DEPRESSION
6 Ways to Live Better With Chronic Depression
Depression doesn’t have to keep you from a good life.
Posted October 9, 2021 | Reviewed by Devon Frye
Amanda Dodson LCSW
Meaning Lost and Found
KEY POINTS
Chronic depression presents genuine logistical difficulties,
as a depressive episode often strikes at the most inconvenient moment.
It’s not necessary for someone to let periodic depression stop them from living life.
Using a few practical techniques can help them navigate themselves safely through
depression. When I went through depression I changed my outlook on life.
Side Note From This Blogger: In 2006 when I overcame severe depression was the day my doctor told me it’s life and unfortunately life ends so get the f’ck over the death of your father to cancer. Thanks Dr. Victor John Stegall for pulling my head out of my arse.
Living with depression can be painful and exhausting. It’s hard enough to get through one episode of major depression—the sadness, the emptiness, the feeling that a gray haze has descended on your life. Sadly, for some, depression returns periodically, more like a chronic illness than a single incident.
This phenomenon, often referred to as chronic depression, may be characterized by recurring episodes of major depressive disorder. You may go months or years functioning normally, then suddenly, depression knocks you off your feet, and you can’t get out of bed for two weeks. For others, their mood disorder manifests in a constant, mild depression, called persistent depressive disorder—a low mood that never quite goes away.
Besides the emotional and social difficulties of depression, chronic depression
also becomes a genuine logistical issue. It is inconvenient to be periodically depressed.
The demands of your life remain maddeningly persistent, even as your resources to cope with those demands are rapidly depleted. Even though your brain feels like a nuclear wasteland, the groceries need to be bought, the bills need to be paid, and you are expected to behave in some approximation of a functional adult.
If you chronically experience depression, emotional endurance is a very handy skill.
It is a strength to have the patience to wait for the storm to pass. But simply enduring is not enough to feel that you live a fulfilling life. Here are a few practical ideas to get you through the next dark time in your life, while still living well.
Stop Resisting and Start Accepting
It is sad to accept that depression may be a permanent fixture in your life.
Nothing could be more natural than wanting an uncomfortable feeling to go away, preferably fast, and forever. Besides, we live in a culture permeated by values of self-sufficiency and self-improvement. It’s tempting to believe that if you could just work
hard enough and stay positive enough, you could overcome your depression for good.
And yet, depression can be situational, environmental, biological, neurological—in other words, there are factors beyond your control contributing to your mood. This isn’t the time for false positivity. When you deny your feelings, they only intensify—determined to make themselves known, because feelings are our internal compass.
There is an old quote from Carl Jung that “What you resist persists.”
To get through your depression, you must first accept that it’s here. When you notice yourself feeling exhausted, tearful, and irritable, practice saying to yourself: “Yes, I am depressed, and it is probably not my fault. I’ve been here before and survived. This hurts, but there is no reason to panic.”
Rebrand Your Depression
Now that you’ve radically accepted your depression as a periodic visitor, you need to learn how to live together in harmony. One of my favorite therapy techniques is getting playful with naming your depression. Depression is a very precise, clinical term, and it is useful and validating in a clinical setting. But if you’re going to be living with depression as a recurring guest, you might need to get on friendlier terms.
Maybe instead of telling yourself that you have chronic depression, you can rebrand yourself into having a melancholic temperament. Oh, that’s fancy! Or try giving your depression a human name, like Carl or Bernadette.
“Bernadette is visiting this week and boy, is she overstaying her welcome.”
Or, imagine your depression as a yearly flu that puts you out of commission for a few days—inconvenient, uncomfortable, but not unexpected. Depression could also be a passing seasonal storm, a resting period, or a mental health sabbatical. Practice trying out the name that feels right for you.
Focus All Your Energy into Basic Self-Care
When you feel like you’ve been drained of your life force, the last thing you want to
do is cook, clean, or shower. These things feel menial and meaningless, so why bother?
But hunger, dehydration, and feeling smelly never improved anyone’s mood.
If you’re depressed, then you’re already scraping the bottom of your energy barrel just by getting through the day. You need to be strategic about how you spend your limited physical and emotional energy. For the time being, dramatically lower your expectations for yourself to the bare minimum. Focus your (admittedly diminished) will on basic life tasks.
If you get out of bed, put on a fresh pair of pajamas, make yourself a bowl of cereal, and drink a glass of water, you’re doing great, sweetie! If you brush your teeth, shower, and go to work, that’s an absolute A-plus. Good job!For extra credit, use that last gasp of energy to keep your depression from getting too deplorable.
Set a timer for five minutes and use that time to tidy up your living space—maybe
throw out old takeout containers and put your favorite sweatpants in the wash.
Race the clock to see how much you can do in five minutes. My mother-in-law calls this method the Tornado Clean Up, and it’s genius: an oddly satisfying game and a healthy activity all in one.
Alison Escalante M.D.
