Monday, November 19, 2018

Tackling Depression

In my view "Depression is a Messenger" come to alert you that SOMETHING Somewhere needs to change in your life...
Perhaps your way of Doing things, Thinking about things, Feeling about things.
Perhaps you need to "Correlate, Reduce and Simplify."  Garry K Moore
Perhaps you are Bored and not challenged enough.
Perhaps you are not Seeing something that you need to See.
Perhaps you are Catastrophizing, Horribilizing, Dizasterizing
Perhaps you are Going Too Fast, or Going Too Slow.

I found this useful.
I've italicised and expanded some.

A Latter-day Saint Therapist’s 
Toolbox for Tackling Depression
By Laura M. Brotherson LMFT, CST, CFLE · Meridian Magazine - November 7, 2018

You can see it in their eyes. You can feel it in their countenance. It’s far too common and can happen to anyone given the right stressors and situational circumstances. Approximately 25% of adults in the U.S. (1 in 4) experience anxiety or depression. Whether depression shows up as sadness, hopelessness, irritability or anger there is hope and help to feel happiness and contentment again!

Underlying causes of depression are a combination of nature and nurture. There can be genetic susceptibilities to biochemical imbalances in the brain and/or life experiences like neglect, abuse, or trauma that contribute to depression. These tend to train you to believe some very depressing or anxiety-inducing things. Mental health issues like depression and anxiety are diseases of the mind just like diabetes is a disease of the body. Depression has nothing to do with one’s personal character or faithfulness.

It’s been encouraging to see efforts within The Church of Jesus Christ of Latter-day Saints to help members who are dealing with the difficulties of depression or anxiety. First Sunday meetings have been dedicated to help de-stigmatize the disease and offer encouragement, outreach and support.

Like addiction, infertility, health, marriage or parenting challenges, depression is such a common difficulty in many peoples’ lives. As a therapist, I’ve compiled the following suggestions to help you get out of the mental muck of depression and into a life of peace, contentment and even joy. My hope is to provide a comprehensive toolbox of easy and practical tips—all in one place—that you can immediately put into practice to make things better as you overcome your depression.

This toolbox of tips for tackling depression includes the following 15 suggestions:

Get Active  
Get Enough Sleep
Eat Healthy 
Connect with People
Get Some Sunlight    
Engage in Process Writing
Do Meditation, Mindfulness or Yoga
Stop the Stinkin’ Thinkin’
Try EFT Tapping      
Smile and Laugh
Accept Yourself and Practice Self-Compassion 
Get Educated about Depression
Take Supplements and/or Medication
Participate in Counseling or a Support Group
Turn to God
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Get Active. Whether you’re more likely to go for a walk, a run, yoga, play tennis or dance, just get your body moving. This helps get the feel-good hormones flowing and helps distract you from the ruminating thoughts in your mind.
Exercise can be as effect as antidepressants for those with mild depression. Start small and find something you are likely to enjoy. Just getting out and doing something different than you normally do can jumpstart your mind and your mood.

Get Enough Sleep. Getting sufficient rest so that your mind and body can relax and process the experiences and emotions of your day is essential in maintaining good mental health. Your brain will have an even harder time thinking positively when it’s in a state of sleep deprivation. If you have trouble falling asleep or staying asleep you might consider reading a book before bed (not electronically), listing out 10 things you’re stressed about, or trying Melatonin supplements that can be a safe way to get a better night’s sleep. If there’s just too much going on in your life, see if you can think of just one thing you can cut back, and then another.

Eat Healthy. Feeling depressed tends to encourage an easy slide into eating unhealthy, self-soothing foods. If you can change even one eating habit to be a little better, it can make a difference in how you feel. It is true that you are what you eat. Cutting out one sugar or one soda and the caffeine and adding one vegetable or an extra glass of water instead can help you combat the “stinkin thinkin” in the brain.

Connect (wisely) with People. Depression tends to make us isolate ourselves. That just exacerbates the loneliness and “loser-ness” we are already feeling. Solicit the help of a few good friends or other family members to assist you and help you avoid disconnecting. Let them know you are struggling with depression or anxiety and just need someone you can be with and talk to without feeling like they need to fix anything. Nudge, or push yourself to reach out to care and attend to them as well so that neither of you will feel like it’s a one-sided relationship.

Depending on the depth of your depression, rather than staying home, nudge or push yourself to go out with friends or family members to activities or join a group or a volunteer organization to have pre-scheduled social opportunities. It can pull your mind out of depressive thinking even just temporarily and help retrain your brain by getting out with people.

