Is Seasonal Depression a Myth?

New research challenges traditional belief that a season, particularly fall or winter, can influence or cause depression.  Investigators performed a large-scale survey of U.S. adults and found no evidence that levels of depressive symptoms vary from season to season.  Read the News

Autumn Anxiety is Real, and Treatable

Depression blogger Therese Borchard writes, “It happens every year. As I watch the first golden leaves fall from the oak tree outside our house and listen to the sound of the cicadas ushering in autumn, my anxiety spikes. I used to think I was relapsing into depression, but having been through this year after year (and documenting it in my mood journal), I now know I’m just going through my annual bout of autumn anxiety: a nervous feeling in my gut that begins the last week of August and continues through the first weeks of September”. Read her Blog

 

7 Delicious Dinners That Help Fight Seasonal Depression

If you’re suffering with the winter blues or have full-blown seasonal affective disorder (SAS), there’s some good news: Not only is spring on the way, but there are actually certain foolds that you can eat to help ease depression and increase your energy levels.  Read the Blog

The Scientific Reasons Why You’re Feeling Depressed

Are you waking up just feeling “blah”?  Like you don’t want to do anything except lie like a couch potato and watch TV, and even that is unsatisfying?  You not only feel low energy, but kind of miserable.  Perhaps you’re mad at yourself for not getting the house cleaned or not getting your work done and papers filed. Perhaps you’re feeling a bit lonely, left out by friends or unsupported by family.  You may dwell on mounting bills or the fact that you’re 10 or 20 pounds overweight.  You may feel aches and pains in your neck or back.  Or you may just may feel grouchy and want to remain undisturbed by life’s demands and conversational opportunities.  You may compare yourself unfavorably to your friend, roommate, cousin, or neighbor, who always seems to be on time, well-groomed, and on track to meet her goals.  We all have those “blah” days, but why do they happen and what can we do about them?

Brain Chemicals

The human brain

Some of us have brains that are more sensitive to the effects of stress. Researchers are just beginning to uncover the biochemistry behind this differential.  The most common forms of antidepressants target the neurotransmitters serotonin and norepinephrine because research shows that low levels of these chemical motivators are part of what makes us depressed. However, only some people respond well to the most common forms of antidepressants, while others try drug after drug with no substantial mood improvement. A recent research study may reveal the reason why. A study published earlier this year in Proceedings of the National Academy of Sciences suggests that differences in the way our brain’s process a chemical called galanin makes some of us less resilient and able to bounce back after difficult experiences.

The Weather

winter day

Less sunshine during the winter months can give us the blues, and this effect is more pronounced for some people than others.  Researchers Keller and colleagues studied hundreds of people and found that during the spring, moods improved along with doing more outdoor activities. We are also more cognitively flexible and able to think creatively about solving our problems in the spring, compared to winter.  A subgroup of us suffer from Seasonal Affective Disorder in which the winter blues turn into full-blown depression along with associated changes in sleep, appetite, and motivation.  Sufferers are more likely to be women. Exposure to outdoor sunlight also provides us with vitamin D; a substance with clear links to depressed mood.

Vitamin D

vitamin D

Most people in the US have insufficient or deficient levels of Vitamin D. The reasons are not clear, but could be related to nutrition and insufficient sun exposure.  People with dark skin are more vulnerable to vitamin D deficiency, due to a decreased ability to process vitamin D from sunlight.  Vitamin D deficiency has been statistically linked to depression. In a large Dutch study by Hoogendijk and colleagues (2008) of over 1,200 persons aged 65 and older, levels of vitamin D were 14% lower in persons with minor depression or major depressive disorder when compared to those not showing depressed mood.

Hormones

Illu_endocrine_system

Hormones are substances produced by the endocrine glands that influence many bodily functions, including growth and development, mood, sexual function, and metabolism. Levels of certain hormones, such as those produced by the thyroid gland, can be factors in depression. In addition, some symptoms of depression are associated with thyroid conditions. Hormones fluctuate during the menstrual cycle and may create vulnerability to sad or depressed mood in the premenstrual period, as well as during peri-menopause, and menopause. There are individual differences in how much our moods are vulnerable to the effects of hormones.  If you are more vulnerable, you may want to consult a physician to see if medications are needed to help regulate your hormones. Or you could try alternative medicine treatments, such as acupuncture to reduce hormone-related mood imbalance.

Expectations

Expectations

Our moods are not only a function of what happens to us, but also of how we view the events in our lives and the meanings we assign to them.  There are stages in most of our lives in which we seem to be working hard and doing all the right things, but don’t see many external rewards coming our way.  We may not be paid what we feel we are worth or be able to afford as nice a house, car, or vacation as our friends.  We may struggle to find the right partner while our friends or siblings seem to have no problem finding love.  We may have to work longer and harder than our friends to get the same grade on a test or earn a living.  We may experience a difficult breakup or loss. Life just naturally isn’t fair and periods of struggle, suffering and loss are inevitable.  If we expect fair or special treatment all the time or expect things never to change, we are bound to be disappointed.  So if you’re feeling sad because of recent events, remind yourself that hard times are part of life and will pass.  Or deliberately broaden your view and focus on the good parts of your life or the experiences you are proud of.

