Depression – why do I feel so bad? Part 1


Depression

I started writing these blogs to share information about common mental health issues and offer suggestions that could help people who were struggling. Talking about #depression is important. You can read about ways I have managed to help people start to feel a little bit more like themselves again. I adapt my approach for individual clients but many aspects of therapy for treating depression are the same. One of the first steps is to instill a sense of hope that things can and will get better. My message here is to tell you that you don’t have to stay like this. You can get past it. I will share what I have learned, what has helped my clients and perhaps there will be something here that will help you.

Depression can happen to anyone – and does happen to one in four of us over our lifetimes. Next time you are out and about, look around you and picture that one in four. Can you tell which ones they are – probably not, but they are there. Someone once suggested that people with depression should wear a super hero outfit so others can tell who they are…those people fighting the fight against depression every day. Depression is also often accompanied by other feelings such as guilt, shame, anger and anxiety. Although depression can happen to anyone, different factors make it more likely. These factors include biological make-up, upbringing, or reaction to life events. Some people seem to become taken over by depression, while others manage to overcome it. The difference is rooted in what keeps the depression going – how you deal with things. The way you think and what you do affects the way you feel.

People who are in a depressed mind state tend to think very negatively about themselves, the future and the world around them. It can be like seeing life through a pair of grey, gloomy spectacles. You can dwell on unhelpful thoughts repeatedly, mulling over things, asking yourself why, thinking regretful things about the past, and what you should or shouldn’t have done.

To make it worse, depression is accompanied by various physical sensations such as: tiredness, fatigue, and lethargy; difficulty concentrating or remembering; sleep changes; eating changes; a loss of interest in things such as hobbies, activities, and sex.

Because of the tiredness, difficulty sleeping and eating, and negative style of thinking, you tend to do less and less. You stop doing the things you used to enjoy. It could get so bad that you can’t even go to work or college, or do things at home. You want to stay in bed, or stay at home doing very little. You might isolate yourself from friends and family.

Depression is now one of the most common disorders treated by psychiatrists and psychotherapists. It poses special problems to therapists as it is a complex disorder that affects the whole person: emotions, bodily functions, behaviours and thoughts. Although depression can be treated with antidepressant medication and psychotherapy, a significant number of people with depression don’t respond to either, leaving them feeling desperate and helpless. In the past 20 years there have been significant developments in the pharmacological and psychological treatments of depression. Selective serotonin reuptake inhibitors (SSRls) have been found to be effective in relieving severe depression, but 40% to 50% of depressed people don’t respond adequately to these drugs, and a substantial number are left with residual symptoms of depression. Antidepressant medications don’t alleviate psychosocial problems such as relationship difficulties, interpersonal conflicts and occupational stress that might have triggered the depression in the first place. They also don’t address the emotional needs that may be lacking in a person’s life.

Many forms of psychotherapy for depression have evolved over recent years to try to address this side of depression. One of the most extensively studied psychosocial treatments for depression that has been shown to be effective is cognitive behaviour therapy (CBT). However, just as with antidepressant medication, a significant proportion of people with depression don’t respond to CBT. Between 50% and 75% of people with depression also experience anxiety and there’s considerable overlap between the two conditions but people aren’t usually treated for both problems at the same time.

So what can be done to help someone who is suffering with depression? In the next part of this series of blogs you can read about what depression is and is not, and therefore what can be done to help you overcome it. If you are struggling with depression, please consider getting professional help.

If you are in the UK and need to talk to somebody as soon as possible:

Samaritans UK – 08457 90 90 90

Samaritans ROI – 1850 60 90 90

Your doctor can help refer you to a therapist or you can seek help directly. I specialise in working to help people overcome depression and anxiety and I’m based in #York. If you need some help I can be reached via my website at: www.mindmakeoveruk.com/contact.html

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#Anxiety – what is it and how do I make it go away? Part 8


 

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In my previous blog, I talked about how you can use breathing and relaxation techniques to help alleviate the symptoms of #anxiety. These are the first small steps in gaining some control over your anxious thoughts and feelings. A skilled therapist will help you address specific issues depending on what would be most beneficial for you. Typically this may include #CBT, #Mindfulness techniques and #Hypnotherapy. #Hypnotherapy is particularly helpful for calming down your automatic threat activation system and helping you change the unhelpful thoughts that feed your anxiety.

