Depression is much talked about. We all either know someone who has suffered from it or have been touched by it ourselves. However, as a condition, there is much that is said and written about depression that isn’t actually true. Over the years, advances in science have brought new information to light about how the brain works. As such we now have a clearer understanding than we had in the past about how the depressed brain works. Of course a lot of information out there is really helpful and based in fact. But some of the statements made about depression hark back to an earlier time when we didn’t have the insights that we have now.

As therapists, we’re often asked questions by clients seeking to clarify information that they’ve been told or read about.

We’d like to shed some light on some of the most common questions we are asked and hopefully help you to understand a bit more about depression. 

 

1. Is depression hereditary? 

 

Clients often say that their mum or dad had depression too so they assume that they have inherited it. Indeed, there is almost an expectation on some level that they were bound to get depression at some stage. However, depression is not primarily a biological illness. Despite millions of pounds being spent on gene mapping and genetic research, scientists have never found a depression gene. 

There are three pieces of evidence that dispute the idea that depression is a biological illness: 

• The amount of depression being suffered is rising dramatically in the western world. The biggest increase is in people aged between 15 and 25. Thirty years ago, depression in young children was rarely reported. (Of course, some of this rise can be attributed to people being more willing to seek help). 

• Where traditional, often called primitive, societies thrive, depression is minimal. However the more westernised these societies become, the quicker the rates of depression rise. 

• Evidence from research shows the the vast majority of depressions lift, if treated by psychological methods. Also, people helped by these methods relapse far less than people given drug treatments.

 

The Three ‘P’s

Despite all this, there is no doubt that families often have a pattern of depression. So, if not genetic, what is the reason for this? 

When we are children, we are intensely exposed to our parent’s responses and attitudes to circumstances. We will naturally learn these responses and ‘inherit’ a tendency towards depression. These tendencies are our personal attributes. There are three viewpoints that can lead you to veer towards a depressive outlook. If someone has a tendency to look at life in these three ways, it is fairly likely that they will suffer with depressive periods. These are the three ‘P’s. 

 

Personal

If something happens, how personally do you take it? 

For example, your company has just made 200 people redundant. Do you tend to think, why me? The fact is, it isn’t just you, it’s 199 other people as well. It may be hard to take that view. 

 

Pervasive

How far-reaching is the impact this incident has on your life? 

Using the same example above, do you tend to think, that all areas of your life are now ruined? If you are calm you may be able to say perhaps that in fact your relationship is good and so is your health. It may be that in fact it’s only one area that is suffering. It may be difficult to put the incident into perspective. 

 

Permanent

How permanent do you think this situation will be? 

As with the example given, do you feel that this situation will continue, and that you won’t be able to find another job? It can be hard when emotional to see that a fluid situation is likely to change sooner or later, and is unlikely to be permanent.

So rather than inheriting depression, it is more likely that if your outlook reflects the above thought processes you will struggle to deal with a negative situation.

 

 

2. Am I depressed because my serotonin levels are low?  

 

When we are suffering from depression, we worry and ruminate a great deal. Our serotonin levels fluctuate all the time and every thought and emotion changes our brain chemistry. When we are depressed, we have low levels of serotonin. Drug companies are naturally keen to promote the idea that low serotonin levels cause depression. However, whilst we do not dispute that there is a biological element to depression, it is in fact the other way round. Rather than depression arising from a chemical imbalance in the brain, it is now clear that the lowered serotonin levels in the brains of depressed people are a consequence of depression. This is further supported by evidence that the right psychological treatment can help to lift depression more effectively than anti-depressants. Additionally, in 75% of cases, depression gets better on it’s own within 6 months. 

 

3. I’ve had depression before, will I keep getting it? 

 

It isn’t the illness that’s recurring again and again, but the difficulties life throws our way. As illustrated with the three ‘P’s, people tend to react to difficult circumstances with the same sort of attitude and response each time they find themselves in a negative situation. It is this recurring response to new difficulties that can produce the same depressive effect. 

However, this is not necessarily how it has to be forever…

We all have emotional needs that need to be met healthily for us to be emotionally resilient. Examples of these are privacy, attention, control, purpose and achievement. 

Sometimes, when something negative happens it can be at a time when we are not getting our needs met in a balanced and healthy way. Or sometimes it is because of the life change that our needs become unbalanced. You may, for example, lose a job or a loved one. The change that this makes to your life might mean that suddenly needs that were being met perfectly well are now no longer well met. This might lead to a dramatic decline in mental wellbeing. Very often, life changes and gradually our needs get met better over time and the depressive state lifts. 

It can be that a few years later something else major happens, such as the loss of a family member. You may think that you would be guaranteed to sink into a period of depression. But this isn’t necessarily the case. It could be that this time, you are living a well balanced life and hard though this new development is, it doesn’t adversely affect your emotional needs. Thus you may surprise yourself with how well you cope and how strong you are, even if you have suffered with depressive periods in the past. 

Why not check out how your current emotional needs are being met by doing an Emotional Needs Audit.

