Radio Lotus FM 20 August 2008
Coping with Depression
By Jimmy Henderson

• In our previous talks we discussed teenage depression and suicide. In this program we will be dealing with depression in adults and the profound effects it has on their lives.

• We will also be looking at ways of coping with depression.

What is depression?
• Feeling depressed from time to time due to unfortunate circumstances is normal. But this usually passes in a day or two.
• If the situation worsens and carries on for at least two weeks and severely affects the persons’ home, work and social life, it could be depression.
• It can last for years
• It can affect chemical balances in your brain (serotonin) mood regulators and stress hormones (Cortisol)
• With treatment, the recovery rate is quite good (90% can recover if less than 5 years- 38% if persists for more than 5 years.

Symptoms of depression
Emotions
• The person’s mood is depressed for most of the day, nearly every day.
• He/she may feels isolated and alone, sad or empty (very tearful) ‘dark place’
• Feelings of helplessness and worthlessness
• Irritability (can overlap with anxiety)
Thoughts
• Increased negative thinking ( I am worthless, useless, no-one cares etc)
• Unable to think or concentrate or make decisions
• Thoughts of death or dying
Behavior
• No longer interested in pleasure (Don’t want to go out) (no sexual interest)
• Apathy/Withdrawal (just leave me alone)
• Possible loss of appetite and weight (or weight gain) (eating to feel better)
• Not sleeping well/or sleeping all the time
• Tired all the time

Important
There are some medical conditions that can mimic these symptoms (thyroid), as well as some medications or the grieving process after loss of loved one (which is natural)
One must be careful not to confuse these issues.

Causes
• Usually an accumulation of stressful events or situations taking place in the home, work
or social life. (stress accumulates) The person becomes overwhelmed and cannot cope
or perceives that they cannot cope. This results in very negative thoughts, feelings of
helplessness and hopelessness and withdrawal into depression

Family or social systems approach (Circular process )
• The person, the group, the family and the community are all interconnected and influence each another. (depression related to combination of factors)

• The person (inherited family factors )
 Person can be ‘predisposed’ to depression. (exists in the family)
 Can inherit chemical imbalances from parents which can contribute to depression.
 Can also inherit certain characteristics from parents that may indirectly lead to social problems later on. For example, levels of intelligence, looks, obesity etc
 Some of these factors could make him or her unpopular or unsuccessful in school or even in his or her career or social life and lead to depression.

• Specific family problems
 Unresolved childhood issues ( negative thinking from the past)
 Not coping with present stress eg (job loss) = sense of hopelessness
 Stress in family relationships ( Bad relationships)
 Marital problems such as physical or emotional abuse, aggression, shouting, fighting
 Family humiliation due to business failure, poverty or a family disgrace.
 Family trauma due to death, divorce
 Alcohol or drug abuse in family

• Social and cultural factors
 Social problems -social isolation (loneliness, poverty, distance from family & friends
 Social and cultural pressures (expectations)
 Community expectations and judgements
 Lack of family or social support (feels isolated and alone)
 Lack of community support (counseling centres, psychologists/social workers, welfare services, rehab centres, church or youth groups, support groups.

• Environmental factors
 Role of environmental stressors (crime, poverty, cost of living)
 Expectations and demands of the type of society (capitalist)
 Advertising : the role of the media (eg thin, perfect bodies and families)

Treatment and coping
• Importance of preventative measures
• Depression is usually related to an accumulation of stress and the feeling that one is unable to cope. This leads to feelings of helplessness, hopelessness and a sense of giving up.
• What you can do to avoid depression
 Build up your coping skills
 Attend programs aimed at problem–solving (coping) and personal growth skills.
 Improve your self-image and self-esteem (build resilience)
 Make necessary changes to your life to avoid unnecessary stress.
Family
• Try to address your family problems early on (not leave to accumulate)
Eg (alcoholism, bad relationships, family violence, abuse)
 Be prepared to discuss your problems with trusted friends
 Make use of social and crisis counseling services to talk through stressful events and situations as they arise
 Also try to communicate within your family to sort out stressful family issues
 Use other community networks to get help (Eg social welfare, religious leaders or other support groups).
Environment issues
• Also address practical problems early on (Crime = increase your security) Poverty –seek employment, cost of living –better budget planning

• The treatment of clinical depression

 If the early steps do not stop the onset of depression, (more than 2 weeks), the person will require professional assistance.
 At this stage it may necessary to involve a psychiatrist, psychologist or at least a registered social worker.
 The family /patient should then act in consultation with the mental health professional and follow their instructions.
 In such cases, a plan of therapy to bring about the required improvement will need to be compiled in consultation with the mental health professional and adhered to.
 This could include medication (anti-depressants) as well as different forms of counseling therapy (Cognitive–behavioural and Interpersonal therapy which may involve the whole family)
 The effectiveness of the intervention will need to be measured over time and the plan adjusted if necessary.

