May 07

Should I Take Antidepressants?

By Vickie | Uncategorised

 “When did you decide to go on antidepressants? I am nervous about taking SSRIs for mild depression, but my friends in their 20s on them. It surprises me because the people who are on meds I wouldn’t have thought were depressed. I am seeing a therapist, which I think has been really helpful, and try to eat healthfully, exercise every day, see my friends, work on hobbies and projects. All these activities really help me get out and about.  And yet I also struggle with low self-esteem and self-confidence, which is really frustrating, because if I just didn’t doubt myself so much, maybe I could just feel better and be more productive. I really want to achieve more in my life, but constantly sabotage myself and put myself down. I don’t believe I’m seriously depressed, but I can’t seem to feel better about myself and wonder if going on medication would help me? Do you think I should take antidepressants?” – Question on depression forum[1]

It is impossible to write about depression and not mention antidepressants.

Some people believe that antidepressants are a little like a life vest or inflatable arm bands; they keep you from drowning while you learn to swim.

The life vest will keep you up while you learn how to float and to use breathing techniques and swimming strokes to move yourself through the water.

But the life vest feels safe and comfortable and you might be wondering if learning to swim is really what you want to do now.  You could just continue to let the life vest buoy you up.

You don’t have to make the effort to learn how to float or move yourself through the water. There’s no real need to do that, is there?

The life ring will keep you from drowning (unless the seas get very rough).

However.

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What do you hope from antidepressants?

This means you’ll have a limited experience of the water, without all the fun games you could play, exploring coral reefs, even challenging yourself to go faster and further.  If you learn to swim you’ll have greater ability to explore the watery world, deeper below the surface.

You may need a good teacher to help you build your confidence and encourage you to let go of the life vest. If you practice what you’ve learned, you’ll be swimming like a fish, with the fish, before too long! What a wonderful experience.

Let’s say the water is life. A good life, a contented life, a life of purpose and joy and one which you design. It’s a life which you are not experiencing right now, not with your persistent low mood sucking all the enjoyment out of life.

So you visit the doctor and he puts you on antidepressants.

Antidepressant Medication: Your Life Vest in a Capsule

In an ideal world, on antidepressants, your negative thoughts will disappear and your emotions will be regulated to cheerful and sad and neutral where appropriate. Before you know it, you’ll be sleeping better and transforming your diet to one filled with fresh fruit and salad, rather than the junk food which seems to be increasingly on the dinner table because you just don’t have the energy to cook.

With a better mood, you’ll feel able to deal with the stress at work and cope better in meetings with your new demanding boss. Or maybe you’ll change career and retrain to be the horticulturist you’ve always wanted to be. You’ll have much more energy to help little Johnny with his homework and be happy to take part in the school working bee next weekend.

Life will be grand!

In reality, there’s no instant relief. After a while the strong negative emotions may seem to have turned down. But you notice that you’re having strong headaches most afternoons and the thought of going to counselling sessions as suggested by the doctor doesn’t appeal so much. You’d rather have a nap.  

Anyway, with the horrible thoughts that had previously plagued you and the sessions of weeping seem to have gone away, so things are not really so bad now, are they? Sure, you’re pretty lethargic most of the time and have that weird dry mouth feel, but in a few months you’ll start to feel better and recover some of that lost energy and zest for life. Every day it’s getting better and better.

Isn’t it?

Tomorrow is another day…

Are you asking yourself, ‘Should I take antidepressants?…everyone else seems to be on them.

I was, for about eight years, on and off. I finally went to the doctor when I was experiencing one of my lowest points and she gave me a prescription for citalopram (celexa, cipramil). I was so relieved. The effect was immediate. Or was it?

I really don’t know now. I had no side effects. I had what I felt was instant relief. That very day. Within hours. I don’t think antidepressants are thought to work like this. I believe the manufacturers say they take 4-6 weeks to take effect.

But I felt re-energised almost from the get-go and started the psychological counselling suggested by the doctor.

Suddenly, I had a name for what I was feeling, I had hope.

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For the first time in a long time, I felt hope that I might live without chronic low mood.

I enjoyed meeting the psychologists, a very funny woman in her mid-50s. I don’t remember doing any actual therapy. She’d put the kettle on and offer a couple of chocolate biscuits and we’d natter away like a pair of old friends catching up on the neighbourhood gossip.

I walked my dog more vigorously. I even started dance class again, salsa this time.

I felt great!

Many people do have good experiences with antidepressants, but I am appalled by the number that do not. A brief internet search will turn up story after horror story of serious and dangerous side-effects and totally ineffective treatment and the nightmare of withdrawal.

Sure, people tend to talk about awful experiences, but in my opinion, there shouldn’t be any, should there?

No awful experiences. If depression is a biological illness these drug should point themselves to the biological cause and dispense with it.

But therein lies the rub. No scientist knows why antidepressants appear to have a positive effect on some people and a truly horrific effect on others.

Yet they continue to be prescribed in greater and greater numbers. Oddly enough, the statistics on the numbers of people diagnosed with mood disorders is also increasing.

OK, maybe some of these people are genuine sufferers who in the past were reluctant to come forward, but could there not be something else rather more sinister going on?

Maybe antidepressants are just not as effective as we hope?

How Do Antidepressants Actually Work?

If you’re asking ‘Should I take antidepressants’ you’d want to know how they work in the brain, wouldn’t you?

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Do you think it matters that psychiatrists don’t really know how antidepressants work?

Well the answer is that nobody knows.

Really.

Nobody knows how they work, why antidepressants work for some and not others. Why they take so long to take effect (if they do at all); why they stop working. Why they have side effects.

Nobody really knows the answer to these questions.

They have ideas about what might be happening in the brain.

But the simplest explanation, ‘Your brain chemicals are unbalanced and these drugs will help balance them again’ is an absolute guess.

The chemical imbalance theory is still widely given to the general public, through mental health websites and by general practitioners, but it has been discarded by the American Psychiatric Association, some 30 years after it was first promoted.

Instead, antidepressants are thought to work on brain chemicals by keeping them in the little gaps between brain cells. These little gaps, called synapses, are where neurotransmitters are released by one neuron, or brain cell, and received by the next neuron and transformed into electrical signals.

Some antidepressants, known as ssri (selective serotonin reuptake inhibitors) are thought to prevent the neurotransmitter serotonin from being sucked back into the first neuron. This would allow more of the serotonin to be passed onto the next neuron, thereby ‘activating’ that pathway or region of the brain.

So the theory now is that antidepressants don’t provide more chemicals or encourage the brain to produce or release more chemicals, but rather, they are believed to allow the chemicals to hang around longer in the tiny spaces between neurons in order to be picked up and passed on.

But is a lack of neurotransmitter in the synapses really the cause of depression?

Nobody knows.

Most doctors view illness in the framework of the medical model, which makes sense really. They are doctors after all and their job is to observe, diagnose and treat.

Many GPS and certainly most psychiatrists, see depression the same way, through the medical model. Hopefully, though, most will also encourage their patients to take exercise and eat better (mine didn’t). If your doctor is of the view that depression is a biological disease, it makes sense for her or him to offer you a pharmaceutical solution, drugs called antidepressants.

There is plenty online about the development and marketing of antidepressants[2]

What did your doctor tell you about what depression is? How did he explain to you how antidepressants work? How long they’d take to work? Did he inform you about side effects? Did she explain how to taper off? Did she suggest you’d be taking them for the rest of your life?

I wonder if people actually ask doctors, ‘should I take antidepressants?’ or whether they get handed a prescription. I really wonder why GPs hand out prescriptions so often.

Do doctors not read the research on how helpful taking exercise is? Or making social connection? Or eating well? Or getting adequate, good quality sleep? Why are these activities not offered as ‘treatments’?

After all, they’re safe (find the type of physical activity that suits you; take a friend not an axe murderer), free (parks in my town are free; I don’t expect your friend charges by the hour), there’s no waiting list (you need to make the time and arrangement to meet your friend) and you can do them in the privacy of your own home (dancing round the living room with your friend can lift your mood too)!

Antidepressants Do Appear To Work Well For Some People

“Zoloft has worked effectively for me. It has got rid of my terrible anxiety which caused the depression. It was rough getting through the initial side effects but I pressed on. There are some remaining side effects, but they’re not so bad now. I don’t think Zoloft has changed the person that I am. It does let me do more during the day rather than staying in bed worrying and crying and hating life. I eventually went on meds after suffering for years and it was the best option. There are some moments when I feel kind of numb, but mostly I feel more optimistic about the future and much happier”. -A comment on an article about antidepressants.

‘My antidepressants work for me. I need them! I couldn’t get anything done without them. How dare you shame me for needing and taking meds.’ –Response on depression Facebook Group.

Once upon a time I’d have put myself in this camp. I was so relieved that my overwhelming and chronic negative emotions had a name that I told all my friends. Some were surprised, others concerned.

I bravely told them I’d started on antidepressants.

One friend told me she’d ‘have to think about it’. Whoa, my first experience of stigma as a depressed person.

To cut a long story short (read the full story here) I went on and off the antidepressants twice because I felt better and the third trip back to the doctor, I promised to remain on them…forever I guessed.

I just popped the little white pill every morning with my tea.

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I felt a huge amount of relief; like a prison door had been opened.

I was fortunate. I didn’t experience any side effects. I felt an enormous relief when I finally eliminated a monumental stressor from my life but stayed on the drugs because I didn’t then understand the connection between stress and ongoing low mood.

I went to China to teach English and right at the end of my time there, I went off the antidepressants because living in China I couldn’t get any more. I did try, but with little English and no desire to go to a Chinese doctor I just shrugged my shoulders and got on with my life.

A year later and that little nagging voice came back. I felt tense, tired. I found myself weeping unexpectedly, just now and then. My mood plummeted and my sleep became disrupted.

Not too badly though. And still feeling pretty good, I got angry rather than distressed by the idea of going back to depression and decided then and there to find and implement alternative ways of living, some of which I already had albeit without realising they were keeping me stable and productive.

So was it the antidepressants?

With hindsight, I think I was one of the lucky (?) ones who experienced a placebo response.

At the same time that I went on the drugs, I started psychological counselling and really enjoyed it, though it didn’t seem like therapy. The drugs are promoted by the companies as being slow acting; it couldn’t have taken effect that quickly. Going off the drug and finding the low mood returning was, I believe, entirely due to the fact that I hadn’t taken steps to improve my life, such as eradicating stress and changing my thought patterns.

So while I had a good experience, I didn’t make the changes which so many advocates of antidepressants suggest you make under their safety net.

