At work the other day, a sickening howl came out of an office near mine. It was guttural. Primal. Unfortunately familiar. A few years ago, it was me making that sound at work and I had made it many times before. It is the howl of those left behind after a suicide. It is a […]
Although I like to cling to the promise that my depression will get better — since it always has in the past — there are long, painful periods when it seems as though I’m going to have to live with these symptoms forever.
In the past, there was a time when I had been struggling with death thoughts for what seemed like forever. One afternoon, I panicked when I surmised that they might always be with me. I embraced the wisdom of Toni Bernhard, who wrote a brilliant handbook for all of us living with chronic illness, How to Be Sick. While reading her words, I mourned the life I once had and made room to live with symptoms of depression indefinitely.
The death thoughts did eventually disappear, but I’m always mindful of my depression. Every decision I make in a 24-hour period, from what I eat for breakfast to what time I go to bed, is driven by an effort to protect my mental health.
When I hit a painful stretch that feels like forever, I return to Bernhard’s insights and to my own strategies that have helped me persevere through rough patches along the way.
Here are some of them:
1. Revisit the Past
When we’re depressed, our perspective of the past is colored by melancholy, and we don’t see things accurately. For example, if I’m in a low mood, I look back on those years when I experienced death thoughts and think that I felt nothing but depression for more than 1,000 days. It’s helpful to peak at my mood journals from that period to see that I did have some good days and good times scattered throughout the painful stretches, which means I will have good hours and days in coming hard periods as well.
I also look at photo albums that bring me back to moments of joy sprinkled in amidst the sadness; these give me hope that even though I’m still struggling, it’s possible to contribute a nice memory to my album.
2. Remember that Pain Isn’t Solid
Going through mood journals is also a good way to remind myself that pain isn’t solid. I may start the morning with excruciating anxiety, but by lunch I might be able to enjoy a nice reprieve. At night I may even be capable of laughing at a movie with the kids.
Bernhard compares the painful symptoms of her illness to the weather. “Weather practice is a powerful reminder of the fleeting nature of experience: how each moment arises and passes as quickly as a weather pattern,” she writes.
I like to think of my panic and depression as labor pains. I breathe through the anguish, trusting that the intensity will eventually fade. Hanging on to the concept of impermanence gives me consolation and relief in the midst of distress — that the emotions and thoughts and feelings I’m experiencing aren’t solid.
3. Maximize Periods of Wellness
Most people who have lived with treatment-resistant depression or another chronic illness have learned how to maximize their good moments. During painful stretches, I consider these moments to be the rest periods I need between contractions. I soak them in as much as humanly possible and let them carry me through the difficult hours ahead.
4. Act As If
Author and artist Vivian Greene has written, “Life isn’t about waiting for the storm to pass … It’s about learning to dance in the rain.”
That sums up living with a chronic illness. There’s a fine line between pushing yourself too hard and not challenging yourself enough, but most of the time, I find that I feel better by “acting as if” I’m feeling okay.
So I sign up for a paddle-boarding club even though I don’t want to; I have lunch with a friend even though I have no appetite; I show up to swim practice with tinted goggles in case I cry. I tell myself “do it anyway” and operate like I’m not depressed.
5. Embrace Uncertainty
Not until I read Bernhard’s book did I realize that much of my suffering comes from my desire for certainty and predictability. I want to know when my anxiety will abate, which medications will work, and when I’ll be able to sleep eight hours again. I’m wrestling for control over the steering wheel, and the fact that I don’t have it is killing me.
The flip side, though, is that if I can inch toward an acceptance of uncertainty and unpredictability, then I can lessen my suffering. Bernhard writes:
Just seeing the suffering in that desire loosens its hold on me, whether it’s wanting so badly to be at a family gathering or clinging to the hope for positive results from a medication or desiring for a doctor not to disappoint me. Once I see the [suffering] in the mind, I can begin to let go a little.
6. Stop Your Inner Meanie and Remember Self-Compassion
Like so many others who battle depression, I talk to myself in ways I wouldn’t even address an enemy. I call myself lazy, stupid, unmotivated, and deserving of suffering. The self-denigrating tapes are so automatic that I often don’t catch how harmful the dialogue is until I’m saying the words out loud to a friend or doctor.
We can relieve some of our suffering by addressing ourselves with the same compassion that we would offer a friend or a daughter. Lately, I’m trying to catch my inner meanie and instead offer myself kindness and gentleness.
7. Attach Yourself to a Purpose
Friedrich Nietzsche said, “He who has a why to live can bear almost any how.”
When my depression gets to be unbearable, I picture my two kids and my husband, and I tell myself that I have to stick around for them. It’s fine if I never wear one of those “Life Is Good” T-shirts. I have a higher purpose that I must complete, like a soldier in a battle. I must see my mission through to the end. Dedicating your life to a cause can keep you alive and give you the much-needed fuel to keep going.
8. Stay in the Present
If we can manage to stay in the present moment and focus only on the thing that is right in front of us, we eliminate much of our angst because it’s almost always rooted in the past and in the future.
When I’m in a painful stretch, one day at a time is too long. I have to break it down into 15-minute periods. I tell myself that for the next 15 minutes, my only job is to do the thing in front of me, whether that’s helping my daughter with homework, doing the dishes, or writing a column. When 15 minutes are up, I commit to another 15 minutes. That way, I patch several days together, and before long, one of those days contains some joy.