In the presence of caring people, you also have more chance to touch, hug and have eye contact (whether you are the receiver or the giver). This can create oxytocin, which is the bonding hormone that can make you feel more connected. Any appropriate opportunities you may have to give or receive an 8-second hug or other touching moment (i.e. someone’s arm around you or your hand on someone’s knee) is particularly potent in releasing that wonderful oxytocin.

Get Some Sunlight. Sunlight stimulates feel-good hormones and neurotransmitters. The winter months can make feelings of depression even worse because of the lack of sunshine. Getting out in the sun when it does shine can do wonders, as can getting a full-spectrum light to use indoors. Opening up your blinds or curtains to let the sun shine in can also be a part of your regular depression-busting routine.

Engage in Process Writing. Sometimes no one is available to talk to when you need to talk. And sometimes there is simply too much to say. Journal therapy, though, is a way to always have someone to help you process what you’re thinking and feeling. It’s like having an ongoing written conversation with God.

Sometimes free-flowing written conversations are needed and other times it’s easier to just write out a list of “I…” statements to express the anger, frustration, guilt or sadness you are feeling. Giving your genuine thoughts and feelings a voice has a way of giving them light and air. It validates the feeling and allows it to begin to dissolve. Negative feelings buried alive don’t tend to die on their own. They need some processing to go away.

Some clients have said that they find it helpful to alternate their anger lists with their grateful lists in order to keep things in check. Developing a habit of listing expressions of gratitude broadens your awareness, increases feel-good hormones, strengthens the immune system and improves personal relationships.

Other clients find that they won’t or can’t stomach any positives until they truly feel heard. Those who try to skip the step of identifying and acknowledging their inner demons often find they don’t really get better. See what works for you.

If you can share your honest pain with your loving Heavenly Father and Savior, it can help you feel closer to Them and help you heal. They already know what you are thinking and feeling, so being honest and open with your feelings—even the unpleasant ones is vital for beating depression.

These writings are just for your own processing. Many people find it additionally therapeutic to burn or shred them as a symbolic way to let it all go.

Do Meditation, Mindfulness or Yoga. Each of these clinical treatments have been empirically studied for help with anxiety and depression. To meditate and connect more deeply with God, simply close your eyes and focus on your breathing for a few minutes every day. While doing so you might repeat in your mind something like, “I’m listening.” These practices can also help you develop greater communion with yourself, and your Heavenly Father in a much more personal and profound way. (You might try Tai Chi. Yoga and Tai Chi get your mind stilling and your body moving.)

Mindfulness is basically being more mentally, emotionally and physically present in the moment and more engaged with your senses—sight, sound, taste, touch and smell. Even five minutes in meditation or mindfulness can do wonders for slowing down a racing mind and calming both mind and body.

The practice of meditation and mindfulness develops mental discipline, which helps you gain greater power over depression’s negative thought patterns. Every time you pull your thoughts back - to your breathing - or to the statement “I’m listening,” it’s like calisthenics for the mind.

Developing greater mastery over your thoughts is a vital step in overcoming anxiety or depression. Meditation, focusing on your breathing, being more mindful, and practicing yoga can all help with the next step of stopping the stinkin’ thinkin’ that tends to run rampant in the mind of a depressed person.

Stop the Stinkin’ Thinkin’. While depression is a physiological ailment of the brain it creates a psychological ailment of the mind. Depression becomes a mental habit of negative and/or depressing, ruminating thoughts. Research shows that depression is best beaten by both 1. medical or physical help (medicine and/or supplements) and 2. psychological help (counseling – to help change how you see things).To stop the depression, train your brain to stop the stinkin’ thinkin’ of unrealistic expectations and other unproductive habits of the mind. Watch for and stop the self-defeating and self-sabotaging patterns in your brain.

Start to catch yourself when you are thinking in extremes or all-or-nothing ways. Catch yourself when you assume negative intentions or outcomes and over-generalize them to everyone and everything. Ask yourself, “What if a positive outcome were to occur instead?” and invite, nudge, let your mind ponder the possibility. Catch yourself when you minimize positives that happen in your life. Just say, “I see you… I hear you… I get you… Thank you… now, Stop!” when these messengers show up.  Send them on their way. Don’t give them a place to stay.

Adding to your grateful lists each day can help highlight the positives in your life and counter the negatives (every negative has a positive.) Actively watch for at least 5 specific things that you can jot down each day for which you are grateful.

Try EFT Tapping. One of my favorite self-help tools for letting go of negative thoughts and feelings and reprogramming more positive perspectives is therapeutic specific tapping called Emotional Freedom Technique (EFT). It’s an energy therapy technique using the philosophy of energy meridians used with acupuncture except you tap on certain spots on your face and body instead of use needles. You might think of it as “psychological acupressure.  ”You can find information and videos about EFT tapping online.

