anger Archives - Lawyers With Depression

Top 5 Traps That People With Depression Fall Into

A trap for those suffering from depression and anxiety is that many of people’s natural coping reactions make the problem worse rather than better. Here are a few examples of that, and some practical solutions.

Note: Please be compassionate with yourself if you can relate to any of these patterns. They’re common pitfalls, not an indictment on you as a person.

Number 1: You don’t fix problems that frustrate you.

Feeling irritable is one of the main symptoms of depression for many people. Some problems that trigger repeated irritation and frustration are easily fixable. However, people with depression often go into a passive “survival” mode and don’t address these issues, even though they could.

For example, you don’t have enough power outlets in the spot where everyone in your household likes to charge their devices. You’re constantly annoyed about people unplugging your device in favor of their own. This is the type of tension that can be solved by getting a multi-plug or another similar practical solution.

People with depression often just put up with this type of issue (and complain about it), rather than deploying a solution. It’s understandable to do this, but not very helpful.

Number 2: You’re waiting for your sleep to improve before you take other actions.

Difficulty sleeping is one of the most horrible symptoms of depression. Unfortunately, it’s often the last symptom to resolve when people’s mood starts to improve. Therefore, even though it’s hard, it is important that you start other strategies even though you’re feeling tired and grumpy. For example, exercise. If you over-focus on getting your sleep right before you start other strategies, you’re setting yourself up to fail.

Number 3: Wanting a pill as a cure-all.

Medication is helpful for many people with depression but it certainly doesn’t address all of the thinking and behavioral patterns that are associated with depression. For example, you’ll likely still need psychological strategies to deal with tendencies towards rumination (overthinking) and avoidance/procrastination.

Solution: Try drawing a pie chart and estimating what role you think medication has in your depression recovery. Include whatever is relevant to you in your pie chart, such as thinking changes, exercise, meditation, laughter, problem-solving etc. Your personal pie chart won’t be the same as someone else’s since everyone’s preferred mix of strategies for depression recovery is a little bit different. When you start adding all these other components to your pie chart, you’ll see that medication is only a part of the picture.

Number 4: Asking for help too often.

People with depression frequently struggle along on their own for far too long before seeking effective help, and may not realize they’re depressed. However, sometimes people can become over-reliant on others when their mood is low. Examples include too frequently asking for help with: making decisions, using technology, or reaching out socially (such as making phone calls).

The same person can be too resistant to seeking help in some respects and too reliant on others in other respects!

When someone who is depressed constantly leans on others it can create anger, resentment, and other problems in relationships. This is especially the case when the depressed person repeatedly asks the same people for help or asks for help with the same task that they could learn to do themselves.

This point relates to the next one, so keep reading to learn more.

Number 5: Putting life, learning, and projects completely on hold.

People often feel like their brain is foggy and their concentration is impaired when they’re depressed. Therefore, it’s natural that people withdraw and think they’ll put off working on projects or learning anything new until they’re feeling better.

When you’re depressed, it’s a great idea to go easy on yourself and resist taking on too much. This does not mean putting off anything and everything challenging or unfamiliar. If you do this, you’ll, unfortunately, dig yourself into a very big hole, where you withdraw from life and avoid, and your confidence and energy erode further.

Don’t push yourself too hard, but understand that experiences of both pleasure and mastery are incredibly important for mood hygiene and depression recovery.

Solution: For this tip, I like to think of each day in three chunks – morning, afternoon, and evening. Aim to have one experience of pleasure and one experience of mastery in each of these chunks. These can be tiny, like canceling a subscription you’ve been paying for but not using.

You can actually fold other advice for alleviating depression into this strategy. For example, exercise could be either a pleasure or mastery experience for you or both. Something like taking the stairs rather than the elevator could be counted.

If you include mastery experiences in your day, you’re not likely to fall into the traps of asking for help too much or failing to solve easily fixable problems that trigger your irritability.

Wrapping Up

Which of these problems seems most relevant to you or your loved one? Which of the solutions presented seems most important for you to try? How can you implement that in the easiest way possible? How can you bypass the most likely obstacle to your succeeding with your strategy?

