“I don’t know what’s wrong with me”
Through the last two years, we as therapists have noticed an increase in folks who have sought out therapy for the first time in their lives, because “they don’t know what’s wrong”. This has been a refrain for all of us at various times during the pandemic. It is upsetting, frustrating, overwhelming…(all the feels) to not feel like ourselves, and to have no idea how to pull out of it because everything that usually helps does not seem to be working.
When we are feeling unwell and our coping skills are depleted, our minds can spin out of control with “what ifs” around possible chronic mental health issues, diagnoses, dependence on medications and the need for professional intervention. It is a scary reality to think we are stuck and unsure if these feelings will ever relent.
As I sat down to write this blog, I decided to google “Am I depressed or…?” to see what popped up. Here is a small sampling: Am I depressed or sad, lazy, tired, bored, burned out, bipolar? WOW! What a laundry list of inquiries, ranging from questioning and attempting to label emotions to querying mental health and diagnosis. We as therapists are pleased that people are becoming more aware of their emotions and mental health, and how they both impact their day to day habits and quality of life. We also worry that the feelings of hopelessness and the overwhelming volume of information on mental health that is all over the internet can actually exacerbate symptoms, rather than providing comfort or relief.
There are literally thousands of tools, therapy interventions and medical treatments used to assess, diagnose and treat depression that need to be utilized by a trained professional. There are also many valid informational and educational pieces on depression out there that you can use to first sort through the symptoms you are experiencing, gain an understanding of the severity of them, learn how to assess and incorporate day to day habits that may help ease symptoms, and finally help you to make informed decisions about seeking professional support.
Here is one, from the Centre for Addiction and Mental Health (CAMH), that provide useful information on depression, diagnosis, coping and treatment. Remember that this is not to be used as a substitute for professional advice and support, but it is from an accredited, professional organization that aims to educate so that you can self-assess before making decisions about reaching out for support.
I think I am depressed…now what?
One of the most studied and supported treatments for depression comes from psychiatrist Aaron Beck, called Cognitive Behavioural Therapy (CBT). To put it very simply, one of the pillars of CBT is the Cognitive Triangle. This triangle helps us examine the intertwined relationship between our thoughts, feelings and behaviours. When you are doing CBT with a trained professional, you are learning how to identify negative and intrusive thoughts that impact how you feel about yourself, your situation and your relationships, which in turn impact the choices you make about how you behave or respond. Again, professional support to help with this triangle is just one of the keys to managing depression, but doing a self-assessment check-in on your own can be a powerful way to understand whether or not to seek professional support to confirm a diagnosis, or treatment to help manage these thoughts and make some changes for the better.
Check Your Thoughts
Many of us resort to googling information on any issue we are faced with, whether it be a leaky faucet or our mental health. We do this because it feels safer to “DIY” our problem, so that we don’t have to say it out loud (because that makes it more real), and so we can hopefully find a solution that we hope will be an easy fix. The other reason we often start with Google is because we are feeling some shame around the issue and the act of even asking for help. Many of us hold longstanding and firmly planted beliefs around the concept of admitting to a problem (think perfectionism) and asking for help (think “weakness”, “incompetence”, and feeling “less than”).
Challenge yourself to really identify your thoughts around what you are experiencing, and how these thoughts may be roadblocking your ability to manage your moods, relationships and overall functioning. It is so easy to believe everything that pops into our heads. The truth is, a lot of what we think about ourselves is hyper-critical, and is driven by fear and shame. Newsflash: we don’t have to listen to these messages!
Check Your Feelings
As therapists, we hear clients using “negative self-talk”, whether it be out loud, or in their heads to put themselves down, name call, and shame themselves for experiencing what are actually normal and healthy feelings. Throughout the pandemic, many of us have resorted to “numbing behaviours” such as scrolling through our phones or Netflix bingeing because we have just not had the will or the energy to identify feelings, much less actually feel them! If this sounds like you, try to get into the habit of asking yourself “what am I actually feeling right now?” Identifying the feeling and actually naming it will help you manage it, rather than pushing it further within by seeking quick fix and feeling-numbing behaviours that actually take us into a perpetual shame spiral of negative self-talk.
Check Your Behaviours
Here comes your mother’s, fitness instructor’s, therapist’s, doctor’s voice: get plenty of sleep, drink lots of water, eat your vegetables, go for a walk, and practice mindfulness. “YUP, got it,” you are saying (me too). The issue for most of us is not that we need this knowledge, it is ensuring that we actually practice these behaviours.
Let’s go back to the thoughts part of this cognitive triangle. When we are feeling depressed, our minds generally block out these simple, yet challenging habits which we know in our heads will help us feel better. Depression can almost act like a magnet that keeps us attached to our bed, sofa, phone or computer screen, thereby blocking out the will to incorporate habits that will naturally increase the happiness chemicals in our brains and will contribute to us feeling even a little better. Again, the shame-spiral of knowing that you already know what to do to feel better but not being able to push yourself to actually do it is activated, thus leaving you feeling further down and depressed.
Just having a basic understanding of this cognitive triangle can be helpful to become more self-aware of our feelings, moods and behaviours. The smallest bit of self-awareness and the tiniest of changes is progress. Drinking one glass of water instead of none, reaching out to a friend to walk and talk, or getting into bed 15 minutes earlier than usual is all part of living the change.
So if you are reading this and still asking yourself whether or not you need help to cope with this post-pandemic reality, the answer is YES! We all do. The past two years have been a harrowing and traumatic experience for every single one of us. For some, emotional and mental health issues that existed before the pandemic have increased in intensity and severity. For others, the current set of circumstances has led to new and uncomfortable emotions that have taken a toll on quality of life.
Seeking the support of a qualified, experienced therapist will help you sort through your own cognitive triangle and make choices around the next steps to take to alleviate the symptoms on one end of the spectrum, to seeking out more intensive and long-term interventions on the other. Regardless, reaching out for professional help will ensure you are getting outside of your head and that you are not walking the path to feeling better all alone.