treatment for depression
I recently came across this story, of a man who committed suicide. According to the story, he had just finalized his divorce, and he had left a recording stating that this was something that he had given some thought to for some years. His body was found by police next to the recording.
The truth about depression is that we choose how we feel. While there are some who would argue that there are certain life circumstances that lead to depression, or that there are certain clinical circumstances that lead to depression, such as chemical imbalances caused by a lack of certain neurotransmitters, what is consistent is that thoughts produce feelings.
You control your feelings through the content and context of your thoughts. When I have worked with clients who were suicidal, the first thing I say to them is this; “given that you have already considered taking your life, what do you have to lose in considering other alternatives for happiness?”
For the man who took his life, after years of “thinking it through” I would argue that he wasn’t thorough in his thinking process, as he clearly engaged in several thinking errors by coming up with several justifications to end his life when things did not go his way. In fact, he most likely had several more options for pursuing happiness, but due to familiarity, he had become anchored to a lifestyle, which he had long decided was the only way he could be happy.
This is primarily how people fall for the trap of depression, they trap themselves into an all or nothing corner with beliefs about how the circumstances of their lives should play out. People do this often, and they do not realize it, until their circumstances change to something they dislike. Another thing that keeps us trapped in rigid thinking, is being surrounded by people who think the same way we do and subsequently reinforce our thought process. It becomes more troubling, when our circumstances change for the worse, that we find ourselves surrounded by others who are unable to give us sound advice on how to cope and make peace with things not going our way.
Be it issues with wealth, health or relationships, there are always healthy alternatives to every lifestyle. It calls for an open mind, and courage to explore and act on other ways of thinking. Suicide is often a final solution to a temporary problem.
Depression is often marked by a feeling of hopelessness. People in this state of mind have come to the erroneous conclusion that their life circumstances are unchangeable. To make matters worse for some people, they have made efforts to change their circumstances for the better, but to no avail, and have subsequently given up.
For people in the predicament, after having experienced repeated bouts of failure, they truly believe that there is absolutely nothing that can ben done about their situation. Fortunately, they are wrong about this belief, for two reasons. The first being that change is a constant, and the second being that they didn’t invest enough time in become good at the change they wanted for themselves.
In truth these situations appear overwhelming to them because they have adopted an attitude of helplessness
Change and Investment
There is a popular joke regarding a man who struggled in his attempts to quit drinking. Once he was asked by a friend how his sobriety was going, and he stated that he had been sober for the past 24 hours. By accident he was doing the right thing, in taking things one day at a time, but it truth, he fully intended to resume his drinking later in the evening.
The point is that change is easy, you simply begin engaging in a preferred behavior you have seldom, if ever engaged in the past. However, that doesn’t mean you will be good at it, to the point where you begin receiving the desired results from the change you are practicing. This is the reason so many people give up, they start doing something new, in which they are novice at, and become discouraged when things aren’t going their way.
It’s like taking up golfing for the first time and becoming discouraged because you golfed a terrible score. Mastery must be achieved, before you can set realistic standards in anything you do.
So, there is hope, however in anything you are doing for which you have very little experience, it’s going to take some time before you can expect to drastically change your circumstances. Regardless of what external changes are taking place, it is important to adopt a patient mindset to create the effect you which to experience in your life.
So how does this help with depression? Well the depression itself is caused by feelings of hopelessness that comes from a belief that an undesirable situation will remain the same or get worse. Further, for those who do attempt to practice change, a lack of patience, will likely derail their progress as they will be too inexperienced to create the effects they desire at what they are doing. However, if one where to adopt an attitude of patience and subsequently humility, their sense of hopelessness becomes forgotten as they become hopeful for what the future holds for them if they continue to practice the change they are practicing. Subsequently, this also decreases the severity of their depression.
Ugo is a psychotherapist and life coach.
Years ago, I was driving home from work, and came out from the highway and embarked on a stretch of road towards my home. Then I encountered a problem, moments earlier, an accident had occurred, and the local police had blocked off the road. I was about five miles away from my home, I was annoyed and for a moment I did feel hopeless. I felt hopeless because I thought I would have to go back out on the highway, take a different exit and drive across to the other side of town to get to my home.