By Alice Boyes, Ph.D. Alice has had her research about couples published in leading international journals, including Journal of Personality and Social Psychology.Her work focuses on how people can use tips from social, clinical and positive psychology research in their everyday lives and romantic relationships. She is regularly interviewed for magazines and radio about a wide range of social, clinical, positive, and relationships psychology topics. She can be contacted for media interviews by emailing admin@aliceboyes.com

The Role of Anger in Depression

Sigmund Freud used to refer to depression as anger turned inward. While many people may regard this as an overly simplistic approach to the most common mental health disorder in the world, there is no doubt that anger plays a significant role in depression. As one study from 2016 found, when it comes to emotional disorders in general, the presence of anger has “negative consequences, including greater symptom severity and worse treatment response.” Researchers concluded that “based on this evidence, anger appears to be an important and understudied emotion in the development, maintenance, and treatment of emotional disorders.” When it comes specifically to depression, science seems to be further supporting Freud’s theory, showing more and more how anger contributes to symptoms. A UK study from 2013 suggested that going inward and turning our anger on ourselves contributes to the severity of depression.

Having worked with depressed clients for more than 30 years, these findings were not surprising to me. Many of the people I’ve worked with who struggle with depression also share the common struggle of turning their anger on themselves. As much as I try to help my clients express their anger rather than take it on and turn it inward, I witness first-hand how hard it often is for people to interrupt this process. It’s a challenge for them to recognize the nasty way they treat themselves; they are significantly more critical of themselves that they are of others.

People who suffer from depression often have intense “critical inner voices” that perpetuate feelings of unworthiness and shame. When they listen to this inner critic, they not only feel more depressed, but they also find it much more difficult to stand up to their depression. This includes acting against their critical inner voices, taking positive actions that could help them feel better about themselves (like engaging in activities they enjoy), and being more social.

Getting angry at these “voices” can be liberating, but that means getting in touch with our core feelings of anger rather than aiming it at ourselves. Dr. Les Greenberg, the founder of Emotionally Focused Therapy, describes an important difference between adaptive anger and nonadaptive anger. Anger is an adaptive response when it motivates you to assertive action to end a violation. For example, when we may feel angry at the cruel way we treat ourselves today, we’re in touch with our adaptive anger, and we feel like we’re on our own side. Letting ourselves feel and express adaptive anger can help us feel less burdened, freer, and more in touch with our real self.

Maladaptive anger, on the other hand, affects us negatively. For one thing, it can contribute to feeling victimized, sulky, or stuck in a feeling of being wronged. Examples of maladaptive anger turned inward can include feeling overly critical toward ourselves, hating ourselves, or seeing ourselves as powerless, pathetic, or helpless. The generally dysfunctional responses that result from maladaptive anger are based on emotional schema from traumatic experiences in our past. Often, our critical inner voice is at the root of maladaptive anger, driving us to remain in a state of frustration and suffering.

We can almost feel the difference between maladaptive anger dragging us down and deeper into a state of anxiety or depression and adaptive anger relieving us of a heavy burden, lightening us emotionally, and contributing to our taking constructive actions. While it can feel scary to face these deeper, core emotions, we must access adaptive emotions to transform our maladaptive emotions. This can be a vital process in helping us deal with depression.

One study by Dr. Greenberg showed that Emotionally Focused Therapy can transform maladaptive emotion through the process of expressing it and eliciting the response of an adaptive emotion, i.e. adaptive anger. This approach was especially effective in improving depressive symptoms, interpersonal distress, and self-esteem. As Dr. Greenberg described it, the process “aims within an affectively attuned empathic relationship to access and transform habitual maladaptive emotional schematic memories [articulated as critical inner voices] that are seen as the source of the depression.” Transforming these maladaptive emotions may, therefore, be one of the keys to fighting depression.

Our approach to transforming anger turned inward, which has some similarities to Greenberg’s approach, is to have the person verbalize their critical inner voices as though someone else was telling them these angry thoughts. We also encourage the person to express the feeling behind the thoughts. Often, when people do this, they express a lot of rage toward self. By saying the thoughts in the second person (as “you” statements), they begin to get some separation from their harsh, critical attitudes, and often have insights about where these thoughts come from. It sets the stage for them “answering back” to these attacks and taking their own side. The goal is also to help the person develop more self-compassion and a kinder, more realistic point of view toward themselves.

