about depression...

After my last post about the autumn, a lot of questions about depression have been coming up. Naturally, people are curious what they can do about seasonal depression, and likewise about their mood in general. 

It's late winter now--we're past the new year and most people's enthusiasm for cold and dark seems to wane sometime around this point. A colleague of mine recently thoughtfully noted to me though that we're actually past the worst part: the solstice--Dec 22nd--is the longest night. We're on our way out now. If you're dealing with seasonal depression, keep this in mind. It will be coming to an end soon. 

Different people experience seasonal depression differently: for some the worst part is the fall. For others, it's the mid-winter darkness. For yet others, it's the sheer longevity of winter or the contrast between the urge to nest and the demands of work and life. Whatever your experience, remember to be kind to yourself. Vitamin D supplements, light therapy, and being around warm people all will help. But something easily overlooked is curiosity about your experience: it's very easy to jump into a mode of fixing things. When it comes to the mind, fixing things doesn't always work. 

More about depression in general...

The most important take home message about depression: 

If you're dealing with depression, you're not alone. Depression is very common. A BBC News article came out last November about the global impact of depression. Depression, is, perhaps surprisingly, a global issue. 
I say "perhaps surprisingly" because a common feature of depression is a feeling of aloneness, alienation, or lack of support or understanding from others. It can be hard to believe others feel exactly the same. Other common symptoms are hopelessness, self-blame, feelings things will just continue like this forever (remember what I said? winter is going to come to an end), lethargy, poor (or over-active) sleep, changes in appetite, certain kinds of obsession, and (in some cases) suicidal thoughts.  Culturally we also tend to sweep depression under the rug, which can add feelings of shame and the need to hide. In truth, these feelings are symptoms, you might say, of something all-too-common. 

It didn't always used to be so common. We don't know why, but depression has increased significantly over the last century. Nobody (as far as I know?) clearly understands why. Perhaps it's something to do with modern lifestyles? Or with lack of community? Other changes in social structures? The industrial revolution?... There are many theories.

In contrast, I talk to many people who understand depression (and most mood problems) as the result of a chemical imbalance. Usually people are referring to the theory that mood is tied to serotonin levels in certain parts of the brain. SSRIs (Serotonin Synaptic Re-uptake Inhibitors) work based on this theory... Though, truthfully, at this point, nobody is sure how exactly neurotransmitters, especially in relationship to one another and to experience.

One very important thing to remember is that brain chemistry (in whatever form) is not a one way street. Often, when someone tells me he or she has a "chemical imbalance" it's a way of saying, "It's not my fault I feel this way--it's biological!" On the one hand, I agree with the sentiment of blamelessness: it's not going to help to say it's your fault you're depressed. Remember self-blame is a symptom of depression (I listed it above)--getting mired in self-blame usually worsens the depression. On the other hand, when someone says his or her depression is biological, it's usually a way of saying nothing can be done about it except a pill.

In a perfect world where antidepressants worked like antibiotics or athletes feet creme, that would be fine: you could say, "it's a biological problem!," take a pill, and be better. But depression isn't like that. Antidepressant medications, when they work, may address a chemical imbalance, but they re-balance it only temporarily. Don't get me wrong--antidepressants can be great tools on the path of recovery, but the real work of depression is to change brain chemistry by changing how one thinks. 

This isn't as hard as you might imagine. We've actually been changing our brains for thousands of years. It seems that that's what our brains are actually built for. We used to think that people would learn stuff and their brains would change until they hit their mid-thirties and then their brains would start dying and it was all downhill from there. We know now that this is very far from the truth. In fact, neuroscientists have been noticing how much what we do with our minds changes our brains. A great layperson's book about this is The Brain That Changes Itself by Norman Doidge. In both classical Buddhist thought and in Cognitive Behavioral Therapy, the idea that thought creates mood (and even one's experience of reality) is well established, and both traditions contain powerful techniques for changing how one thinks. Happily, psychotherapists (at least ones like me) are learning from both of these lineages.

If you're looking for a practical take-away, remember how I started: first to remind yourself that you're not alone. Get yourself whatever kind of help you need: see a therapist, a psychiatrist, or your doctor and talk to warm friends. If you're noticing suicidal thoughts, utilize lifeline or contact emergency services for your area (link is for Western MA). Like my colleague pointed out, the darkness will come to an end.