While some people have a good result with antidepressants, for others, the drugs have no effect at all:

“I’ve been taking various anti-depressants for over 10 years and none of them have had a positive effect on my life and sense of well being, no matter how high the dosage. My GP says he’s run out of ideas but is the first to admit that doctors don’t get any real pharmacological training”. -A comment on an article about antidepressants.

For some people, they simply experience neither an improvement nor a worsening of their chronic low mood. There are numerous stories of psychiatrists trying one medication after the other in the hope of finding relief for the people who consult them.

It must be an agonising process, not to mention costly.

Some people end up with a diagnosis of ‘treatment resistant depression’. This blames the so-called illness, rather than the treatment. What if the person was just not ill?

While you’re asking ‘Should I take antidepressants?’ statistics show that you’re more likely to get a better outcome if antidepressants are used in conjunction with talk therapy and also lifestyle change.

Why not try talk therapy and lifestyle change first?

The problem is that you can’t tell in advance if you’re going to have a good or bad experience with antidepressants. It’s a bit hit and miss, a guessing game. Read the depression forums and you’ll find stories of people who have been through hell and back trying to find the type and dosage that gives them the most relief from their depressive symptoms while at the same time not inflicting any more pain on them through unwanted side effects.

If you do decide to try antidepressants, please be informed. Ask lots of questions.

If you are currently taking antidepressants and are finding them effective, that’s great. Don’t stop taking them because of anything you read on this website. Should you wish to try tapering off, do so only under medical supervision.

Some People Experience Appalling Side-Effects On Antidepressants

“On/off sertraline severe withdrawals every time. Couldn’t restabilise and dr switched me to Prozac. After a severe reaction to Prozac started withdrawal with more depression, thinking of suicide, wanting to self-harm…Put back on Sertraline to see if would help. No change and was admitted to hospital for the terrible rage and suicide threat, and given 50mg Lofepramine which took two weeks to decrease symptoms but now I have insomnia. Shrink stopped Lofepramine but I still can’t sleep”. -A comment on an article about antidepressants.

“I know from personal experience that anti-depressants can cause serious side effects and trying to come off them is an absolute nightmare. I believe anti-depressants can also seriously negatively impact relationships due to the “numbing” effect they have on your emotions”. -A comment on an article about antidepressants.

“The drugs made me feel emotionless and numb and unmotivated. I couldn’t pay attention to my studies. They affected my memory I couldn’t remember anything in lectures or when I read. Thanks to the meds, I had to give up my course. I hate the fact that I was lied to about the pills”. -A comment on an article about antidepressants.

Numbing the emotions means that people may feel more emotionally stable and therefore less low in mood. But this may have an unwanted consequence.  If unpleasant emotions are eliminated or blunted, you don’t feel motivated to explore the cause of your depression and make any changes that might prevent relapse. You’re just stuck on the meds. 

So, whether the antidepressants will actually make you feel better is questionable. For some people, they take the drug, feel no side effects and at some point, feel better. Others take the drug and feel no effect at all. Yet others take the drug and feel side effects so horrendous they are much worse than the depressive symptoms they were prescribed for, with little or no benefit to their depressed mood.

Finally, if antidepressants remove the painful feelings of depression (low mood, negative thinking), then how will you get the motivation and energy to change the things that need to be changed? If you muck about with your emotions, then you muck around with your neurobiological basis for change.

Entering the mental health system via the GP and regularly being put onto the anti-depressant merry-go-round. One after the other for years and years and years. If people are not thinking critically about their diagnosis and treatment, they may believe they are chronically, physically ill and end up a nightmarish journey through antidepressant hell.

Instead of asking ‘Should I take antidepressants?’ why not ask, ‘What are the alternatives?’

Antidepressants: Are There Alternatives?

“I am struggling with long term depression and anxiety and I can’t seem to find anything that works, even after at least 15-20 different antidepressants and antipsychotics mood stabilizers. I’m giving up on medication to improve my mental illness. Anyone got experience with ECT?” – depression forum post

It’s not fair or kind to suggest that people who choose antidepressants do so because they think it is the easy or fastest option. That smacks of stigma to me.

Most people choose antidepressants because they want relief from their overwhelmingly painful experiences. They feel really awful, sometimes for years and just want that pain to go away. They don’t want weeks of talk therapy. Quite naturally, they want relief and they want it quickly.

If the doctor gave you a prescription for ‘20 minutes vigorous exercise, 3 times each week’ you’d probably feel a bit miffed, but in fact, exactly this prescription has been shown to have the same mood lifting result as antidepressants – sometimes more so – and the effects are more long-lasting.

But for you to accept this, the doctor would probably need to spend time talking to you, about how you feel and your lifestyle, explain to you what depression is and how it can be treated.

And what doctor has time for that?

So what should you do?  Should you take antidepressants?

Ultimately, you must do what you feel is right for you.

Read widely, ask lots of questions. If you start on antidepressants, how long will you need to take them and what kinds of side-effects can you expect?

Talk to your doctor about your lifestyle and what you want to achieve from being free of chronic low mood. Gather the information you need to make an informed decision about antidepressants.

Finally, have a good, honest look at your ideas of what depression is and whether there could be anything in your life right now that might be contributing to your low mood. Ask your doctor what other strategies you could use to feel better.

I didn’t learn to swim while wearing my antidepressant life vest. I made some changes, sure, but not in the knowledge that they would make me resilient to depression.

If you’re asking yourself ‘Should I take antidepressants?’ the very next question needs to be, ‘If the antidepressants make me feel better, what then?’

If the idea of making lifestyle changes such as incorporating more exercise into your life or eating differently or getting more socially active seem daunting, email me and ask how I can help you get started.

What you need is someone who can coach you along the road, because they’ve been through it too. I struggled with chronic depression for 21 years and have transformed my life. I can help you do that too.

Contact me today.

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[1] All quotations used in this post have been edited by me to maintain the anonymity of the writer. The gist of the quotation has not been changed.

[2] Carlat, D, 2010, Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis, Free Press. If you’d like to read more about the development of the chemical imbalance theory of depression, try these resources… Whittaker, R, 2010 Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America.  Useful websites include www.madinamerica.com, www.behaviorismandmentalhealth.com, www.psychologytoday.com/blog/science-isnt-golden and joannamoncrieff.com.

 

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May 06

The Benefits of Taking Antidepressants

By Vickie | Uncategorised

I’m excited.

So excited I’ve been to the toilet four times already and it’s only 9am.

It’s the day of my book launch. I’ve written up my doctoral research for a general reading audience of people who might be interested in archaeology and ancient figurines. It’s a project that took 13 years, thanks mostly to the thought that I could never do it. But I have done it and I’m excited.

I head down to the venue 45 minutes before to see, to my utter horror, that the room has been set up in rows before a stage. I had expected people would stand, milling around enjoying champagne and cake and I would say a few words and the woman I had invited to make a longer speech would officially launch the book and then I’d sit behind a desk signing copies.

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I just wanted to run away and hide in the cushions like a little kid.

I had no idea that I’d be on stage in front of all those faces. My speech suddenly seemed woefully inadequate, I felt tears pricking at my eyes. What was I doing? I wasn’t a writer. I was completely out of my depth and very anxious.

But I didn’t have time to dwell on my thoughts or feelings.

People started arriving and I took to the stage, threw on my ‘teachers’ face and began to speak. I invited the keynote speaker to give her address and then I thanked people for coming and invited them to enjoy the refreshments. I scurried off stage, feeling very stupid.

I sold a few copies of the book, mostly to my friends and family. No strangers came to talk to me about the book.

I felt like the whole event was an utter failure.

It wasn’t, of course. I was just in the grip of a return to the old negative ways of thinking.

Up to that point, I had felt so good.

I’d been living and working in China creating a professional life for myself as an English teacher, I’d had wonderful experiences travelling in China, I’d started to exercise more regularly and see my friends often. I felt like the depressive thoughts and feelings were gone for good. I thought I was definitely a classic example of the benefits of taking antidepressants.

But my depressive thoughts and feelings were not gone for good and I began to feel the signs – negative thoughts about myself and my life, poor sleep, loss of motivation and energy – beginning to creep in again.

I got very angry.

Not this again! No way. Not again. I’m not having it.

I still felt well enough to get angry with myself, rather than allow my mood to get the better of me.

I was also very angry with the medications. Where were the benefits of taking antidepressants? I thought they were supposed to make me well.

Why Doctors Prescribe Antidepressants

Before I saw the doctor I had, of course, heard of depression and had wondered, on and off through the years, whether that was my problem.

But I hesitated to see the doctor for two main reasons:

1/ I thought I should be able to deal with my emotions on my own

2/ I thought depression was a sickness and I didn’t think I was sick.

When the GP gave me the prescription for an antidepressant, citalopram, almost without asking any questions at all and certainly without providing any information about depression, I felt a strong sense of relief and also one of resignation.

OK, maybe I was sick after all…

Maybe I needed the benefits of taking antidepressants.

Because I thought depression was like an ear infection, I decided taking antidepressants was like a

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Sick.

course of antibacterial medication. You have a sore ear, so you go to the doctor and she gives you some tablets which will fight the infection and give you some relief from the symptom, the worst one being pain.

That’s what doctors do. They diagnose illnesses and give medications. They work within a framework known as the ‘medical model’. They can hardly be expected to do anything else really. Not after decades at medical school.

However.

It seems that depression is not like an ear infection, because the brain in depression is not like an ear when infected.

Antidepressants do not attack the cause of the depression the way antibiotics attack an infection, because there is no biological cause of chronic low mood.

The doctor (GP or psychiatrist) diagnoses depression on the basis of the ‘symptoms’ which you explain to your doctor. There is no scan, blood test or x-ray for depression. The doctor uses a manual called the Diagnostic and Statistical Manual of Mental Disorders (DSM, published by the American Psychiatric Association) to identify your ‘mental illness’. Because depression is diagnosed on ‘symptoms’, it is quite subjective. Natural grief may present in exactly the same way as major depression, according to the DSM.

You may wonder at the benefits of taking antidepressants when there is no biological cause to depression. Click To Tweet

Well, for decades the APA put out the word (indeed, marketed rather heavily) that depression is caused by a ‘chemical imbalance’ in the brain and that antidepressants ‘rebalance’ these chemicals by topping them up. They’re the so-called benefits of taking antidepressants. Even though that idea has been well and truly debunked, doctors still tell their patients that they have an imbalance in chemicals and prescribe medications.

Antidepressants are believed to help a brain chemical (serotonin or dopamine, for example) remain in the tiny space between two brain cells, so that they can activate the next cell in the chain.

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Nope, no brain chemical imbalances here!

