What is Depression?
Depression is the second biggest health issue after cardiac conditions in the Western context today, contributing to a global burden of disease that impacts many people in communities across the world. It is something we all experience at some point in our lives. Many individuals present to health professionals self-diagnosing themselves with depression. Feeling depressed is a natural response to the problems of everyday living, for example having a difficult day or hearing sad news. However, depression can be more disruptive and all consuming, leading to intense and sustained lethargy, hopelessness and worthlessness. Left unchecked it can become a serious clinical condition which negatively affects a person’s thinking, energy, feelings and behaviour.
Freud, generally considered as the father of psychotherapy, understood the suffering of depressed individuals as emanating from trying to cope with mourning, melancholy, heartbreak, failure, loneliness and harshness towards the self. In fact he believed that self-hatred was a core element in understanding depression. These supremely judgmental tendencies are targeted towards the self in self-harming and self-destructive ways. Talking about depression is the first step to understanding yourself, your moods and your behaviour.
Depression and Repression of Feelings
For many of us just recognizing and understanding our feelings is a lifelong task, and a difficult one at that. We are so busy just trying to get through, paying the mortgage, rearing our kids, doing the next thing. With depression, however, recognizing and experiencing emotions is essential to recovery. Indeed, it is the starting point for overcoming and preventing depression. Due to what Freud called “repression”, lots of feelings, emotions and even parts of ourselves can be repressed out of our conscious mind. This causes havoc with everyday living. Indeed, repressed emotions drain ourselves of life and vitality. Many individuals who struggle with depression can be apprehensive of being in touch with their emotional selves. They are out of touch with their emotions because they fear feeling them. Many of us treat other individual’s feelings with respect and compassion, the very ingredient needed to treat depression. However when it comes to ourselves we can be more dismissive, harsh and lack the compassion needed to start to reconnect with ourselves, our feelings and ultimately our needs.
Feeling depressed irrespective of age, gender, culture or social status, is a natural response to many of life’s difficulties. Experiencing loss or bereavement in our lives will naturally cause us to experience “reactive depression”, which is a normal response to loss or change in life. However, depression can be more serious, when our whole energy and concentration is lowered and we struggle to focus, believing ourselves to be worthless and useless. One in ten Irish people at any one time are struggling with debilitating depression. It is a condition which affects a person’s thinking, energy, feelings and behaviour. People with depression may struggle to get out of bed in the morning, eat well, sleep well and be well. Individuals feel sad, anxious or apathetic. Their whole body may feel sluggish, indeed the person may experience deep fatigue and low self-esteem. There is a loss of interest in usual hobbies or in their social life and the individual may being to retreat or isolate themselves from life. This loss of interest in living may accelerate into suicidal and self-harming thoughts. Sometimes people with depression can experience very real pain in their chest, tummy or joints. It’s important to recognize that some women suffer from postnatal depression after the birth of their babies, and this is a relatively common, natural phenomenon.
My Inner Critic
Freud believed that at the root of depression or what he termed “melancholia” is the concept of self-hatred. In fact, he believed that self-hatred or this self-attacking “inner critic” was a core element in understanding depression. These supremely judgmental tendencies are targeted towards the self in self-harming and self-destructive ways. We all have an “inner critic”, that inner voice that nags or berates us into what we should or could be doing or feeling. That aspect or part of ourselves that judges us so unmercifully. The “inner critic” robs us of our innate goodness, worth, talent, values, and ability. It’s a part of us that is a conglomeration of harsh voices from our past: our parents, teachers, pastors, priests and individuals in authority over us.
The first step in psychotherapy is to identify this “inner critic” or “inner judge”, as most of the time we have become so used to this in our mind, we aren’t even aware when it’s speaking or operating. The next step is in giving ourselves the permission to fail or to be compassionate towards ourselves. But this of course is easier said than done and requires that working through in therapy to highlight these entrenched beliefs and ways of being in the world.
Approach at LifeChange
At LifeChange we do not believe in pathologising depression but we believe in line with current research that what is required is a relationship-based treatment. We believe that each individual has a unique set of circumstances that contribute to feeling depressed.
The talking-cure that Freud advocated is vital. Talking through your concerns and worries with a non-judgmental therapist can be a huge help at such a distressing time.
Treating ourselves with compassion
Many of us treat other’s with more respect and compassion and yet we treat ourselves like our worst enemy. Indeed, we talk to ourselves in self-berating and vicious ways. It’s important to be compassionate and sensitive toward our own feelings. Pay attention to changes or sensations in your body with openness and curiosity rather than anger or judgement. You may discover that you’re feeling anxiety or fear for example, by noticing somatic signs such as tightened chest, butterflies in the stomach or shortness of breath.
Learning to take care of yourself
In order to overcome depression, it’s important to take care of yourself. This includes having a healthy lifestyle, learning to manage stress, setting limits on what you are capable of, adopting healthy spiritual habits, and implementing fun activities into daily life. Additionally, it will be critical to develop and implement a wellness approach to your entire life.
Support – Finding The Right Therapist
The first step in overcoming depression is to talk to a mental health professional who is caring, warm, confidential and non-judgemental. Indeed, in counselling it is imperative that there is a “right fit” between therapist and client. Many individuals find it difficult to identify their emotions or know how they feel. In fact many individuals have effectively “numbed” out their emotions. They can feel disconnected from themselves. A huge goal of therapy is in developing a compassionate and nurturing side in the individual to counteract the self-attacking “inner critic” side of themselves.
Creating a Mood Diary
In helping fully recover and overcome depression getting in touch with your feelings and emotions is vital. Many psychotherapists recommend a Mood Diary as a powerful tool in developing this much needed awareness.
In treating depression, therapists will often recommend keeping a Mood Diary as part of treatment. This can be very structured as in using an Excel sheet or more fluid like a daily journal. It’s a tool to slow the individual down and is designed to help trace and monitor feelings. The Mood Diary is a powerful tool in developing awareness of the mind and body connection.
When you are aware of a shift in your mood, write down the feeling (such as neutral to very sad ), what your are sensing in your physical body (tightness in chest, butterflies in stomach), external circumstances (what you were doing, where, who you were with), and the internal circumstances (what you were thinking, daydreaming/fantasizing or remembering). Then describe how you believe a well-adjusted person might feel (such as happy, sad, proud, discouraged). Then rate how much your mood agrees with those feelings (1= no agreement, 10 = complete agreement).
Review the Mood Diary each day, and at the end of each week to see emerging patterns. The Mood Diary is to assist in locating your emotions and in listening to them with a compassionate heart. In tandem with therapy it helps individuals make strides in recovering from depression.
