Physical Aspects

DEPRESSION PROGRESSION

I found this diagram very useful in understanding how depression affects us physically. I remember when the doctor told me that I was suffering from depression I was horrified! After all who wants to acknowledge that they have a mental illness. Maybe you reacted the same way. Somehow understanding that it was also a physical illness made it more acceptable. Let me explain this diagram of the Depression Progression to you going anti-clockwise, starting in the top left corner with stress.

STRESS

Depression always starts with stress. It is also associated with loss. Sometimes it is a very real loss like the death of a loved one, or the loss of a job. It can also be an internal loss, like a loss of self-esteem. Stress is not the same for two people. An event that one person might find to be hugely stressful might cause no stress to another. It all depends about how the situation is viewed.

A very important concept in cognitive therapy is that it is not the situation or event that causes stress, but rather what it means to the individual that causes stress.

So when you want to blame someone else or blame a situation for your depression you need to ask yourself what it means to you personally. We have to take responsibility for our reactions to a situation, rather than allowing our moods to be under the control of other people or external circumstances. This is dealt with in more detail in PSYCHOLOGICAL ASPECTS but read the following examples to start understanding the concept.

• Perfectionists are very prone to depression as their standards are impossibly high; they never meet them and constantly feel that they are a failure. The motto for many perfectionists is ‘If you can’t do something perfectly, don’t do it at all.’ Often this fear of failure stops them from even trying, as mistakes are a train smash. This type of thinking is very stressful. Whereas another person sees a mistake as part of life and a part of life’s learning process. It’s okay make mistakes because you can learn from them. After all how else do you learn? Obviously the second person’s thoughts are more based in reality and this type of thinking does not result in stress or depression.
• ‘People pleasers’ are another group of people who are prone to depression as they depend so much on other people approving of them to feel good. This is actually an impossible ideal, places the responsibility for your moods in the hands of others. Also it is impossible to please everyone and every time someone disapproves of you it pushes you into the downward spiral of depression.
• You have two salesmen and neither of them closes a particular sale. The one salesman says ‘On, darn it, I’m useless as a salesman, I’ll never make it, I may as well just give up’. How is this man going to feel? Without a doubt he will feel down in the dumps. Whereas the other salesman who didn’t close the deal might say ‘Well I can learn from that experience. I think I need to polish up on some of my selling techniques so I can do better the next time’. These thoughts won’t pull him into depression.
• You phone an acquaintance, leave a message for him to phone you and he doesn’t return your call. What goes on in your mind? Maybe thoughts like ‘what did I do wrong? He can’t like me if he doesn’t bother to return my call and if he can’t be bothered to phone me – well I won’t bother with him any more!’ These thoughts will lead to a loss of self-esteem and make you feel down. On the other hand your thoughts may go along these lines. ‘I wonder if he got my message, or maybe he’s forgotten as he’s busy. Anyway, let me give him a ring to find out.’ These thoughts won’t lead to depression and internal stress as they are grounded in reality.

I hope you can see that it is the way we think that causes us to feel depressed and stressed rather than the event. Just think about it when you have happy thoughts, you feel happy. When you have sad thoughts you feel sad. Your thoughts determine your mood, not the other way round. The difficulty is that most of us are unaware of our thoughts and our thoughts have become automatic. You can liken it to driving a car. After years of driving I no longer consciously think about changing gear, I do it automatically. However if I were to drive in a country that drives on the other side of the road I would have to be focused on my driving if I value my life.

STRESS LEADS TO DECREASED SEROTONINS

I am not a medical doctor, but I found this diagram useful.

• Thoughts are transmitted in the brain by travelling as an electrical impulse along one nerve and across the synapse to the next nerve.
• A chemical messenger (serotonin) facilitates this move.
• This chemical gets depleted if the person is subject to an excessive amount of stress with no time for the chemical to naturally replenish itself between the stressful events.
• A symptom of this chemical being depleted is the negative thoughts that are a symptom of depression. Basically the thinking process short-circuits and the thoughts are not transferred properly.
• The negative thinking is a symptom that there is a physical illness and the person needs medical treatment to restore the chemical level.

NEGATIVE THINKING

The symptoms of depression are negative thinking. Feelings of being worthless, unlovable, guilty are very common symptoms. For a full list of symptoms see What is depression? The negativity showed by a depressed person might be very uncharacteristic and well-meaning people might tell the person ‘to pull himself together’. Maybe you reprimand yourself in a similar way but it really doesn’t help as there is a physical problem – the brain is ill. It really is ridiculous advice just as would be ridiculous to tell heart patients ‘to pull themselves together’.