As we externalize our negative thoughts and the accompanying anger, we can better stand up to our inner critic and take a compassionate stance toward ourselves, treating ourselves as we would treat a friend. This doesn’t mean denying our struggles and setbacks, but it does mean embracing the practice of self-compassion. Self-compassion, as defined by researcher Kristin Neff, involves three key elements: self-kindness, mindfulness, and awareness of common humanity. Research has shown that the practice of self-compassion can significantly reduce a depressed mood. As one study pointed out, maladaptive or irrational beliefs underlie the development of depression, however, when high levels of self-compassion helped to counteract these negative thoughts, there was no longer a significant relationship between irrational beliefs and depression. This same study showed that it is “especially the self-kindness component of self-compassion that moderated the irrational belief-depression relationship.” Thus, the primary aim for someone struggling with resolving their emotions around depression is to treat themselves and regard their feelings the way they would a friend. It’s not about feeling sorry for ourselves, but about feeling strong and worthy and less afraid to make mistakes.

Ultimately, accepting that anger plays a role in our depression should be an empowering tool in our fight to feel better. When people express anger outwards in a healthy adaptive manner, they feel less depressed. Accessing and expressing this anger isn’t a matter of acting out, being explosive, or feeling bitter toward our surroundings. In fact, it means exactly the opposite. It’s an act of standing up for ourselves and accepting that we are not who our “voices” are telling us we are. It’s a process of facing up to the things that hurt us but also facing off against the inner enemy we all possess that drives us deeper into our suffering. The more we can take our own side and resist our tendency to turn our anger on ourselves, the more compassionate and alive we can feel in facing any challenge, including depression.

Lisa Firestone, Ph.D., is a clinical psychologist, author, and the Director of Research and Education for the Glendon Association. She studies suicide and violence as well as couples and family relations. Firestone is the co-author (with Robert Firestone and Joyce Catlett) of Conquer Your Critical Inner Voice, Creating a Life of Meaning and Compassion, and Sex and Love in Intimate Relationships. Firestone speaks frequently at conferences including the APA, the International Association of Forensic Psychology, International Association of Suicide Prevention, the Department of Defense and many others. She has also appeared in more than 300 radio, TV, and print interviews including the BBC, CBC, NPR, the Los Angeles Times, Psychology Today, Men’s Health and O Magazine.

How Exercise Reduces Depression, Anxiety, Cynicism, & Anger

Exercise is good for you. If you’re procrastinating a run or putting off a walk, then we recommend that you close your computer and get outside, content in the knowledge that you have fully grasped the thesis of our article. If you are still here, then we assume that you would like to know more.

First, let’s review exercise’s benefits for the body.

Individuals who exercise a total of 7 hours per week have a premature mortality rate 40 percent less than those who exercise less than 30 minutes per week. Physical activity also appears to reduce your risk for colon and breast cancers. Furthermore, there is evolving evidence that physical activity may also reduce your risk for endometrial and lung cancers.^1–3

Research also suggests that health benefits may be appreciated from even modest exercise programs. As little as 2.5 hours of exercise per week significantly reduces your risk of type 2 diabetes and cardiovascular disease. When it comes to exercise, half a loaf really is better than none. In fact, physical inactivity is estimated to cause one in 25 deaths worldwide each year.^1–3

And yet despite all that is known about the health benefits of exercise, a little more than 50 percent of Americans do not meet the current CDC recommendations of 2.5 hours of moderate-intensity (50-70 percent maximal heart rate) or 1.25 hours of vigorous intensity (70-85 percent maximal heart rate) exercise per week.¹

For reference, maximal heart rate can be calculated by taking 208 – 0.7 x age (an older, unvalidated version of this equation used 220 as the base).⁴ As an example, a 30-year old’s maximal heart rate is calculated to be 187 beats per minute (“bpm”). This means that in our 30-year old example, a moderate-intensity activity should achieve a heart rate of at least 94 bpm while a vigorous-intensity exercise should aim for a target of at least 131 bpm.

