How to release the stress stored in your body
How to release the stress stored in your body
How to release the stress stored in your body
- The facts:
Anxiety and depression can be caused mainly by biological and genetic factors, psychological and traumatic problems, environmental problems or a combination of these.
- Reflect on:
Consider that because of the popular stigma of A & D, a narrow-minded belief system and the severity of these conditions, it is prudent to keep an open mind and learn more to be more compassionate and helpful to those who suffer.
Clinical anxiety and depression ("A & D") are often frightening experiences, especially when we do not know what is happening to us and have no support. A general description and a relatively complete information guide on self-treatment and professional support can be invaluable and what I will try to share with you here. When I was caught in the vortex of A & D, I searched for privileged information for a long time to help me. I could not find much and the therapists that I saw initially did not help much either, until I found the right kind of therapists with experience in A & D.
This article shares some of what I learned in my successful journey through A & D to the other side (which at one time I thought I would never see). It contains a lot of what I wish I had known when I was in the middle of that storm. I also share some commonly misunderstood facts and aspects of these conditions. Part of the reason for much of the conflicting information that exists is the large number of ideologies and limited understanding that perpetuate people who had mild events, who have not gone through a serious A & D, and who have not been in close contact with other people who have A & D. .
I also went through extreme anxiety and depression, I had A & D patients as patients and lived intimately with the patients while I was in treatment. Having said that, I am a Chinese medicine doctor, not a psychotherapist, and this article is not intended to replace professional psychotherapy or psychiatric help, which I believe are crucial for anyone with severe A & D.
So, I speak both personally and objectively about these extremely challenging conditions. My hope is that part of the pain I suffered will be saved and this writing will help inform your choices wisely.
The stigma
The most common mental illness in America is anxiety; This is followed by depression, the latter affecting more people around the world than any other mental illness. I call A & D "evil twins" because they had nothing less than hell to overcome, more than any other experience I had, including the massive one pain and almost paralyzing as a teenager.
The stigma, a fear, attack and mischaracterization of society, perpetuated in society, has developed due to the lack of understanding, fear and perpetuation of false perceptions that do not serve anyone, especially those who suffer them. When your brain is on you, as your knees or hips can do, it's devastating because you can no longer guide your life the way you ever did. Except that our brains affect all aspects of our lives, not just gait and movement. When we lose our inner world by A & D, at the same time we lose our outer world because nothing makes more sense and it can be impossible to navigate through the simplest tasks.
Most recover from a mental illness, as we do from other diseases. In fact, between 70 and 90 percent of people who receive treatment for their disease have a reduction in symptoms and a better quality of life. Therefore, get adequate and fast The treatment is crucial.
We have a long way to go in our understanding, acceptance and treatment of these disorders, which will undoubtedly help the victims of these hellish diseases to receive more compassionate care and financial assistance.
Mental illness is not usually a frightening monster that makes us "crazy". And no, mental illness is not well correlated with mass shootings; this false meme only increases the stigma in mental illness; Revealing and revealing articles on the subject are here Y here.
It is also useful not to describe mentally ill patients with pejorative and vague terms such as "crazy" that offer little meaningful information and are more critical than anything else. Mental illness is a disease process, like flu or diabetes. The latter affect the lungs and the pancreas, respectively, and mental illnesses mainly affect the brain, the endocrine system and the nervous system, also parts of the body.
While we can learn from A & D, and from them can be extracted important "messages" and psychological growth, this may not be the best perspective to consider. Sometimes we just have to overcome them, as we would with the flu, and balance our physiology again, covering both psychological and physiological treatment (mind and body). Most of the time, a combination of cognitive and emotional learning, as well as good traditional biomedical help, are in order.
Due to the stigma, we could resist identifying, admitting and, therefore, seeking help for a mental illness for fear of being marginalized, embarrassed or ridiculed. But, as with most other disease processes, the sooner we receive treatment, the better the recovery will be. Therefore, if you or a loved one has a mental illness, try to eliminate the wrong information and fears of healing sabotage and get help. In general, those who have suffered a mental illness are able to understand and sympathize with other patients, just like an experienced therapist.
Yin and Yang "Evil" Twins
exist different types of anxiety, just like there Different types of depression.
