The winter months are once again upon us. As our thoughts turn to turkey, tinsel, and holiday cheer, an unwanted companion will be joining many in their living rooms as well this season: depression.
Depression is one of those mental health conditions that’s quite complex and a bit hard to wrap one’s mind around. Depression can manifest itself in many ways. I’ve found that to be quite true not only in the lives of those I’ve worked with throughout the years, but in my own life and struggles with it as well.
Depression is caused by many things and there are effective ways to deal with it. In this article we will talk about some of the common causes of depression as well as some things you can do to help minimize its effects.
Common Causes of Depression
Biological and Genetic
Professionals don’t fully understand the workings of all the components that appear to be involved, but it’s clear that depression has some definite biological roots. The number of physiological factors involved is stunningly complex. Several areas of the brain appear to be involved including the Thalamus, Hippocampus, and the Amygdala.
In addition, it’s commonly believed that a number of neurotransmitters (naturally occurring chemicals that relay messages between neurons (brain cells)) affect our mood including: Serotonin, Norepinephrine, Dopamine, Acetylcholine, Glutamate, and Gamma-aminobutyric acid (GABA). Low or high levels of any of these can significantly alter moods.
Hormone levels (in both men and women) also can have profound impact as well. Hormone and neurotransmitter levels alone don’t seem to be able to account for depression, though, as the number of connections between neurons also appears to play a role. A number of medical conditions and illnesses including thyroid issues, diabetes, Parkinson’s Disease, and many others also appear to have ties to depression.
Research is also showing that depression appears to be genetically inherited as well. That said, even though you may have some genetic and biological predisposition towards depression, you are not destined to be chronically depressed. The mind and the will have considerable influence and power over the body. If we were to equate your physiological and genetic makeup to a game of cards, I would sayyou don’t necessarily control the hand that you’re dealt in life, but you DO have control over how you choose to play your hand.
Weather Changes and Key Times of Year
We clinicians see it every year. As the long, sunny days of summer slowly fade into the sunlight shortened fall and winter, depression inevitably increases. Lower amounts of sunlight is known to increase levels of serotonin transporter protein, which in turn lowers overall serotonin levels in the brain, which then can lead to increased depression.
But spring and summer can also bring on depression in some people, as melatonin and serotonin levels in the brain appear to play a role in bringing on insomnia and restlessness, which can over time increase depression and lead to possible mania.
This is commonly known as Seasonal Affective Disorder. Christmas, Thanksgiving, loved ones’ birthdays, key dates (i.e. a deceased loved one’s birthday, an anniversary of a traumatic event, etc.) can all bring about and intensify bouts of depression, as holidays and key events are emotionally linked to powerful memories (good and bad).
The annual sights, sounds, and smells associated with these events can lead to the annual re-experience of these memories, which can increase feelings of sadness, loss, trauma, and so on for some people.
Abuse, Neglect, and/or Trauma
Unpleasant life experiences, especially if they occur early in life and are either intensely painful and/or re-occur over a period of time, can lead to changes in the brain. Sustained stress leads to a production of cortisol, a chemical that we know now can cause changes in the brain and make people more susceptible to depression as adults. The good news is that we know now that the brain is a lot like clay. It is always molded, so over time as people can learn effective coping skills and new ways of being, it can be reshaped.
Recurrent Thinking Patterns
Our thoughts are one of the most powerful mood shapers of all. The messages that we tell ourselves about ourselves, about life, and so on influence how we feel about ourselves and perceive our world. For example, young kids who grow up subconsciously and repeatedly telling themselves, “I’m ugly … I’m stupid … I’m unloveable” and the like will be much more susceptible to depression as adults. Patterns of learned helplessness and low self-esteem can become ingrained traits if we allow such thoughts to take root.