We will return to these parameters in a moment, but for now, let’s turn to the benefits of exercise for the brain.

Before diving in, it is necessary to review the concept of effect sizes. An effect size expresses the difference between two groups; usually between a treatment group and a control group. Effect sizes are calculated as numbers but can be represented categorically as “small,” “medium,” “large,” and “very large.”^5–7

Very generally, a medium effect size should be able to be “seen” by the naked eye. For example, in Professor Jacob Cohen’s pioneering work on the subject, he cited the difference in average height between 14-year-old and 18-year-old females to be an example of a medium effect. As an example of a large effect, Professor Cohen cited the difference in IQ between a “typical” college freshman and a “typical” Ph.D. holder.⁵ For the purposes of our discussion, the larger the effect size, the more likely it is that the treatment (e.g. exercise) is better at treating depression than the control condition (e.g. no exercise).

With our introduction to effect sizes out of the way, let’s study the effects of exercise on the brain.

Studies have demonstrated a strong antidepressant effect for exercise. For example, one meta-analysis that examined well-controlled studies of exercise as an intervention for clinical depression found a very large effect size when compared to nonactive control groups. Notably, previous work had demonstrated a large effect size for study populations of undifferentiated clinical and non-clinical subjects with depressed mood.⁸

We wish to pause at this point to put these antidepressant effect sizes for exercise in perspective. Let’s turn briefly to effect sizes associated with various psychiatric and general medical pharmaceuticals and treatments. We will use the most optimistic estimates of efficacy for the various classes of interventions so as to level the playing field as much as possible. We fully acknowledge that we will not be comparing apples to apples. The following discussion is not meant to be a definitive statement regarding the efficacy of various treatments. Instead, we hope that the comparisons will help place the magnitude of exercise’s effect size in context.

To begin, let’s compare exercise’s large or very large effect size with antidepressant medication’s small effect size in acute depressive episodes.⁹ Psychotherapeutic interventions have similar effect sizes to psychopharmacologic medication in the treatment of depressive episodes. However, the combination of psychotherapy and psychopharmacologic medication yields a medium effect size; a value notable for its superiority to either intervention offered in isolation.¹⁰ Electroconvulsive therapy for an acute depressive episode has a large effect size.¹¹

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There are numerous potential confounding variables in this very brief comparative overview. Despite every effort to control for the various confounds, it is likely that depressed cohorts who were able to exercise were qualitatively different in some ways from some of the populations included in electroconvulsive trials for example. Researchers have employed various techniques to try to eliminate these confounds, and there are reasons to treat much of the data as valid, but caution is certainly warranted.

Antipsychotics for acute psychosis, antihypertensives for high blood pressure, and corticosteroids for the prevention of asthma exacerbations all have similar medium effect size. Whereas, antibiotics for ear infections and metformin for diabetic mortality have small effect sizes. To find a general medicine medication with an effect size on par with exercise we have to turn to proton pump inhibitors and their large effect size in the treatment of esophagitis.⁹ In fact, the mean effect size for all general medical medications corresponds to a small effect.¹⁰

Research has revealed benefits for exercise in other domains of mental health as well. Meta-analytic reviews have found a small effect size for exercise on state or trait anxiety.⁸ However, upon closer examination research reveals that exercise has a stronger effect on state anxiety than on trait anxiety.¹²

Evidence also suggests a broader application of exercise beyond strictly pathological states.^13–15 One large non-clinical population-based study demonstrated that individuals who exercised more than two times per week experienced reductions not only in depressive symptomatology, but also in cynical distrust, anger, and stress when compared to individuals who exercised less often.¹⁵

There is also significant evidence for a dose-response relationship between exercise and mental health. Exercise regimens with higher intensities, greater frequencies, and longer durations tend to lead to greater response rates in depressed populations. Interestingly, depression remission rates seem to peak at moderate levels of intensity, frequency, and duration suggesting that sustainability of a regimen is an important ingredient to consider when developing a program.⁸

The setting that one exercises in also appears to play a role. Research has demonstrated that exposure to nature and so-called “green space” exerts powerful effects on mood and self-esteem. Exercising outdoors in a natural setting with trees and plants appears to be superior to exercising in an environment devoid of such “green” qualities. The positive effects rapidly develop with even just five minutes of outdoor time offering a very achievable goal even for busy individuals.³

Interestingly, natural settings with bodies of water present (e.g. streams, rivers, lakes, etc.) appear to offer enhanced benefits over and above those seen in other natural settings.³ Natural settings seem to exert their positive effects on health through a variety of mechanisms; however, it should be noted that the effects are not fully explained by the association of green space and exercise.¹⁶ In fact, greater exposure to nature, in general, has been associated with as much as a 12 percent reduction in all-cause non-accidental mortality!¹⁷

How does exercise exert these far-ranging effects?

