Psychotherapy for depression

Depression can’t be treated without psychotherapy. The patients aspire themselves to this form of medical and psychological help. For a long time they hesitate to take medications, and starting with antidepressants they quite often stop pharmacotherapy. By virtue of helplessness and constant doubts, patients are usually suggestible. While reading annotations to one or another remedy, they easily find by themselves some side effects already in first days of the treatment. Besides, the patients suffering from depression have functional disturbances of internals, and thereby, they are really sensitive to side effects of this medication.

Many patients experience false alarm regarding constant dependence on antidepressants. Considerable part of patients, suffering from depression, belong to placebo-reactor, i.e. people who are easily susceptible even for pills, which do not contain some active pharmaceutical substances. All just-listed determine heighten interest of such patients in psychotherapy.

The telling argument, testifying the role of psychotherapy in depression treatment, are those experimental data, which show the importance of psychological factors in the formation of therapeutic resistance to medical products. The effective course of psychotherapy in the long term is possibly more useful than pharmacotherapy, because it teaches the patient. The last one acquires the skills to overcome the depression, learns to recognize its approximation and prevents its recurrence. According to the results of many studies, the normalization of endocrine indicators in the therapy of depression is achieved not only in the process of treatment with antidepressants, but also in psychotherapy. The influence of the psychotherapy on endocrine indicators are observed both in the case of its combination with pharmacological therapy, and in the case of using it as the only method of treatment.

In a number of cases, psychotherapy allows patients to adjust to reality with the continuing violations of affection, thinking and attitudes. With an independent therapeutic effect, psychotherapy promotes the optimal collaboration of the patient and physician, raises the efficiency of medical treatment, and improves family relationships and professional status of the patient.

Frequent start of depression after acute trauma or prolonged stress leads to a persistent search of psychological reasons of its occurrence. This situation increases the desire of patients to psychological care. However, excessive revaluation of its capacity, unfortunately, can lead to a complete denial of psychotropic substances, formation of resistant and prolonged depression variants, cause her early exacerbations.

In respect to a doctor, the psychotherapy of depression first of all should be aimed at elimination of its symptoms. Some of them are more sensitive to psychotherapy, and other are relatively difficult to its impact. It is generally believed that by severe depressions psychotherapy’s possibilities are more limited than in cases of slight disease.

As psychotherapeutic targets are chosen mood disorders, paralogia, behavioral disorders, motivation and physiological symptoms. Among affective symptoms – are sadness, sense of guilt and shame and especially anxiety.

There are a number of general principles of operation which have a psychotherapist with a patient suffering from depression. Here the doctor’s control over his own feelings regarding to patient is very important, because of the possible sense of futility, anger, excessive fatigue and sympathy. Psychotherapist not only sympathizes with the patient, but he also carefully observes him, keeping some distance. During the therapy doctor should strictly regulates communicating time with patient and maintains the structure of the momentum to recovery. Active statements of the purposeful questions, confidence in the diagnosis, the real hope are basic rules of depression treatment. The studies have shown that hope, which was received from a doctor, is retrospective by patients and taken as an important help in overcoming a depression.

The peculiarity of work with a patient depression is not so much empathy, as understanding the condition, and in particular, the possibility of change of mood. Often patient aspire to «petrify» the psychotherapist by means of his endless waiting for assistance, and the latter makes an error, starting with theoretical explanations and searches of psychological reasons of depression. In fact, the psychotherapist must ensure that the patient drew attention to himself and seek adequate perception of his situation. A particularly undesirable conversation with the patient is about the symptoms of his condition. More important is to emphasize the dependence of the expression of different situations, to talk about the features and relationships with other people. Psychotherapist’s compassion is usually increases by patient the waiting for assistance, an attempt to ease the symptoms lead to its strengthening, consolation – to inconsolable. It is important to bring the patient to the need for self-help, but not comfort him, show him the importance to understand himself as he is.

For depression treatment it were proposed different methods of psychotherapy:

  • Psychoanalysis
  • Person-centered psychotherapy
  • Existential therapy
  • Interpersonal therapy
  • Cognitive therapy
  • Reminiscence therapy
  • Projection variations with time
  • Relaxation training
  • The therapy of social problems and other methods of psychotherapy.
  • Including its mixed and eclectic variants.

According to the most researches the most effective method by depression treatment is cognitive therapy, focusing on correct mindset characteristics of patients suffering from depression.

Depression Treatments

Depression is a mental disorder that affects a person’s moods. It affects millions of people around the world. People with depression may feel sad, angry, irritable, tired, confused, guilty, hopeless or worthless. When a person is diagnosed with depression, it’s bad news for himself and his family. It’s painful for the person and can also be difficult for the person’s family. Depression if left untreated could get worse. It will affect a person’s ability to function in daily life and work. Worst still, depression even may lead a person to suicide.

A serious disease depression may be, it is treatable. Proper treatment can help people with depression get back to normal daily activities.

Main treatments for depression are antidepressants and psychotherapy. Antidepressants are medicines that help to relieve depression so that a person suffering from depression can function more normally. There are mainly four types of antidepressants:

1. Selective Serotonin Reuptake Inhibitors (SSRIs) – Celexa (citalopram), Lexapro (escitalopram oxalate), Luvox (fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine), Zoloft (sertraline). These antidepressants help the brain absorb the chemical serotonin.