Loneliness and Isolation
We are social beings by nature, created for relationship. Unfortunately, many of us out there don’t live like it. People who experience grief, loss, trauma, and anxiety often wall themselves off from others. There is a reason that prisons use solitary confinement as a punishment. Feelings of loneliness and depression (not to mention psychotic thinking) only increase the more one is alone or cut off from others.
Grief and Loss
Whether it’s the death of a loved one, a divorce, regrets over an abortion, or getting fired or laid off from a job, losses in life and the grief associated with them bring on feelings of sadness that can become depression over time if people aren’t able to learn how to cope and move on.
One thing that we as clinicians have learned over time is that many people don’t like change. Retirement, loss of a job, moving to another town, and so on can potentially throw people for a loop. Many men tend to define themselves by their job, so for them, retirement can really make them depressed, as they are asking themselves the question, “Who am I now?” For young people especially, moving to a new town, having to attend a new school, and leaving old friends can be extremely difficult and make them prone to depression.
Stress and Worry
People often feel anxiety due to pressure related to finances, jobs, children, marriage, school, and countless other reasons. Stress and depression often go hand in hand. As recurrent concerns can become significant stressors, people become more and more despondent, feeling like they can’t do anything about them.
Disappointment can take many different forms and is a common cause of depression. For some, it’s disappointment with others, as people have let them down and failed to meet expectations. Others carry around the scars of past hurts, so may be disappointed with God, wondering how in the world a loving God could allow such evil to happen.
Many people have been disappointed by the church, sporting deep wounds from having been hurt by God’s people. Still others are disappointed with their own lives, saying to themselves, “I’m not even close to the man or the woman that I’m supposed to be.”
A lot of people feel like they’ve been a disappointment both to others and to themselves. It’s very common for many older people especially to become quite depressed, as they look back upon their life and feel like they aren’t leaving much of a legacy behind.
Failures and Sins
This is an area that is commonly linked to depression that takes many different forms. In school, students who repeatedly fail tests or constantly strike out in social situations may begin to feel like a failure. Workers who’ve been fired or laid off from a job (especially if it’s not the first time) have a marked tendency to feel that way.
Some of the strongest fuel for depression, however, is regret related to past choices. How could the ones I love ever forgive me for what I’ve done? How could anyone possibly ever love and forgive me when I don’t love or forgive myself? Unresolved guilt and shame such as this can be a downward spiral into the bottomless pit of despair.
Lack of Control or Feeling Trapped
Psychiatrist William Glasser (the founder of Reality Therapy) identified power and control as needs that are basic to all human beings. People need to feel that they have some semblance of power and control over their lives. Feeling out of control and/or trapped whether in a relationship, a job, or other circumstances in life can be a source of significant stress.
There are a lot of unhappy, depressed people who feel trapped in a marriage. Many housewives feel trapped and all alone, left to care for their children on their own and contend with a distant and neglectful (or perhaps even abusive) husband. Likewise, there are thousands of teenagers sheltering themselves alone in their rooms, feeling like their estranged parents control their lives, counting the days until they leave home. Such feelings are a breeding ground for depression.
Unfulfilled or Unmet Needs
People have God-given needs woven into the very fabric of their being that they are driven to meet. When people sin, it is often because they are acting in unhealthy, unbiblical, and often destructive ways in order to fill these needs.
People have an ingrained desire for love, affection, attention, connection, belonging, and a host of other emotional, physical, and spiritual needs (depending on whom you listen to). When these needs go unmet or unfulfilled for long enough, depression inevitably (and often quite forcefully) results.
Ways to Deal with Depression
How can you cope with and minimize the effects of depression? Here are a few effective ways:
The choice to turn to modern medicine is a decision that should be carefully considered in consultation with professionals. Among the key questions you may be asked are:
- How long has your depression been going on?
- How intense is your depression?
- How is your overall energy?
- Is your depression keeping you from leaving home and/or from doing needed and desired activities?
- Have you had thoughts of suicide?
- Does depression or other mental illnesses run in your family?
- Is your depression related to a specific incident … or has it been recurrent throughout your lifetime?