In this article, I am referring to anxiety mainly as severe anxiety that is more than the daily worry or anxiety that comes and goes. Clinical anxiety is persistent anxiety that is considered an "anxiety disorder". It usually does not go away on its own, it can get worse without proper treatment and may be accompanied by anxiety or panic attacks.
I argue depression mainly in the context of severe depression that is known as clinical depression or major depressive disorder (MDD). Depression is more than a bad mood and normal sadness. It is more than feeling disappointed because it rains or that you missed a movie date, or that you feel "off". In fact, depression makes us perceive extreme negativity in things that normally cause us a slight discomfort. This is consistent with the well-known adage among patients that "depression lies". Well, anxiety also makes us believe the worst, and also lies. Both evil twins distort our beliefs about most of the reality that otherwise would not when we are regulated ("normal" and manageable) in mind and body.
Depression and anxiety are neurological partners and often occur simultaneously, as well as Yin and Yang. Anxiety is Yang (external, activating) and depression is Yin (internal, inactive). True to the interdependence of Yin and Yang, depression generates anxiety. And anxiety can lead to depression, especially when it begins to drain our resources. Both usually affect normal sleep patterns and cause insomnia. In atypical depression, one can sleep more than usual. In any case, these evil twins are a threat and in my own battle with them a few years ago, I could barely determine which was worse.
Depression and anxiety often also affect relationships, the ability to make even the simplest decisions, the ability to work and perform ordinary daily tasks and, otherwise, lead a normal life. Suicidal ideation and suicidal plans are also common symptoms. A & D can become completely paralyzing and can consume us completely, especially without proper treatment. Again, the sooner they are treated, the more quickly and better a recovery is usually made. A more complete list of the symptoms of depression can be found. here and for anxiety here.
Not necessarily a reason
If you are anxious or depressed, you might think that there is a reason for this beyond genetics and physiological imbalance, and that this reason can be identified. Like many, you might think that there is a psychodynamic reason for this, which refers to some aspect of your psyche beyond its mere physiology. Examples include past traumas, lifestyle circumstances, childhood problems, unconscious forces, or other inter-relational events that affect your mental state. This is not always the case, and it may be impossible to determine what caused your fall.
In most cases, focusing on what goes instead of why is this happening It is more useful for recovery. In other words, first try to improve by any means and leave any query in why For later. An exception to this is if your A or D has really been precipitated by a cause, which I mention just below. With this said, recovering from depression often takes action, not thinking much, except trusting in what others know to encourage them to "rethink" (think from a different perspective). As a good therapist told me: "Jack, you can not think how to get out of this." I learned the truth of that as time passed.
Anxiety and depression, like other mental illnesses, often have a genetic component, which means that you inherit the predisposition (called "diathesis"). If one or more of the family members suffer, you might have the genetics, making it more likely that you will sustain yourself. Often, a stressful life event can trigger genetic predispositions and even activate epigenetically (alter the gene expression of) these syndromes. Many stressors and physiological changes that work together and combine together can precipitate A & D episodes.
Once we are more regulated (balanced and homeostatic), we are likely to have a clearer perspective of our condition. Then we can understand more of the why. With that said, sometimes the main reason we fall into anxiety or depression is because of an identifiable cause, and learning about and solving problems can help us recover. It is best to speak with a good therapist with experience in A & D to determine the best course of treatment.
If we are very anxious or depressed, it is logical to think that something is making us anxious or depressed. In other words, if I'm depressed I might think that I should be depressed by something. After all, our emotions are signs of something, right? Well, sometimes yes and sometimes not, and often both. Feelings of anxiety or depression often have no more meaning and value than making us suffer, so it is helpful not to take our feelings or thoughts seriously.
Clinical depression and anxiety are disorders, and there is not necessarily a psychodynamic cause behind them. In fact, it is believed that depression is 50% attributable to genetics, according to studies in Stanford. This means that in many cases it is truly it's not your fault (it's not like that), and depression is not easy to control or navigate on our own, nor can we be cured of cancer or a heart attack on our own.