Next to process writing, this is one of the tools that helped me most in overcoming my own depression. It is a powerful tool in your toolbox for healing. 

Smile and Laugh. Any time you see a mirror smile at yourself even if just for a second to exercise your facial muscles. It sends a signal to the brain that you are happy. It may take some time to change the mental message, so keep on smilin’!

Humor can put a pause on depression as well. Give yourself a mental break by watching a funny movie or find some comedy clips to keep you laughing. Smiling and laughing can counter the default negative thinking of depression telling you that life is always sad, dreary or depressing – it isn’t.

Accept Yourself and Practice Self-Compassion. Women seem to be especially good at guilt and shame—feeling like they are never good enough. Learn to gently accept things as they are.  Trust that the Lord is mindful of you and has a purpose for all things (Doctrine & Covenants 122:7)  See yourself through the eyes of compassion.  Learn, Trust, See are all necessary in breaking the spell of depression.

Good enough really is good enough most times. We are all imperfect humans having an earthly experience where we get to practice being okay when we might not actually be or feel totally okay. By partnering with God, we can do that.

We all have our own struggles that show up in a variety of ways at any given time.
I love how Elder Henry B. Eyring (Ensign Nov 2018 “Try, Try, Try) recommends that we assume that everyone we meet is fighting a hard fight of some kind. I also love how Elder Dieter F. Uchtdorf (Ensign May 2012 “The Merciful Obtain Mercy”) reminds us that we are all imperfect and all in different ways from each other.

Sometimes people feel like it’s their fault if they have depression. Depression isn’t anyone’s fault any more than any other disease. No one chooses cancer. No one chooses depression. All the ways we beat ourselves up and think we are not good enough, not worthy enough, not perfect enough, not lovable enough are just tools of the adversary to keep us stuck in the muck of self-denigration, which fuels depression. 

A helpful tool in addition to the grateful list we discussed earlier, is keeping a daily numbered log of 10 specific things you like, love, or appreciate about yourself.
This list helps you accept yourself and have more compassion for yourself.

You can begin to reprogram your self-view to that of a person with strengths and worth by keeping this list and by listening to the audio book Self-Compassion by Kristin Neff. Perfectionism is a perfect poison for anyone—especially anyone struggling with depression or anxiety. Self-compassion is great way to combat perfectionism that fuels depression.  “Be your own best friend.”

Get Educated about Depression. After doing some of the other suggestions here to start feeling better first, it can then be helpful to seek out learning about the specific struggles you are having. I believe the Lord will direct you to the specific resources you need.  “There hath no temptation taken you, but such as is common to man…”  Someone will have written or talked about what shackles you.

Some good books on depression to consider are: The Depression Cure by Stephen S. Ilardi, Cognitive Behavioral Therapy by Ryan James, Undoing Depression by Richard O’Connor, any of the Change Your Brain resources by Daniel G. Amen, M.D., or You Can Heal Your Life by Louise L. Hay. You might start by reading some of the reviews to see which ones seem best to you.

Take Supplements and/or Medication. Mild, situational or seasonal depression may resolve itself with some of the other suggestions here, but many times some kind of physiological assistance will be needed. If the above suggestions and stategies haven’t been enough to get you back onto a happy track, then a supplement and/or an antidepressant may be needed to get your brain’s neurochemistry back in balance. Often times this physiological step will be needed in order to do the other psychological work necessary for overcoming depression.

Many people who are hesitant about taking medication will often consider trying some other helpful, healthful supplements. Check out the naturally occurring compound – SAM-e, or EmpowerPlus Q96 a multi-vitamin for the brain. (You can learn more about SAM-e in the book Stop Depression Now by Richard Brown and search for more information on Q96.) These two supplements have shown the most success in naturally assisting my clients in the physiological processes to combat depression. There are also many other supplements like Omega 3 fatty acids (fish or flax oil) that can help.  (Valerian may help.  5HTP may help.)

People have found that these supplements help them reduce stress, feel more at peace and have an overall improvement in their sense of well-being with no side-effects. I personally found SAM-e to be a life saver when I experienced post-partum depression many years ago. SAM-e is backed by research and is even being recommended by the medical community, which is rare for an alternative supplement. Talk to a doctor and do your own research to see what makes sense for you. You have the Holy Ghost as your companion.  Not all doctors will be familiar with supplements or alternative health approaches for mental health issues.

Many people also find medication to be a lifesaver. See what makes the most sense to you. There is no shame in having to take something for depression any more than there would be in taking insulin for diabetes.