However, because there is no evidence that the brains of depressed people have a lack of brain chemicals, this means there is more brain chemical in that little space than there should be. The brain tries to rebalance the chemicals itself, which works temporarily, but then it just gives up the fight and the whole system is frankly left in a mess.

Antidepressants do have long-term effects on the brain. And some of these effects may be irreversible. Some antidepressants have very unpleasant side effects in some people, including a numbing of the emotions, which may seem like a good thing if your emotional life is a roller-coaster, but wait…

But I was discovering, back in 2013, after taking citalopram for about 8 years, that it doesn’t seem to work like that for anti-depressants.

I was really beginning to wonder about the benefits of taking antidepressants.

I had expected that whatever depression is would be fixed by the antidepressant medication and sure enough, they appeared to make me feel brighter and more clear-headed. In fact, in the first three years I went on and off the meds twice because I felt so much better.

With hindsight, I’m not sure that the brighter moods was due to the benefits of taking antidepressants. Rather, I think I was experiencing the placebo effect.

Stress and Depression

But now, when I had not taken them for a year, the signs of that low mood were returning. So that must show they worked? No, because I was re-experiencing a period of stress.

However, because I had built some resilience over the past 8 years – creating for myself, albeit unbeknownst to me, an ‘antidepressant lifestyle’ and mental resilience – I was able to recognise the return of the depressive thoughts and feelings and to decide to do something about them.

One thing was for sure, I wasn’t going to give in to them!

In fact, chronic low mood is caused by stress and ineffective coping mechanisms to handle stress.

For example, increased pressure at work causes stress. You begin to worry about work and that keeps

you awake at night. An inability to sleep well means you function poorly during the day. Being ineffective at work is stressful. You worry more and lose your appetite which affects your energy levels.

You give up sport on the weekend because you don’t have the energy and end up staying home all weekend. You don’t see your friends as much as you would like. Your mood drops rapidly. You worry about how life went so wrong. And so on and so on.

Some people have described antidepressants as life vests or rings thrown out to people who are difficulty in the water. They’ll help you float, but if you want to get back in the water, you’re going to have to learn to swim.

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Antidepressants may feel like a life saver…but are they?

Nonetheless, some people have very good experiences with medication. Some people do report clear benefits of taking antidepressants. Bear in mind that this cannot be measured in a scientific way. That is, it can only be described by the person themselves. If they say they feel better thanks to the drugs, then that is the effect of the drug. There is no way to measure objectively whether the drugs are effective.

Other people have no real effect at all (like me). Still others suffer appalling side-effects and withdrawal symptoms. Thankfully I had no side effects nor withdrawal symptoms. The drug seemed completely inert in my case.

If Antidepressants Don’t Help, What Then?

Sure, scans have shown that the brains of depressed people have different brain activity but this is not a cause of depression. The different activity in the brains of people with chronic low mood is a result of thinking and behaving in the ways which maintain low mood. This different brain activity is correlated with depression, that is, it’s a ‘symptom’ if you want to use medical terminology.

So, to recover from low mood, all we have to play with are the feelings of low mood.

Let’s say I am a depressed person. I sleep and eat poorly, I ruminate on my life, my negative thinking, my sense of hopelessness and helplessness, I have very little energy, I don’t exercise or socialise and I feel like my brain is in a fog.

I go to the doctor who talks to me about depression and gives me a prescription for anti-depressants which I fill at the chemist and start to take regularly. My mood lifts a little and I begin to feel better. The benefits of taking antidepressants are beginning to take effect.

But I still don’t do any exercise or see my friends. I still feel stressed, sleep poorly and eat badly. My energy levels are a little better but I don’t exercise. My brain seems a bit clearer but I don’t make any other decisions about my lifestyle.

If I go off the anti-depressants, my depressive symptoms will return.

Why?

Because there is nothing wrong with my brain except in the way that I live my life. Chronic low mood is life out of whack.

So what was going on in my life during the year leading up to the book launch?

I was feeling increasingly stressed at work, not really feeling part of the educational institute I was working for and doubting my ability to do a good job. My sleep was beginning to be affected as was my thought patterns. I was physically active but not deliberately taking exercise. I saw my friends and loved ones fairly often but was noticing that I was yet again comparing myself with them, my life and achievement with theirs.

Anti-depressants don’t fix your life – they don’t teach you how to swim – they may keep you feeling a bit better (or a whole lot worse if you are struck with side-effects and there is no way to predict that) – your head above water – while you do what you need to do to get your life back in order. But you have to take that action.

Roadblock to Eliminating Depression: It’s an Illness, a Disease of the Brain

Because I thought depression was a mental illness, I had believed there was something malfunctioning in my brain and that the cure was something I had to take into my body to make my brain work again.

My father has advanced Alzheimer’s. The disease is causing his brain to shrink away. He’s lost all but a very distant memories, he can’t process language, he doesn’t recognise anyone. He’s confused but he’s not in distress (as far as we can tell). For many years he’s taken a drug which has helped delay the onslaught of the worst symptoms, but it’s a losing battle.

Scans show the damage to brains of people with dementia. Symptoms show in their behaviour and speech.

With chronic low mood, the ‘symptoms’ are real, but there is no brain disease causing them.

I wasted years thinking my brain had some form of abnormality that had to be fixed with drugs.

This idea that my low mood was biologically caused and that I was sick was my biggest roadblock to a happier, healthier future.

What did I try instead of the anti-depressants?

I decided that I was sick but that I was not going to continue to pay out for doubtful benefits of taking antidepressants which did not seem to be working at all.

I took myself on a quest, a journey to finding the miracle cure that would make me feel better and lift my mood.

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It’s a good idea to check whether a deficiency in vitamins, minerals or other essential elements might be the cause of your low mood.

I began to read. I read about how being low on certain vitamins and minerals  – Vitamin D, B, magnesium – can lead to low mood.  I went to my local health food outlet and dragged home massive containers of tablets.

I took high doses because I wanted to be sure I was giving myself the best chance.

No real change in mood.

Perhaps I was taking the wrong dose. Perhaps I didn’t stick with it for long enough. Perhaps they weren’t the right things.

I read about St John’s Wort, an apparently potent weapon in the armoury against depression. Perhaps I should have been taking advice about doses, but frankly, it did not affect my mood either.

I went back to Evening Primrose Oil, which had had a good effect on pre-menstrual symptoms including emotional outbursts and lack of energy and motivation when I was younger. No real difference noticed, nor with valerian.

Meditation was the next treatment I tried. I thought if I could just calm myself down I might feel better. This is a reasonable assumption but I found that with meditation, I couldn’t control my racing thoughts. I couldn’t even let them go peacefully. I just ended up in another session of rumination.

I tried journaling my feelings but that just ended up in a rant; basically ruminating with paper. Writing out my feeling didn’t ‘let them go’. They just went round and around on the paper and in my mind.

I was beginning to feel a bit desperate but not ready to give up and give in to the low mood.

 Roadblock to Eliminating Depression: Side-Effects of Antidepressants

Many people who take antidepressants do so because they believe that the drugs ‘take the edge off their low mood’ and that if they just weren’t so sad and lacking in energy, that they could change their lives and that will make them happier.

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We need our emotions to help us regulate our mood and behaviour.

Antidepressants certainly don’t make you suddenly feel bright and happy.

Sure, the drugs might calm that overactive amygdala but sometimes they go further than that. Many people who take antidepressants report feeling numb to any emotions – good or bad.

What is the purpose of emotions? They are sources of information that tell us whether to approach, draw closer to or have more of something. When an experience makes us feel good, we are prompted to do it again.

Other emotions tell us to back off, be careful, give up. If we are feeling bored, we are prompted to get up and do something more interesting. If we are feeling irritated, we are prompted to deal with the source of our irritation.

Our emotions prompt us to change.

The problem is that antidepressants can blunt the emotions. Many people describe feeling numb and ‘unable to cry’ or feel any kind of emotion when taking antidepressants.

So if the antidepressants are dampening down your emotions so much that you can’t really feel anything at all, where is the motivation for change?

When the antidepressants proved useless, I still had that same belief about the origin of my mood, it’s just that I started trying ‘natural’ alternatives.

Throughout this process my mood did lift a little, mostly because I was angry and actively on the hunt for a solution.

Being angry is a much more productive emotion that being flat, numb and depressed in your emotions.

So I read and I lingered in pharmacies looking for the magic pill or potion that would eradicate low mood from my life altogether.

It was only when I realised three things:

  • I wasn’t actually sick
  • I didn’t need drugs or supplements to feel well
  • And that my thoughts and my lifestyle were affecting my mood

that I left the pharmacy and went back to the library in search of answers.

What I found took me back to my first love, archaeology. It was time to go back in time….

Read here for how hunter-gatherer communities may hold the answer to eliminating depression…

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May 04

My Journey With Antidepressants

By Vickie | Uncategorised

Was I Sick?

I remember the experience well; the heavy fogginess in my head, the almost impossibility of making decisions, the sense of overwhelm when I gazed, almost unseeing, around my distressingly messy house,

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The brain-fog of depression.

the tape of negative thoughts about everything running constantly in my mind, bashing my head against the bathroom tiles to dislodge the fuzziness, the inability to sleep, the all-pervading sense of hopelessness when I thought about the future.

I was profoundly unhappy and at a complete loss as to how to help myself.

But was I ill?

I think I might have been emotionally unsteady, out of whack, not thinking straight…but I don’t think I was sick.

Sickness implies a biological basis.

Of course, I had wondered, many times, if there wasn’t actually something very, very wrong with me. I certainly didn’t feel normal. I knew what I was feeling was not normal because it was not always that bad.

For much of my life, from around my teens, I have felt a bit low.

What form did this ‘low feeling’ take?

I cried a fair bit, especially in my teens, a time known for angst. I remember spending a great deal of time on the floor with the dog, bawling into her furry neck and my mother, hands wringing, saying, ‘If I only knew how to help you!’

Self-consciousness and lack of confidence were features that marred university life.

Worry about what other people thought of me, my introverted and rather sensitive nature and thoughtful personality created a broodiness that coloured my experience of life.

None of these characteristics – self-consciousness, introversion, sensitivity or being reflective – meant that I was profoundly unhappy, but they may have created my way of being in the world, a way which made me aware of what I believed were my personal shortcomings, led me to require time alone away from others, heightened sensitivity towards sorrows and miseries and cruelties of the world, and contributed to the underlying sense of melancholy and uncertainty that coloured my young adult life.

But I wasn’t ill.

In fact, I was often filled with a sense of excitement about life and the world. I longed to travel and when I first went overseas in my early 20s, I thought I was coming home to myself. Finally, overseas, I felt alive, confident, adventurous, optimistic, joyful.