We need help, and in a fiercely independent culture where we believe that we are supposed to be able to handle everything on our own, we can try to do it on our own, which can aggravate our anguish. It is especially important to have support through mental illnesses, not only of professionals but also of support for family and friends. This need raises a bit of catch-22 because depression and some forms of anxiety make us want to withdraw and isolate ourselves. While this may feel good in the short term, it is often not advisable, so in A & D we often have to act counterintuitively ... going against what feels right at the moment in service of what It will help us to heal little. little in the long term.
Feeling understood, accepted and genuinely supported is crucial to the recovery of A & D. It is just as important that we treat each other with the greatest kindness, that we be our own best friend.
Recovery
Very often, and more commonly among some popular online psychology gurus, unconditional acceptance is offered as a way out of any disturbing psychological dynamics. Some even promote shadow work as the proper psychological medicine for such ailments. While I believe that shade work is crucial to becoming a human being of integrity, it is not necessarily the best way to overcome clinical anxiety and depression, or at least not at the beginning
A certain degree of unconditional acceptance is useful in any therapeutic process, but it must also be carefully integrated with hard love when it comes to healing from a mental illness. This is because the healing of a mental illness often requires what is called opposite action: that we do the opposite of what seems intuitively correct, that we do what we do not want. The opposite action is usually what is counterintuitive. The opposite action is to do what we do not feel like doing, or we do not think it helps, but in fact it is useful. For example, unconditionally accept that a depressed person does not feel like exercising and, therefore, can not help him improve. This is because the exercise is considered. important medicine to recover from anxiety and depression and it's generally better to get something from any, exercise even if a depressed person, and less frequently, an anxious person, does not feel like doing it.
By uniting compassion and hard love, we could respond in this way, in a compassionate but clear tone, to someone who is depressed: "I hear that you do not want to exercise and you feel you can not do it, but it is important that you try to move, even for a few minutes. "We can also talk to ourselves (talk to ourselves) in this way if we have depression, if the anxiety is predominant, we could legitimately need to rest (possibly in addition to exercise), because anxiety taxes our resources and tires us The same goes for depression, remember to speak softly and kindly, even when it is firm, with any person with A & D, you can not imagine how horrible it is if you have not suffered it yourself.
Interestingly, and contrary to what is often believed, stress hormones often attack someone who can not seem to get off the couch. Because depression causes real biological fatigue, a person with severe depression may not be able to exercise. In this case, pure unconditional understanding is useful. Maybe the next day, the encouragement to walk even a few steps is a good idea, and the next hour or day, some more. When I was in recovery, I started with 3 minutes of walking, which I increased from there. Before getting sick, I exercised every day and could walk for hours. When I feel depressed, 3 minutes seemed like a marathon. Often, a depressed person needs to cancel real or perceived inertia in order to feel better in the long term, while not overdoing it. Slow and steady usually win this race.
Although anxiety or depression can make us feel like we are going to die, it is not a good idea to be scared by this feeling, which is "worry about being anxious". Feeling as if you were going to die is how the brain automatically interprets intense fear. Again, these diseases "lie", making us believe a reality that is not real, except in our temporal perception of it. And this is key: the perceptions and imaginations that we have while we are sick are temporary, as if we could feel that we will never improve, or that we will always be in bed, if we have the flu. We can and we improve. Life can change to a dime, and we need others to keep this hope and reality reasonable for us if we can not do it, which is usually the case because it is very, very difficult to believe this when we are in the midst of severe anxiety or depression. .
While empathy can be generated, only those who have gone through the A & D challenge really know what it is like. If you have not experienced them, trust me, it is practically impossible to understand, and it is worse than you can imagine. Before my fight, I worked in a medical clinic to treat people with these disorders. While I felt his anguish, as I do with anyone who suffers, in retrospect, I see that I could never have really understood his experience. After going through them, I am back at work in the clinic and my compassion and compassion are much deeper, and I can relate at all levels with the absolute confusion and terror of these states. While I can never know precisely what another is feeling, suffering the same disorder gives a new order of relatability.
When I was clinically depressed and anxious, I responded better to those who spoke slowly and gently and who actually listened to what I was saying and could understand. Even if you do not understand what it is to have clinical anxiety or depression, you can empathize to some degree by remembering the times you have suffered a lot. In fact, part of why I wrote this article is to give an external perspective if a loved one of yours is suffering.
