With the arrival of half decent weather, I have been thinking about the correlation between the seasons and our mood and energy levels. For many people, there is a discernible lift to their spirits as the sun comes out, particularly as in recent days, with the distinctly summer feel which can be easily forgotten about here in the Northern hemisphere. The days are longer, and during May, June and July we get more sunlight, because the hemisphere is facing the sun.
For a minority however, the weather does not improve their mood, and their energy levels may remain unaffected. This may be a familiar state of affairs for those of us who have a relationship with depression that is not seasonally affective. Our mood does not lift as the sun comes out, and we may continue to feel frozen within the numbness of our bubbles, even when the rest of the world seem to be stripping off to soak up the rays and enjoy the warmer temperatures. Whilst others dash to pick up ice and fuel for the BBQ, it may seem difficult to leave the solace of our darkened bedrooms, where we feel tired even having done so little, with compromised energy or enthusiasm even for things we usually enjoy.
Sunshine can be an antidote for low mood. The reason for this is the chemical imbalance in our brain cells that acts as a trigger for depression. Sunshine can help to restore the balance by triggering secretion of mood improving chemicals and reducing or stopping the secretion of melancholy-hormones. Nowadays many of us work indoors, in environments of artificial light even in the daytime. Research has shown that this seriously impinges upon our natural bio clocks and negatively affects the secretion of a hormone called melatonin. The secretion of melatonin is a key factor in regulating our moods. A low level of melatonin is directly linked with a depressed state of mind. Going for a walk in the early morning sunlight, for just 15-30 minutes has been shown to have a positive impact, as this exposure is capable of adjusting the level and secretion of melatonin in the morning, thereby increasing it in the evening.
Depression is a very real issue for a great many people, and it hits just as hard during the 'holiday' season. In fact, the sense of isolation may be greater as everyone else seems to be having such fun in the sun. Everybody can feel fluctuations in mood. Sometimes you feel down and sometimes you feel on the top of the world. That is part and parcel of life. It feels very different when you find yourself in the clutch of a serious depression. Feeling sad and depressed is often a normal reaction to a stressful life situation. For example, it is normal to feel down after a major disappointment, or to have trouble sleeping or eating after a difficult relationship break-up. Usually, within a few days, perhaps after talking to a friend, we start to feel like ourselves again.
Depression is very different. It involves a noticeable change in functioning that persists for two weeks or longer. Imagine that for the last three months you've slept more than 10 hours a day and still feel tired, you have stomach problems, you're unable to cope with life, and you wonder if dying would solve all your problems. Or, imagine not being able to sleep more than four hours a night, not wanting to spend time with family or friends, and constantly feeling irritable. And when friends try to reach out to you, you get even more upset and bothered. You lose perspective, and you don't realize that what you're experiencing is abnormal. You want to just "wait it out," and you don't get help because you think it's weak to ask for help or you don't want to burden your friends. These are some of the experiences that people can have when they suffer from depression. Unlike normal stress and sadness, the symptoms of depression persist and do not go away no matter how much the individual wants them to.
If you have been feeling down, or out-of-sorts, your thoughts can easily turn to whether you are depressed or not. Whether you 'fit' the depression diagnosis or not is unimportant. If you are feeling so down that you need to do something about it, that is enough.
Usually, individuals with depression report one or more of the following:
Exhaustion on waking
Insomnia or disrupted sleep, sometimes through upsetting dreams
Early morning waking and difficulty getting back to sleep
Persistent sad or 'empty' mood, lasting 2 or more weeks
Decreased energy, fatigue
Changes in appetite and/or eating: much more, or much less
Headaches, stomachaches, digestive problems or other physical symptoms that are not explained by other physical conditions, or do not respond to treatment
Doing less of what they used to enjoy
Loss of interest or pleasure in going out with friends, hobbies, sport, sex etc.