My feelings of hopelessness soon faded when I realized that there might be another route to my home at the time. So, I quickly pulled out my phone, and after a thorough check on goggle maps, I soon found the alternative route I was looking for. Fifteen minutes later I was back home. This story is an analogy for how to cope with and move past feelings of hopelessness. When people are dealing with a situation where they believe they have reached a dead end, feelings of hopelessness start to set in, when they come to think that they would have to start all over in pursuing whatever it is they were trying to achieve.
The mere idea of the amount of effort they would have to muster in order start things over again, is enough to cause feelings of dread and exhaustion. People who run into road blocks in various facets of their lives only need to pick up where they left off as they discover a new route to resume their journey.
This is easier said than done, as the mere thought of creating a new path, will certainly bring up difficult feelings for the person pertaining to his current experiences. However, this is the best way forward, for the person to envision an end goal that he finds happiness in, and then create a pathway towards this end goal that he strongly believes in.
I typically will spend an entire session with my clients helping them figure out their desired outcome relative to the difficulties they are currently experiencing. Most people initially balk at this exercise, as they deem it “unrealistic.” However, what is unrealistic is the hyper focus on a situation where things are no going your way. Before the hopelessness, there is panic, where people unintentionally engage in the same thinking and subsequent behaviors that led to their current experiences in the first place.
By keeping an open mind and visualizing a desire outcome and practicing the courage to think and do things differently, people who struggle with depression take the first step towards transitioning out of a state of hopelessness.
“It’s all in your head,” maybe cliché, but it’s true.
Feelings are important, but your thoughts are more important. The reason for this is because, your feelings are influenced by your thoughts. For people who struggle with symptoms of anxiety and depression, this can be frustrating because they certainly have no intention of entertaining thoughts which cause them to feel anxious or depressed. This frustration is understandable given that people don’t consciously give precedence to depressive and anxious thoughts.
Two types of thoughts.
The problem is that most people don’t understand that they have two types of thoughts that go on in their heads simultaneously. They have thoughts, that they are conscious about, and then they have non-conscious thoughts.
Conscious thoughts are thoughts that we actively create, through our interactions with our daily experiences. Through our interactions with daily experiences, we are either confirming what we have already come to believe, expanding on the principles of what we have come to believe, making corrections on the principles of what we have come to believe, or completely disregarding what we have come to believe and embracing an entirely new concept.
Conscious thoughts are thoughts we actively and intentionally create, through our inner dialogue or dialogue with others. This is the reason people often have a difficult time believing that their thinking about an experience or a series of experiences have led to their issues with anxiety and depression. No one intentionally thinks their way to depression.
Non-conscious thoughts are previously established thoughts that work automatically in the background while you are consciously focused on tasks and activities you have determined to be more important. An example would be learning how to drive. When you first learn how to drive, you are consciously aware of the reasons for every little thing you do with the driving of the car. You are consciously aware of when you decided to time the breaks, when you decide to accelerate, when and how you make a turn and so on and so forth. After six months of driving, the thoughts you give to these activities occur beyond your awareness when driving as you give more attention to other things, such as finding a radio station you like or seeking out directions in a new place.
Non-Conscious thoughts are pre-programmed and occur automatically, in response to specific stimuli. With the car example, the stimuli in question was pretty obvious, however in most cases the stimuli, or trigger for unhealthy non-conscious thoughts are subtle. Keep in mind that most of these powerful thoughts were formed during early like experiences, most of which people don’t remember.
The solution is to identify what a life without any of the symptoms associated with depression or anxiety would look like. This process involves the practice of optimistic thinking and identifying the behaviors that go along. The next step would be the process of behaving as if you were already in a place of calm and happiness. This process triggers a reverse feedback loop where your behavior begins influencing your feelings, which in turn strengthen your practice of new thoughts.
The process of practicing change for the better is a difficult one and well worth it.
Depression is a state of mind, caused by an overwhelming loss of hope. People who experience depression have reached the erroneous conclusion that they can never find happiness due to a series of unfortunate life experiences. As a psychotherapist, I am a firm believer that people can permanently transition past chronic experiences of depression. However, such a transition is a process, that comes from the exercise of practicing positive and reality based thinking.
Here are 3 cognitive strategies for effectively managing difficult periods of depressive feelings.
