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Recognize Depression by the Lies it Tells

I wonder if you’ve noticed some negative thoughts about yourself lately. These might be something like:

“Nobody really likes me.”

“I’m not good at anything.”

“I’m not loveable.”

“Nothing I do works.”

“I have nothing to look forward to.”

If these sound familiar, there’s a good chance you’re experiencing some depression. Depression often generates these kind of negative, judgmental thoughts. There are a couple of important things to remember about depressive thoughts.

  1. Thoughts are not facts! We can have thoughts that are true or false. In fact, thoughts generated by depression are often false (or greatly exaggerated). Just because a thought pops into your head does not make it true. Depression is a really good liar! So when you recognize that you’re having a bout of depressive thoughts, remember not to buy into the content.

  2. Depressive thoughts are a useful indicator! When you learn to recognize that these kind of thoughts are generated by depression, it lets you know that you’re experiencing a bout of depression. That will allow you to take care of yourself properly so you can get through the depression, instead of making it worse by ignoring it.

This may sound simplistic, but many times we do not recognize we’re experiencing a depressive episode until it’s been going on for a while. And during that time, we may be buying into the content of depressive thoughts, berating ourselves for not functioning normally, self-medicating or making other bad choices in an effort to cope, wondering why we’re exhausted or down, and generally making the depression worse. This happens surprisingly often, even for people who have known for years that they are susceptible to depression.

So the key is: notice your depressive thoughts. And instead of simply believing them (buying into the content) and spiraling, mentally “step back” from the thoughts. Notice how you’ve been feeling overall. Take the thoughts as an indicator that you may be having a depressive episode that needs to be managed.

It’s never too late to stop believing the lies. ❤️

We offer remote therapy sessions anywhere within Pennsylvania. Most people qualify for a sliding-scale discount; use the calculator to instantly see what your fee would be. Email IntersectionalLife@gmail.com to schedule a session.

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Depression Part 4: Just do the little bit that you can.

Part 1: Is It Depression?  Part 2: When Depressed   Part 3: Nurture Yourself Back to Life

Part 4:

Exercise: We’ve been told so often that we must exercise, that now we may hear it as a burden. Who can carry any more burdens when severely depressed? Who can go lift weights when it’s a struggle to get the bathroom and brush their teeth? But exercise is not supposed to be horrible. You can’t go wrong if you focus on exercise primarily as a way to make your body feel a bit better. It’s not some kind of punishment for resting, or for eating, or for existing in a body of any shape or size. It does not have to be within a contest. It is not a “cure” for mental illness, though it can help to improve your mood. It is an activity your body can like if done in a pleasant, kind way!

I often suggest to clients that if they are too exhausted to go to the gym or whatever their preferred exercise may be, just walk around the block. If that is still too much for right now, then just go outside and walk around the house and back in! Just do the little bit that you can.

There are very few texts that “get” how to approach exercise when you’re experiencing severe depression, but this excellent article really helps when you need to ramp up from zero: “Depression-Busting Exercise Tips For People Too Depressed To Exercise” (Sarah Kurchak)

Social Interaction: Maintaining social interaction can be a tricky aspect of depression. You need some level of social interaction to help stabilize your emotions and keep you woven into reality. If you are in a marginalized group, it is especially important to have supportive others to validate your experiences and keep you feeling sane, cared for, and safe. However, there is a HUGE difference between how much social interaction you need if you are more extroverted versus the amount you need if you are more introverted.

Extroverts can more easily harness the power of friends and family to help recover from a depressive episode: being around others will energize you and give you a bit of motivation. It’s straightforward. Seek out others to talk to daily and if possible, to see in person. It may be hard to ask for help, but see if you can ask for help with something simple. This could be something like dishes, child care, or taking you to the grocery store. You can also just ask someone to watch a movie with you or go for a walk. Ask several different people to do several different things. Being able to be in supportive company will be very useful in your recovery.