Difficulty concentrating, remembering, or making decisions
Neglecting responsibilities and/or personal appearance
Anxious worrying and intrusive upsetting thoughts
Feeling hopeless, helpless, guilty or worthless
Becoming emotional, upset or crying 'for no reason'
Shortness of temper, feeling irritable, or agitated
Thoughts of death or suicide
Not everybody will have all of these, and some people have different signs, but if you are depressed, at least some of these will probably ring true with you. The individual signs of depression - the way you feel - are what are used in diagnosing depression. It's easy to see why there is so much confusion, as most of the 'symptoms' are generally common emotions and feelings. Although it is often classed as 'mental illness', depression often has as many physical symptoms as mental. The feelings or emotions that are depression symptoms actually begin to cause the physical effects. How this happens is a vital part of understanding depression and the symptoms that come with it.
If you are depressed at the moment, or know someone who is, some of the following symptoms may sound familiar:
You feel miserable and sad.
You feel exhausted a lot of the time, with no energy.
You feel as if even the smallest tasks are sometimes impossible.
You seldom enjoy the things that you used to enjoy.
You may be off sex or food or may 'comfort eat' to excess.
You feel very anxious sometimes.
You don't want to see people or are scared to be left alone.
Social activity may feel hard or impossible.
You find it difficult to think clearly.
You feel like a failure and/or feel guilty a lot of the time.
You feel a burden to others.
You sometimes feel that life isn't worth living.
You can see no future. There is a loss of hope.
You feel all you've ever done is make mistakes and that's all that you ever will do.
You feel irritable or angry more than usual.
You feel you have no confidence.
You spend a lot of time thinking about what has gone wrong, what will go wrong or what is wrong about yourself as a person.
You may also feel guilty sometimes about being critical of others (or even thinking critically about them).
You feel that life is unfair.
You have difficulty sleeping or wake up very early in the morning and can't sleep again.
You seem to dream all night long and sometimes have disturbing dreams.
You feel that life has/is 'passing you by.'
You may have physical aches and pains which appear to have no physical cause, such as back pain.
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| Getting from glass half empty to glass half full... |
I am often asked what helps. Here are some ideas...
Get a good understanding of what depression is
Self help is far easier when you know what you're dealing with. What you know about your depression has been shown to have an effect on well you respond to treatment. Read about the condition and about others' experiences - it's the best way to start helping yourself. Understand that depression is not part of you, it is due to a set of symptoms. These symptoms cause you to feel, think and act differently to normal. Once depression goes, things will be different. And when you have the skills to beat it, it is more likely to stay away.
Cut down on rumination
Do whatever you can to decrease the amount of rumination you are doing. (Ruminating is 'chewing over' emotional issues in your mind without coming to any decision to act.) If you are facing a big problem, make the decision to put off thinking about it for, say, 1-2 weeks until you get your energy back, or whatever is appropriate in your case. If you cannot put it off, speak to someone else who you know to be a good practical problem solver.
Stop yourself when you spot yourself doing 'all or nothing' thinking.
Read when you have nothing to do, to occupy your mind.
Try to exercise
Work, if you canDo things to occupy your mind. If you have nothing to do all day, you will tend to ruminate over your problems.
Find ways to assess and monitor your depressive episodes
The way depression makes us adopt all or nothing thinking is a unique and crucial part of understanding depression. The way depression makes us generate seemingly hopeless outcomes to our situation can make it almost impossible to see a way out of it. Finding ways to gauge your depression can help to show the shades of gray, that will ultimately defeat the black and white thinking on which depression thrives.
Begin a 'depression diary'. In this rate each day from 1 to 10, where 1 is the worst kind of day, and 10 the best. Then, after 2 weeks or so, you can look back and see how things have varied over that time. This will help break down the 'all or nothing' thinking that depression can cause.
Lower your emotional arousal levels Calming down emotions such as anxiety and anger helps your brain function more subtly and decreases the amount of catastrophising you do. Along with getting proper rest, being able to relax is incredibly important. Relaxation therapies are effective in overcoming some of the other issues that can co-occur with depression. The effects of panic attacks, anxiety and anger etc. can be lessened and overcome with the ability to relax properly and deeply.