IN THE PIT

A person experiencing severe depression often refers to being in the Pit or in a dark tunnel. I wrote this description using the symptoms of depression to try and help people who have never experienced depression to get some sort of idea of what it is like. Maybe you can read it to a loved one who is trying to understand what you are going through.

Ask them to please close their eyes as you read the following ……
Imagine yourself in a dark pit; you don’t know how you got there. You just seemed to land on a slippery slope and down you went. It’s very scary, nothing makes sense, and you can’t see anything. Thoughts bombard you from within, a bit like bats flying round you in a dark cave — you’re worthless, you’re guilty, you’re unlovable, life’s hopeless. You become restless and irritable. You can’t sleep. You’re tired but sleep doesn’t come. Your appetite is gone and you can’t eat. Things that you used to enjoy hold no appeal now you’re in the pit. You try to claw your way out; it’s such a battle — maybe death would be a welcome alternative. It’s very scary and you realize you need help to get out. But this is also scary because it’s difficult to trust anyone — you’ve learnt to be so self-sufficient- people can hurt. You get a grip on the edge of the pit and hope someone will give you a hand and pull you out. Someone does come along and your hopes rise.
People peer over the edge and you hear comments like:

1. What’s your problem?
2. I’m surprised, I thought you were stronger than that.
3. No one ever said life was fair.
4. Pull yourself together.
5. Stop feeling sorry for yourself.
6. There are lots of people worse off than you. You feel yourself loosing your grip on the edge of the pit.
7. You have so many things to be thankful for, why are you depressed?
8. You think YOU’VE got problems…!
9. Cheer up!
10. You need to get out more.
11. Well, everyone gets depressed sometimes.
12. You never think of anyone but yourself.
13. You’re just looking for attention.
14. You don’t LOOK depressed.
15. Maybe you should take some vitamins, or camomile tea for your stress.

All these comments hurt you so much; maybe you were right in not trusting people. Other people come by and see your struggle to get out of the pit maybe these people will help. You hear these words.

1. I love you; let me give you a hand.
2. I do care; let’s go out for a cup of coffee.
3. You’re not alone in this.
4. I’m not going to abandon you.
5. Hey, you’re not crazy!
6. I can’t fully understand what you are feeling, but I’ll try.
7. You are important to me.
8. All 1 want to do now is give you a hug and a shoulder to cry on.
9. When all this is over, I’ll still be here and so will you.
10. It will pass. We can ride it out together.

These comments came from a list I read of the best and worst comments people had been told when they were depressed. I hope this helps in getting your loved one to understand your depression a bit better.

MEDICATION

Medication has come a long way in recent years and has helped many people to lead normal lives. Anti-depressants are not addictive and are not ‘happy’ pills. Tranquillizers are addictive and alter your mood. All that anti-depressants do is make you normal by restoring brain chemicals to normal levels.

We have to accept that the brain too, is just another organ of the body and can get ill. Somehow we can accept all the other body organs getting ill but not the brain. We expect the brain to always work perfectly and it makes recovery so much harder if we don’t accept that the brain can get ill and can need treatment. So, my advice is, swallow your pride, go to your doctor and get treatment.

Anti-depressants don’t take away the knocks that hit you but they will keep your serotonin level normal so that you don’t go into the pit of depression while sorting out your problems. Sorting out the emotional side is very stressful but worth it in the long run. Although there is nothing to be ashamed of in getting treatment and it might be the wisest decision you’ll ever make, be careful whom you tell about your depression. By all means tell a friend who is sympathetic to you but there are many people who might cause you more hurt by their inappropriate although possibly well meant advise.

It will probably take at least two weeks before you start feeling a bit better and find that your thoughts are becoming a bit more normal. Often at this stage people feel so relieved that they are ‘better’ they throw out their pills. This is a big mistake as it is actually the pills that are making you feel better and it won’t be long before you are down the slippery slope to ‘the pit’ again. It’s a bit like being thirsty. A sip of water might take away your thirst for a short time but you need a glass of water to quench your thirst. Likewise your brain needs a full dose of medication to ‘quench its’ thirst’.

Work with your doctor and tell him how the medication is affecting you. You might be lucky with the first medication you get but if you have side effects talk to your doctor, as there will be one that agrees with you. It is very important to have counselling when you are on medication as sorting out what is causing you stress will help towards preventing a subsequent breakdown.
How long must I stay on medication?