Introverts, however, may have a harder time with this. Since interacting with others can drain you of energy, you may need to be choosy about whom you contact and how you interact with them. It’s still a good goal to speak with another human at least once a day. But it’s okay if this is just talking to a friend on the phone, getting your change from the clerk at the corner store, or even calling a help line. If you have the energy to tolerate having someone in your space, it’s good to ask a friend for a little help. But make sure it’s someone who understands your limits and does not expect you to be entertaining or emotionally fulfilling to them. You can offer that later when you are not in a depressive episode! If it is still very hard to see people or even to just talk on the phone, you can start with just texting or emailing with someone(s) daily. But try not to let a day go by without communicating with others. And keep doing it.

Furthermore, you may also be considering medication.

Medications: There are a lot of non-medical things you can do to manage your depression, and medication is certainly not mandatory. However, medications can be a useful part of managing depression. They will not make you immune to sadness, but if you are especially low or “flat” or suicidal they may pull you up enough to get to your self-management.

Other people in your life may have a lot of strong opinions about medications, but this is your decision, not someone else’s. If someone tells you that you should take medication but you don’t want to, you do not have to. If someone tells you that you should not take medication but you want to try it, you may try it. That decision is between you and your physician, and you need to do what will help YOU to recover.

Most antidepressants and anti-anxiety medications are prescribed by people’s primary care physicians, though often your PCP will require that you are also seeing a therapist if they are to prescribe psychoactive medications. A psychiatrist can address more complex psychoactive medication issues than your primary care physician. A psychiatrist may be necessary if you have resistant depression or other mental health issues, such as hypomania or psychosis. It may take up to three months to get an appointment with a psychiatrist, since they are in short supply everywhere. So if you think you may want a psychiatrist, don’t wait to start looking.

Now you have stabilized yourself as best you can! You have examined the four crucial life aspects influencing mental health (sleep, nutrition, exercise, and social interaction), you have considered whether you’re interested in medication, and you have begun doing what you can to develop a healthy rhythm in those areas.

For today, you are doing the little bit that you can. And you will keep doing it. It’s very hard to manage your mood at all when even one of these aspects is disrupted, so stabilizing them all is the basis of recovery.

Next part: Emotional Aspects: Mood Management

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

 

~You may qualify for our new sliding-scale fee discount.~
~Please contact us for an application.~

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You Are Not Your Trauma

 

An early experience of trauma can have effects that you may not start experiencing until adulthood. It can feel “crazy”! But having PTSD symptoms doesn’t mean that you will always feel that way. It means that you have emotions and reactions that are ready to be processed so that you can begin healing.

While healing from trauma can be a lifelong process, you can often start feeling better in many ways right away! You are still a whole, worthy human being, rich in the capacity to enjoy life in your own ways.

If you are ready to start processing, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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You Are Already Worthy!

 

Calling yourself “lazy” or “unproductive” is usually an internalized message of shame from your formative years. The message is “If you would just ‘will’ yourself to do more, then you would be acceptable and worthy. Otherwise, you must just be a bad, unworthy person.”

The fact is, you are already acceptable and worthy, without doing anything to “earn” that worth. Now, you might feel better or happier if you were doing certain things, and they are certainly worth trying, to see if that is the case.

But feeling terrible about yourself is not a good motivator for anyone! In fact, it is likely to worsen your exhaustion, depression, anxiety, insomnia, and concentration, which will make it even harder to do whatever it is you would like to be doing.

If you are ready to start healing your self-worth, please review our quick chart to see how you can access our therapeutic services from anywhere in Pennsylvania!

 

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Mental Health: Accepting Healing Over Time

 

Valarie Ward has written a good breakdown of how pop mental health writing is often not only unhelpful, but perpetuates stigma and judgment. Treatment–whether chemical, cognitive, or situational–can support and help to heal mental health, but it’s not a magical instant “cure.”