Disclaimer: While I have written about the dangers of happiness and positivity madness Y Not ignoring our difficult thoughts and feelings., this approach is not generally useful during the distorted experience of A & D, as it is useful to pay too much weight and attention to our difficult thoughts and intense feelings when we are upset or melancholic due to a bad night's sleep, a discussion, an excessive feeling. stress, being hungry and having a low blood sugar level, or being sick with the flu, as examples. Tip: Sleeping badly, something common during A & D, can make depression feel worse. Then, when I did not sleep well, I reminded myself throughout the day: "Do not take yourself too seriously what you think or feel today." I no longer took things too seriously and when I did not sleep well. This was especially the case.
A & D are distorted states and a Catch-22: it is practically impossible to think clearly about anything in these states because the brain with which we think is unbalanced, and this imbalance affects the quality of our thinking. But it is not black and white: there are usually some thoughts and moments of intuition or revelation that you can recognize as healthier than others, which are more like "the old you". Stick to these, trust these, even if they are short. lived; Use them as anchors.
It is crucial to take advantage of any positive experience, any point of support we have, to recover the regulation and a better functioning, so that we move in spiral upwards and not downwards. This leverage could be the hope that someone else has for us, the part of our thinking that realizes that we are distorted and can let go of these distortions more easily, the ability to exercise, laugh, quiet our mind, do something rewarding and complying, a medication or supplement that helps us feel and / or think better. Whatever is. We use whatever leverage we can to recover more of ourselves. During A & D, we try to invest our attention in the things that help us recover in the same way that we would invest money wisely to increase our profits. Sometimes we do not have any leverage, which is just one more reason why it is valuable to have others who can stop us (above) and remind us when we can not.
Meditation and mindfulness
I have been a meditator for years. However, I discovered that sitting meditation with closed eyes (mindfulness style) was not useful during A & D. My mind was so disturbed and distorted that I could not help but get stuck thinking about my thoughts and automatic negative perceptions. Such rumination made me feel worse and is actually contraindicated in depression and anxiety. What I needed was a break from these thoughts, and I'm sorry, but while suffering from anxiety and depression I did not have the regulation and mental stamina to just "let go of the bad thoughts".
In fact, the capacity and quality of "consciousness" is not constant and immutable; Varies with physiological and neurochemical changes. I was not in a place to be closer to my negative thoughts and feelings; I needed a break from them, as far as I could get from them in reality, so that my psyche can begin to find its equilibrium again through the "mind that heals the mind," as I comment below. For me, this meant letting my mind take a breath.
Therefore, meditation in silence, with closed eyes, sitting, simply was not my medicine. But it could be yours, Especially if you are suffering from mild depression., also known as "depression below the threshold", and anxiety. Therefore, ignore what I say if it does not fit you for any reason. I just want those who suffer from meditation during the A & D to know that they are not alone and that they feel capable of getting rid of it if they wish and that they do not suffer more than necessary.
In researching this topic I came across a bold and useful Article by Teresa Borchard, echoing my feelings about conscious meditation. She cites the work of Jon Kabat-Zinn, the "Dalai Lama" of the mindfulness meditation world, who says in his book:
"It may be wise not to undertake the whole program while in the middle of an episode of clinical depression. Current evidence suggests that it may be prudent to wait until you have received the necessary help to get out of the depths and to be able to tackle this new work of working with your thoughts and feelings, with your mind and spirit laden with weight by the crushing weight of acute depression. "
In response to this statement, and how her depression was not really helped by mindfulness meditation, she reflects:
In retrospect, I would like there to be more than one paragraph in Zinn's book about when mindfulness It is not the solution, about when it is better to swim or ride a bicycle to the city or call a friend with whom you have not spoken in a long time. I would still have taken the course, and I think I benefited greatly from it, but I would have forgiven myself more than not "working" like the magic of everyone else.
And in response to her meditation teacher finally agreeing with her, she goes on to say:
"He confirmed what I was thinking at that moment and what my experience has been: "Attention is better to prevent a person from getting depressed than to get a person out of depression."
