Stop right now and check in with how you are feeling. Now put the spotlight on how you felt yesterday. And last week. And last month. And last year. What does your emotional audit tell you?
Are you in a good place much of the time? Do you have moments where you enjoy life, connect with others, experience pleasure and meaning and fulfillment and feel good about yourself and positive about life? Or have you been mostly flat lining?
If you can’t remember the last time you had a good belly laugh or climbed out of bed feeling happy to face the day, you could be at risk of depression. Or you could be en route to depression or already experiencing this serious mental health condition. You’re not alone.
Depression is the leading cause of ill-health and disability worldwide, says the World Health Organization. It’s a global health crisis with more than 300 million people living with the condition — an increase of more than 18 per cent between 2005 and 2015 and that figure is constantly rising. This is startling given that research shows that chronic depression carries risks that are equal to the impacts of smoking or not exercising.
In Australia, one in 11 people report having depression or feelings of depression, according to the last 2014–2015 National Health Survey by the Australian Bureau of Statistics. Women (10.4 per cent) experience more feelings of depression than men (7.4 per cent). This may be due to hormonal shifts during the menstrual cycle and life changes like pregnancy and motherhood.
Though it’s normal to suffer low moods that pass, chronic gloom, teariness and exhaustion that interfere with day-to-day life should never be ignored. Depression is more than just feeling a little down. It dominates mind, body and soul,changing the way you think and behave. It can impact on everything from hormones and brain chemistry to thought patterns and physical responses to stress.
One key point of difference is that depression lasts more than several weeks and the feelings become chronic and start to impact on your quality of life, relationships, work or study performance and health. Common symptoms of depression include:
- Feeling sad, teary, empty, hopeless, worthless, overwhelmed and that life is not worth living
- Withdrawing from close friends and family
- Recurring thoughts of guilt, self-blame or feelings that you are a failure
- Significant changes in sleep patterns, appetite and/or weight
- Constant fatigue and difficulty getting out of bed
- Increased irritability, frustration or moodiness that’s out of character
- Loss of interest and enjoyment in activities you once found enjoyable
- Agitation and anxiety
The many faces of depression
Depression is an umbrella term that refers to a range of different mental health conditions, including:
- Mild, moderate or major depression: You feel persistently sad, unhappy and low and find it hard to function at work or face work. You may withdraw from friends and family, lose pleasure in activities you used to enjoy and feel empty and that life has no meaning.
- Bipolar disorder: For no obvious reason, moods swing from intensely high (mania) to extremely low (depression). The highs often lead to erratic or energetic behaviour, while the lows may cause lethargy and the desire to hide away from the world.
- Dysthymia: Is a form of low-grade depression that causes ongoing low mood. It can persist for years without being diagnosed.
- Cyclothymic disorder: Causes alternating mood shifts, such as feeling very happy or quite low. These shifts may go on for months then suddenly change. Meanwhile, they may lead to changes in behaviour, appetite, self-confidence and ability to socialise.
- Seasonal Affective Disorder (SAD): You experience a plummet in mood during the winter months. SAD can make you feel depressed, withdraw and want to eat and sleep more than usual. SAD is thought to be caused by lack of exposure tos unlight, affecting the production of melatonin, which regulates daily biorhythms and the sleep/wake cycle. Sitting under special sun lamps and seeking short episodes of sun exposure may help.
- Antenatal and post-natal depression: During pregnancy or after the birth of a child,some women experience depression due to the big life transition of becoming a mother, with the range of feelings that go with this, including anxiety, exhaustion and fear of being responsible for the health and wellbeing of their child.
- Agitated depression: This can lead people to suffer chronic anxiety, which makes them feel physically uptight and emotionally drained. Overtime, this anxiety can lead to major depression.
Depression does not always hit your life like an electrical storm; sometimes it’s more like an overcast day that goes on and on with no promise of sunshine. It can be caused by chronic stress at work (such as a job you dislike or a high-voltage boss), relationship issues (a bad break-up) or your lifestyle (for example, a combo of too much stress, too little downtime and too little sleep).