It’s useful to find the type of treatment or intervention that is most helpful and supportive to YOU. It doesn’t mean you’re “doing it wrong” if you still have symptoms or flare-ups. It means that humans are biological, not mechanical objects that can have new parts swapped in for an instant fix. [See: PTSD as chronic illness]

There is nothing wrong with trying to find things that help you feel better and function better. We encourage you to explore treatment modalities!

But the danger in chasing a “cure” can be the idea that if it’s not “cured,” then we just aren’t trying hard enough. Plenty of people with mental illness and injury hear this message from well-meaning friends, family, and loved ones, though sometimes in different words.

“You’ve been in therapy for weeks/months/years, why isn’t it helping?”: If it’s truly not helping, then of course try something else, or something additional!

But often this really means “I’m upset that you’re not ‘cured’ yet.” Unfortunately, we may also internalize these messages ourselves, which just means that we have found another “should” with which to beat ourselves up; another way to use perfectionistic standards against ourselves.

Instead, notice how far you’ve come since you started working on your healing. Even if it has only been a few days, I bet you already learned some things that help you to comfort yourself or to reframe your thoughts in a healthy way that hurts less!

And if you’ve been working on healing for a while, I bet you are experiencing more days during which you can get out of bed. Or get out of the house. Or days you can do some meaningful work or play. Or days you can spend time with your children. Or fewer days spent in the hospital. Or a better ability to see yourself having a future. Or a few more relationships that are going a little better than they used to. I bet you’ve already done a lot more healing than you think!

So instead of beating up on yourself for not suddenly being “cured” or “fixed,” take stock of how your healing really is progressing, and be proud of yourself. ❤

 

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Healing, Not Fixing, PTSD

 

Post-Traumatic Stress Disorder (PTSD) is often best approached as a chronic condition that may have “flare-ups.” This is true of many other mental illnesses and mental injuries as well.

It can certainly be the case that someone experiences some symptoms of PTSD one time and never again in their life, but for most of us, what it means is that we are vulnerable to experiencing symptoms again during periods of stress (or in the case of activating events).

We are experiencing healing, which means we are able to improve certain things with support and as we learn to attend to ourselves, but we don’t know how much everything will heal nor how long it may take. This is different than “fixing,” which is when we remove a “broken” part and replace it, and then everything is as though nothing ever happened. You are an organism, not a bicycle.

This does not mean “I have PTSD, so now everything is hopeless forever,” it means that we need to learn how to manage our environments, life situations, and our selves in order to reduce the severity of symptoms and the likelihood of recurrence, rather than to assume “I haven’t had any symptoms in a year, this must mean it’s okay to stop attending to myself!”

It means not subjecting ourselves to unreasonable stressors and life-sucking situations, personally and in our work. It means taking our physical and emotional discomfort seriously instead of blowing it off until it blows up. It means not listening to internalized minimizing messages that say “suck it up” when distressed. It means learning to re-parent ourselves where necessary.

It means treating ourselves with support, care, and dignity, and developing boundaries to ensure that others do, too. It means practicing self-care as a habit, not only when unduly stressed. It means recognizing symptoms as symptoms, rather than as some kind of weakness that deserves self-punishment.

It means learning what events, people, and circumstances make your symptoms worse, and modifying those as best you can. It means learning what activities, people, and circumstances help you feel better, and including those more. It means taking yourself to the doctor or the therapist when you need to go. Sounds simple, but it’s not always easy!

Basically, it means learning to take care of ourselves “as though” our well-being actually mattered instead of as an afterthought. Let me repeat: treat yourself like your well-being matters, because it does. ❤

 

“Treating yourself with kindness is a life skill. It doesn’t matter whether you are ”good at” this skill It only matters that you keep going💛” — Jeffrey Marsh

 

 

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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: Part 4: Crucial Needs–Exercise, Social Interaction, Medication (?) / “Just Do the Little Bit That You Can”

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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

 

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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