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One of the many difficult things about mental illnesses is that an illness can construct a narrative in your head that isn’t necessarily true. With depression, a combination of stigma and difficult-to-pinpoint symptoms may make diagnosis difficult. But the symptoms of depression are well-documented, and the first step is paying attention.
Since depression can alter your thoughts, it can be hard to differentiate when the illness is talking, versus when you are “When we are depressed we are viewing the world through a lens that isn’t congruent with our external reality, but during a depressive episode, our internal reality changes so it seems like things can be hopeless which often leads us to feel helpless,” Travis McNulty, LMHC, GAL, of McNulty Counseling & Wellness, tells Bustle. “ […] Usually depression manifests its form in a cycle of negative thoughts, negative emotions, and negative behaviors that further perpetuate one another.” These negative influences can actually start to convince you that you aren’t dealing with depression.
Some of these self-doubting thoughts may begin to dissipate when you acknowledge that depression is a serious diagnosis, and that you deserve help for the things you’re struggling with. Finding a mental health professional you can trust may help get you there even sooner.
Here are nine thoughts that can mask depression for what it is, according to experts.
1. That It’s Not “That Bad”
If you’ve been noticing yourself feeling worse and worse for a while, but have a narrative of “I’m fine” running through your head — you may want to examine that thought further.
“One of the biggest lies that depression tells us is that we are OK,” licensed clinical social worker Melissa Ifill, tells Bustle. ” […] Unfortunately, we are often slow to give credibility to [any changes] or are truly unaware of how the depression is impacting us.” So if you find yourself minimizing your feelings, remind yourself that you don’t have to be at absolute rock bottom to deserve help.
2. “I Can Deal With This On My Own”
Depression is a serious illness, not a burden you have to bare alone. Even if you have been through blue spells before, you deserve help this time around.
“One of the major thoughts people often have when experiencing depressive symptoms is that they do not need help,” Ifill says. “They believe that the mood, feelings or thoughts will go away by themselves or if they keep behaving as if things are OK, they will be eventually.” While some wounds may heal with time alone, it’s OK to admit that you may need the support of friends, family, or a professional, for what you’re dealing with.
3. That Everything Is Bad
While it’s harmful to downplay your symptoms, it can also be harmful to catastrophize what you’re feeling as well.
“Black and white thinking is a classic thought pattern for those who are experiencing depressive symptoms,” Ifill says. “[…] Having a good supportive network (which should include a helping professional) can assist you in challenging some of these thought patterns and help you to see the more varied perspectives that life has to offer.” Many people have felt like there’s no way out before, and there are a plethora of resources to help.
4. That It Doesn’t Matter Anyways
Another harmful way depression can try to trick you into thinking you’re not depressed is by telling you that it doesn’t matter either way.
“Depression causes helplessness and hopelessness,” Lara Schuster Effland, regional managing director of clinical operations for Eating Recovery Center’s Insight Behavioral Health Center, tells Bustle. “One may believe they are the problem and [that they are the reason] why they feel lonely and lost.” Blaming yourself for causing the consequences of your depression is hurtful. Finding a therapist or psychiatrist may help you break out of this thought pattern.
5. That You “Just Need A Vacation”
Minimizing your symptoms does not always take the form of self-blame. Even telling yourself that you “just need a vacation” can be a way that the depression can get ahead.
“Feeling overworked, under-rested, and overwhelmed when depressed [is common],” Effland says. If you have a sense that you’re unable to get ahead, reaching out for support on that level is likely more helpful than a few days off could be.
6. That You’re Fine Because You’re In A Relationship
Depression doesn’t discriminate. Having depression doesn’t make you ungrateful, either. So if you’re equivocating by telling yourself that you’re fine because you’re in a relationship, have a good job, or have great friends, you may actually be minimizing a serious illness.
“People who have the ‘perfect’ situation aren’t immune to depression, and often depression can come when everything is going well, because it often can’t be explained,” LGBT-affirming therapist Katie Leikam, LCSW, LISW-CP, tells Bustle. It’s important not to discredit your need for support just because things seem good on the outside.
7. That You Don’t Cry Much, So It Doesn’t Count
While depression can cause symptoms like excessive or easily-triggered crying, that doesn’t mean you should discount all of your other signs of the illness just because you haven’t been experiencing this.
“Depression can present itself in a lot of ways and only one of those ways is tears,” Leikam says. “Depression can also present itself in feeling lonely or numb of emotions and often people who feel numb, aren’t always able to cry.” If you’ve noticed that you’re feeling more apathetic than usual, then it’s a good first step to talk to your doctor.
8. That Excelling At Work Discounts Your Feelings
Depression doesn’t always take away your ability to function. Many people with depression are still able to go about their daily lives. Just because you’re excelling at work doesn’t mean you don’t have depression.
“You can be on top of your game at work and still have clinical depression,” Leikam says. “Successful people can still have depression. Depression can be a chemical imbalance so it doesn’t discriminate against who has it and who doesn’t have it.” You deserve help even if you’ve been noticing symptoms, but are ignoring them because you think being high-functioning disqualifies you from the support you need.
9. That You’re Just Not “Normal”
Mental health stigma can be incredibly powerful, especially if you’ve internalized it to the point that you believe something is wrong with you for feeling this way.
“Without an understanding of mental illness individuals often believe that depression is an indication that they’re not normal anymore, and that they are somehow different,” Dr. Neeraj Gandotra, MD, chief medical officer at Delphi Behavioral Health Group, tells Bustle. Reminding yourself that you’re still you, and that any changes to your health are worth taking care of, may help you get the boost you need to seek help.