Sometimes depression occurs with no obvious triggers. If you tend to be self-critical, anxious, pessimistic or a perfectionist, you may be more vulnerable to developing depression.
Depression comes in different forms. Reactive depression sometimes follows a life event, such as a loved one dying. Biological depression often has no obvious trigger or may kick in after chronic difficulties such as being unemployed.
A tendency to depression and anxiety can also run in families due to inherited genes. However, just because you have a genetic predisposition it doesn’t mean you will definitely suffer from depression — there are proactive steps you can take to help protect yourself.
Changing your emotional landscape
In our busy modern world, many people complain of being pushed for time, which can prove a fast track to feeling overwhelmed or isolated and then depressed. Don’t ignore those powerful feelings.
Your emotional state impacts on every level of your physical health. If you’re often feeling upset, unhappy or stressed, this can switch on your fight-or-flight response to varying degrees. This response prepares your body to fight a tiger, so your blood pressure and heart rate go up, while your body pumps out more glucose and fats for extra energy. Meanwhile, processes like digestion slow and your immunity drops.
If the tigers are in your mind, however, you don’t get the chance to utilise those adrenal chemicals through physical action, such as fighting or running. Over time, repeated release of these adrenal chemicals can increase your risk of getting conditions like diabetes and heart disease.
Depression is often triggered by a range of different emotions and concerns. Identifying those recurring feelings can help you address which of the following emotional states you’re stuck in so you can work on changing and challenging them.
Signs: You breathe faster and feel sweaty, shaky, hyped up and nauseous.
Impact: Though anxiety can help you run from a burning building, if it’s disproportionate to the situation, it negatively affects everything from your relationships to your ability to fight off a cold. Grappling with chronic anxiety can wear you down to the point where you suffer depression about feeling anxious and constantly wired.
Change it: Recognise your anxiety triggers, such as going to parties or worrying about work deadlines. Consciously slow your speech, movement and thoughts. Breathe in and out to the count of three or five to reduce your stress levels.
Channel more: calm.
- Become more mindful: When you fully engage in the sights, sounds and feelings of every moment you can’t worry about the past or future.
- Eat regularly: Skipping meals causes a drop in blood sugar that’s bad news for your energy levels and can cause hormonal changes that totally ramp up anxious and depressed feelings.
- Try EFT: The Emotional Freedom Technique can help to promote calm and elevate your mood. Often called Psychological Acupressure, it involves tapping on a number of acupressure points on the body while you either repeat positive affirmations or state your most negative thoughts and feelings. Tapping on certain acupoints while activating your most negative thoughts appears to help reset your neural functioning so those feelings no longer trigger the same big responses and you feel less bothered by them.
Signs: You feel the future is bleak and obsess about things like climate change, your diet or whether you will ever find the right partner.
Impact: When you often get upset or stressed or despairing, you strengthen the wiring for those emotions in your brain, so the gloomier you are the gloomier you continue to feel.
Change it: Have positive expectations. Expect the best from life and people and this will help to open your eyes to all the positive things happening around you every day.
Channel more: Hope.
- Enjoy feel-good thoughts and activities: Take up painting, book in for a massage, watch the sun set. The neuroplasticity of the brain means that every time something makes you feel happy, stimulated or uplifted, you strengthen those positive pathways in your brain. Feel good more often and the pathways forming your negative brain networks will grow weaker.
- Shake things up: Take risks, make new social connections, eat at a different cafe or go for that promotion. Trying new things can lift you out of the rut that may be causing you to feel gloomy.
- Choose to be happy: Write a list of emotional states you would like to feel more of and five ways to increase each emotion. For example, for more laughter, watch some comedies on DVD, speak in a silly voice, tickle your partner, ask a friend to tell you a joke. Then give your happiness action plan a try.
Signs: You tell yourself constantly that you’re not good enough and lie in bed going over your conversations with people, worrying that you may have talked too much or said something tactless.
Impact: Every time you are critical of yourself your negativity encourages the release of chemicals that make you feel lower than before.
Change it: Engage in emotional regulation. Don’t suppress emotions like annoyance or frustration, but acknowledge their presence without getting caught up in them.
