Listening to Depression

I came across an interesting article today, reviewing a book called ‘Listening to Depression’. The premise of the book is to not treat Depression as a problem in your life, but as reaction to problems in your life. The article uses the analogy of a warning light coming on when a plane drifts off course, to let the pilot know to make some changes to get back on course. So the experience of  depression is our brain’s way of letting us know that something is not right.

The analogy of a warning light is good, as it reminds us what to focus on. Sometimes we focus so much on the symptoms of depression, and forget about dealing with the underlying issues. It can be worthwhile to take a step back and stop focusing on the ‘warning light’, and look at what is setting the ‘warning light’ off in the first place.

The article has an exercise you can go through to try and explore what has set off your ‘warning light’, which I’ve copied here so you can try it:

A cultural perspective on Depression

One of the more startling findings is that the rate of depression in the western world has been on the increase over the past century. One study (summary here) found the rate of major depression in U.S. adults increased from 3.33% to 7.06% over a ten year period. The study interviewed a large sample, and used their own questions, rather than relying on the numbers diagnosed by doctors, so an increase in the rates of diagnosis wouldn’t explain the result. The study found increasing substance abuse could account for some, but not all of the change.

One researcher has explained the increase in depression in cultural terms. Stephen Ilardi, from the University of Kansas, argues that depression arises because people are more adapted to primitive times:

“As a species, humans were never designed for the pace of modern life, we’re designed for a different time — a time when people were physically active, when they were outside in the sun for most of the day, when they had extensive social connections and enjoyed continual face time with their friends and loved ones, when they experienced very little social isolation, when they had a much different diet, when they got considerably more sleep and when they had much less in the way of a relentless, demanding, stress-filled existence.” (Source: Kansas University News)

His six recommendations for depression are to get more physical activity, spend more time in the sun, keep up social connections, improve our diet (by eating more food with omega-3s, and less fast foods), getting more sleep, and engaging ourselves in tasks to avoid rumination. I’ve come across similar recommendations before, and they are good self-care behaviours.

The thing about culture is that we can often be sucked into thinking that the way we do things is the way things are meant to be done. So we should look at whether we’re buying into the modern high-stress culture, and consider whether we should make some changes to our lives. Maybe it’s time to go ‘primitive’, and live healthier lives?

Depression Treatments in Scotland

It’s interesting to see how depression is being approached overseas. In Scotland, the government is attempting to cut down on antidepressant prescriptions, recommending GPs prescribe a program of exercise, and reading self-help material. Patients are only to be prescribed antidepressants after the exercise and reading hasn’t worked (link). While going for a run and having a read isn’t going to work for everyone – like any form of treatment – it’s promising to see the acknowledgement for holistic treatments for depression.

In New Zealand, the equivalent is the Green Prescription, where free support is provided to help people get more exercise.

Positive Psychology: How to be Happier

Continuing on from the previous post, we look at some research performed by the positive psychology movement. One of their main areas of research is how to make yourself happier. One study (which is summarized in the latter half of this document) looked at the effectiveness of internet based interventions on happiness.

People did a number of activities online, and their happiness and depression was measured over the next six months. For a lot of the exercises, happiness went up (and depression went down) immediately after the activities, but then returned to normal over the next few months. However, for two activities, there was an increase every each month for six months.

The two that caused an increase in happiness over the six months were: ‘using signature strengths’, and ‘three good things’. These were as follows:

• Three good things in life. Each night, people would write down three things that went well in the day, and write down an explanation for why this had happened.
• Using signature strengths in a new way. People took an online test to identify character strengths.  They received information about their top five strengths, and were asked to use one of these strengths in a new way each day for a week. (The online test can be found here – free registration required)

(Note, the increase in happiness was greater for people who continued these activities for longer than the week.)

So there you have it. Two ways that have been scientifically shown to improve happiness. So here’s a challenge for you. Why not give it a shot? Spend a short time each night for a week doing one of the two activities, and chances are you’ll be happier by the end of the week. What have you got to lose?