• Coping with depression
Apart from treatment by a professional, a depressed person could assist in their own recovery by keeping a daily journal and focusing on three aspects of their lives, that is, their thinking, their emotions and behaviour.

• Deal with your Negative or self-defeating thoughts
 You can daily challenge your negative thoughts of being a failure, of not coping and of being worthless by disputing them in your mind.
For instance: ‘I am not coping
I am a failure’
‘No one cares for me’
 Consciously affirm present realities in your life which dispute the negative thoughts.
For example:
‘I am not a failure. I have a wonderful family and am a good father/mother’
It is not true that I cannot cope, I have coped with many things in my life’.
‘It is not true that no-one cares for me.’ ‘I have the support of my family and
many good friends.’

• Positive Affirmations
 You can adds to the power of your thinking by affirming new realities in your life and releasing the old negative thoughts and beliefs
For example:
‘I am not a failure’. ‘I am a hard working and dedicated person’
‘I am not helpless’. ‘I am a very valuable asset to my family and company’
‘I was never worthless’. ‘I am worthy of love and happiness’
‘I intend to be the best that I can be’.

• Deal with your Negative emotions and feelings
 Examine the ‘costs’ and the ‘benefits’ of holding onto emotions of helplessness and hopelessness as well as any other unhelpful emotions, to your present peace of mind, health, career and relationships.
For example
Benefits: Withdrawing into these feelings may allow you to avoid facing up to your
problems and bring people in to support you. .
Costs: However, in the long term, this will eventually push people away and will
affect your relationships, social life and career advancement.
Costs: A person who is ‘emotionally crippled’ by depression could have difficulty
finding enjoyment and happiness again. (Is this what you want?)
Costs: These strong negative emotions can also affect your health.

Notice that in most cases, the costs far outweigh the initial benefits.
 Decide that the benefits of holding onto these emotions are simply not worth the costs and consciously try to let go of them. (make a decision)

• You can also choose your thoughts and emotions on a daily basis
 Try to keep your mind relatively clear and at peace at all times. (you may try meditation or other forms of relaxation exercises)
 Consciously choose to immediately release all thoughts or emotions that are unhelpful, self-defeating, or do not require your immediate attention.
 In this regard, you may use simple affirmations, such as;
‘I choose to release these unpleasant thoughts and emotions’.
‘I am simply not prepared to fill my mind with these thoughts or emotions’.
‘I simply do not wish to upset myself with this feeling or issue’
‘I cannot be bothered with this matter at the moment’.
‘I need to focus all my attention on my immediate concerns’.

 Allow potentially unwanted thoughts and emotions to pass through your mind without further processing. In other words, simply do not dwell on them at all.
 Only your thoughts and feelings that are of immediate importance, should receive your focus and attention.
 Try to cultivate a sort of philosophical ‘detachment’ from stressful matters which do not really concern you. This may sound unfeeling, but you are still free to express altruistic emotions such as love and compassion.

(Many of these exercises are contained in my new book Multi-Dimensional thinking)

• Changing your behaviour
 Depressed people usually avoid activity of any kind as well as avoiding people and social situations.
 You should try to become active again by getting involved with a new hobby, a new social group or sports activity.
 Exercise and enjoyable activities such as hobbies have been shown to be beneficial for depressed persons.
 A good balanced diet also helps to reduce stress and make you feel better.
 In my counselling I generally try to motivate people with depression to discover their passion for engaging, creative and rewarding activities such as painting, writing and volunteer work.
 This takes the mind away from negative thinking and feeling and builds a sense of purpose again.
 I also find it useful to support and encourage them in any positive area in which they are achieving. (Motivation)

Sources: Barlow, D.H.& Durand, V.M. (2002). Abnormal psychology: An integrated approach. (3rd ed.). Belmont : Wadsworth/Thompson Learning.