Some interesting pilot studies in 2014 are providing hope for the future of depression. Curiously, these new possibilities all involve the mouth and nose. Breathing a certain way, speaking a certain way, and inhaling nitrous oxide all may have potential in reducing symptoms and breaking the cycle of depression. Read the News
Are New Treatments for Depression Right Under Our Noses?
7 Stress Management Tips for Busy BigLaw Attorneys
Check out these 7 tips for managing stress for BigLaw Attorneys. Read the Blog
Early Bed Time Helps To Reduce Negative Thoughts
New research suggest that night-owls may have trouble reducing negative thoughts, a trait that may lead to downstream mental health issues. Read the News
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
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
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
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 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
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
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
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
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
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
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.
The 7 Reasons Why Depression Is More Common In Women
In recent decades depression has become increasingly common in industrialized countries such as the US and the UK, and is often referred to by physicians as ‘the common cold of psychiatry’.
Figures for the lifetime prevalence of depression vary according to the criteria used to define depression. Using DSM-IV’s criteria for ‘major depressive disorder’, which are similar to the ICD-10 criteria for ‘moderate depression’, the lifetime prevalence of depression is about 15 percent and the point prevalence about 5 percent. This means that an average person has about a one in seven (15 percent) chance of developing depression in the course of his or her lifetime, and about a 1 in 20 (5 percent) chance of suffering from it at this very point in time.
However, these figures mask a very uneven gender distribution as depression is about twice as common in women than in men. The reasons for this uneven gender distribution are not entirely clear, but are thought to be partly biological, partly psychological, and partly sociocultural.
Biological explanations
1. Compared to men, women may have a stronger genetic predisposition to developing depression.
2. Compared to men, women are much more subjected to fluctuating hormone levels. This is especially the case around the time of childbirth and at the menopause, both of which are associated with an increased risk of developing depression.
Psychological explanations
3. Women are more ruminative than men, that is, they tend to think about things more—which, though a very good thing, may also predispose them to developing depression. In contrast, men are more likely to react to difficult times with stoicism, anger, or substance misuse.
4. Women are generally more invested in relationships than men. Relationship problems are likely to affect them more, and so they are more likely to develop depression.
Sociocultural explanations
5. Women come under more stress than men. Not only do they have to go work just like men, but they may also be expected to bear the brunt of maintaining a home, bringing up children, caring for older relatives, and putting up with all the sexism!
6. Women live longer than men. Extreme old age is often associated with bereavement, loneliness, poor physical health, and precarity—and so with depression.
7. Women are more likely to seek out a diagnosis of depression. They are more likely to consult a physician and more likely to discuss their feelings with the physician. Conversely, physicians (whether male or female) may be more likely to make a diagnosis of depression in a woman.
Neel Burton, M.D., is a psychiatrist, philosopher and writer who lives and teaches in Oxford, England
Exercise Protects Against Depression – But How?
A new study investigates the mechanisms behind the protection from stress-induced depression offered by physical exercise. Read the Story
12 Tips for Getting Regular Exercise – and the Benefits for Happiness and Fitness
From Gretchen Rubin at The Happiness Project website, 12 tips for getting and keeping your butt moving. Read the Blog
Regain Motivation With A Depression Action Plan
Everyone feels down at some point in their lives. But if you have major depression (also called major depressive disorder), you likely feel depressed every day for most of the day, especially in the morning. You might wake up and have no energy to get out of bed. And even when you do get up, deciding what to do first can feel like a mountainous task.
At those times of inertia, it’s easy to get discouraged. But giving up the idea of getting anything done can make you feel powerless and perpetuate feeling depressed. Instead, fight back with an action plan that propels you ahead, even when you’d rather lag behind.
Creating a Depression Action Plan
A depression action plan can help take the guesswork out of where to get started each morning. It can also empower you to see just how much you can do, which is important because people with depression tend to compare their current levels of activity to past ones.
“For an action plan to be effective, you first have to understand that major depression is an illness, not a weakness,” says Stephen J. Ferrando, MD, a professor of clinical psychiatry and clinical public health in the department of psychiatry at the New York-Presbyterian/Weill Cornell Medical Center in New York City. Stop comparing yourself to the past. “It’s not your fault you have depression,” he says.
To get started creating an action plan, it’s best to work with your doctor or therapist. “When you’re depressed, it can be difficult to determine where to begin,” says Randy Auerbach, PhD, ABPP, a researcher, an assistant professor in the department of psychiatry at Harvard School of Medicine, and the director of the Child and Adolescent Mood Disorders Laboratory at McLean Hospital in Belmont, Mass. Your doctor or therapist can help you identify both short-term and long-term goals to work toward.
