Living with a black dog-his name is depression(Based on the WHO educational video of the same name)

Credit:

https://youtu.be/XiCrniLQGYc

https://wechc.org/library/i-had-a-black-dog-his-name-was-depression/

 

In my last article, I discussed resilience in an individual. Today, I will be discussing a similar issue: depression.

 

Depression is defined by the WHO as presenting symptoms of either “depressed mood, loss of interest or pleasure, decreased energy, feelings of guilt or low self-worth, disturbed sleep or appetite, and poor concentration.” In this article, I will be focusing a specific kind of feeling of depression, called existential depression. I came across this concept in this blog (1), and these symptoms I think capture the essence of depression:

 (This blog mentioned throughout the article can be found in this link  https://projectenergise.com/what-is-existential-depression/)

1. low energy
2. a lack of interest in most things
3. feelings of meaningless
4. feelings of disconnection and isolation
5. lack of patience in normal social situations
6.  low mood
7. feeling numb

The reason why I want to address depression in this manner is because I think that these days, adolescents, who undergo an emotional rollercoaster during their teenage years, especially during the process of puberty, may struggle to find a purpose or motivation in life, and as such, may prone to suffering from depression. Although I have not undergone depression, there were episodes  that I experienced a feeling of meaninglessness with respect to my studies because I felt stressed out, a feeling compounded that at the time, I had few friends to be with.

I will begin by addressing what I think are two important aspects of depression:

 

1. The negative thought processes involved in depression 

2. The feeling of a lack of purpose

 

 

1. Thinking more positively

From a recent CNA article I read, sufferers of depression can think that they do not have a problem in the first place. They may also feel guilty and rationalize that they don’t have anything to be sad about, and as such do not tell any one about their problems. This is very saddening.

Regardless of whatever the severity of depression, or even simple stress-induced negativity, here are some methods of self-help which we can practice by ourselves to challenge such negativity, and break out of such a vicious cycle:

1. Write down your recurring thoughts in a journal. Ask yourself:

1. Please describe a stressful experience of yourself or someone that you know of.
2. How did you or the other feel?
3. What helped? Was there someone helping you or the other? What did that person do to make you or the other feel better?

At the same time, focus on all the positive experiences which you have had. Keep a journal, perhaps of photographs, or of other reminders of all the positive experiences which you have had. The good thing about the above format is that you can use it to reflect on positive experiences as well:

 

1. Describe a positive experience.
2. How did you feel?
3. What made you feel this way?

 

Personally, although I have never experienced depression, I have had been trapped into negative thoughts before. For example, whenever I did badly in a subject before, I told myself, perhaps subconsciously, that I was useless in the subject and should not continue. From this experience, I agree with a depression victim’s words, that we should not let the past dictate our future 

Through this, you could also identify specific thinking errors in your thoughts. This was something which my counsellor suggested to me when I was distressed by my thoughts. From https://www.therapistaid.com/therapy-worksheet/cbt-thinking-errors

1.         Should statements “Believing things have to be a certain way” I used to believe that I should not feel stressed, because other people did not appear to be stressed, and not bearing stress was to be weak. However, with time, I realised that everyone shared the same struggles as me, and I accepted that such a view is not true.

 

2.         Mind reading “Believing you know what someone else is thinking, or why they are doing something, without having enough information.

 

3.         Setting the bar too high: Thinking that you must be perfect in everything you do, otherwise your’re  no good

 

2. The discovery of purpose

 

From the same abovementioned blog, the author, who has suffered from depression before, postulates that perhaps isolation happens because we have no friends. We cannot truly experience what others feel. From my own personal experience, I agree. Having few friends sometimes before meant that I felt a sense of sadness and disconnect from those around me.  To make matters worse is stress from other aspects of our lives , for example school work, because we can feel even more isolated from other people if we do not have friends, making it seem like we are all alone. In my experience, here are some ways in which we can find meaning in our lives:

 

1. Exploring a new hobby, or engaging with present interests.

2. Talking to people who you trust or even joining a support group where everyone is facing the same problem. There are many other people who have gone through the same problem. By connecting with those who have not previously 

3. Exercising. This prevents you from being trapped in a feeling of numbness.

4. This is from the person in the blog, and I agree with him. We as people, sometimes have to accept existential thoughts. As he neatly states, "There are things that are out of our control, no matter how much we think about them and try to solve them!" Returning to the first article, this is also another way of improving one's resilience- not worrying and being distressed by every thought that comes to our mind.

 

 

For parents/friends etc(This can be used by anyone!)

 

Before I continue, I think it is useful to distinguish between normal sadness and depression. According to the American Psychological Association, normal sadness tends to ebb and flow, while depression feels heavy and constant, with people who are depressed less likely to be cheered, comforted or consoled. 

 

Here are advice from the WHO on how to engage sensitively with someone who may have depression:

 Link: https://youtu.be/2VRRx7Mtep8

Good things to say and do:

 

What not to say

 

1.         You can be thoughtful and kind, but do not try and jolly them along.

 

2.         Don’t point out that there are people far worst off than them. It will add to their feelings of guilt and hopelessness.

3.         “Be a man!” This does not help, especially if they are already a man. 

 

4.         Do not tell them that “It is all in their head.” You may very well be right, but it is better to let the professionals provide a diagnosis

 

Good things to say

1.         Be sensitive about how you talk about their mental health. Not everyone is comfortable with talking about their mental health, or their lack of it. Crossing that line means that you care.

2.         Try not talking. Instead grow your ears and open your heart. 

3.         Help them to simplify their lives, both at home and at school. Stress is a major driver of depression.

 

Embracing the black dog:

 

1. Agree to a course of action to get rid of the black dog. If ignored, the problem will worsen. 

2. Acknowledge that you yourself cannot help a person with depression, and that professional help is necessary. 

 

What to say:

 

Simple rules of engagement:

 

1.  Agree that no one can help them until they help themselves. 

2. Agree to follow the course of action that your doctor sets for you.

Self-preservation for the caregiver:

 

1. The person will respond at times with anger, negativity and apathy(lack of emotion). It is important to accept that it is the depression that is "barking".

2. Misery loves company, so do not be sucked in.

 3. Talk to friends. They may not be able to solve your problems, but they can offer incredible wisdom and support.

 

For all:

 

I think the most important takeaway from the video is the last sentence: "The most important aspect in this journey is to constantly remind each other that it will pass, it will pass it will pass.” While I was writing this article, I chanced upon this quote by Stephen Aitchitson, and I think this is something that we can all apply to our lives: "it's in the darkest moments that we find our greatest strengths."