Beyond the Blues: Depression Decoded, Your Ultimate Guide to Overcoming Depression
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دکتر ترانه موذنی
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Although depression can be a natural emotional reaction, and few people have not experienced this condition at some point in their lives, if it is prolonged and severe, it is definitely considered a disease. For example, when you lose a loved one, you become depressed, cry and wail severely, and may lose your sleep and appetite. When a relationship breaks down and ends, we may experience trauma, cry, not eat, become angry and irritable, our sleep is disturbed, and finally, we become anxious and irritable. Usually, this condition disappears after a few days, and we return to normal life. In such situations, we say that we were depressed or sad or heartbroken.
But this low mood is not what doctors call depression. They use the term depression to describe a much more severe condition that affects a person for at least a few weeks and affects their body and mind. This condition may occur without any cause and can sometimes threaten a person’s life. There is no specific sign that indicates whether you are just sad or have developed depression. Many of the symptoms of these two conditions are similar. Although when you are depressed, the symptoms worsen and last longer.
It can be roughly said that if your sadness or low mood has affected all aspects of your life, lasts for two weeks, or leads you to the point where you think about suicide, you should look for a solution.
Anxiety, which is another emotional state, although it is also observed alone, in many cases attacks a person along with depression, and in fact, in many types of depressive disorder, anxiety also exists.
Recognizing the Symptoms of Grief
The very important question is: Are you depressed or just sad?
The answer to this question is very important. We have all experienced grief and sadness. Bad days and depressed moods from time to time. Feeling sad is not the same as feeling depressed. Therefore, it must first be determined what natural sadness is and how it is distinguished from depression.
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What exactly is sadness? Sadness can be defined as: spiritual longing or suffering, without any physical pain, which can include experiencing the death of a loved one or feeling sympathy with our loved one who is ill. For example, a mother who sees her child’s suffering, despite not having any physical pain, suffers and experiences grief and sorrow. When we are sad, our emotions are expressed through crying, talking, or constantly thinking about our grief and sorrow, and it may be difficult for us to eat, sleep, or concentrate.
Sadness is characterized by feelings of grief and sorrow, and this is the opposite of numbness and indifference, which is the main feature of depression.
The problem is that it cannot be exactly determined what can be the beginning of grief and sorrow. For example, when we see that our life or our conditions are not progressing and improving, and we are even declining, our sorrow may take shape. Stagnation or seeing that our life is getting worse instead of getting better is a condition that causes suffering and sorrow. As a human being, we seek basic needs such as security, food, shelter, and love, and we try to bring them closer to reality. But when the events and conditions of our lives become an obstacle to our spiritual-psychological growth or our existential reality, we suffer and feel sad.
Grief vs. Depression
Grief begins in a period for often external reasons and then ends, while depression continues. This is the way you can tell if you are just feeling sad and grieving or are really depressed. Feeling grief and sorrow in many situations is certainly normal and common. The symptoms of grief are often similar to the symptoms of depression, you cry, you cannot sleep, but over time you return to normal, and the grief and sorrow end. This does not mean the problem has disappeared. You just manage to handle it well with the right support. You may need to talk about your problem with friends or family members and help the issue become less and less important every day. Having a bad day or even a bad week while being naturally happy and enjoying life does not indicate that you are depressed.
While feeling the loss of the ability to be useful and efficient all day and every day for at least 2 weeks can be a sign of depression.
Symptoms of depression may vary from person to person and include all or some of the following:
- Feeling of sadness or boredom
- Sleep problems
- Frequent awakenings in the middle of the night
- Lack of energy and feeling tired and listless
- Changes in appetite (usually loss of appetite)
- Difficulty concentrating, making decisions, and thinking
- Losing the desire and interest in something that was previously enjoyable, such as sex, an activity, or a hobby
- Anxiety attacks or morbid fear
- Obsessive attention to negative experiences and thoughts
- Feelings of guilt, worthlessness, hopelessness, or helplessness
- Restlessness and irritability
- Thoughts of death or suicidal thoughts
Checking the Biological Factors of Depression
If you are suffering from symptoms that seem to be signs of depression, be sure to see your doctor and make sure that there are no physical reasons mentioned below.