There are many gaps in our understanding of the mechanisms by which exercise exerts its anxiolytic and antidepressant effects. There is some evidence that exercise may increase turnover of serotonin, leading to an adaptive downregulation of the serotonergic 5-HT2C receptor. Activation of the 5-HT2C receptor seems to inhibit dopamine and norepinephrine release. Thus, a downregulation at the 5-HT2C receptor leads to an increase in availability of dopamine and norepinephrine. This effect is thought to be particularly important in the prefrontal cortex and is hypothesized to contribute to the anxiolytic and antidepressant effects associated with exercise.⁸

In addition to increasing serotonin turnover exercise seems to trigger a release of beta-endorphins. Endorphins are part of the brain’s endogenous opioid system and also tend to produce anxiolytic and antidepressant effects when released.⁸

From a more macroscopic scale exercise, like antidepressant medication, helps restore sleep patterns frequently disrupted in the setting of depression. Furthermore, evidence suggests that activity in the prefrontal cortex is reduced during exercise and that this modification of cognitive processing may correlate with the subjective anxiolytic and antidepressant effect of exercise.⁸

Finally, exercise engages an individual in an activation and approach set of behaviors that are diametrically opposed to passive and avoidant cognitive strategies classically found in depression and many other psychopathological states. In this way exercise seems to operate on a similar theoretical framework as the psychotherapeutic technique known as behavioral activation. Behavioral activation targets behavior first rather than cognition as many other forms of psychotherapy do.¹⁸ It must be noted that although exercise may be a component of a behavioral activation treatment regimen, the psychotherapeutic technique utilizes many other activation strategies to catalyze change.⁸

Let’s be optimistic and imagine that the preceding discussion helped you move from the contemplative to the preparatory stage of change and that you are preparing to make a change in your exercise habits.¹⁹ How much exercise do you need to get before you can appreciate the mental health benefits?

Evidence suggests that an optimal exercise program is about 30 minutes in duration, has a frequency of 2-4 times per week, and is of such an intensity level that an individual achieves 70-80 percent estimated max heart rate.⁸

Recall that our maximal heart rate from our 30-year old example was calculated to be 187 bpm. This means that the targeted intensity level of exercise for mental health should achieve a heart rate between 130-150 bpm.

Finally, the individual should commit to at least four weeks of the new exercise program to optimize the chances for long-term habit formation. Evidence suggests that while 70 percent of individuals maintain a short-term exercise program, only 50 percent maintain the program for six months.⁸

We have covered a lot of ground in our exploration of the varied health benefits associated with exercise.

We began by discussing the significant benefits of exercise for our general medical health. We learned that exercise reduces rates of mortality, some cancers, type 2 diabetes, and cardiovascular disease. For more on the mortality benefits of exercise visit our website Neuraptitude.org.

We next turned to exercise and mental health, studying depression as our archetype condition. We found that exercise can be considered a valid “antidepressant” or augmentation strategy in the treatment of depression and that its effects are comparable to antidepressant medication and psychotherapy.

As we discussed before, we are not comparing apples to apples, and direct comparisons between techniques are not fair outside of a given trial. Our point is not to assert the unrivaled superiority of exercise to psychopharmacologic agents, psychotherapeutic techniques, or other therapeutics. Rather, we wish to elevate exercise from a healthy lifestyle habit to an adjunct treatment.

And finally, let’s recall that exercising in natural outdoor settings, ideally in close proximity to a body of water, may enhance the health benefits associated with exercise.