Separating yourself from the symptoms of your depression can help you from being tricked by negative self-talk. “I like to help my clients refer to their depressive symptoms as ‘the depression,'” Ifill says. This way, you may be able to externalize the symptoms and emotions associated with depression, potentially making it easier to find a professional to support you.
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By Marie Miguel
There are times in our lives when we feel down, and we can’t figure out what the source of the problem is. There’s a difference between feeling sad and being depressed. When you don’t want to do anything – not even simple things that you enjoy – there’s a problem. When you find yourself with no motivation, it’s time to seek help because you may be depressed. When you’re thinking “I don’t want to do anything,” there’s something inside of you that’s telling you that life isn’t worth enjoying or pursuing, and that’s not true. You have individual interests and motivation, and there’s inside you. You have things that make you happy, but you can’t see them at the moment. That’s the problem; when you feel stagnant and lack positive emotion. It’s a symptom that shouldn’t be ignored, and it’s important to know that you can get through this time.
Pushing past the “I don’t want to do anything” feeling
One way to push past this feeling is to pursue therapy, but getting to that point is difficult because your brain is telling you that there’s no point in doing anything; including going to therapy. It’s essential that you work past those feelings of stagnancy. It’s vital to remember that what your brain is telling you isn’t true; there is a point to live, and you do have things that you enjoy. It’s about pushing through and remembering that the thoughts going through your mind are attributed to depression; they aren’t a reflection of who you are as a person.
Depression isn’t who you are. Depression is a mental illness that has symptoms such as lacking motivation, sleeping too much or not sleeping enough, changes in appetite, thoughts of emptiness or hopelessness, and thoughts of suicide or a plan to end one’s life. If you’re having thoughts of suicide, please call 911 or go to the emergency room. Contact a mental health professional and get medical attention immediately. Depression is a legitimate illness, and it needs to be addressed. If you’re feeling an emptiness inside, it could be because of this mental illness. It is treatable, it isn’t your fault, and there’s nothing wrong with you.
There is nothing wrong with you
Hear this now: there is nothing wrong with you. If you have depression, you are not alone. You’re struggling with a medical condition that many people, in fact, millions of people in the US alone, battle every single day. If you look at it that way, you’ll be more apt to seek help. It’s okay to acknowledge that you feel hopeless, as long as you pursue something that’ll help you move past this feeling. You’ve got this. Things will not be this way forever, and you will be able to move forward, no matter how hard it seems. Remember a time when you felt emptiness or sadness and were able to push past it and keep going. If you’re reading this article, you are alive. If you’re reading these words, you are strong, and you deserve to seek help.
Online counseling is an excellent place to seek help for feelings of emptiness and that “I don’t want to do anything” feeling. You are allowed to feel lost, but your online counselor is there to help you push through these feelings and find a way to cope. You might feel helpless, but your online counselor believes in you. Don’t be afraid to reach out for help.
This is a featured post by site sponsor Better Help.
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By Hallie Gould
According to the National Alliance on Mental Illness, approximately 18.5% of adults in the United States experience mental illness every year. That’s a significant portion of our population—one in five people—yet the stigma and misunderstanding that surround mental health remain. If you are feeling symptoms of depression, talk to your doctor to learn more about treatment options.
We throw around the phrase “I’m depressed” to describe a stressful situation at work or the end of a relationship. But just like the word “crazy,” for which the etymology has shifted over time, depression can often be mistaken for a way to characterize an emotion rather than a mental health issue. It trivializes those who suffer from the disorder, a real chemical imbalance that creates negative and difficult circumstances beyond our control.
Because it all can seem convoluted, the definitions melting into each other, it’s often challenging to know when to seek help. “Treatment should be sought for depression when the symptoms are interfering with the quality of your life,” says therapist and mental health expert Scott Dehorty, LCSW-C. “Depression is treatable, and there is no reason to suffer in silence.”
To get a better understanding of the hallmark symptoms of depression, I reached out to two experts for their opinions and advice. Below, they detail 10 different, common warning signs to look out for. Keep reading for their thoughts.
1. Disturbed Sleep
“This is due to depression’s sidekick: anxiety,” explains Sanam Hafeez Psy.D., an NYC-based licensed clinical psychologist. “Some people when depressed are also anxious. This is when you start to struggle with falling or staying asleep. You may wake up in the night crying or panicked. If this persists and you find lack of sleep interfering with your ability to function during the day, seek help.”
“Sleep is often disrupted during a depressive episode,” adds Dehorty. “It can come in the form of insomnia or hypersomnia. Both increase the symptoms of depression because they leave one to feel fatigued and lethargic. It would be a big misstep to treat this as a sleep disorder and miss the depression diagnosis.”
“About 80% of those experiencing depression have feelings of anxiety,” notes Dehorty. “Anxiety can manifest in several ways: It can be an inner restlessness, increased concerns or worries about issues which are outside of your control, or difficulty being around groups of people. This can be treated as different forms of anxiety disorders when, in fact, they are symptoms of a major depressive disorder.”
“You don’t want to get out of bed. Your thoughts are of hopelessness and you even feel sick. Toxic, defeating thoughts that are chronic won’t lead to a jump-out-of-bed, ready-to-take-on-the-day kind of attitude,” says Hafeez. “When you prefer to stay in bed and can’t seem to feel energized, seek help.”