Positive Psychology: Learned Optimism

Positive psychology is a recent movement in psychology, which emphasises the scientific study of strengths as opposed to weaknesses. While Psychology has often examined what can go wrong with people, positive psychology attempts to examine what goes right with people. Over the next couple of weeks, I plan on writing about some of this research. Today we’re looking at ‘Learned Optimism’

Martin Seligman is credited as being the father of positive psychology. In his earlier work, he proposed the ‘Learned Helplessness‘ theory of depression: Depressed people learn hopelessness from previous situations, and come to think that there is no way to get out of unpleasant situations. Later in his career, Seligman instead wrote about ‘Learned Optimism’ and how people can move from hopelessness to optimism (see these lecture notes  or this book review).

Optimism depends on an individuals explanatory styles:

• Permanence. Optimistic people tend to view good things as being the norm, while negative events are viewed as ‘one offs’. Negative events set everyone back, but people viewing these events as not being permanent recover quicker.
• Pervasiveness. Optimistic people tend to view the good things that happen to them as global, affecting all of their life, while bad things that happen only apply to the area in which the negative event occured. So, good events affect a lot, whereas negative events are somewhat isolated and meaningless.
• Personalisation. Optimistic people tend to accept good things as being a product of their own effort, while negative events are the product of external events. So when things go wrong, it needn’t be viewed as being your fault.

In order to move from Learned Hopelessness to Learned Optimism, an ABCDE exercise similar to cognitive restructuring is suggested:

• Adversity – Identify the negative event that is occuring
• Belief – Identify the thoughts you have about the event
• Consequences – Examine what happens when you think such thoughts, how it affects your feelings, and actions.
• Disputation – There are two main ways suggested to deal with these consequences, distract yourself from such thoughts, or, for a more long term solution, dispute with the beliefs, using one of the following techniques:
  • Evidence – Often negative beliefs are unrealistic. Show yourself that the negative belief is wrong, by asking whether there is any real evidence for what you’re thinking.
  • Alternatives – There are usually a number of alternative explanations for what has happened, but people often adopt the most negative one. As yourself whether you could explain what has happened in another way
  • Implications – Even if a negative belief is correct, it’s not the end of the world. People can often make things seem a lot worse than they actually are, by expecting themselves to be perfect. Sometimes it’s just a matter of accepting that we might have a small flaw – without forgetting also have a lot of good points as well.
  • Usefulness – In some situations, it’s better to think pragmatically than being caught up by negative beliefs. Rather than thinking ‘there’s no way out of this situation’, it’s better to think ‘how can I attempt to get out of this situation?’
• Energization – The usual product of changing beliefs like this is that you will be more likely to engage with the situation, and to come up with ways to approach whatever is affecting you in the first place, leading to you feeling better about the situation, and yourself.

So, there’s an approach that you might find helpful. It might help to go through the exercise with a past situation, or a hypothetical situation, and look at what you would do should it happen to you.

Internet based help for depression

One recent development in the treatment of depression has been online self-help programs. These programs can provide information or self-help exercises, or both. The University of Otago is currently running a study to evaluate some of these programs. If you’re experiencing depression, and you should consider taking part in the study, you would be contributing to a greater understanding of depression and how to deal with it, and you are likely to gain skills and information which could be helpful in managing your mental health.

If you’re interested, check out: http://otago.ac.nz/rid

Mental Health Awareness Week: It’s in your hands

This week is Mental Health Awareness Week. One of the themes for this week is ‘It’s in your hands’: make good mental health a priority in your life. In accordance with this theme, I’ve put together some tips for making mental health a priority in your life.