Get some kind of relaxation during the day. If you know how to do meditation, or some other mind-calming technique, do it. It will help reduce the physical effects of the depression greatly. Physical disciplines such as Yoga, Xi Gong or Tai Chi, which occupy the mind whilst performing gentle, relaxing exercise can be useful, as can mindfulness meditation, and relaxation training such as guided imagery or self hypnosis.
Eat 3 meals a day
...whether you are hungry or not, at the right times.
Exercise, if you can
Get as much exercise as you can. Make yourself walk briskly every day, at least.
If you can increase the amount of physical exercise you get, it can be a great self help for depression. The results of the physical exertion will lift your depression temporarily at least, in addition to the other benefits of exercise. (You should consult your GP before starting any strenuous exercise regime.)
Do What You Enjoy
Do what you used to enjoy doing, even if you don't particularly feel like it. Even complete small tasks within the home if you don't feel like meeting other people. Seemingly mundane tasks, if they have an end result, can result in a feeling of satisfaction, and actually increase your serotonin levels.
Maintain a regular sleep pattern
Do not lie in if you feel exhausted in the morning. All that happens is that you dream a large amount if you sleep through the morning, because your REM periods get longer the longer you have been asleep. Set a time to get up every morning, and get up. Try to spend 8-9 hours in bed, and get up regardless.
Take a proactive stance to regulate your sleep patterns. Get up no later than 9am and go to bed no later than 11.30pm, even if you can't sleep. If you experience problems getting up in the morning, get someone else to rouse you, or have a friend call.
Get up, Get out
Ensure you get outside early to make sure you get enough bright light to help regulate your sleep patterns.
Prioritise meeting your basic emotional needs
To function 'properly', human beings need to meet a number of 'basic needs'. These are often taken care of by work, home life and pleasure pursuits; however depression can cause them to be impaired. This list is given so that you can take a look at your own life to see if any area could be improved. Of course, anyone may fall down on one or two, but much more than that and you will probably be feeling the effects.
Our need to give and receive attention
Human beings are social animals - we used to survive by being able to exist in close-knit groups, so the exchange of attention can be seen as almost as vital as food. This is why solitary confinement is seen as the ultimate punishment within prison. Without human contact, mental health degrades rapidly. As depression causes you to participate less in social occasions, this need can be affected. You may also find yourself talking more about your problems to friends and family, hoping to find a solution. While of course it is good to talk about problems to an extent, too much focus on them can put others off talking with you.
Taking care of the mind-body connection
This means looking after yourself. Eating regular, healthy meals, exercising appropriately, getting enough rest and relaxation. Again, this need is often impacted as depression sets in.
Our need for meaning, purpose and goals
In the larger context, it is important that you have something to focus on outside of yourself. When a person becomes depressed, their sole goal can become to 'get rid of the depression'. They might say things like, "Once I've got rid of my depression, then I'll do X, Y or Z." This is perfectly understandable, but can worsen the situation as the person focuses on the depression more and more, to the detriment of their wider life goals.
Our need for a connection to something greater than ourselves
People have been shown to be healthier generally when they feel committed to some cause, idea or group that involves more than just their own well-being.
Our need for stimulation and challenge
The human brain seems to have an innate need to create, and to absorb new information. Without an external source, the imagination can turn to creating all sorts of unpleasant scenarios, often increasing anxiety, rumination and worry, all bad for depression. The experience of being 'stretched', or using skills to their maximum in a focused way, is also an essential part of a healthy mind.
Our need for intimacy and connection
We all need to feel that we are connected in some way to something or someone else. For some people, this can be fulfilled by a pet, but more often this needs to be another person or people. If a person cuts themselves off, this basic need can suffer.
Our need for a sense of control
This is a key need, and it is obvious what happens when a person's life is controlled by others. Torture, imprisonment, violence and psychological abuse all remove control to varying degrees.
And of course, the place where we are used to having control is our own body and mind. Depression removes some of this control, as you wonder what is happening to you.
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