In fact, this is the result of a study that found this to be true: that MBCT (cognitive therapy based on mindfulness), which "revolves around mindfulness meditation," can help prevent a depressive relapse. Y anxiety as well.
Now we know that through neuroplasticity (reconnecting the brain) we can use our minds to heal our minds; This happens because the quality of our thoughts affects the biological functioning of our brains to, among other functions, produce a more balanced flow of neurochemicals. The trick in A & D, however, is to have enough mind (mental leverage) to be aware enough that our impoverished mind is again in balance. This is one of the ways in which CBT (cognitive behavioral therapy) therapy is of great help in A & D. It is this good thinking that helps us to do the right things for ourselves (personal care), as the distraction to give us a break from the avalanche of negative thoughts and feelings that are symptoms of A & D and Causes For this it gets worse.
Thinking positive thoughts into reality has a corresponding positive physiological effect. The same goes for smiling, even if we do not feel happy. In other words, the simple fact of having positive thoughts (very strong during severe depression and / or anxiety) can make us feel and think better. In the same way, the mere act of smiling can make us feel happier changing our neurophysiology. So, it's usually a good idea to try to smile during depression and do it counter-intuitively and in opposite action to what we want to do, that is, not smile.
Many meditation practitioners can tell you that it is okay to feel worse and this is part of the "meditation process". do not sick (and currently), I agree, sitting with distressing thoughts and feelings is difficult but useful. But not during A & D. I also remember that I felt worse about myself because meditation would bring me closer to my distorted thinking (including suicidal thoughts), which was difficult to get away from even with my eyes open and active. This was not right, and when I finally stopped trying to meditate on my path to health, I felt relieved and it went better.
What I did However, the usual attention was useful: being aware of my distorted and anxious negative thoughts. And, I did not need to sit with my eyes closed for this. As mentioned above, this is the basis of CBT therapy, which helped immensely. It was easier for me to let go of the distressing thoughts ("thought of defusion") And feelings ("emotional defusion") While it is active. To do this, I did not practice stories or buy the apparent importance and truth of my thoughts and emotions, which are distorted during the A & D. The "distraction", which I mentioned also helped, is a DBT technique. As for Therese Borchard, it was useful to walk with friends, exercise, write, watch TV and listen to music, read, play games, anything that kept me from ruminating. By giving my mind a break, after a while, my physiology and neurochemistry became more balanced and I could see my disturbing thoughts and feelings more accurately for what they were: distorted, useless and largely meaningless.
In short, be as attentive as you can and stop beating if you can not or do not want to sit and meditate, it's okay. Ironically, this can help your mind to heal your mind, which is supposed to be a benefit of conscious meditation.
Medicine
I am a holistic doctor practicing Chinese medicine. I and many of my colleagues, including M.Ds, try to stay away from pharmaceutical products. When I was in the early days of A & D, I never imagined I would need to take antidepressants. I felt mortified at the thought of it and resisted it for months, until it got so bad that I received anything that could help. Lesson: Just as Western medicine is useful for many conditions that holistic therapy can not address, such as surgery and life support, pharmaceuticals can save the lives of those who have A & D. And, yes, I tried all the available holistic treatments. So did an old wise and now sensible friend who told me this during a recent discussion:
"I tried all the alternative recipes for the recovery of A & D. . . like diet and herbs and acupuncture and supplements and exercise and massage, etc. . . I tried them with a huge commitment and dedication, and even then I HAVE to end up taking antidepressants. I'I'm sure the other things helped. . . But it just was NOT enough to save my life. . . It was 'Big Pharma' and a couple of impressive psychiatrists who saved my life."
In the end, I do not know if the medication helped me, and I do not regret taking the pills. Like Western medicine in general, pharmaceutical companies have a bad reputation and often for good reason. Therefore, we can conclude that all your medications are unnecessary and useless. This is not only unfair, but reckless. While there are many more people taking antidepressants than they should, for many patients, these medications offer relief from a disease as debilitating as any. You can hear what a world-renowned teacher and depression survivor is. Robert Sapolosky has to say about depression. In addition to injuring the injury, many who take antidepressants are embarrassed or stigmatized in addition to the stigmatization they already suffer. The propaganda of alternative medicine and the stigmatization of pharmaceutical drugs are likely to cause more harm and more suffering than necessary.
