To understand depression better we must take a look at sadness and its evolutionary purpose. Sadness as all other feelings we have is simply a tool. It's neither good nor bad, but has a valid purpose to have. If you look at our ancestors (Igor Caveman and his family ) and try to imagine their way of life few million years ago, they lived a very difficult and tough life just like most of the mammals at that time. It was pure survival of the fittest. When a loss occurred, for instance, a family member being lost to an attack by a predator such as a saber-tooth tiger, the family was alerted to the danger lurking in the environment. The loss of the family member created grief. When looking at this from a biological and evolutionary basis, the grief meant withdrawal and reassessment of what happened.
In fact, the emotional center in the brain (the limbic system or mammalian brain) reduced certain neurotransmitters (chemicals in the brains) and secreted others in order to remove us from that environment. In other words, the evolutionary reason of sadness is to remove the individual from the dangerous environment and have the individual take time out to reassess the situation and plan what to do next. If you think about it, it makes a lot of sense. Our grieving ancestor Igor is now sitting in the cave feeling sad. Igor is isolated from the environment, have no motivation to do anything, thinking about all the negative things out there, has no appetite for food, no sexual interest, hardly any energy and is having trouble in sleeping.
Let's take a look at each of these symptoms:
• Isolated from the environment and others in order to have some time alone to reassess things clearly.
• No motivation so he can stay inside and be safe.
• Thinking negative is a survival instinct so that we can be aware of only the danger in the environment.
• No appetite for food so he can stay in the cave rather than having to go hunting and be in more danger.
• No sexual interest, again so that he can stay in and not go out looking for a mate. Also, to conserve energy.
• No energy so that he can stay put and conserve whatever energy he has left.
• Lack of sleep so that can be alert to any danger still lurking in the environment.
As you can see from these symptoms and examples, sadness is a great tool to have. It's a survival instinct. In case you are wondering, why this all happens without our consent or control, just remember that this is taking place in the emotional center, the mammalian brain. It is created for animals that operate with little or no cognitive abilities. This center takes over for us whenever we are in danger or in need for help.
The great news is that we are higher animals and we have luckily developed a cognitive brain that can help us tremendously when used correctly and appropriately (there will be more about this later.)
• Agoraphobia: is anxiety about, or avoidance of, places or situations from which escape might be difficult, or embarrassing in the event of having a panic attack or similar anxiety symptoms.
• Anxiety Disorder Not Otherwise Specified (NOS): This is applied when the person suffers from anxiety or fear but does not have enough symptoms to meet any of the above diagnostic disorders.
• Anxiety Disorder due to Medications or Drugs: The anxiety is present and due to the intake of medications and/or drugs whether prescribed or not.
Why do we have problems with sadness? As you know, not all parents are well versed or educated in the art of parenting. In fact, even the best of them still wing it and learn by trial and error. When we were small children and felt sad, our parents may have felt helpless or frustrated. Scared and worried for us feeling such agony and pain. Instead of teaching us to be ok with such feelings, perhaps they banned us from feeling sad or expressing ourselves. Or, we may have watched how they have dealt with sadness and copied them. In our youth, we may have learned bad habits dealing with an emotion such as sadness.
In fact, that may go for a lot of other emotions, but for now we will just focus on sadness. Some of the things we have learned about sadness is that it's not healthy, or it doesn't look good, or it's a sign of weakness. Some parents even avoided sadness all together by not talking to their children about death or loss. Others drank, used drugs or food to numb their sadness and so on. Therefore, is it any wonder that some of us today do not know how to deal with sadness? Instead, we repress, we hide, we cope by using numbing tools, or whatever it takes to remove us from such awful feelings.
Imagine if our ancestor Igor did not learn how to deal with sadness. What do you imagine Igor would have done when his brother was eaten by the Saber-Tooth Tiger? He may have just pretended that everything was ok and went out there again, and he too would have been eaten by that same tiger and you and I would not be having this exchange right now. Lucky for us Igor used sadness appropriately.