Selective Serotonin Reuptake Inhibitors (SSRI’s) such as Celexa, Paxil, Prozac, and Zoloft are the most commonly prescribed psychotropic medications. For some people, medicine is the only thing that is able to bring them out of the funks that they find themselves in. They can be an important tool for many people (and that is exactly the way they should be viewed). Some need that tool in order to keep themselves stable.
Medications are not the only tool, however. If I’m building a house, can I do it with only a hammer? The answer is obviously no — I’ll need many different tools and perhaps even many different contractors who have expertise in different areas. The same is true for depression. Psychotropic medications have their place, but they can be a bit of a mixed bag.
Whether we’re talking about SSRI’s or even natural supplements such as St. John’s Wort, all medications have side effects that can be undesirable and sometimes unpleasant and unwanted. Some medications can actually induce depression or mania. This is why, should you choose to take psychotropic medications, you need the expertise and the ongoing monitoring of a medical professional such as your primary care physician, a psychiatrist, a nurse practitioner, etc.
A Word about Alcohol and Marijuana
Illicit drug and alcohol abuse is a problem that dates back centuries. There has long been a belief in the social service field that many people end up turning to drugs and alcohol due to an unconscious desire to self-medicate (to fix something that they perceive to be broken within their brain) and escape their problems.
People who are depressed have long turned to drugs and alcohol to try to numb themselves to the pain they feel. Alcohol is among the poorest choices for depression relief, as it actually intensifies (rather than relieves) those feelings of sadness. In addition, alcohol use also lowers inhibitions. So, if a person already has thoughts of suicide, he or she is much more likely to act upon them when under the influence of alcohol.
One drug that’s been the source of considerable debate is marijuana, which is now legal in several states (including Washington). All politics aside, I will fully admit marijuana has its benefits. One psychiatrist that I used to work with once admitted to me (prior to it becoming legalized) that there was nothing better for depression that he could prescribe.
As is the case with all drugs, however, it has clear drawbacks. Besides being psychologically addicting, research is showing that THC found in marijuana hampers memory, weakening connections between neurons and widening the synaptic gaps between them.
Marijuana impairs overall brain function and just as with cigarette smoking, studies also show that it causes respiratory and cardiac damage and that it may even have adverse effects when it comes to reproduction. Marijuana can also cause psychosis and there is mounting evidence that it may contribute to the development of schizophrenia. So, if you are considering using it for depression, be aware that there are definite risks that go hand in hand with any potential rewards.
Other Helpful Coping Strategies and Interventions for Depression
Here are some helpful attitudes and interventions to consider:
#1 – Set and try to keep a regular routine. When people get extremely depressed, it’s very common for them to hibernate in bed or lack the energy to get off the couch. The vast amount of research tells us that our brains like and in fact need structure. We need a predictable schedule – to get up at a certain time, eat breakfast at a certain time, etc – each and every day. Don’t allow yourself to be in bed and to do nothing all day long. That can become a slippery slope that leads down into the abyss.
#2 – Do first and then you will feel like it. The lie those who are depressed always tell themselves is, “I’ll do it later when I feel like it.” Don’t wait until you feel like doing something (you never will). Your feelings will follow later AFTER you start to do things.
#3 – Get outside and get regular exercise. As noted above, lower amounts of sunlight throughout the winter months lead to elevated levels of Serotonin Transporter Protein, which can deplete your brain’s supply of Serotonin, which in turn can increase depression. If you’re spending most of your time indoors due to poor weather, that makes the situation even worse.
Sunlight is known to naturally increase Serotonin levels. At the same time, exercise is known to release the body’s natural endorphins, which also are known to elevate one’s mood. So getting outdoors and moving on a regular basis is a real key to managing depression. Additionally, full spectrum sunlight lamps can also be therapeutic for some people, especially during the darker winter months.