That said, I tried every means possible to alleviate my symptoms by natural means and none worked well enough, not even close. I felt like a failure because of this, which added (unnecessarily) to my anguish. Finally, and too late in the game, I had to go to the big guns. So, by all means, try the natural remedies. In the case of serious A & D, this decision must be made with the help of your health care professional (s). But if nothing works well enough, do not be afraid to consult a psychiatrist to get medication. Los antidepresivos y otros medicamentos, incluso con sus posibles efectos secundarios, pueden proporcionar un alivio muy necesario. Sí, puede llegar a ser tan malo que cualquier alivio se desea tan pronto como sea posible.
Con esto dicho, los medicamentos antidepresivos no siempre funcionan la primera vez. De hecho, para la depresión moderada a severa, son efectivos sobre 50% del tiempo. A menudo se necesita un período de prueba y error para encontrar el medicamento que funcione mejor para cualquier persona, y por lo general tardan entre 4 y 8 semanas en tomar efecto. Le animo a asociarse estrechamente con su médico y profesionales de la salud mental. Usted es el experto en sus síntomas y su médico necesita escuchar lo que está experimentando. Esto lo ayudará a trabajar juntos para encontrar el medicamento correcto o la combinación de medicamentos.
Para algunos, y de ninguna manera todos, los ansiolíticos (medicamentos contra la ansiedad) y los antidepresivos ayudan a resolver la ansiedad y la depresión, respectivamente. Recuerde, no siempre hay una razón psicodinámica por la cual nos sentimos ansiosos o deprimidos. La medicación también puede ser útil para ayudarnos a lograr un punto de apoyo y comenzar a sacarnos de las trincheras. Pueden ayudarnos a regularnos para que nuestra corteza prefrontal (la parte racional y autorreflexiva del cerebro que se cierra en la depresión) esté "de nuevo en línea" lo suficiente como para que podamos absorber, recordar y comprender información crucial y obtener la perspectiva necesaria sobre nuestra enfermedad para poder navegar en formas que apoyen nuestra recuperación. En estos casos, la medicación no enmascara la enfermedad mental ni actúa como una muleta dañina, sino que nos ayuda a recuperarnos de ella. Una vez que avanzamos y somos capaces de hacer ejercicio y funcionar más normalmente, es posible que no necesitemos el medicamento. Sin embargo, la elección de retirarse o tomar medicamentos, debe hacerse con la ayuda de un médico.
Incluso si la depresión o ansiedad de una persona is Debido a problemas psicodinámicos, la medicación puede ayudar a regular la mente para que cualquier problema identificable que precipite la enfermedad pueda resolverse productivamente. Nuevamente, en la aguda A&D es difícil, por decir lo menos, percibir algo lo suficientemente claro como para avanzar. Pero, nuevamente, puede ser útil hacerlo, especialmente con la ayuda de un buen terapeuta. De hecho, la medicación en combinación con la psicoterapia. ha sido mostrado para ser más útil que la medicación sola para la recuperación de la depresión mayor (que a menudo se presenta con su hermana gemela malvada, ansiedad).
Nuevamente, los antidepresivos no son para todos, y la literatura de investigación lo establece claramente. Pero para algunos, son un componente invaluable para la recuperación. Dado que el suicidio es un síntoma de depresión, la medicación literalmente salva vidas. Dicho esto, e irónicamente, se ha demostrado que los antidepresivos Aumentar las ideas y conductas suicidas. en una “pequeña cantidad de niños y adolescentes”, por lo que se necesita precaución y monitoreo específicos para este grupo de edad. Estos son detalles específicos para discutir con un profesional de la salud calificado. Y, si ha estado clínicamente ansioso o deprimido, es probable que sepa la desesperación que tiene que hacer. anything para salir de la oscuridad de la grave depresión y el implacable infierno de la ansiedad. From my own experience, witnessing others go through the gauntlet, as well as from researching the subject, I endorse whatever helps someone get through without creating a bigger problem.
