Happy Saint Lucia’s Day!

Celebrate the returning of the light. Your hypothalamic pituitary axis certainly will be!

Checking In With Yourself

When you’re feeling really depressed, upset, or anxious, it can be hard to come up with ways to understand what is happening with yourself, let alone what to do about it. Even the most basic self-care can be hard to remember when your executive functioning is down.

This is a very helpful list to have handy for those times when you are unable to generate the energy to remember how to support yourself:

 

National Depression Screening Day

Whether you use the October 4th date or the October 11th date, it’s about time to get your “checkup from the neck up”!

There are several online depression screening tests you can try:

A very brief one from Psych Central:  https://psychcentral.com/quizzes/depression-quiz/

A screening that has several languages: https://t.co/qY9aMiJwxh

An overview of NDSD: https://mentalhealthscreening.org/media/fact-sheet-national-depression-screening-day

Depression Part 3: Nurture Yourself Back to Life

Part 1

Part 2

Part 3: Physical Aspects–Sleep and Nutrition

It can be very hard to take care of yourself even at the best of times, especially if you have a trauma history. And when you’re depressed, it can be even harder to take care of yourself. You might feel too drained, sad, and even unworthy of care. But this is exactly when it is most important to take care of yourself, even if you can only do a little bit.

Just do the little bit that you can. And keep doing it.

First, stabilize your physical aspect as best you can. The four most crucial mental health needs of your body are sleep, nutrition, exercise, and social interaction. You may also be considering medication.

Sleep: regular sleep is probably the single most important thing your body needs to maintain mental health. If you have been skimping on sleep in order to get things done, you may need to let a lot more tasks go in order to recover. The purpose of sleep is to release toxins from your brain cells. If you are not getting enough sleep, then you are intoxicated, and not in a fun way–your brain is poisoned. Start developing a sleep routine that is as regular as you can make it, close to the same time every night.

If you are struggling with insomnia, the insomnia needs to be addressed so you can get the sleep you need. It’s not uncommon for depression or anxiety to remit simply by getting your sleep stabilized. Don’t use alcohol as a sleep aid: alcohol is not only a depressant, but it also interferes with sleep cycles, so it can worsen sleep problems.

If depression is causing you to sleep too much, it may be most useful to first address other physical aspects of depression before trying to cut down on sleep. Besides, is it actually “too much”? You may need extra sleep for the time being. If it feels like you are convalescing from an illness, that is because you are.

Nutrition: Your body needs fuel in order to operate physically and mentally. Your mood will be worsened by hunger, even if you are not feeling the hunger. At least get a bit of  protein and some complex carbohydrates. If your appetite has dropped and you are having trouble eating, or caring about eating, then try having something like Ensure, or chocolate milk, or kefir on hand – it can be easier to drink something. If you can eat a little something a few times a day, even if not your usual meals, it will help you not to sink further into depression.

When you’re feeling up to it, treat yourself nicely when you eat. It can be comforting. It may be you’re just eating condensed soup sitting on the couch, but see if you can eat it from your favorite bowl. Or try eating something that reminds you of childhood in a pleasant way.

When you have regained enough energy to attend better to your meals, you can get back to what you would normally eat, but for now it’s okay to just eat something.

If you are suddenly eating a lot more than you normally would, try to be gentle with yourself. There is a reason you are doing this–you feel bad!–and it’s not worth harshly criticizing yourself. Indeed, you will make yourself feel worse and it might compound the issue. Remember the important thing is to fuel yourself and restore your balance overall, and do so gently. The goal is not to sternly restrict. That may backfire.

 

Next: Physical Aspects–Basic Exercise, Social Interaction, Medication

Depression Part 2: When You’re Depressed

Part 1

Part 2:

Recognize Depression: Depression often creeps up gradually and may affect you for a while before you realize what is happening. What effects do you usually experience? Are your symptoms usually physical, emotional, or cognitive, or a combination? Exhaustion, achiness, overwhelm, lack of motivation, negative thoughts, suicidality? (See Part 1.) If you have a better idea of your own symptom profile, you will be able to catch a depressive episode sooner when it occurs.

It is often a great relief simply to realize why you’ve been feeling bad. Also, it can be encouraging to remember that most depressive episodes remit within two weeks even without intervention!

Accept Depression: Depression can be tricky because we often have a belief that if we recognize what’s going on, we should be able to “snap out of it” by some act of will. While it’s good to try some things you think might help you feel better, the process is healing rather than fixing. You are an organism, not a mechanical device. It may take some time to get through the healing process.

Most people feel impatient about this, because depression interrupts whatever else you’re trying to do with your life. That’s the part most people have a hard time accepting. But depression is a real thing that really affects people on many levels, so work on accepting how your feelings and your functioning are affected. Then you can better decide how to address it.

Beating yourself up for “feeling bad for no reason” or “not getting enough done” will only make things worse! It may be that during some depressive episodes you will  feel bad “for no reason” or that you may not get as much done as you want to. That’s what happens during depression. You can do many things to support your healing, but you can’t just decide to not have depression.