During the years when I felt at my lowest were those years with significant levels of stress. A failed romance followed by 5 tough PhD years at the end of my 20s, the loss of a loved, but potentially unlikely career, two job losses in my early 30s, an unsuccessful business in my mid-30s.

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The sense of fear and hopelessness are the most cruel.

These were years typified by heart-felt sorrow, regret, attempts to remake myself again and again, a fear that I would never settle into a normal life, make money, buy a house or apartment and feel strong and optimistic.

These were years typified by frequent weeping, very poor sleep and a tendency to isolate, bursts of energy between periods of being barely able to move, moments of clear-headedness which dissolved into days of inability to think through situations or make decisions, flashes of knowing I was headed in the right direction which disappeared into the fog of deep uncertainty.

I was Profoundly Unhappy

I don’t think I was ill, but I know I was profoundly, overwhelmingly, intensely unhappy and my thinking didn’t help.

I couldn’t apply my logical brain to the situation. This brain, which had got me around Syria alone as a 24 year old, through a PhD, through training in immigration law, and whose analytical abilities had kept me resilient and empowered, suddenly seemed to abandon me.

It seemed obsessed with how terrible my life was, how I’d ‘always been’ weak and useless, how grim the future looked, how it was all hopeless and nothing would ever change.

These thoughts were not a reflection of reality, of course. I was very fortunate in many, many ways, I was a strong, intelligent, sensible woman, the future wasn’t bleak and there were lots of ways it could and would improve.

I just found that hard to believe at the time.

I don’t think I was ill.

But my thinking was definitely disordered.

Is a disordered mind an illness? Or just out of working order? Needing a tune-up?

But aren’t all illnesses symptoms of something that is out of whack?

Illnesses that begin with the infiltration of a foreign body – a germ, say – such as a stomach upset, a bite or sting, an infection, make one physically sick. Something that doesn’t belong in the body gets into the body and wreaks havoc. Physical illnesses or sicknesses are biological in origin.

Such illnesses are treated with antibiotic medication and often clear up. They may clear up even without medication, though they may take longer and be more uncomfortable.

But what about cancer, Alzheimer’s, Parkinson’s, diabetes, MS, arthritis…what should we call those?

What about blindness, deafness, Down’s Syndrome…what should we call those? Are they disorders? Malfunctions?

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What does it mean to be sick, diseased, defective or disordered?

What about birth defects, like the one I was born with, a hole-in-the-heart or atrial septal defect? How should we label them?

What about developmental or growth disorders like the one I experienced, scoliosis of the spine? What should they be called?

Surely they are not sicknesses because they are not caused by the infiltration of a foreign body or germ. They are not biological and are not treated with medication.

They are caused by the body’s own systems malfunctioning or wearing out. They are not bacterial diseases, but rather changes or even failures in the way the body works. Organs, glands, systems not working as they are expected to or simply breaking down.

They are medical conditions. They are treated in the operating theatre. I had surgery for my heart and back conditions.

They are also treated pharmacologically, with drugs developed to mimic the body’s own processes, like taking thyroxine for an underactive thyroid.

What about the range of problems referred to as mental illnesses? There are many and they have different manifestations.

Are they biological diseases, caused by a foreign body, or bacteria? Are they medical conditions, physical malfunctions of some system in the body?

The short answer is, we just don’t know.

All we have are ‘symptoms’.  I have little knowledge of psychotic conditions, but I do have experience with depression, because this is what the GP called my unrelenting sadness.

A bunch of symptoms.

My depression was diagnosed on the basis of what I told her about what I was feeling emotionally and how this manifest physically.

Most doctors’ appointments go like this. You feel sick. You go to the doctor and explain how you’re feeling. Depending on what you’ve said, the doctor may look at your body, feel around the uncomfortable or painful area, listen to your heart, take your blood pressure, ask for tests to be done, order x-rays or scans. The doctor gathers information and having reviewed the facts before her, makes a diagnosis.

When the doctor diagnosed my sadness as depression, the GP didn’t do any tests; no blood samples were taken, she didn’t listen to my heart, check my pulse, order a scan or x-ray. 

She couldn’t.

There’s no biological basis to depression, not that we know of.

You can’t stick a needle into your head and test whatever comes out. There’s no test for how many neurotransmitters you have in your brain. You can’t scan for or test for an ‘imbalance of chemicals’. Even if there is something ‘malfunctioning’ in the brain of a person with depression, this is not proof that there is a biological basis to the condition.

Yet, chemicals (drugs) are prescribed in ever-increasing numbers to people who present at the GP with overwhelming sadness.

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There’s no scan for dysregulated emotions…

So perhaps it’s a medical condition of the brain, like Alzheimer’s or MS, a malfunction of a brain system. You can scan for that. The brain can be scanned and the cause of the condition can be pinpointed. Some malfunctions of the brain cannot be cured, yet. They can be improved with drugs, the inevitable end delayed, but not, unfortunately, ultimately avoided.

No one has yet come up with a scan for depression.

You can’t take an x-ray of deep, deep sadness. Click To Tweet

But sadness is different to depression. They feel different. They last for different lengths of time. They are different. The experts say so.

I went to the doctor when my profound feelings of sadness were beginning to frighten me.

I was already hurting myself, banging my head against doorframes or the hard white tiles of the shower. I made fists and pummelled my head. I wanted the fuzziness out of there.

People cut themselves to rid themselves of the pain. Teenagers who cut are taken to doctors because clearly hurting yourself in this way is not normal. People who are found semi-conscience or worse and have put themselves in this condition are often hospitalised because damaging yourself in this way is not normal.

So perhaps there is a sliding scale of deep and profound unhappiness. Perhaps it can lead to such a deep malaise that death is the only way out and perhaps this is the moment that deep and profound unhappiness turns into a disease.

But I don’t know that I believe that.

Not really.

Isn’t it just part of being human to have unpleasant and unwanted feelings?

Antidepressants or Placebos?

People who are at the cusp of (or are actually attempting to) hurting themselves may not present at the family doctor. They may present at the emergency room of a hospital, either conscious or unconscious. Something very disordered has caused them to decide to die. Pharmacological assistance (antidepressant drugs) seem to be effective in treating the deep and profound sadness that leads to that decision.

Perhaps people who believe death is the only answer are ill, because their behaviour is not normal. It’s not normal to wish yourself out of the world. The normal prerogative for human beings is preservation of life.

When people present at the GP with a deep and profound sadness, pharmacological assistance is not so effective. But they feel bad so they go to the doctor, just like I did. They are not sure where else to go. They are wondering if they are ill. They are frightened. They want to the doctor to tell them what’s wrong and to put it right. They understand that doctors deal in medication and that medication makes pain go away. They want the pain to go away and expect that medical treatment will be offered.

And sometimes it works. I felt instantly better. Merely a few hours after taking my first antidepressant tablet I felt the fog beginning to lift. I knew it was going to be OK.

But how is this possible? Antidepressants are famed for their long lead time. Effects are often not felt for at least 4 weeks, so the manufacturers say.

I now believe that what I felt was not the antidepressant taking effect, but a placebo effect.

I have been brought up in the western medical system in which doctors treat diseases with drugs and medical conditions with surgery. I have received plenty of both in my lifetime. I fully expected to leave the surgery with a prescription for an antidepressant medication. I wanted it. I felt really, really bad and wanted to feel better. So I had a high expectation that the medication would have a positive effect.

Now I was what Rutherford and Roose describe as a ‘treatment-naïve’ patient.

I had no idea how antidepressants worked nor of side-effects.

I was hungry for help, desperate for the seemingly endless sadness to go away. I had wondered for a long time whether I was actually unwell, but never quite certain as I thought my feelings might be something to do with my personality. I had some kind of defective character.  I don’t think that is true either, but it was part of the reason that it took so long to seek help. I just thought I had to pull up my socks and be more positive. Or something. Rutherford and Roose report that the placebo effect is noticeable even in treatment-naïve individuals.

I think what I was actually feeling was tremendous relief that I was finally getting help. What is relief?  Relief cuts the fight-or-flight response and allows calm to be restored.

I felt calmer because I had taken action. Sharing a secret fear, confiding in a sympathetic human being was a therapeutic relationship which made me feel less like it was my fault, and more as though I could actually be unwell and that medication was the answer. It was a relief to put a name to my feelings and a solution I could understand.

Simply deciding to visit the doctor, revealing my deep and profound sadness to her and taking away an antidepressant prescription was enough to raise my mood through the production of neurotransmitters involved in good feelings and gave me a sense of control, and that made me feel better.

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There were still doubts, but my head seemed clearer…

This was not the antidepressant being effective, I don’t think. I had gone to the doctor expecting to be listened to and given a solution. I was. I took the pill and felt better, because that was what I anticipated would happen.

So is a positive response to antidepressants all in the mind?

No, I think it’s in the brain.

My actions had led to my feeling calmer and more in control, which released my brain’s own healing chemicals: opioids, which slow breathing, block pain and have a natural antidepressant effect. 

I had no side-effects. I didn’t know what the side-effects were, with the exception of lower libido, the only side-effect my second (male) GP asked me about. There may have been other side-effects, but if there were, I either didn’t experience them or experienced them as part of the illness which I knew I must have, the illness of depression.

I wonder whether antidepressants work for some people because they believe they will.

Like me.

On/Off

Having been to the doctor and obtained a packet of antidepressants, I took them faithfully for 6 months and then went off them, because I thought they had cured my depression. I felt pretty good, at least much better than I had for years, and I had no negative experiences going cold turkey.

But the horrid feelings came back. Suddenly I was back where I was; weeping, confused, frightened and angry with myself for going off the antidepressants.

Obviously they were working and I had foolishly thought I was cured. Clearly the cure takes a bit longer.

I decided I needed to take control again and returned to the doctor who frowned and said I needed to stick with the antidepressants. She handed over another prescription and relieved and determined I went to the chemist, now convinced they were making me better, fighting this illness.

I went back home, back to my usual life. Nothing changed significantly. Oh yes, my intense, profound sadness became just plain old sadness, and sometimes dipped again into profound sadness, but nothing in my life changed. My business was stressful, I took little exercise, I isolated from my friends, my home was still a mess, I ate and slept poorly.

But at least I didn’t have side-effects. Others take the prescriptions from their doctors and enter the vicious world of antidepressants: doses, side-effects, more drugs to counter the side-effects, deciding that putting up with some side-effects are not as bad as the profound and intense sadness that drove them to the doctor in the first place.

