In the last blog I wrote about depression, I promised more information on the relationship between connection and depression. Some of my clients have described depression as being like a black hole, or like a heavy and suffocating blanket. Others have described feeling as if the world is muffled or distant. Many go through their day with a smile on their face that they wear for the benefit of others; you may have seen that commercial for depression medication where the woman holds up a smiley face mask but behind the mask, she is clearly unhappy and disengaged. The imagery of these descriptions conveys a sort of darkness and loneliness. People who are depressed often feel alone. And they often do an amazing job of posing as a happy person. They struggle to believe that others could or would want to understand the depth of their pain, or that anyone would want to be around them if they knew the truth. Often, people with depression may feel they are “too much” and do not want to burden loved ones. As a result, they turn inward and isolate, pushing away those that care the most. Putting on a smiling face and isolating oneself for the benefit of others is a huge problem in dealing with depression because it doesn’t work. Just to emphasize … isolation and pretending do not work!!! Those strategies don’t work because they serve only to deepen the depression. Isolation’s counterpart, connection, is what is needed. Often when one thinks of the word connection, the image of an in interpersonal relationship comes to mind. Connection to people is absolutely a main component of one’s well-being. Healthy, nurturing, and reciprocal relationships with others, such partners, friends, and family members have been shown to improve people’s quality of life and health. Good relationships make the ups and downs of life bearable because we have others with which to share both the joys and sorrows of life. Humans are not meant to walk alone. We thrive and accomplish more when we are in meaningful relationships.There are other kinds of connections that are important as well, such as doing meaningful work. Do you remember a time when you were so excited about a book you read, or inspired by someone’s story? Or that time when you knew what you wanted to do and couldn’t wait to get started? Or when you found yourself in a place that moved you so much, that you knew you needed more of that in you life? That is connection! It is connection to people, and it is also connection to that which helps you to know your place in the world and allows you to contribute something meaningful, something that gives you a sense of purpose and contributes to your broader understanding of life. Earlier, I said that pretending to be okay and distancing oneself from others only exacerbates depression. It reinforces ideas of being alone and unwanted. The reality is we need to be with others, especially when we feel at our lowest and most vulnerable. The support we receive from others, personally and professionally, is essential to recovering from depression. There are people who want to help. It may not be the first person you ask, or even the second and third, but there is someone in your life who will say, “yes, I want to be there for you”. So, no matter how murky the depression waters seem, or how deep the black hole seems to be, ask for help. Do the opposite of what you feel in those moments. Go to where the people are.
Serotonin is a neurotransmitter and hormone that is involved in the functioning of multiple organ systems in the body. Commonly, it is known as the happy chemical. There is a strong correlation between low levels of serotonin and depression. This is a simple enough explanation and if that is in fact the case, then medication should do the trick. And indeed, medication can help ease the most severe symptoms of depression such as fatigue, decreased concentration and focus, sadness, feeling as if one is in a fog, and general apathy. Notice that I used the word “ease” when explaining how anti-depressant medication can address symptoms of depression. I use this word because anti-depressants are not a cure-all and because depression is a complicated condition. We know that serotonin is implicated in depression, but it is a chicken or the egg argument. Does depression happen because of an insufficient amount of serotonin, or is the production of serotonin impacted by depression?This is an important question because it tells us that managing depression requires a multi-modal approach. Think about it. If you are someone reading this blog right now that has suffered from depression, whether it is infrequent or chronic, what things made it bearable? Was it the great feeling you got from exercise? Or a lovely lunch with a dear friend? A successful presentation at work? Or being selected for a prized opportunity at school? And maybe it was as simple as a walk or eating your favorite ice cream. These events create pleasure,contentment, or a sense of accomplishment which in turn boosts our mood. And those momentary feelings are just that, momentary, when you have depression. Why is that? There are a couple of explanations. One being that people who are depressed are often extrinsically motivated. One who is extrinsically motivated seeks affirmation and approval from the outside world. Success and happiness are determined by the approval of others whether that is in the form of praise, admiration, or the number of followers/likes/retweets on social media. On the other hand, a person who is intrinsically motivated experiences satisfaction with knowing they have done a good job or are a good person without lots of validation from the outside world.By itself, there is nothing wrong with being extrinsically motivated. Nor is it necessarily sufficient to only be intrinsically motivated. The reality is we need both. We need to know our worth without excessive amounts of validation, and yet it sure is nice when someone notices when we have done a good job. In my opinion, it all comes down to connection. Real, meaningful, life giving connection to others and to a life with purpose. People are healthiest when they know they matter and that what they do matters. People are healthiest when they enjoy relationships where they can be themselves in all of their multifaceted and complex wonderfulness. Do you have people in your life that help you to know you matter and are you engaged in activities or work that give you a sense of purpose? If the answer is no, and you are feeling depressed or anxious, perhaps it is time to re-evaluate and seek new experiences and relationships. Psychotherapy is a great place to begin that exploration and uncover what might be holding you back. More to come on the relationship between connection, depression, and anxiety.
“I just don’t feel like myself.”“I can’t seem to concentrate on anything.”“I cry for no reason all the time.”If you have recently experienced any of the thoughts above and have noticed these thoughts lingering for some time, you could be experiencing symptoms of depression. But before we make any assumptions, it is important to clarify the difference between being sad and actually struggling with depression. Sadness, like any other emotion, is healthy in moderation and usually is triggered by an event or situation. Sadness eventually passes. However, depression is more than just a passing emotion. It is a lingering state that affects every aspect of your life… you don’t enjoy the things you used to, things seem less worthwhile, and you just don’t feel like yourself.Truthfully, many people do not seek help for depression because they are unaware of what symptoms of depression look like are or do not recognize they are depressed. And, there is still strong stigma around seeking help for mental health issues, which can be discouraging for people to reach out for professional and personal support.Thankfully, help is available! I want to assure you that if you are struggling with depression, you are not alone in your struggle. In 2017, over 15 million Americans were struggling with some form of depression. Depression is a very real thing and it is very treatable. Reaching out for help to deal with depression is not a sign of weakness. Getting help for yourself and improving your overall quality of life is a sign of strength and courage.If you feel like you are struggling with any form of depression, consider the following options:
- Reach out to professional help (i.e. your primary care doctor and/or therapist)
- Get educated on the signs and symptoms of depression
- Stop beating yourself up for not feeling like your ‘normal’ self
Remember…. there is always hope and it is okay to ask for help.