Finding the right coping mechanisms for you.

I realized today that it’s only been five months since I came out of hospital where I was treated for major depressive disorder, GAD, and dysthymia. Only five short months, but it feels like a lifetime ago.

In the five months that have passed I have tried living as ‘normal’ a life as possible. I did still see my psychiatrist and take my medication (always recommended!), but we also started a support group for other depression and anxiety sufferers, bought a new car, sold our apartment, bought a new apartment, and I am proudly seven weeks pregnant. The one thing I have learnt from all of this though is that distractions are nothing but that, distractions. I was hoping it would spur me on and give me new life, but instead it’s been stressful and sometimes coping has been tremendously difficult. I have had to quickly learn new coping mechanisms to deal with each situation, some have been more helpful than others, but all have been of some benefit to me over the last few months – hopefully some of them will be of value to you too!

depression

Firstly, I would encourage expressing yourself. Be it in writing, colouring and art, music etc., it doesn’t matter, just find a way to express how you feel in a tangible way. I love painting but I have not had the inspiration to do very much, so we made a mood-board instead. On this board I would write emotive words (sad, happy, frustrated, down) in different colours – black would mean that it’s just caused by the depression and my husband could not do too much to help except for quietly being there for me. Red would mean that I was angry or upset, and that there was a reason other than the depression for it (in other words, a situation that could be dealt with). Blue meant that I was struggling to deal with something on my own. It was the signal that I needed help. This exercise meant a lot to me as a person in that I was able to express how I feel, but it was also helpful for my husband to know what he could do to help me deal with the way I was feeling.

Secondly, the emotional benefits of exercise are too great to explain. Physical exercise helps you deal with stress more effectively, is a good way to help your body work out the hormones caused by anxiety and depression, and alleviates a lot of the physical symptoms of anxiety and depression (sleeplessness, aches and pains, etc) Sticking to a good exercise routine will be hard, sometimes you just won’t have the will to put in the effort, but believe me – it is well worth your while to do this. I took up a martial arts class to help improve my concentration (something that flies out the window with depression), give me discipline, and help me get rid of some of my frustration. Your exercise of choice might be running, or Pilates, or joining your local gym… it doesn’t matter – just do something!

According to many sources, sticking to a schedule can be very helpful. This schedule should help you maintain a healthy work/life balance, and should not be crammed to the max with ‘to-do items’. With depression, something that goes quickly is motivation. Sticking to a well-balanced schedule helps you feel more productive and fuels your feelings of achievement and worth. Make sure to schedule some down-time, some time to do something you enjoy, as well as some time for that exercise routine we just looked at!

Last but not least, learn to lean on others from time to time. Close friends and family can help you feel better about yourself when depression has you feeling down. They can encourage you to follow your treatment plan, help you stick to your schedule by doing certain tasks with you, help motivate you to eat a healthy diet, and generally take care good of yourself. You can also join a support group for the chance to talk to others who understand what you’re going through and can give you some insight on how they managed to cope through difficult times.

The above is not an exhaustive list of coping mechanisms, but are the items I found most helpful on my journey. I would love to hear what you have found to be helpful as well!

 

Depression.. from the inside out

This post was written by one of our members who suffer from Bi-Polar Depression, and is meant to give non-sufferers a better perspective on what depression loos like, from the inside out. The content is harsh but creates a clear picture of what depression feels like, but unfortunately after a few months the writer is still in search of the right treatment, so the happy ending you may be looking for is still pending…

Again, please remember that even though this is a very personal look at depression, help is available from SADAG and your local medical practitioner, and we will be starting a support group for sufferers (or those who are close to sufferers and wish to learn more) on the first Wednesday of July this year. Speak to Tracy or Zane at SADAG for more information on this.

Depression

Depression is a dark place. It is hole inside of me. It is the feeling of hopelessness that grips me too tight. Its something I wouldn’t wish on an enemy. Empty but full of pain. Sometimes I feel numb and other times it hurts so badly I want to die.  When I wake up it holds me down, “there is no point in getting out of bed”, it says. It is very strong. It tells me I am nothing, that no one cares. This intense darkness pulls at me and cackles at me when I try to move forward. I feel as if I am a burden to all that know me. Depression pushes me so far down I feel I have no one that could possible help me, I can’t even help me. I don’t even care if I get help or not.

Life just feels pointless. Why do I need to get out of bed? I can’t accomplish anything and if I did, why would it matter? I just hurt people around me by being alive but I will hurt them if I die. Nothing I do is ever good enough. People say that it is just a temporary feeling but I have felt like this for a very long time with no end in sight.

What is the point of life? I have lost most of my friends because I just don’t have the energy to fight when they get tired of me, I don’t have the energy to talk to people.

Depression drains me of all energy. I am told that exercising will help get rid of depression or at least bring my mood up. How can I do that when I have no energy? My spirit is crushed because of depression. I just get tired of fighting sometimes and sleep away my days. Some days it isn’t so bad but then it slaps me in the face as if it had played a cruel joke, letting me think I was feeling better. I tumble down into the dark hole again.