 

 

4. Why can’t I just snap out of it? Am I just weak? 

 

Someone who is suffering from depression is in a cycle that becomes very hard to break. As we said above worrying and ruminating go on to have a physical effect on the brain and body. This in turn affects our sleep and our energy levels. Poor sleep and lack of motivation combine to increase the amount of worrying and introspection and the cycle goes on. So it’s not a question of  just ‘getting on with it’. Understanding what is happening to cause the depression is a helpful way to make small achievable changes that will begin to break this cycle. 

Click here for a fuller explanation of the cycle of depression plus 8 Things to Help Combat Depression,

 

Things to try

Lowering your emotional levels and getting your emotional needs met in healthy ways will help to break the cycle. 

1. Lower the amount of emotional thinking that you are doing during the day. Do things that will distract and raise your mood. By spending less of the day ruminating and worrying, you will improve the quality of your sleep. Try simple things such as having a shower, going for a walk outside in the sunshine or phoning a friend. 

2. As another way to lower your emotional levels, do this breathing exercise, morning and night.

3. Determine how well your emotional needs are being met at this time.

4. There may be trauma at the root of the depression which needs to be addressed. Trauma can stop us from living our lives in a balanced and healthy way, and from getting our needs met. Get some specialist help from a dedicated trauma therapist to help you to move on and break the cycle of depression.

5. Focus outwards rather than inwards. Helping other people with their problems helps to lessen the amount of introspection and worrying you do.  

 

5. Why am I so tired? 

 

Tiredness is one of the most common aspects of depression. Sufferers find that they lack motivation and routinely suffer with broken sleep or insomnia. At face value, it doesn’t make sense. It may be that you’re spending a large part of the day not doing very much, perhaps watching TV. You may be getting up later because sleep is poor or hardly leaving the house. 

To understand what is happening here, it is necessary to briefly explain about REM sleep and the function of dreams. 

 

 

Dreaming, REM sleep and depression 

The function of dreaming is to deactivate emotional thoughts that we couldn’t resolve during the day. All of us dream every night and even when life is good there will always be unresolved emotions. Dreaming allows us to reset our natural instincts and awaken ready to face the next day. 

However, if you are having lots of depressive thoughts during the day, then you will dream more. For example, worrying about losing your job, and the thoughts arising from that, will not be resolved during the day. The emotion generated by those thoughts needs to be processed by dreaming them out. Raised levels of dreaming cause problems because they deplete our energy levels. So, instead of going to bed and waking up with more energy, we end up using more than we gained. We end up creating an energy deficit.  

This is why someone with depression is often exhausted. Constantly feeling tired makes you feel more emotional, and this leads to irrational thoughts and even poorer sleep. This of course lowers your serotonin levels too. 

 

 

Reducing the amount of dreaming you do

One way to reduce the amount of dreaming we do is reducing the amount of emotive thinking we are doing. Try this breathing exercise, which promotes our ‘relax and rest’ nervous system. If you do this morning and night as a routine it can help to reduce the amount you dream. In addition, you can do this whilst driving to and from work or sitting at your desk. In fact you can do it any time when you begin to feel emotional thoughts are taking hold. 

Although you might not feel much like it if you’re feeling depressed, exercise is another way to counteract depressive thinking. Another advantage is that it tires you out physically rather than mentally and aids sleep. Don’t exercise right before bed though as this will likely prevent you from dropping off to sleep. 

 

 

6. Will I have to feel worse before I feel better? 

 

This long held belief often prevents sufferers of depression from getting help. After all, you already feel bad, the last thing you want is to do something that’s going to make you feel even worse!

We don’t believe this to be true. Bearing in mind the idea that the cycle of depression is created and maintained by emotional thoughts, then it’s clearly counter-productive to routinely dig up emotional pains from the past. It is not a question of ‘not digging deep enough’. Imagine a doctor treating stomach pain, by giving you something to increase it and then saying, ‘Yes, this will get to the root of it now’.

 

 

Rehearsing depressive behaviour 

New understandings that neuroscientists have uncovered about how the brain works, show that encouraging painful memories is just about the worst thing to do for depression. As Professor Ian Robertson eloquently says in his book, Mind Sculpture, ‘the mind is a trembling web of connected cells’. Our experiences are literally re-sculpting our brains all the time. If we stimulate and challenge our brain, we make new connections. The more we use these (practice these new skills), the stronger the connections grow. Conversely, if we keep mentally revisiting a particular source of misery then we reinforce negative experiences at the expense of positive ones. We are in danger of deepening our depressive mood by rehearsing and perfecting depressive thinking. This is no different to perfecting a musical or sporting skill by rehearsing or practicing. 

 

What kind of therapy will help depression? 

Any therapy undertaken to help depression must be solution focussed and aim to help process any distressing memories, This should be done in minimal sessions, without unnecessary emotional exploration. In addition the therapy should aim to only target issues that are relevant to the current distress, and not dig up irrelevant past trauma. You shouldn’t have to feel worse before you feel better. 

 

I hope you have found this information about depression helpful. As ever please share if you know someone who would benefit from reading it. For more information and useful downloads, head over to our website.

With very best wishes

Tanya