In this last blog on anxiety I wanted to talk about how it is also helpful to look at the wider picture – at what else in your lifestyle could be contributing or helping to maintain your anxiety. A balanced diet and a regular exercise routine might not be cures, but they can help improve overall mood and wellbeing. Certain foods have been shown to reduce stress, and similarly a number of foods and drinks may help to limit anxiety, too. Below are a few ideas that you might like to consider:

Sugar

Eat a healthy, balanced diet and cut down on high sugar foods such as cakes, biscuits and sweets. These foods detrimentally affect blood sugar levels, causing them to soar and then dive and may help fuel anxiety.

Caffeine

Caffeine can help make you feel alert but the effects of too much caffeine can be the same as those of anxiety. Caffeine is a stimulant that affects the brain and central nervous system. It can be found in: coffee, tea, Coke, Fanta, aspirin, cold remedies, headache tablets, energy tablets, drinks like Pro-Plus and Red Bull and even in chocolate at a low level.

Oily Fish

A small study showed that university students given an omega-3 fatty acid supplement exhibited a 20 percent reduction in anxiety compared to students given a placebo pill. Rather than rushing out to buy supplements, you could consider increasing omega-3 through your diet.

Chamomile Tea

Chamomile has been utilized for its natural healing properties since ancient times, but modern science is beginning to catch up. A small study found a modest improvement of anxiety in people with mild to moderate generalized anxiety disorder (GAD) treated with chamomile extract.

Eggs

The brain needs a wide range of B vitamins to operate at it’s best. When you’re lacking in vitamin B, you may experience confusion, irritability and anxiety. You can make sure you’re getting enough by incorporating vitamin B foods into your diet, such as beef, pork, citrus fruits, or eggs. Eggs have the added benefit of being one of nature’s richest sources of choline, a crucial B vitamin for brain health.

Probiotics

We know that our brains and our bellies communicate – we all recognise hunger pangs – but research suggests the bacteria in our guts are also involved. The good ones, probiotics, live in the intestines and promote healthy gastrointestinal functioning. Researchers have found that feeding a certain probiotic bacterium found in yogurt to mice reduced behaviours associated with stress, anxiety and depression.

Green Tea

Green tea is rich in an amino acid called L-theanine, which has been reported to have calming effects in general. In one study, taking 200 milligrams of L-theanine before a test helped anxiety-prone university students stay calm. However, it’ll take you anywhere from five to 20 cups to get that much from tea alone.

Return to being a non-smoker

As previously mentioned in an earlier blog, smokers often believe that smoking helps them relax, but nicotine is in fact a stimulant. The relaxation effect people associate with smoking is nothing more than deep breathing when you inhale.

Exercise

Don’t underestimate the beneficial effects of exercise or increased activity in reducing anxiety. Doing something physical helps you to complete the stress cycle – all the extra adrenalin created by stimulating your threat activation system has to go somewhere and exercise is a good way of using it up fast. Even going for a fairly fast paced walk can help. A change of scenery is often enough to shift your focus away from your anxiety-provoking thoughts too.

I hope that you have found these 8 blogs on #anxiety interesting reading. Perhaps you have learned something, challenged something, or thought about changing something. If you have a different perspective to offer then perhaps you could share your ideas too. If you have been inspired to seek help for your anxiety, then there are many dedicated professionals out there waiting to help you.

I am Susan Tibbett, a Chartered Psychologist and #Hypnotherapist. I specialize in helping people overcome anxiety and I work in #York. I can be reached via my website at: www.mindmakeoveruk.com/contact.html

In my next series of blogs you can read about #depression.