It makes me want to die but it also tells me that the people around me will mourn my going. So I live for them but is it really living when I die inside every day, every moment?

I don’t understand how it is fair that anyone would have to through this pain, this hopelessness, this agony of depression.

It is a wound that can not be seen. People who have never experienced it look at me as if I am crazy. They say things like “just cheer up”, “its not that bad”, you are fine”, the list could go on. Just because they cannot see it, they discredit it as if it were a fake. I promise you it is real and it hurts more than a physical wound. It is heavy and dark. I look “normal” on the outside. No one can see my pain.

It makes me feel as if I have no future. How could I possibly have a future? I am such a stupid person, a reject, someone who is not worthy of anything. I am not able to function properly, I sleep too much, sleep too little, eat too much, don’t eat at all. Why does this horrible thing exist. If I have no future why am I even here?

My depression is linked with self harm. “I don’t deserve to be happy, I just deserve the pain I have and I deserve more pain, I deserve physical pain too”. It also takes the focus off inner pain to the physical pain. It is not right, it is quite messed up but it is a drastic measure that is taken by many.

Most days I feel like I am too far gone to even exist. I cry a lot and it hurts. It really hurts having depression. People want to help but I push them away because I don’t see how they possibly could. When I have no point in living and no future, how can someone change that? Depression is a terrible companion, a darkness that you cannot explain, an emptiness that persists…

Understanding the enemy…part two

In our last post we looked at the different kinds of depression, and explored the symptoms of each of them. Now that we understand a little more (and hopefully can relate to one of the types of depression described) we can look at the actual physical cause of depression and anxiety.

It has been said that by 2020 depression will be the No.2 cause of disability worldwide. Speaking of it as a disability seems demeaning, but in reality it’s not – it’s just seeing the facts for what they are. You see, depression and anxiety is an illness that stems from changes in the actual chemistry of your brain. Anything from childbirth, to circumstances, to head injury can cause these changes in your neurotransmitters, manifesting itself in the different kinds of depression discussed earlier. It is, however, a disability with an excellent response to treatment, and in many cases doesn’t need to be a life sentence.

One example of such a neurotransmitter in your brain is Seratonin. It allows for the transmission of impulses from one nerve cell to another accross a tiny gap called a synapse. In depression though, the Seratonin levels in these gaps is too little or does not get reabsorbed properly, and that is where the problem lies.

With treatment, the aim is to get these neurotransmitters back up to the levels they should be.

It has been medically recorded that depression affects:

The attention-centre of the brain, impacting your ability to focus on one of several objects or trains of thought;

Your memory, including memories of time and space (episodic memory) and the meaning of things (semantic memory)

Your mental flexibility, meaning your verbal fluency, planning and problem solving capacity, inhibition, and working memory;

The time it takes to perform motor activity, for example your reaction time, rate of speech, and information processing speed;

Your ability to concentrate, which diminishes with time, and;

Your ability to be decisive, decreasing it dramatically.

The most common age of onset is in the late 20’s, but there is a steady rise of cases in the age bracket 15-19 as well. The female to male ratio ranges from two to one to three to one in all cultures, and there is a 6% chance of any adult getting depression at least once in their life. The chances increase to 12% if you have an immediate family member who suffers with the same disease. It must be said though, 70% to 80% of people will respond well to an anti-depressive medication combined with psychotherapy of some kind. For more serious cases, hospitalization (not a bad thing in my experience) and/or ECT (Electro-convulsive therapy) works well, with patients showing improvement within the first 10-14 days, and reports of ‘feeling normal’ again within 6-8 weeks. It is important to remember, however, that treatment should preferably not be stopped within the first six months – the treatment that got you well will keep you well, and it takes a while to get back on your feet.

In some cases, prevention is also better than a cure… in people who have recurring problems with depression, or more severe cases of depression, medication may need to be continued indefinitely to ensure that those ‘dips’ are avoided.

As mentioned in our previous post, help is available from the SADAG-website and we will have a support group starting on the first Wednesday of July this year. The aim of the support group is not to substitute treatment, and we encourage all our members (and members-to-be) to still seek professional help either from SADAG or their doctor.

Depression.. understanding the enemy

Yes, I will label it an enemy. It starts off small, feelings of being blue, and gradually turns into something that affects your entire life. It affects choices, perspective, can cause physical pain, moods, and your ability to live life like your seemingly carefree friends.

But, understanding the enemy is half the battle won, so in this post we will discuss a little more about what depression really is and why it affects us the way it does.

First, it is important to know that there are different types of depression. Types like Seasonal Affective Disorder, which can be affected by simply using light as treatment because it’s caused by too little sunlight during the summer months. Then we have Bi-Polar Depression, which is a manic-depressive illness that needs more intense treatment because of the cycling mood changes. There are up to four different types of Bi-Polar Depression as well, so this will not be the focus of today’s entry. Depression can also be caused by factors as multi-faceted as substance abuse, or as common as Post-Partum depression. (common by no means denotes that it is any less severe than any other type of depression!)