The most effective treatment for a given mental illness is almost certainly to be pluralistic rather than singular. A holistic treatment strategy that targets biological, psychological, and sociological substrates of disease offers a significant synergistic advantage over a singular approach.

By Matthew Mackinnon, M.D.

Dr. MacKinnon is a psychiatric resident physician at the University of Washington who researches and writes about the neuroscientific intersection of mental health and mental illness. Dr. MacKinnon runs Neuraptitude.org, an online scientific publication dedicated to uncovering the natural capacities of the human mind by exploring topics that reveal, bit by bit, the intrinsic enormity latent within the brain.

References

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Barton J, Pretty J. What is the Best Dose of Nature and Green Exercise for Improving Mental Health? A Multi-Study Analysis. Environ Sci Technol. 2010;44(10):3947-3955. doi:10.1021/es903183r.
Tanaka H, Monahan KD, Seals DR. Age-predicted maximal heart rate revisited. J Am Coll Cardiol. 2001;37(1):153-156. doi:10.1016/S0735-1097(00)01054-8.
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Fritz CO, Morris PE, Richler JJ. Effect size estimates: Current use, calculations, and interpretation. J Exp Psychol Gen. 2012;141(1):2-18. doi:10.1037/a0024338.
Sawilowsky S. New Effect Size Rules of Thumb. Theor Behav Found Educ Fac Publ. November 2009.http://digitalcommons.wayne.edu/coe_tbf/4.
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Leucht S, Hierl S, Kissling W, Dold M, Davis JM. Putting the efficacy of psychiatric and general medicine medication into perspective: review of meta-analyses. Br J Psychiatry. 2012;200(2):97-106. doi:10.1192/bjp.bp.111.096594.
Huhn M, Tardy M, Spineli LM, et al. Efficacy of Pharmacotherapy and Psychotherapy for Adult Psychiatric Disorders: A Systematic Overview of Meta-analyses. JAMA Psychiatry. 2014;71(6):706. doi:10.1001/jamapsychiatry.2014.112.
Lisanby SH. Electroconvulsive Therapy for Depression. N Engl J Med. 2007;357(19):1939-1945. doi:10.1056/NEJMct075234.
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James P, Hart JE, Banay RF, Laden F. Exposure to Greenness and Mortality in a Nationwide Prospective Cohort Study of Women. Environ Health Perspect. 2016;124(9). doi:10.1289/ehp.1510363.
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Depression and Anger: A Destructive Partnership

Here’s an excerpt from blogger John Folk-Williams excellent piece on anger: “It took me a long time to understand the connection between depression and anger. One psychiatrist I visited would often ask a simple question toward the end of a session: How’s your anger? I couldn’t understand why he asked. I hadn’t been talking about anger. Depression was my problem.” Read his entire blog.

Lawyers: Find Freedom From Anger, Anxiety, and Stress

Dr. Rebecca Nerison, a psychologist and author of the ABA Web Store bestseller “Lawyers, Anger and Anxiety: Dealing with the Stresses of the Legal Profession,” says that the accumulated pressures have damaging effects if left unchecked. In this interview, she offers some practical tips for managing stress and developing the resilience to bounce back from stressful events. Read the this article.

Working Through Stress and Depression

Depression is tough. Stress is also tough. Being depressed and stressed at the same time is even tougher. As a person who struggles with depression and has to manage stress on a daily basis, I have some good news for you:

Managing stress while being depressed is possible if you have a plan.

Depression has been a part of my life from as early as I can remember. Like a never-ending fog, I walk through it each day. As I have gotten older, I have discovered that it manifests itself in a variety of ways.

● Sometimes it feels like anger.
● Sometimes it feels like sadness.
● Sometimes it feels like emptiness.
● Sometimes it causes me physical pain.
● Sometimes it is a combination of the above.
● Sometimes it is all of the above.

Like most children, I wasn’t as aware of my thoughts and feelings as I am now, as an adult. At it’s worst my depression became extremely frustrating and overwhelming. The only way I knew how to cope with it was to act out.

Acting out included violent outbursts and harming myself.

● Acting out got me hospitalized 3 times in a psychiatric hospital.
● Acting out got me expelled from 3 schools.
● Acting out lead me to try and take my own life at age 10.
● Acting out mad friendships and dating difficult.