Psychoterapy
Two of the most helpful therapies for depression and anxiety are CBT (cognitive behavioral therapy) and DBT (dialectical behavior therapy). Here’s the classic DBT handbook authored by its developer, though my experience is that the book is not a substitute for working with a therapist, even a DBT-trained therapist. Part of this reason, is that in severe A&D, it can be tough to read a single line, much less a chapter or a book, make any sense of them, identify the proper advice for you and then, after all that, put the suggestions into action.
As mentioned previously, acting counter-intuitively, or what is called “opposite action” in DBT terms, can make a big difference. This includes do not listening to our warped feelings and cognitive distortions (faulty perceptions and bad ideas). This is also why “intuition” and “trusting our feelings” as guides for how to act during A&D can be counter-productive and outright disastrous. An ordinary example we can all relate to is not wanting to get outside or get out of bed to take a shower or go for a walk. But once we do we feel better. Same for depression, unless we truly can’t get up for physiological reasons not due to an apparent lack of motivation.
As mentioned, psychological depth work is not usually appropriate in severe depression unless a significant cause of the disorder is due to these psychodynamic causes and one is regulated (functional) enough to undergo the process of hashing through past hurts and the emotional upheaval this causes. In severe A&D, depth work is usually not a recipe for success because bringing up more dysregulation and intense emotion when balance and stability are needed can sabotage recovery. Again, it’s difficult to see any issue accurately during A&D. Getting counsel from a good therapist with experience treating these conditions is invaluable and usually best to help assess what is appropriate to guide treatment.
Lastly, I want to mention that when medication and talk therapy don’t help enough, other treatments for depression you can consider include: ECT (electroconvulsive therapy) and rTMS (repetitive Transcranial Magnetic Stimulation). Even psilocybin mushrooms seem to have helped some, but opinions vary and the evidence is yet scant.
Other Factors
Biochemistry shifts with age, stress, diet, hormonal changes, environmental factors, genetic/epigenetic expression, and anomalous brain wiring. All these can cause significant mood changes. So, if you are anxious or depressed, it might not be due to something you are doing or have control over—that you can put your finger on and fix. It might be largely genetic and triggered by a stressful life event. OCD (obsessive-compulsive disorder), for example, is an anxiety disorder that causes anxiety for no logical reason (other than anxiety!). OCD and other anxiety disorders amplify usually mild issues or events and make them seem multiple times worse than for a person with more common responses to everyday anxiety.
OCD, GAD (Generalized Anxiety Disorder) and depression cause us to think that events themselves are causing our distress and they are responsible for our feelings and perceptions. It’s actually more our highly distorted response to events that causes our suffering. Anxiety and depression latch onto whatever we might think about. Our mind is “latches onto” and spins tornadoes from what would otherwise be mildly distressing events. This is why therapy in general, and specifically being able to witness and be aware of our reactions (a key tenet of CBT), is so helpful to recovery; it allows a more regulated and balanced version of us to guide our responses to disturbing thoughts and feelings, rather than being so caught up in our negatively-generated and alarming thoughts and feelings that they take over and own us.
Psychodynamic triggers can indeed trigger unpleasant emotional states but are not the cause of all, or even most, of anxiety, depression, and other mood changes. With this said, sometimes our anxiety and low moods are signals for real-life issues, past or present trauma, lifestyle, coping, and other unhelpful dynamics that need to be addressed. Often, it’s some combination of both real-life events and underlying anxious or dysthymic (low mood) tendencies to which we are genetically predisposed and/or triggered into that cause anxiety and depression.
In cases of mild and even moderate A&D that have their source in life issues, sorting out the impacts of such dynamics with a trained and sympathetic therapist and/or psychiatrist is a good way to learn more. When psychodynamic issues are at the root of depression or anxiety and go unaddressed, chances are that suffering will continue, even if temporarily masked by medication. Again, skillful timing and personalized treatment are key here. If the cause is more biological in nature, medication is a modern miracle that can help recovery.
