Measuring Depression: Physical Signs

One strategy used to measure depression is to look at the physical traits that are around the person.

*How organized is their home, bedroom, or office? Is it typically this way?

  Was it this way before they were depressed?

*Are they keeping up on their physical hygiene? Do they remember the last time they   showered or brushed their teeth?

*Is the vehicle they drive being regularly maintained?

 *How is their yard or balcony? Are indoor plants being cared for?

By looking at the physical surroundings, you can start to get an idea for the internal state of the person. If the person is recently depressed, you can compare recent behavior to past behavior. The cleanliness and completed tasks are a way to measure varying levels of depression; typically the more disorganized and undone things are, the deeper the depression may be.

For me personally, I know I am feeling the best when my yard is cared for, my children are clean, and my dishes are done. Some other things may be falling apart (I can't be perfect!) but these three areas are key peices of insight to my mental health.

I also find that the previous areas (yard, children, and dishes) are coping strategies for me. I enjoyed reading Ginger's blog today on how she used her coping skill of nature (inSERIOUSLYsane: The Healing Power of Nature).

Finding God in Trauma

One exercise I have been developing for helping abuse victims heal from trauma is developing a conversation with diety. I give the assignment for the client to write out what a conversation would look like. We then process how that conversation would feel. We then use this conversation as a way to anchor an alternative feeling to the abuse as a way to de-sensitize and help the client visualize another reality to the abuse.

This is an example one of my clients gave me permission to use:

I imagined that I had a conversation with the Father. He told me things would be hard down here. I nodded and said “I am Strong.” He told me that things would happen to me that I wouldn’t choose and that He wouldn’t choose for me, but that He wouldn’t intervene because of His plan. I told Him I trusted His plan and repeated, “I am Strong.” And “You can depend on me, Father.” He said the things I would see, He would be there for and He would send others. I told him I would watch for them and I would believe in Him. He said, “Others will want you to give up, they will teach you to hate me, that I am the source of your pain. You will want to believe them. The choice will be yours, but I believe in you. I believe you can live through it and heal through it.” I was confident and said, “I will be strong. You can trust me.” He said, “Others will cause you pain but I will place angels and sentinels to be by you.” I told him that I would watch for them. He told me that I would question His plan and His existence. I promised that I wouldn’t and He cried. He said, “Down there, earth there are people hurting my children. I see them and I hear their pleas. I need one, one to hold them, comfort them, and understand the abuse they’ve seen. You will hurt, but I will heal you. You will cry and I will send one to wipe your tears. You will heal, and then heal my other children. You will give them what I have given you."

I personally believe that healing from abuse happens in many stages and based on the client, spirituality can be one way to help the individual find peace.

Things NOT to Say

There are several things that are discouraging that you should not say to someone with depression or anxiety. I have put them in categories:

Spiritual: "Let God carry the burden."  "Read your Bible more." "Serve others and you will feel better."
You get the gist, any idea that by reading more, praying more, or serving other people will make the depression go away is just not true. People who are expriencing depression will be more frustrated with you for not understanding what they are feeling. Many cannot muster the energy to brush their teeth, let alone pray, read, or serve others. Some may have tried doing these things, only to find they didn't help and so they are frustrated with themself about why these things may have worked for someone else but not for them.

Cognitive-Behavioral: "Act Opposite to your Emotion." "Fake it until you make it."
Statements along this realm are frustrating to hear because they implicate that you have a choice over how you are feeling. While there is some choice involved in an emotion caused from an event like sadness over a death, clinical depression is not an emotion or a choice. A person cannot choose to feel something they didn't choose to feel in the first place.

Worst-Story: Please don't give examples of "someone you know who is worst and you are doing so much better than them because you brushed your teeth today." Or not good also, "You don't have anything to be depressed about, you have a beautiful family, nice house, etc." (Indicating that you have a choice.)

Well-Intentioned Advice:
These usually start out as, "My sister had this problem and she did xy or z" and ends with a sales pitch for a specific diet, vitamin, water purifier, or exercise equipment. In my mind, if there is something that is powerful and effective, it would be a million dollar money maker and not some obscure thing that a friend, heard from a friend. Likely, someone who is depressed will interpret this as your way to push your own agenda and make a buck off of someone who is vulnerable. You can tell your story, just don't expect a depressed person to jump at it as they have either tried it and it didn't work or are unmotivated to try it because they feel helpless.

If you shouldn't say things that are explained above, what can you say???

1-Run it through your head first. If you wouldn't replace it with something like "cancer" or "high cholesterol", don't say it. ("If you just act like you don't have CANCER than you'll feel better." or "If you serve others, you're HIGH CHOLESTEROL will disappear.")

2-After it passes #1, determine if it is something that would be genuinely helpful. Something like, "what can I do to help you?" is a start. It's likely they won't want to be a burden on you so be proactive and do something that you observe needs to be done.

3-Something like "I hate that you're experiencing this" is also a good idea. Empathy is helpful, as long as it doesn't come across as pity.  Pity is frustrating and demeaning.