Consider these steps you might want to include in your daily action plan:
Tasks you need to do
Make a list of four or five things you need to get done today, such as work and chores. To avoid getting overwhelmed, break down each goal into small parts. For example, instead of making cleaning the entire house your goal, decide to clean just one room today, says Brian Iacoviello, PhD, an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
Activities you enjoy
If depression has taken the enjoyment out of all activities for you, write down what you once found pleasurable. Working toward doing the things you once enjoyed can help you slowly regain momentum. You can also try adding new activities, such as soothing stress-coping experiences (e.g., meditation, yoga, and tai chi).
Time with your support network
Research shows that a support network is critical for depression recovery. Make plans with friends and family and show up even when you don’t feel like it. It helps to have a friend who will hold you accountable. “Social support can be an enormous ally when you’re in dealing with depression,” Dr. Auerbach says. A local or online depression support group can also be a good resource.
Exercise
In a review published in in 2013 in the American Journal of Preventive Medicine, researchers reported that even low levels of physical activity, such as walking or gardening for 20 to 30 minutes a day, can help ward off depression. If you’ve stopped exercising, set reasonable goals to allow yourself to slowly get to the level of physical activity you want to reach. You might even combine exercise with socializing by picking a workout activity to do with a friend.
Healthy meals
Eating a balanced diet may help alleviate depression symptoms. Include steps in your depression action plan to create healthy meals each day. To maximize benefits, aim for three meals that include whole grains, fresh fruits and vegetables, beans, lentils, nuts, seeds, lean meat, fish, eggs, and low-fat or fat-free diary. Never skip breakfast. Be sure to drink plenty of water because even mild dehydration can affect mood. Limit your alcohol intake.
Medication
If you’re taking medication, include specific times to take it in your depression action plan. Sticking to your prescribed treatment plan is the best way to speed recovery.
Journaling
Your entries can provide insight for you and your doctor or therapist to review together to determine patterns of behavior that may be holding you back from doing everything you want to do. Record behaviors such as what you’re doing, how successful you’re being at doing those things, and what you think about when you’re doing them. Once you’ve identified any negative patterns, you can work with your doctor or therapist on how to let them go.
Rewards
Implement a system of rewards to give yourself when you’ve accomplished a goal in your depression action plan. Self-care activities — such as a massage, a new haircut, a movie, or any other activity that makes you feel good and follows your plan for recovery — make good rewards.
How to Stick to Your Depression Action Plan
When the temptation to do nothing crops up each morning, realize that you’ll have to push yourself to take the first step to get started. Once you do that, know that your level of motivation will likely increase. To stay on track, be sure to schedule activities at specific times so you don’t get overwhelmed about what to do next or how much you have to get done. Post your depression action plan in a visible place, and set up reminders by programming alerts on your phone.
Also, remember that your depression action plan may not follow a straight path. There may be setbacks, and that’s okay — just do your best to keep going. Then at your regular doctor appointments or therapy sessions, you can discuss your progress and work together with your doctor or therapist to identify what may still be getting in your way and figure out what to do to change it.
At the end of each day, focus on what you’ve accomplished instead of what you haven’t. “The greatest challenge for a person with depression is to overcome pessimistic thinking, helplessness, and hopelessness,” Auerbach says. “But with proper treatment and a good action plan, depression can be conquered.”
By Barbara Sadick
Copywrite 2014, EverydayHealth.com
Genes Determine Traces That Stress Leaves Behind On Our Brains
Our individual genetic make-up determines the effect that stress has on our emotional centers, researchers have found. Read the News
The Psychology of Scarcity: Learn to Avoid the Deprivation Thinking Trap
When we experience emotional deprivation in childhood, this feeling of not being important or lovable enough can persist into adulthood as a “deprivation mindset.” We may never feel as if we have enough of the things we need. This sense of insecurity can harm our close relationships. We may expect our loved ones to let us down, never express our needs directly or choose romantic partners who are avoidant of intimacy. Feeling deprived of important resources like love, food, money, or time can lead to anxiety or anger. We may obsess about the thing we are deprived of. Or we may feel like we need to operate in emergency mode—penny-pinching or scheduling every second of our days. New theories and research about the psychology of scarcity provide some insights into how perceiving scarcity negatively impacts our brains and behavior.
