By Gail Ludwig, RN, LCSW

In this time in our history where catastrophic events such as the Iraq war and Hurricane Katrina have occurred, many people are experiencing immense sadness.  For some individuals, the sadness is always present and life is always a “catastrophe.”  They believe that they will never find happiness or have good things happen to them.  It is estimated that 30 to 40 million people in the US suffer from depression severe enough to require treatment.  Depression, now, is out “of the closet,” as more and more people are diagnosed.  Depression can be defined as a “learned helplessness” in which a person has low self-esteem and a despairing outlook.  Depression and its counterpart, anxiety, are often connected.  Many individuals seem to experience a combination of both.  Symptoms of depression include, a persistent sad mood, loss of interest or pleasure in activities that were once enjoyed, significant changes in appetite or body weight, difficulty sleeping or oversleeping, physical slowing or agitation, irritability or anger, loss of energy, feelings of worthlessness, hopelessness or inappropriate guilt, negative thinking, difficulty thinking or concentrating, and recurrent thoughts of death or suicide.  There may be an increase in substance abuse such as, street or prescription drugs and/or alcohol in order to “self-medicate”.

Science has shown that, with depression, critical neurotransmitters in the body, chemicals used by nerve cells to communicate, may be out of balance.  Changes in the brain, genetic and hormonal shifts within the body suggest that the mind and body are intrinsically linked.  A healthy body can help support a positive mood, and a positive mood influences our physical health.  While biology can play a part in depression, recent data indicates that depression has increased dramatically, perhaps more as a result of social and environmental factors rather than biological ones.

Stress, as it shows up in one’s lifestyle, relationships and family unity, can be a major catalyst of depression.  People can feel disenfranchised, alone, with little or no support system.  Studies are showing that children are reacting to these factors as well, as more young children and teenagers are being diagnosed with depression.  Psychotherapy has emerged as an essential mode of treatment as it can address issues of loneliness, lack of fulfillment and low self-esteem.

Self esteem is how we value ourselves as a human being.  It is formed in part by others’ opinion of us, but more importantly, by our own belief system.  Our belief system dictates how we live our life.  If it is negative, then life can become a self-fulfilling prophesy of negative experiences.

One of the pitfalls of depression is to attack our own self-esteem by being overly self- critical or judging of oneself for being unhappy or needing help.  A question to think about is: what if depression is viewed as an internal war or a personal hurricane causing havoc to the psyche?  Suppose it is not a failure on our part, but an experience that needs to be addressed in order to move on in life.  As hurricane stories of the strength and courage of both rescuers and victims are reported, there is an inner core of love and resilience demonstrated that  is a  testimony  to the generosity of the human spirit.  Since depression can focus on the devastation and emptiness in one’s life and oneself, there is an opportunity here to be generous, to love your self, to get help and to rebuild, which is quite powerful.

What to do if you may be depressed.

1.     Identify that you want to change this pattern of negativity in your life.  This is a powerful and courageous decision.  Have a thorough assessment from a qualified clinician (medical doctor, psychotherapist, psychologist or psychiatrist. Some good resources are: your HMO, local mental health agency or hospital, Primary Care Physician, or a professional source that you trust.

2.     When necessary, begin the process of therapy, which can be short-term or long-term. Therapy is a partnership between an individual and a therapist, a shared experience of mutual trust and confidentiality. The therapist is a good listener and support person.  The process of self-reflection in therapy enables a person to sort out both positive and negative feelings. It can help improve communication and encourage expression of hidden feelings that have caused sadness. As a person becomes aware of the problems causing the depression, develops solution strategies, has more self understanding and compassion, the door is open for a change in belief system.

3.     Learning what triggers negative thoughts is a key factor. Depression can be experienced in cycles, with different intensities. Cycles of the seasons, holidays, and aging cycles can trigger depression.  People prone to depression may get more depressed when their life changes (i.e. a move, job change or a loss) or when there is a health or relationship crisis.

4.     Changing one’s habitual thinking patterns is important. Recycling the negative thoughts over and over also reinforces the depression. Continually thinking that “Life will never get better.” Or “I will always be a failure.” influences the depth and length of the depression. Therefore, changing one’s thinking patterns from self judgment to compassion, from hopelessness to hopeful is necessary. Therapeutic techniques that reframe negative thinking i.e., cognitive exercises, positive reinforcement, breathing, meditative and relaxation exercises, as well as other therapeutic techniques, all seem quite beneficial.

5.     Understanding how to “empower yourself” by taking responsibility for your own health and well-being, while not blaming others for your problems is critical.  Disconnecting from the negative patterns which keeps you powerless and focusing on positive life patterning helps to increase self-esteem, i.e., healthy diet and exercise regimen; fulfilling and joyful connection to family and friends, a sense of humor, involvement in hobbies, music, theater, dance, art; relaxation techniques, positive affirmations, yoga, TaiChi; having someone to confide in, asking for help, reaching out to help others, joining a support group, improving communication within relationships and learning to problem-solve. And there are many more. You can use your own creativity to bring the positive into your life.  Sometimes you just need someone to help light the way.

Gail Ludwig is available for appointments in our offices in Wexford and Robinson Township.