2. Tricyclics antidepressants (TCAs) – Adapin (doxepin), Anafranil,(clomipramine), Elavil (amitriptyline), Endep (amitriptyline), Ludiomil (maprotiline), Norpramin (desipramine), Pamelor (nortryptyline), Pertofrane (desipramine), Sinequan (doxepin), Surmontil (trimipramine), Tofranil (imipramine), Vivactil (protriptyline)

3. Monoamine Oxidase Inhibitors (MAOIs) – Nardil (phenelzine), Parnate (tranylcypromine)

4. Serotonin/norepinephrine reuptake inhibitors (SNRIs) – venlafaxine (tradenames Effexor XR®, Efexor®), nefazodone (tradename Serzone®), milnacipran (tradename Dalcipran®/ Portugal; Ixel®/ France), desipramine (tradenames Norpramine®, Pertofraneis®), duloxetine (tradename Cymbalta®)

In the market, there are also antidepressants that don’t fall in the above categories available such as buproprion (Wellbutrin), nefazodone (Serzone), trazodone (Desyrel), venlafaxine (Effexor), and mirtazapine (Remeron).

Certain antidepressants cause side effects. In most cases, side effect disappears once a person’s body has adjusted to the medicines. Sometimes people on antidepressants may feel worse before feeling better. It takes time for depression medication to work correctly.

Besides taking medications, psychotherapy or talk therapy can be also of help to depressed individuals. It includes short-term therapy sessions, usually from ten to twenty weeks. Positive results for the depression patients will generally be showing up after one or more sessions of psychotherapy. This type of depression treatment actually helps the individuals by slowly making them open up about their feelings, the root of their problems, most important of all, the root of their depression. Healthy verbal exchanges between the cognitive behavior therapist and the depression patient is great depression treatment that’ll positively affect the depression patients by helping them discuss and talk about whatever they’ve been keeping inside.

Even though either medication or psychotherapy works independently all by itself, many experts feel combination of both medication and psychotherapy can work more effectively to help depressed individuals overcome depression and become mentally healthy.

Ten Appalling Truths About Celiac Depression

If you are a celiac (a person having celiac disease) then you will get a depression as a consequence of celiac disease sooner or later. A research study shows prevalence of celiac disease in one out of every 133 persons in US. So even if you are not aware of its occurrence, you may be continuously noticing peculiar symptoms. They all start from diarrhea and then go on to abdominal pain, chronic fatigue, abnormal skin sensations and finally headaches and depression attacks. In fact celiac is the disease of body and mind. As the disease catches you unaware most of the times, its important to understand the realities about celiac depression.

1. If you have English, Irish, Scotch or Scandinavian origin, if you have a ‘family history’ of celiac disease, if you get frequent diarrhea or constipation, and most important, if you experience constant fatigue and discomfort, affecting your performance in job and also in social engagements, then you are most likely the patient of celiac disease and consequent depression.

2. Celiac disease causes persistent low energy and depleted health condition in one-in-ten people. And this is caused by damage to your brain and nerves.

3. The mal-absorption of nutrients is also an important factor contributing to depression. Researchers are successful in establishing a possible link between depression and mal-absorption. A large number of food factors are involved in monoamine synthesis. Depression disorders as well as anxiety found in celiacs (people with celiac disease) could be consequent to a reduced production of monoamines.

4. The important factor about celiac depression is accepting your realities. Generally people are reluctant to accept that they are depressed and this makes things very difficult to manage. You cannot correct a problem which you are not prepared to even accept. Only after acceptance, you are geared to get back the control of your life.

5. Different people are bound to experience depression in different methods. A 25 year old depressed man may not experience similar symptoms as a 70 year old man. For some, the symptoms are so severe that it’s seems obvious that something isn’t right. For others, they may feel miserable or sad without knowing why.

6. Women tend to underestimate celiac depression. Many surveys suggest that women have a very different perception about it. They generally tend to underestimate the severity. They often think that the depression symptoms will spontaneously go away.

7. Depressed men are usually less likely than women to admit feelings of hopelessness and self-loathing. Frequently, depression is expressed in men in many “socially acceptable” forms like anger. Violence, aggression, reckless behavior abuse, may be signs of an implicit depression.

8. Children with Celiac Disease are more vulnerable to depression. Not being able to eat with their friends would certainly make things worse. Symptoms include crying, continuous feelings of sadness, increased sensitivity to rejection and repeated emotional outbursts, shouting or complaining.

9. The most important single treatment for celiacs is to follow a gluten-free diet. This means to avoid ALL foods containing gluten – avoiding all foods which contain wheat, barley, rye and oats. Gluten can ‘hide’ in many foods which are processed (such as modified food starch). Even soy sauce is manufactured with “wheat”. All of this is to be avoided.

10. However, gluten-free diet cannot be considered as the only fix for depression all the times. Celiacs generally feel that their quality of life is lowered due to restrictions on them. They are also afraid about the effects celiac disease may carry on their life. These apprehensions and anxieties lead to severe depression, which needs to be treated with appropriate treatment.

A few treatment options are available for treatment of celiac depression. Understanding by both the care-giver and the celiac patient of the peculiar aspects of celiac disease is very helpful for employing the correct treatment options.

Note: This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Please consult with your physician on any matters regarding your health.

Recovery From Depression – A Case Study

People who suffer from depression need access to good quality information and resources in order for them to make a recovery and get on with living. Good information and resources enables the depressed person to make informed choices, to access the right help, to embark on the journey of recovery. The right help comes in many different forms from the psychiatrist to the anti depressant to self help techniques. All of the above are essential when making a recovery from depression.

