Not very long ago, the C word (Cancer) used to be a dreaded but popular currency but now we are living in the “Age of Depression” as the number of depressive people is skyrocketing worldwide. A government survey puts the number of Indians in need of professional help for mental disorders at 13 crore i.e. every 11th Indian is a psychological patient. If you couple it with the fact of India having too few psychiatrists to handle this virtual epidemic, the spectre gets horrifying. A great majority of those afflicted suffer from mood disorders, mainly depression, of which married women are the worst affected (my hunch, too), as they are constrained by so many personal, familial, social and economic limitations.
Though most millennials use the D word like a loose change, as a practicing life coach, I can tell you with confidence – Depression is more debilitating, incapacitating and wasting than they can possibly think of. For many people, a bad exam, a tiff with a partner or a professor or friend’s remark may be enough to make them feel depressed (They are not! They are just sad.). But in sharp contrast, for professional mental health caregivers, it is a much more pregnant, serious and persistent phenomenon to the extent that it implies great personal, social and economic loss causing absenteeism, low productivity, poor life quality, bad relationships, separations, divorces and suicides. A study by NIMHANS, Bengaluru shows depression to be a major trigger in a majority of the suicides in India. More tragically, a good enough number among these suicides are committed by young people.
So, the popular idea of depression is a gross distortion of a severely limiting mental disorder. Sadly, most of us are oblivious to the great price we are paying for ignoring its grave consequences.
There is hope
Being a life coach, I get to talk to many people with depression. Such problems contribute to the issues which people bring to a life coach. Besides, being the daughter of a severely depressed mother and a depressive patient myself, I can well understand the personal distress, dysfunction and the social costs of depression. My mother had developed severe depression when I was a young schooler. She lay in bed all day long, hardly moving out of it. Though I wasn’t alive to it then, I could still make out that not all was well with her. And at a point in time, her condition worsened so much that she had to be given electro-convulsive therapy to give her some relief.
Later, my husband committed suicide, leaving behind two teenage daughters and me, a 60-crore debt, multiple court cases to fight, and a new textile plant to manage. I believed I, too, would slip into a depressive cycle given my harrowing circumstances and my genes. But mercifully, I could collect the pieces of life with determination and positive attitude to rebuild my life. So much so that I took training to become a qualified life coach to help others to improve their lives. My story is a message to all of the immense value of hope, optimism and determination to come out of life’s adversities.
Signs and Symptoms of depression
Depression is a common but serious medical illness which can negatively affect your feelings, thoughts and actions. Though the symptoms of depression vary, in general, depression leads to persistent sadness and/or a loss of interest in activities once enjoyed. It creates many emotional and physical problems and reduces your ability to function effectively both at home and the workplace.
Of course, being disappointed, dejected or sad over events is pretty common in daily life and is not a symptom of depression. Such feelings lift on their own and no medication or other medical help is required. But depression goes much beyond i.e. persistently low mood, and sadness for more than 14 days.
Depression Vs. Sadness and Grief
The loss of a loved one, a job or a relationship are difficult experiences and the feelings of sadness or grief are natural, normal responses. The grieving process is unique to each one and has some features common with depression. Both may involve feelings of intense sadness and withdrawal from normal activities but they differ in other important ways:
- In grief, painful feelings come as waves, intermixed with positive memories but in major depression, mood and/or interest show a serious decline.
- In grief, self-esteem usually remains intact but in major depression, the feelings of worthlessness and self-loathing are common.
- For a grieving person, the ideas of death may surface while thinking of “joining” the deceased one but in major depression, the ideas are focused on ending one’s life due to the feelings of worthlessness or inability to handle depression.
- Grief and depression may exist together. In such cases, the grief is more severe and lasts longer than grief without depression.
A major depressive episode means experiencing five or more of the following symptoms of depression daily or on most days for two weeks or more:
- Feelings of sadness or hopelessness
- Persistent anxiety or feelings of emptiness
- Feelings of guilt, worthlessness, and/or helplessness
- Difficulty in concentrating on something
- Problem in making decisions
- Loss of interest in once pleasurable activities or hobbies
- Feelings of Restlessness, agitation, irritability
- Suicidal or self-harming thoughts (i.e., intentionally cutting or burning yourself)
- Fatigue and low energy levels
- Sleeplessness or excess sleep
- Persistent pains, headaches, cramps, or digestive problems
- Overeating/weight gain or loss of appetite/weight loss
- Purposeless physical activity (can’t sit still, pacing, handwringing)
- Feelings of worthlessness or guilt or self-blame
- irritable mood
- unrealistically low self-image
- Significantly low energy and/or change in self-care (i.e., not showering anymore)
- Agitation or severe anxiety/panic attacks
A few medical conditions like thyroid problems, brain tumor or vitamin deficiency can have signs similar to those listed here. So, before making a proper diagnosis, it’s important to rule out other general medical causes, which may be responsible for these symptoms.
