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Do you, a loved one or someone you know suffer from depression? If so, you are aware that depression can be tough to live with – tough to understand and tough to treat.

For many people, depression is not just a single “episode”, but a long-term, chronic disorder requiring long-term management. Research tends to be more focused on resolving the first episode, rather than maintaining good health and developing positive habits of self-care after the depression has resolved. Unfortunately, relapses are very common.

Episodes of depression can become a learned habit.  Habits are developed through repetition and become deeply ingrained. Resolving depression becomes more challenging when depressive habits have become part of a person’s personality.   The depressive thinking, helplessness, body sensations, energy loss and shut down becomes part of the behavioral ritual when a stressor hits making intervention more difficult.

As an Addictions Counselor and Behavior Therapist, I see this a lot in my practice in Chestnut Hill, Philadelphia and West Chester, Pa.  Many of my clients have struggled with addiction(s), chronic medical illness, early life trauma, and unexpected life events, which have challenged their resilience and ability to cope in a helpful way. At times, stressors have compounded over time and have outstretched the person’s ability to move forward.

Some self help groups and organizations which tend positive support include:

National Alliance on Mental Illness (NAMI)

Depression and Bipolar Support Alliance (DBSA)

Each group has a local Philadelphia and Tri-state presence with regular support meetings.

It is important to identify and understand the depressive pattern and to construct a plan to dismantle the behavior chain as promptly as possible as it gets tougher as additional episodes occur, and the pattern reinforces itself. Being able to “head off” depressive episodes in their early stages is important in minimizing their impact and ceasing their progression.

Early intervention is paramount; this includes identifying the warning signs of relapse.

Some early warning signs of depression relapse include:

–    Becoming more isolated and withdrawn; not responding to emails or phone calls,

–    enduring some loss; personal or professional,

–    moving or changing jobs,

–    suffering through some disappointment, or

–    stress at work or home.

It is at this point that many people drift from their treatment providers, losing confidence in their ability to make progress. Termination of treatment is usually done unilaterally, with little or no response to outreach.

Sometimes people with a long history of depression or several relapses may have to stay on medication for several years. Developing a strong collaborative relationship with a prevention-minded primary care physician is a key part of the treatment plan.  Improving and optimizing health status is a foundational part of developing resilience.  The body must be as healthy as possible for the brain and mind to heal. Sleep, nutrition, and exercise are all part of improving one’s health.

What helps?

The conditions of our lives are directly related to our health and sense of well-being. Creating conditions for our well-being and growth enhance self-esteem and satisfaction.

A few things that can help, include:

–    Seeking pleasurable emotions and sensations each day (through healthy means, of course!),

–    pursuing goals and activities that require full engagement,

–    doing things for other people,

–    being connected to good friends and a strong social support network, and

–    having a healthy partnership or marriage, affection, and physical intimacy.

Staying focused in the “here and now” rather than past, future, or other topics and places are what it means to be “mindful.”  Study after study has demonstrated that happiness and satisfaction come from the ability to “live in the moment” and “being in the moment” – Experiencing life in the moment versus living in the fiction and anxieties associated with thoughts of past and future.

To successfully prevent depression developing strength of focus and attention is most important.  Without mindfulness, there can be no treatment or progress for there is no presence in order to receive the help that is offered.

Our world is a 24/7 almost 365-day place that is ever evolving and dynamic. Rapid and sudden change has become the “new normal.” These changes sunk in for me last year when I was getting emails on Thanksgiving morning and LinkedIn invitations on Christmas Day. On some level, I found it mildly entertaining and on another quite concerning. Regardless, it became apparent to me that there has been a shift in the way we are navigating life, not to mention the erosion of boundaries that have historically protected out down-time.

There is more, however. We are all aware that our world is in a state of flux. World-wide shift in weather patterns, competitive business climate, mergers, acquisitions, the turbulent economy, and fragile international politics are requiring us to adapt and live differently in order to function.  The problem with that is we just don’t change that quickly.  In fact, did you know that it takes many hundreds of years for humans’ and animals to adapt to a change in their food source? If that’s the case what do, we do in the face of constantly changing conditions in our lives? After all, for some of us getting a new Smart Phone is a big change! Read More

Keeping a pulse on our stress level is always a wise idea. Many of us don’t really know our baseline stress level; therefore we don’t really know where we are and what is manageable for us so we keep doing more. For example, all of a sudden we can find ourselves triggered into anger by an erratic driver on the road and wonder how we went flew off the handle. This is what often happens when stress piles up. We become reactive and, at times, out of control. We can decline quickly.