#4 – Improve your diet/quality of food. Interestingly, several studies have shown that people who eat junk food or poor quality processed foods report higher levels of depression. At the same time, studies also demonstrate that people who eat healthier foods show lower levels of depression. I guess we truly ARE what we eat after all.
#5 – Do something to tantalize the senses. Research has shown us just how much we rely upon and are impacted by our 5 main senses (Sight, Sound, Smell, Touch, and Taste). People who are depressed can often experience some measure of stress relief and even alter their mood through sensory experiences (especially if several senses can be engaged simultaneously). Here are a few suggestions:
- Watching a good comedy or comedian – laughter is often the best medicine.
- Hugs, affection, and attention from a loved one – touch is a deep normal need of all human beings.
- A nice hot shower.
- Listening to uplifting, upbeat songs.
- Posting uplifting scripture verses on the wall
- Good tasting favorite foods. If you have fond memories associated with mom’s chicken soup, make yourself a cup.
- Drinking hot beverages such as tea, hot cocoa, etc.
- Pleasing smells, like burning incense, essential oils, potpourri, and/or plants and flowers.
- Journaling and/or writing
#6 – Establish and increase momentum through small incremental daily goals. For the severely depressed person, just finding the energy to do anything can be tough. Newton’s 1st Law of Thermodynamics states that “an object in motion tends to stay in motion.” That principle applies to depression as well. Often times, it’s all about getting and maintaining momentum.
So, let’s say that all you can muster is getting out of bed and taking a shower. If that’s all you end up accomplishing for the day, don’t get down on yourself. Instead, consider that you’ve made progress! The next day, add to it. Make a point to get up, take a shower, and then do some housework, go on a short 5- to 10-minute walk, or some small task. Suddenly, you’ve got a bit of momentum that you can keep adding to little by little, day by day.
#7 – Reach out to and lean on loved ones for support. Depressed people often find themselves in a deep, dark pit that they don’t know how to get out of. Oftentimes, they need other people to reach down into that pit to pull them out. If that’s you, don’t be afraid to reach out for help. We are social beings by nature. We need each other. None of us can do it alone. In fact, we were never meant to. (1 Corinthians 12:12-31)
#8 – Accept responsibility for and attempt to change only the things that are within your control. So many people frustrate themselves beyond belief by attempting to do things that are outside of their power. They spiral down into a tailspin of depression because they accept responsibility for the attitudes, beliefs, feelings, and choices of other people. No matter how hard they try, they can’t make others lift even a single finger. The only person you are responsible for and whom you can control … is YOU. Choose to live like that and accept responsibility for yourself, alone, moment by moment … hour by hour … day by day.
#9 – Let go of the things that are beyond your control. In parts of Asia, hunters have for centuries caught monkeys using a rather ingenious method. They will cut a hole in the bottom of a gourd that’s just big enough for a monkey’s hand and place a piece of fruit inside. The monkey, seeing the piece of fruit, will reach in and grab it … but when it tries to get its hand out, its fist is now too big for the hole.
The monkey has trapped itself. It will scream, yell, and tug with all its might … but it won’t let go of the fruit. If the monkey were able to just let go … it would be free. Many people are just like that monkey. If they could only learn to let go of the past, of the pain and the hurt that they feel, and the bitterness, anger, and hatred that ensnares them, their depression would begin to subside and they would be free.
#10 – Make new and different choices. Our destiny in life is the result of little choices that we make moment by moment. Do I choose to take my anger out on the person I’m upset with by screaming and yelling at them … or do I choose to calm myself down, sit down with them, and try to work through our differences? And if you make the same choice often enough, it eventually becomes a habit.
Many depressed people find themselves doing the very same things again and again … and becoming more and more depressed as time and again they keep getting the same disappointing results. If you’re finding yourself unhappy with the results you’re getting, why not make new choices? If you change nothing in your life, why expect different results?