Nothing changes. Work stays boring or stressful, relationships are still battle zones, lives are spent on couches, in cars or cubicles, fast food, convenience food, food devoid of nutrition appears on dinner plates every evening. Life has little meaning; people are buffeted about by its dramas and challenges.

When I took myself off the antidepressants, the depth of my sadness lowered again. Does this mean they were working? Not really. I just didn’t feel particularly empowered to change anything in my life.

Why?

Because I didn’t know that my deep and profound sadness was caused by my reaction to what I was experiencing in life and possibly because the antidepressants were numbing my emotions so that I was bereft of any motivation or desire to change anything about my life.

There was no biological basis to my deep and profound sadness.

I was deeply and profoundly sad because I didn’t know how to be happy or contented or satisfied. Click To Tweet

The second time I went off antidepressants the same thing happened; the symptoms returned in a flood. The GP sighed and made me promise I wouldn’t go off them again without his assistance.

I promised and I kept my promise.

Things improved dramatically after I closed my incredibly stressful business, retrained as an English teacher and went off to live and teach in China. I had new experiences doing something I loved, travel. I joined a gym. I mostly ate home cooked food. I felt my job had purpose and meaning and my students were grateful for my help.

My brain wasn’t out of whack; my life was and nobody, not the GP, nor the psychologist, had the insight to ask me about how my life was going.

Why should they? To the doctor, deep and profound sadness is biological and needs to be treated with chemicals. To the psychologist, it is a disorder of thinking, possibly caused by childhood traumas which need to be analysed and healed with ‘closure’.

Meaningful Change

There is some truth in the psychological basis for deep and profound sadness. But psychoanalysing the past doesn’t necessarily lead to meaningful change in the present.

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Isn’t it time for meaningful change?

And meaningful change in the present is what’s needed to resolve deep and profound sadness. Click To Tweet

Some people call antidepressants ‘life-rings’ you throw to someone while they are drowning. Drowning in the normal deep deep sadness of life. They say that if you want to get back in the water, sooner or later you’re going to have to learn how to swim. In other words, take the antidepressants, but if you want a less sad, less dissatisfying life, you’re going to have to create it.

Reduction in stress and a meaningful life will eliminate deep and profound sadness. Exercise, nutrition, good sleep and close friends will eliminate deep and profound sadness.

Some degree of symptomatic reduction may be achieved through the use of antidepressant medication. But studies have shown that symptomatic reduction can also be achieved through exercise, nutrition, good sleep and close friends. Exercise, nutrition, good sleep and a close friends change the brain in the same way that antidepressants are claimed – but not proven – to do.

And without all the side-effects.

A healthy body. Good friends. Meaningful work. Strong relationships:

You don’t get those in a pill.

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Is it time for a new life?

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May 03

Why Am I Depressed?

By Vickie | Uncategorised

Not matter how you look at it, depression is a very, very unpleasant experience.

In this series of five posts I will be outlining my views on the nature of depression or as I prefer to call to it, chronic low mood; what is it, what causes it and how to treat it.

Some of my views may agree with your own; others may trouble you.

Please understand that my intention is not to deny your experience of depression. We all have different experiences, opinions, knowledge and ideas that we bring to our experience of depression.

If you are wondering whether to engage with me or this information on this site, understanding my philosophical viewpoint of depression might help you decide if this is a place where you are comfortable.

Of course, sometimes being uncomfortable is where the journey begins!

If you believe that you will never stop being depressed, it may be hard for you to accept that I was once where you are now and that I am no longer there.

You may believe that that shows I could never have been ‘properly’ depressed.

I can assure you that I met all the DSM criteria for both persistent depression and major depression. My low mood began in my teenage years, and I count until I first sought help in my mid-30s as the total time I was depression; 21 years.

From about 2008 onwards, I have lived without depression and it’s been amazing. My goal for this website is to share how I no longer live under the greyness that is chronic low mood and to offer you the hope that this can also be your experience.

So, I lived the life, I walked the walk, cried the tears, agonised through sleepless nights, struggled with the lack of energy, low motivation, feelings of helplessness and hopelessness.

I was just where you are now, wondering if that was going to be my forever.

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Depression is not a sickness.

What you will learn in this post is that I believe depression is not a sickness but a disorder of thinking and lifestyle. It is caused by stress and maintained by negative thinking patterns.

You can eliminate depressive symptoms by dealing with stress, changing your thinking and recognising what you want from life.

You can live without depression should you choose to, by getting informed, asking questions, gathering support and taking action.

Still with me?

Let’s keep going…

If Depression is Not a Sickness, is Depression Real?

Emotions are real and depression is caused by being hijacked by your emotions. It is maintained by unhelpful emotional responses.

Yes, depression is real.

People experience emotions every day; it would be weird if you didn’t.

Some emotions make us feel nice – happiness, pride, love, excitement, relief – while others, such as grief, sadness, anger, boredom, frustration and disappointment, regret, guilt and hopelessness, make us feel bad. I know you know this.

Some people experience the normal ups and downs of life, great joys and minor disappointments, profound sorrow and utter delight. They revel in the good times and bounce back from the bad.

Some people (perhaps you?) feel an overwhelming feeling of intense sorrow, tremendous frustration, deep dissatisfaction with life and crushing sense of despair and hopelessness.

They seem relentless, these feelings.

Day after day, you may feel you are carrying your desperation with you; it sits on your shoulders, substantial and weighty like the helmet of an old-fashioned deep-sea diving suit. Dragged behind you like a boulder.

There is no bouncing back from feelings like these.

Oh yes. Depression is real all right.

Is Depression Found in the Brain?

The brain is a very complex organ made up of interconnected regions. The brain can be roughly divided into regions responsible for ‘cognitive’ or thinking activity, and those responsible for ‘emotional’ or feeling activity. It is less effective communication between these regions which sustains depression.

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Scans may tell us something about the effects of chronic low mood, but they don’t show us the cause.

Chemical signals known as neurotransmitters are passed between neurons and form what are known as ‘pathways’. This activity shows up on fMRI scans.

Depressed people’s brains have the same regions and neurotransmitters as other people’s brains. However neuroscience has begun to reveal how the interactions between the brain’s regions are affected by depression. This is a complex issue and it’s not as simple as to say ‘this part of the brain is responsible for this feeling in depression, so we just have to fix that part’; all regions of the brain work in circuits and interact with each other in different ways.

However, we can make some general statements about what’s happening in the brain when we’re depressed. Let’s have a quick look at the most distressing manifestations of depression:

‘I can’t sleep:’

Sleep and depression have both a cause and effect relationship. Let’s say you’re just not getting enough sleep because you’re needing to work late at night. Some people say they can get by on 6 hours sleep each night but for most of us, that’s just not true. Our brain performs important tasks while we are sleeping. Lack of sleep makes us feel less energetic the next day and effects our mood. Continual nights of less-than-adequate or poor quality sleep lead to chronic low mood, particularly if the reason for the lack of sleep is stress.

Working late at night under electrical lighting plays havoc with our natural sleep cycles. We are designed to be awake when it’s light and heading for bed when the sun goes down. Forcing ourselves to remain awake long after dark interferes with the production of sleep inducing chemicals and also chemicals involved in waking us up.

‘I can’t concentrate/make decisions’ and ‘I have no motivation:’

The hardest thing for me when I was chronically distressed was getting out of bed. I’d usually slept poorly and just couldn’t summon up the strength to get myself up. If I was working that day I’d manage to drag myself into the shower, but it was always as if I was pulling a ten tonne weight behind me. I’d make plans and never follow them through. On weekends I’d flop around the house, unable to decide what to do next.

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Making decisions is so hard when you’re depressed…

Difficulty focusing on tasks or making carefully weighed up decisions is a classic manifestation of chronic low mood. I made dreadful financial decisions when depressed; buying very expensive items on my credit card. I was also so taken up in my negative feelings I couldn’t concentrate on what I was doing. I regularly locked my keys in the car or the house, lost things or forgot to take important papers or other items with me. Reacting emotionally when things go wrong is another debilitating beahviour. For me this meant crying bitterly and occasionally throwing things around.

Scans have shown that people with depressive symptoms have less activity in the prefrontal cortex, that part of the brain which sits behind your forehead, and is responsible for thinking, analysing, making decisions. It’s known as the CEO of the brain. Evolutionarily speaking, it’s the last piece of the brain to appear. Only humans have such a well-developed prefrontal cortex.

Disrupted activity in various regions of the prefrontal cortex can lead to difficulties in making plans, thinking clearly and getting motivated.

‘I feel tense and anxious’:

When I was depressed, I found myself anxious about what the day would bring. I don’t think I felt highly anxious because quite quickly the feelings of worry would dissolve into feelings of numbness, not being able to care. But there was always a great deal of stress and worry around work.

The hypothalamus, a small organ in the feeling part of the brain, controls the body’s stress response or ‘fight or flight’ response in times of stress. In depression, the hypothalamus is constantly on high alert. Stress is both a cause of low mood and can also maintain it if we are not able to find ways to ‘switch off’ the hypothalamus’ response to situations which cause us to feel tense.

Closely connected to the hypothalamus, the amygdala is often also highly reactive in depression. It is responsible for feelings of fear, anxiety and other negative emotions.

‘I feel sad all the time. I can’t even remember a time when I felt happy’:

The hippocampus, a region in the feeling brain located close to the amygdala, is responsible for storing away memories. In depression, it’s harder to remember and relive more joyful moments but easy to recall negative or sad memories.

An article on the Harvard Medical School website notes that “Research shows that the hippocampus is smaller in some depressed people. For example, in one fMRI study published in The Journal of Neuroscience, investigators studied 24 women who had a history of depression. On average, the hippocampus was 9% to 13% smaller in depressed women compared with those who were not depressed. The more bouts of depression a woman had, the smaller the hippocampus. Stress, which plays a role in depression, may be a key factor here, since experts believe stress can suppress the production of new neurons (nerve cells) in the hippocampus”.[1]

“I don’t enjoy anything’ and ‘I just can’t be bothered’:

The worst part of depression is thinking that you’ll always experience it, that there’s no hope. It’s the cruellest part of having chronic low mood. The sense of overwhelming sadness, grief, regret, sorrow and pain is made all the worst by the belief that it’s all hopeless. Feeling paralysed by not knowing what to do to help yourself out of it – either by going to the doctor, talking to a friend, doing some research – just feeds the worry and sense that there is no hope.

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It’s just so hard to get motivated to do anything when you’re depressed.

Depression saps the joy out of life. Often activities which used to fill you with happiness no longer tempt you. I abandoned the dance classes which used to make me feel very good and never went to movies or out for drinks. I literally ‘wasn’t in the mood’. I found it hard to enjoy anything much at all.

