The amount of times I have heard people say to me “I’ve just never felt like I am bad enough to see a psychologist”. Struggling in silence for years because there “are people heaps worse than me out there”. Not wanting to bother those around them with their troubles or worries.
Despite some great awareness campaigns out there such as ‘R U OK? Day’ we still hesitate to talk about what is going on in our lives. This brings to mind two things that I want to share with you.
ONE: anytime is a good time to talk.
Let me say that again: anytime is a good time to talk. Whether you meet the diagnostic criteria for depression (which we will get to in a sec) or not – talking helps. It can be useful for gaining a better understanding of your situation, it can help you feel supported and assist you in processing what is happening in your head.
When you get out of your head and talk aloud, you can begin to feel less trapped in a cage.
Still don’t believe me? Then try this: depression is an illness that can get worse if left untreated.
Remember that everyone feels sad or down sometimes, especially during tough times. Feeling sad or upset is a normal reaction to difficult situations. Talking about it can help you move on rather than letting these feelings linger and end up impacting the quality of your life.
Anyone who tells you it is a sign of weakness is full of it. In fact, there is nothing but strength in opening up and allowing yourself to be vulnerable. It takes courage to be willing to experience whatever comes with talking to someone. To be willing to feel fear of judgement and anxiety. Charging towards these emotions rather than running from them.
If you don’t have someone in your life that you can go to, reach out to the supports around you. There are Men’s Sheds, GPs (who can refer you to a psychologist, some of whom bulk bill), online help (such as Beyond Blue), LIFELINE (13 11 14), apps (such as Mind Compass by the Black Dog Institute), the list goes on. You can also jump in with the barefoot community and get some useful info straight into your mailbox (click here).
TWO: empower yourself with education.
Like many things in life, the more you know about it the less overwhelming it can seem. It can also help to normalise what you are going through and help you to deal with your experience in an optimal way.
This ties into another question I often get asked: “How do I know if I am depressed?”
Ok. Are you ready?
To begin with, there is a chance that you or someone you know is experiencing depression. A 20% chance actually, as depression affects one in five Australians.
While those who meet a diagnosis of depression need support, I want to add a little caveat here:
I think the people who just fly below the radar, who just miss the criteria and yet still experience the swings in negative mood and emptiness, who for the most part bounce back rather spontaneously, make up a part of our communities who miss out. This is a group who go along thinking they are not bad enough to reach out. The guys and girls who live with transient depression (my term for it).
Because it tends to pass on its own, there is less emphasis on learning skills to be proactive rather than using the passage of time as their go-to strategy. I want to connect with these individuals, hold you kindly by the shoulders and gently say “Talk about it. Chat with a friend. Get it out of your head”. The ideas that can help someone who has been diagnosed with depression will absolutely help you reconnect with your life and rekindle some joy. Some hope.
Ok, where were we? Ah-ha! That’s right – what is depression…
While we all have the capacity to feel sad or low (which is still a good time to talk, remember?), but depression is more than this. People with depression can have these overwhelming and often intense feelings for weeks, months and even years.
From a traditional clinical point of view, a Major Depression diagnosis relies on someone having a depressed mood and / or a loss of interest in daily activities for more than two weeks. They also need to meet five (or more) of the following criteria during that period of time: significant weight loss or weight gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue or loss of energy, feelings of worthlessness or excessive guilt, poor concentration or indecisiveness, and recurrent thoughts of death or suicide.
Phew. That’s a mouthful. But we are getting there.
When breaking this down even further, current trends in models of depression suggest that there are three subtypes: psychotic, melancholic and non-melancholic depression.
Psychotic depression makes up about 1% of those with clinical depression. This is characterised by a severe depressed mood, psychomotor disturbance (think retardation or agitation) and psychotic features (such as delusions and hallucinations).
This is an extremely severe form of depression, with research suggesting effective treatments are physical and biological (think antidepressants and Electroconvulsive Therapy in some cases).
Melancholic depression makes up about 9% of those diagnosed with depression. For these individuals you would be experiencing a severely depressed mood and psychomotor disturbances (but no psychotic features).
If this is you, anti-depressants are usually required here (although the range of effectiveness for different ones tends to be very wide). Unfortunately psycho-therapy and counselling are not appropriate as stand-alone therapies in melancholic depression, although they can be used in addition to medication.
Finally, non-melancholic depression makes up the remaining 90%. Clearly the majority of people diagnosed with depression fall into this category. Here you would notice you have a depressed mood that lasts more than two weeks and is affecting your ability to function in important areas of life such as work or at home. No psychomotor disturbances or psychotic features are evident here.
The good news is that psycho-therapy and counselling can be used as the primary treatment therapy here (and this is where the transient depressed group can share strategies). Talking about your situation, gaining perspective, problem-solving, reframing the way you think, noticing your thoughts, planning for enjoyable activities, regular exercise, nutrition, improving the quality of your relationships, connection with values and matching actions…. The list goes on and on.
So how do I do this? An important step is to find a psychologist or counsellor that you click with. Just as you find there are some people in your day-to-day life you get along with, it’s the same with finding a therapist. Take your time to find someone you like. Check out their website, listen for word of mouth ideas, look around. If you don’t get along – say so and move on. It is your life, you know?
There is also plenty really cool research out there around the effectiveness of a regular mindfulness practice in managing depression (and preventing relapse). Did you know that they have discovered that mental training practices such as mindful meditations can actually change our brains both functionally and structurally? Think about how awesome that is – we can actually use our own minds to change our brains! What is even cooler is that research is showing that those changes can help to cultivate a greater resilience to stress and worries in our lives. If you want to try out a mindful meditation for yourself, subscribe to our mailing list and I’ll send a 10 minute mindful meditation with yours truly. That way you can dip your toe in a give it a go for yourself.
So in summary:
If you think you’re not bad enough to talk with someone, then that is actually a cue for you to talk with someone.
And if you notice any of the symptoms listed above, guess what? It means there are many other people out there like you who are going through tough times. You’re not alone and it’s important to reach out. And there are things you can do to get back on track. Now you know what signs to look out for so you can get in early and cut off depression at the pass. Remember, it is like a skin cancer – the earlier you get it treated the better the outcome.
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