Some of the worst symptoms of depression are the hopelessness, the darkness and the loneliness. You want a better life but you are an expert at being depressed and don’t know how to get better, don’t know how to change the circumstances you find yourself in. For this reason, I find it so relevant to use a case study of one person who against all odds made a recovery and got on with the business of living. And this person is at this moment busy striving to live their best life imaginable. That is a far cry from the life of depression which consumed this person for many years. In sharing this person’s experience I desperately want to convey to you that there is a better life to be lived and a glimmer of hope can be the beginning of change. Hope can be the seed from which recovery grows and flowers and brings beautiful colour to your garden.

A childhood trauma is at the root of many peoples’ depression and this person was no different. He was completely convinced that his childhood trauma was the reason why he was so unhappy. Many years later the root of the depression is not all that important to him. He realizes now that his personality and temperament may have contributed to how he dealt with his problems. This man grew up in a loving home but always in the back of his mind he felt unhappy. He cried a lot on his own. As a teenager he continued to be unhappy. In the midst of his unhappiness the one thing that kept him going was he felt he was destined for greatness. He often visualized a better life, a great life even!

As the man entered his twenties his problems started to show on the outside. He had no sense of responsibility, couldn’t hold down a job, couldn’t follow through on most things. He developed two different addictions and was absolutely consumed by a sense of hopelessness and depression. The next ten years were full of destruction, heartbreak, darkness, hospital admissions and basically a depression of the worst description possible. And yet during these dark years this man often visualized a better life, a great one. Sometimes visualizing the great life and not achieving it made him feel even more hopeless.

Eventually two things probably happened. The first was the man was ready to get better. He realized that he truly wanted a better life not the mere existence he was living. Secondly, he realized he needed someone to help him make a recovery. He also knew it was going to be very difficult to change the habits of years. Up to this on the face of it he was receiving plenty of help and support in the form of a great doctor, hospital admissions, medication, counselling and family support. In many ways he had more support than most. All of the help up to that point hadn’t enabled him make a full recovery.

Once he set about truly wanting a better life, the life he often visualized over the years, remarkable things started to happen. There is an old saying “when the pupil is ready the teacher will appear”. This man believes this saying is at the root of his recovery. He would be the first to tell you his recovery often seemed impossible. However, he overcame his addictions and gave up smoking too. The pain of recovery at times was almost unbearable, however, looking back he doesn’t remember how difficult it was. He does know how great it feels to be living his best life imaginable.

He believes that there is a great life after depression because he is living it. He also believes all of his barbaric suffering at the hands of depression has shaped him into the man he is today. He tells me he is so proud of his achievement. He says he only ever wanted to be in a place where most people are without trying, for example, holding down a job. But anyone who is or who has suffered from depression knows that his achievement is something to be very proud of. Today this man is actively embarking on the journey of life. He knows recovery is not a destination to be reached. Recovery is living your life and being happy.

One thing bothered this man during his years of depression. He was overwhelmed by how people judged him as a result of his depression. He felt this somehow delayed his recovery. It took great courage on his part to overcome the stigma attached to his depression. It goes without saying that mental illness is very difficult to understand particularly if you have no personal experience of it. It can present itself in so many guises and affects each person differently (although there are many similarities in peoples’ experiences).

This man wonders, as I do, whether it would be easier for people who suffer with depression to make an attempt at a recovery if mental illness was viewed in society the same way as all other illnesses. He also wonders would more people come forward looking for help if there was no stigma (perceived or actual) attached to mental health problems. This is certainly food for thought. Wouldn’t it be truly magnificent if people were not afraid to reach out and ask for help for their problems. No more suffering in silence!

Remember, people can and do make recoveries from depression and go on to lead their best lives imaginable. Seek help.

Welcome to my world. I grew up and live in a small rural town on the east coast. I am passionate and dedicated to providing resources to help others help themselves. I am embarking on a journey to tell the world that one in five of us, including myself, will suffer from depression at some point in our lives. I want to change peoples’ attitudes towards depression and mental illness. My wish is that people who are suffering from depression will access the right help to enable them to recover and go on to lead the best life imaginable for them. I was fortunate to get the help I needed to live my best life imaginable. Come and join me on this great journey! We can truly make this world a better one to live in!

My Top 10 Tips For Recovering From Depression and Anxiety

I suffered from depression badly for years, years of being stuck in a never ending nightmare. I was in psychiatric hospital three times between the ages of 23-29 for prolonged stays, and little did I think back then that I would make a recovery to the level that I have today.

These days I am in good form much more often than I am down. I also think that the quality of my happiness is very good when I am happy, which is most of the time. My depression symptoms are practically non-existent now, I am happy today and am very optimistic about the future, despite all of the gloom and doom in the media.

The following top 10 tips for recovering from depression are not theory – they have been hammered out on the anvil of experience, for me, who has been a chronic sufferer of severe depression and anxiety.

Will they work for you? I do not know, but my guess is “yes”.

Some people reading this may think “what an order, I can’t do this!”, well all that I will say is that if you WANT to recover, and you really have to WANT it, you need to become an opposite, you need to slowly change the way that you live and also very importantly the way that you relate to yourself.

1. If you drink too much or use drugs and it is making you depressed or anxious (or covering up your depression) and cannot stop then go to Alcoholics Anonymous, or Narcotics Anonymous, and most importantly, don’t judge it on the first few meetings. This is a vitally important piece of advice. This fellowship is an amazing gift that has been given to me. Make lots of friends there. Over time watch your anxiety and depression evaporate into thin air.