The striatum is a region of the brain involved with forming enjoyable habits. Reduced amounts of the neurotransmitter dopamine seems to be responsible for feelings of boredom, lack of motivation and not enjoying activities as you might once have.

Scans have not found the cause of depression.

If you’re interested in learning more about the brain and depression, I highly recommend The Upward Spiral Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time by Alex Korb[2].

Scans show differences in the brains of people with depression compared to those without depression, but they do not show us that these differences are causes, or effects of depression.

Differences found in the brains of people with chronic low mood are not necessarily causes. They are correlated to the experience of depression.

‘OK’, I hear you say, ‘If my brain is not functioning normally, doesn’t that make depression an illness?’

No, because your brain is functioning normally.

The brain is simply functioning as it is being directed by the experiences of its organism or its body, that is, you!

The brain’s job is to process information. Sounds, sights, smells…all the physical sensations come into the brain and give us information about where we are, who we are with, what’s happening around us and how we feel about those experiences.

The brain processes the information based on what it has already processed.

If you have pleasant memories associated your beloved grandma making homemade strawberry jam, then the smell or taste of strawberry jam, when encountered as an adult, may invoke those good memories again.

You have ‘laid down’ in the very neurons of your brain, a memory that associates strawberry jam with feeling good.

To give another example of how we ‘direct’ our brains, let’s say you grew up bullied at school and with little sympathy or support from your family. Today, as an adult, being in situations which make you feel uncomfortable (work meetings with the boss, unpleasant situations with hostile neighbours, at the doctor with a cold indifferent manner) may bring up those same feelings of fear and not being listened to and being pushed around.

Your brain is associating certain situations with apprehension and worry because they are the messages you heard as a child and they have become part of your response to those uncomfortable situations. Those emotional responses are telling you to be afraid because something ‘dangerous’ is about to happy and that you need to run away.

Your brain is not malfunctioning. Your brain is doing actually what your brain is supposed to be doing.

OK, Maybe my Brain isn’t Malfunctioning, but Depression is Chemical, isn’t it?

That’s what the doctor told you, did she? That’s what he said as he wrote out the prescription for antidepressant medication? That the drugs would rebalance your brain chemicals? That you’re a bit low in serotonin and that’s what causes depression? That the drugs will top up your serotonin?

Well, she wouldn’t be the only one.

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Is depression a chemical imbalance in the brain? Really?

Here’s what Dr Daniel Carlat, psychiatrist, (author of Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis amazon link)[3] admits to saying to patients:

“If a patient asks me how the medication works, I will respond with, ‘We’re not completely sure, but it has something to do with increasing levels of neurotransmitters like serotonin or norepinephrine—basically, these pills rebalance certain chemicals in the brain.”[4]

The repetition of this message from the doctor is likely to be a reason why so many people believe it. Why wouldn’t you? Doctors have been trained in this kind of thing. They’re the experts, aren’t they?

So, is your serotonin out of balance? Not sure?

Well I understand your confusion because your doctor probably didn’t measure your serotonin. How could she? You can’t stick a needle into a living human brain, draw out brain fluid and peer at its contents. Not yet, anyway.

Did you know that there’s no evidential basis for the chemical imbalance theory of depression? There are lots of good resources online to help you understand where this theory came from and what it means.[5] But it simply isn’t true. There’s no evidence.

None.

No scientific research has found any evidence for the ‘serotonin imbalance’ theory.

It’s all a bit of a guessing game, diagnosing depression and offering chemical treatment.

The doctor (GP or psychiatrist) uses information provided by the American Psychiatric Association in their manual of mental illnesses, called the Diagnostic and Statistical Manual of Mental Disorders. 297 ‘mental disorders’ are contained within this manual, each with a checklist of descriptors which doctors can use against the information provided by their patients.

You see, the diagnosis is made purely on the information you give to the doctor. He doesn’t listen to your heart, order an x-ray or blood scan, measure your blood pressure or tap your knees!

No, there is no physical examination which can be done for depression.

Despite not being able to do a physical examination, most doctors use the ‘medical model’ to think about depression. The medical model views depression as a physical illness with a biological basis (though none can at present be identified), similar to Alzheimer’s Disease or diabetes.

I wonder…when did natural human feelings become sicknesses?

So There’s Nothing Wrong With My brain, But Could I Still Be Sick?

Yes, but physically, not mentally.

Inflammation as a cause of depression

Dr Kelly Brogan, doctor and author of A Mind of Your Own[6]  writes powerfully about how depressive ‘symptoms’ originate in the body and that certain substances, such as sugar, chemicals found in the environment,  as well as stress, cause inflammation in the body which results in mood changes.

She writes: “In the brain, inflammation serves to shunt the use of tryptophan toward production of anxiety-provoking chemicals like quinolinate, instead of toward serotonin and melatonin”. These chemicals produce a series of behaviours sometimes known as ‘sickness behaviours’ – lethargy, loss of appetite, desire to sleep, loss of motivation to participate in activity – which are actions needed to heal the body.

Dealing with the cause of inflammation in the body is likely to reduce the unpleasant ‘symptoms’ of depression. This means changing your diet, eliminating toxins and pathogens from the environment and incorporating relaxation techniques such as meditation or mindfulness into your daily routine.

Talk to your doctor about having a range of tests done to eliminate physical causes of your chronic low mood.

Am I Stuck With Depression Forever?

When you read the online discussion forums and Facebook groups for people with chronic low mood, a common view is that depression is a biological illness which needs medication to be treated. There are lengthy discussions between members about experiences with medications, which have been effective and which have unbearable side-effects, dosage, combinations and so on.

Some people see depression as something outside of themselves. Something which ‘descends upon them’ at different times, which they feel ‘coming on’. They feel it’s going to be a ‘bad day’ and hope that tomorrow will be better.

Many people who contribute to online forums seem to believe that depression is something you’ll have forever, all you can do is manage the symptoms – this leads to medication, lots of ideas about keeping your mood up day by day, some hints about lifestyle change (go for a walk, eat more salad).

It’s as if they have no control over their emotions or moods. And if you’ve been struggling with a low mood for years, it might indeed seem as if your moods are something external that has a hold over you.

Nonetheless some forum contributors do suggest daily tips for keeping your mood up, so there must be some belief that the things you choose to do can help. Leaving aside the obvious question (why aren’t the medications doing this?), it is true that doing certain activities each day or regularly through the week will help you feel better.

The next obvious question is, why not do these things more, if you know they make you feel better?

The medical model of depression is widely accepted in both the medical profession and broader community. The idea that depression is a lifelong battle with which the person will be locked in combat forever is well-entrenched.

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Let’s ditch the warlike language around depression.

Mental health advocates believe depression is a sickness and describe people who talk about their depression as brave. They ‘fight the disease’, ‘will not give in’, are ‘not ashamed of their illness’ and that ‘tomorrow will be better if we all just keep battling depression’. They are heroes.

All this war-like language. All this drama.

Mental health bloggers who have built businesses, selling their story in their memoirs or creating personal glory through their websites and hashtags need to maintain the narrative of depression as an illness because if they recovered, what then?

Who would they be?

  • Has ‘depression’ become part of your identity?
  • Do you believe it is something that you will experience forever, holding you back from your dreams and goals?
  • Preventing you from having a rewarding, enjoyable life with full repertoire of emotions, both sad and happy?

I believe it is a crime that the over-diagnosis of depression as a mental ‘illness’, a biological disease, that there’s something inherently wrong with you and there always will be has left so many without hope.

It has created in people a sense of disempowerment, that living with chronic low mood is a life sentence and that all you can do is ‘manage your symptoms’.

No.

You can do way more than that.

You can learn to control stress and regulate your emotions so that you don’t need to plummet into chronically low mood.

Life is not about hoping to feel a little bit better tomorrow.

Life is about intending to feel much better and know that you can, for every tomorrow for the rest of your life. Life is about experiencing the whole range of human emotions – joy, grief, bliss and distress – without thinking there is something wrong with you.

You are worthy of a rewarding, pleasurable, contented life, full of moments of happiness, satisfying challenge, and delightful memories.

You can live as global as you want, travelling the world, building a career, changing the course of history, or as local as you want, contributing to your community and local environment, living sustainably, leaving a light footprint on the planet.

Or something in between!

There are no limits once you decide that you can learn how to handle stress and regulate your moods, rather than the other way round, rather than letting stress and emotions restrict you!

Come, share yourself with the world, or with your neighbours. We need you.

But do it for yourself first.

Learn more here about why I think antidepressants are not the whole answer.

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[1] http://www.health.harvard.edu/mind-and-mood/what-causes-depression

[2] https://www.amazon.com/Upward-Spiral-Neuroscience-Reverse-Depression/dp/1626251207

[3] Carlat, D, 2010, Unhinged: The Trouble with Psychiatry – A Doctor’s Revelations about a Profession in Crisis, Free Press.

[4] Hickey, P, Exploiting The Placebo Effect:  Deceiving People For Their Own Good? https://www.madinamerica.com/2016/02/exploiting-the-placebo-effect-deceiving-people-for-their-own-good/ viewed April 2017

[5] If you’d like to read more about the development of the chemical imbalance theory of depression, try these resources… Whittaker, R, 2010 Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Crown; Lynch, T, 2015, Depression Delusion, Volume One: The Myth of the Brain Chemical Imbalance (Volume 1), Mental Health Publishing.

[6] Brogan, K, 2016, A Mind of Your Own, Harper Thorsons.

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May 02

Overcoming Depression

By Vickie | Uncategorised

Reflecting On My Journey to Overcoming Depression

I am not a psychoanalyst. I’m not really interested in dwelling on negative events that happened in the past. I’m not sure this form of therapy is not very much practiced these days anyway.

You know, that clichéd scene with the patient lying on a couch and the therapist in a white coat asking questions about the patient’s relationship with his mother.

I’m not so sure it’s effective in overcoming depression either, because when you’re struggling with negative thinking styles, the idea of going over and over the horrible things that have happened in your life just ‘wires’ them in more and more strongly.

While I’m not suggesting just denying any painful or hurtful memories (that would be unrealistic and unnatural), I just don’t believe thinking about them over and over is such a great idea.

Unfortunately, if we are experiencing chronic low mood, we are likely to have fallen into a habit of dwelling on the past, focusing on all the bad things that have happened to us to get us to where we are now. Rumination is one of the most insidious symptoms of depression. Breaking the habit of focusing our thoughts on our painful pasts is really important for a brighter future.

However, what I do think is helpful is to put on our scientist’s lab coats, and reflect briefly back on our own histories to try to identify periods of time when we were more optimistic, happier, calmer, had more enjoyment out of life.