 

 

 

#Anxiety – what is it and how do I make it go away? Part 7


stress

In my last blog I talked about taking control of anxious, emotional thinking and that the first step in training your mind to work better for you in anxious situations is to take a step back – recognise a thought driven by strong emotions and allow your mind time to calm and get some perspective. A quick and easy way to help you begin this process is to shift your awareness to your own breathing. Did you know that breathing plays an essential role in anxiety? When you are anxious, your breathing rate becomes elevated, and a number of physiological changes begin to occur. The way you breathe is a major factor in producing these and other sensations that happen when you are anxious.
You probably remember learning that you breathe in oxygen and you breathe out carbon dioxide. To run efficiently, your body needs the correct balance between oxygen and carbon dioxide, and this balance is maintained by how fast and how deeply you breathe. When you exercise, there is an increase in both oxygen and carbon dioxide. When you are relaxed there is a decrease in both oxygen and carbon dioxide. In both cases the balance is maintained. When you are anxious, this balance is disrupted as you breathe too quickly and take in more oxygen than your body needs. Your body responds with a number of chemical changes that produce the symptoms I talked about in an earlier blog such as dizziness, blurred vision, feeling light-headed, confused or breathless, an increase in heart rate to pump more blood around, numbness and tingling in your extremities, cold clammy hands and muscle stiffness.

A Calming Technique

In order to gain control and get your system back in balance you need to slow your rate of breathing and change your breathing style. Slower, deeper breathing stimulates the part of your nervous system responsible for relaxation. This is a basic biological process and if you breathe in this way then your body will have no choice but to relax. It may take a few minutes but the body will respond regardless of what your mind is thinking.

Experience this now. Find a place where you will be undisturbed for a few minutes. You can close your eyes or keep them open, whatever is comfortable for you. Sit with your feet flat on the floor and your hands resting lightly in your lap.

• Breathe in deeply (from your diaphragm) to the count of 4 seconds (through the nose if possible)
• Hold your breath for 2 seconds
• Release the breath taking 6 seconds (through the nose if possible) then pause slightly before breathing in again
• Just allow the oxygen to gently and slowly flow in and flow out.
• Practice breathing this way as often as you can

The counts are less important than remembering to lengthen your out breath. This is what sends the calming signal to your mind and body. You may have seen similar breathing exercises elsewhere, such as 7-11 breathing where you breathe in for a count of 7 and out for a count of 11.

When you are doing your breathing exercises, make sure that you are using a diaphragmatic breathing style rather than a chest breathing style. You can check this by placing one hand on your diaphragm under your rib-cage. The hand on your diaphragm should rise when you breathe in.

When you first begin changing your breathing, it may be difficult to slow your breathing down and you might feel like it is not worth the effort, or think it is not working and give up. Notice that this is your unhelpful anxiety talking, so challenge those assumptions and persevere. Allowing yourself to breathe like this regularly forces your general anxiety level to come down. With enough practice you will find that you begin to breathe this way automatically if you feel anxious. Regular periods of relaxation inhibit the production of stress hormones in the body so it actually becomes harder and harder to panic. As you become more generally relaxed the ‘baseline’ of arousal from which you are starting lowers and it actually becomes harder to get stressed.

Once you are comfortable with this breathing technique you can add the following:
• As you breathe in, imagine that the air around you is a wonderful colour of calm and relaxation. As you breathe in allow the colour to flow in and through your body like a wave of calm, clearing any tension in your body or stresses in your mind
• As you breathe out, imagine any tension or stress flowing out and away from you and disappearing into the air where it evaporates and disappears

#Mindfulness relaxation – it only takes a minute every day

This technique is simple yet very effective. Take a moment to practice it every day. Find a comfortable place to sit. It can be on a chair or on the floor, but don’t slump or slouch. Keep your posture straight but relaxed, making sure you are not rigid or stiff.

• Close your eyes and focus your awareness on your body and become aware of any and all sensations there
• Now focus your attention like a spotlight on any particular tightness or discomfort anywhere in the body. If there are none then just focus on the stillness in the body. You are not trying to judge any sensations or change them, but simply to become aware of them. If your mind wanders then gently escort it back to focusing on your breathing
• You may find that any areas of tension begin to loosen and relax. You don’t need to try to do this, just be aware of any relaxation happening. You can stay like this for as long as you wish but even a minute is beneficial

Please give these techniques a try – all you have to lose are your feelings of anxiety! I specialize in helping people overcome anxiety and I work in #York. I can be reached via my website at: http://www.mindmakeoveruk.com/contact.html

In my final blog of this 8 part series on #anxiety, you can read about lifestyle changes that can help improve overall mood and wellbeing.