4. Loss of Concentration and Cognition
“When depressed, the brain just doesn’t fire on all cylinders,” explains Dehorty. “Memory, retention, and word-finding can be difficult. This presents several difficulties and frustrations. It can lead to decreased work performance, which can bring about feels of lower self-worth, and it can decrease pleasure in activities you used to find joy in.”
5. You’re Alone, a Lot
“You prefer to withdraw and be by yourself so you can ruminate,” says Hafeez. “Some who struggle with depression tend to alienate themselves. If you notice the last time you interacted with someone was more than a few days ago and you feel like you’re on your own little island unable to talk to anyone, seek help.”
6. A Change in Appetite
“A change in appetite is a common symptom of depression,” notes Dehorty. “This can take the form of overeating or under-eating. Both are problematic, as overeating can bring feelings of shame and physical discomfort, and under-eating starves the brain—which is already struggling.”
7. You’re Looking to Escape
“People who struggle with depression often try to play chemist and use alcohol or drugs to manipulate how they feel,” notes Hafeez. “You think going out with friends will lift your spirits. However, alcohol is a depressant. This is why when you drink excessively, you may start crying and recalling painful memories. Those who use stimulants to improve their mood crash hard when they come down and then need the drug to soothe them again. Painkillers are numbing, so if you’re looking to escape pain, it’s easy to become addicted. If you’re noticing you’re turning to drugs to soothe depression, seek help.”
8. Loss of Pleasure
“A lack of pleasure in activities once found pleasurable is a hallmark of depression,” notes Dehorty. “This is typically one of the first and most distinguishable symptoms. If there was an activity that once added joy and value to your life and now just doesn’t do anything for you—that very well may be due to depression.”
“Another hallmark of depression is the feeling that you shouldn’t be feeling this way; you should be better. This differs from most other diagnoses and is a good differentiator for depression. You feel like you can’t get out of bed to face the day, and you feel guilty for feeling that way.”
10. Pain and Discomfort
“Depression manifests physically as well,” explains Dehorty. “During a depressive episode, you tend to feel your physical body differently. Pain sensations increase, leading to more discomfort, aches, and new onset physical pains. The physical issues need to be examined, but it could be an ongoing problem that was once filtered out by the brain. We are consistently feeling aches and pains, but the brain filters them, and we don’t even notice most. With depression, we feel everything, and it becomes bothersome.”
“Any of these symptoms can occur with any of us at any given time, and that can be completely normal,” notes Lindsay Henderson, Psy.D., a psychologist who treats patients virtually via the telehealth app LiveHealth Online. “But if you are experiencing more and more of these symptoms, or they are growing in severity, start paying a bit more attention to how you are feeling overall. If you notice that these symptoms are impacting your overall functioning, it may be time to seek professional help. The good news is that help can come in many forms and individuals have options for how they address their mental health.”
We know that things like social activity, healthy eating, good sleep, and regular exercise all directly contribute to a healthier mood. If you notice yourself experiencing symptoms of depression, take a look at your daily routines and overall physical health to identify areas that can improve. “It can be beneficial to engage in therapy and talk with a mental health professional about what you are experiencing,” says Henderson. “Not only can a therapist help assess and diagnose the experiences you may be having, but they can also offer tips and tools to better understand, manage, and cope with the many complex emotions you feel.”
Here’s the thing: We know the idea of finding a therapist and getting to appointments can be overwhelming. Online therapy can be a wonderful way to break down many of the barriers that can get in the way of accessing therapy, as the appointment can take place wherever you feel most comfortable. Talk to your doctor to make the best plan for you and seek out an appointment with a psychiatrist. Your doctor may talk with you about the pros and cons of taking medication, which can be particularly helpful with depression and anxiety, but not for everyone. It’s best to talk first with a professional about your options before making any decisions.
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By Chris Palmer
Diabetes is now an epidemic in the United States. About one-third of the US population has either diabetes or pre-diabetes! It is well established that people who have diabetes are at much higher risk of developing clinical depression– about double the risk of people who don’t have diabetes. What is much less appreciated is that people who start off with depression, with normal blood sugars at the time, are at much higher risk of developing diabetes in the future – the rates are about 60% higher than in people without depression. Why do these disorders go together so frequently? Is it more than just a coincidence?
First of all, let’s define what we mean by “depression.” We’re not talking about simply feeling bad or tired for a few days. We’re talking about major depressive disorder, or clinical depression – the illness that leaves people feeling depressed or sad most days, that robs them of almost all joy and pleasure in life, that disrupts their sleep, leaves them feeling tired and exhausted, interferes with their ability to work or concentrate, and might even have them contemplating suicide as a way to end their suffering. Clinical depression is all too common, and is now the leading cause of disability in the world!
One of the most popular theories about why people with diabetes have higher rates of depression is that it’s difficult to have diabetes, and maybe the stress of having a chronic illness, with worries about blood sugar levels, diet, and taking pills or insulin injections would leave anyone feeling down, if not downright depressed. Given that diabetes most commonly occurs in those who are overweight or obese, another theory is that our society’s biasagainst heavy people might take a toll on self-image, and might make getting a job or dating more difficult, which could leave people feeling depressed. While both of these theories may, in fact, play a role in causing clinical depression, it appears that there is much more to this connection than simply stress, society, and psychology.
