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Depression | Depresión

Depression

When things do not feel right

What is it?

Depression is an emotional state marked by great sadness and feelings of worthlessness and guilt. We all experience sadness occasionally but when it is persistent and accompanied by a loss of interest in activities that we normally enjoy, we could be looking at depression.
Depression does not look the same for everyone and consequently how we deal with depression changes from person to person. For example, many focus on physical (somatic) symptoms rather than emotional ones. Others brush it under the carpet, ignore their feelings and live in a depressed mood state for a long time.
 
 

What does it feel like?

Depression is felt in every area of our lives and it is felt both physically and emotionally. People with depression isolate themselves; some lose their appetite while others eat more than usual. Some lose their sleep while others have a hard time getting out of bed. People experiencing depression feel exhausted easily, speak slowly or might prefer to remain silent. Others cannot sit still, sigh, moan and complain often. They find it hard to solve problems or come up with creative ideas. Every moment feels heavy and simple tasks can look like huge mountains. Their heads are filled and reverberate with self-recriminations. They can neglect their personal hygiene and appearance.
These deep feelings of sadness and hopelessness are hard to deal with, so our natural tendency is to numb them. In order to do so some resort to alcohol, drugs (both prescribed and/or illegal) or other addictive behaviours. Frequently, the family focuses on the behaviour rather than on the root cause, or the disconnection that comes with depression.
On a physical level, people who experience depression feel aches and pains with no apparent physical basis.

How depression is felt

Depression can be felt in the form of:
  • headaches,
  • migraines,
  • pain in the upper arms and shoulders, stomach and/or abdominal aches.
  • Lower back pain .
  • Insomnia

However, there is no way to know what is physical and what is psychosomatic. The best thing to do is to talk to your family doctor and share your concerns, both physical and emotional. Talking to a therapist at the same time can be the best course of action. 

Note: Some studies suggest the possibility that men and women do not cope with depression in the same way. They propose that men try to numb depression by getting distracted while women tend to ruminate about their feelings and question their validity and logic. This could lead them into a dangerous cycle. On the other hand, men who would rather not talk about it (because of the expectation or assumption that real men do not feel sadness or fear) vent by using the only “appropriate” feeling…anger.

What to do about it?

I hope is clear to you by now that living with depression, albeit more common than you think, is not “normal”. It might be hard to accept it and even harder to believe that it can get better, but it can.
The first thing to do is to STOP telling yourself or others to “GET OVER IT”. No one chooses to be depressed, IT IS NOT A CHOICE. Be compassionate to yourself or someone experiencing it and if possible lend an empathetic ear.
Talk to your family doctor and share your symptoms. They might be able to guide you to community resources that can help you connect with others in the same situation as yours. They can perform assessments (or at least suggest a professional who can), and if necessary prescribe medication. Keep in mind that it takes time and several iterations to find a medication that works for you, so be patient and share with the doctor any relevant information.
There is evidence that the combination of medication and therapy is the best course of action for severe depression. For mild depression, therapy might be the first recommendation.
Some therapies have been proven to be more effective than others in the treatment of depression. For example, CBT (Cognitive Behaviour Therapy) and ACT (Acceptance and Commitment Therapy) are two of them. They will teach you coping and thinking skills that can eliminate what are called NATs (Negative Automatic Thoughts). NATs are ideas and beliefs that you have about yourself that could be unrealistic, distorted or based on a specific time of your life that is no longer prevalent but from which you learned something about yourself. TA (Transactional Analysis) is an effective therapy that can guide you to uncover your life script and allow you to review what some of those beliefs are and how to re-decide or change them.

Managing Anxiety

We all experience anxiety differently depending on our personal situation, our history, our personality and circumstances. Dealing with anxiety in a healthy manner can be as simple as looking online for some resources that can help you cope or as complex as getting a formal diagnosis for the disorder. Of course, there is always the middle ground, the place where simple online links will not help but a diagnosis is not necessary. That is the perfect place to seek help from a trained professional, someone who can listen to your worries, your concerns and provide you with insights regarding strategies, behaviour changes you could make, feedback on your thoughts and/or distortions, and more importantly explore the reasons why some people, incidents or situations might have become triggers for you. At the other end of the spectrum, we have a disorder. An anxiety disorder diagnosis is not a death sentence though. You can learn to manage and cope with anxiety in a very healthy way. The first thing to do is to consult with your family physician. He/she can help you or connect with community resources and/or a trained mental health professional that can help you with diagnosis and to acquire some strategies that will help you overcome anxiety.