The first time you are on medication you will need to stay on for between 6-9 months so that the serotonin level can be properly restored. The second time you are on medication you will probably need to stay on for about a year and after a third breakdown you will possibly need to be on a life long maintenance dose. Don’t despair; rather be thankful to medical science for medication that can keep one normal.
Mixing medication

Do not mix homeopathic or naturopathic medication with pharmaceutical medication as they might have an allergic reaction. I did hear of someone who died from taking a combination of Prozac and St. John’s Wort. I cannot emphasise too much the importance of working with your doctor to overcome your depression. If your doctor does not take your symptoms seriously, find another doctor who is sympathetic to depression. It is an illness that can be treated and there is no need to suffer unnecessarily.
Self-medication

Many people use alcohol, drugs, and some men womanising to self-medicate. All of these are a substitute for real psychological health and it’s really a bad idea to replace depression with one of these other problems. Rather see a psychologist and get to the root of the problem. Many people with an alcohol problem are actually self-medicating for depression. Alcohol initially increases the serotonin level in the brain causing one to be happy. The problem is that the next day the serotonin level drops to an all time low and more alcohol is needed to boost up the serotonin level again.

DEALING WITH STRESSORS

A basic principle in cognitive therapy is that depression or anxiety are caused by your thoughts, so the way to stop the depression cycle from reoccurring when you are under stress again is to change the way you think. An explanation of “cognitive therapy” as well as “Changing your thoughts - step by step” is given in detail in the section called PSYCHOLOGICAL ASPECTS.

SELF ESTEEM

The biggest blow during depression is the loss of self-esteem and sense of self worth. Your confidence takes a down ward plummet. This unfortunately is part of depression. The important thing is not to buy into this idea of having no worth as allowing this type of thinking to take root just makes the situation worse. So the next time the thought comes into your head that you are worthless talk back to that voice – it’s as if we have to get our ‘best friend voice’ within us to counteract this ‘worst enemy voice’ within us.
Our behaviour always matches what we believe about ourselves so if you feel that you are worthless your behaviour will match this feeling so you can imagine how you will come across say for example during an interview for a job that you desperately need.
Everyone has the same worth just because we are created beings with a place on this planet. In this world we so often get our sense of esteem from our looks, our wealth, our status, the type of car we drive or our job position. This really makes no sense. We don’t judge a baby as being worthless because it has a nil bank balance. Nor do we judge someone like Mother Teresa as worthless. She too had none of these worldly things. We just need to look at superstars like Elvis, Marilyn Munroe and Freddy Mercury. They had all the material things the world could offer them but they died lonely, unhappy people.
This concept is well illustrated in the Bible in Matthew 16:26 where it says: What good will it be for a man if he gains the whole world yet forfeits his soul?
Don’t link your self-worth or the worth of others to material things. In the Bible 2 Corinthians 5:16 says: So from now on we regard no one from a worldly point of view. It really will do you no good. Your looks will fade as you grow older and your bank balance may diminish through no fault of your own. Some men have their sense of worth so tied up with their jobs that their sense of purpose is lost when they retire and some die within 6 months of retirement because they have lost their purpose in life.
If you are a Christian base your self-esteem in Christ and what He says about you. You know what it is like when you are so in love with someone that you would rather die than be separated from your loved one? How often do we hear young lovers say they can’t live without their loved one? This is the kind of love that God has for each one of us, a love so deep that Jesus, God the Son chose to die rather than be separated from us for eternity. All we have to do is accept this love gift. Who am I to say that I am worthless, when the Son of God was prepared to die for me? Believing that you are worthless will obviously make you feel depressed.
In the Bible, 2 Corinthians 5:17 it says: If anyone is in Christ, he is a new creation; the old is gone, the new has come! If you have accepted Jesus as your Lord and Saviour this applies to you, you are a new creation. It is the truth. The problem is that you might read this but not believe it to be true for you. An anorexic girl looking into the mirror continues to believe she is fat despite what she sees in the mirror. Despite the evidence she continues to starve herself, as she has not changed her belief to match what she sees in the mirror. As Christians our mirror is the Bible, it is God’s love letter to us. Do we believe what the Bible tells us about who we are? Or do we continue to believe we are worthless and behave in a way that matches this faulty belief? If God says you are a new creation this is the truth despite what you might think or feel.
Improving your self-esteem (a Christian perspective).