Inflammation is found in both disorders. In fact, inflammation in the bloodstream has been found in many chronic disorders, including both diabetes and clinical depression. No one knows for sure what is causing this inflammation, and we don’t yet know if it is causing these disorders, or simply a consequence of these disorders. In other words, it’s possible that inflammation causes both depression and diabetes, or having diabetes or depression causes the inflammation. Clearly, there’s more to the story than just inflammation – otherwise, everyone with it would develop both diabetes and depression. However, if inflammation is a risk factor for both disorders, it’s not at all surprising that these disorders go together, and this would point to a biological reason for the overlap in disorders, as opposed to simply a psychological reaction to being overweight or having diabetes.
Cortisol is another factor. We know that cortisol is often elevated in people with depression, and we also know that cortisol worsens blood sugar levels and insulin resistance, so this may also be a factor in how depression can make diabetes more difficult to control.
Does the overlap of these disorders really matter?
Unfortunately, all too often, medical professionals assume that it doesn’t – they assume that people simply have two different disorders that really have nothing to do with each other. In reality, people who have diabetes are not only twice as likely to develop depression, but when they do, on average, it lasts 4 times longer than in people without diabetes – 92 weeks vs 22 weeks. That’s almost two years of suffering from depression, even when getting treatment! Likewise, depression can affect diabetes. When depression occurs in people with diabetes, their blood sugar control gets much worse – they tend to have higher blood glucose readings, worse insulin resistance, and higher rates of diabetes complications, such as blood vessel damage. Some people assume that this is because people who are depressed might eat more junk food to comfort themselves, or may not have enough energy to take care of themselves. While these might be true, it’s also possible that the inflammation from having clinical depression also worsens their diabetes, and that it’s truly a physical thing, not a mental thing or a matter of willpower.
What to do?
1. If you have diabetes, be aware that you are at higher risk for developing clinical depression, and seek help if you notice these symptoms. All too often, people ignore them, and assume they are just getting older and running out of steam. Your primary care doctor can help assess if you have clinical depression, and can likely start appropriate treatment.
2. If you have clinical depression, know that you are at risk for developing diabetes, which could make your depression even worse. Routine screening of your blood sugars can be helpful. If you have depression that is not getting better with current treatments, you should get checked for diabetes to see if this might be contributing to your poor response to treatment.
3. Consider a change in diet. There is some evidence that the Mediterranean diet can help improve both diabetes and mood, even in people with chronic depression. The Mediterranean diet emphasizes more whole foods and eliminates processed foods and junk food, which may be enough of a dietary change for some people. Alternatively, diets low in carbohydrate and higher in fat, such as the ketogenic diet, have shown more dramatic results, even reversing diabetes in a study of over 300 diabetics, and this can help improve mood and energy as well. If you have diabetes, however, you should consult your doctor before trying a ketogenic diet, as your medications and/or insulin will need to be reduced rapidly due to the powerful effects of this diet.
4. Exercise! There is abundant evidence that exercise can help both diabetes and depression. It’s a new year, so if you haven’t already started a new year’s exercise routine, time to start now. You don’t need to start at a gym if that makes you uncomfortable – you can start with short walks and work your way up to longer walks and short jogs along the way. If your knees can’t handle that, think about swimming, cycling, yoga, or a myriad of other ways to move your body and get your blood flowing. If you have severe diabetes and haven’t exercised in years, talk to your doctor first about starting safely.
It’s time to eradicate stigmas.
Life is hard even under the best of circumstances. Without physical and mental health, it’s difficult to enjoy life and to thrive. It makes good sense to take care of ourselves and that includes getting help when we suffer physically or psychologically. When we feel sick we get ourselves to the doctor. And when we feel so bad that we think about hurting ourselves or others, or when we cannot engage positively in work or in relationships, or we cannot accomplish what we want, we should seek help to feel better. That is what all of us deserve.
Mental health shouldn’t be a dirty word. Still damaging stigmas prevail allowing ignorance to end lives. Judging others or ourselves for our suffering is just plain harsh, not to mention counterproductive. When was the last time telling a depressed person to “get over it” worked? Try never! And using shame as a tactic to “encourage” someone to be what you think they should be only adds to a person’s suffering.
Mental health problems should be thought of no differently than physical health problems. In fact, they are completely related: mental health problems affect physical health and physical health problems affect mental health. We need a world where no one feels embarrassed or ashamed about their suffering. We need a world where suffering evokes only kindness, compassion, and a desire to help.
Here are 5 enlightened ways to think about mental health:
1. Everyone suffers.
I have never met anyone who is happy and calm all the time. It’s just not possible, no matter how good someone’s life looks like from the outside. Most people suffer at some point in their life from anxiety, depression, aggression, PTSD, shame, substance abusedisorders, and other symptoms. And, if a person is lucky enough to never suffer psychologically, they surely love someone who does suffer in these ways. Instead of living lives of quiet desperation, to paraphrase Henry David Thoreau, let’s encourage honest talk. If someone gets uncomfortable with honest talk, we can talk about that too.
2. Mental health checkups are an important part of wellness.
Do you feel ashamed when you go for a check-up at your internist? Probably not. On the contrary, you’re likely to feel proud that you are taking care of your health. Yet most people are ashamed to call a psychotherapist for a consultation. This makes no logical sense. A mental health checkup is a great idea especially if you are suffering and not able to function the way you want. You should feel very proud for taking care of your mental health.
3. Gym for the brain.
That’s exactly how I describe therapy for my patients who come in feeling bad that they “have to come to therapy.” In our society, we praise people for working out at the gym. We think of them as maintaining their health and taking good care of themselves. Well, that’s no different for a person wanting to enhance their psychological wellbeing. Therapy grows new brain cell networks, calms the mind and body, makes it easier to meet life’s challenges, and helps us thrive as we become the best versions of our self that we can.