Strategies to remember

Besides medication, there are several strategies and therapies that are scientifically proven to help us cope with anxiety. These are some of them:
  • CBT
  • CBT + TA
  • Biofeedback
  • EMDR
  • Meditation
  • Relaxation techniques
  • Acupuncture

“Adverse Childhood Experiences (ACEs) can have a lifelong impact on your life. Knowing what those are can serve as an explanation for your current situation. They can provide you with the inspiration to responsibly change your life”

Depression

Cuando sientes que no hay esperanza

¿Qué es depresión?

Depresión es un estado de animo en el que sentimos gran tristeza, sentimientos de inutilidad, impotencia y sentido de culpa. Todos sentimos tristeza en nuestras vidas pero cuando es persistente acompañada de perdida de interés en actividades que normalmente disfrutamos, debemos considerar la presencia de depresión.
Cuando se trata de depresión, todos tenemos maneras diferentes de sentirla y como consecuencia, todos tenemos maneras diferentes de enfrentarla. Por ejemplo, muchos se enfocan en lo que sienten físicamente (que se le dice síntomas somáticos) en lugar de lo que esta pasando desde el punto de vista emocional. Otros prefieren ignorar los síntomas, los sentimientos y las emociones y vivir deprimidos por mucho tiempo.
 

¿Qué se siente?

La depresión afecta todas las áreas de nuestras vidas y se siente emocionalmente y físicamente. Las personas con depresión se aíslan, algunas pierden el apetito mientras que otras comen más de lo normal; algunas pierden el sueño mientras que a otras les cuesta trabajo salir de la cama. La mayoría se siente cansada todo el tiempo y con facilidad, en parte debido a la lucha interna con sus propios pensamientos auto-recriminatorios. Les cuesta trabajo pensar con claridad y resolver problemas con facilidad o ser creativos.
Cada momento se siete pesado, como si fuera una carga abrumadora. Se descuidan su higiene y de su apariencia personal. Estos sentimientos de tristeza profunda, de inutilidad, de impotencia son difíciles de explicar y de eliminar, por ende nuestro instinto es de anonadarlos. Para eso usamos alcohol, drogas (ambas prescritas o ilegales) u otro comportamiento adictivo. Frecuentemente, los miembros de la familia se enfocan en el comportamiento en lugar de los sentimientos, o sea la falta de conexión con los seres queridos que ha creado la depresión.
Desde el punto de vista físico, las personas que luchan con depresión, sienten dolores que no tienen aparentes conexiones con causas físicas reales. La depresión se puede sentir en forma de dolores de cabeza o migraña, dolor en los hombros o el cuello, o en los brazos, dolor de estómago o intestinal. Se puede sentir también la parte baja de la espalda o en el pecho. Como no hay manera se saber por seguro si el dolor es debido a una causa física real, es recomendable que vea a su medico de familia y le comente los síntomas ambos físicos y emocionales.
Nota: Algunos estudios sugieren la posibilidad de que hombres y mujeres sientan y expresen su depresión de manera diferente. Por ejemplo, se piensa que los hombres tienen la tendencia a hacer actividades que los distraen de su depresión (ver la televisión, beber más de lo normal, hacer tareas caseras sin intensión) mientras que las mujeres tienen a rumiar sobre sus sentimientos, la validez y la lógica de los mismos lo que las puede llevar a un circulo vicioso peligroso. Por otra parte, los hombres que prefieren no hablar de su depresión (debido a normas sociales contraproducentes y anticuadas que dictan que no es normal que un hombre sienta tristeza o miedo) tienden a usar el único sentimientos “apropiado”, la ira.
 

¿Qué se puede hacer?

