“Am I Depressed?”
“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.
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Finding Hope During the Pandemic
During the pandemic, initial days of isolation turned into weeks, then into months, and now nearly two years later, our lives have become entirely uprooted and far from the reality we once knew. Normal routines and tasks became increasingly stressful, with more demands placed on us, and the lockdowns proved it was not just our routines that became disrupted, but our relationships too.
Facing uncertainty or an upheaval of our routines can wreak havoc on our minds and it is easy to get lost in worry for the future or to play out the worst case scenarios. It’s natural to experience feelings of helplessness during these times or anytime of uncertainty.
Hope is the key trait that allows us to be resilient in the face of uncertainty. A fundamental aspect of being human is having hope, and it is a big part of the reason why we are able to achieve our goals and push through difficulties. History has demonstrated over and over again, even in situations of complete devastation, such as war, genocide, or a global pandemic, people have persevered because they had hope for a brighter future. Zen Master Thich Nhat Hanh stated, “ Hope is important because it can make the present moment less difficult to bear. If we believe that tomorrow will be better, we can bear a hardship today.”
So how can we find hope during challenging times? The antidote is to bring awareness to our thoughts and emotions, and to try to be in the present moment. Take a moment now to reflect on how hope has helped you through a difficult time in life or even through the pandemic:
- What were your best hopes?
- What aspects or areas of your life helped you persevere (e.g., family, friendship, faith, an activity, a group, or even a purpose)
These questions will help us when we find ourselves in spaces of panic, helplessness or feelings of despair, where we may believe we lack hope and this tends to cloud our judgment. The challenge is to retrain our minds and begin to shift our perception. To shine light on areas of hope. The moment we make this shift, everything begins to change. You may remember your purpose, look forward to new challenges, and start to face life with a renewed optimism.
As humans we are able to change the way we think and perceive our world. The more you engage in a particular task, way of thinking or perceiving, the stronger the neural pathway gets. Shifting neural pathways or even creating new ones can be done and is a process called Neuroplasticity. The idea of neuroplasticity is profound as it means with conscious and mindful effort we can rewire our brain (Neuroplasticity, www.psychologytoday.com/ca/basics/neuroplasticity).
From reading blogs, self directed tools, books or attending therapy, there are many options for how we can begin to shift our perceptions, to find or identify the places of hope that already exist within our lives.
A useful approach is to use Solution Focused Strategies as it helps people shift their perceptions by identifying their strengths and to further develop their skills and coping mechanisms, even in the middle of chaos. It is a goal-directed model, focused on locating solutions using hope as a guide.
Here are some questions you can begin to ask yourself using a Solution Focused lens:
Desired outcome or goal:
- Define and envision what it would look like once your problem has been solved. How would you know a shift happened?
- Think about what you would rather be feeling or thinking, doing differently, and what others may notice to indicate a change has happened.
- Define the change or outcome with language that is positive, realistic, specific and behavioural.
- Now that you have defined your desired outcome or goal, think about what difference it would make in your life. I invite you to explore multiple aspects of your life, such as your emotional, physical health, social, financial or spiritual.
Explore your current coping skills and resources:
- What is currently working to help you manage or cope with the problem?
- Who are the significant people in your life that have helped you along the way?
- Remember: If it works, keep doing more of it!
Its about the small shifts that lead to bigger or sustainable change:
- Ask yourself first, what needs to change?
- The idea of making big changes and shifts can feel overwhelming, unattainable and scary. It might be helpful to think about a small change that you can do in the next 2-3 weeks that helps you move closer to your desired outcome.
Where are the exceptions?
- Think about past situations in which the problem was minimized or not prevalent. Explore in detail what was different. What worked before and what would be useful to keep doing?
Bringing awareness to the small changes:
- For the next 2-4 weeks, be mindful and acknowledge moments in which you are moving closer to your desired outcome. It may help to keep a journal or log. Remember, even the smallest of shifts are worth celebrating!
If you are looking for a deeper dive and 1 on 1 support in your journey, book a session with a therapist who is trained in Solution Focused Brief Therapy at Maratos Counselling and Consulting Services.
References
Bannink, F. (2010). 1001 solution focused questions. W.W. Norton & Company Inc.
Neuroplasticity: https://www.psychologytoday.com/ca/basics/neuroplasticity
Warner, R.E. (2013). Solution-Focused Interviewing. Applying Positive Psychology. A Manual for Practitioners. University of Toronto Press.
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