Causes of Depression
Depression can affect anyone, even someone living in relatively ideal circumstances. Several factors can play a role here:
Genetic causes of depression
Genetic factors play a role in affecting one’s vulnerability to depression. Depression is triggered by a combination of genetics and external factors. Depression often tends to run in families. If an identical twin has depression, the other one runs a 70 percent chance of having it sometime later. It has a high degree of heritability (about 40%) in cases where first-degree relatives (parents/children/siblings) suffer from depression.
Biological causes of depression
Depression is associated with changes in brain function and neurotransmitters like serotonin, norepinephrine, and dopamine.
Adverse medical conditions
A person with a chronic or life-threatening illness (such as coronary heart disease or cancer), sleep disorder, thyroid issue, or hormonal disorders is more likely to experience worsened symptoms of depression if they have it.
Alcoholism and substance abuse
Excessive consumption of alcohol or other substances can trigger or worsen depression.
Women are twice as likely as men to develop depression and are more prone to depressive disorders around their menstrual periods, in pregnancy, post childbirth, and peri-menopause.
Many situations or incidents can trigger depression e.g. death of a loved one, close association with a sick relative, abuse or neglect as a child, divorce or marital issues, loss of job, financial stress, moving to another city, social isolation and discrimination. Such events need not be negative to cause distress as even positive events such as getting married or having a baby may lead to a depressive episode.
Dealing with depression
As a life coach, I understand well that dealing with depression is hard as it drains one’s energy, hope and drive. Though there is no quick fix there yet, but a combination of medication and counselling under a trained psychiatrist is the best way to go. Besides, you can take several steps on your own to help you come out of the emotional morass and rumination.
Of course, depression must not be taken lightly at all and if you have such symptoms, do visit a trained psychiatrist for diagnosis and treatment. But the medications also work best in tandem with changes in your thought processes, exercising, better dietary habits etc. Being depressed can make you feel helpless. But you’re not. Along with therapy and medication, there’s a lot you can do to fight back. Changing your behavior, physical activity, lifestyle, and ways of thinking — all these natural ways to fight and keep away depression.
- Break the ongoing cycle
Depressive people tend to give a negative taint to everything, including the way they look at themselves and the world and their expectations about the future.
As a life coach, I often tell my depressive clients that in such cases, they need to remember it as a depressive symptom. Such irrational, pessimistic attitudes or cognitive distortions are unrealistic and you need to break out of this mould by telling yourself to “think positive.” The trick is identifying the negative thoughts that are triggering your depression and replacing them with more balanced thoughts.
Try to get rid of negative things like
“My last test was horrible. What a moron I have been!”
“He told me he had a blast with me at the party, but I guess he’s just being polite.”
“The boss must be thinking of me as a pathetic fellow” or “I’m caught for life in this sucking job.”
“I am such a loser. They must be making fun of me!”
“I shouldn’t have gone to the interview. What an idiot I was thinking It could crack it.”
“What a total flop I am!”
Once you identify the toxic, destructive thoughts that lead to depression, start challenging them with something like
“Is there some evidence that this is true? Not true!”
“What would I suggest to a friend having such a thought?”
“Is there another way to understand and analyze the situation or is there an alternative explanation for it?”
“How would I look at it if I weren’t depressed?”
Throughout my therapy work with depressive patients, I have found such cross-examination to be very helpful, which reveals how easily these negative ideas crumble and help you gain a balanced cognitive perspective, which relieves your depressive symptoms.
- Finding Meaning
Try to find personal meaning by serving something larger than yourself. The service doesn’t always have to be big in order to be counted. “Success, like happiness, cannot be pursued; it must ensue… as the unintended side effect of one’s personal dedication to a course greater than oneself.” – Viktor E. Frankl, Man’s Search for Meaning
- Feel Good
Relax with stress management, set your limits and be part of fun activities. While you can’t force yourself to feel pleased, push yourself to do things – even reluctantly and you’ll find how much better you feel. You’ll feel more cheerful and energetic being part of fun activities. I can vouch for it as I have been doing them consistently and advise my clients to do so.