Childhood Adverse Events

child-abuse1

Stressful life events can wear down our physical and mental resources, making us more vulnerable to both depression and physical illnesses.  A history of childhood trauma, including abuse, poverty, or loss of a parent, can reset our developing brains to be less cognitively flexible.  It seems that our brains naturally go into a “fight, flight, freeze” response to stress or threat and we often have to use our prefrontal cortex or executive center to get out of this state. Prolonged stress in childhood can make our brains less interconnected and resilient..  Our brains can more easily get “stuck” in negative thinking patterns or stressed out states and we become less able to change tracks.

Stresses Piling Up

Debt_Piling_Up

As Robert Sapolsky argues in his book Why Zebras Don’t Get Ulcers, our human stress response systems were designed to respond to acute, time-limited stressors that normally require a physical response.  When our ancestors had chased off that marauding tiger, they could relax and eat.  The stressors in today’s world are much more chronic and less controllable by taking action, and we often don’t get the break afterwards to recover and regroup. Financial stress, loneliness, constant fighting with loved ones, being bullied, long commutes, academic or job demands, or unemployment can drag on and have a cascade of effects across many areas of our lives.  When stresses hit us one after the other without time for recovery, they can leave us depleted and despondent, with insufficient pep to bounce back.

Negative Ruminations

rumination

You may be feeling bad because you’re sitting around brooding about life’s disappointments or trying to find a reason why things aren’t going your way.  Research studies by University of Michigan psychologist Susan Nolen-Hoeksema and colleagues show that sitting around thinking about your negative mood or negative events just makes everything worse!  One negative thought leads to another until you get buried in a mountain of problems and negative predictions. This leads to a loss of perspective and motivation that interferes with actually doing something about the problem! If you find yourself in a negative thinking cycle, get up immediately and do something else pleasant or neutral to engage your mind.  This can be as simple as emptying the dishwasher, rearranging your closet, going for a walk, talking to a friend or getting on with a work project.

Your Inner Critic

inner critic

Do you have a critical inner voice constantly judging and criticizing everything you do, especially when things don’t go your way? The inner critic compounds the effect of anything negative in your life by blaming you for it.  It keeps drawing your attention to the negative and spoils your pleasure when something positive happens by telling you ”it won’t last” or “you don’t deserve it”.  This negative dialogue takes you out of the moment and makes you feel depressed. Negative thinking is, at minimum, a symptom of depression, and may be a causal factor in interaction with negative life events. The first step to combat an inner critic is to become aware of what it’s saying.  Second step is to externalize it. You could give your critic  a name and imagine what it looks like (e.g., a grumpy old crone or a vicious barking dog). Then begin telling it to back off or talk back to it.  The inner critic generally has a negatively biased perspective and overestimates your responsibility for and control over outcomes in your life. It also often has perfectionistic expectations. Tell it to give you a break for a change!

Loneliness

lonelines

Our human brains are wired of be part of a social group, and we experience loneliness as chronically stressful and depressing. Unfortunately, some of us have toxic or neglectful families that don’t provide support or presence when we need it. Or we may feel that our friends are moving on in finding romantic relationships or having kids and leaving us behind. Research using fMRI brain scans shows that even minor social rejection lights up the same areas of our brains as physical pain. Feeling left out, rejected, or excluded makes us sad and can also lead to rumination about what is wrong with us that further darkens our moods.  We become scared of further rejection and isolate ourselves, perpetuating the negative cycle.  While there may not be a immediate cure for loneliness, it helps to get out in the world and pursue your natural interests, which can lead to expanding your social network. Staying in touch with old friends or family and deliberately seeking opportunities to connect may help as well.

Final Thoughts

The reasons for a down mood may be multifaceted and difficult to determine. If you feel depressed for two weeks or more, seek a medical consult to rule out or treat underlying biological factors. Consider consulting a mental health professional for help in managing stress and expectations, negotiating life changes, or dealing with the emotional aftereffects of past traumas and dysfunctional families. If you can’t afford therapy, antidepressants may help to change the underlying biology. Exercising outdoors can provide both sunlight and mood elevation. Develop a toolkit of stress-reducing activities, such as regular exercise, yoga or meditation, watching funny movies, playing team sports, doing something creative or novel, hanging out with and/or confiding in understanding friends.

 

By Melanie Goldberg, Ph.D.

Dr. Goldberg is a clinical psychologist with a private practice in Mill Valley, California.

 

 

Is it Lawyer Sadness or Lawyer Depression?

I can spot sadness on a lawyer’s face like a good poker player can read dog-eared cards in a smoky, backroom bar.  To others, his or her expression may seem like a seasoned lawyer’s humorless and steely resolve. But, I know better.  There is something tragic in his or her gaze, his or her face a subtler shade of grey.  The repartee, if any, is deeply cynical and sarcastic. It is a tough life for many in this boat, and many dream of a different life.  “Every man has his secret,” wrote Tennyson, “which the world knows not; and often times we call a man cold when he is only sad.”

sad woman

Such sadness, however, does not necessarily equate with clinical depression. Like all humans that walk this earth, sadness is woven into the life of every lawyer.  One of the tougher aspects of their lives is that their demanding careers often leave little time to be with and enjoy their families.  Because sadness is often about the loss of people we care about and/or the time we spend with them, this one seems to be particularly piercing for lawyers. Too much sadness is the price they pay for too much time at work.