Most people experiencing depression–even severe depression–are mostly functional in some life areas, which can lead to denial or minimization. “They must not be very seriously depressed, I just saw them laughing and joking at a party,” or “I can’t have severe depression since I’m able to work 12-hour shifts on a busy floor.”

Functionality varies from situation to situation and from day to day. You can be functional in one or more life area, or appear “okay” to others. That doesn’t mean the depression isn’t real or isn’t serious.

 

Depression Part 3: Nurturing Yourself Back to Life

 

Depression Part 1: Depression and Functioning

Because we often think of depression as “lying on the couch crying,” many people don’t recognize what they’re experiencing as depression, especially if they’re high-functioning or have “smiling” depression.

But the most prominent and common symptom of depression I see is a lack of motivation. It can be anything from “I don’t care about anything and I don’t want to do anything” to “I’m too exhausted to do even the smallest thing” to “I want to do this one thing and somehow I just…don’t.” It’s also very common to function well at work, only to “fall apart” off the clock.

While actual proportions vary from person to person, few if any depressed people look like the “just sad” stereotype. A graphic in an article by Anna Borges depicts the discrepancy:

 

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It makes sense if you think of what “depress” means: to push down. Depression pushes down your physical, emotional, and/or cognitive functioning, in any combination.

If your physical functioning is depressed, you may feel exhausted and achey or move and speak more slowly than usual (often without realizing it). You may experience sleep difficulties.

If your emotional functioning is depressed, you may feel low, sad, hopeless, pessimistic, guilty, or even strangely flat, empty, and detached.

If your cognitive functioning is depressed, you may have difficulty concentrating, planning and implementing anything, or trouble with memory. The “planning and implementing” piece is the brain’s executive function. This is where the motivation problems come in, and why a person experiencing depression can’t simply “snap out of it” and “motivate.”

Also in terms of cognitive functioning, you may generate a lot of irrationally negative thoughts (and you may believe them uncritically), or have thoughts of death or suicide. It’s especially important to recognize that suicidal thoughts, while scary, are a symptom of depression and usually diminish when depression improves, so seeking help with depression is important.

 

Next:

Part 2: When You’re Depressed

Self-Care: Becoming Your Own Good Parent

I frequently hear people describing “luxury” activities, such as getting a manicure or buying things for themselves, as “self-care.” Often it’s said jokingly, but I get the sense that many people do not really know what self-care is. Sure, self-care may usefully incorporate some luxurious activities. But that’s really not what it’s about. Self-care is simply doing for yourself what a very good parent would do for you, to the best of your ability. And a good parent would make sure your needs were met. Every day.

We learn what we live. If you grew up in a chaotic, dysfunctional, or abusive household, you may not have received a complete template for what a good parent does.  If that is the case, then you have had a long time to practice not treating yourself very well. The only way to retrain yourself in that skill is the way you develop any other skill–by practicing. So here are some things a good parent would do for their child that you can practice doing for yourself:

A good parent would make sure you had a regular bedtime and enough sleep, maybe even a nap when you’re feeling cranky or sick. They would make sure you were getting enough nutritious and enjoyable foods. They would make sure you bathed, brushed your teeth, and had clean clothes.  They would make sure you had some time to run around outdoors. They would make sure you got medical care.

Do you do those things for yourself? Or do you make yourself operate on too little sleep and put off eating until you’re drooping? Do you treat meals like sins or punishments instead of necessary and pleasant events? Do you treat exercise like a penance for eating? Do you ignore illnesses and injuries until they are simply unbearable?

A good parent would arrange for playtime with nice friends, and would limit time spent with those who were mean to you. A good parent would comfort you when you were sad or afraid, listen when you were angry, and share your happiness. A good parent would maintain healthy boundaries: they would allow you to have your own feelings and not make you responsible for theirs.

Do you do those things for yourself? Or do you spend more time with unpleasant people out of obligation, and less time with people who are good to be around? Do you dismiss your feelings, swallow your sadness, minimize your anger, ignore the importance of your joy?  Do you call yourself stupid for having a feeling? Do you take responsibility for making sure things are okay for everyone around you, even if it means you are unhappy?

A good parent would encourage your interests, your curiosity, and your work habits, and would help you develop your talents. A good parent would also give you adequate unstructured time to relax between all that working and practicing.

Do you do those things for yourself? Or do you dismiss your interests as silly or insignificant? Do you put off necessary tasks repeatedly? Do you tell yourself that your talent for sewing, mechanics, dancing, writing, music, art, is unimportant and not worth practicing? Do you always forgo pleasurable, enriching, or relaxing activities in favor of your to-do list or more work hours, even when you have some free time?

One of the tasks of adulthood is to re-parent ourselves, which really means developing the habit of self-care. If you want to feel better and function better, start the practice of becoming your own very good parent.