Think of all the emotions you've ever experienced: anger, fear, disgust, happiness, surprise, shame, sadness, guilt, or blame. Can you name what you're feeing right now? Many depressed people can't.
Many years ago, our son and one of his friends, along with three other young men, were kidnapped by an escaped convict who had previously murdered three people. The five were held hostage for a couple of hours before the killer started shooting. Our son and his friend were both shot in the head, and two of the other young men were killed instantly.
If you had asked me what I was feeling as I drove to the hospital, I probably would have said, "worried." I was worried that our son might not live, or that he would be a paraplegic or severely brain-damaged for the rest of his life. I had already experienced forty years of depression, and although I had only a year earlier finally discovered the root of my depression, I hadn't yet learned to identify my feelings, so as I drove to the hospital, I didn't know that I was angry and scared. I had developed the habit of coping by becoming numb. I hadn't been able to cry for years, but soon I realized I needed to cry. The following day I asked my psychiatrist for an emergency appointment so she could help me to release my tears.
Both my son and his friend survived, but not without some nerve damage and some psychological damage.
Over the years since then, I've learned to identify my emotions and analyze them to see if they are helping me or hurting me.
When I took writing classes the teacher would point deficiencies in our stories, and it hurt to be told that the piece you'd worked so hard to create wasn't as wonderful as you thought. I saw there were two kinds of students: those who accepted criticism quietly and came back next time with improved versions of their stories, and those who became defensive, even angry, insisting that the teacher didn't understand! Occasionally, one of them would leave the class and never come back. It didn't take long for me to figure out who was handling emotions successfully.
I realized that if I wanted to become a good writer, I had to accept the feelings of embarrassment, even humiliation, of having my shortcomings pointed out. I learned to replace those feelings with ones of gratitude for the help I was receiving.
Interestingly, as my writing improved and I began to get published, my self-esteem rose, too.
Last time we talked about how anger is relate to depression, and that there are two ways the depressed people deal with anger. One way is to become a walking timebomb, using anger to gain a sense of control. In this case, anger is often directed at people who are handy, rather than those who are the source of the problem.
The other method depressed people use to cope is to suppress the anger, leading to all sorts of symptoms that resist explanation, as mentioned in the previous blog. People who suppress anger may not even realize they are angry. If you asked them what they're feeling, they'd say things like "sad," disappointed," "misunderstood," "alone," "unappreciated," or "like a failure." They are telling the truth. What they don't understand is that those feelings are psychologically painful, and pain automatically arouses anger, which is a physiological response. That response may include raised blood pressure, muscle tension, and increased respiration, but the angry person is so used to these feelings that they don't recognize them as byproducts of anger.
Neither of these strategies solve the problem, so the anger continues.
Once you realize you have a lot of anger, what can you do?
1. Think before you speak (or shout!). Words spoken in anger cause a lot of damage, and they are not easily forgotten.
I once heard a mother call her teenage daughter a terrible name. I asked her how she could say such a thing to her daughter, and she shrugged. "Oh, she knows I don't mean it." What that mother didn't appreciate is that words spoken in anger are more deeply impressed on the other person's brain, along with the emotions those words aroused. It's one thing to say, "I'm sorry. I didn't mean it," but these words cannot erase the impressions already formed in the brain. Too many people feel that, "I'm sorry," are the magic words that erase the effects of damage. They don't! It takes time and work by both parties to repair the effect of angry words.
2. Take time to figure out exactly what it is that you are angry about. Realize that often we misdirect our anger to a "safe" person when we feel we can't show anger toward the person who is causing our distress. It's safer to yell at your spouse or your children than at your boss.
3. Calmly state what is bothering you. Avoid terms like "always" and "never."
4. Allow the other person to explain his or her point of view and be sure to listen. Too often when we're angry, we don't really hear the other person. Consider what is true about the other person's statement. Can you understand how that person feels? Anger prevents you from empathizing. That's why it's easier to hurt people when you're angry, and to minimize in your own mind the hurt you've caused. Are you able to reframe the situation?
5. Don't hold grudges. If you tend to hold grudges, you of all people should understand how much pain is caused by angry words and thoughtless deeds. If you can't let go, how can you expect others to let you off the hook?
