Depression is the number one mental health problem for the Western world, its rate of diagnosis is continually rising, and its growth in children is frightening. Half of all depressed people do not ask for help, as they feel they are beyond help. According to the British Medical Journal more than half of those who do ask for help leave their doctor without being diagnosed.
Of course, depression is not something that you can just ‘snap out of’ but it is helpful to think of it as an illness, as real and debilitating as a broken leg.
The good news is that massive research of over 100,000 separate studies has now shown us very clearly the causes of depression, how to treat it and how to prevent its recurrence.
Drug companies are spending over £3 billion worldwide just to persuade us through advertising that depression should be treated with drugs, yet the rates of depression still increase. How could that possibly be? We have been told for decades that depression is caused by a chemical imbalance in the brain, yet there is scant evidence to support that claim. Chemical imbalance may be there, but it is a symptom, not the causation. Nearly 15% of the western world is taking antidepressants, yet the situation just gets worse. Of course, those pills may have a significant effect, much of which may be placebo, but the withdrawal from them can be a difficult and tortuous process. If you are already taking antidepressants it is absolutely vital that you continue with the course of medication prescribed by your doctor, but do explore ways of getting your needs met in healthy and sustainable ways, putting your emotional health on a firm foundation, and leaving you much less likely to ever suffer from depression.
We ow know that depression results from a REM sleep disorder, that part of your sleep in which most of your dreaming is done. Many depressed people report the two hallmarks of depression - waking exhausted, completely unable to get out of bed, as well as losing interest in activities that used to offer pleasure. They then do the worst possible thing – they stay in bed, lapse into further REM sleep and make the symptoms even worse. It’s hardly surprising that suicide rates have increased so alarmingly.
That REM sleep is the time in the night when our dreams allow us to get rid of the previous day’s emotional arousal, using our dreams as metaphors in which we experience emotional reactions. That completes the cycle of getting aroused and de-aroused, this leaving us ready to face another day. However, in some people, it is clear that heightened emotional reactions, and disproportionate arousal can lead to a busy and exhausting night, dogged by too many intense dreams.
A Major Depressive Episode is indicated by five or more of the following symptoms for a period of two weeks or more:
Loss of pleasure or interest in usual activities,
Disturbance of sleep,
Disturbance of appetite,
Loss of motivational energy,
Feelings of worthlessness and guilt,
Difficulty in thinking and making decisions,
Thoughts of death or even suicide.
Of course, there are often other symptoms which may be present at the same time – chronic pain, particularly lower back pain, and anxiety disorders.
It is also important to understand that depression is not necessarily caused by outside events in our lives. There are many thousands of people who have lost loved ones, suffered terrible trauma themselves and managed to quickly regain their enthusiasm for life and to avoid depression. It is clear that there is some biological component to depression, but one of the main causes of depression is the way we have learned to respond to the challenges that life throws our way. It is vital that we each develop the skill of reducing the intensity of our emotional reaction when things don’t work the way we hoped.
We must also recognise that many of the old ways of dealing with emotional illness are not helpful at all, and may, in fact, be quite damaging. Getting in touch with your feelings and ruminating over past traumas and upsets is the last thing that is needed. Hollywood’s archetypal therapist who provides weekly opportunities to discuss what a terrible week it’s been, sometimes with groups of other depressed people, are now being successfully sued for offering seriously damaging treatments.
Successful therapy must teach people a way of relating to the world, to step away from their current view of their existence and to be released from the negative trance into which they have fallen. It must also help people develop and hone their own calming-down skills - being able to self-sooth. There is great hope for depressed people from the more modern interventions which are now available, and this includes bipolar disorder and postnatal depression. By normalising sleep and dreams we can quickly and effectively bring an improved mood and great hope. We then work to quickly break the negative introspection and rumination, and we focus on solving problems and engaging in real life again, developing greater coping mechanisms, learning new and improved social skills, joining in the community, feeling stretched and finding ways to achieve.
There is growing list of textbook cases where people who have been depressed for many years, with symptomatic treatment leaving them feeling continually worse. However, modern interventions with Brief Solution-Focused Therapies, Human Givens Therapy and other focused approaches, now offer a relatively fast yet powerful way to bring hope and relief from depression.