Today, however, we will focus on Comorbidity, where there is at least one other unrelated illness (like anxiety or ADD), Dysthemia, Persistent Depressive Disorder, and Major Depressive Disorder.

Comorbid depression is, as mentioned, when there is at least one other illness that links to but is unrelated to the depression itself. Often it will be anxiety, ADD, or substance abuse. Although this is a serious type of depression, mild treatment and a short stay at a facility such as St Joseph’s in Durban (linked to Entabeni Hospital, and the Life Group Hospitals) will often be successful if taken under the watchful eye of a psychologist and psychiatrist.

Dysthemia is somewhere in between feeling a bit blue, and having full on Major Depressive Disorder. It usually lasts about two years or longer for it to be diagnosed as dysthemic depression, but is easily identifyable – think of Eyore in the popular kids’ series Winnie the Pooh.  You are able to do things with your friends, but nothing ever seems as bright or as fun as it does to them. Your energy levels are low, you sleep A LOT, it may affect your appetite, it causes back, neck, and/or chest pain, and if left untreated, may turn into Major Depressive Disorder.

Major Depression, also known as Unipolar Depression or Major depressive disorder. shows its face in many ways. It is the easiest to spot in others, and has the following symptoms;

  • Feelings of emptiness (like an empty tin, or a hollowed out shell)
  • Moodiness or irritability,
  • Feelings of guilt
  • Thoughts of suicide
  • Low energy levels, no enthusiasm for anything
  • Binge-eating or not eating at all,
  • Loss of interest in things that you previously enjoyed,
  • Loss of libido
  • Difficulty concentrating or making decisions,
  • Difficulty sleeping or sleeping too much.

The above list is not exhaustive, but will give a good indication that it is time to seek out help and make some real lifestyle changes. It is recommended that you seek the help of someone qualified enough to diagnose and prescribe medication to help you cope, and perhaps a support group in your area who can help you keep to the changes you need to make in your life. In the beginning, it may feel like things are the same or even getting worse before it gets any better, so many people give up on the process before it’s actually effective – be careful to ‘stick to it’ no matter how it feels. For most people, even with treatment, it can take six months to a year to get out of this rut.

Many people cannot afford to seek out professional help, but there are avenues of getting the help you need through other channels as well. I know the organisation Focus on the Family offers treatment by professionals at a fraction of the standard price, and has a group of practicing psychologists and psychiatrists who assist them when someone cannot access help on their own. Local churches many times have counselors who can offer assistance in a basic way, and support groups are an invaluable source of help, motivation, and support for anyone suffering with the above. If you are in the Durban area, I would like to invite you to come to our support group meetings on the first Wednesday of every month at 171 Bulwer Road in Glenwood – please see our website for more details.

A Mental Illness.. what?!

“You need to be admitted to a mental facility as soon as possible, your anxiety levels are through the roof…”  “I know, but everyone gets anxious from time to time. It’s not a big deal” “It is, it’s a mental illness in your case, and you need treatment to bring you back down to normal levels of anxiety”

A mental illness…What?! It suddenly became very real. Very, very real. All the stress, all the times I felt inexplicably ill, all the ‘bad moods’. It suddenly had a very ugly name. The first thing I thought was that if I had a mental illness, no-one should know… after all, I don’t want to be seen as crazy for the rest of my life, do I? But I went home and told my husband, whose amazing response was “oh, okay.. when do you need to be admitted, and what can I do to help you?”

I went to hospital that week for a fourteen-day stay, not knowing what to expect. But, instead of people in gowns dribbling down the hall with drips in their scrawny arms, I found normal people like me, just a bit stressed out and with a slightly darker sense of humor than most. We would joke about our diagnoses at the breakfast table, swop stories about our lives and families at lunch, and laugh about the craziness of life in general that got us admitted in the first place. It was a sense of family, a sense of belonging, and best of all, no sense of shame in admitting we could not cope. We still keep in touch with each other, still complain about rough days, and still help out with names and recommendations of medications to discuss with our doctors now – almost a month and a bit later.

I think to a degree we all feel depressed, anxious, or downright nuts sometimes. We even joke about it, and say all too often that someone is certifiable. But when it comes down to it, and we expect this to be the way in which our “news” will be met as well. Instead, we need to understand that this is a reality for very many people, and that it’s not a sentence to the mental-hospital forever. It’s no worse than going to the hospital for a broken leg really, but we all are hesitant to go seek help when we really feel like things are going off the rails, and many people struggle through life either offended by the diagnosis, or simply not getting diagnosed at all. The stigma attached to mental illness of any kind, not only depression or anxiety, is alive and well even in our enlightened age.

Today I heard that a dear friend (whom I met during my stay at St Joseph’s Hospital in Durban) took a very brave step, and went to be readmitted to hospital because she still was not coping with every day life. I applaud her bravery and would encourage more people to face it head on as she did, and still does. It saddens me that her recovery isn’t going as well as we had hoped, but I admire her for being open and honest about it, and for reaching out to her friends and family for support instead of accepting silently that she needs to be hospitalized again out of a misplaced sense of shame. Well done, Bronwyn, for putting yourself out there. We can all stand to take a page from your book!