The one thing that you must start with before anything else from now on is that you must embrace your emotions one and all no matter what. We must allow ourselves to feel sad and be ok with it. This is nature's way of telling us to survive, and if we ignore such a powerful survival instinct how do we expect to carry on?
It's your number one priority right now to begin permitting yourself to embrace sadness. How? Well, start by cleaning up some of your distorted thoughts about sadness and all the bad negative beliefs you have associated with it. Begin with thinking of Igor and how lucky we are today that he felt sad at times. Instead of sadness meaning weak, sadness means courage, or sadness means reassessment, or sadness means time out which we all need. Can you think of some new beliefs that can help you embrace sadness better?
What's Sadness got to do with Depression?
Well, depression is an extreme and pathological form of sadness. If you look at the two and their symptoms, they are highly related. The difference is that the severity and the time frame of depression are much worse. Additionally, sadness is a very natural feeling where depression is an illness which requires serious attention. However, once you understand sadness and you learn to embrace it and learn how to deal with, it may give you the foundation to dealing with depression.
Depression, as you may know, is a chemical imbalance in the brain, particularly in the emotional center of the brain. This chemical imbalance may be due to a genetic predisposition coupled with environmental factors. Or, it may be due to purely environmental factors where the individual lacked healthy and appropriate coping skills to dealing with it. In either case, it's a chemical imbalance that needs immediate and proper attention. Sadly, most people are ignorant about depression and can't differentiate between the two, the other being sadness. That's why sometimes we hear family members or friends saying things like: "snap out of it" or, "come on, just get over it", or, "don't be sad, just forget about it." This, of course, hurts very much, in addition, it gets us to feel all alone, feeling helpless and no one that can understand what we are going through. This is important for you to realize because this is when you need professional help and medical attention.
Most of us might be ok feeling sad, but terribly ashamed when being clinically depressed. I say "clinically depressed" because many times the word "depressed" is used casually in place of sadness. We will talk about this in a minute. For now, we need to address the stigma of depression. As I said earlier, many people are ignorant about depression. Ignorance is the basis of the stigma and shame. Sadly, we are at the dawn of 21st century and despite the education and publicity of mental illness, many, including ourselves still lack proper education and knowledge of depression. Therefore, we must start with ourselves and inform and educate ourselves about these mental illnesses. Part of our shame is us not accepting the illness just as any illness. Think about it, you don't feel ashamed or stigmatized when you have a cold or a flu, but you do when you feel depressed or anxious. If that's the case, how do you expect others to accept it if you yourself do not accept it? Begin working on that!
As for the casual usage of "depressed" vs. "sad", it's important for you to begin distinguishing the two from each other. You can begin by using the proper usage of each. For example, just because you are depressed, it doesn't mean that you can't also feel happy or sad at times. As you begin to feel better and happy, it's important to use the word "sad" rather than "depressed". This is important because sadness is natural and ok to feel while depression is pathological. The words also carry different meanings and set your mind and body accordingly. In other words, if you recall the power of language and words on our body and mind, you must remember how these word make you feel just by casually using them. Begin practicing using each word properly and appropriately.
Treatment of Depression
Sadly enough, over 19 million Americans suffer from a depressive episode every year. Worse is that although excellent help is available, very few seek or utilize such help. This is a well treatable illness yet some chose to ignore or hide it for years before seeking help. Since depression is biological in nature, meaning it has to do with pathology in the neurochemistry of the brain, medication may be a good defense in severe cases.
Medications
Since depression, dysthymia, and bipolar are considered medical disorders they are treated like any other medical condition and one of the first options maybe medications. There are several types of medications that can work on depression and dysthymia and the most common and effective medications are known as SSRIs such as Prozac, Paxil, Zoloft, Celexa, Lexapro and many others. However, there are many others that can work as well; however, each medication may work differently on each person. You must consult with your psychiatrist and keep informing them accurately of your progress until the right medication and dosage is reached. If psychosis is part of the depression, additional medications may be prescribed such as Seroquil, Resperidol and others.