6. Learn to discuss problems without eye rolls, insults and name calling. They are counterproductive.
7. Learn to recognize defensiveness in yourself and in others.
Other things you can do:
Exercise. It relieves the physical and mental tension that anger arouses.
Think about possible solutions to problems beforehand.
Practice relaxation skills.
Realize that if you are a chronically angry person, whether you recognize your anger or not, it will take time and practice to change, but learning to manage your anger in a healthy way will change your life!
Sigmund Freud claimed that depression is anger turned inward. Today, psychologists have learned that is not always true. Sometimes anger is outwardly directed, and the person doing so doesn't realize that the anger is connected to depression. In cases where the anger is turned inward, the person may know he or she is depressed, but doesn't realize that they have a lot of anger, and it is the repressed anger that is causing the depression. Consequently, I thought it would be worthwhile to look at the connections between anger and depression.
First of all, we need to understand what anger is, what triggers it and why, and what effects anger has on the brain.
Anger is an automatic response to fear or pain. You can't prevent this response. Your body automatically produces norepinephrine, a brain chemical that reduces pain and energizes you to act. It's easy to see how anger helps us survive when we're threatened or injured. The trouble is that your body doesn't distinguish between physical injury and psychological injury. Nor does it see any difference between physical pain and psychological pain. The bottom line is that your body produces epinephrine whether someone is pointing a gun at you or giving you the finger.
It's easy to understand how continuing physical pain can lead to depression. Less obvious are the dynamics among psychological pain, anger and depression. What causes psychological pain? Feeling ignored, powerless, guilty, unimportant, rejected, or alone, for starters. In general, feeling bad about yourself arouses anger.
We cope with anger in several ways. Blaming our pain on someone or something else gives us a kind of comfort. It's not me that's bad, it's someone or something else. Lashing out bolsters our sense of power--remember that rush of adrenaline that norepinephrine provides? Unfortunately, the temporary sense of power is often followed by diminished respect from others, and the perpetually angry person has no real friends.
Finally, many people have been brought up to believe that displaying anger is not nice, nor really civilized, and they've learned to squelch their feelings, sometimes to the point that they can't even admit to themselves that they are angry. Keeping anger bottled up can lead to a host of symptoms that are easily recognized as being signs of depression, but those symptoms are seldom associated with suppressed anger, which is really the root cause of their depression. Some of those symptoms are:
1. Easily bothered by trivial things.
2. Constant muscle tension.
3. Always tired.
4. Chronic pain which can't be traced to a cause.
5. Addictive behavior.
6. Workaholism--inability to relax.
7. Being a people pleaser.
If you find that you are regularly troubled by any of these symptoms, consider that anger may be the underlying cause.
Next time, we'll look at healthy ways to deal with anger.
When you're depressed, your feelings are going to be negative. If you base your decisions on those negative feelings, chances are you'll get negative results. The more negative results you experience, the more your depression deepens. It's like being caught in a whirlpool. Everything seems to pull you down. The important thing to realize is that feelings are not truth.
Depression begins in several ways. One lady I know had a hard time in school. Her siblings all did well, but she struggled. She felt stupid and concluded she was stupid, not realizing that her feelings did not reflect truth. Understandably, she felt shortchanged, became angry and began to act out. It was only as an adult that she discovered she had a learning disorder, and she wasn't stupid at all! In fact, she had a lot of artistic talent and a great imagination. She is now a successful writer and illustrator of children's books, and she's one of the most cheerful people I know.
Sometime depression is rooted in unrealistic expectations. As a child, I spent a lot of time trying to be perfect. Somehow I decided that anything less than a 100% on a test was a failure. This is All or Nothing Thinking, and it's one of the characteristics of depression. It doesn't matter how it started, if you can recognize it, you can change it!
Do you focus on a failure and conclude that that one incident defines you? Once I confided to my psychiatrist that I was a terrible parent. I'd lost my temper and slapped my child for mouthing off. He asked me an important question: Is this a pattern or is it a one-time event? I told him I'd never done it before, and I was so appalled by my behavior that I sure wasn't going to do it again! His reply burned into my brain. He said, "One event does not define who you are." I realized then that I had formed a pattern of defining myself by individual events. If you do that, you're probably giving up too soon, further contributing to seeing yourself as a failure. Thomas Edison once said, "Many of life's failures are people who did not realize how close they were to success when they gave up."
