Depression

Coping with Depression

Are you struggling with depression? Here’s a quick guide to help you recognize signs and symptoms of depression. Find tips to help build your resilience and discover your strengths. 

Depression

What is depression?

Depression is more than simply feeling unhappy or down. It is a medical illness that impacts the way you think, act, and feel over a prolonged period of time. The time period can vary, however, typically people who experience depression over a two-week period or more meet the criteria for clinical depression. Depression can arise concurrently in the presence of other life stressors, including loss, life transitions, medical conditions, and physical injury.

If you have depression, you might feel as if you're sinking into a black hole, such that everyday tasks take enormous amounts of energy and you feel little to no motivation. People who are depressed often describe being in a perpetual state of "negativity" despite efforts to feel happy. It's often associated with a loss of interest or pleasure in activities once enjoyed.

Although depression can feel all consuming at times, it is treatable and there are evidence-based psychotherapies that can help you not only survive, but also learn to thrive.

So how do you know if your depression is problematic?

Start by asking yourself two questions:

    1. Are your symptoms of depression getting in the way of living a meaningful life? 
    2. Are your symptoms of depression negatively impacting your work, school, relationships, and daily routine? 

If you answered yes to either of these questions, please find out how to get help below.

Step 1 - Remind yourself you are not alone

Depression

How common is depression?
If you or a loved one is experiencing depression, know that you are not alone.

  • Depression affects almost 1 in 9 adults in Canada at some point during their lifetime.
  • Depression is also the second leading cause of disability in the world.

Millions of people experience depression each day and many recover and learn to live meaningful and healthy lives.

Is depression just sadness? Can't I just get over it?
Sometimes when you turn to people for support they offer well-intentioned messages, such as "You shouldn't feel that way!" or "Just look on the bright side!," without realizing the true nature of depression. Unfortunately, these kinds of messages reinforce the notion that someone suffering from depression should simply be able to 'snap out of it'. If it were that simple, then depression wouldn't be the second leading cause of disability in the world and one of the most common mood disorders recognized by the DSM-5.

According to the DSM-5 clinical depression, or major depression disorder (MDD), can make you feel helpless, hopeless, and worthless for long periods of time up to months and years. Depression can permeate other areas of your life and impact your ability to focus, socialize, and reliably function, which generally further disconnects you from the life you want to live.

If you believe you're struggling with depression, then you might benefit from speaking with your doctor or a mental health professional for further assessment. Taking this step allows you to receive treatment recommendations for depression and potentially start working with a licensed mental health professional to support you on your journey.

Why do I feel alone?
The feeling of loneliness is all too familiar for people suffering from depression. It's common for them to isolate themselves from others and withdraw from social activities. There are many possible reasons for isolation that differ on an individual basis. Potential reasons why someone suffering from depression might withdraw include:

  • Negative self-talk and beliefs that they are unwanted, inadequate, or alone
  • Little to no energy for engaging in activities
  • Physical exhaustion
  • Narrowed window of tolerance for dealing with potential issues or conflict
  • Loss of interest or pleasure in activities

It's no wonder people with depression can feel lonely and disconnected if they don't have the capacity to engage in ways that they used to.

Depression often goes hand in hand with unhelpful thinking patterns and cognitive distortions that exacerbate emotional suffering. You can view a list of ten common cognitive distortions here. Rumination is the act of continuously thinking about the same thoughts or events that tend to be sad, negative, extreme, or unhelpful. Imagine what it would feel like to repeatedly tell yourself [and believe] "I'm not good enough," or "People don't want to be around me,". It's understandable why people with ruminative, depressive thought patterns tend to stray away from social situations and relationships. Unfortunately, these depressive patterns often influence people away from the values and activities that would actually help them make connections and have corrective experiences. The more isolated you feel, the more loneliness emerges, the more rumination and harsh self-judgment continues and a vicious cycle of self-isolation develops.

Therefore, it's important to acknowledge when you're isolating so that you can reach out and get connected to people that can help.

