Thursday, October 3, 2013

October is Depression Awareness Month

Feeling the bite of the black dog?

It's probably no coincidence that October is national Depression Awareness Month.  The days of decreasing light are paralleled with increases of calls to my office of people seeking support for anxiety and depression.

Depression is a life-threatening disruption that takes on a life of its own.  This graphic shows some of the connections.  It's not perfect, but shows some of the self-feeding flow of stress (psychological or physiological).  Wish I could cite the source.  It's been reprinted a lot and the few citations I find lead to dead ends.  

I've been in practice a long time.  In a town with a population of 50,000 and over 40 therapists, you'd think I'd run out of clients.  But I get 5-10 requests a week even with a phone recording saying my practice is full.  Most of my colleagues also are full.  And every year,  demand seems to increase.
What's up? 

I have a few ideas.  I have lots to say on each of them, but we'll start with the bullet points, and I'll talk in more detail in future posts.

1)  Complexity of life has increased geometrically, and with it, stress.
 a)  Work patterns have changed.  We work more, have fewer vacations, and work leaks into domestic life in ways unprecedented in history.
 b)  We are interrupted more:  by auditory and visual stimulation, by devices and demands.  There are constant challenges to our attention and rest.
 c)  Increased information leads to anxiety
      1)  We are fed ceaseless bad news about isolated events to the point we feel in constant threat.
      2)  We are exposed to countless choices that drown out intuition and lead us to second-guess if we
            are good enough or have made the ultimate best decision.

2)  Eating, sleeping and light exposure patterns of humans have changed dramatically.  Each of these affects our circadian and hormonal rhythms in ways our evolution has yet to accommodate.
  a)   24 hour food availability changes long-term human patterns of seeing food as sustenance into              sources of comfort or entertainment, leading to obesity and hormonal challenges.
  b)   Availability of cheap, heavily marketed and nutritionally thin foods appeals to instant
        dopamine rewards; robs us of vitamins and minerals that protect our physical and mental health.
  c)  Constant artificial light, night shifts, 24 hour stores, etc profoundly disrupt sleep cycles.

3)  Social connection and support are decreased.
   a)  Communities have lost their centers.  People go out less, and when they do, they engage less with each other and more with their devices.  Natural support communities such as   churches are weaker (see 1-- no one has time).
    b)  This generation reports having fewer friends and spending less face-time with those they have.
    c)  Multi-generational family connections are less valued.  More people live away from where they were born, and they move more often and more widely than in previous generations. 

In a nutshell:  lots of us are stressed out, overstimulated and overworked, underconnected, and not sleeping, exercising or relaxing as much as our body needs to come even close to the demands of modern day life.  We are anorexic not of food, entertainment or choice, but we are vastly underfed of love, support, rest and community.

It's no wonder we get depressed and anxious.

You know who fares well in times like these?  Sociopaths.  Through a quirk in their genetic evolution, they lack empathy and don't rise high on many other emotional scales either.  They don't get angsty about much that doesn't effect their personal and immediate bottom line.  We're getting good case presentations on this genotype with the current Middle School Machinations of the country's political parties.  They don't seem to be losing a lot of sleep over the jobs that folded overnight because they are in a pissing war with the president. 

But those of us who through religious or humanitarian ethos feel it is our job to be kind, to be just, to help those who cannot help themselves, to protect the earth for future generations, who put people before profit... we're feeling the pain big time.  As William Blake said:  "Can I see another's woe, and not be in sorrow too?"  Yes, apparently some can.  Watch out for them.  They are dangerous.

The more oyxtocin-dipped among us tend to be in sorrow.  Throw some complex stress, lousy sleep and poor support, and sorrow morphs into full-fledged depression.  The predisposition may have always been there, but the cultural nudges are throwing it right off the cliff.

There are interventions for depression.   Like cancer, it's a serious disease and the treatments aren't comfortable or easy, whether we're talking about talk therapy, CBT, mindfulness training or medicine.
Flawed as the approaches are, they beat the disease.  I'll be listing resources in each post.  Some you can do easily on your own.  Some that seem easy, aren't at all if you are really gone into the cycle.  Then it helps to have a coach, counselor, best friend, doctor, religious leader--somebody you trust-- hold you up when your backbone's slipping. 

But:  Don't give in.  Fight the cycle.  Choose one of the three areas mentioned and come up with a plan to intervene.  Improve your sleep, reach out for support or connection, simplify your obligations and reduce as much complexity as you can.  More details to follow.

For catch up reading, here's a few past blogs about depression.  Feel free to comment or to email me with questions.  We'll be talking more soon.
Jana


http://www.janasvoboda.org/2011/02/delving-into-blues.html

http://www.janasvoboda.org/2011/03/fading-blue-gene-cognitive-behavioral.html

http://www.janasvoboda.org/2012/04/rip-mike-wallace-newsman-and-depression.html

http://www.janasvoboda.org/2011/03/fading-blues-ii-understanding-and.html

http://www.janasvoboda.org/2012/04/marked-for-depression-maybe-implant.html

http://www.janasvoboda.org/2011/03/more-bytes-on-black-dog.html

1 comment:

  1. Hi Jana! I've found some good things that help with the seasonal blues: Dancing; Playing fiddle or psaltery; Going to venues with live music; Fellowship at a café with buddies; hiking in the woods; and being with my dog. :0) Plus, the more good times you have, the more resilience you build up. And it helps a ton to appeal to all five senses, to get something in your house that pleases each one of your senses. When I travel, I bring along some cinnamon for the comforting scent, like the smelling salts of olden times. THANK YOU FOR YOUR BEAUTIFUL BLOG!

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