Depression and anxiety are a common human condition. About 10% of people suffer from this, from high flying professionals to teenage students. It is even more common in the elderly, with about 40% of those over the age of 65 years suffering with the symptoms that are often not recognised or diagnosed.
Many people and those around them “miss out” on fulfilling lives because of undiagnosed depression
Everyone understands that feeling of being overwhelmed, of not coping, having that sense of dread, a feeling of impending doom. Usually we can pinpoint the cause of the feeling: work pressure, busy children, financial problems, relationship problems and so on. For a short while we cope with a “fight or flight” response. We can gather our strength and push through to fix the problem and get the job done. This is usual, and allows us to cope and even to achieve things beyond our expectations.
However, sometimes the problem or difficult situation is enduring. We dig deep into our reserves and beyond becoming ever weary. We have difficulty in sleeping, wake up feeling tired, start feeling irritable over inconsequential things and become tearful. These are early signs of burnout and if they endure clinical depression develops – a sense of alienation, loneliness and sadness, we are unable to plan or prioritise things, we argue with those around us and even strangers, we have a sense that everything is difficult, we lack a sense of pleasure from things that we’d normally enjoy and our libidos disappear. We have a sense that something terrible is about to happen all the time but can’t place what it is that causes us to feel that way. And for those unlucky few, these feelings develop without an obvious cause. In most cases, these feelings develop over a period of time that makes it difficult for us to feel the subtle changes or for those around us to see the changes in us, until there is some precipative event – a major problem at home or at work for example.
At the root cause of these feelings of being overwhelmed is diminished neuro-chemicals like serotonin, dopamine and noradrenalin. Over time this deficiency causes some of the brain structures to change shape. Fortunately, these structures can “snap” back into shape again with the correct management by a process called neuroplasticity.
Nature has instilled in us two basic survival techniques, namely self-rescue or maladaptive coping
Self-rescue
- This is a positive, proactive approach to address the underlying problem
- Recognise that you have problem and give yourself some space.
- Let someone (a friend, your spouse) know that you are in difficult place. You’ll be surprised by their relief and by their desire to help you.
- Exercise 3-4 times a week to get your heart rate up, sweat and feel short of breath for about 30 minutes
- Stick to a daily basic routine that includes some pleasurable activity.
- Avoid excessive alcohol
- Avoid illicit drugs
- Don’t make any major life decisions
- If you are waking up in the early hours of the morning, feeling irritable and emotional all the time, seek professional help.
Maladaptive coping
- This is a negative, destructive approach to avoid addressing the underlying problem
- Blaming others or circumstances to avoid taking ownership and control of the problem
- Retreating from day to day activities and responsibilities
- Using illicit drugs or consuming excessive alcohol
- Unhealthy eating and not engaging in regular exercise
- Engaging in unhealthy activities to distract our attention
I try to assist with an approach that looks at re-balancing the pre-frontal cortex (the modern ‘thinking” part of our minds) and limbic system (the “fight or flight” part of our minds) using appropriate cognitive therapies and medication where appropriate, working with psychologists and specialists when needed. A regained sense of “purpose and place” in our home, work and social settings leads to a more fulfilling life.
I recommend this video by Dr Alan Watkins https://www.youtube.com/watch?v=q06YIWCR2Js
You can assess your psychological load using the CES-D Scale below. Consider professional help for scores >19 .
CIRCLE EACH OF THE FOLLOWING STATEMENTS THAT BEST DESCRIBE HOW OFTEN YOU FELT THIS WAY DURING THE PAST WEEK (7 days).
| DURING THE PAST WEEK | RARELY OR NONE OF THE TIME (LESS THAN 1 DAY) | SOME OR A LITTLE OF THE TIME (1-2 DAYS) | OCCASSIONALLY OR MODERATE AMOUNT OF THE TIME (3-4 DAYS) | MOST OR ALL OF THE TIME (6-7 DAYS) | |
| 1 | I WAS BOTHERED BY THINGS THAT USUALLY DON’T BOTHER ME. | 0 | 1 | 2 | 3 |
| 2 | I DID NOT FEEL LIKE EATING. | 0 | 1 | 2 | 3 |
| 3 | I FELT THAT I COULD NOT SHAKE THE BLUES EVEN WITH THE HELP OF FRIENDS AND FAMILY. | 0 | 1 | 2 | 3 |
| 4 | I FELT I WAS JUST AS GOOD AS OTHER PEOPLE. | 3 | 2 | 1 | 0 |
| 5 | I HAD TROUBLE KEEPING MY MIND ON WHAT I WAS DOING. | 0 | 1 | 2 | 3 |
| 6 | I FELT DEPRESSED. | 0 | 1 | 2 | 3 |
| 7 | I FELT THAT EVERYTHING THAT I DID WAS AN EFFORT. | 0 | 1 | 2 | 3 |
| 8 | I FELT HOPEFUL ABOUT THE FUTURE. | 3 | 2 | 1 | 0 |
| 9 | I THOUGHT THAT MY LIFE HAD BEEN A FAILURE. | 0 | 1 | 2 | 3 |
| 10 | I FELT FEARFUL. | 0 | 1 | 2 | 3 |
| 11 | MY SLEEP WAS RESTLESS. | 0 | 1 | 2 | 3 |
| 12 | I WAS HAPPY | 3 | 2 | 1 | 0 |
| 13 | I TALKED LESS THAN USUAL. | 0 | 1 | 2 | 3 |
| 14 | I FELT LONELY. | 0 | 1 | 2 | 3 |
| 15 | PEOPLE WERE UNFRIENDLY. | 0 | 1 | 2 | 3 |
| 16 | I ENJOYED LIFE. | 3 | 2 | 1 | 0 |
| 17 | I HAD CRYING SPELLS. | 0 | 1 | 2 | 3 |
| 18 | I FELT SAD. | 0 | 1 | 2 | 3 |
| 19 | I FELT THAT PEOPLE DISLIKED ME. | 0 | 1 | 2 | 3 |
| 20 | I COULD NOT GET GOING. | 0 | 1 | 2 | 3 |