"The good life is a process, not a state of being. It is a direction, not a destination." - Carl Rogers

Step 2 - Recognize the signs and symptoms of depression

What causes depression?
There is no one single cause of depression. Contributing factors for depression might include:

  • Life events (i.e., divorce, trauma, transitions)
  • Genetic or family history of depression
  • Biological factors (i.e., neurological imbalances, physical health, concurring medical conditions)
  • Major life stressors
  • Physical and/or psychological trauma
  • Environmental factors (i.e., financial stress, housing issues, caregiver responsibilities)

What are common symptoms of depression?
The following symptoms of depression can range from mild to severe according to the Personal Health Questionnaire (PHQ-9):

  1. Little interest or pleasure in doing activities once enjoyed
  2. Feeling down, depressed, or hopeless
  3. Trouble falling asleep or sleeping too much
  4. Feeling tired or having little energy
  5. Poor appetite or overeating
  6. Feeling badly about yourself, or that you're a failure, or that you've let yourself or your family down
  7. Trouble concentrating on such things as reading the newspaper or watching television
  8. Moving or speaking more slowly than usual, so that people could have noticed, or the opposite, being more fidgety or restless than usual
  9. Thoughts that you would be better off dead, or thoughts of hurting yourself in some way

Please note: if you or someone you know is experiencing a medical emergency or mental health crisis, call 911 or go to your nearest hospital. You may also contact Talk Suicide Canada Crisis line (Call 1-833-456-4566 or Text 45645).  

Quick Screening Tool: Find out if you're suffering 

Reflect on the past two-week period and answer the questions below to the best of your ability:

  1. Do your symptoms of depression prevent you from doing things you care about?
  2. Do your symptoms of depression negatively impact your physical health in ways that cause you concern (i.e., eating, sleeping, exercise)?
  3. Do your symptoms of depression negatively impact your relationship with yourself or others in ways that concern you or cause distress?
  4. Do your symptoms of depression interfere with your ability to be present and enjoy activities you value?

Results: If you answered “Yes,” to any of the questions above, then you may benefit from speaking with a licensed mental health professional to further assess severity of symptoms and learn more about your treatment options.

Connect with one of our licensed therapists here.

Step 3 - Considerations for depression treatment

There is no 'one size fits all' approach to treating depression, nor is there a 'magic wand' of sorts, although wouldn't that be fantastic?

The decision of whether or not to supplement psychotherapy with medication is up to the individual seeking treatment. Research has shown that talk therapy alone has efficacious outcomes in the treatment of depression. However, some individuals report being better able to apply skills learned in therapy when supplementing with medication. Speak with your doctor or psychiatrist to learn about your options for adding medication to your treatment plan.

Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are evidence-based in the treatment of depression that tend to focus on the here and now. Alternative psychotherapies, such as psychodynamic, that might include more in-depth exploration of early childhood experiences also demonstrate efficacy in treating depression.

While there are many options for recovering from depression, successful outcomes in therapy can likely be attributed to:

  • A strong therapeutic relationship between client and therapist
  • Willingness, motivation, hope, committed action, and desire to improve from both therapist and client
  • Alignment in treatment goals between client and therapist
  • A strong support network
  • Open-mindedness and non-judgment
  • Therapist warmth, compassion, and unconditional positive regard directed towards the client
  • Therapist competence level in their theoretical approach and interventions delivered
  • Corrective experiences and relationships outside of therapy
  • A good match with medication

Step 4 - Tips for coping with depression

Depression

1. Stay active with low motivation:

When depression washes over you it can rob you of your motivation and energy to do pretty much anything. Your hobbies, passions, interests, and activities that once gave you meaning may not give you the same satisfaction as before.

You might get stuck on thoughts such as, "What's the point of doing anything?", which makes sense when we're feeling disconnected or our energy is depleted. Unfortunately, doing less tends to result in unpleasant feelings worsening and perpetuating a vicious cycle. That's why it's crucial that you keep doing things that used to give you pleasure even with little to no motivation.