Nowadays, I still experience depression. Fortunately, I don’t act out like I did as a child. Through therapy, support groups, and being a mental health speaker, I have learned that there are other people who struggle with depression, too.

In addition to depression, I also get stressed out from time to time. Stress can be the result of challenges at work, at home, or in my personal life. Sometimes stress is the result of living your life. Let’s face it, life can sometimes just be overwhelming.

Through learning to manage my depression, I’ve also learned to better manage my stress. I’ve learned the hard way that being stressed while you are depressed is a crisis waiting to happen. If you don’t have a plan in place to manage both, it can end up costing you your job, your health, your relationships, and worst of all, your life.

Here are some tips that I have learned to help me cope. They are part of my plan to manage my depression and stress:

1. Get sun every day

According to Healthline, “Exposure to sunlight is thought to increase the brain’s release of a hormone called serotonin. This is associated with boosting mood and helping a person feel calm and focused.”

My goal is to shoot for a half an hour of sun. Ironically, an hour before I began writing this article. I was feeling extremely stressed and sad. I spent about a half an hour in the sun and am feeling much better.

2. Exercise every day

Like sun, it’s important that I keep my body moving, even if it’s just a quick ten-minute walk in the morning. In fact, you can walk and get sun at the same time. The combination of both, even for a short period of time will do wonders for your stress level and depression.

My trainer and nutritionist, Maik Weidenbach, has helped me manage both my stress level and depression with customized plans. Check out his article, Depression and Exercise: 10 Tips to Stay Motivated and Strong and his book 101 Fitness Myths.

3. Writing Things Down

When you are feeling overwhelmed, sad, angry, upset, anxious, etc…, a yellow legal pad can be your best friend. By taking a few minutes to write down everything that is on your mind you can quickly clear your head. As you clear your head, you will feel better.

Also, by seeing what is on your mind written down on paper, you will feel less overwhelmed. I am not sure exactly why this works, but it does. Ironically it’s an exercise that many therapists and professional organizers give their clients.

As I am finishing up writing this article, I feel a bit depressed and a bit stressed. Regardless, it’s not stopping me from being productive because I have a plan in place that I used to take care of myself today.

Managing your stress while being depressed is doable, but you have to be proactive. I encourage you to make a commitment to try one of the ideas listed above every day for the next week. I also encourage you to spend the next week creating a plan for yourself to manage your stress.

What will you include in your plan to manage stress while depressed?

Mike is a mental health advocate and creator of the website Transforming Stigma. To read more about Mike and his courageous work, click here.

12 Signs of Depression in Men

“While the symptoms used to diagnose depression are the same regardless of gender, often the chief complaint can be different among men and women,” says Ian A. Cook, M.D. Read the Blog

Six Truths About Depression

A common misconception about depression is that it is something people can just “snap out of.” Unfortunately, for those people who experience major depression disorder, it’s not that simple. While depression can be serious, it is far from hopeless. There are effective treatments and actions people can take to overcome this disorder. There are certain truths about depression that are important to understand; as we target this debilitating disorder that often spans generations.

1) Depression is a more than just a bad mood.

It’s important for friends and relatives of those struggling to understand that people who suffer from depression can’t just feel better. People experiencing a major depression really need professional treatment. Depression is a mind/body issue and should be treated with the same self-compassion and treatment-seeking with which we would treat any major illness. Different forms of therapy and/ or medications work for different people. According to the American Psychological Association (APA), psychotherapy can benefit depressed individuals by helping them uncover the life problems that contribute to their depression, identify the destructive thinking that makes them feel hopeless, explore the behaviors that exacerbate their depression and regain a sense of pleasure in their lives.

2) Depression is affecting younger people.

In what’s been referred to in the field of psychology as “the greening of depression,” younger people are reporting increased levels of stress and depression. According to the Federal Center for Mental Health Services, “depression affects as many as one in every 33 children and one in eight adolescents.” APA’s additionally reported that higher numbers of college students are seeking treatment for depression and anxiety, with the number of students on psychiatric medications increasing by 10 percent in 10 years.