Channel more: Compassion.
- Be kind to yourself: Speak to yourself the way you would to a friend if they were feeling upset or unhappy.
- Break with the past: Don’t hold on to past annoyances and upsets, such as being retrenched from your job. Reliving those feelings over and over will only make you more bitter and miserable. Write a letter outlining the many ways in which a past hurtful event upset you then tear it up as a symbol that this is in the past and you are putting it behind you.
Signs: Worry and what-ifs dominate your thinking.
Impact: The worry doesn’t change anything but can leave you feeling constantly inadequate and overwhelmed. Overtime, such fears can also hold you back from taking risks that could open up your life to new pleasures, people and experiences.
Change it: Take control where you can. Challenge your fears by asking yourself, “What’s the worst thing that could happen?” You will soon realise that you can cope with worst-case scenario. Then look at what the evidence is that the worst will happen and it’s probably much more likely that things won’t get that serious (and even if they do, you will be able to cope).
Channel more: Hope.
- Face your fears: Write a list of your fears then beside each one note strategies to address them so you realise you do have some control.
- Hear hopeful stories: When you’re with loved ones, talk about great things that have happened to you this week so that they share their hopeful stories, too.
- Stare at a flower: This kind of spot meditation also works well when you look at a pond or clouds or picture. Better still, engage in deeper meditation for up to 20 minutes once or twice a day. The act of slowing down and becoming more mindful during meditation not only re-energises your body and mind but also benefits the immune system, helping your body work more efficiently to keep you well.
Signs: You often feel overwhelmed and caught in a rut but don’t know how to reconfigure your life.
Impact: The more you tell yourself your life is beyond your control, the more hopeless and helpless you feel and the less you will try to improve your situation.
Change it: Separate thought from reality. Remind yourself that just because you think something doesn’t make it true.
Channel more: Realism.
- Watch what you think: Avoid unhelpful thinking styles, such as black-and-white thinking or catastrophising. This will help you keep events in perspective, so life seems less overwhelming.
- Remember other low times: Remind yourself of other life difficulties you have managed to cope with even when you thought you couldn’t go on.
Signs: You constantly beat yourself up over everything, from eating that piece of cake to losing your temper or saying something you regret.
Impact: When guilty thoughts becom ea habit they can provide a roadblock to happiness, even though they are often unfounded and irrational. Guilt can often be a sign of low self-esteem; you beat yourself up to remind yourself you’re not worthy.
Change it: Accept you’re not perfect. We all make mistakes and if we learn from them we become better people. Know when you’re not to blame. If your pet cat was sick and died before you could get to the vet, then the illness, not you, is responsible.
Channel more: Pride.
- Pat yourself on the back: If you’re honest you’ll realise that most of the time you’re doing your best as a friend, partner, work colleague and human being.
- Write yourself a letter of forgiveness: Address it to yourself to help let go of guilt or feelings of failure about times when you feel you made mistakes or were not your best self. State why you are writing the letter and what you feel guilty about. Make your expression of forgiveness to yourself and note what you learned, what you are managing better now and how well you are doing.
Good mood food
A growing body of evidence suggests depression is not simply caused by what you think but is related to a chronic state of inflammation in the body that then affects everything from your hormone levels to your brain function.
Eating too many processed foods that are high in fats and sugars can contribute to this state substantially by causing low-grade inflammation that contributes to anxiety and depression, according to research from Deakin University. Fast foods have also been linked to a smaller hippocampus — the part of your brain responsible for regulating mood.
Most importantly, a poor diet increases the populations of bad bacteria in your belly and a growing body of evidence shows that unhealthy gut bacteria can directly impact on mood and is linked to depression.
Unsurprisingly, research shows that people who eat a diet rich in fresh fruit and vegetables, whole grains and lean protein are less depressed and less anxious than those eating a diet high in processed foods. That’s good reason to plate up with depression-beating foods including:
- Mediterranean meals: People who eat a traditional Mediterranean-style diet, tucking into foods like Moroccan vegetable tagine, minestrone and chicken cacciatore, enjoy better mood and lower incidence of depression, says research from the School of Health Sciences at the University of South Australia. The Mediterranean diet is high in minerals such as magnesium and zinc, needed for many important biochemical reactions that benefit mood and ensure optimal brain function.