Are you a "Yeah, but..." person? When someone makes a suggestion, is your first response, "Yeah, but..." and then you list all the reasons why you can't do that? That's another example of negative thinking, and it often results in giving up too soon. Stop to evaluate the reasons you want to list and consider whether they really prevent success.
When you make a decision, do you base it on a single past negative event? I once had a student who wrote a very nice short story. When I complimented her on it, she began to cry. She told me that she had taken a single writing class years ago, and her teacher told her that she wasn't a very good writer. She was so discouraged by one person's opinion that she didn't try again for ten years!
Pay attention to what you're thinking. Are you thinking or feeling? Examine the reasons you want to give up, and remember that Edison made 1,000 unsuccessful attempts to make a workable lightbulb, and the Wright brothers were laughed at for try to make an airplane. People said that if God meant for men to fly, he would have given them wings!
Last time I discussed some of the symptoms caused by depression. Now I want to talk about some of the causes of depression and the accompanying anxiety.
Fear of abandonment
It has been said that babies are born with two fears: fear of falling and fear of abandonment. Children who experience the loss of a parent through death or divorce or being placed into foster care will feel abandoned, which leads to questions: Am I not loveable enough? Will my present caretaker abandon me, too?
That fear can be completely unconscious. I know a couple who adopted a one month old baby boy. In the one month before they got him, his birth mother decided she couldn't care for him, his birth father, who was not living with the mother, took him, but soon realized he couldn't care for an infant, and the child was put into a foster home and adopted a couple of weeks later. Now most people think that a child that young won't remember those events, and they won't--not consciously. Now that little boy is six years old and has nightmares of his parents dying. He can't endure separation from them in order to go to school. He has no idea why he feels this way. He's receiving psychological counseling, but his anxiety is so strong that it will take a long time to overcome it. What happened to him in the first month of his life may haunt him into adulthood.
Adults who aren't aware that they fear of abandonment may sabotage a relationship rather than take the chance of being abandoned again, and they won't even be aware of the reason for their behavior. Then they wonder why they end up lonely and depressed.
Fear of being unloved
Sometimes people feel that their parents never really loved them, that somehow they were a disappointment. That assumption can lead to a lowering of self-esteem and self-confidence. In this case, it's important to understand that parents' expectations do not impose an obligation upon the child.
One of my college students suffered from anorexia. I learned that her parents were a doctor and a lawyer and she told me that they wanted her to become a doctor or a lawyer. (I had no way of knowing how realistic her belief was.) At that particular time, she was faced with having to declare a major. She really wanted to become a biologist, but was afraid she'd be letting her parents down, so she had starved herself to the point where she had to be hospitalized for a year. She saw her alternatives as disappointing her parents (and losing their love and respect) or spending her adult life doing work she really wasn't interested in. The internal conflict she endured made death seem preferable.
It's also important to have an adult view of your parents. When you're a child, your parents may seem to know everything and to be able to do anything, so when they fall short of your expectations, you feel disappointment that's easy to interpret as being unloved.
Remember, too, that parents and children often have different personalities. A father who grew up loving sports will have a hard time understanding a son who's not interested in playing ball. Such mismatches can have parents thinking there's something lacking in their child and the child feeling that he or she is a disappointment.
The death of a sibling or a friend or even being present at the death of a stranger can leave the survivor with a sense of guilt. Why wasn't it me? Why am I still here? As illogical as it seems, the survivor can feel he or she has no right to enjoy being alive. This is a form of Post Traumatic Stress Disorder, and is not limited to combat veterans. A teenager who survives a fatal car accident can be burdened with the feeling that he or she did something wrong or should have done something to prevent the tragedy. A parent who loses a child is another candidate for PTSD. Therapy is often necessary to overcome the guilt and accompanying depression.
Feelings of failure
Feeling like a failure can lead to depression, and if you feel this way, there are two important questions you need to consider: 1)Is it possible that someone--a parent or a teacher, perhaps--shamed you, and you concluded that you deserved the label of being a failure? 2) Have you defined yourself as a failure?