Try resuming a hobby/game you loved earlier – music, dance, art, or writing. Go out and have fun with friends. Be with nature, read a book, watch a laughter show, have a relaxing bath, play with a pet, talk to a friend or family, enjoy music and be ready for a surprise result.
- Eat healthy, fight depression
The food you eat impacts the way you feel. Limit the intake of foods that adversely affect your brain and mood like caffeine, alcohol, trans-fats, and foods with preservatives or hormones.
Don’t miss a meal as a long gap can make you feel irritable and tired. Have a small meal every 3-4 hours but avoid sugary snacks, bakery, comfort foods like noodles and pasta as the “feel-good” things crash your mood and energy.
A deficiency of Vitamin B i.e. folic acid and B-12 can also trigger depression. Talk to your doctor for a B-complex vitamin supplement or eat more of citrus fruit, leafy greens, beans and eggs.
- Reach out
The support of your family, friends, colleagues and elders can have a vital role in combating depression. Depression brings a tendency to withdraw and isolate, thereby making the connect with family and friends even tougher.
You may be feeling tired, ashamed or guilty but remember, this is just depression talking. Be connected with others and be part of social activities; trust me, it makes a world of difference to your mood and outlook. Never take it as a weakness or a burden as your loved ones care about you and would love to help you.
Forge new friendships for a better social support network. Even if the other one may not solve it, they can be of great help – by being attentive, compassionate and non-judgmental listeners.
Phone calls and social media cannot replace the good old face time. Talking to someone personally plays a big role in relieving depression and keeping it at bay. Besides, think of ways to help others as it can your boost your mood in return. Work with an NGO, a volunteer group, be a good listener for a friend, be a Good Samaritan for somebody and it will drive away your depression, too.
- Get Going
For a depressed person, getting out of bed or home is a task, let alone working out! But exercising is a potent antidepressant, which can aid your recovery fast. In fact, regular exercise has been found to be as effective as medication in relieving depression. Regular exercise heightens the levels of the happiness hormone (dopamine) in your brain. Remember the runner’s high you experienced- That exhilarating feeling after about half an hour of intense running, jogging etc? Do at least 30 minutes of exercise daily.
To begin with, have a 10-minute walk to see how it improves your mood. Explore continuous, rhythmic exercises like walking, weight training, swimming, martial arts or dance, where you move both your arms and legs. Also have a partner to socialize and keep yourself motivated at a club, aerobics class or in a soccer team.
- Try something new
When you’re depressed, you feel in a rut. Try to do something different – visit a museum, pick up an old book and read it, volunteer for a service organization or learn a new language.
When we challenge ourselves to do something different, chemical changes happen in the brain. Trying something new heightens dopamine levels, which is linked to pleasure, enjoyment, and learning.
- Health Is Wealth
Sleeping too much/little can be problematic. So, try to sleep for 8 hours as depression often involves sleep problems. Learn about healthy sleep habits to have a good, quality sleep cycle.
Keep your stress under check as it worsens depression, apart from triggering it. Think of strategies to relieve the pressure from workload, money, or bad relationships and regain control of your life. Regular relaxation helps you relieve your depression and stress to boost enjoyment and well-being. Try out yoga, deep breathing, progressive muscle relaxation, or meditation or some such.
- Sunny Side Up
Bask in the sunlight to improve serotonin levels to improve your mood. Expose yourself to the sun for a minimum of 20 minutes daily. Walk in the open during lunch break and improve the natural lighting in your home and workplace by opening blinds, drapes and sitting near windows.
- Make a routine
Depressed people need a routine as depression can strip the structure out of your life. One day melts into the next. Sp setting a gentle daily schedule can help you get back on the track. When you’re depressed, you may feel you can’t do, which makes you feel worse. To push back, set daily goals for yourself. Begin small, something that you can succeed at, like doing the dishes every other day. As you begin to feel better, add more challenging daily goals.
When you’re depressed, you may want to withdraw from life and give up your responsibilities at home and at work. Instead, be involved and have daily responsibilities to help you maintain a lifestyle that can counter depression. They give you a sense of accomplishment. If you can’t do full-time work, think about part-time work. If it seems like too much, consider volunteer work.
If these tips do not help you, look for professional help. Remember, seeking help doesn’t mean you are weak. Depression is certainly treatable and curable and you can feel better! Even while you are getting professional help, these things can accelerate your recovery and help you avoid a relapse.