4. Education in emotions is a game-changer.
We live in a challenging society because it is not very nurturing. That’s why rates of anxiety, depression, and substance abuse disorder have skyrocketed. According to a new disturbing report from the CDC, suiciderates are steadily increasing. At the very least, our society could provide an accessible and understandable education on emotions. This would help us all understand how our childhood experiences translate to directly affect our adult mental health (for better and for worse). Emotion education debunks myths like “emotions are just for weak people” and we can control our suffering with “mind over matter.” Our schools should be teaching us trauma-informed tools like the Change Triangle. Our educational institutions should be teaching skills for managing relationships and interpersonal conflicts constructively so bullying, for example, would become a thing of the past. Parents should be taught about emotions so they don’t unwittingly create shame and anxiety in their children. Education on emotions and how emotions affect the brain, body, and mind depending on how we work with them, has great power to change society for the better and even reverse the current epidemic in depression, anxiety, and addictions.
5. Question assumptions, judgments, and fears around mental health and mental illness.
Many of us fear difference. When people feel, act or look different than we do, we tend to judge them. Judgment, while a form of misguided emotional protection achieved by distancing ourselves from those we fear or don’t understand, is destructive for all of us. Judgment is the basis of stigma and justifies the horrible way we treat people who suffer mental illnesses and substance abuse disorders. Judgment shames those who suffer, and that is all of us. No wonder shame-based depressions are rampant in our society. Instead of judging others for emotions and suffering, can we instead be curious about our assumptions and question where we learned to judge or fear people who struggle psychologically?
Most suffering can be eased with support, proper treatment, and a variety of resources. Let’s be proud to grow our collective and individual mental health. What a difference it makes to wholeheartedly say to someone seeking help, “Good for you! I could use some help for myself too!” Because we all can.
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By Diwash Gahatraj
Despite a booming economy, Sikkim has the highest suicide rate among all Indian states, second only to the Union Territory of Puducherry.
Gangtok: For Sukhrani Limbu of Sordung village, about 120 km from Gangtok, 29 May 2016, was just another usual day at work. But upon her return home, she found her eldest son, 30-year-old Aitey Singh Limbu, hanging from the ventilation shaft in his room.
Life somehow went on for the grieving mother. But then came 29 May 2018, when her third son, 27-year-old Aitey Hang Limbu, hanged himself from the same ventilation shaft in the same room.
“There was no suicide note, no signs of sickness… I am still clueless about what triggered their suicides,” Sukhrani says, fighting back the tears.
Sukhrani is not the only mother or family member in Sikkim who’s searching for answers. A National Crime Records Bureau study reported that the landlocked Himalayan state witnessed 241 suicides in 2015, 2.1 per cent of all the suicides in India that year.
But in terms of suicide rate in the last decade, Sikkim has the highest (37.5) among all states, and the second highest in the country after the Union Territory of Puducherry (43.2). Suicide rate is the number of suicides per one lakh population. According to the 2011 Census, Sikkim’s population was 610,577.
The West district, where Sukhrani lives, is Sikkim’s worst-affected region. Between 2008 and 2018, 278 cases of suicide were reported here.
Underbelly of the ‘golden state’
Sikkim joined the Indian republic in 1975, and has gradually become the poster child for development and a booming economy. Between 2004-05 and 2011-12, the state witnessed the highest net state domestic product in the country, and was the third richest state in India according to the 2015-16 Economic Survey.
In September 2018, Sikkim got its first airport at Pakyong near Gangtok, and in October, it was awarded by the United Nations for becoming the first state in the world to become 100 per cent organic. Literacy and cleanliness are high, and it’s often referred to as a ‘golden state’.
Yet, it has a sordid underbelly, which is manifesting itself in suicides and the questionable mental health condition of its residents. Regardless of age, gender, rural-urban divide, economic or health status, suicide looms everywhere.
A number of factors
“It would be very difficult, and even unfair, to pinpoint a particular reason for why Sikkimese people are turning suicidal. There are several factors: A long history of alcohol and drug abuse, unemployment, high aspirations, ignorance of mental health illnesses and changing family structures,” said Yumnam Suryajeevan, assistant professor of sociology at the Sikkim Manipal University.
Social worker Dr Satyadeep Chhetri adds three more factors — lack of socialisation, loneliness and high rates of adultery.
“Around 70 per cent of people who have committed suicide were loners — either they were separated couples, aged people living away from their children, or kids from broken families. There is no study to connect suicide with adultery or other factors, but many people have committed suicide due to marital discord,” Chettri said.
A case in point is that of a 12-year-old girl who committed suicide on 26 June 2017 because she longed for parental love.
The seventh grader from Timberbung village in West Sikkim used to live with her old grandparents after her parents drifted apart and started living with their respective lovers, said an investigating officer from Soreng police station.
Drugs and alcohol
Many Sikkimese youth are high on pharmaceutical drugs like Nitrosun 10mg, Spasmo Proxyvon (SP) and cough syrups like Corex and Phensedyl, which are smuggled into the state from the neighbouring Siliguri in West Bengal.
“Drug users are very vulnerable to suicide,” said Prashant Sharma, member of the Sikkim Drug User Forum.
Former drug user Robin Rai recalls trying to kill himself during one of his weak moments nine years ago. Rai, who works as a counsellor at a suicide helpline centre in Gangtok, said he gets numerous calls from drug users with suicidal tendencies.