2. Use Udo’s Choice vegetable oils (as directed) or a quality Fish Oil supplement (2 grams a day) – this will help to repair your brain, and help to heal your body in all aspects.

3. Consider becoming a vegetarian or vegan – Eat lots of grains, legumes, pulses, nuts, fruit and vegetables. Eating meat and dairy products is very bad for you. A vegetarian or vegan diet will help you recover much more than you think. You’ll also be slimmer, feel more energetic and will be much less at risk of heart disease, cancer and stroke.

4. Drink LOTS of mineral water. You cannot heal or live healthily without consuming lots of pure water.

5. Exercise – Take a walk regularly, in the countryside if you can. This will lift your spirits immensely.

6. Quit caffeine – that means coffee and tea and cola drinks if you drink them – caffeine has a very pronounced effect on all anxiety and depressive illnesses, there are too many negative effects to list here. Research it for yourself – just Google “caffeine negative effects” and you’ll see what I mean.

7. Do this one thing and it will MASSIVELY aid your recovery – I cannot stress this enough – Look into the mirror once per day, look into your own eyes, and repeat three times “I love and respect you ___________ exactly as you are” (replace ___________ with your own first name). Most people will see a positive result within a day or two, and over the longer term, this will have a HUGE impact on your self-esteem, confidence and your overall mood.

8. If you are into reading, which I am, then instead of reading “how to get better from depression” books, read Osho and Eckhart Tolle instead. Their teachings are very powerful. And they have loads of audio programs also.

9. See your doctor regularly – those who do have a much better chance of a full recovery.

10. Get an Alpha Stim SCS – this will “wake up” your brain from its foggy slumber. It will re-balance your brain chemistry. Use it lots at the start (the first few weeks) and thereafter every day or every second day.

Dealing With Depression – 5 Stages For Recovering From Post Psychotic Depression

People tend to think that the recovery from post psychotic depression that usually comes as a result of some kind of psychosis should be long and tiring. This case shouldn’t be the usual case. If people strict to go through the next 5 stages of recovery, they can assure themselves an easier and shorter way recovery from a post psychotic depression:

1) Getting out of bed

One of the most common characteristic of people who suffer from post psychotic depression is the unwillingness to get out of bed. If you really want to recover from that depression, you should force yourself to do so even though it seems like an impossible task.

2) Doing the opposite

When you suffer from depression, your body and mind tend to channel your actions into minimum waste of energy as if you don’t want to do deeds that are not necessary for your survival. In order to fight back you should not tempt to accept these thoughts and force yourself to take actions and not to give-up.

3) Being occupied

In order to not thinking about your depression all day long, you should find a steady occupation that will help you with it. This kind of occupation will also give you the reason to get up in the morning and to begin your daily routine. Any occupation is fine; it can be a job, a class, a club meeting, and a course etc.

4) Making company

It has been said that being alone is not good for the human being. In order to fight back your depression, you should search for company. It can be a boy or a girl friend, a mate, people who suffer like you, colleagues, and family relatives etc. If you won’t be alone most of the time, then you will have many other matters to focus on instead of only in your disorder.

5) Getting treatment

In order to get well, it is a good advice to get a proper treatment in order to defeat your post psychotic depression. That treatment should be a combination between getting medicine and a natural treatment such as therapy, exercise, diet, tending a support group etc.

Depression Recovery Differences Between Men And Women

Depression affects far less men than females yet it is nonetheless a figure of six percent on a global scale. Although the medications and treatment offered to women dealing with depression is like that offered to men, the symptoms are different. So male depression recovery has to be approached differently.

According to the majority of physicians and therapists, men react differently compared to females in terms of dealing with depression. Men are more inclined to anger, bad temper and violence. It is more usual for males to lose their self-control whereas women experience greater levels of feelings of insignificance and hopelessness.

Nonetheless, many of the signs are common to both men and women. Some of the most common signs and symptoms include:

— feelings of sorrow

— feelings of worthlessness for no evident reason

— sudden weight loss

— appetite changes

— putting on weight

— eating too much

— not being able to sleep

— feeling irritated

— decreased energy levels

— frequently feeling drained and sleepy

— often feeling guilty for no apparent reason

— unexplained aches and pains

— lack of ability to focus on things

Males who are depressed tend to cover their feelings and control their emotions to hidden. While females find it easier to verbalize their grief and are more likely to shed tears. They are as well more likely to increase their amount of hours asleep and sometimes eat too much although men more frequently still go to work, visit the gym and continue their every day engagements.

Males also tend to keep their thoughts to themselves rather than tell their family and friends how they are feeling. When this happens, they habitually detach themselves from their normal social life which tends to make matters worse and is one of the numerous reasons why depression amongst males can be difficult to discover.

Even though there are numerous treatments and medications readily accessible to help men with recovering from depression, it is frequently rather challenging to encourage them to ask for such remedies or even simply to see a physician. This is when their condition gets worst.

If you know someone who’s going through depression try to talk them around to see a professional so they can get the appropriate medication for them.

Make sure you give them extra care and support. If you spot that they are experiencing frustration and other signs and symptoms associated with depression in men, try to reach out to them and lend a helping hand. You could give them some books or extra materials to help them understand their condition better. These resources may even convince them to search for professional assistance.

Remember that this condition is easier to handle at an early phase plus the fact that the sooner they can be supported the sooner their recovery from depression can be started.

