“I wouldn’t tell anyone you have it. They’ll judge you and treat you differently.” “I wouldn’t tell your boss. It could affect your job.”
Sadly, this is often true. I’ve experienced it first hand and usually the ones who give this response are others that have dealt with the repercussions of disclosing their mental illness. I’ve done this many, many times. I’m quite good at it. I push through it. I smile when I am miserable. I slink off somewhere to manage an anxiety attack. I don’t talk to anyone when I am depressed.
When I reveal it, it is often not met kindly. However, that’s the reason I have decided to talk about it even more. The stigma is there because most keep quiet. This is what emboldens me to share my experiences. You never know who is suffering mentally. You can say you have a physical disease and most often, you are treated with concern or empathy. If you mention a mental disorder, the subject gets changed or the conversation get quiet. It’s an isolating experience.
Music 🎶 helps me a lot … “Then, when I am not feeling well and I find it harder to escape, I can use those same songs to connect to happier times and escape my reality even for a few minutes and give myself a break.”…
🌻 Sophie’s Note 📝. I struggle a lot with depression bouts because of my Bipolar 2 … and I find that there are days when meds don’t work, and I just have to push through it.
This article is based on people’s experience living with TRD – Treatment-resistant depression, and I find many of the suggestions helpful. I hope it can help you too …
“Don’t be a victim.” “No one ever said life was fair.” “Happiness is a choice.” “It’s your choices and your fault.” “You just have to get over it and get on with it.”
Just STOP 🛑.
Family members, friends, ‘friends’, whoever whatever; if you have someone in your life that has Depression or any mental illness, do yourself a favor and educate yourself, at least a tad. It’s not good making your own judgement on them and an illness that you don’t even understand.
The article above is helpful. If you take the time, THANK YOU ❤️ 💜.
Even if you don’t, please stop saying this unhelpful things to people.
It’s either pointless or damaging; but in your eyes you’re ‘helping’. You’re NOT.
So please stop doing it.
– A guest post by Lauren Barker, one of our members.
🌻 Sophie’s NOTE 📝: If you want to suggest a guest post, please feel free to inbox/PM this Page 😊
pic credit: keeleyshawart
Snap Out of It” or “Try Harder”
Having someone tell you to try harder when you are already giving it your best effort can be demoralizing and may make a person with depression feel their situation is hopeless.
There are many reasons depression develops and a person cannot necessarily control all of the risk factors involved. Once a person has become depressed, it’s not a matter of just “talking themselves out of” a low mood.
Like diabetes or hypothyroidism, depression can happen because the body is not making enough of substances it needs to function properly.1 A person with diabetes cannot will their body to make more insulin. Similarly, a person experiencing depression due to low levels of neurotransmitters can’t simply “think” themselves into having more.
Similar to how people with diabetes might need treatment with insulin, people who have depression need medical intervention and support. For some people, this may mean taking medications that address chemical imbalances that can contribute to the condition.
Your well-meaning exhortations to “cheer up” or “smile” may feel friendly and supportive to you, but they oversimplify the feelings of sadness associated with depression.
Just as someone who is depressed can’t force their brain to make more serotonin, they also can’t just “decide” to be happy. While there are certainly benefits to practicing positive thinking,2 it’s not enough to cure someone of depression.
“But You Don’t Look Depressed!”
“People who need help often look like people who don’t need help,” said American author Glennon Doyle. In other words, how a person appears on the outside does not necessarily reflect how they feel on the inside. This is true of many mental illnesses, but also chronic illnesses and conditions that are sometimes deemed invisible.
It’s not uncommon for people with depression and anxiety to try very hard to “put on a good face” and hide how they really feel from others.
They may be embarrassed, confused, guilty, ashamed, or afraid of what would happen if other people found out that they were depressed. They may worry that they will be seen as incompetent at work or as a parent, or that their spouse, family, and friends will stop loving them. These thoughts can become very intense and, in fact, are characteristic of depression itself—even though they don’t reflect reality.
Just because someone who is depressed tries to cover it up, it doesn’t mean they want to be dismissed when they do choose to open up about how they really feel. It takes courage to speak openly about the pain they feel. If someone responds with doubt or disbelief, it may make them feel like talking about their depression is not safe.