- Chronic fatigue syndrome
- Thyroid disease
- Sleep disorders such as narcolepsy or sleep apnea
- Side effects of some medications
- Hepatitis
- Seasonal depression
- Obesity-related numbness and fatigue
- Lyme disease
- Sexually transmitted diseases such as AIDS or syphilis
- Anemia (anemia), fatigue is often one of the signs of anemia, which in women can lead to heavy bleeding during menstruation.
- Symptoms of delayed behavior and psychomotor retardation can be an allergic reaction to eczema, pain, and fatigue. (Foods and environmental toxins can be the initiating factors of allergy)
In this article, my effort will be to first explain this important psychological disorder and mention the symptoms that everyone should know to diagnose the disease in themselves, and then I will show you step by step how you can help yourself even without taking medication and visiting your doctor and get rid of the clutches of these devastating psychological states.
Of course, if these unpleasant conditions are very severe in you, so that, for example, you have suicidal thoughts, or the severity of the disease has made you fall out of work, life, and social relations, or you have accompanying symptoms such as severe insomnia and loss of appetite, inability to enjoy recreational activities and feelings of guilt, you most likely need to see a specialist. Remember that depression is a treatable disease, and your condition will improve over time.
Interesting Facts about Depression:
- At least one in five adults will experience depression during their lifetime.
- In Iran, about three million and five hundred thousand cases of depression are diagnosed annually in the offices of psychiatrists and psychologists.
- On average, every general practitioner sees one depressed patient daily, and every psychologist sees two depressed patients weekly.
- Many famous people suffer from depression, such as Abraham Lincoln, Queen Victoria, and even Winston Churchill, who called depression his “black dog.”
- Depression affects all age groups.
- According to studies, women are twice as likely as men to suffer from depression, which is largely due to genetic predisposition, brain structure, and women’s rumination on this issue.
- Research has shown that the prevalence of depressive disorder in Iranian society is very high, and approximately 12 out of every 100 people suffer from clinical depression, which requires referral to mental health professionals, including psychiatrists and clinical psychologists.
- Mild symptoms of depression require prompt attention to prevent its progression.
By reading this article, find answers to your questions in the following cases:
- Is depression treatable?
- Interesting facts about depression
- Causes of increased depression in today’s world
- What is depression?
- What are the psychological symptoms of depression?
- What are the physical symptoms of depression?
- What are the characteristics of depressed thinking?
- What is smiling depression?پ
- How to implement depression treatment
- Stages of depression treatment
- What to do when our mood is low?
- An excellent homework assignment to deal with depression
- What are the traps of depression?
- Important points for the treatment of depression
Causes of Increased Depression in Today’s World
In the past 40 years, the rate of depression has increased dramatically, and this increase may be due to the way we have lived in recent decades. For many people, the world is becoming more and more stressful, and stress can lead to depression. The increase in divorce rates, crime, long working hours, and high unemployment rates are just a few examples of factors that increase the pressure of life in vulnerable people.
Where you live can also contribute to the likelihood of developing depression. One study has shown that the probability of developing depression in those who live in the central parts of large cities and away from nature is twice as high as those who live in small towns.
The good news is that regardless of the cause of depression, this disease is treatable. Many people who suffer from depression and receive treatment recover.
What is Depression?
Depression is a mental and physical illness, and often depressed people have both physical and mental symptoms. But these symptoms vary from person to person. The symptoms of each person’s illness are more or less constant throughout their illness. Some people do not experience any symptoms, but they develop unusual behavior. For example, a person who was previously very committed to principles and rules develops impulsive behaviors after developing depression, including stealing from stores.
What are the Psychological Symptoms of Depression?
Although depression has become a common term today, remember that not all depressed people become sad, some become agitated, some become numb and listless, and some do not experience any mood changes, but instead suffer from physical pains and complaints and behavioral changes that after visiting a doctor, no reasonable scientific justification other than depression is found for them.