- Deep sea fish: Omega-3 fatty acids found in foods like fish, nuts, seeds and dark leafy greens help maintain the health of the brain’s cell membranes and assist the transmission of feel-good chemicals like dopamine and serotonin.
- Blueberries and broccoli: Fruit and vegetables are packed with polyphenols. These potent antioxidants support brain health. Their high fibre content helps keep blood sugar and energy levels stable, which can reduce anxiety and lower depression. People who eat three to four serves of vegies every day experience lower levels of stress, according research from the University of Sydney.
- Nuts: Snacking on almonds, cashews, walnuts and macadamias is good news for your mental health. Nuts contain the mineral magnesium, which is a natural muscle relaxant. If you have low magnesium levels you’re more likely to experience anxiety, shows research from the University of Innsbruck.
- Jasmine rice:T his kind of rice is rich in tryptophan, an amino acid that helps your brain make serotonin. As serotonin helps your body make melatonin, the sleep hormone,you may then enjoy better zzzs, according to research from the University of Sydney.
- Whole grains: Foods like rye sourdough bread, wholemeal pasta and brown rice give your body a slow release of energy, which keeps hormones stable. They also boost serotonin, which can help improve mood.
- Fermented foods: Women who eat more fermented foods have lower levels of social anxiety, according to research by the University of Maryland. So serve up a little sauerkraut, sourdough, kefir or kimchi (a Korean vegetable dish) every day to boost good belly bacteria and help you feel more relaxed.
Emotional life rafts
When you are depressed you can feel all at sea and struggle to feel grounded and centred. The following can help shift depression and make you feel more in control of your life and your mood.
- Find more meaning in life: Birthdays, life changes and a dull day-to-day routine can prompt you to ponder everything from the big life questions (“Why are we here”) to the choices you are making in your life (“Why do I stay in a job/relationship I hate?”). If you are confused about the answers you may feel purposeless, aimless and downhearted because your life appears to lack meaning.
- Boost your mood: Help others. Do volunteer, charity or fund-raising work or simply help out a frazzled mum or ageing person living in your street. Contributing to other people’s lives can help your own life feel more meaningful.
- Discover your passions: Go back to old hobbies you’ve let go or try learning new skills to find activities that make you feel vital and satisfied. Make time to fit them into your life on a regular basis.
- Read books about self-knowledge and wisdom: These will give you ideas about how to live and think in a more spiritual way.
- Express your values: Speak, think and behave in ways that promote the ideals you value most, whether you want to be open and authentic in your relationships, more available for your family or less materialistic.
- Stop deferring happiness: Do you live your life thinking “I’ll be happy when I’m five kilos lighter/don’t have a mortgage/find the right partner”? When you create preconditions to happiness it’s often more difficult to attain. You also forget to be happy in all the present moments when you could be more fully enjoying your life by being more mindful. Instead, realise that happiness is not an unchanging state but occurs in moments such as feeling the sun on your face or enjoying a hot cup of tea.
- Take back control: Give your life a simplicity makeover with changes such as finding a less demanding job, moving to a smaller house to downscale your mortgage,cutting back on one after-school activity to have more family time and putting yourself first instead of always trying to please everyone.
- Slow down: Keeping chronically busy can be a subtle form of avoidance that shields us from recognising and changing the things in our lives that are not making us happy. Reality check to identify these roadblocks to calm and happiness and address them.
- Keep a worry diary: Write down what is bothering you then try to put it out of your mind. At the end of the day, review your concerns and address their causes (eg “I take on too many tasks”) and some solutions (eg “I need to delegate more”).
- Write a letter from the future: Fast-forward a few years or a decade and write a letter that prioritises how you wish your health,relationships, career and lifestyle will be. Focus on your character strengths. Describe what is happening in your life in the future and what you are thinking and feeling. Write about how your needs and values are being met and how these are motivating you. Write about how you created these changes. Be as detailed as you can. A powerful tool, the letter from the future helps you recognise your core values so you can then work on achieving them. This can help combat depression. After writing the letter, identify two or three little things you can do to help make purposeful change towards those desires for the future.Write down those action steps and follow them through. This will help you feel far more in control of your life, which will reduce fears about the future.
