Depression’s Vicious Circle

Here’s a brief discussion of how depression leads to hurting yourself, sometimes in ways you’re not even aware of.

Depression is best understood as a vicious circle, the result of current stress acting on a vulnerable individual to push him or her into this cycle that feeds itself: depressed moods lead to depressed thinking and behavior, which leads to a more depressed mood, and so on in a downward spiral. Depression is also accompanied by negative thinking (I can’t. . .The cards are stacked against me. . .There’s no use trying) and hopelessness.  In addition, depression affects the brain directly:  we stop producing dopamine (hence have less drive and energy) and the cells that are meant to receive endorphins, the happy hormones, shrivel away so that we can’t experience good feelings.  The depressed person is usually slowed down, stuck in molasses, unable to think clearly or see a better future; his/her speech is often a slow monotone that sounds like an effort and conveys no feeling at all.  What does it matter. . .why bother. . .it’s useless. 

If you have a mood disorder, by definition you have trouble with self-destructive behavior.  It’s usually a passive form of self-destruction—staying home isolated, giving up hope, expecting the worst—though there are angry depressed people who get into fights and emotionally abuse others.  You may turn to alcohol or drugs to help comfort you.  Depression is usually accompanied by suicidal thoughts and impulses, and suicide is often a real risk.  Impulses like driving into a bridge abutment or stepping off a high place can come out of nowhere and convince you that you are going crazy, though they’re very common with depression.

Your assumptive world changes drastically with depression, and the depressed assumptions turn into self-fulfilling prophecies that just make you feel worse.  Depressed people tend to take too much responsibility for the bad things that happen in life, but feel that the good things are just accidents that they had nothing to do with and are unlikely to happen again.  If you’re depressed, you are probably quite pessimistic in your thinking, assuming that everything is getting worse all the time, and there’s nothing you can do about it.  You feel that you have to be in control every moment, and if you relax, things will fall apart; at the same time you don’t really believe that your efforts to control will really do any good.  The glass is always half empty, good things are temporary and unreliable, bad things are permanent and pervasive, other people are always better, more attractive, more successful than you.  When you know what you ought to do to feel better, but are too depressed to do it, you blame yourself for lacking will power, as if it’s a character trait that you either have or don’t have, and that adds to your low self-esteem.

Here are some of the self-destructive behaviors most commonly associated with depression:

  • Overeating to comfort yourself, a consolation prize
  • Social isolation because you don’t feel worthy of attention
  • Substance abuse
  • Procrastination—for all kinds of reasons
  • A cycle of overwork and collapse
  • Staying in destructive situations—letting your partner, boss, or coworkers take advantage of you
  • Neglecting your health because you don’t feel you’re worth the effort
  • Poor sleep—insomnia or waking at 4 AM and obsessively ruminating is a classic sign of depression
  • Not exercising—you don’t have the energy and you don’t think it’ll do any good
  • Won’t ask for help because you’re ashamed and guilty
  • Suffering in silence—not expressing your feelings is both a cause and symptom of depression
  • Depressed shopping, spending money you don’t have to buy things you hope will make you feel better
  • Parasuicide—nonfatal suicide attempts, suicidal gestures
  • Self mutilation
  • Anorexia/bulimia
  • “Wearing the victim sign”—unconsciously communicating that you can be taken advantage of
  • And many more

All these things obviously interfere with recovery, but they also make your mood problems worse.  Every time you try to get control over these patterns and fail, you have another experience that confirms your own shame about your illness.  You blame yourself, and you become more hopeless.

If you ask depressed people to spend ten minutes thinking about their problems, they become more depressed (because of all their negative thinking patterns).  If you give them another subject to spend ten minutes thinking about, they become less depressed.  Pay attention to this, because it’s counterintuitive; it’s important to our worldview to believe that if we just apply mental power to our problems, we’ll find a way out.  But that just backfires with depression, because the illness has so pervaded our minds that our beliefs and assumptions are twisted, and our ability to concentrate and make decisions is damaged.  In fact, it’s rather obvious that if the ordinary powers of the conscious mind were able to counter depression, we wouldn’t be depressed to begin with.  This is a very ironic form of self-destructive behavior, and why I refer to depression as the Catch-22 of mental illness; trying your best to figure out what’s wrong and what to do about it just makes you feel worse.  But no one recognizes this without help.

That doesn’t mean there’s nothing you can do about it.  I ask people to keep a log of their depressed mood shifts, what’s going on around them at the time, and what their thoughts and feelings were.  They thus learn to identify their triggers, and develop some control because they can strategize how to avoid or respond differently to things that make them feel bad.  At the same time, they develop some of that metacognitive awareness that accompanies mindfulness; the fact that there are explanations for their mood shifts means that they’re not crazy or out of control, and lends hope.

By Richard O’Connor, Ph.D.

Dr. O’Connor is a psychotherapist in NYC and Connecticut who specializes in treating those with depression. He is the author of the bestselling books, Undoing Depression: What Medication Can’t Give You and Therapy Can’t Teach You.