In either case, you need to consider how realistic your definition of a failure is. Realize that Thomas Edison made 1,000 attempts to produce a working lightbulb. He later said, "I didn't fail 1,000 times. The lightbulb was an invention that took 1,000 steps."
J.K. Rowling's idea for her Harry Potter books was rejected 12 times. Lincoln lost 8 elections before he became President.
Are you quitting after a couple of setbacks and defining yourself as a failure? When you look back, do you focus on those setbacks instead of remembering the things you did that worked? In an earlier blog I talked about horribilizing, expecting things to go wrong. Horribilizing leads to procrastination, and procrastination doesn't lead to success.
The bottom line is: A setback is not a failure, but persistence is a necessity for success.
As I mentioned earlier, depression leads to horribilizing, that is, always expecting the worst. When you're anticipating trouble, your body goes on alert, and your amygdala--the part of your brain that prepares you to deal with stressful situations--becomes more active. You go into fight or flight mode, which is a good thing if you're actually in danger. Blood flows from your skin to your muscles, which tense up, preparing to run or fight. Your heart rate increases, and your eyesight, hearing and sense of smell become more sensitive, alerting you to changes in your environment. Digestion is interrupted, because digesting your food is less important that preserving your life.
But if you aren't actually in danger, and you are on constant alert, consider the wear and tear on your body. Those always-tense muscles lead to aches and pains, including headaches. While increasing your heart rate temporarily--as in exercise--strengthens your heart, constant increased heart rate can lead to heart disease. Frequently interrupting your digestion causes upset stomachs, constipation, diarrhea and nausea.
Emotions are affected as well. You may be easily agitated, irritable, moody or frustrated. You might feel overwhelmed and unable to relax, leading to forgetfulness and inability to focus. Clenched jaws and teeth grinding often follow.
Your brain suffers, too. Constant stress depletes the brain chemicals serotonin and dopamine. Serotonin regulates your mood, sleep, appetite and digestion, as well as memory and sexual function. Low serotonin levels also lead to impulsiveness and aggression. Low dopamine levels affect your memory and ability to concentrate.
One study I came across concluded that 50% of Americans with major depression don't seek treatment for their depression. Instead they look for "something to help me sleep," "something to help me relax," "something for my upset stomach or muscle pains."
Why don't they seek help for the cause of their health problems? One reason is that many people still fear that seeking psychological help will stigmatize them. Another--more important--reason is that many of them don't realize they are suffering from depression. They see their lives as being inherently stressful and are unaware that much of that stress is coming from within themselves.
If you experience more than a couple of the symptoms mentioned above, consider that you may actually be suffering from depression.
Depression and anxiety are often connected. Because depressed people think negatively, they regularly assume (or fear) the worst possible outcome, a process I call horribilizing, which raises their anxiety level. Now they're not only living with sadness, they're on edge, worrying and constantly anticipating problems. They can get caught in a cycle of ruminating, endlessly thinking about how bad they feel or what awful things might happen. All of this increases the activity of a part of the brain called the amygdala, which is designed to alert you to danger. The trouble is, when the danger isn't real, your body is experiencing unnecessary wear and tear, for depression and anxiety put your body under constant stress, inviting muscle tension, headaches, asthma and panic attacks as well as long-term damage. (More about this in another blog.) When you learn to monitor your thoughts, you become aware that you're making assumptions that aren't necessarily true and wasting time and energy preparing to deal with things that probably won't even happen.
One of the best ways to monitor your thinking is to write your thoughts down. Then examine each statement and ask yourself, "Is this factual or does this idea reflect my feelings?" Suppose you've written a statement like, "I really don't want to go to work today." That's a feeling. Now you have to examine why you feel that way. Perhaps your answer is, "My boss is never satisfied and always criticizes my work." See what's happening? You're attributing your feelings to someone else's behavior. Now you have to ask yourself how realistic that is. The first thing to do is question the words "never" and "always." They are often a sign that you're horribilizing. Are you exaggerating? Is every single thing you do
being criticized? Do you find it difficult to accept criticism? If, so, why? Is it realistic to believe that everything you do is perfect? Are some of the criticisms valid? If so, can you accept that? Are you responding more to your boss's choice of words or tone of voice that you are to what is being said?