“It Can’t Be That Bad” or “It Could Be Worse” or “You Think You Have It Bad. . .”
When you’re talking to a friend who is depressed or going through a difficult time, resist the temptation to compare pain. Remember that pain (emotional and physical) is not only subjective but relative.
People with depression also lack the internal resources needed to cope with stress in an effective and healthy way.4 To you, an event or situation that constitutes a minor annoyance or inconvenience may feel like an insurmountable obstacle to your loved one with depression.
What someone’s life looks like on the outside doesn’t always reflect, or change, how they feel on the inside. Depression doesn’t need a justification. The experience is highly personal, and even if you care about someone and want to help, be aware that you can never know for sure how it feels to be them.
Maybe a person’s life could be worse, but depression isn’t about how bad things are—it’s about how bad they feel for that person at that moment.
Avoid making comparisons or staging a “competition” for who feels the worst. Doing so isn’t helpful and can make a person with depression feel that you’re minimizing their experience or not really listening to what they’re telling you.
“It’s All in Your Head” or “It’s Your Fault”
While a deficiency of mood-regulating substances is technically occurring in the mind, the phrase “all in your head” tends to be dismissive. People who hear the phrase may also feel attacked, as though they are being accused of “making it up” or lying about how they feel.
Furthermore, depression very often is not just in someone’s head but in their body as well. There are many physical symptoms of depression, including chronic pain, which are very real. Depression is a medical condition that can’t be expected to improve without treatment.
Depression is not a condition someone chooses to have, and while researchers don’t understand all the potential causes, they know that there are many factors.
One factor believed to play a significant role in depression is genetics. Some environmental factors may also play a role, perhaps by triggering an underlying inherited vulnerability to depression.
As with genetics, people can’t always control environmental triggers such as the type of home environment they grew up in. It’s well known that people who experienced trauma or abuse in childhood are at an increased risk for depression later in life.
There are some theoretically modifiable risk factors and lifestyle changes that can have an impact on symptoms,5 but simply telling someone with depression to “get out more” or recommending lifestyle changes they may not be prepared for can also be unhelpful. The symptoms of depression (such as fatigue and lack of motivation) can make mental and physical activity overwhelming and exhausting.
When someone is depressed, they may carry feelings of guilt and shame. They may feel that they are a burden to the people in their lives, and these feelings can make depression worse and may even lead to suicidal thoughts or self-harmingbehaviors.6
Minimizing the pain of another person is not helpful and, for people who are dealing with depression, can be very hurtful and harmful.
When you’re caring for (and about) someone who is depressed, you may say hurtful things when you are feeling frustrated or worried. If you find yourself thinking “who cares?” when you’re listening to a loved one, recognize that it might be a sign you are burnt out.7
You need to take care of your own emotional and mental health before you can help someone else with theirs. If you are feeling frustrated, irritated, or helpless, check-in with yourself and make sure that you have the support you need.
“You Don’t Think About Anyone But Yourself”
It may seem, at times, like someone who is depressed is very preoccupied with their own life (or, more specifically, their own thoughts) but that doesn’t make them selfish. Implying that a person with depression doesn’t care about other people provides no comfort and only fuels feelings of blame, shame, and guilt.
“I Don’t Understand”
Even if you have experienced clinical depression yourself, your experience may be different from someone else’s. If you’ve never had depression, it may be hard for you to empathize. In either case, if someone you love is depressed, the best thing you can do is be open and willing to learn.
Rather than giving up on a conversation by saying “I just don’t understand”—or saying you do understand when you really don’t—start by reassuring your loved one that you care about them.8
If you are struggling to understand what they need, be honest. Calmly explain, then be patient and ready to listen.
“This Too Shall Pass” or “Let It Go”
While this may be true, a person who is depressed may not have the perspective necessary to entertain the idea—let alone believe it. Platitudes, clichés, and vague statements don’t offer much for someone to hold on to in terms of hope.
A person who is depressed may have a hard time envisioning the future because they are overwhelmed by the present. It’s also not easy to “let go” or “escape from” the past, especially for someone who experienced loss or trauma.
You may feel like you’re offering hope by saying that, eventually, things will get better—but a person who is depressed may be frustrated wondering how long they will have to wait.