Think about where you were living, what work you were doing, whether you were involved in sports or physical activity, whether you had a spiritual practice (religious or non-religious), who you were living or working with, what your diet was like, what your physical health was like.

You might begin to see patterns emerging around when you were feeling OK and when you were feeling really bad.

Read on for how I briefly went back over my life. I’ve broken it up into study/work and then thought about the kind of lifestyle I had during each period of time.

Childhood to End of School

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Books are definitely my favourite things.

I was a happy child, though quiet, serious and introverted. My favourite place on a Saturday morning was the local library. I had odd interests; Anglo-Saxon history, where surnames and placenames come from, chimpanzees. I loved learning about other countries and cultures, languages and history. I enjoyed playing with other children but for a short time, when I was very young, I did experience bullying and for a while took my teddy bear to school. I was happiest on my own with a book.

For years through my childhood I was taken regular to doctors who examined me, stuck wires to my chest, scanned, poked and prodded me until I was absolutely sure I was physically defective.

The operations were traumatic and I remember crying after Mum left me after day visits. She was probably crying too! Overall, they were successful and I have lived long after the ages when death was a possibility and am very grateful to all the medical people involved.

But psychologically, being physically examined, being the centre of medical attention and something to be worried about, and then the trauma of the hospitalisations and rehabilitation may have been the start of my self-consciousness which plagued me through my adult life.

I remember being allowed out of bed for the first time after my heart operation. All I wanted to do was run down to the tall oak tree near our house and climb into its leafy branches, away from the worried eyes of the adults around me.

Looking back, I think my teenage years were when my tendency to negative self-talk became more obvious.

I hated exercise and was pretty hopeless at it. In fact, my parents put me through extra physical education classes before school for a while. Humiliating and excruciating. While my friends went to netball or gymnastics after school, I went home to my books.

I did some walking each day, a kilometre to the tram stop and back going to school and I even went swimming occasionally, though I was very bad at it and only managed a few laps.

I also had very low self-esteem. This might have been a ‘growing up’ thing, but I always thought people

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My childhood was full of medical things; doctors, nurses, hospitals, machines, procedures.

were staring and whispering about me, laughing at me behind my back. Not my close friends, but other people at my school or even just strangers in the street.

I lacked confidence and hated my body. I thought I was weak, defective and unattractive. This may stem from the two major operations I went through: my open-heart surgery at seven and a major back operation at fourteen. After the back operation I wore a brace for six months which necessitated large baggy clothes. I had no bust and massive hips. I felt ugly.

The stage was set for depression.

University

After school I went to the University of Melbourne and enrolled in a Bachelor of Arts (honours) degree in archaeology and Middle Eastern Studies. I loved uni. I think I was one of those odd people who went to uni to learn stuff.

But I still felt blue and down in the dumps quite a lot of the time. I still lacked confidence around others and when I needed to present in tutorials. I found it very hard to share my opinions and ideas in class.

I thought everyone was so much cleverer than me.

I had friends but no very close ones. I went out with my friends fairly regularly but I often felt lonely. I still didn’t do any regular exercise and had talked to myself in very negative ways. I often compared myself to others and judged myself lacking.

I vividly remember suddenly noticing my reflection in the tram window one morning going to lectures and being shocked at how tired I looked. I wasn’t sleeping well. I was ruminating: thinking and worrying.

After University: My 20s

At the end of my degree, I asked to join a research team which was excavating in Syria. I was keen to pursue a career in archaeology, my major at university. I was accepted and spent the next five years going to Syria and in between, because I had finished my course, working temporarily at a receptionist or admin clerk for businesses around my city.

I had started flamenco dance classes so I was exercising regularly.

But I hated my jobs, still lacked confidence and was very confused about my future. I thought maybe objects conservation might be a way of working with archaeological materials, but after taking first year chemistry and feeling like a fish out of water, I gave up that idea.

I had a few failed relationships, one of which left me particularly devastated.

Rumination, worry about my future and negative self-talk continued to affect my sleep.

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I loved research but it wasn’t a completely healthy lifestyle…

In my late 20s I decided I’d go back to archaeology and began my PhD, but the work in Syria stopped. I was excited to start my research but noticed in June, July and August, the winter months in my home town, my mood plummeted. I felt the loss of the hot Syrian sun. I had stopped taking dance classes but I did walk every day with my dog.

The first years of my doctoral studies went badly with my lack of confidence showing through in supervisory meetings where I tried to support my ideas but was regularly shot down. Finally I did get a good, supportive supervisor, but I think the damage was done. I felt disconnected from the department, unsupported and miserable.

I emerged from the years of research with a doctoral degree and a heavy dose of depression.

Research is a solitary affair and I found all my friends had moved on and were marrying and even starting families. Meeting with my supervisor was the only social activity I had.

I was still walking the dog but sleeping very, very badly.

I was desperately worried about my future and knew I couldn’t handle the academic life. I was miserable about the thought of leaving archaeology but couldn’t see, realistically, how it could give me a living.

After Archaeology: Age 31-34

I left my first love; archaeology.

I retrained in immigration law and got a job at a centre assisting newly arrived migrants and refugees.

The work was challenging and I was busy, but I was reasonably happy. I enjoyed the advocacy work, learning about my client’s stories and experiences. I loved being surrounded by colleagues from so many different countries and hearing a multitude of languages around me.

In the evenings and on weekends I continued walking the dog, my only form of exercise, but my stress of the doctorate was still with me and I didn’t have the energy to do much more than stagger around the park.

Occasionally I went out for Friday night drinks with my work friends, but spent most weekends alone.

Looking back, although I was eating sufficiently, many meals were pasta or rice based, heavy on meat and lighter on vegetables. I also munched my way through Chinese takeaways and fast food fairly regularly.

The work gave me a huge amount of satisfaction, though it was quite stressful and the politics of the centre was getting everyone down.

Job Loss 1

One day, completely out of the blue, I got a call (I was on leave at the time) that the centre was closing down and we’d all be out of a job. I wavered between anger, distress and confusion.

The centre director had made very poor spending decisions and the government body which funded the centre had refused to throw any more good money after bad. We were all angry and I spoke at several public meetings about the closure.

We were all very distressed about where that would leave our vulnerable clients; many of whom had complex needs around housing, employment, mental health and immigration.

And I was confused about what to do next. As the weeks went on I applied for other jobs, sometimes getting an interview, other times not. My anger faded and was replaced with a deeper depression than I had yet known.

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When I lost my job I was so confused and desperately worried about my future.

Finally I got a job offer with an organisation which had been given some of the funding which would have gone to the first centre. Apparently I made an impression and for the ten months I was there, I led the team of settlement workers helping newly arrived migrants and refugees find the assistance they needed to start their new lives in Melbourne.

Job Loss 2

After that first year, the organisation decided to make some changes to the roles of the team and everyone’s job was put out for application.

Although they invited me to apply for the team leader role, I knew I wouldn’t get it. It was an organisation which was at loggerheads with my own values. They acted like a corporation, with all the structures and rules and regulations that corporations like to act with. I’d come from a community based organisation that aimed to make differences in people’s lives, while this organisation was more concerned about corporate colours and marketing materials and presenting a business face.

I didn’t apply for the leadership job and found myself without work yet again.

A Very Small Business Age 34-38

Looking back, I can hardly believe I decided to set up my own business. I found a small office and put out a shingle hoping for clients to flood through the door.

They didn’t. I didn’t know how to get clients; in fact, I didn’t know the first thing about running a business.

I think I wanted to hide from the world, doing my own thing in my own little space. In reality, I was way out of my depth and sinking fast. 

I continued to get out to the park, but shuffled between park benches where I’d spend time sitting and ruminating. Wearing massive sunglasses that covered half my face I avoided all eye contact with other people and chose other paths if I saw someone coming.

Because I was running out of money my meals become filled with cheap fatty sausages, pasta and tomato sauce, fried rice and eggs, with the occasional piece of fresh fruit.

Nights were excruciating. Sleep came only after hours of thinking, the thoughts churning around in my head. How could I get more clients? How would I make any money? Why did I lose my job? How did I end up here? What’s wrong with me? Why couldn’t I just be happy and get my life working? How would I survive?

I never saw anyone and dreaded the phone ringing. Every few weeks I’d go and visit my parents, forcing myself to dress nicely and slapping on a happy face, all the while crying inside. I felt I was a complete failure and an utter disappointment to them. After all they’d done for me, raising me and educating me, I was this terrible loser.

In fact, my parents loved me dearly and would have helped me out if I had had the presence of mind to ask. But my self-esteem was truly rock bottom.

My house was a pigsty because I couldn’t summon up the energy to tidy it up. I only showered if I had a client coming in (very, very slowly I was getting more appointments, but they often did not turn into further work for a variety of reasons).

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The very worst years.

I could barely get out of bed, wept bitterly every day and beat my head against the hard tiles of the shower cubicle or a door frame to dislodge the fuzziness that seemed to have taken over my brain.

These were the very worst years of my life.

Yet I didn’t slip into suicidal ideation and the only reason I can think of for that was the presence of my dog. I cared way more for her than I did myself and that made me get outside into the sun once, often twice a day. Later, when I eventually sought professional help I remember telling the psychologist that the only time I felt even slightly brighter was in the park with my dog and I think there is a very good reason for that. Sunshine and even just a little movement does much to clear the cobwebs in the head.

I was at my lowest point.

I wanted to live and I wanted to live well. I just had no idea how. Years of telling myself I was no good (after all, what had I achieved? No house, no job, very little savings) and life just brings disappointment after disappointment had led me to the point where I began to wonder what the point of it all was.

I had wondered for a while whether I had a malfunctioning hormone system. My monthly cycle was horrendous; massive dips in mood, weeping, complete loss of motivation, energy and appetite. I started to track my moods, plotting on a graph my overall mood that day, noting whether I had done any extra exercise and what I had eaten. But no patterns emerged. I was up and down like a yoyo. Or rather, down and then very down.

Seeking Professional Help: My Late 30s

Finally, I went to the doctor. I was feeling worse than usual, with dizziness, dry mouth, aches and pains and an inability to do anything but sit and cry.

She diagnosed flu and depression.

I got onto a low dose of citalopram, a SSRI anti-depressant medication and signed up for 12 weeks of psychological counselling.

Things looked up.

I managed to find a few more clients, but these were small local businesses and business migration was an area I knew nothing about, so I spent many long nights reading up on the laws and regulations.

Each client I went to meet filled me with expectation and almost every time I returned to my office filled with dread; there was always something about each case that would make it extra complicated, difficult or impossible and the fees I had imagined flowing into my business account just evaporated.