The list below describes who you really are and what you enjoy in Christ. You can’t earn these qualities any more than you can earn or buy the rights and freedoms you enjoy as a citizen of the nation where you live. These traits are guaranteed to you by the Word of God simply because you were born into God’s family by faith in Christ. There is nothing you can do to make these characteristics more true of you. But you can make them more meaningful and productive in your life by simply choosing to believe them. One of the best ways to grow and mature as a believer is to continually remind yourself who you are and what you possess as a child of God. The more you affirm who you are in Christ, the more your behaviour will reflect your true identity. Print out this list for easy daily reference.
Who am I? – My identity in Christ

• I am the salt of the earth (Matt. 5:13).
• I am the light of the world (Matt. 5:14).
• I am a child of God (John 1:12).
• I am Christ’s friend (John 15:15).
• I am a slave of righteousness (Rom. 6:18).
• I am a joint heir with Christ, sharing in His inheritance with Him (Rom. 8:17).
• I am a temple, a dwelling place, of God. His Spirit and His life dwells in me (1 Cor. 3:16; 6:19).
• I am a member of Christ’s Body (1 Cor. 12:27; Eph. 5:30).
• I am a new creation (2 Cor. 5:17).
• I am reconciled to God and am a minister of reconciliation (2 Cor. 5:18,19).
• I am a saint (Eph. 1:1; 1 Cor. 1:2; Phil. 1:1; Col. 1:2).
• I am God’s workmanship, His handiwork, born anew in Christ to do His work (Eph. 2:10).
• I am a fellow citizen with the rest of God’s family (Eph. 2:19).
• I am a prisoner of Christ (Eph. 31; 41).
• I am righteous and holy (Eph. 4:24).
• I am a citizen of heaven, seated in heaven right now (Phil. 3:20; Eph. 2:6).
• I am hidden with Christ in God (Col. 3:4)
• I am chosen of God, holy and dearly loved (Col. 3:12; 1 Thess. 1:4).
• I am a partaker of Christ; I share in His life (Heb. 3:14).
• I am one of God’s living stones, being built up in Christ as a spiritual house (1 Pet. 2:5).
• I am a member of a chosen race, a royal priesthood, a holy nation, a people for God’s own possession (1 Pet. 2:9,10).
• I am an alien and stranger to this world in which I temporarily live (1 Pet. 2:11).
• I am an enemy of the devil (1 Pet. 5:8).
• I am born of God, and the evil one, the devil, cannot touch me (1 John 5:18).

Since I am in Christ, by the grace of God

• I have been justified, completely forgiven and made righteous (Rom. 5: 1).
• I died with Christ and died to the power of sin’s rule over my life (Rom. 6:1-6).
• I am free forever from condemnation (Rom. 8:1).
• I have received the Spirit of God into my life that I might know the things freely given to me by God (1 Cor. 2:12).
• I have been given the mind of Christ (1 Cor. 2:16).
• I have been bought with a price; I am not my own; I belong to God (1 Cor. 6:19,20).
• Since I have died, I no longer live for myself, but for Christ. I have been crucified with Christ and it is no longer I who live, but Christ lives in me. The life I am now living is Christ’s life (Gal. 2:20).
• I have been blessed with every spiritual blessing (Eph. L3).
• I was chosen in Christ before the foundation of the world to be holy and am without blame before Him (Eph. 1:4).
• I was predestined, determined by God, to be adopted as God’s son (Eph. 1:5).
• I have been redeemed and forgiven, and I am a recipient of His lavish grace. I have been raised up and seated with Christ in heaven (Eph. 2:6).
• I have direct access to God through the Spirit (Eph. 2:18).
• I may approach God with boldness, freedom and confidence (Eph. 3:12).
• I have been rescued from the domain of Satan’s rule and transferred to the kingdom of Christ (Col. 1:13).
• I have been redeemed and forgiven of all my sins. The debt against me has been cancelled (Col. 1:14).
• Christ Himself is in me (Col. 1:27).
• I have been made complete in Christ (Col. 2:10).
• I have been buried, raised and made alive with Christ (Col. 2:12,13).
• I died with Christ and I have been raised up with Christ. My life is now hidden with Christ in God. Christ is now my life (Col. 31-4).
• I have been given a spirit of power, love and self-discipline (2 Tim. 1:7).
• I have been saved and set apart according to God’s doing (2 Tim. 1-9; Titus 3:5).
• I have the right to come boldly before the throne of God to find mercy and grace in time of need. (Heb. 4:16)
• I have been given exceedingly great and precious promises by God by which I am a partaker of God’s divine nature (2 Pet. 1:4).

My Commitment to Affirm My Identity in Christ

I will continue to affirm my scriptural identity in Christ by reading this list aloud …….time(s) each day between now and …………………………
Reference: Neil Anderson: Victory over the Darkness. Regal Books, Ventura, California

Filed under Uncategorized |