Instead of pushing them to focus on the future or forget about the past, just do your best to be present with them at the moment. Just sit with them and try not to worry about saying the right or wrong thing: You may find the most helpful thing you can do is to listen.
The reason DBT works for so many individuals who struggle BPD is because the founder/creator of DBT suffered from BPD herself …
‘I Was in Hell’ — She learned the central tragedy of severe mental illness the hard way, banging her head against the wall of a locked room.
Marsha Linehan arrived at the Institute of Living on March 9, 1961, at age 17, and quickly became the sole occupant of the seclusion room on the unit known as Thompson Two, for the most severely ill patients. The staff saw no alternative: The girl attacked herself habitually, burning her wrists with cigarettes, slashing her arms, her legs, her midsection, using any sharp object she could get her hands on.
The seclusion room, a small cell with a bed, a chair and a tiny, barred window, had no such weapon. Yet her urge to die only deepened. So she did the only thing that made any sense to her at the time: banged her head against the wall and, later, the floor. Hard.
“My whole experience of these episodes was that someone else was doing it; it was like ‘I know this is coming, I’m out of control, somebody help me; where are you, God?’ ” she said. “I felt totally empty, like the Tin Man; I had no way to communicate what was going on, no way to understand it.”
The DBT distress tolerance acronym ACCEPTS is a group of skills to help you tolerate a negative emotion until you are able to address and eventually resolve the situation. In an early season of the 90’s sitcomFriends, Monica is dating Pete Becker. He calls her from out of town and says, “We need to talk.” Monica wonders if it is a good talk, or a bad talk? She is in psychological distress waiting for his return. The skill set she would use while waiting for Pete to come home is ACCEPTS.
This DBT skill stands for Activities, Contributing, Comparisons, Emotions, Push away, Thoughts, and Sensation. These techniques are designed to keep your emotions manageable until you can resolve the problem.
Engage in an activity, and this can be just about any healthy activity. Read a book, make strawberry jam, go for a walk, call your friend, wash the dishes. Anything that keeps you busy and keeps your mind off the negative emotion will help. If you finish, move on to a new activity. (You could potentially have a very productive day while awaiting that dreaded situation!)
Do something kind for another person. Giving service can help you relieve emotional distress in a couple ways. An act of service is also an activity that, as mentioned above, will help get your mind off of the problem at hand. Additionally, we feel good about ourselves when we help someone else, and that in itself can help you deal with stress. Help cook dinner, mow the neighbor’s lawn, or bake cookies for a friend or relative. Each of these contributing ideas will distract you from your current situation.
Put your life in perspective. Is there a time when you’ve faced more difficult challenges than you’re facing today? Maybe not—maybe this is the most intense situation and most intense emotion you’ve ever experienced. (If so, you may need to jump back up to the TIPP section.) If that’s the case, is there another person who has suffered more than you? Are you in your safe home, while in another part of the world someone else is searching for food and shelter after a natural disaster? The goal of this exercise is not to add more distress and emotional pain to your current situation. Instead, use this skill to add a different perspective to what you’re experiencing right now.
You have the power to invoke the opposite emotion of your current distressed feeling. If you are feeling anxious, practice meditation for 15 minutes. If you’re feeling depressed, go ahead and Google Image search “adorable puppies”. (If you’re in need of a real laugh, search “ugly puppies”.) Adding a dose of the opposite emotion helps reduce the intensity of the negative emotion.
When you can’t deal with something just yet, it’s okay to push the problem out of your mind temporarily. You can push away by distracting yourself with other activities, thoughts, or mindfulness. You can even set a time to come back to the issue. You know that it will be addressed, and you can relax in the interim.
Replace negative, anxious thoughts with activities that busy your mind, such as saying the alphabet backwards or doing a Sudoku puzzle. These distractions can help you avoid self-destructive behavior until you’re able to achieve emotion regulation.
Use your five senses to self-soothe during times of distress. A self-soothing behavior could be taking a warm bath with a lavender bath bomb and relaxing music, eating a comforting snack, or watching your favorite show. Anything that appeals to your senses can help you cope with the present situation.