Hope for the Hopeless – Depression and Eating Disorders

Approximately 80% of all severe cases involving anorexia or bulimia have a coexisting major depression diagnosis. Depression is a very painful and all consuming disorder in and of itself. However, in combination with an eating disorder, depression is beyond devastating and is often masked within the eating disorder itself. Depression in eating disorder clients looks different than it does in clients who have mood disorder alone. One way to describe how depression looks in someone who is suffering with an eating disorder is: hidden misery. For eating disorder clients, depression takes on a heightened quality of hopelessness and self-hatred, and becomes an expression of their identity, not a list of unpleasant symptoms. The depression becomes intertwined with the manifestations of the eating disorder, and because of this interwoven quality, the depressive symptoms are often not clearly distinguishable from the eating disorder. One purpose of this article is to highlight some of the distinctions and differences in how depression manifests itself in someone suffering with anorexia or bulimia. Another purpose is to provide suggestions that will begin to foster hope for these hopeless clients within the therapy setting.

When dealing with eating disorder cases, it is important to understand that if major depression is present, it is most likely present at two levels. First, it will be evident in a history of chronic, low level, dysthymic depression, and secondly, there will be symptoms consistent with one or more prolonged episodes of acute major depressive disorder. The intensity and acuteness of the depression is not always immediately recognizable in how the client is manifesting their eating disorder. Clinical history taking will reveal chronic discouragement, feelings of inadequacy, low self-esteem, appetite disturbance, sleep disturbance, low energy, fatigue, concentration troubles, difficulty making decisions, and a general feeling of unhappiness and vague hopelessness. Since most eating disorder clients do not seek treatment for many years, it is not uncommon for this kind of chronic dysthymic depression to have been in their lives anywhere from two to eight years. Clinical history will also reveal that as the eating disorder escalated or became more severe in its intensity, there is a concurrent history of intense symptoms of major depression. Oftentimes, recurrent episodes of major depression are seen in those with longstanding eating disorders. In simple words, eating disorder clients have been discouraged for a long time, they have not felt good about themselves for a long time, they have felt hopeless for a long time, and they have felt acute periods of depression in which life became much worse and more difficult for them.

Unique Characteristics

One of the most unique characteristics of depression in someone who is suffering with an eating disorder is an intense and high level of self-hatred and self-contempt. This may be because those who have these major depressive episodes in conjunction with an eating disorder have a much more personally negative and identity-based meaning attached to the depressive symptoms. The depressive symptoms say something about who the person is at a core level as a human being. They are much more than simply descriptive of what the individual is experiencing or suffering from at that time in their life. For many women with eating disorders, the depression is broad evidence of their unacceptability and shame, and a daily proof of the deep level of “flawed-ness” that they believe about themselves. The intensity of the depression is magnified or amplified by this extreme perceptual twist of the cognitive distortion of personalization and all-or-nothing thinking. A second symptom of major depression shown to be different in those who suffer with severe eating disorders is that their sense of hopelessness and despair goes way beyond “depressed mood most of the day, nearly every day.” The sense of hopelessness is often an expression of how void and empty they feel about who they are, about their lives, and about their futures. Up until the eating disorder has been stabilized, all of that hopelessness has been converted into an addictive attempt to feel in control or to avoid pain through the obsessive acting out of the anorexia or bulimia.

Thirdly, this hopelessness can be played out in recurrent thoughts of death, pervasive suicidal ideation, and suicidal gesturing which many clients with severe anorexia and bulimia can have in a more entrenched and ever-present fashion than clients who have the mood disorder alone. The quality of this wanting to die or dying is tied to a much more personal sense of self-disdain and identity rejection (get rid of me) than just wanting to escape life difficulties. Fourth, the feelings of worthlessness or inadequacy are unique with eating disorders because it goes beyond these feelings. It is an identity issue accompanied by feelings of uselessness, futility, and nothingness that occur without the distraction and obsession of the eating disorder.

A fifth, distinct factor in the depression of those with eating disorders is that their excessive and inappropriate guilt is tied more to emotional caretaking issues and a sense of powerlessness or helplessness than what may typically be seen in those who are suffering with major depression. Their painful self-preoccupation is often in response to their inability to make things different or better in their relationships with significant others.

A sixth factor that masks depression in an eating disorder client is the all consuming nature of anorexia and bulimia. There is often a display of high energy associated with the obsessive ruminations, compulsivity, acting out, and the highs and lows in the cycle of an eating disorder. When the eating disorder is taken away and the individual is no longer in a place or position to act it out, then the depression comes flooding in, in painful and evident ways.

Compassion for the Hopelessness

The reality of working with people who are suffering in the throws of depression and an eating disorder is that it is difficult not to feel hopeless for their hopelessness. Their hopelessness is extremely painful. It is an inner torture and misery, and it is encompassed by intense feelings of self-hatred and self contempt. For many, their emotional salvation was going to be the eating disorder. It was going to be thinness, physical beauty, or social acceptability. Many come to feel that they have even failed at the eating disorder and have lost the identity they had in the eating disorder. Hence, the hopelessness goes beyond hopeless, because not only is there nothing good in their lives, there is nothing good in them. Not only is there no hope for the future, there is nothing hopeful at the moment but breathing in and out the despair they feel. It feels to them like the suffering will last forever. Therapists who work with eating disorders need to be prepared for the flood of depression that pours out once the eating disorder symptoms and patterns have been stabilized or limited to some degree.