As I highlighted in my recent blog “Depression in Mothers,” babies born to women who struggled with depression while pregnant have “higher levels of stress hormones … as well as other neurological and behavioral differences.” Thus, whether it’s based on biological factors or new social and academic demands, the vulnerability among younger people makes it all the more essential that we target depression earlier and more effectively. Studies have shown promising results to early intervention among school-age children who showcased symptoms of depression.

3) Mindfulness helps with recurrent depression.

There are a lot of great treatments out there that have proven effective for dealing with depression. Research by psychologist Mark Williams, co-author of The Mindful Way Through Depression, has shown that mindfulness-based cognitive therapy (MBCT) can have a positive effect on preventing relapse in recovered depressed patients. His research indicates that if you teach people with recurrent depression mindfulness skills, such as meditation and breathing exercises, it reduces their chances of having another depressive episode.

Mindfulness practices don’t change our feelings or thoughts, but they do change our relationship to our feelings and thoughts. This enables a person who has a tendency toward depression to not get swept up in the thoughts and feelings that contribute to his or her depression. Another way mindfulness skills can benefit people struggling with depression is by helping them to be better able to regulate and tolerate emotion.

4) Anger often underlies depression.

Often, one strong emotion behind depression is anger. Anger can be a hard emotion to deal with, but it is actually a natural human reaction to frustration. Getting angry may seem like it would only make you feel worse, but when you don’t deal with anger directly, you tend to turn it on yourself. It is important to allow yourself the freedom to fully feel your feelings, but at the same time, to control yourself from acting them out in any way that is harmful. You can recognize and accept your anger in a healthy way that releases the emotion without allowing it to fester or be turned into an attack on yourself.

5) Depression is fueled by an inner critic.

We all have an inner critic, what my father, psychologist Dr. Robert Firestone, refers to as your “critical inner voice.” For people who are depressed, this critical inner voice can have a powerful and destructive influence on their state of mind. It may be feeding them a distorted commentary on their lives: You are too fat to leave the house. You are so stupid. No one will ever love you. You aren’t capable of being happy. You will never succeed at anything. The critical inner voice may then persuade you to act in destructive ways: Just be by yourself; no one wants to see you. Have another piece of cake; it will make you feel better. You shouldn’t even try for that job; you’ll never get it. Finally, once you’ve listened to its directives, the critical inner voice will attack you for your actions: You are such a loser, staying home alone on a Saturday. You messed up your diet again. What is wrong with you? You’ll never get a decent job. You’re so lazy.

To combat depression means taking on this internal enemy. This may involve looking into your past to help determine where these critical thoughts came from. How do these thoughts affect the actions you take in your life? How can you challenge these “voices” on an action level? On Oct. 8, I will be hosting a free online presentation on “Overcoming the Inner Enemy that Causes Depression,” which further explores how your critical inner voice leads to depression.

6) There are active steps you can take to alleviate depression.

One of the worst symptoms of depression is a feeling of hopelessness. This very feeling can inhibit someone suffering from taking the steps that would help them combat their depression. In my blog “Eight Ways to Actively Fight Depression,” I outline a series of actions people can take to fight depression. These include:

Recognizing and challenging your critical inner voice
Identifying and feeling your anger
Engaging in aerobic activity
Putting yourself in social or non-isolated situations
Doing activities you once enjoyed, even when you don’t feel like it
Watching a funny movie or show
Refusing to punish yourself for feeling bad
Seeing a therapist

For people struggling with depression, it’s important to have compassion for yourself and to take actions to overcome this state, including seeking help. Remember that no matter what your critical inner voice may be telling you, the situation is far from hopeless. There is good help available and many active ways to treat your condition. For more help or information visit the National Institute of Mental Health.

Lisa Firestone, Ph.D., is a clinical psychologist, author, and the Director of Research and Education for the Glendon Association. She studies suicide and violence as well as couples and family relations. She is the co-author (with Robert Firestone and Joyce Catlett) of Conquer Your Critical Inner Voice, Creating a Life of Meaning and Compassion, and Sex and Love in Intimate Relationships.

Depression and Anger: A Destructive Partnership

From the blog Storied Mind, an insightful piece on the powerful connection between anger and depression. A must read for all attorneys. Read the Blog