Shouldstorm
According to the Polyvagal Theory, Trauma and Neuroscience of the Mind – Dr. Stephen Porges – HPP 101 -The Polyvagal Theory, discovered and articulated by neuroscientist Stephen Porges, our daily experience is based on a hierarchy of states in the autonomic nervous system. When the ANS feels safe, we experience a sense of well-being and social connection. That’s when we feel like ourselves.
But the autonomic nervous system is also constantly scanning our internal and external environment for signs of danger. If our ANS detects a threat or even a simple lack of safety, its next strategy is the fight or flight response, which we often feel as anxiety.
Sometimes the threat is so bad or goes on for so long, that the nervous system
decides there is no way to fight or to flee. At that point, there is only one option left: immobilization. The immobilization response is the original biological defense in higher animals.
This is the shutdown response we see in reptiles. Also known as the freeze or faint response, immobilization is mediated by the dorsal vagus nerve. It turns down the metabolism to a resting state, which often makes people feel faint or sluggish.
The immobilization response dulls pain.
Immobilization has an important role. It dulls pain and makes us feel disconnected.
Think of a rabbit hanging limply in the fox’s mouth: that rabbit is shutting down so it won’t suffer too badly when the fox eats it. And the immobilization response also has a metabolic effect, slowing the metabolism and switching the body to ketosis. Some doctors speculate that this metabolic state could help to heal severe illness.
In humans, people often describe feeling “out of their bodies” during traumatic events, which has a defensive effect of cushioning the emotional shock. This is important because some things are so terrible, we don’t want people to be fully present when they happen.
So the immobilization response is a key part of the biological defense, but it is ideally designed to be short-term. Either the metabolic shut down preserves the organism,
i.e. the rabbit gets away, or the organism dies and the fox eats the rabbit.
But if the threat continues indefinitely and there is no way to fight or flee, the immobilization response continues. And since the response also changes brain activity,
it impacts how people’s emotions and their ability to solve problems. People feel like they can’t get moving physically or mentally, they feel hopeless and helpless. That’s depression.
Does Depression Have Value?
It’s easy to see why Laura’s childhood circumstances would set off the immobilization response, and even how it might have helped her survive. But why does it happen in people with less obvious adversity? Our culture tends to think of depression in the person who finds work too stressful as a sign of weakness. Self-help articles imply that they just need more mental toughness and they could lean in and solve it. Even some therapists tell them that their depression is a distorted perception of circumstances that aren’t so bad.
But that is not how the body sees it. The defense responses in the autonomic nervous system, whether fight/flight or immobilization are not about the actual nature of the trigger. They are about whether this body decides there is a threat.
And that happens at a pre-conscious point. The biological threat response starts before we think about it, and then our higher-level brain makes up a story to explain it. We don’t get to choose this response; it happens before we even know it.
Studying anxiety has revealed that many modern circumstances can set off the fight or flight response. For instance, low rumbling noises from construction equipment sound
to the nervous system like the growl of a large predator. Better run.
Feeling like they are being evaluated at school removes kids’ sense of safety and triggers fight-or-flight. Better give the teacher an attitude or avoid homework. And to most of us, fight-or=flight feels like anxiety.
Eventually, if these modern triggers last long enough, the body decides it can’t get away. Next comes immobilization which the body triggers to defend us. According to Porges, what we call depression is the cluster of emotional and cognitive symptoms that sits on top of a physiological platform in the immobilization response. It’s a strategy meant to help us survive; the body is trying to save us. Depression happens for a fundamentally good reason.
And those changes everything:
When people who are depressed learn that they are not damaged, but have a good biological system that is trying to help them survive, they begin to see themselves differently. After all, depression is notorious for the feelings of hopelessness and helplessness. But if depression is an active defense strategy, people may recognize
they are not quite so helpless as they thought.
Shifting Out of Immobilization
If depression is the emotional expression of the immobilization response, then the solution is to move out of that state of defense. Porges believes it is not enough to simply remove the threat. Rather, the nervous system has to detect robust signals of safety to bring the social state back online. The best way to do that? Social connection.
One of the symptoms of depression is shame, a sense of having let other people down or being unworthy to be with them. When people are told that depression is an aberration, we are telling them that they are not part of the tribe. They are not right, they don’t belong. That’s when their shame deepens and they avoid social connection. We have cut them off from the path that leads them out of depression.
It is time that we start honoring the courage and strength of depressed people. It is time we start valuing the incredible capacity of our biology to find a way in hard times. And it is time that we stop pretending depressed people are any different than anyone else.
References:
‘I’m a Neuroscientist and Sleep Expert for the U.S. Army, and Here’s Exactly What I Do To Get a Restful Night of Shut-Eye’ (msn.com)
Porges, Stephen. (Apr 2009) The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleve Clin J Med. – Search (bing.com)
Porges, Stephen. (Feb 2007) The polyvagal perspective. Biol Psychology. – Bing video
Depression Is 9 Times More Likely for People with This Chronic Disease, Says New Study (msn.com)
How to Silence Your Thoughts And Drift Off to Sleep: An Expert Explains (msn.com)
Daytime sleepiness: How to manage and not feel sleepy during the day (msn.com)
Healing My Gut with Probiotics Relieved My Depression: I Tried It
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