Participate in Counseling or a Support Group. The two key steps in overcoming depression are counseling plus addressing the brain chemistry with either supplements or medication as I just mentioned. Having a non-judgmental and therapeutically helpful person or group to talk with is pretty vital in being able to address the underlying experiences and beliefs that fuel depression.

A good counselor can help you change the depressing cognitions and reprogram the way you see yourself and the world. A good counselor can offer a profound gift of helping you to truly feel seen and heard. Since depression can sometimes lead to suicidal feelings, a counselor can work with you to collaboratively determine a good safety plan with helpful coping strategies.

If you don’t know where to start with all these tools your best first step is to find a good counselor who can help you figure out your next best steps. Cognitive Behavior Therapy (CBT) is a common empirically validated approach to addressing depression. In addition to CBT, a counselor has many tools and approaches to help with the specific aspects of your struggles as well as the challenges that depression can bring to your relationships.

Couples or family counseling can also help a spouse or loved ones who are trying to love and support you through your depression and give them some support as well. Support groups can be so helpful in decreasing your feelings of loneliness and isolation by sharing your journey with others having similar challenges. You are not alone. You’ll probably want to start with a counselor, though, before a support group to get the more specific and personal direction you’ll need in the beginning.

One of the most comprehensive resources for finding a good counselor (or a support group) in your area is to search PsychologyToday.com. You can specify all the specific characteristics you would like (i.e. gender of the therapist, counseling issue, therapeutic approach, insurances taken, etc.)  Or ask your doctor or pharmacist.  A friend who seems mentally stable to you might also know someone they trust.

Turn to God. This is the most important step in this whole process and should technically be the first step, but many people overlook the practical need to turn to our Savior, Jesus Christ, and submit our lives as they are, and our challenges, to Him. Those who have actively worked the “12 Steps” of addiction recovery know that some challenges are simply out of our human reach.  Please also note the recently added Gospel Library > Life Challenges > “Support Guide” - for Spouses and Family.

When we turn our lives and our will over to God and humbly trust in Him, His will and His timing—even when things aren’t happening the way we think they should, or would like them to —we are able to access His mighty enabling power. Confidence and faith in Him to do for us what we cannot do for ourselves according to His will allows us to endure better, for longer, or overcome the challenge when we couldn’t have done so on our own.  We can then be a little light for some other.

The faith and humility of partnering with God and surrendering ourselves to Him brings peace, despite any of our challenges. Many of the suggestions here will help you stay in closer contact with your Savior even while you may continue to struggle with feelings and physical aspects of depression.

Depression is a great refiner’s fire. Trust the Lord. Trust that He knows what He is doing with you, and why He is doing it. Let Him refine you by willingly submitting to whatever He would have you go through (see Mosiah 3:19). He may be simply developing and refining your compassion, endurance, patience, or a host of other Christlike characteristics, which we all agreed to and came here to develop, in His way. Trust that he loves you and knows what He’s doing with and through you. Know that He will consecrate your afflictions for your highest good (see 2 Nephi 2:2).

I like to remind myself that God is a lot smarter than I am. His ways are higher and better than our ways (see Isaiah 55:9). I can truly say I’m so grateful now for my trial with depression. Because of it I have learned to turn to Him and turn my will over to Him. I have grown in so many ways and can now help others who struggle. With spiritual submission comes peace and eternal hope despite the difficulties in our lives. All of our difficulties are designed to turn us to Christ. I hope you will let that happen for you.

Consider this beloved quote about our mortal afflictions:
“No pain that we suffer, no trial that we experience is wasted. It ministers to our education, to the development of such qualities as patience, faith, fortitude and humility. All that we suffer and all that we endure, especially when we endure it patiently, builds up our characters, purifies our hearts, expands our souls, and makes us more tender and charitable, more worthy to be called the children of God, . . . and it is through sorrow and suffering, toil and tribulation, that we gain the education that we come here to acquire.” Orson F Whitney quoted by Spencer W Kimball.

I pray you are able to find some hope and healing a as you try the 15 suggestions I shared to help you understand and overcome your challenges, and find more peace, contentment and even joy – along the journey and even more joy in due time. Please feel free to share this toolbox with anyone else that may be in need.
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— Laura M. Brotherson, LMFT, CST, CFLE
Licensed Marriage and Family Therapist, and Certified Sex Therapist.
She counsels with couples, individuals and families in private practice (and online). Laura is the author.  She is passionate about helping couples navigate the intricacies of intimacy to help build strong marriages and families. Laura and her husband are the founders of StrengtheningMarriage.com   

(Edited occasionally by Judy Bray)