The state’s climate, geographical location, and the easy availability of alcohol has made it vulnerable to alcohol abuse as well.
Sikkim’s history with alcohol dates back to 1954, when Sikkim Distilleries was set up in Rangpo to ensure quality liquor for its citizens at a reasonable price. The then Chogyal (king) agreed to give the company absolute monopoly for the manufacture of alcohol, on the condition that the government was given 47 per cent of its shares. The state earns considerable revenue every year from alcohol sales — in 2013-14, the figure stood at Rs 120.64 crore.
K.C. Nima, a public health activist, shared the story of Suresh (name changed), a 40-year-old chronic alcoholic who had attempted suicide twice.
“The Sikkim High Court had to order the state to provide rehabilitation for him. There are many such cases,” Nima said.
Charvi Jain, a Kolkata-based psychotherapist, said that dysfunctional families, loneliness and drug and alcohol abuse are all interconnected. “It can be a deadly cocktail for suicide,” she said.
According to a report by the Labour Bureau of the Ministry of Labour & Employment, Sikkim has the second highest unemployment rate in India.
Prawesh Lama, guitarist for the popular local band Tribal Rain, said the rush for government jobs had something to do with it.
“The problem of educated unemployed youth is high here. Sikkimese youth focus only on government jobs. But such jobs are for just a few who have the ‘right’ contacts,” Lama said.
“People are not willing to compete in the private sector. In this struggle to grab a government job, many youth get frustrated-some fall victim to drug and alcohol abuse, while a few even lose the urge to live.”
Cultural stigma of mental illness
Historically, the rulers of Sikkim have had no record of suicidal deaths. However, according to local tribal myth, adultery in a past life could lead to unnatural deaths, said L. Khamdak, professor of Limbu cultural studies at Namchi Government College in South Sikkim.
Tshering Tamang, a shaman based in Pelling, West Sikkim, added: “Every person has a predestined time to live. If someone kills themselves before time, their soul turns into Sian (evil spirit).This Sian can take lives of other people known to him or her in the similar way. More suicides will take place till the spirit completes its life-circle.”
In Sikkimese religious practices, mental health is often misunderstood. People with serious mental health illness approach religious gurus and shamans rather than coming to a doctor, said a psychiatrist based in Geyzing, West Sikkim, who did not wish to be named.
What has the administration done?
Other than an unpublished study conducted by Sikkim University, the state government has done very little research on the issue. ThePrint repeatedly tried to contact state health minister Arjun Ghatani, health secretary Vishal Chauhan and other senior officials, and emailed them questionnaires on the issue. But the only official response was an email from the health department, acknowledging receipt and saying it would take time to reply to the questions, “as this is a government procedure”.
However, that’s not to say there haven’t been efforts to curb suicides. A senior health department officer said on the condition of anonymity that the state was trying its best to combat the growing problem.
“The Sikkim Mental Health programme is operational since 2011, and we are conducting many awareness campaigns across the state,” the officer said.
In 2015, a state-funded 24×7 suicide helpline centre (03592-2021111, 18003453225) equipped with trained counsellors was started from the psychiatric department of the Sir Thodup Namgyal Memorial Hospital in Gangtok. However, the centre has received just 182 genuine calls so far, because hardly anyone seems aware of it. There were no advertisements for this number in Gangtok or West Sikkim, and helpline head Dr Jigmee K. Topgay said the reason was a lack of funding for promotion.
Hardly any local psychiatrists or health department officials were willing to speak on record when contacted for this report, because when a few of them spoke to a national daily on this issue, they were transferred from Gangtok to far-flung regions of the state.
One exception was Dr Satish Rasaily, a psychiatrist who has worked closely in the past with the government on suicide awareness programmes.
“The state has done several suicide prevention campaigns in Gangtok,” he said.
But outside the state capital, the track record of awareness programmes gets a bit murky. On the one hand, health department officials claim they conduct regular camps, as do local government officials like Hemant Limbu, vice-president of the Darap village near Pelling.
“We have a conducted a community level awareness programme where doctors, psychiatrists and suicide counsellors from Gangtok visited our area on the occasion of World Mental Health Day on 10 October 2018,” Limbu said.
But on the other hand, people in many other villages in West Sikkim said such camps were a rarity.
How to fix this problem
Parul Agarwal, a Siliguri-based counsellor and psychotherapist suggested that the Sikkim government should work on spreading awareness about mental health.
“Forming a team of well-trained counsellors and psychiatrists who can work at the grassroots level can be a good start. Regular workshops, seminars in schools and colleges and a compulsory HR policy on mental health awareness at workplaces can be helpful,” she said.
Among all the religious groups in the state, incidents of suicide are least among the Christian community, and that’s because of a conscious effort that others could emulate, said Father Moni Clement Lepcha of St Mary’s Catholic Church, Geyzing.
“We regularly hold conversation with our parish members. When we talk about our problems, it helps a lot in venting out,” he said.
Social worker Chhetri added: “We have to tap the emotional quotient of Sikkim’s citizens. We have to tackle this situation as a society. We need to be more open to talk to each other, create occasions to meet and socialise.”
HEYLO… call me Mina, or Amelia. Here is a picture of a baby alpaca I just got, that is made from REAL F’N BABY ALPACA FUR! (Her name is Bettie Page).
Anyways, I currently am living in Portland, Oregon with my boyfriend & my dog. PROUD DOG MOM ALL DAY. (his name happens to be Fox).