- Become more mindful: Mindfulness can be a powerful ally against depression because it reduces rumination.
Boost your mood
- Find your flow: You know that great feeling when you’re so absorbed in an enjoyable activity that you forget the time and lose yourself for a while? This state, which musicians, painters, athletes and writers often enter, has been called “flow” by psychologist, Mihaly Csikszentmihalyi, who has found it’s a powerful path to happiness. So embrace activities that lead to a state of flow, such as painting a water colour, rock climbing, doing a jigsaw puzzle or playing an instrument,and increase happiness and satisfaction with life.
- Unhook from your thoughts: Ask yourself, “Is it helpful for me to dwell on this, hold on to my fear or sadness and play it over and over in my mind?” This will encourage you to realise that worry is no protection and does not better prepare you for the worst but actually wears you out. This is your cue to bring your thoughts back to the present and become mindful.
- Express yourself: Tell friends and family how much they matter to you. This will bring more love, connection and intimacy into your life.
- Practice kindness and giving: Drop a meal in to a sick friend, baby-sit for your exhausted sister or offer to make your partner breakfast today. Being thoughtful, generous and empathetic will make you feelgood about yourself and the higher self-esteem helps reduce negative emotions.
- Change the focus of life goals: Shift from setting goals to make yourself happy to seeking to fulfil your values to feel happy.
- Enjoy a cuddle: Nothing is more precious than a big, lingering hug with your kids, partner, friend or dog.
- Move it: Exercise boosts natural feel-good chemicals such as serotonin, causing a sense of wellbeing. The more time we spend doing vigorous exercise, the less depression, anxiety and insomnia we experience, according to research at the University of Illinois. Keep in mind, though, that at the severe end of depression, exercise on its own is not treatment enough and other strategies such as counselling(and sometimes medication such as antidepressants or supplements such as St John’s wort) are important, too.
- Believe in yourself: Acknowledge that you are a good person and that you are intelligent, compelling and appealing. Tell yourself you deserve to be happy.
- Salute the sun: After taking up yoga, people enjoy increased levels of a brain chemical called gamma-amino butyric acid (GABA), which is linked to improved mood. Poses like down-facing dog and tree posture may be the ultimate mood-enhancinge xercise, says 2010 research from the Boston University School of Medicine.
- Become a pleasure seeker: Walk at sunset. Catch up with friends. Enjoy a candlelit bath. Scheduling pleasurable activities into every day provides an instant mood boost and ensures you always have something to look forward to.
- Try karaoke therapy: Sing in the car or at home while cooking dinner. Studies show that singing helps boost your release of endorphins, natural painkillers that make you feel calmer and happier.
- Keep a gratitude journal: Notice and record great things that happen every day.Note everything from the sun shining on your face to a lovely chat with a fellow commuter or a relaxing soak in an evening bath. Research by the University of California has shown that people who keep a gratitude journal enjoy increased enthusiasm, alertness and optimism and reduced depression and stress.
- Look for beauty: Linger on the sparkle of the dew on a spider’s web, the changing cloudscape or the sound of your friends laughing. You will feel instantly uplifted.
Take a technobreak
A study of 25,000 people by Chiba University in Japan has found that people on a computer for five or more hours a day suffer more anxiety, depression and sleep problems. Too much television also makes us feel less satisfied with our lives and is linked to depression. That’s good reason to engage in non-techno activities to boost your brainpower and spirits. So why not:
- Read a book or the newspaper (not online!).
- Play a game of chess, memory or Trivial Pursuit.
- Knit a jumper or scarf.
- Do a crossword or Sudoku puzzle.
- Handmake cards for birthdays of loved ones.
- Start a herb garden.
- Write a short story or haiku poem.
- Sit outside and cloud watch.
- Listen to old records or CDs.
- Call a friend or relative to catch up.