Low Mood:
Low mood or the feeling of constant and excruciating sadness that you experience during depression is much worse than the feeling you get when you are disappointed and bored. When you experience such a mood, you constantly feel discomfort, emptiness, failure, anxiety, and restlessness. Some say that depression is like a black cloud that covers the sky of your life and casts a heavy shadow of blackness on all parts of your life.
Diurnal Variation:
In moderate or severe depression, sadness is often more severe in the morning and gradually decreases throughout the day, although it never disappears. This phenomenon is called diurnal variation.
Anhedonia:
Sadness makes you not enjoy anything. You may lose your interest in your previous hobbies and ultimately nothing will make you happy. This situation is called anhedonia. In some milder depressions, sadness worsens in the evening. If your depression is mild, there is a possibility that you will still enjoy being with others, although the companionship will soon discourage you again because it cannot create any motivation or enthusiasm in you. During sadness, a person’s tendency to cry increases and they cry spontaneously with the slightest discomfort or no particular discomfort.
Anxiety and Agitation:
Some depressed people wake up in the morning with severe anxiety because they are terrified of facing a new day. Restlessness and anxiety are their constant companions. Anxiety in such a situation may precede the symptoms of depression and become a more lasting complication. When you are anxious, you become more irritable and aggressive, and tolerating such a situation is as difficult for yourself as it will be for those around you.
Emotional Numbness:
Some severely depressed people say they feel like they have completely lost their emotions. This is one of the most distressing symptoms of depression. You have no feelings, you cannot do anything. It is as if no tears or emotions remain for you. You do not feel yourself a part of your surroundings and you may not even have any feelings for many people who are closer to you, such as your spouse, family, or children.
Depressed Thinking:
A person suffering from depression changes the way they think in a completely tangible and perceptible way. They see the world in a different way, and everything takes on a negative appearance. Such a view in itself can be a trigger and reinforcement of depression. In such a situation, the person blames himself for the misfortunes of life, but does not give himself any value or credit for the positive performances he has. Good deeds are forgotten and attributed to luck and fortune, and bad and inappropriate deeds are always clearly remembered, embellished, and attributed to constant internal causes. The depressed person, due to selective attention, only focuses on negative details and is unaware of positive generalities. They may also make hasty conclusions and from single events with partial and hasty observation, reach general negative conclusions.
These negative thinking patterns ultimately lead to anxiety, decreased self-esteem, feelings of worthlessness, inadequacy, and shame for the depressed person. In this way, the person’s world becomes full of self-deprecating, anxious, and sad thoughts, and not only will they become more depressed and nervous, but this vicious cycle will continue.
What are the Characteristics of Depressed Thinking?
Depressed thinking causes a person to see the world through dark glasses. There are three important factors in negative thinking:
- Negative Thoughts: (For example, I am a useless and incompetent person in my work.)
- High and Illogical Expectations: (For example, I can only be happy if everyone loves me, or I must be successful in my job.)
- Incorrect Thinking: For example:
- Hasty negative conclusions
- Focusing on the negative details of issues and neglecting the positive points
- General conclusions based on various and irrelevant events
- Blaming yourself for issues and events that have nothing to do with you (self-referencing).
Concentration and Memory Problems
A depressed person finds it difficult to concentrate on important issues around him and follow the flow of his thoughts. Weakness of concentration makes it difficult to retrieve memory, and usually these two complications (weakness of concentration and memory impairment) occur together. It also leads to inattention and hesitation in decision-making and may even create a feeling of confusion and disorientation. These problems in a depressed person can be so severe that they are mistaken for dementia.
Suicidal Thoughts
A deeply depressed person considers his past full of mistakes, losses, and the present time painful and unbearable, and he is also terrified of the future. In such circumstances, some depressed patients come to the conclusion that life is not worth living or that others will have a better life without them and that they should end their lives. Most depressed people think about suicide, even if it is a very fleeting thought. Many of them do not actually attempt suicide, but they go to bed at night with the hope that they will not wake up the next morning and thus be relieved of the torment of living.
What are the Physical Symptoms of Depression?
Depression can also have physical complications. Those who experience these complications often imagine that they have a physical illness because they constantly feel pain, have digestive problems, and are always tired and weak.