*this is called a sploot, if you didn’t know. –>
I work on a vineyard as a “Tasting Room Associate.” The irony in this is that we moved all the way to Oregon because I was accepted into a doctorate program with a focus on substance abuse. SoOoOo… a 180 in the whole career thing.
I’m from the East Coast ~ New York & Massachusetts, but Cape Cod is where I grew up. I lived in New Orleans for 5 years for undergrad have a degree in Psychology.
I am no pro but I have seen some shit. I have a list of different psychological diagnoses & feel like the poster child for Big Pharma at times. I decided to start a blog after a failed suicide attempt that I swore I’d keep a secret… it is cathartic, but heavy. Really heavy. I never sleep, don’t leave my house without my xanax, and try to avoid small talk like the plague. Buttttt we’re all just getting by & that’s what this is all about.
I grew up in and around addiction, and have struggled and continue to struggle with an addictive AF personality. I used to hate the saying “one day at a time,” I don’t anymore. I haven’t struggled with any significant substance .issues since 2011, but it’s always there.
Most of the relationships that I stay in turned out to be toxic, with the exception of my boyfriend now. He is the fkn best, and never judges or manipulates. I don’t deserve him.
I am a firm believer of using Cannabis …..for anything, really. So there’s that.
….I don’t really have an answer about why you should read stuff that I share. Maybe because I just want to spread the word about living honestly in the lens of mental illness but still making it through, and make 0 bucks typing these words. Zilch. That’s not the point.
I’ll share more later! It got weird talking about myself so much.
*Me as a child. Yes, I’m serious. I also had to wear headgear at night around this time.
& yes, that’s pleather.
See HuffPost Article Here
By Emily Blackwood
Anyone who has ever gotten cut off in traffic or stubbed their toe on a coffee table knows how quickly anger can go from zero to 100. Most of the time, getting mad is just a part of being human. But in some cases, constant rage could be a sign of a deeper issue: depression.
A 2014 study found that that anger — both overt and suppressed — is actually a common sign of the mental health condition. Psychologists suggest that people who have difficulties coping with their anger are at risk of developing depression. Experts have even described the mental illness as “self-directed anger” or “anger turned inwards.”
“It doesn’t always look like depression, but it is,” said Marianna Strongin, a licensed clinical psychologist in New York.
Research has shown anger is associated with “greater symptom severity and worse treatment response” when it’s part of a mental health condition like depression. That’s why Strongin encourages anyone who is feeling angrier than usual to reach out for help instead of brushing it off.
“A patient will say they’ve noticed, or their friends have noticed, that they’re lashing out more,” she said. “Although they come in to address their anger, when we start digging, the anger is usually a symptom of depression.”
Rather than feeling sad or empty, like we commonly believe people with depression do, some people more quickly turn to anger. Strongin said that’s because it’s often easier to feel angry than it is to experience more morose emotions.
“Sadness is much harder to experience,” she said. “Sadness is a phase, and anger is a verb ― it moves through you. So sometimes [people with depression] distract themselves to not feel sad, so instead, anger gets triggered.”
According to the National Institute of Mental Health, many of the estimated 16.2 million American adults who live with depression are women ages 18 to 25. But Florida-based psychologist Sherry Benton says it’s typically men who exhibit anger as a symptom.
“Their natural inclination tends to lean toward isolation,” she said. “With this comes the need to withdraw from relationships with others, even ones that are healthy. Anger is a seamless secondary symptom to this, since lashing out is generally an effective method of pushing people away.”
Because men so often push loved ones away and mask their depression entirely, it’s more likely to be deadly. Approximately 17 percent of men will have major depression at least once in their lives, and men are 4 times more likely than women to die by suicide, according to a Harvard Medical School report.
But that doesn’t mean women don’t experience anger as a symptom of depression too. Bess Meade, an art director, designer and writer living in Oregon, was diagnosed with depression when she was 19 and experienced anger as a main symptom. She noticed it was getting out of hand when she snapped at a co-worker during a meeting and broke a window at an ex-boyfriend’s house.
“My mom has commented before that I seem angry, and that I should ‘do something about it,’” said Meade, who is now 29. “I think I had a perception of depression as being a weakness, which I don’t believe at all anymore, but made me hesitant to call a spade a spade when I was younger.”
Meade was able to manage her condition and her anger symptoms through a combination of antidepressants and healthy lifestyle changes.
“I started going to yoga classes while I was really struggling with depression about a year ago, and definitely feel like it has increased my awareness of my body and my breathing, which can sometimes help me get out of a funk,” she said.
“With just anger, it’s never just anger. It’s always symbolic of something not working.”– MARIANNA STRONGIN, LICENSED CLINICAL PSYCHOLOGIST
In addition to medication, breathing practices and exercise, Strongin said journaling can be a beneficial tool in managing anger and getting to the root cause of a patient’s depression. She tells her patients to write down their negative thoughts, then question them and look for evidence that what they’re saying is true.
“If the thought is ‘I’m not good enough,’ I’d ask, ‘How are you not?’” she said. “When you have insecure thoughts, follow them up with answers.”
But no matter what tools you find useful, the first step is getting help. Talking with a mental health professional can help you manage depression and its accompanying symptoms.
“With just anger, it’s never just anger,” Strongin said. “It’s always symbolic of something not working.”
“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues that people live with by offering stories, advice and chances to connect with others who understand what it’s like. In February, we’re covering depression. Got an experience you’d like to share? Email email@example.com.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.