Espero que para ahora ya se haya dado cuenta de que vivir con depresión, aunque común, no es algo normal. Es posible que sea difícil aceptarlo e incluso mas difícil creer que haya algo que se pueda hacer al respecto, pero lo hay.
Lo primero que hay que hacer es DEJAR de decirnos cosas como “deja la payasada” o “IGNORALO”. Nadie escoge estar deprimido por su propia voluntad. No es algo que uno ESCOGE ser o estar. Ten compasión y paciencia, especialmente contigo mismo y si es posible presta atención con empatía.
Hable con su medico de familia y comparta los síntomas, ambos emocionales y físicos. Él o ella podrá guiarlo a recursos comunitarios que lo ayudaran a conectar con personas que al igual que usted, están sufriendo en silencio o solas. También el medico puede hacer algunas evaluaciones mentales (o al menos referirlo a un profesional que pueda) y si es necesario el medico también puede prescribir medicamento. Por favor, sepa que toma tiempo y variaciones para encontrar un medicamento que le sea efectivo y con pocos efectos secundarios, así es que sea paciente, y comparta con su medico cualquier información relevante.
Hay evidencia de que la combinación de medicamento y terapia es la mejor manera de combatir la depresión severa. Para la depresión moderada, la recomendación principal es terapia.
Algunas terapias específicamente parecen ser más efectivas que otras en el tratamiento de la depresión. CBT (terapia cognitiva de comportamiento) y ACT (terapia de aceptación y compromiso) son dos de esas terapias. CBT y ACT le enseñaran mecanismos de comportamiento y pensamiento que pueden ayudarlo a eliminar sus NATs (pensamientos negativos automáticos). NATs son ideas y creencias sobre sí mismo que son posiblemente distorsionadas, exageradas o poco realistas que adquirió en algún momento en su vida o basadas en momentos específicos que ya no son prevalentes pero que cargan el peso de su auto-definición. TA (análisis transaccional) es una terapia muy útil para sacar a relucir su guion de vida y permitirle revisar algunas de esas creencias sobre usted mismo, explorar si dichas creencias son ciertas o creadas y como consecuencia, tomar la decisión de cambiarlas o reajustarlas.

Managing Anxiety

We all experience anxiety differently depending on our personal situation, our history, our personality and circumstances. Dealing with anxiety in a healthy manner can be as simple as looking online for some resources that can help you cope or as complex as getting a formal diagnosis for the disorder. Of course, there is always the middle ground, the place where simple online links will not help but a diagnosis is not necessary. That is the perfect place to seek help from a trained professional, someone who can listen to your worries, your concerns and provide you with insights regarding strategies, behaviour changes you could make, feedback on your thoughts and/or distortions, and more importantly explore the reasons why some people, incidents or situations might have become triggers for you. At the other end of the spectrum, we have a disorder. An anxiety disorder diagnosis is not a death sentence though. You can learn to manage and cope with anxiety in a very healthy way. The first thing to do is to consult with your family physician. He/she can help you or connect with community resources and/or a trained mental health professional that can help you with diagnosis and to acquire some strategies that will help you overcome anxiety.

Strategies to remember

Besides medication, there are several strategies and therapies that are scientifically proven to help us cope with anxiety. These are some of them:
  • CBT
  • CBT + TA
  • Biofeedback
  • EMDR
  • Meditation
  • Relaxation techniques
  • Acupuncture

If you are experiencing depression and/or anxiety, unplugging for just 1 hour from social media and/or your electronics can help moderate your symptoms. Also, pay attention to your sleep patterns. Consult with your doctor to make sure there are no physiological factors influencing your mood. 

Resources and Handouts

Sometimes we just need a little help

Considering medication

Use This

resource to help you through moments of depression in an organic way
Click Here

Challenging ANTs

Use This

resource to recognize and fight ANTs (Negative Automatic Thoughts)
Click Here

Behavioural Activation

Use This

resource to help you break the cycle of depression (depression/isolation/lethargy)
Click Here

Critical voice

Use This

document to keep track of the negative thoughts and the critical voice in your heead.
Click Here

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