Remember that some people are tactless--and that is not a reflection on you--and some people simply have an irritable personality--and that isn't a reflection on you, either. How does your boss speak to other people? How do others respond to him or her? Learning to analyze your thoughts forces you to rethink the way you're looking at the situation, and almost always there is more than one way to interpret events.
Here's an example: I once worked for a man who spoke in a loud, authoritative voice. I felt intimidated, as if I was being ordered around. After thinking about it, I realized he spoke to most people that way. Two exceptions I noticed were when he spoke to small children or to someone he was asking a favor from. Then I learned that he'd been in military and that his hearing had been damaged in combat--two things that affected the way he talked when he wasn't consciously aware that the tone of his voice affected the present situation. I decided that his manner of speaking had nothing to do with me, and my the tension level at work dropped considerably.
That insight continued to pay off, even for others. Years later, a friend complained to me, "My dog won't listen to me, even though he behaves perfectly for my wife!" This friend had a hearing loss and had a habit of speaking loudly. Because of my insight, I was able to point out that animals and children respond to loud voices with alarm, triggering the fight or flight response, and they generally react by avoiding you or becoming combative. My friend was surprised, having never thought of that. When he consciously lowered and gentled his voice, his dog and his son both responded positively!
Experts claim that the average person thinks anywhere from 12,000 to 60,000 thoughts a day, and that 95 to 98% of them are the same thoughts you thought the day before. Furthermore, some studies show that 70 to 80% of these thoughts are negative. You might think it's surprising that everyone isn't depressed!
We all have concerns and worries, regrets and unfulfilled desires that generate negative thoughts. The difference between depressed people and non-depressed people is the conclusions they draw from these thoughts and the actions (or non-actions) they take.
Suppose Maxine and Andrea each receive a call from their child's school, advising them that their child has vomited and is running a fever. Both mothers are upset as they drive to the school to pick up their children.
Maxine is worried, but she's also feeling angry. She's thinking that she'll probably have to miss work for a couple of days if she can't find someone to take care of little Max. Maybe it's the flu, and he'll be sick for a couple of weeks. She calculates the loss of pay and/or the cost of a caretaker. She anticipates losing sleep with a sick child. Furthermore, she'll have to cancel her book group and her best friend's visit. She decides this is going to be a terrible week.
Andrea has different thoughts. She wonders how serious the situation is. She realizes it might be a temporary bug or possibly the flu. She'll ask the school nurse whether little Andy has been given anything to reduce his fever or settle his stomach. If not, she'll give him the appropriate meds at home. She'll also ask the nurse what's been going around the school and whether she should have the doctor check Andy out right away to minimize the effects of flu if that is a possibility. She knows she may have to miss some work or find a temporary caregiver, but she'll figure that out somehow. As for other things on her schedule, they're not as important as getting her child healthy again.
See the difference? Maxine is horribilizing, expecting everything to go wrong, feeling helpless and focusing on herself and how circumstances are going to affect her. Andrea is focused on her child and what she can do to make the situation better. She's made a plan. She has also prioritized her values, so she can easily give up what she considers less important.
Depressed people focus on problems and conclude they are helpless. Then they let their feeling of helplessness rule their actions (or non-actions). Non-depressed people focus on solutions and take control or look for help, regardless of their feelings.
Becoming aware of your thoughts and learning to change the way you react is key to overcoming depression.
Studies are finding that many people are depressed, some even severely, and they don't know it!
That may sound unbelievable, but I was depressed for more than twenty years before I was diagnosed, and I was surprised to learn that there was actually something wrong with me. I had just thought that life was hard, so it was normal to feel sad, tired, anxious and even hopeless.
Nobody else realized I had a problem because, in spite of my depression--my constant fatigue, my sleeplessness, my expectation that no matter how hard I tried, I couldn't possibly do as well as I should--I functioned pretty well. There's even a term for this--it's called smiling depression, although when I look at pictures of myself as a child, I almost never smiled after the age of three or four or five, because that's when my depression actually began.
I wasn't in the depths of depression all of the time. Instead, my general mood was one of sadness, of not being good enough, no matter how hard I tried. From time to time--and for no obvious reason--I would sink into a world of blackness where life seemed hopeless. Nightmares would haunt me, and sleepless nights left me more tired than ever.