Business clients I did take on were pushy and rude, or had expectations which were far higher than I could deliver and I dreaded listening to messages on my office phone or reading emails for fear of yet another angry client.

I seemed to feel slightly calmer but I still slept badly, ruminated constantly, took no other exercise than a slow stroll around the park and remained isolated from friends.

But I wasn’t any closer to really overcoming depression.

Losing Frances and Closing the Business

Eventually I realised that I couldn’t continue with the business. I felt an utter failure but looking back, I had many clients who were very happy with my work and whom I’d been able to make a huge difference in their lives, reuniting them with loved ones. But at the time, I just wanted out.

Then my beloved dog died.

For weeks after I was on auto-pilot, finalising applications, moving furniture out of the house and into storage, cleaning the house, dragging myself through the day, pushing my emotions away and just focussing on what needed to be done.

I moved back to my parents and went to bed and didn’t get up for a fortnight.

I cried every day for exactly three months and then decided I had to get on with the rest of my life. I felt I was on my way to overcoming depression. Click To Tweet

I went back to temping, getting work as a receptionist or admin clerk, living at my parents and thinking about my future. During this period I had more contact with friends and family, though I didn’t exercise as much. I was eating better and starting to ruminate less as my brain was focused on making decisions about what to do next.

Teaching English in China 39-44 years

Finally I decided to retrain as an English language teacher and took a course which was partially online and partially in the classroom.

I had thought about teaching English before, when I was wondering what career option to take after university. I love languages, reading and writing. It seemed like a good fit.

I felt happier and enjoyed getting to know my fellow students at the course, often stopping for a coffee or drink after class. I was getting out and about, had plans for the future and although I was still lying awake for some of the night thinking and worrying, I was getting more sleep than before.

I went to China. I taught in Hohhot, the capital city of the province of Inner Mongolia, in China’s central

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Yurts on grasslands around Hohhot, China

north. A beautiful, small city surrounded by mountains and grasslands, Hohhot was cold, very cold in winter, but had bright blue skies and brilliant sunshine, attractive parks and all the modern conveniences one could need.

My colleagues were wonderful. My students were enthusiastic. I adopted lost dogs and accommodated them in my tiny flat until I could new homes for them. I borrowed a bike and explored the edges of the countryside. I bought fresh fruit and vegetables in the little village next door, exchanging smiles and the same few Chinese phrases I had with the woman who ran her shop out of a tiny dark room.

I began to ruminate less as my brain was taken up with lesson planning and all the exciting new experiences I was having. I felt I had finally found an occupation that suited me. I had friends, had joined a gym in town where I worked out and did Mongolian dance classes, was getting enough sunshine and sleep, preparing healthy meals and had meaning in my life.

I was sleeping well, waking refreshed and eager to go to work. My mood rose steadily. Finally, finally, I was well on my way to overcoming depression.

Towards the end of my second year in Hohhot I made the mistake of deciding to go to another city to teach. I didn’t know that at the time and while I was sad to leave Hohhot, I was excited about moving and getting to know another Chinese city.

I went to the ancient city of Xian, at the Chinese end of the Silk Road, where the terracotta warriors were found.

And life took a dive.

The job I had been promised, teaching students in the department of English vanished and I ended up with unmotivated students from the accounting, engineering and IT departments who are forced to learn English and usually end up cheating or paying their way through. I felt unvalued.

My colleagues were rather aloof and unfriendly, despite my best efforts. Both American, they chose to hang around together and I soon felt excluded.

The promised gym was not yet built and the campus was on the far outskirts of town, which meant joining a gym as I had in Hohhot was impossible.

The atmosphere was full of pollution; a disgusting heavy grey fog that hung low over the land and obscured the sun.

My mood took a battering and I found myself quite unhappy. My only comforts were the stray dogs I found and hid in my apartment, in fear my colleagues would tell the authorities. I had a few very able and keen students who became ‘friends’ and took me to visit their families but I often felt lonely.

Counting the days until the semester was over, I looked forward to going home.

Back in Melbourne: Teaching International Students

I arrived back in Melbourne tired but happy to have left China. I enjoyed my time there but three years was enough. I quickly got a job in one of Melbourne’s universities, teaching in the English language centre. At the same time I started building a house- and dog-sitting business, taking care of people’s homes and pets while they were away.

I enjoyed the teaching but found the administrative processes quite demanding. Meetings, teaching from a set curriculum (rather than creating my own as I had in China), marking to an assessment rubric; I found it rather stifling creatively. But I had wonderful colleagues and felt I was still on my right path.

I was seeing my friends regularly and walking almost daily. I was enjoying the fresh, unpolluted food of Australia and generally sleeping well.

A project that had always been at the back of my mind – publishing my PhD research – resurfaced during that time and I decided to do something about it, finally!

You see, I had pushed archaeology away. It had been my passion but during the PhD years, I had become so unhappy and my confidence so low that I couldn’t see how to create a career out of archaeology. Regret and sadness haunted me but I never allowed myself to think of archaeology because it seemed futile.

Finally, now, I seemed to have the emotional energy to do something with that research. I took a course in self-publishing and reworked the thesis into a readable book for a general audience. The whole process only took a few months, after nearly thirteen years of wondering what if!

Even more exciting, I was chosen to launch the book at the Melbourne Writer’s Festival, an internationally acclaimed festival of writing and books.

As the launch day approached I got more and more nervous. I was convinced no one would come. I had some hiccups finding a specialist who would agree to speak at the launch. I got so caught up in details that I barely spent time on my own speech and threw something together last minute. I began to sleep badly and spent more time ruminating than I had in years.

The launch went well in hindsight but even now I blame myself for not selling more books. I had botched it up, I was sure. My negative self-talk really affected how I saw the success of the launch and even today I look back with a sense of regret, even though, in reality, it went quite well.

The Low Mood Returns

The thing is, I was beginning to experience low mood yet again.

I had gone off the anti-depressants because I had run out while in China and feeling pretty good on return to Australia, had not gone back to the doctor for more. I thought I was overcoming depression by myself.

http://depressionrecoveryschool.com/wp-content/uploads/2017/05/depression-1250870_1920.jpg overcoming depressionI began to feel a bit of a failure, both at book selling and at teaching.

Chatting with colleagues at work I realised that most of them had higher degrees in teaching. They always seemed to have great ideas for their lessons and breezed through their classes. I began to feel like an imposter. I wasn’t a real teacher!

I began to struggle with classroom management issues and putting together engaging lesson plans. I got flustered when students asked me questions and struggled with marking.

My negative self-talk grew into rumination and interrupted my sleep. I dragged myself drowsily out of bed, talking myself through each step of preparing for work. I began to dread each day.

Because I had spent so many months preparing the book I had neglected my regular walking and my days went from being indoors at home to indoors at work and back again.

Being a casual teacher I was able to reduce my hours and having enough insight to know that my mental health was beginning to suffer, it was more important to get myself right than to work full-time at that point in my life.

So what have I learned from all this?

For me, what I’m doing in my working life has been a potential stressor and trigger for low mood.

That is, if I’m happy in my study or work, my mood is high. If things are not going well at work, I tend to dip (or plunge) into a low mood.

I’ve also learned that messages learned about my physical self, my body, when in childhood and especially my teenage years were carried through into my adult life in the form of self-consciousness, lack of confidence and self-doubt.

I’ve also learned that having to reinvent myself constantly was a source of stress, but ultimately also of great joy as I realised that not everyone has to have the kind of life that society sets out for us – school, college, the same job or occupation, marriage, children, mortgage, and so on.

This means I don’t need to feel strange or useless or a failure if I choose to follow a different occupation.

Nor do I need to compare myself with others, judge my achievements or my sense of self-worth.

Overcoming depression means I have learned that I need to eat well, exercise regularly, stay connected with friends and family and find meaning in my work to stay well.

I haven’t tumbled back into the full effects of chronic low mood because I am doing things in my life that make me more resilient. Again, I didn’t know exactly what they were but on reflection and with the knowledge I now have, I can see how my lifestyle has supported me to stay strong and not dip down again.

Now that I have that knowledge, I can consciously choose to live in a way that protects me from dipping down into stress and negative self-talk and I can share that with you so that you too can live in hope.

So How About You?

It’s your turn now.

Go on, go back through your past (briefly) the way I have. Don’t dwell on causes of pain or hurt. Remember, you’re a scientist doing an experiment. It’s important not to get emotionally caught up in the events of the past.

If you like, you can use a chart like this one below. Copy it out. Fill it in. What patterns do you notice? When did you feel happier and more positive? When did your mood and emotional life plummet downwards?

Date

How did I feel about my job (or school)?

My friendships

My diet and exercise

My hobbies, volley work etc

Childhood

 

 

 

 

 

 

 

 

 

Teenage years

 

 

 

 

 

 

 

 

 

College, uni, training, first job, 20s

 

 

 

 

 

 

 

 

 

30s (extend the table up to your present age)

 

 

 

 

 

 

 

 

 

 

The key is not to assign blame, go over painful events or conversations. Think for a short time about each period in your life and make notes on:

  • Your general mood at the time (were you an upbeat person, enjoying life, happy and optimistic?)
  • Your diet at the time (include alcohol consumption)
  • Your physical activity
  • Your relationships with friends and family
  • Your work/study
  • Your sleep patterns
  • Your spiritual life, your sense of contribution to the community, any voluntary work, involvement with social or environmental groups
  • Your hobbies and interests

Try to identify patterns and stressors in your life. The following are just examples…

  • Were you always a bit happier living near the beach?
  • Did you loathe your accounting job and become much more satisfied when you moved into marketing?
  • Was it a blow to move cities for another job, when you had to leave your family behind?
  • Did you feel life became empty when the children left home?
  • Was the loss of your mother early in life a tragedy you never quite came to peace about?
  • Was the diagnosis of cancer something that triggered you to withdraw from the world, or go out and embrace it?
  • Were you always a bit happier when on the road, travelling from place to place?

This is a crucial exercise but it is very important that you stay objective about it.

Pretend you are looking back over the life of another person, someone you don’t know. It is very important to remain as emotionally distanced as you can. Please stop this activity if it brings up very painful memories that threaten to overwhelm you.

Don’t take too long over it. A brief look back and a quick think about your lifestyle is really what we are aiming for here.

Then, do something to relax. A shower or a bubble bath. A cup of tea and a good book. A walk through the park with the dog. You’ve achieved a major step forward in overcoming depression.

Good on you!

What to do next? Read on for the next step.

http://depressionrecoveryschool.com/wp-content/uploads/2017/05/grey-heron-139979_1920.jpg overcoming depression

You’re on your way!

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