There are more than one ways to be happy, however as creatures of habit, it is understandable that we would become habituated to a lifestyle, we believe we can find happiness in. To make matters worse, we often surround ourselves with a tribe of people who agree and reinforce our path to happiness, even though such a path may have run its course.
Most people in this predicament, find it difficult to imagine themselves reinventing their lives, for fear of the ties, connections and conveniences they would lose. While there is a kernel of truth to their concerns, establishing a path in your life cannot come from fearing what you will lose, instead it can only come from envisioning, what you truly desire.
The process of reestablishing hope, comes from focusing mostly, on what you desire. Creating a picture in your head of your desire, experiencing the feelings of joy from the picture you have created, then going through the process of modifying your behaviors to make your vision a reality.
It is well known that daily exercise helps your body release a cocktail of chemicals known as endorphins. Endorphins bind with receptors in your brain that relieve you of feelings of pain, which allow you to create positive thoughts and ideas which trigger positive feelings.
The most important step towards addressing depression is reestablishing thoughts and feelings of hope. Such a feat cannot be accomplished when you are engulfed in negative thoughts and feelings. Being engulfed in negative thoughts and feelings, leads to you brooding over worst case scenario along with chronic feelings of despair.
Another benefit of staying fit, is that it boosts overall brain performance and it also allows more access for use of the executive functions of the brain. This is important for being able to solve complex problems. Such as being able to transition past an overwhelming sense of hopelessness.
Establishing a Routine.
Most people who struggle with depression, will often forgo routines pertaining to self-care and self-development. A good example will be daily hygiene. The reason for this is that the depressed person desires to feel good again, and has non-consciously decided that the only way they are going to engage in any meaningful tasks is if they feel good.
While good feelings are important, they are not consistent. This is because change is a constant in the world around us. Due to this, our perception of whether we are getting our needs met changes often, and subsequently so does our feelings. So therefore, relying on our feelings to determine whether, we are going to follow through with tasks in our daily lives is notoriously unreliable.
Establishing a routine is a matter of self-discipline. You need to practice doing things that are important, regardless of whether you are in the mood to do these things or not. Also, once a routine or several routines have been established, it helps with your sense of self confidence even in your most troubled days. This is because you will have certain things going for you are a result of your routine.
Which came first the chicken or the egg? This is a question that plagues us in all facets of our lives, and all fields of study notwithstanding. Take for example, the field of psychology. It is not uncommon to read about most medical professionals and biologist identify dopamine, a neurotransmitter produced in the brain as a primary determinant for how motivated a person is. There is truth to this, for example if you used a positron emission tomography (PET) scan to identify and measure dopamine production in the brain of a healthy person, you will find increased dopamine production and activity in response to the anticipation of a reward.
This then raises the question, is motivation based on genetic factors that predispose people to a certain type of chemical disposition, or does experience in a person’s natural environment, or environment of origin influence the chemical disposition of a person’s brain? Consider this study by Vanderbilt University, where researchers using a PET scan, determined that a person’s willingness to work hard was determined by his or her dopamine levels. The problem I have with this study is that the researchers did not go in depth into why the differences in dopamine levels existed in the first place, they simply measured dopamine activity on certain tasks, drew their conclusions and called it a day.
As a clinician who believes in neuroplasticity, (the brains’s ability to rewire itself based on stimuli), I suggest that the brain’s ability to produce certain levels of dopamine is influenced by the beliefs of the participants. For example, people who believe that they are capable of completing a hard task and earning a reward, are probably most likely to have increased dopamine activity as opposed to people who view themselves as incompetent when it comes to completing difficult tasks. Proof of the brain’s ability to rewire itself can be found in this study where, cocaine addiction, followed by chronic relapses was determined to have been caused by cocaine-induced neuroplasticity changes in the brain. Where chronic abuse of cocaine led to the brain to rewire itself to become dependent on cocaine for motivation.
So if neuroplasticity is true, (which it is) how does one increase their level of dopamine production naturally without resorting to unhealthy habits? One technique would be to visualize the outcome of your goals and embrace the process towards realizing these outcomes. Life in the modern world is more complicated than life in the wilderness, which humans beings originally evolved to thrive in. The reason for this is that the process of stalking and hunting game, foraging for food or cultivating food is more linear and straightforward than finding employment in a high salary paying job. With the latter, not only do you have to be qualified for the job, but you also have to have a good relationship with someone high up in the hierarchy in the industry, not to mention experience. So while hunting for game in the wilderness might require patience, it would be fueled by certainty if you have an understanding of the game you are hunting, such as knowing where to find them. With finding a high paying job, despite your qualifications, you may become intimidated if you were not raised in the same socio-economic background as the people you would need to apply to for the job, and this level of intimidation might reduce your dopamine levels, thus reducing your level of motivation in applying for said high salary job.