Often, a good strategy is to ask yourself why it's important to you to stay engaged even when you don't feel like it. Get clear on your why because it makes any how a lot more manageable. Allow yourself to not be happy right now. Normalize that the way you feel now likely has more to do with depression than any real truth about you, your life, or the people in it. Act from a place of discipline rather than emotion (or waiting for motivation) in keeping your routine as existent as possible. Again, remind yourself of your why. You can do hard things.

2. Connect with the present moment

You might notice that when you're depressed you tend to get caught up in your internal world, such that you lose touch with the world around you. You might have difficulty being present as you ruminate on painful or unwanted thoughts, memories, and emotions.

Grounding skills are a valuable practice to strengthen your ability to return to the present moment. Grounding or 'anchoring' can be done through mindfulness exercises that help you use your five senses to reconnect with the world around you. Pay attention with intention and without judgment to what you can see, hear, smell, taste, and touch. Simply observe.

The 5-4-3-2-1 technique is a common exercise for grounding in the present. It can be used anytime anywhere. To practice, pause what you're doing and notice:

Five things you can see.
Four things you can touch.
Three things you can hear.
Two things you can smell.
One thing you can taste.

3. Learn to unhook from unhelpful thoughts

It's hard to change problematic thinking patterns without first being aware of them in the moment. That's why mindfulness has been proven as an effective component of many psychotherapies that you hear about today; becoming aware of your thinking patterns that perpetuate or exacerbate suffering is essential for responding to them differently. You may get 'hooked' on thoughts that prevent you from living according to your values. For example, if deep connections and relationships are at the core of what you want, but you're hooked by fear, self-doubt, and thoughts such as, "No one will like me," then you might not take the necessary steps to form connections in the first place.

One strategy for 'unhooking' is an ACT-informed cognitive defusion technique: say your thoughts out loud or write them down. This can help you become aware of how your thoughts directly influence how you feel. Try saying a painful or scary thought in three phases, for example:

"I'm a failure." Pause. Notice how you feel.
"I'm having the thought that I'm a failure." Pause and observe.
"I notice I'm having the thought that I'm a failure." Pause and observe.

What did you notice? The thought may still be present, but hopefully you've at least created some space from it to see it for what it is.

4. Connect with a psychotherapist and learn how to suffer less with depression

Speaking with a mental health professional for the first time can be intimidating and bring up conflicting feelings. This is a common reaction and sometimes presents a barrier for people getting the help they need. A trained and licensed psychotherapist can help you manage your depression in a number of ways. A registered psychotherapist can help you gain a sense of understanding and clarity on how depression may be impacting you. Any good therapist will help you develop a better relationship to your internal experiences and foster skills for improving your external experiences. A psychotherapist can help you uncover your strengths, resiliency, and skills gaps, which helps your therapist better understand what treatment approach could be right for you. Working with a psychotherapist means working with a mental health professional who is trained to listen and help evaluate your needs without judgment. Our registered psychotherapists genuinely care about helping you unpack what is going on and make improvements in your life - whatever that looks like for you.

Step 5 - Find a psychotherapist to help you with depression

Depression

As a client seeking help from a mental health professional, you have the right to ask if your therapist has experience working with depression and practices treatment that is evidence-based.

At ACTion psychotherapy, each of our therapists is experienced in helping people with depression using evidence-based interventions. Once you're connected with one of our therapists, you'll start with an initial session. During the first session, your therapist will listen to your concerns and collaborate with you to clarify your best hopes for therapy. Your psychotherapist will take a brief psychosocial history to get to know what's most important to you and how you want things to change. You'll work collaboratively with your psychotherapist to form a treatment plan that's best suited for your needs over the first 1-3 sessions. Throughout the entire process you have the opportunity to ask questions and provide your feedback as you continue to progress.

Learn about the therapists on our team here.

Connect with one of our licensed therapists here.