It is my personal observation that clinicians need to change what they emphasize in treating depression in those engaging in recovery from eating disorders compared with those for whom depression is the primary and most significant disorder. Therapists need to find ways to foster hope for the hopeless, much more so for someone with an eating disorder because oftentimes these clients refuse comfort. They refuse solace. They refuse support. They refuse love. They refuse encouragement. They refuse to do the things that would be most helpful in lifting them out of the depression because of their intense inner self-hatred.

For the therapist, the pain that fills the room is tangible. Clients are often full of sorrow and anger for who they are, which takes the symptoms of depression to a deeper level of despair. In working with eating-disordered clients with this level of depression, it is important for the therapist to show a deep sense of respect, appreciation, and love for those who feel so badly about themselves and who are suffering so keenly in all aspects of their lives. In spite of all the suffering, these people are still able to reach out to others with love and kindness and function at high levels of academic and work performance. They are still able to be wonderful employers, employees, and students, but they are not able to find any joy in themselves, or in their lives. These clients tend to carry on in life with hidden misery, and a therapist’s compassion and respect for this level of determination and perseverance provides a context for hope. As therapists it is important that a sense of love and compassion grows and is evident in these times when the client feels nothing but hopeless and stuck.

Separating Depression from Self-hatred

One of the key components of working with the depression aspects of an eating disorder is to begin to separate the depression from the self-hatred. It is important to help the client understand the difference between shame and self-hatred. Shame is the false sense of self which leads someone to believe and feel that they are unacceptable, flawed, defective, and bad, an inner sense that something is wrong with their “being.” They feel unacceptable to the world and to themselves, and feel that somehow they are lacking whatever it is they need to “be enough.” Self-hatred is the acting out of that shame within and outside of the person. The self-hatred can be acted out in the negative mind of the eating disorder, that relentless circle of selfcriticism, self-contempt, and negativity that is a common factor in all who suffer with eating disorders. The shame can be acted out through self-punishment, self-abandonment, emotional denial, avoidance, minimization, self-harm, self-mutilation, and through impulsive and addictive behaviors both within and outside of the eating disorder. Self-hatred is the ongoing gathering of evidence within the client’s own mind that they are broken, and unacceptable. In time, the eating disorder becomes their main evidence that there is something wrong with them and that they are unacceptable. And so, in a sense, the eating disorder is their friend and their enemy. It is a source of comfort and it is the reason they will not be comforted, and until they can achieve perfection in the mind-set of an eating disorder, they have great cause to hate themselves for who they are and who they are not.

All of these examples of self-hatred become intertwined with the symptoms and the expression of the depression, and so it becomes important in therapy to help the client to separate what depression is and what self-hatred is for them. It has been my experience that focusing on the aspects of shame and self-hatred has been more helpful to those who have eating disorders than focusing only on the depression itself. The self-hatred amplifies the intensity and the quality of the depressive symptoms. By focusing on the self-hatred aspects we begin turning the volume down on how the depressive symptoms manifest themselves with the client.

I have found that emphasizing the separation of self-hatred from the depression and its symptoms, and then beginning to change and soften the expressions of self-hatred fosters hope and generates hopefulness. Clients begin to see and sense that maybe the problem is not entirely who they are. Some hope comes from knowing that the feelings and the sense of self they have may not be accurate and true. They may recognize that some of what they have done forever and what has felt very much a part of their identity is really a chosen and acted out pattern of self-hatred. Somewhere in this separation of self hatred and depression they begin to feel hope in themselves, hope in letting go of pain, and hope in having their life feel, look, and be different.

Another reason for the emphasis on self-hatred is to help clients begin to recognize and challenge the unique quality of the all-ornothing thinking that leads them to filter everything about their lives in this most negative, personal, and self-contemptuous way. Hope is generated by learning that everything does not say something bad about who they are, that normal life experiences are not evidence that there is something wrong with them, and that negative feelings do not prove as true, what they have always felt about themselves. The unique perfectionism inherent in this all-or-nothing thinking allows no room for anything but perfection in any area of thought, feeling, or behavior. To be able to let go of the self-hatred filter and begin to see many of these thoughts, feelings, and behaviors they experience every day as typical, usual, and acceptable begins to foster hope, more importantly the kind of hope that is not tied to the false hopes of the eating disorder itself. Part of what has made the eating disorder so powerful is that clients put all of their hope in the eating disorder itself. Eating disorders are hopeless because after clients have done everything in their power to live them perfectly, they have only brought misery, despair, dysfunction, and more hopelessness. The attempt to generate hope through anorexia and bulimia has failed. By focusing on the self-hatred, they begin to separate their eating disorder from themselves. They also begin to separate the eating disorder from their source of hope. They begin to recognize that hope is within themselves and hope is within reach if they will soften how they view themselves and if they will change how they treat themselves internally and externally. Separating the depression from the self-hatred can help clients see the eating disorder for what it really is, with all its lies and consequences, and can help them begin to see who they are in a more honest and accurate way.

Renaming the Depression

I have also found it helpful in working with this clientele to rename or re-frame the depression and its symptoms within some kind of specific pain they are experiencing. I emphasize the pain aspects because part of what makes the depression so painful for those with eating disorders is the internalization of hopelessness. We can remove the global, ambiguous, and future sense of the depression, and break it into smaller pieces, more specific, immediate, and emotionally connected to their experiences rather than to their identity. We talk a lot about their feelings of hurt and sadness, and explore and deepen their understanding about their sense of feeling unloved, or their sense of inadequacy, or their feelings of rejection and disapproval, etc. I try to underpin the depression in very specific and emotionally-connected understandings and expressions. Rarely do I talk to them about their depression explicitly while we are trying to understand, validate, and generate hope in specific areas of their pain. I have found it more helpful to spend sessions talking about how to generate hope for themselves over a sense of loss, a sense of powerlessness, a sense of disappointment, etc., rather than to keep talking about depression and what to do to help lessen it. The realization is that in the process of fostering hope by focusing on and discussing the different kinds of pain, we are also de-amplifying and de-escalating the depression. It is impossible to get to the bottom of depression and avoid the specific pain, since avoiding the pain is what clients have been trying to do through the eating disorder.