4-You can ask questions, if you ask first and have permission! You could say, "I notice you seem down, do you mind if I ask questions to better understand what you're going through." Some good questions are, "Is everyday bad or just some days." "How do you know the difference between a bad day and a really bad day." "Has anything been helpful in the past?"

5-If it's none of your business, keep it that way!

6-If it is your business, evaluate in your mind how severe you think they are and if you think they are a risk to themself or others, ASK them. Many times they will tell you. If they don't tell you, and you still think they are a risk, intervene with the advice of a trusted professional.

If you have other ideas about helpful things to say, or not to say, feel free to leave a comment!

Burn-Out

I just love reading Stephanie's blog from Keeper of the Home. This week she did an amazing article that really sounded familiar. She wrote: My Journey to Burnout: Proof that I can't do it all and I was too emotional to even cry.

My burnout was a little different. My priorities a little different. My feelings, very similar. I make time for things I find important, but not people I find important. I find I emotionally drained by the end of the day.

She listed things she is doing to recover from burnout and to avoid burnout again.

I look at what she is able to cut-out and I think, wow, it would be nice to have the finances to cut out one of our businesses/jobs and try to use that as an excuse to not make any changes. I recognize that I am overwhelmed and exhausted but I am resistant to change.

If you read Stephanie's article and relate, what are you willing to change?

If you are resistant to change (like me) what does that change mean?

If I do less, am I worth less?

Over-coming Depression: Step One

Okay, so probably not step one for most people, but a good place to start is to Consider life without depression.

Be specific. Make a list. Some journal or assignment prompts:

*What would I do if I felt better?

For me, I have a huge long list of things that pile up I would definately hit that hard if I had the energy, drive, or just plain felt better.

*How would I look if I felt better?

I have never been a fan of make-up, so that wouldn't be on my list. I would definately shower, fix my hair, and change clothes. I would wear contacts.

*Some days are worst than others. How do I know it's a good day?

For me I know I feel better on days I shower. When I make lunch for my kids (instead of letting them eat Oreo's for lunch!).  When I wash the dishes.

*How would my spouse, child, co-workers respond if I did things differently?

For some, this is a BIG question. Sometimes depression becomes a part of your identity, especially if you've had it for a significant amount of time. How do you let go of that identity?

These are some ideas on things to explore with yourself (journaling, blogging), a spouse or close friend, or if they are harder to answer maybe with a trained therapist or physician.

Imagining a life without depression can be one way to give yourself hope that you will feel better someday. Knowing what a good day means to you is one strategy for starting to recognize when you do feel good and to fully take advantage of that day or moment the fog lifts.

Neurofeedback: The Day After

I just wanted to jot down my thoughts about neurofeedback.

We have been treating my depression with neurofeedback since March of 2009. I'm lucky that my husband is my practitioner and that we can do various protocals and try to work on different areas of my brain. This has been a very long process for me, and could be very expensive if it weren't for the generosity of the Utah Youth Village who allow us to keep the equipment at our home.

I have been having a very rough go of post partum depression. I was expecting to get bad, it did after my first child and as I've been weaning our 7 month old I've been feeling it again.

Sunday, Jeff did a new protocal that worked very well. I didn't notice any changes that same day. However, Monday, the next day, I felt more clear. I felt more in control. That night, I was more observant and couldn't believe how I have let my eye brows get so out of shape.

Tuesday I got up earlier than I usually do. I also got up on my own, without the baby crying or Elijah begging me to get out of bed. That was the biggest relief. We spent the day delivering Sub for Santa for the children we work with. I felt great!

I still have an appointment next week to check into a possible underlying health concern or thyroid issues. I am starting to see a little sign of light through the clouds though and am so grateful for a husband that supports me through these times. I feel really blessed tonight.

Depression

Most of my friends (and now strangers, too) will know that I have varying degrees of depression. I don't know why that feels embarassing to say. Maybe not embarassing. Maybe fearful. I'm not sure. I've had it for years and am about 80/20 these days (good/bad). This is huge progress for me, as it's been worst at times.

Some things I do that seem to help:

1-Tanning bed, some reason the extra warmth can do wonders. Sometimes, I just sit in the room with it on and don't even get in!

2-Making sure I shower everyday and do my hair. If I don't do that, I'd probably stay in pjs all day and worsten my depression.

3-Affirmations. Sometimes they are simple, "I am fine." sometimes, they are more complex but I repeat it when I am feeling overwhelmed.

4-Boundaries. I mostly have no problem saying no. I have no problem that my sidewalks aren't shoveled, my house isn't clean, and my work is behind.

5-Support System. I think what makes the difference from today, vs ten years ago is that I have a husband that is present and aware of my emotions when they change and can alert me to the change. He is non-judgemental which is crucial.

6-Cymbalta. Neurofeedback. Gluten-free. Who knows. These are three other things in my life. I don't know if they are making a difference or which one is making the most difference.

I feel that most people, at some time, suffer varying degrees of depression. My hope is that someday it wont be taboo to discuss depression and that we can sometime openly discuss even more taboo things like suicide and suicide ideation. We'll get there, as a society, but not today.