Anxiety and depression are illnesses like any other biological illness, it’s just that they occur primarily in the brain. We are more familiar with less stigmatized diseases such as diabetes, migraines, or Alzheimer’s and cancer. These are diseases that largely happen to people, just like mental illness. But with mental illness, somehow we have the idea, in whole or in part, that someone with depression or anxiety can just snap out of it and that they have control over their condition. We wouldn’t say this to someone with diabetes or cancer; neither should we address an anxious or depressed person this way. An astute friend recently commented this in response to an on-line post I made about A&D:
“There is a mountain of stigma, judgement, opinionating and misinformation to be overcome by people who are trying to live with and manage their Anxiety and Depression (as though just being afflicted with these dreadful conditions it isn’t hard enough already.) No need to take on the shame or misinformed projections of people who ‘think they know’ what these illnesses are, and where they come from and what you should do to manage them. Beware of rejecting what modern medicine has to offer you, and double beware of people who think they know what is best for you. Take any lifeline that is offered to you, and relinquish your attachments to romantic notions of recovery entirely through excessive self examination and compulsive scab picking of deep emotional wounds (which can be extremely dangerous for people who are very unwell). The causes of your illness might be extremely complex, and your recovery is likely to require a multi-faceted and uniquely personal set of strategies, which may well include medication. Hugs to anyone out there wrestling with A&D.”
—Darielle Bydegrees
Time For Compassion
For all our similarities, we are complex biological organisms with many nuanced differences. Just like other animals have personality types, oddities, seeming imperfections, and unique gifts, so do we. Yet, we seem to think that just because we are conscious and self-reflective creatures that we should be able to fix our anomalies, or even that they are in our control, especially when it comes to the mind. This myth perpetuates suffering, violence, and abuse when we treat others with judgement, condemnation, and meanness according to this flawed perception. People with severe depression and anxiety can’t just snap out of it or get over it, at least not quickly, the way you or I (when well) would normally shift a low mood or worry. Clinical depression and anxiety are different animals and sometimes lifelong events.
If we are significantly anxious or depressed this does not necessarily mean that something is complexly wrong with us, or that we can fix our predicament by digging into our current or past issues or venting our emotions. It might mean we need medicine, just as we would for any other less stigmatized form of physiological illness towards which we are culturally less judgmental. Because mental illness happens in the brain, it effects our thoughts and emotions more than other biological illnesses. Usually it means that we need both medicine (pharma, herbal, and/or nutraceuticals) and the support of caring, informed, and understanding health professionals who aren’t pigeon-holed and attached to a one-size-fits-all approach.
Images and stories of “crazy” and “unpredictable” people with anxiety, or even depression, perpetuate our irrational fears and judgement of these debilitating conditions. Such people are usually not violent unto others. Those who carry unresolved pain and trauma are more likely candidates for this.
Most people with mental illness suffer in shame and silence and are some of the most vulnerable, tender, compassionate and empathic people I know. So, let’s break the mould together, lift the mythic curse of judging mental illness due to our usually innocent ignorance of these menacing and crippling invisible illnesses. We do this in part through opening our minds and humbly learning about them so that our beliefs about these conditions can match reality. This in turn informs how we help sufferers and those who love them.
Some resources for Depression & Anxiety:
Books:
The Upward Spiral by Alex Korb, CBT for healing through depression
The Noonday Demon by Andrew Solomon, on depression
The Imp of the Mind: on OCD and intrusive, bad thoughts
Videos:
“The Refugees” by Andrew Solomon at The Moth
Depression, Too, Is a Thing with Feathers by Andrew Solomon
Depression Talk at Stanford by Robert Sapolsky
Sam Harris and Robert Sapolsky: from 48.00 minutes to the end
Disclaimer: The information in this article is not intended to diagnose or treat any disease, or substitute for professional help. It is based on the author’s personal and clinical experience, research, and direct observations. The author is not a psychotherapist.
Jack Adam Weber, L.Ac., MA, is Chinese medicine physician, having graduated valedictorian of his class in 2000. He has authored hundreds of articles, thousands of poems, and several books. Weber is an activist for embodied spirituality and writes extensively on the subjects of holistic medicine, emotional depth work, and mind-body integration, all the while challenging his readers to think and act outside the box. Weber’s latest creation is the Nourish Practice, a deeply restorative, embodied meditation practice as well as an educational guide for healing the wounds of childhood. His work can be found at jackadamweber.com, on Facebook, or Twitter, where he can also be contacted for life-coaching and medical consultations.
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