For most of us, sadness seems to be short-lived before we bounce back up.  When sadness goes on for a day or two, we might say that we have “the blues.”

It’s normal to feel the blues; a bittersweet type of sadness that colors our lives from time to time. Blues music is very popular given the universal nature of this experience.

But while sadness and the blues are inevitable parts of life, clinical depression is not.  The most significant difference between sadness and the blues is that someone that’s sad goes about their daily business without much trouble.  But depression involves impairment in one’s ability to carry out daily task at work and home.

Dr.Richard  O’Connor, in his deeply insightful book Undoing Depression, captures some of the difference between the two:

“Everyone has had a taste of what depression feels like.  Everyone feels the blues at times.  Sadness, disappointment, fatigue are normal parts of life.  There is a connection between the blues and   depression, but the difference is like the difference between the sniffles and pneumonia.”

Other differences between the blues and depression include the length of time the sadness endures and whether or not there are other symptoms associated with depression which are tagging along with the perpetual sadness.

“I think the difference between just having the blues and depression lies in the symptoms,” writes Raymond Crowe, M.D., professor of psychiatry. “If the blues’ persist for more than a couple of weeks and are accompanied by trouble eating, difficulty sleeping, or suicidal thoughts, you should see a therapist or psychiatrist or your family doctor.”

depressed cave

Psychiatrist Peter Kramer, author of Against Depression, underscores the point that depression is a serious illness and not ordinary sadness:

For the psychiatrist, then, depression becomes an intimate.  It is poor company.  Depression destroys families. It ruins careers. It ages patients prematurely. It attacks their memories and their general health. For us – for me – the truth that depression is a disease is unqualified.  Depression is debilitating, progressive and relentless in its downhill course, as tough and worthy opponent as any doctor might choose to combat.”

It’s important to recognize the difference between lawyer sadness and depression because a suffering lawyer will not be able to resolve the depression by himself; talking it out with a group of workpals over some beers at lunch just won’t get to the heart of the problem.  This person will need a mental health professional to evaluate him or her and get him or her the serious help he or she needs.

Too frequently, the culture at large, and perhaps the legal profession in particular, mix up sadness, discontent, malaise, unhappiness and clinical depression.The titles of media and journal articles, while they may touch on depression, reflect this clumping together of unhappiness and depression.  I was interviewed for an article by The Wall Street Journal about depression in the legal profession.  While it was clear that the story was going to be about depression, the article’s title was Even Lawyers’ Get the Blues. A recent Law Journal article, which included a small section on depression, was titled How to Be a Happy, Healthy and Ethical Member of an Unhappy, Unhealthy and Unethical Profession.  Martin Seligman, the guru of the Positive Psychology movement, wrote a chapter in his book “Authentic Happiness” called, Why Are Lawyers So Unhappy? In the chapter, however, he wrote about both unhappiness and depression without attempting to differentiate the two.

This commingling of ordinary sadness, unhappiness and depression is confusing and misleading. And dangerous.  It is confusing because a sufferer and those around him may underestimate the gravity of the situation: “Bob is just sad, going through a tough patch at the law office.  He’ll get over it.”

But, Bob might not.  He may get worse.  The depression may deepen.  He may need medication that he’ll never get. He may need to talk to a therapist to address the distorted thinking that goes on during a depression. He may need medication to lift himself out of the darkness. Absent such help and hope, he may commit suicide.  As much as 80% of suicides are committed by those struggling with depression and lawyers have much higher suicide rates than the general population.

Others simply do not have a reference point for depression unless they have been through it before. Sadness? Yes. The deep psychic pain of depression? No. Misidentifying a person with depression as having the blues can have severe consequence because the more people do so in the life of the depressed person, the greater the isolation, the greater the pit of desolation the depressive falls into because no one understands. It causes them to queston themselves: “Why can’t I snap out of this?  What’s wrong with me?”

DSM

According to The Diagnostic Statistical Manual (DSM), the bible used by mental health workers, to be diagnosed with depression you need to have had a depressed mood or loss of interest or pleasure in daily activites for more than two weeks.  According to the National Institute of Mental Health, you also must have some, but not all, of the following symptoms:

  • Difficulty concentrating, remembering details, and making decisions
  • Fatigue and decreased energy
  • Feelings of guilt, worthlessness, and/or helplessness
  • Feelings of hopelessness and/or pessimism
  • Insomnia, early-morning wakefulness, or excessive sleeping
  • Irritability, restlessness
  • Loss of interest in activities or hobbies once pleasurable, including sex
  • Overeating or appetite loss
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not ease even with treatment
  • Persistent sad, anxious, or “empty” feelings
  • Thoughts of suicide, suicide attempts

Do you think either you or someone you care about is suffering from depression?

Take this depression test to see if you or someone you care about might be suffering from depression.  If so, get help now.

 

 

 

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