- Meditate on a water feature, painting or flower.
- Do some yoga stretches.
- Take fantastic portrait photos of family members.
- Practise a musical instrument.
- Start a scrapbook of family history and stories.
Reaching out for help
As depression cannot be wished or willed away, it’s important to seek help. The following will boost your level of support and make you feel less alone:
- Talk to trusted and empathetic friends or family.
- Network with friends about the names of good counsellors or see your GP for a referral. Ventilating feelings and fears often lightens the load and puts problems in perspective Make an appointment and debrief about your feelings while getting helpful strategies. Find a counselling modality that is a good fit for your personality such as cognitive behavioural therapy(which deals with distorted/faulty thinking), psychotherapy (which uses different modalities) or behavioural activation (which involves scheduled mood-boosting activities).
- Join an online chat group for people suffering depression.
- Ask your GP about antidepressants. Or see your naturopath for a personalised program, which may include taking St John’s wort, which studies show can help reduce depression.
- Read self-help books or look at online programs that walk you through strategies to deal with depression. Try sites such as:
- My Compass (Black Dog Institute): mycompass.org.au
- Beyondblue: beyondblue.org.au
- This Way Up:thiswayup.org.au
- Moodgym: moodgym.com.au
- Headspace National Youth Foundation: headspace.org.au
These can give your body and mind support when you are depressed.
Ashwaganda: Often called Indian ginseng, this herb is used in Ayurvedic medicine to lower stress hormones and stabilise thyroid hormones. It’s a calming tonic that reduces anxiety, improves sleep and combats inflammation.
Rhodiola: A potent herbal adaptogen, rhodiola helps your body reduce anxiety and irritability. At the same time it boosts immune function, hormonal balance and concentration.
Vitamins & minerals
Vitamin C: Your adrenal glands utilise vitamin C and store it, too, so take a good vitamin C in powder form or powdered camu camu, a Peruvian berry that contains more vitamin C than oranges.
Vitamin B: When you’re stressed you burn through your B complex vitamins, so a good B complex is important.
Magnesium: This important calming mineral helps relax both your nervous system and muscles.
Nervines & relaxants
St John’s wort: A Cochrane review of numerous studies has shown that this helpful herb can be effective in treating mild to moderate depression. Make sure you don’t mix it with antidepressants as this can lead to unhealthy high levels of serotonin.
Skullcap: This has traditionally been used to treat conditions like panic attacks and anxiety and also to promote better-quality sleep.
Chamomile: This is a calming herb that boosts levels of glycine, a nerve relaxant with mild sedative properties. It also contains a potent flavonoid called apigenin, which acts like a mild tranquiliser, encouraging better sleep.
Lavender: Research comparing the use of lavender to sedating benzodiazepine medication for anxiety has found it provides equal benefit, minus the side-effects of the medication,which may include tiredness, trembling, dry mouth, nausea and addiction.
Energisers & wellbeing tonics
Liquorice: This herb has adaptogenic qualities that help your body regulate stress hormones such as adrenaline, countering adrenal fatigue and encouraging hormonal balance.
Ginseng: This has been used for thousands of years to treat issues like low adrenals, fatigue, lack of vitality and low libido.
Spices: Warming spices such as ginger and cinnamon can increase energy, boost metabolism and stabilise blood sugars.
Should you take antidepressants?
A growing number of people are taking antidepressants to help alleviate mental health issues such as anxiety and depression. Some people report that antidepressants do a great deal to lift their mood and reduce issues like teariness, rumination and malaise caused by depression.
However, many people also find that antidepressants can cause side-effects that range from agitation and weight gain to belly problems and sleep issues. In some cases these side-effects don’t kick in immediately but develop over time, so the link between the medication and the health issues is not always obvious.
What’s important to remember is that any medication, including antidepressants, should be used with caution. Taking them for a short period of around three months is a good compromise. However, in cases of severe depression, if antidepressants are working for you, you might choose to stay on them for a lengthier period of time. Or you could try a herbal alternative such as St John’s wort, combined with exercise, as both of these approaches have been proven effective in helping to reduce depression.
First published on wellbeing.com.au