#11 – Re-adjust your perspective and what you choose to focus upon. Is the glass half empty or is it half full? The answer is that it all depends on how you choose to look at it. Take a look at a painting hard enough and you will find a flaw. Do you choose to focus on that flaw or at the overall beauty of the painting? If we focus on flaws and dwell upon the things that are wrong in life, it’s amazing how often that’s all we see. Those who do that end up blinding themselves to their blessings and all of the good things they have in their life as well.
The great reformer Martin Luther once said, “You can’t stop the birds from flying over your head, but you can keep them from making a nest in your hair.” Bad things happen in life all the time. The question is, are you going to choose to let those things “build a nest” in your hair?
#12 – Monitor and modify your self-talk. As noted above, recurrent thought patterns are one of the most powerful shapers of mood and self-esteem. What you tell yourself about the world, about others, and about yourself is huge. When you find yourself feeling depressed, pay careful attention to the messages you are sending through your words. Keep a journal and see if you can identify a pattern in the things you say over and over again. Think of those messages like a CD that’s playing inside your head. If the majority of messages are negative and critical, then depression is bound to follow.
Where do those messages come from? They not only come from our past, but also from the music you listen to, the TV shows and movies you watch, the magazines and books that you read, and so on. All of those things fill our heads with thoughts which can form the foundation of how we see the world, others, and ourselves.
When personal computers first started, there was a saying: “Garbage In-Garbage Out.” Will you choose to listen to the garbage and lies that come from the world, the flesh, and the devil, or will you choose to listen to the truth from your Heavenly Father who loves you unconditionally? Record over that CD and replace it with new, uplifting, positive, Godly messages. As the Apostle Paul said, “Be transformed by the renewing of your mind”. (Romans 12:1-2; see also Philippians 4:4-8).
#13 – Transform your environment. So many messages that our minds accept come from our environment. If you want to that CD player in your head to be playing positive messages, may I humbly suggest that you transform your environment?
Be brutally honest in asking yourself whether or not the people and the things around you reinforce a more negative or a more positive and Godly self-image. Music, TV, movies, websites, books – even the types of posters, pictures, paintings, and decorations found throughout your house – fill our heads and our hearts with powerful messages that shape our worldview.
#14 – Examine your priorities. Take an honest look at your priorities in life. Often times the things that frustrate and depress people the most revolve around things that are the central love of their life. What’s most important to you? You will recognize it as the area where you choose to invest the majority of your energy. Is it money and financial security? Is it relationships and sex? Is it power, status, and fame?
Solomon, the wisest and one of the most powerful rulers in history, had wealth, power, fame, sex – every worldly pleasure that one could possibly ask for in abundance. In the end, he looked at everything he had and declared it all “meaningless, a chasing after the wind” (Ecclesiastes 2:11).
Ask yourself “who or what in life is going to make me happy and content?” If you conclude that the things you are pursuing are ultimately unsatisfying and empty, then you should pursue the things that will fulfill you.
#15 – Cultivate a relationship with God. Cultivating a relationship with God is far more than simply attending church or a Bible study for one hour a week and living life with yourself in the driver’s seat the other 167 hours of the week. Let God and His Word live inside of you and become a part of you. “The Word of God is living and active” (Hebrews 4:12); it became human, lived among us, connected with us, and died and rose again to break the power of sin and darkness (John 1:1-5).
That same Word wants nothing more than to have an intimate relationship with you. Cultivate that relationship through regular practices such as Bible Study, prayer, reading Christian books, listening to Christian music, and regular fellowship with other believers in Christ. The closer you get in your relationship with God … the more you’re going to begin to see the world, others, and yourself as He does. Truly learning to see and feel about yourself the way God does will definitely impact your overall depression.
#16 – Try focusing some of your energies outward. Severely depressed people can become constitutionally self-focused. More and more, everything becomes about them. The more depressed they become, the smaller their world becomes and the more focused on themselves and the miseries of their life they can become, the pain they feel begins to be all that they can see.