It is important to note here that there certainly can be, and usually is, biochemistry involved in the quality, intensity, and type of depression they are experiencing, and that careful evaluation and utilization of antidepressant medications is strongly encouraged as an active part of the treatment. It is also important to remember that clients with severe eating disorders often resist the notion of medication or sabotage use of the medication as an attempt to control their body and weight, and to foster a sense of control. It is important to be very attentive and regularly follow up on taking medication and continue to help them in the positive interpretation of the use of medication. Too often, medicine represents weakness and becomes evidence to again engage in self-hatred rather than being viewed as one more piece of the puzzle that will help generate hope in their recovery. It is my experience that clients often respond to and benefit from medication if we can reframe the medicine as a hopeful part of their healing and their recovery from both the depression and the eating disorder.

When dealing with eating disorders it is also important to continue to evaluate and recognize the impact of malnourishment on clients’ ability to process and/or modify the way they process information about themselves and about their lives. It is important to stabilize the eating disorder as a primary intervention and to emphasize renourishment before there will be a lot of success in treating the depression. Renourishing the brain and body is an important early framework for fostering hope.

Reducing Isolation

Another important component in treating depression among eating disorder clients is moving them out of isolation. It is often a very powerful intervention for clients to re-engage and reconnect with other people. Moving out of isolation and reconnecting with others in their lives generates hope. Pursuing a re-connection with others emphasizes opening themselves up to feel connected, to feel the love, compassion, and interest from others towards them and in expressing their own compassion and love toward family members, friends, other clients or patients, etc. Involving families in family therapy, partners in couple therapy, and friends in the treatment are often very powerful ways to lessen the depression and increase hope for clients because they feel comforted and supported by those who love them and care for them. Helping clients to communicate again with people in their lives brings hope and renewed ability to feel something different than self-hatred. To receive expressions of someone else’s love, concern, and genuine caring is hopeful and becomes a very important part of treatment for the depression.

Letting go of False Guilt

Another aspect of the treatment of depression relates to the intense and unrealistic levels of guilt. Again, the reason the guilt becomes unique for those with eating disorders is because of the self-hatred. The guilt tells them to feel bad and terrible about themselves because they are not perfect, or not in complete control, or not accomplished, or not accepted or liked by everyone, or because there are people in their lives who are unhappy. A pain that will not heal is the false guilt associated with untrue or inaccurate realities. It is helpful in working with eating disorder clients to help them clarify the difference between real guilt and false guilt. We can help them recognize that real guilt is associated with having literally done something wrong. Their recognition of that fact can lead them to correct it. False guilt tells them to feel bad and terrible about themselves, and whatever has happened becomes the evidence against them which supports the feeling of guiltiness. Oftentimes I try to help clients understand specific ways that false guilt enters the picture and feeds the self-hatred. It is frequently tied to areas of their lives where they feel or have felt powerless but have made themselves emotionally responsible. An example of this might be feeling bad about themselves because they feel responsible for a specific relationship outcome they do not really have the power to create on their own. They may feel badly about themselves because they cannot fix a situation or problem someone they love or care about is experiencing, or because they could not prevent a tragedy. False guilt is a sense of shame, feeling like they “should have known better” or had it “figured out” beforehand. False guilt is often an expression of what they are not, rather than who they are or what they are capable of doing. Sometimes the false guilt is just an active expression of the intense pattern of negative comparison between themselves and others that is so common with eating disorders. Eating disorder clients are constantly comparing themselves to someone else, both physically and behaviorally, and end up feeling a great deal of guilt about who they are because they do not match up in their comparison with someone else. Sometimes false guilt is an expression of self-hatred for some wrong done in the past, something they will not let go of or forgive themselves for. They continue to actively punish themselves for what happened or what they felt bad about doing, sometimes a very long time ago. They hold it against themselves mentally as support for their self-rejection.

Often the false guilt and feeling bad about themselves is tied directly to how important people in their lives are behaving or acting. They tend to somehow feel responsible or accountable for someone else’s negative choices or behaviors. False guilt gives them a sense of hopelessness because their ability to change it or re-frame it differently is impeded by their all-ornothing filter of self-contempt. They may compare themselves to unreasonable self-standards that no one could live up to, and therefore they become the exception to all the rules of normalcy. Somehow they have to live above acceptable, and the sense of guilt is evidence that they are not living at that expected, higher level of performance. Oftentimes when they hear feedback from other people about their behaviors, in particular their eating disorder, it becomes another encouragement to feel false guilt. The problem with self-guilt is that it produces intense feelings of fault, blame, guiltiness, shame, anxiety, and sadness, but instead of moving them to correction and change, it moves them to selfhatred, self-criticalness, self-doubting, and self-punishment. False guilt always leads to more hopelessness. Releasing false guilt fosters hope because it leads to an increased sense of freedom and choices through the setting of clear emotional boundaries.