 

Lawyers, Depression and Substance Abuse

From the website Attorney at Work, a great Q&A from James Kelleher, a Licensed Professional Counselor in Arizona, and Brian Cuban, a lawyer who has been open about his struggles with depression, substance abuse and other mental health issues.  Read the Blog

Dallas DA Sets Ethical Example with Depression Treatment

The website, Law360 reports: “When Dallas County’s district attorney took a leave of absence to treat serious depression — a problem that affects attorneys in disproportionate numbers to the general population — she faced calls for resignation, but experts say getting treatment and ensuring that any clients are taken care of is the ethical thing to do.” Read the News

How Much Should You Push Yourself with Depression?

Depression blogger, Therese Borchard writes: “In deciding whether or not to push yourself, you must first ask yourself if you are doing this thing — a job, a new class, having lunch with someone — because you WANT to do it, or for other reasons.”  Read the Blog

How to Turn Your Depression from Life-Crushing to Life-Enhancing

Blogger Therese Sibon writes: “Depression is a powerful energy lodged in your body. It can control your thoughts, moods and actions. It can control your life. Yet you are the one holding this energy. That takes effort and stamina. As depression threatens your existence, can you actually use it to enhance your life?”  Read the Blog

 

Pushing Back Against Depression

Depression will push our backs up against the wall. It often seems bigger than us: a bully. If we let it, it will pound us down. So, we’ve got to push back.

If we don’t fight back, together with the help of others, depression can consume our lives leaving only our pulse and some air in our lungs, but precious little else. The vitality, the passion and full array of emotions that make life worth living may be sucked up out of us as if by an alien ship from above.

There are many tools to fight depression. They can certainly help us regain our footing and make our lives functional and productive again. But isn’t life more than just about a return to “normal”? We all have dreams and aspire to live them. Theres’s something wild about dreams.  So often, they are outside our “normal”. And regaining them is a big part of recovery for it is these passions that bring us most fully alive in the cosmos. And we have to fight for our dreams.

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Just like fighting a bully, pushing back against depression takes courage. We have to reach deep down inside ourselves to listen to that part of our life force in us all that gives us the grit to say to depression,“no more”. We must say to ourselves, “I’m sick and tired of being ‘sick and tired’”.

When we’re ready to make some changes, we push the bully back. A small push in the beginning will do. We gain some space and separation from this goblin. We stop defining ourselves as a “depressed person,” as if our identity were wholly made up of our affliction. We are not our depression. It is a part, albeit a very painful part, of our lives. But it need not be all of it.

To fight back against depression, we need to empower ourselves to level the playing field. One of the best ways is learn mindfulness. With it, we gain detachment from our negative thoughts and emotions. Mindfulness teaches us that pessimistic thoughts and disturbing emotions are clouds passing in the sky, not reality.  Check out the excellent book, The Mindful Way Through Depression to learn more.

If we don’t buy into the depressed stories our minds spin out, we can begin to see them for what they are: puffs of cerebral and neurochemical smoke. We don’t have to buy into them.  We don’t have to live by that script.

This takes a lot of practice and we have to start slowing. This is, by no means, a quick “fix”. But in detaching ourselves from our mental jumble and the over reactive emotions that accompany my anxiety and depression, we gain freedom. We again have choices in life. We need not walk in the deep ruts of depression anymore.

And this is empowering.

Poet, Mary Oliver in her poem, “The Journey,”beautifully captures the sense of determination we need to recover from depression:

One day you finally knew
what you had to do, and began,
though the voices around you
kept shouting
their bad advice–
though the whole house
began to tremble
and you felt the old tug
at your ankles.
“Mend my life!”
each voice cried.
But you didn’t stop.
You knew what you had to do,
though the wind pried
with its stiff fingers
at the very foundations,
though their melancholy
was terrible.
It was already late
enough, and a wild night,
and the road full of fallen
branches and stones.
But little by little,
as you left their voices behind,
the stars began to burn
through the sheets of clouds,
and there was a new voice
which you slowly
recognized as your own,
that kept you company
as you strode deeper and deeper
into the world,
determined to do
the only thing you could do–
determined to save
the only life you could save.

 

 

 

Did You Know That Lawyers Suffer From Depression More Often Than the General Public?

The idea that lawyers shouldn’t have problems increases the sense of isolation for those suffering from this debilitating disorder. People with depression often feel emotionally numb, empty and completely alone, even when surrounded by other people. Many lawyers who struggle with depression suffer in silence so as not to appear weak to colleagues.  The Washington D.C. Bar offers help.  Read the Blog

Preventing Depression Among Lawyers

Kevin O’Keefe, CEO and founder of LexBlog, writes, “Having personally experienced the lows of depression and the positive energy that comes from blogging and social media, I have to believe the effective use of social media could prevent depression for many lawyers.”  Read his Blog

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