Friday, December 11, 2009

Taking on Depression: The Bottom Line: No Laughing Matter

The need to make a change in order to overcome depression has been the theme of this series. The mind, heart/feelings, and body are the 3-in-1, highly reciprocal triumvirate of the human personality. Change the mind, and the emotions and body respond. Change the body, and the mind and emotions respond. Change the feelings, and the body and mind respond. Therefore, when it comes to depression, there may be a variety of access points to begin to leverage change.

If you are someone who struggles with mild to moderate depression, you may find the strategies described in this series very useful, enlightening, and effective. If you have a persistent moderate depression, and experience difficulty implementing and/or benefitting from these approaches, you should consider “hiring” a good therapist to help you support and focus your efforts to change. In some cases, the use of medication for a period of time can help you get some traction to the point that self-reinforcing behaviors begin to “take,” and for many the need for medication diminishes.

Depression is no laughing matter and should be addressed as early as possible, preventing a more severe decline in mood. A long-standing, severe and entrenched depression is often best addressed as a medical problem, and anti-depressant medication is often necessary, perhaps for an extended period. In such cases, symptom reduction via medication can make it possible to make better use of psychotherapy to address deeper needs, wounds, beliefs, and losses.

Fundamental to these deeper sources of depression are troublesome undercurrent human emotions such as fear and anger. When, despite the discomfort associated with them, fear and anger are consciously experienced and acknowledged, i.e., when you “own” them, as some say, they have less power over you, and offer useful information about your personal experience. You are then able to respond, rather than react, with constructive, responsible, decision-making concerning the situations/conditions that evoked them. In so doing, you are no longer victim; you reclaim and exercise your power.

One of the issues to be addressed in psychotherapy may be what I call an unconscious commitment to depression. Sufferers of long-term depression may be quite aware that they are depressed, may even be quite aware of many of the root causes, but they may be quite unaware that their depression has become a part of their identity, that they are unwittingly clinging to it, trapped by their grief, and by their vulnerabilities and fears of a fuller engagement in life with all its surprises, disappointments, and responsibilities. When this is the case, they may refer to their depression as “my depression,” see themselves as defined by their depression, and anticipate feeling quite lost without it. They may doubt their capacity to even imagine feeling truly good, truly alive. No wonder depression can be, for some, so insidious and tenacious!

Depression can have an insidious affect on loved ones as well, as the sufferer of long-term depression may also unwittingly hold and subtly communicate an expectation that others understand and be complicit with their limitations. However, for others to take responsibility for, or somehow participate in the depression, only serves to generate guilt and resentments that tend to feed and “spread” the depression. The challenge for family members and friends is to offer compassionate acceptance and support without infantilizing or buying into the loved one’s incapacitation, and to insist that the depressed person obtain treatment. To curtail their own enjoyment of life in any way, or succumb to guilt for being happy or having fun when their loved one may be miserable is a type of co-dependent behavior that serves no one, especially not the depressed person. It is therefore important that family and friends take care of themselves and allow themselves as full a ration of fun and enjoyment as possible.

There ought to be no shame in suffering from depression, and no stigma for seeking help. Depression is part of the human experience, and severe depression is now recognized as a treatable medical condition. Combination therapy that may include medication, psychotherapy, and use of techniques such as those offered in this series are generally quite successful and offer the participant valid hope for change and the prospect of becoming more happily and gratefully engaged again in life.

When you take on depression, you are taking on a challenge; the longer and deeper the depression, the greater the challenge. Whether you struggle with a low grade, a moderate, or a severe depression, you can overcome it with persistence, determination and patience. Strive for progress, slow steady progress, and take it one day at a time, employing at least one strategy every day, starting as early in the day as possible. Keeping it in the day, so to speak, can help free you from the failures or regrets of the past (and we all have them) and protects you from anxieties about the future.

For many, overcoming depression, whether accomplished through self-help strategies or with professional help, is a learning, letting go, and self-acceptance process: learning how to be happy, letting go of (or becoming reconciled with) those conditions or parts of yourself that have held you back, and embracing yourself with compassion and humor.

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