughts of death or suicide


Behavior:

● Crying

● Change in appetite, weight loss/weight gain

● Avoiding people/isolating

● Difficulty sleeping /Loss of energy

● Self-harm behaviors


What Happens?

Sometimes, depression can be prompted by recent experiences, such as death of a loved one, loss of a job or relationship difficulties. Other times, depression can occur without an identifiable prompt. Yet in both cases, the way one thinks about their circumstances often contributes to depression. When someone is depressed the brain focuses more on negative experiences and has negative beliefs about the world, other people or the future. With this understanding, one can then learn strategies to reframe their negative thoughts. Depression is also thought to be maintained by the dynamic that when someone is depressed they are often isolated and withdrawn, with little access to stimuli that offer any reward. While it may feel intuitive to cut back on activities and responsibilities when you don’t feel up to it, becoming less active can actually increase low energy, fatigue and worsen depression. When this happens, one can become a part of a vicious cycle of worsening depression. In order to break the cycle, one must work to increase activity.


How to Cope:

Depression is among the most treatable of mental disorders. Almost all individuals who experience depression experience some relief from their symptoms with proper intervention.

  1. Talk to your doctor or mental health provider. If you are experiencing symptoms of depression talk about your concerns with a professional who can help. Cognitive Behavioral Therapy (CBT) is one of the most effective treatments for depression. This treatment can help you learn how your thoughts and your behavior influence the way you feel. You will learn ways to change your thoughts and your behaviors so that you can overcome depression.

  2. Tell someone that you trust that you are struggling. Oftentimes, if you’re experiencing symptoms of depression there can be a tendency to withdraw and isolate from others or you may feel too exhausted to talk or too ashamed or guilty to ask for help. Remember, that this is the depression talking. Be nonjudgmental toward yourself and let go of any preconceived notions that you shouldn’t ask for help. Reaching out for help is a sign of strength and it’s never too late to ask for help when you need it.

  3. Challenge negative thoughts. Put your thoughts on a witness stand as if they’re on trial. Ask yourself, what’s the evidence that these negative thoughts are true? Cross examine your thoughts to determine if they are the most accurate. It’s not that you are only allowed to think about positive things all the time (this probably wouldn’t be realistic anyways!), yet you do want to learn to think more accurately and not always assume the worst. Check out this list of common unrealistic thoughts.

  4. Engage in pleasurable activities. You might not feel up to doing anything, but begin by making a list of pleasant activities that you might enjoy. If you need help brainstorming, begin by thinking about the past; what did you like to do before you were feeling this way? Try to pick a few things to do even when you don’t feel like it. Gradually, as you engage in pleasant events you’ll feel more upbeat and energetic. Keep reading about behavioral activation; a treatment that emphasizes engagement in pleasant activities in order to overcome depression here.

  5. Take care of your physical health. Your physical health has a huge impact on your mental health, and when depressed, your physical health can be altered and may need more focused attention. Make sure you're eating balanced meals with plenty of nutrition and don’t skip out on meal times, as lack of nutrition can increase irritability. Furthermore, focus on getting some exercise. While getting out of bed can seem daunting, let alone going outside for a walk, research shows that exercise can be as effective as medication for some people. Additionally, developing a new sleep routine may be helpful. Check out this list of sleep hygiene tips.

  1. Monitor stress and use relaxation techniques. Oftentimes, individuals experiencing depression will also experience anxiety. Monitor your stress level and use relaxation techniques to reduce the physical arousal associated with stress. You may also want to develop a “wellness toolbox;” a prepared kit of items to help you self-soothe and relax when you need it.

Depression can be very isolating and a difficult disorder to manage. Remember, you are not alone and there are people who want to help. Do not hesitate to reach out for support when you need it. If you are ever in need of immediate assistance and support, you can call the 24-7 National Suicide Prevention Hotline at 1-800-273-8255.


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