As for bipolar disorder, the medication approach maybe a little different than depression due to the different types of bipolar and the types of cycles the person experiences and whether it is with psychosis or not. Some of the most well known medications for bipolar also known as mood stabilizers such as Lithium, Depakote, Lamictal, and Topamax. However, as mentioned earlier, this is a complex disorder and requires expert consultations, so please talk with your psychiatric and discuss the many options he/she may offer.
Side Effects – One of the biggest problems is resisting medical treatment due to side effects which are common symptoms of most psychotropic medications. However, most of the side effects that are experienced when taking some of the medications are short lived and temporary. The body eventually gets used to and adjusts to it. You must give it time because sometimes you may experience the side effects before you begin to feel the benefits of the medication prescribed. It always best to consult with your psychiatrist and advise them of any symptoms regardless. In extreme cases other medications maybe tried and at other times other medications are prescribed to alleviate some of the side effects. Quitting medications without consulting or informing a professional may cause you decompensation or relapse and in some cases may cause you severe harm. Some medications such as SSRIs may take 4-6 weeks before you begin to feel relief from the depressive symptoms. Therefore, it's imperative to continue taking these medications for at least that period or more and if troubled with the side effects, please inform your psychiatrist before deciding to quit.
Psychotherapy
The second line of defense is psychotherapy. Research and patient testimony have revealed the power of psychotherapy in treating a myriad of mental illness such as depression. There are several types of psychotherapy that can treat mental illness effectively, however, the most studied and proven to work according to research is Cognitive-Behavioral Therapy "CBT' (also my favorite). CBT approaches mental illness by helping the client to address the cognitive part of their brain in identifying dysfunctional and distorted thoughts (beliefs) and replacing them with healthy and constructive ones. In addition, it also helps by identifying and modifying maladaptive (dysfunctional) behaviors. Beliefs and behaviors play a major role on regulating and modulating our feelings. Once these beliefs and thoughts are changed and modified, the client will begin to feel better and life begins to be perceived with a more positive outlook which will help in coping with its stressors and unexpected events.
Of course there are several types of psychotherapies such as Psychodynamic Therapy, Art Therapy, Rogerian Therapy, Narrative Therapy and many many more. If you are interested in finding more information about the latter types, information is mostly and commonly available via the internet, public libraries, bookstores, or you may ask you current psychotherapist.
In fact, the emotional center in the brain (the limbic system or mammalian brain) reduced certain neurotransmitters (chemicals in the brains) and secreted others in order to remove us from that environment. In other words, the evolutionary reason of sadness is to remove the individual from the dangerous environment and have the individual take time out to reassess the situation and plan what to do next. If you think about it, it makes a lot of sense. Our grieving ancestor Igor is now sitting in the cave feeling sad. Igor is isolated from the environment, have no motivation to do anything, thinking about all the negative things out there, has no appetite for food, no sexual interest, hardly any energy and is having trouble in sleeping.
Let's take a look at each of these symptoms:
• Isolated from the environment and others in order to have some time alone to reassess things clearly.
• No motivation so he can stay inside and be safe.
• Thinking negative is a survival instinct so that we can be aware of only the danger in the environment.
• No appetite for food so he can stay in the cave rather than having to go hunting and be in more danger.
• No sexual interest, again so that he can stay in and not go out looking for a mate. Also, to conserve energy.
• No energy so that he can stay put and conserve whatever energy he has left.
• Lack of sleep so that can be alert to any danger still lurking in the environment.
As you can see from these symptoms and examples, sadness is a great tool to have. It's a survival instinct. In case you are wondering, why this all happens without our consent or control, just remember that this is taking place in the emotional center, the mammalian brain. It is created for animals that operate with little or no cognitive abilities. This center takes over for us whenever we are in danger or in need for help.
The great news is that we are higher animals and we have luckily developed a cognitive brain that can help us tremendously when used correctly and appropriately (there will be more about this later.)
• Agoraphobia: is anxiety about, or avoidance of, places or situations from which escape might be difficult, or embarrassing in the event of having a panic attack or similar anxiety symptoms.