Many stresses cannot be avoided altogether, but we can support our bodies in being more resilient, as well as reorganize some of our routines to minimize mood and energy problems. To help our bodies, it is important to:

–          Get adequate sleep each night. During seasonal change, more sleep is often needed to sustain the shift. Adding an extra half an hour can be of benefit to you.

–          Decrease sugar and carbohydrate intake. When mood declines you may notice increased food cravings, especially for sweets and carbs as the body is looking for that spike in energy. Focus on eating a balanced diet, including fruits and vegetables.

–          Move your body. Make sure that you are getting some physical exercise daily; a walk, time at the gym, working outside.

–          Take your supplements, including probiotic, Vitamins B, C, D, and fish oil.

–          Attend meditation, yoga, or tai chi classes – especially if you are anxiety-prone or get overwhelmed easily.

Creative thinking is important in learning to help you and may lead to stress-reducing methods, such as delegating work or deleting less important items from your to-do lists. Then you can look for ways to improve your coping ability, such as learning a new, useful skill or spending more time unwinding each day.

Cognitive therapy or skills-based counseling can be helpful in learning how to control the mind and work through thoughts that fuel depression and drain energy. But, working with the mind and body together is necessary in improving or resolving mood issues. After all, the mind and body dwell in the same organism.

To maintain a healthy mind and body, it’s important to engage in the effort to review and assess yourself – and, if need be, consult a professional to help.

Quote:

The higher your energy level, the more efficient your body. The more efficient your body, the better you feel and the more you will use your talent to produce outstanding results.

~ Tony Robbins

Life is all about cycles – Seasons change, weather moves in patterns, the economy fluctuates, trends … change…transition…all of which are happening constantly.

Recently, I was talking with a woman who had moved into a lovely home.  It was the home of her dreams.  She had been very excited about the move and creating this wonderful space. However, about a month or so after the move she found herself feeling depressed and lethargic.  She was very concerned and considered anti-depressant medication.

Change brings forth many emotions, sensations and shifts – ups and downs. Generally we don’t associate depression with “good things” but in truth each one of us responds to change in our own unique way.

Plants were my first teachers about change. Have you ever moved a plant from one spot to another? What happens? They tend to wilt and look like they might die. Just when you think it is a lost cause the plant perks up! Go figure…

We do a little of this too. Our moods and energy are always in flux and subject to change. This can make most people nervous – Who really feels comfortable when feeling, a bit depressed or down?

However, is what is being felt a symptom of depression or a human experience? There is a difference between a clinical condition and a response to a life event. We tend to label unwanted feelings and experiences as being related to sickness, but just like the plant or the woman who moved, that might not be the case. It just might be because change takes energy and lots of it – more than we might think.  Also, anytime something is gained something is lost. Loss is part of every change – Even the changes that we want or goals we have worked towards. Grieving is a natural response to loss. Depression is part of grieving.

Preparation for change is key in setting ourselves up for success.  Being able to move through change and transition safely and successfully without putting ourselves at risk or sabotaging our success. Each one of us may be sensitive to specific triggers/ stressors, events or circumstances – The conditions that may challenge our sense of mental, emotional and physical balance.

Mood and energy cycles often parallel with the environmental conditions occurring within and around us. If you are a person who is sensitive to change and or has mood, addiction or chronic health problems it is important to pay extra attention to change, especially when it involves your personal space, work or people in your life. Self knowledge is key.

The ability to understand our own cycles is needed in order to help ourselves in the best ways possible.

In order to feel well and to be effective, we need to adapt to changing conditions. This means that we need to identify, understand and prepare for them according to our individual needs.

This is why it is critical that we create the conditions we need to be well and successful. We can control that part.

This helps us in becoming skilled in managing change.  Being adaptive and able to work with change is needed to be able to grow, increase our skills and capacities and to reach our personal and professional goals.  As we move through life and experience its’ joys, our victories, defeats and losses we will have many intensive and personal feelings many of which are part of the process of becoming a whole person. Growth can be stressful and uncomfortable, but necessary if we are to become more skilled in living life.

Approaching ourselves with kindness, inquiry and flexibility allows us to create the conditions we need to move forward through the changes in our lives. This means not judging every uncomfortable feeling and or event that does not go as planned as something wrong or a sign of failure. Instead setting things up so that we have what we need – support, healthy lifestyle habits and a mindset of willingness and openness.

Through this process we become more resilient- meaning stress hardy. Then we truly become more healthy, adaptive and bounce back from set backs and stressors even using them as leverage to move forward.  We are then truly able to move forward with confidence and in a manner by which we can be our best selves.