Personally, I think motivation is relative, which leads me to suggest that dopamine levels are also relative. For example, for experiences in which I have excelled at, my dopamine levels become increased when faced with a goal to accomplish, versus experiences in which I have had little success at, in which my brain responds by producing reduced levels of dopamine. In following through with the technique mentioned in the previous paragraph, if you are faced with a need to follow through on a goal in which you have little experience in, it becomes a matter of recollecting the best of your previous achievements, regardless of how different that goal was, applying the work ethic you used towards your visualization of success with the new and foreign goal, and following through with faith in yourself.
Ugo is a psychotherapist and life coach.
One thing about chronic procrastinators is that they are extremely thoughtful. So thoughtful that if you ever find yourself discussing with any of them why why they have yet to initiate a task, they tell you in some detail how they believe their partaking in the task is going to turn out. Usually the story transitions into how the process would turn out to be a waste of their time due to circumstances they are certain that they wouldn’t overcome.
The following is a technique that was inspired by my transition into using Linux as my primary operating software. Given the the number of issues I kept encountering with my windows software in spite of spending good money on anti virus software, I debated going over to Mac, but was reluctant to ditch my computer all together. So I explored the idea of Linux Ubuntu. Before I installed Ubuntu on my pc, I installed Ubuntu virtually into my windows environment, so I could compare the pros and cons before making my final decision. Needless to say I was so impressed, that Ubuntu became my primary operating system.
The virtual installation of Ubuntu in my Windows program was enabled by a software called the virtual box, which pretty much enabled me to test run any software before properly installing it on the computer. I found this process to be ingenuis because in the event issues with the software were to be detected, my computer would not be compromised.
So that what’s this anti procrastination technique is based on, you pretty much create a narrative of what you are specifically going to do accomplish any long term or short term goal. Without experiencing any unpleasant consequences, until you actual implement the narrative.
So let’s say that you are planning to write a short novel, and you are procrastinating on starting the project. What most procrastinators would do in regards to their thoughts about this project would be to think through to the completion of the novel, and determine how difficult it would be for them to get published and then never start the project.
With the virtual narrative technique, instead of worrying about rejection letters you are going to receive from agents and publishers, you instead focus on the story you are going to write. So you begin with some research by asking by asking yourself and answering a few questions. Such as, why will you be writing this story? For whom will you be writing this story for and what evidence you have that they will be willing to spend money on reading this story?
This would be the first phase of your narrative creation, which you will document. The next phase of your narrative creation would to determine the actual process you will use to write the story and how long the process will take. For example, you could start by dedicating forty-five minutes of your time every day to writing your story, with the intention of sticking to this writing schedule for twenty-one consecutive days. The twenty-one days is actually the meat of the plan, because most people would look at forty-five minutes for twenty-one days as a small sacrifice. Heck, that’s sacrificing some television time, particularly those mind numbing reality shows.
After the twenty-one days, anything is possible, meaning that you will become more proficient at writing that you will probably develop the discipline to write longer, write more in forty-five minutes or more than likely, a combination of both. I have found that the combination of researching into the how and why a goal is going to be accomplished, coupled with the twenty-one day commitment, is enough to motivate most people into taking action.
Why? Probably because they realise on a deeper level that regardless of whether or not they set out to accomplish what they intended in the long run, that they will inevitably accomplish something about themselves in the twenty-one days. A big part of the reason is that the twenty-one day period becomes somewhat of a mystery to them. They know that they are going to experience some cognitive changes from the commitment of practicing a skill everyday for the next twenty-one days, but to what extent?
I have also found that for clients who have properly honored their twenty-one commitment, close to the end of the twenty-one day trial they usually will come to the appointment with clearer definitions regarding what they are going to be specifically doing for the next thirty to two sixty days. In short, they learn to embrace the process.
Ugo is a psychotherapist and life coach.