• Sort out things that cause you worry and stress – The less that you have to stress about, the better. If things are stressing you, this will be a strain on your mental health.
  • Money – Consider budgeting, remembering there are services available that can help.
  • Work Demands – Consider talking to your boss about your mental health. Consider taking time off, and having time for yourself. Don’t take on more than you are able.
  • School/University Demands – Make sure you are aware of what is required, and when, don’t leave things for the last minute. Consider reducing your course load.
• Become aware of what things cause you to feel down, and what things you can do to make yourself feel good again. Consider making a Wellness Action Recovery Plan 
• See your Doctor – While Medication will not solve all problems, it may play an important role in your recovery.
• Talk to someone – Whether it’s a therapist, a counsellor, or even a trusted friend, find someone who you feel comfortable talking with. It’s important to have an outlet, to express your feelings. Counselling often is available inexpensively.
• Make your life healthier – having a healthy lifestyle does wonders for your mental health.
  • Exercise – get involved in some form of exerise that you enjoy. It could be anything, organised sports, walking, running, dancing, anything that you enjoy and gets you moving. For more ideas, see Push Play.
  • Healthy eating – make sure you get a balanced diet, particularly making sure you are eating plenty of protein, and avoiding high energy foods. For more healthy eating information, see ‘Food for Health‘ (a pamphlet put out by the ministry of health).
• Deal with negativity. negative thoughts & low self esteem
  • Remind yourself about things that you like about yourself
  • Be aware of automatic negative thoughts, and what to do about them.  About.com http://depression.about.com/cs/psychotherapy/a/cognitive.htm
• Reach out to others, friends and family, meet new people and reconnect with old friends. 
• Reconnect spiritually – This means different things for different people, for some it may mean going to church, for others it might mean spending time with nature.
• Take the time to do things you like – Make sure you’re spending some time doing things you want to do, and getting some enjoyment. If you don’t have anything, maybe look at picking up an extra hobby?

You may find some of these may work for you. They may not, but the important thing is to find what works for you, and do it. Your mental health is yours, so make sure you own it.

Relationships and Depression

Relationships can be difficult, especially when we experience depression. Mental Health America has some useful tips for having a relationship while experiencing depression:

• Share your feelings with others as much as possible.
• Let your partner know that you still find him or her attractive.
• Consider couples or family counseling.
• Keep working toward recovery.

There are also some tips for people in a relationship with someone experiencing depression. To see these, and for further explanation, Click here to read the article.

The Mental Health and Education Resource Centre

If you’re in Christchurch, a good place for quality information and resources regarding mental health is the Mental Health and Education Resource Centre (MHERC). MHERC are involved in a variety of education and training activities, importantly they run a free mental health library:

Our free mental health library is open to the public and provides information on all aspects of mental health and mental illness. We have available for loan – books, DVD’s, CD’s, and videos on topics such as depression, bipolar (manic depression), post natal depression, post traumatic stress disorder, personality disorder, schizophrenia, anxiety, phobia, obsessive compulsive disorder (OCD), agoraphobia, ADHD, children’s health, abuse, violence, personal development, personal experience and much more! Pamphlets and articles are also available at no cost.

Their library database can be accessed from their website.

Exercise and Depression

Exercise seems to be a pretty effective way to help with depression. The mental health foundation in the UK has a useful online booklet that gives some reasons why it can be helpful:

Exercise is believed to increase the release of the brain chemicals that affect our mood and make us feel happier.

Exercise helps us to get active and meet new people. This stops us from feeling isolated and unsupported.

Exercise can give us new goals and a sense of purpose.We have something positive to focus on and aim for.

Exercise can boost our self-esteem – it can improve the way we look and how we feel about ourselves.

The online booklet also gives a few suggestions for getting involved in exercise, but some of the information is specific to the UK. Other websites offer other suggestions; FamilyDoctor.org offers some practical advice, including warming up and stretches, while LifeHack.org offers some interesting approaches.

There are a lot of suggestions out there, so maybe it’s better to go ahead and do it? Pick something you think you might enjoy (even just something small), and give it a shot! See what difference it’ll make.