I later learned in therapy that each increased depression came about after some incident that unconsciously reminded me of the roots of my depression, which I didn't remember because they occurred when I was so young. Whether the memories were repressed because they were so painful, or whether they were simply buried in my unconscious due to early childhood amnesia makes no difference. At the time it seemed that my depression was worsening for no clear reason.
One of the difficulties in treating a depression that began in early childhood is recognizing that the depression is long-standing. When I first went into therapy, the therapist quite logically asked, "What's been going on?" As I had just had a child and left my job to stay home with the baby, our finances were tight. My husband was a student and we lived out of town because the rent was cheaper, so I was isolated with an infant all day. "Understandable," the therapist said. "Your hormones are readjusting, you're not getting enough sleep, you feel you've lost your professional identity, and you miss the interaction of your coworkers. No wonder you're feeling down!" It is true that just talking to a sympathetic listener made me feel better for a while, but before long, I was down in the dumps again. By then we'd moved across the country, and I had to find another therapist. He took the same approach with the same results. And so did subsequent therapists.
I kept searching for someone who could break the cycle. When a therapist couldn't find an immediate reason why I should feel down, I was given antidepressants. They only numbed me. Then I finally found someone who thought to ask me about my childhood. It was only when, with his help, I was able to recall the initial incidents, and to view them with adult eyes and understanding, that healing began. I could then alter the patterns of depressive thinking that I had lived with for so long.
What sorts of things might be clues that you're depressed, but you don't realize it?
Are you always tired; unable to concentrate; often irritable, even angry; experiencing aches and pains that seem to have no cause; unable to enjoy almost anything; self-medicating with sugar, alcohol, caffeine, amphetamines or other drugs; beating yourself up; feeling numb; or thinking about death?
It's unlikely you'll have all or even most of these symptoms, but if you have more than one or two, you may well be suffering from depression. Remember, too, that if these symptoms have been around for a long time, it's important to look beyond what's happening in the present and discover the roots of your depression.
Today I'd like to address a specific form of faulty thinking that often plays into depression.
Do you feel that somehow you've been cheated? Does it seem that everyone else has it better than you do? In today's society where so much attention is directed to having better "stuff" than the next person, and where 20% of television time is devoted to telling you that you need the latest model of whatever they're selling, it's easy to feel that you should have a lot more than you do.
On top of that, when you look around and it seems that everyone else is enjoying themselves, it's easy to feel that you're being left out of something important.
I remember a time, earlier in our marriage, when we were living on a tight budget, a couple befriended us and invited us to their home. We were living in a small house (all we could afford) with second-hand and garage sale furniture. They lived in a tastefully furnished luxury apartment. I remember worrying that our three year old son might accidentally spill something or put sticky fingers on that expensive-looking sofa, but the woman dismissed my concern, telling me that she and her husband loved little children. We quickly discovered that they and we both played bridge, and soon I was faced with the necessity of inviting them to our home. I was in one of my deeper depressions at the time, and I felt totally inadequate. Their life seemed so wonderful. They played tennis regularly, traveled widely, belonged to several social groups and entertained a lot. In contrast, my husband worked long hours, we struggled to make ends meet, and depression drained my energy to the point where it seemed there was no joy in my life.
Then I learned that they, too, were struggling. They desperately wanted a child and for several years had gone from one fertility center to another, only to be told over and over that it was very unlikely that they would ever have a child of their own.
I was shocked to realize that we already had what they so desperately wanted. I learned a great lesson when I asked myself if I would trade places with them. I couldn't imagine life without our little boy. That would create a hole in my heart that nothing--not a beautiful home, lovely furniture, money, travel, or a busy social life--could ever fill.
The lesson I learned was that we all have gifts and we all face challenges, but sometimes we don't appreciate or even realize the gifts we already have, and often the challenges others are dealing with are not apparent to us.
Stephanie Kay Bendel is the author of EXIT THE LABYRINTH: A Memoir of Early Childhood Depression – Its Onset and Aftermath, MAKING CRIME PAY: A Practical Guide to Mystery Writing, and A SCREAM AWAY, a romantic thriller published under the house name, Andrea Harris. She has also written numerous short stories and articles on writing.