THERAPIST THURSDAY: Stop the Cycle of Depression!

Currently depression is categorized as a “mental illness”, as are many of the issues I treat as a psychotherapist. This categorization often creates a stigma that I think hinders people who are suffering from seeking help. They often see mental illness as a “them” issue, and feel that it cannot be something impacting a functioning member of society. It is my hope that eventually these categorizations will change. As we have come to understand more about the brain, we now know that most issues that fall into the category of “mental illness” are really disorders of the brain. Just as something can not function optimally in any other organ in our body, the same thing can occur within our brain. When we understand this, we begin to realize that these “mental illnesses” are really nothing to be ashamed of, in the same way we wouldn’t be ashamed if we suffered from an issue like diabetes, an autoimmune disease, a digestive issue, or any other illness that has a physical origin. Depression is the same. It is a brain disorder as well as a state of mind. Its origin can be due to either biological factors, situational issues, or a combination of the two.

So, what causes depression? Just as one can have a biological issue that was inherited like heart disease or high blood pressure, we can also inherit a chemical imbalance in our brain. When I think of all the brain does and all that is managed there, it surprises me that there are not more things that go wrong! It is the most complex organ in our body! And we really are only just beginning to understand it. The other cause of depression can be our environment. Just as a person can have high cholesterol due to environmental factors or lifestyle choices, a person can also develop depression due to these issues. This is what is known as situation depression. It is the result of something that is not working in a person’s life. Then, of course, there is depression that is due to a change in a person’s life that has led to an imbalance, such as post-partum depression or unresolved grief. Also, if a person has stuffed their emotions and not addressed things as they have come up, this can lead to depression. With all of these issues, if the core cause is addressed and resolved, the depression typically subsides and the person can often return to their typical level of functioning without further intervention.

Whatever the cause, depression is a cycle, with several factors contributing. Some of these factors are choices, others are not. If a person can work on changing the things that are choices, it will impact the other items and the depression will lessen. The challenging thing about doing this, of course, is that when a person is depressed, they don’t feel like doing the things they need to do to begin to alleviate the symptoms, because their energy is low and they have feelings of hopelessness. It is often the case that they need the support of professional intervention to begin to take action to change this cycle.

So, what exactly are the items that are part of the cycle of depression? While this is not an all-inclusive list, because there is variation in the symptoms from person to person, these are some of the common items contributing to depression that are part of the cycle. I will list these in two categories, things that are actions or things within one’s control to change (although sometimes these can not be changed without further intervention due to the severity of the depression) and those that are not choices. When I work with someone who is suffering from depression, we focus on the items that are within one’s control. By doing so, we determine together if they are able to put into action what they need to create the change they desire. If they are not, we begin discussing other interventions, such as the temporary use of medication, to give them the boost they need to be able to complete the actions necessary to create the change that will impact the things that are not within their control.

Items that are “choices” (I use that word with quotes because I want to be clear that if someone is suffering from depression, it is often not something they can just choose to change. It is often something that requires other interventions to create change). Items on the depression cycle that can be actively worked on include: activity level, eating healthy and appropriate amounts (as opposed to over eating, binge eating, or under eating), getting enough sleep but not too much sleep, changing negative thoughts, not isolating.

Items that cannot be controlled include: feelings of hopelessness, lack of energy, lack of motivation, low mood, feeling sad, inappropriate guilt, etc. When a person begins to focus on the things that are within their control, it will directly impact the things that are not within their control, and change can begin to occur. For example, when one is depressed, he does not want to be around people. So he begins to isolate himself from others. The more the person isolates, the lower his energy is, and the more he wants to isolate. So as difficult as it is, he can begin to develop a schedule to be around people, to interact with loved ones. When this occurs, his energy level is likely to increase, which will in turn make it easier to isolate less. If a person doesn’t get enough sleep or sleeps too much, she is likely to feel more tired. This will cause the person’s sleep to be more dysregulated, which will lead to her feeling more tired, and so forth.

The bottom line is, depression is a very treatable issue and no one should suffer in silence. If you or a loved one is experiencing depression, I urge you to reach out to those you love, talk to your doctor, or seek the assistance of a mental health professional. Depression does not mean you are “mentally ill”, it simply means something is not properly regulated in your brain. Getting a proper diagnosis and a treatment plan in place can make all the difference.

Rochelle Whitson is a Licensed Marriage and Family Therapist in private practice in Temecula, CA. She is the author of the blog www.meetme4therapy.com.

Ms. Whitson can be reached at meetme4therapy@gmail.com.