Often the way out is a matter of focus. The question is what will you choose to focus on? Sometimes it can be helpful to focus one’s attention OUTWARD – to think about and direct one’s energies towards others and their needs. Consider ways in which you can love your neighbor as yourself by using your time, your energies, and your God-given talents to bless others (Church youth group, Church worship team, Big Brothers/Big Sisters, school volunteer, etc.). Often times when you give of yourself you receive back just as much (or more) than you give.
#17 – Seek healthy ways to meet your God-given needs. Many people make a wreck of their lives, trying to meet their God-given needs in sinful and unhealthy ways. Sin can be viewed as seeking the things of God by going to the wrong address. People who continue to try to meet their needs in sinful ways will damage themselves and others around them. Sin is always ultimately unfulfilling and has consequences that are often quite painful, causing people to become more and more depressed and unhappy over time.
Where does one go to look for healthy ways to meet those needs? Numerous books and articles have been written within the Christian community on a variety of subjects. There are many strong leaders within the church who are more than willing to help you find resources.
#18 – Seek first to understand others rather than to be understood. So many things in life that people tend to get depressed over stem from misunderstanding the intentions and actions of other people. Thirty years ago, Stephen Covey wrote a book entitled, 7 Habits of Highly Effective People. Covey recognized that most people have a tendency to see things only from their own point of view.
When disagreements happen, they naturally argue their point, attempting to win the argument by making others see how they were right and the other person was wrong. If the other person is doing the same (as they generally are), it is small wonder that frustration and hurt feelings ensue.
If people seek to have open and honest communication, attempting first to understand the other person, pursuing “win-win” (rather than win-lose) solutions (another one of Covey’s principles) and using effective communication techniques (such as Active Listening, Clarification, Using “I Feel” Statements), they will that find their relationships, in general, will be much better. I’m convinced God that gave us two ears and one mouth for a reason – we need to be listening twice as much as we speak.
#19 – Seek and choose to forgive. Has there been someone you’ve hurt or who has hurt you? A lot of the issues for which people come to therapy stem from someone in the past who has hurt them in some way – often, quite significantly. That bitterness, over time, can become an anchor around the soul that drags it straight down to the bottom of the sea of despair. If possible, I’d highly encourage you to pluck up your courage, reach out to that person, and seek reconciliation.
It may not always be possible nor advisable in some cases, depending upon the offense (i.e. childhood sexual abuse, domestic violence, if the person is deceased, and so on), but if it is, I encourage you to do it. For those who tend to avoid conflict let me implore you: don’t sweep things under the rug. The pile will only get bigger and you will eventually be tripping all over it. The person who hurt you may never end up saying “I’m sorry” or take responsibility for what they did but you still have to choose to forgive them and let go of the pain if you want to heal.
On the other hand, perhaps the person who’s really in need of forgiveness is you. Can you forgive yourself? For those who believe that they cannot, let me remind you that someone has already done that for you; his name is Jesus (Romans 5:8). Jesus has already paid the price for your sin. Isn’t it time you laid your burden down and experienced the freedom that only He can provide.
#20 – Individual and/or group counseling. As mentioned earlier, the Christian life wasn’t meant to be lived on our own. Sometimes despite our own efforts, we need the help of others to figure things out. The Body of Christ is there to lean on especially when we’re stumbling blindly through the valley of the shadow of depression.
A trained Christian therapist and/or support group can assist you in gaining the skills you need to navigate your way through those dark valleys to the light beyond. If you find yourself mired in the depths of depression, don’t be afraid to reach out. You have many brothers and sisters in Christ who would love nothing more than to give you a hand.
“Downcast,” courtesy of whoismargot, pixabay.com, CC0 License; “Alone,” courtesy of PublicDomainPictures, pixabay.com, CC0 License; “Crying,” courtesy of markzfilter, pixabay.com, CC0 License; “Depressed,” courtesy of HolgersFotographie, pixabay.com, CC0 License