Time-Management Mistakes
The topic of scarcity is fascinating to me because I never feel as if I have time. Perhaps it is because I was born premature, as one therapist friend suggested. She reminded me of Macduff in the play Macbeth, who was also “”from his mother’s womb untimely ripped.” More likely it’s because I’m a busy working mom trying to run a therapy practice and write a book proposal. When I wake up in the morning, I never feel as if I have had enough sleep and I have to pull myself away from all the interesting things I want to do to go to bed at night. I am bad at time management and have to rely on good traffic flow to arrive on time. This is not a good strategy in Marin country, with its plethora of slow drivers! I also don’t know where the years went since I still feel 25 inside, despite the sagging and wrinkling. I double schedule appointments and then have to waste time changing them, and I am notorious for paying my credit cards a day late and then wasting time calling to ask them to drop the $35.00 late fee.
I thought I was just losing it because of age, but it turns out I’m not the only Ph.D. who is incompetent at managing time. I was delighted to read that the first author of the recent bestselling book, Scarcity, a famous Harvard economist and winner of a $500,000 McArthur Genius Grant had the same issues with time that I did. Not only did he double book his time and overcommit like I did, he also regularly allowed his car registration to expire, then had to waste time avoiding traffic cops. Rather than just feel sheepish about the whole thing, as I do, this productive individual turned the whole experience into a new theory of scarcity, which he developed with a Princeton psychologist colleague. It turns out that people living in poverty make similarly poor decisions about money and that this is not their fault, but rather a result of how our brains naturally react to scarcity.
How Scarcity Affects Our Thinking
A scarcity mindset narrows our time frame, causing us to make impulsive, short-term decisions that increase our difficulties in the long-term, like putting off paying credit card bills or not opening the envelopes, hoping they will magically disappear. Poor farmers in India do better on cognitive tests at the end of the harvest when they are flush than at the beginning of harvest when they are running out of money. The size of this effect was equivalent to a 13-point drop in IQ! Dealing with extremely limited resources increases the problems and barriers we have to deal with, resulting in mental fatigue and cognitive overload. Other studies show that being lonely or deprived of food results in an unhealthy obsession, hyper focus, and overvaluing of the thing we don’t have. Ironically, the nature of scarcity itself impedes our coping efforts.
Scarcity and Motivation
Stress and anxiety associated with scarcity interfere with motivation, causing us to be more vulnerable to temptation. Do you notice how people buy stuff they don’t need at after-holiday sales when they’ve already spent most of their money? Perceiving scarcity, we’re unable to resist the time-limited super-bargain. Similarly, crash diets make us more likely to binge eat—not to mention the physiological effects of hunger on thinking and performance. Lonely people see themselves and others more negatively and may counterproductively avoid joining group gatherings and activities for fear of rejection.
What to Do
So, how do we overcome this scarcity mindset without becoming too complacent and living in ‘la-la-land’? While different people may be comfortable with different levels of scarcity versus abundance mindset, the following suggestions can help you feel less deprived.
Practice Gratitude – Deliberately focus your mind on what is good about your life, including the people who support you, the sense of community in your neighborhood, your achievements, or your exercise and healthy lifestyle. This can stop you from magnifying the importance of any one scarce resource like time or money.
Don’t Compare Yourself With Others – You will always be exposed to people who have more time, money, or possessions and may experience a touch of envy. But in reality, you don’t know what it’s like to walk in that person’s shoes. As the saying goes, “Don’t compare your inside to everybody else’s outside.” Your struggles may have created inner strengths that you don’t fully appreciate.
Stop Obsessing – It is easy to get caught up in mental scripts about all the wrong decisions you made or worries about “what if.” To break these cycles requires a lot of effort and preparation. Make a plan for what you will do if you catch yourself ruminating. Getting up and getting active can activate the left side of your brain, which breaks the depressive emotional focus. So, take a walk, call a friend, tidy your closet or read a book.
Take Preemptive Measures – Make a list when you go to the supermarket or program automatic appointment reminders and deposits into savings accounts. Don’t take your credit card to the mall—take a frugal friend with you instead. Put the cookies on the top shelf or give them away before starting your healthy living plan.
Don’t Be Greedy – When resources are scarce, people get competitive because they think that more for somebody else means less for you. In fact, when you help somebody else grow their business, they may be more likely to refer extra business to you. Being helpful to others can lead to deeper friendships, gaining respect and reputation, creative bartering, or making allies.
Melanie Greenberg, Ph.D.is a Clinical Psychologist, and expert on Mindfulness, Managing Anxiety, and Depression, Succeeding at Work, and Mind-Body Health. Dr. Greenberg provides workshops and speaking engagements for your organization and coaching and psychotherapy for individuals and couples.
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