Depression: an alternative discussion
With mental health slowly getting the consideration it deserves, several interested parties have produced data over the past 10+ years to try to understand how such illness impacts us common folk. Studies have been undertaken by Statistics Canada, the World Health Organization, and the Canadian Mental Health Association to name a few. The results have produced evidence supporting the same trend; that the number one cause of disability in Canada for people ages 15-44 is depression (Institute for Mental Health Metrics, 2015).
Depression is a widely used term, and often misunderstood.
For starters: biological vs. situational depression.
Biological depression may be genetically inherited or caused by dysfunctions and mutations in the patient. Situational depression still causes chemical changes within the brain’s neurotransmitters, but is brought about by the patient’s situation; a life altering event (a divorce, death or financial crisis), lifestyle (drug and alcohol use, obesity, poor nutrition), or perhaps cognitive distortions (perfectionism, low self esteem, trouble with body image) (Joffe et al., 1993).
Regardless of the ‘cause’ or triggering event, the manipulation of these neurotransmitters distorts how the brain receives and interprets information. There is no “one-off” answer as to the “cure” for depression. Most often, a variety of therapies are trialed and continued at the discretion of the patient; medication and therapy being the primary interventions.
I’m here to share a controversial opinion: you might not always need medication and therapy - especially right away.
It seems counter-productive for a therapist to potentially not recommend therapy. In many cases, even when there is a biological cause, therapy can be extremely beneficial. I personally have seen the tremendous, life altering benefits of therapy; both as a client and as a practitioner. Therapy brings in an objective third party in to maneuver these huge emotions, help to build healthy coping skills and provide productive feedback. Some things a client shares in therapy they may have never said aloud before which in itself can be very cathartic. In it’s essence, therapy is a form of personal growth work and self care. When nothing else seems to be working, a professional is a great sounding board for bridging gaps that you might not know you don’t know about.
The catch 22: if you haven’t tried anything at home, your therapist is likely going to recommend starting there.
It sounds like a cliché, but if we act depressed, we are more likely to feel depressed. It’s also important to note that feelings are subject to change. Getting into the habit of identifying too much with our emotions is a tricky spot to be in as we simply EXPERIENCE our emotions and are not defined by them.
Sometimes having a day in your pajamas to hang around the house is restful and refreshing. When that turns into a lifestyle, your motivation to move out of that sedentary place is likely to plummet.
If you’re filling your body with empty calories and depriving it of the essential fuels it needs, you’re not creating the optimal environment for brain functioning. Your stomach and gastrointestinal tract is unlikely to be too happy with you either, and this system is like a second brain (Makris et al., 2020). “Garbage in, garbage out” I think the saying goes. This was the foundation for my Masters thesis work, hence the slight (!) urgency towards this single idea.
If you’re filling your mind with toxic information and images on the internet all day - guess what - this too is a perfect storm. Social media is a breeding ground for comparison and injuries to our self esteem. When we ourselves are feeling isolated, spending time on social media has been shown to INCREASE feelings of loneliness (Yang, 2016) not increase connectedness. Obsessively checking news or tracking pandemic numbers has never once made one of us feel merry.
The point is: our lifestyle habits have an enormous impact on how we feel. We can look at the “Cycle of Depression” model (Unutzer and Park, 2012) to explain:
A visual model of: I am in pain, I act out the pain, it creates more pain.
A common response to this is some variation of: “but I’m depressed. Fresh air and exercise won’t fix that. It’s a mental illness”. This argument has some merit and also lacks some. Improving one’s lifestyle won’t necessarily fix all the neurochemical imbalances in a depressed brain and put all transmitters back into ratio. But it can certainly help (Saris et al., 2014) even when the source of the illness is biological and not situational. With introducing habitual changes, we can stimulate the correct production of said neurotransmitters- easily another blog spot in itself.
An exercise I often do when I hear this language among clients is to have them reframe it and repeat it out loud the alternative way “ ____ is very hard for me.” This is the actual truth. Change is not impossible. What these people are experiencing is simply very difficult.
A comparison we could make is that an overweight person with hereditary rheumatoid arthritis in their knees didn’t necessarily cause the condition, but suffers a great deal anyways. Part of their condition is (miserably) genetic. Losing weight would not resolve their arthritis, but I’d bet a nickel it would relieve some undue pressure on those joints and make moving around easier for them. Eventually, they are able to do more work with less effort than they originally had to exert for the same outcome.
It is a complex rarity to be healthy in one’s mind if their body is not also healthy. If we can take away just the basics from this dissertation, it would be that the mind and body are complexly connected. Depression itself is intricately complicated. Depression takes advantage of this fact and misleads many victims into thinking they are helpless. The truth is, we must make change to feel a change. Painful? Often. Worth it? Most assuredly.
Still not convinced? Call me.
Global Burden of Diseases, Injuries, and Risk Factors Study (Rep.). (2015). Institute for Health Metrics and Evaluation.
Joffe, R. T., Levitt, A. J., Bagby, M., & Regan, J. J. (1993). Clinical Features of Situational and Nonsituational Major Depression. Psychopathology, 26(3-4), 138-144. doi:10.1159/000284813
Makris, A. P., Karianaki, M., Tsamis, K. I., & Paschou, S. A. (2020). The role of the gut-brain axis in depression: Endocrine, neural, and immune pathways. Hormones. doi:10.1007/s42000-020-00236-4
Sarris, J., & O’Neil, A. (2016). Lifestyle Medicine for the Prevention and Treatment of Depression. Lifestyle Medicine, 281-289. doi:10.1007/978-3-319-24687-1_25
Unützer, J., & Park, M. (2012). Older Adults With Severe, Treatment-Resistant Depression. Jama, 308(9), 909. doi:10.1001/2012.jama.10690
Yang, C. (2016). Instagram Use, Loneliness, and Social Comparison Orientation: Interact and Browse on Social Media, But Don’t Compare. Cyberpsychology, Behavior, and Social Networking, 19(12), 703-708. doi:10.1089/cyber.2016.0201