• Anxiety Disorder Not Otherwise Specified (NOS): This is applied when the person suffers from anxiety or fear but does not have enough symptoms to meet any of the above diagnostic disorders.
• Anxiety Disorder due to Medications or Drugs: The anxiety is present and due to the intake of medications and/or drugs whether prescribed or not.
Why do we have problems with sadness? As you know, not all parents are well versed or educated in the art of parenting. In fact, even the best of them still wing it and learn by trial and error. When we were small children and felt sad, our parents may have felt helpless or frustrated. Scared and worried for us feeling such agony and pain. Instead of teaching us to be ok with such feelings, perhaps they banned us from feeling sad or expressing ourselves. Or, we may have watched how they have dealt with sadness and copied them. In our youth, we may have learned bad habits dealing with an emotion such as sadness.
In fact, that may go for a lot of other emotions, but for now we will just focus on sadness. Some of the things we have learned about sadness is that it's not healthy, or it doesn't look good, or it's a sign of weakness. Some parents even avoided sadness all together by not talking to their children about death or loss. Others drank, used drugs or food to numb their sadness and so on. Therefore, is it any wonder that some of us today do not know how to deal with sadness? Instead, we repress, we hide, we cope by using numbing tools, or whatever it takes to remove us from such awful feelings.
Imagine if our ancestor Igor did not learn how to deal with sadness. What do you imagine Igor would have done when his brother was eaten by the Saber-Tooth Tiger? He may have just pretended that everything was ok and went out there again, and he too would have been eaten by that same tiger and you and I would not be having this exchange right now. Lucky for us Igor used sadness appropriately.
The one thing that you must start with before anything else from now on is that you must embrace your emotions one and all no matter what. We must allow ourselves to feel sad and be ok with it. This is nature's way of telling us to survive, and if we ignore such a powerful survival instinct how do we expect to carry on?
It's your number one priority right now to begin permitting yourself to embrace sadness. How? Well, start by cleaning up some of your distorted thoughts about sadness and all the bad negative beliefs you have associated with it. Begin with thinking of Igor and how lucky we are today that he felt sad at times. Instead of sadness meaning weak, sadness means courage, or sadness means reassessment, or sadness means time out which we all need. Can you think of some new beliefs that can help you embrace sadness better?
What's Sadness got to do with Depression?
Well, depression is an extreme and pathological form of sadness. If you look at the two and their symptoms, they are highly related. The difference is that the severity and the time frame of depression are much worse. Additionally, sadness is a very natural feeling where depression is an illness which requires serious attention. However, once you understand sadness and you learn to embrace it and learn how to deal with, it may give you the foundation to dealing with depression.
Depression, as you may know, is a chemical imbalance in the brain, particularly in the emotional center of the brain. This chemical imbalance may be due to a genetic predisposition coupled with environmental factors. Or, it may be due to purely environmental factors where the individual lacked healthy and appropriate coping skills to dealing with it. In either case, it's a chemical imbalance that needs immediate and proper attention. Sadly, most people are ignorant about depression and can't differentiate between the two, the other being sadness. That's why sometimes we hear family members or friends saying things like: "snap out of it" or, "come on, just get over it", or, "don't be sad, just forget about it." This, of course, hurts very much, in addition, it gets us to feel all alone, feeling helpless and no one that can understand what we are going through. This is important for you to realize because this is when you need professional help and medical attention.
Most of us might be ok feeling sad, but terribly ashamed when being clinically depressed. I say "clinically depressed" because many times the word "depressed" is used casually in place of sadness. We will talk about this in a minute. For now, we need to address the stigma of depression. As I said earlier, many people are ignorant about depression. Ignorance is the basis of the stigma and shame. Sadly, we are at the dawn of 21st century and despite the education and publicity of mental illness, many, including ourselves still lack proper education and knowledge of depression. Therefore, we must start with ourselves and inform and educate ourselves about these mental illnesses. Part of our shame is us not accepting the illness just as any illness. Think about it, you don't feel ashamed or stigmatized when you have a cold or a flu, but you do when you feel depressed or anxious. If that's the case, how do you expect others to accept it if you yourself do not accept it? Begin working on that!