The dialectical behavior therapy skills in ACCEPTS help you tolerate your distress until the appropriate time to resolve the situation. Once you’re ready and able to address the problem head on, other skills, such as DBTinterpersonal effectiveness, can help you get your needs met.
You’re at your emotional breaking point. Maybe the worst has happened, or maybe it was just the “last straw”. The DBT distress tolerance skill you need is TIPP. This skill is designed to bring you down from the metaphorical (hopefully not literal) ledge.
TIPP stands for Temperature, Intense exercise, Paced breathing, and Paired muscle relaxation.
When we’re upset, our bodies often feel hot. To counter this, splash your face with cold water, hold an ice cube, or let the car’s AC blow on your face. Changing your body temperature will help you cool down—both physically and emotionally.
Do intense exercise to match your intense emotion. You’re not a marathon runner? That’s okay, you don’t need to be. Sprint down to the end of the street, jump in the pool for a few laps, or do jumping jacks until you’ve tired yourself out. Increasing oxygen flow helps decrease stress levels. Plus, it’s hard to stay dangerously upset when you’re exhausted.
Even something as simple as controlling your breath can have a profound impact on reducing emotional pain. There are many different types of breathing exercises. If you have a favorite, breathe it out. If you don’t, try a technique called “box breathing”. Each breath interval will be four seconds long. Take in air four seconds, hold it in four seconds, breathe out four, and hold four. And then start again. Continue to focus on this breathing pattern until you feel more calm. Steady breathing reduces your body’s fight or flight response.
PAIRED MUSCLE RELAXATION
The science of paired muscle relaxation is fascinating. When you tighten a voluntary muscle, relax it, and allow it to rest, the muscle will become more relaxed than it was before it was tightened. Relaxed muscles require less oxygen, so your breathing and heart rate will slow down.
Try this technique by focusing on a group of muscles, such as the muscles in your arms. Tighten the muscles as much as you can for five seconds. Then let go of the tension. Let the muscles relax, and you’ll begin to relax, as well.
Temperature Intense Exercise Paced Breathing Paired Muscle Relaxation
The distress tolerance skills in TIPP will bring you a step closer to wise mind, where you will be able to make a constructive choice and cope productively.
Telehealth has many advantages, including keeping patients safe from possible exposure to the coronavirus that causes Covid-19, improving access to care, cutting health care costs, and contributing toward a greener earth by cutting down on car trips to see doctors in their offices. It also offers its own type of personal and lighthearted or even heart-warming connections.
Over the past few weeks, I have had conversations with several colleagues about this new wrinkle in our professional lives. Here are some of the things we enjoy about telemedicine in the time of Covid-19:
Seeing our patients in their pajamas.
We can work in pajamas, too.
Finally “meeting” the dogs and cats they talk so much about.
Gently reminding them about social distancing as their grandkids play on their laps.
Feeling amazed after a successful FaceTime visit with an 89-year-old.
Getting magnified views of chin hair, moles, nostrils, and other facial features of patients who aren’t fully familiar with the cameras on their phones or computers.
Conversing about their home décor and choice of wall color.
Realizing that it’s now acceptable to enjoy a cup of coffee with our patients.
Actually seeing ourselves as we chat, and fixing our hair or smiles in response to the image in the video window.
The fact that many people are unable to see their friends and loved ones in person only makes the situation worse. “Social distancing is really hard on people, and it’s especially taking its toll on people who are isolated at home alone,” Meredith said. “Loneliness can be a big source of stress.”
Even under more normal circumstances, prolonged loneliness can contribute to depression and anxiety, as well as to physical health problems. One 2016 study, for example, found that being lonely was associated with an increased risk of stroke and heart disease. Today, the ordinary risks of loneliness could be magnified by the stress of living during a pandemic. For people who are social distancing right now, “there is a high risk that they’re going to become more anxious, much more depressed, and it’s going to have longer-term effects,” Rima Styra, an associate professor of psychiatry at the University of Toronto, told Vox.
Overall, a lot of people around the world are experiencing a dip in mental well-being. Factors from “looming severe shortages of resources” to the “imposition of unfamiliar public health measures that infringe on personal freedoms” are likely to increase emotional distress during this time, psychiatry professors Betty Pfefferbaum and Carol S. North wrote in a paper published this week in the New England Journal of Medicine.