Sleep Disorders:
Sleep problems are very common in depressed people and can be somewhat related to the constant feeling of fatigue that the person feels. If you have moderate or severe depression, you may wake up very early in the morning and not be able to sleep anymore. All depressed people have trouble falling asleep because they are constantly worried and agitated. They may experience insomnia and are deprived of having a long sleep that enters stages 3 and 4 of deep sleep.
Decreased Appetite:
A depressed individual may experience severe weight loss, and eating food may be a difficult and unpleasant experience for them. They may not even feel hungry at all.
Psychomotor Retardation:
Doing anything is a great effort and struggle for a depressed person. Their speech is slow, monotonous, and devoid of emotion, and even movements may follow a fixed and slow pattern. Even sometimes the functions of the body become slow, so that their saliva dries up or they suffer from constipation. In some women, the menstrual cycle is stopped or becomes irregular.
Sexual Desire:
Many depressed people have no desire to have sex because they are emotionally interrupted and feel that they are unable to establish a lovely physical relationship. Psychological problems can lead to physical problems. For example, men’s penises do not have an erection, and women’s vaginas become completely dry, and intercourse will be a painful experience for them. Many depressed people, without knowing it, have no desire to have sex.
What is Smiling Depression?
Depression is not always characterized by low mood. Smiling depression is a type of depression in which a person does not have proper social and communication functioning, experiences excessive sleep or overeating, and visits a doctor with symptoms such as physical pain such as headaches, which ultimately leads to the diagnosis of one of the types of depression for him.
How is Depression Treatment Implemented?
In general, depression often occurs as a result of not having or feeling of not having, being deprived and not benefiting. In times of depression, the person should determine which of the following items in the present moment and in their current life are considered lost or limited.
- Physical activities such as walking and exercise
- Friendship relations, joint social activities with friends and relatives
- Being with family and spouse on occasions and family gatherings
- Having a goal or meaning in life
- Enjoyable activities and hobbies in solitude (having rich solitude)
- Nature tourism and being in contact with nature
- A job or purposeful activity
- Music, art, creativity
With a feeling of deficiency, it is not surprising that you become depressed in a number of the above cases. It is natural to feel bad when life is not satisfying and to do daily tasks to a lesser extent due to problems caused by depression such as psychomotor retardation or weakness in concentration or memory.
You can think of it this way: depression is a sign or warning from the brain and body to warn us about the problems in the current life. A sign that shows that you need to make changes in your current lifestyle to reach an acceptable level of efficiency. One part of this is finding again the sources of well-being that have been lost.
These activities are followed up in the behavioral activation program for a depressed person.
Identifying the Sources of Trouble, Grief, and Stress
Feeling sad and low mood is natural. Depression is considered a response of vulnerable people to despair and failure. Response to losses such as bereavement, failure in relationships, being abused and harassed, discrimination, humiliation or criticism, stresses related to illness or physical pain or worry about health, economic issues, housing, security, and job.
Is it possible that some of these sources of trouble play a role in your depression? Mark next to the items that apply to you.
- Being criticized or abused or humiliated at home
- Being criticized or abused or humiliated at work
- Loss or failure in emotional relationships
- Loss or problems in the work environment
- Constant financial problems
- Health problems with a hereditary background or chronic illness
- Housing problems
- Family problems
If you have a serious loss or important concern in one of these areas, your feeling of sadness is somewhat understandable. When you feel depressed, it is difficult for you to solve everyday problems, so part of the behavioral activation program will be devoted to problem-solving skills to use it when needed
In some cases, depression may occur without the presence of these events, which we will discuss later.
What to Do When Our Mood is Low?
When our mood is low or we are under life’s pressures, we lose our motivation and energy. It is natural, when things are not going well, to distance ourselves from problems and hide ourselves. It is clear that we try to protect ourselves from things. But this
exacerbates the problems. This coping style to ignore depression intensifies the symptoms and is called “depressive behaviors.”
Which of the following do you do when you are depressed?