As for the casual usage of "depressed" vs. "sad", it's important for you to begin distinguishing the two from each other. You can begin by using the proper usage of each. For example, just because you are depressed, it doesn't mean that you can't also feel happy or sad at times. As you begin to feel better and happy, it's important to use the word "sad" rather than "depressed". This is important because sadness is natural and ok to feel while depression is pathological. The words also carry different meanings and set your mind and body accordingly. In other words, if you recall the power of language and words on our body and mind, you must remember how these word make you feel just by casually using them. Begin practicing using each word properly and appropriately.
Treatment of Depression
Sadly enough, over 19 million Americans suffer from a depressive episode every year. Worse is that although excellent help is available, very few seek or utilize such help. This is a well treatable illness yet some chose to ignore or hide it for years before seeking help. Since depression is biological in nature, meaning it has to do with pathology in the neurochemistry of the brain, medication may be a good defense in severe cases.
Medications
Since depression, dysthymia, and bipolar are considered medical disorders they are treated like any other medical condition and one of the first options maybe medications. There are several types of medications that can work on depression and dysthymia and the most common and effective medications are known as SSRIs such as Prozac, Paxil, Zoloft, Celexa, Lexapro and many others. However, there are many others that can work as well; however, each medication may work differently on each person. You must consult with your psychiatrist and keep informing them accurately of your progress until the right medication and dosage is reached. If psychosis is part of the depression, additional medications may be prescribed such as Seroquil, Resperidol and others.
As for bipolar disorder, the medication approach maybe a little different than depression due to the different types of bipolar and the types of cycles the person experiences and whether it is with psychosis or not. Some of the most well known medications for bipolar also known as mood stabilizers such as Lithium, Depakote, Lamictal, and Topamax. However, as mentioned earlier, this is a complex disorder and requires expert consultations, so please talk with your psychiatric and discuss the many options he/she may offer.
Side Effects – One of the biggest problems is resisting medical treatment due to side effects which are common symptoms of most psychotropic medications. However, most of the side effects that are experienced when taking some of the medications are short lived and temporary. The body eventually gets used to and adjusts to it. You must give it time because sometimes you may experience the side effects before you begin to feel the benefits of the medication prescribed. It always best to consult with your psychiatrist and advise them of any symptoms regardless. In extreme cases other medications maybe tried and at other times other medications are prescribed to alleviate some of the side effects. Quitting medications without consulting or informing a professional may cause you decompensation or relapse and in some cases may cause you severe harm. Some medications such as SSRIs may take 4-6 weeks before you begin to feel relief from the depressive symptoms. Therefore, it's imperative to continue taking these medications for at least that period or more and if troubled with the side effects, please inform your psychiatrist before deciding to quit.
Psychotherapy
The second line of defense is psychotherapy. Research and patient testimony have revealed the power of psychotherapy in treating a myriad of mental illness such as depression. There are several types of psychotherapy that can treat mental illness effectively, however, the most studied and proven to work according to research is Cognitive-Behavioral Therapy "CBT' (also my favorite). CBT approaches mental illness by helping the client to address the cognitive part of their brain in identifying dysfunctional and distorted thoughts (beliefs) and replacing them with healthy and constructive ones. In addition, it also helps by identifying and modifying maladaptive (dysfunctional) behaviors. Beliefs and behaviors play a major role on regulating and modulating our feelings. Once these beliefs and thoughts are changed and modified, the client will begin to feel better and life begins to be perceived with a more positive outlook which will help in coping with its stressors and unexpected events.
Of course there are several types of psychotherapies such as Psychodynamic Therapy, Art Therapy, Rogerian Therapy, Narrative Therapy and many many more. If you are interested in finding more information about the latter types, information is mostly and commonly available via the internet, public libraries, bookstores, or you may ask you current psychotherapist.
SAD
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Stress, Anxiety, & Depression CliniC
Mind Over Matter: If you DO Mind, it Will Matter
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Sadness Vs. Depression