In conclusion, it is important to emphasize that in order to truly intervene in the area of depression with those who have an eating disorder, we need to first stabilize and lessen the intensity and the acting out of the eating disorder. Until we do that, we are probably not going to truly see the depth and the extent of the depression and the very personal nature of how the depression manifests itself in eating disorder clients. It is also important to increase our awareness and understanding of how depression is uniquely different in those who suffer with eating disorders because it gives us therapeutic options and a framework to intervene in a more compassionate and hopeful way with those who have these coexisting disorders. The most helpful thing we can do in every session with these clients is to generate hope. Nurturing hope is not always a clear-cut and obvious list of techniques or interventions, but rather a willingness by both client and therapist to face the hopelessness in a kind and loving context. I hope that these therapeutic distinctions and suggestions will begin to foster some hopefulness for clients suffering with a coexisting depression and eating disorder. In facing the hopelessness, pain, selfhatred, guilt, and isolation, we can, little by little, foster and generate hope and decrease the depression. New hope will lead to answers. Genuine hope will lead to something better. Honest hope will lead to change.

Depression – 5 Steps to Recovery

Taking antidepressant medications is very common in treating depressive disorder. Self-help medications are also very common and are often recommended by therapists. Here are five steps on how to recover from depression naturally.

The first step is to take time out. It is very important to take out time to relax especially after a very stressful activity. Find a safe and peaceful environment such as the beach or park. Let the nature give a relief of depression. Go out of the house and take time to relax in a variety places. Avail of all the support other people can give. Sleep soundly. Attend counselling. Join social activities as these dilute the depression and can help a person forget the past and move to a new and better future.

The second step is to exercise. Sitting and thinking of the things that depressed a person often just worsen the situation. Take time to relax and exercise at least 30 minutes everyday. Exercising helps a person recover from depression as it releases happy hormones into the body. According to specialists, aerobic exercise is the best way to relieve depression symptoms.

Changing your diet is the third step in the recovery process. Eat well-balanced foods to help the body circulate well and distribute nutrients throughout. Avoid processed foods and eat foods such as fruits, vegetables, fish and lean meats. Researchers say that eating foods rich in Omega 3 and 6 helps depression. Foods rich in Omega 3 fatty acids are fishes such as tuna, salmon and halibut, sea foods such as algae and krill and some plants and nut oils. Imbalanced blood sugar and insulin can also cause depression so this should be avoided. Also, avoid alcohol and other recreational drugs.

The fourth step to recover from depression is to do yoga exercises. It improves mood and functioning of the body parts. Taking three simple yoga poses a day accompanied by proper and controlled breathing is a great way to relieve depression. Researchers say that yoga, taking time to relax and doing exercises give the same benefits in depression recovery.

The fifth and final step to depression recovery is acupuncture. It originated in China and it has been said to treat depression symptoms like Western medicine and psychotherapies do. Acupuncture help in the production of natural chemicals in the body such as endorphin which is responsible for a person’s mood and well-being.

Remember, people can and do make recoveries from depression and go on to lead their best lives imaginable. Seek help.

Welcome to my world. I grew up and live in a small rural town on the east coast. I am passionate and dedicated to providing resources to help others help themselves. I am embarking on a journey to tell the world that one in five of us, including myself, will suffer from depression at some point in our lives. I want to change peoples’ attitudes towards depression and mental illness. My wish is that people who are suffering from depression will access the right help to enable them to recover and go on to lead the best life imaginable for them. I was fortunate to get the help I needed to live my best life imaginable. Come and join me on this great journey! We can truly make this world a better one to live in!

Recovery From Anxiety and Depression

I also went through depression with my anxiety and got caught in the cycle of being depressed because I was depressed. I realised that if I was to recover from anxiety then I was to have no self pity, if I felt down then I felt down there was nothing I could do about this, what I would try to do is not be filled with self-pity and make myself worse.

The best thing you can do with feelings of depression through anxiety is to tell yourself the way you feel is temporary and start to invite new things into your day, don’t let how you feel dominate your day. I started to take walks and go for a swim to shake the cobwebs off how I was feeling, this helped me greatly and it gave me another focus to my day instead of focusing on myself. I believe that nature and a natural diet can be great mood lifters and also ease the feelings of anxiety, going out for a run or a walk, taking some daily exercise is far better than sitting at home brooding on how you feel. Exercise in itself releases endorphins which are great for lifting your mood, also exercise burns off all those stress chemicals than can built up through the day.

Your thought pattern is also very important when over coming anxiety and depression, too many people think negatively when they feel how they do, this is understandable but is counter productive and becomes a habit, the habit to always think negative which in turn makes us feel worse and crushes are spirit even more. Watch out for all the negative thinking and try and change your thought pattern, instead of saying ‘This is me now I just want to curl up and hide’ say ‘I don’t feel great at the moment but I am going to make the changes and come through this’ instead of saying ‘I have nothing to look forward to and I hate my life’ say ‘Life is what I make it from now, the only person that can make changes is me, this is just a part of my life that I will come through’. There are many different things you can say to yourself, but the main thing is to try and have as little self-pity as possible, to see the good in the day instead of all the bad, to come through this time a better, stronger person.

I came through my depression and it was because I made the changes above, these changes also helped me after my recovery, I am a far more confident person than I was before my own suffering and I tend to always see the good in my life. This all came about because I understand the importance of being positive, this now has become my new habit and my life is so much richer for it. I am also very proud that I stayed positive and came through this very tough part of my life; this has given me a new inner strength, a strength that I can overcome anything. I now no longer worry about anything I cannot change, if I learnt one thing it is that worrying is the most useless emotion we have and serves us no purpose whatsoever.

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