- Isolation and distancing from others
- Abandoning daily tasks and not fulfilling job responsibilities
- Staying at home and disregarding social relationships
- Spending time without sufficient satisfaction and proper use of time (e.g., watching television without receiving correct information from it or spending a lot of time in virtual space without a specific purpose and plan)
- Stopping useful activities and necessary hobbies such as sports
- Using alcohol or substance abuse to escape from thoughts or avoid confronting them
- Excessive eating and emotional overeating
If you are doing a number of the above, or phrases similar to the following are familiar to you:
- I am not ready
- I cannot tolerate it
- I am tired
- I have no choice
- I do not enjoy this activity at all
- Nobody really wants to see me
- I am definitely not well
- I am confused
- Everything will get worse
In this situation, you should ask yourself what the consequences of these behaviors and thoughts will be for you?
By implementing the behavioral activation program, you can pay more attention to the actions you take to avoid confronting depression and identify the grounds for avoidance and denial in yourself.
What are the consequences of the behaviors we do when our mood is low?
1.Impact on Well-being Resources:
Take a look at the well-being resources you have lost in life.
Do you remember the things you stopped doing after you started feeling depressed?
This natural response to feeling sad and distancing oneself from daily activities after a while reduces well-being resources. So it is not surprising that we fall into the vicious cycle of worsening mood, and this means the trap of depression.
Low Well-being Resources Low mood, low energy, low self-confidence Isolation, avoidance, and procrastination
2.Impact on Problems and Worries, Stress:
When we stop doing routine tasks, what happens to our problems? Often problems become bigger, or new problems start that did not exist before. There are also cases where not solving them creates a lot of worry and stress.
Of course, when problems increase, our condition will also worsen, and as a result, coping with them becomes more difficult. This is another trap of depression.
More Problems Due to Avoidance and Non-Acceptance of Depression Low mood, low energy, and low self-confidence Social isolation, avoidance, and procrastination
Summary of Understanding Depression
In short, depression occurs by losing sufficient resources of well-being and the presence of sources of trouble. It is natural to feel sad in these circumstances.
Insufficient Positive Reinforcers + Many Life Problems = Low Mood → Avoidance and Isolation → Exacerbation of Problems → Decrease in Reinforcements
Behavioral activation is designed to break free from the trap of depression and prevent the recurrence of depression.
Homework
As homework, on a piece of paper, express your view about the experience of depression, and according to the topics discussed in this article, write down charts similar to what we have drawn, considering your resources of well-being, sources of trouble, and your procrastination behaviors.
What are the Other Traps of Depression?
Fear of Depression:
If you have a history of severe depression or have experienced depression several times in the past, you will easily fall into its trap again.
Minor Discomfort:
Feeling of sadness and low mood → Fear of the return of depression → Worry, avoidance, isolation → Worsening of the problem and exacerbation of depression
As the mood drops, the fear of depression starting again takes shape. Fear causes worry and avoidance and isolation behaviors. Therefore, sometimes depression stems merely from failures and minor discomforts, and there will be no need merely for catastrophic events to start depression.
Important Points for the Treatment of Depression
1.Learn as much as you can about your depression: It is important to determine whether your depression symptoms are due to an underlying medical condition. If so, 1 the underlying condition must be treated first. The severity of depression is also an important factor. The more severe the depression, the more likely you need more serious treatment.
2.Finding the right treatment for depression takes time: Finding the right treatment and support method for you may require trial and error.
3.Do not rely solely on medication: Although medication can relieve the symptoms of depression, it is usually not suitable for long-term use. Other treatments, including evidence-based psychotherapies such as cognitive-behavioral therapy and behavioral activation, can be a suitable alternative to medication and can be as effective as medication and do not have the unwanted side effects of medication. If you decide to try medication, remember, medication works better when you make healthy lifestyle changes.
4.Receive social support: The more you cultivate your social connections, the more you protect yourself against depression. If you feel trapped, do not hesitate to talk to trusted family members or friends. Asking for help is not a sign of weakness.
5.Treatment requires time and commitment: All methods of depression treatment are time-consuming. It may sometimes seem overwhelming or frustrating. But it is natural because recovery usually has ups and downs.
6.Lifestyle change is an essential part of depression treatment: Lifestyle change is considered a simple but powerful tool in the treatment of depression. Making the right changes in life can help to alleviate depression more quickly and prevent its return.