#Anxiety – what is it and how do I make it go away? Part 6


stress

If you suffer with #anxiety you are probably very aware of the amount of “What if?” type thinking that spirals around in your mind. “What if I do it wrong?” and “What if they don’t like me?” and “What if something bad happens?” As humans we are hard-wired to watch out for danger and threats in order to stay safe and protect ourselves. In this way our brains have developed a natural negativity bias and we are prone to overlooking the positive in situations in favour of watching for what might create a problem for us. For anxious people this mechanism can go into over-drive and result in incessant worrying about everyday things.

A skilled therapist can help you to train your mind so that those worrying thoughts are not able to take your thinking hostage. We know that the more we look for something or expect something to be there, the more likely we are to find evidence of it – for example, have you ever been looking to get different car and then suddenly you see the same make and model everywhere? It all depends where and what you are training your brain to focus on. With a narrowed focus, your mind can mislead you as you only notice certain things and disregard others, and this is what is happening when you pay too much attention to your anxious thoughts. You can become hypervigilant – watching out for anything that might be a threat, day and night. Anxious people are usually very tired – they don’t sleep well as they are constantly ruminating – going over and over things in their minds and building things up out of proper proportion. Your mind is very powerful and you have learned to trust your own thinking, so when you are having a particular anxious thought or feeling you automatically believe that it must be right, or factually correct, and so the perpetual cycle of worry keeps on turning as worry builds on worry. However, you can train your mind to recognise which thoughts and feelings to pay attention to and act upon, and which thoughts are perhaps just an emotional response to a situation or event and are unhelpful.

When you are not paying attention to your thoughts you may not realize that they are being triggered by emotion. You can learn to recognise these emotional shifts and put your thinking in perspective. When you think emotionally, the feelings are fast and strong and can overwhelm you. Because the feeling is so strong, you believe the associated thoughts must be right – but this is just the way you think with the emotional, instinctive part of your brain, the protective part that is there to alert you to threats. Once this threat activation system is in full flow, it can be hard to think logically and rationally – that usually happens only when you calm down again. So the first step in training your mind to work better for you in anxious situations is to take a step back – recognise a thought driven by strong emotions and allow your mind time to calm and get some perspective, allowing your rational brain time to evaluate the situation and make an evidenced, sensible interpretation of what is going on, and then guide your behaviour appropriately. Have you ever observed a ‘hot-headed’ person in action – perhaps in a store or driving? They react emotionally and irrationally getting everything out of proportion, getting themselves very agitated and upsetting people around them.

Most of my clients with anxiety tell me that they have tried to put their anxious thoughts out of their mind, but have failed miserably. This is not entirely their fault – they have set themselves a virtually impossible task as we can’t stop anxious thoughts from happening when they are part of our natural threat activation system. It can be helpful to understand that everyone has anxious thoughts but it is how we choose to react to them that gives us a sense of control. When you notice those thoughts arising, notice what is happening and how your body is reacting. The physical symptoms are evidence that you are thinking emotionally. You can send a strong, natural signal that tells your mind and body that there is no real threat by taking several slow, deep breaths. Give your rational mind time to challenge your emotional thoughts. You can learn to recognise those unhelpful thinking styles and shift your thinking to something that is more helpful and diffuses the anxiety. Ask yourself questions that put your fears in perspective. Evaluate the evidence for and against the thoughts. Remember they are just thoughts, just mental events in the brain, and they are not always a true reflection of a situation, but are filtered through your past interpretations of such events. If you have got used to interpreting events in a particularly unhelpful way that reinforces your anxiety, then it is likely you have a very narrow focus on your current interpretation and are not seeing the bigger picture. Allow yourself to shift your perspective and see how your thinking changes. Have you ever worked for a boss who seems to pile the work on you? Did it make you feel put upon and stressed? Did it get you fired up and ready for a showdown or did you think about quitting the job? Perhaps the boss was not getting at you personally but was allowing you to stretch your capabilities so you could develop your skills? After all, good managers will often do this. Sometimes considering alternative interpretations of situations can bring a more helpful perspective and guide any discussion of the situation in a more productive way. Whether your initial interpretation turns out to be right or wrong, surely considering alternatives is helpful and allows you to reason with your rational mind rather than reacting with your emotions and getting stressed and upset.

Of course, developing this new way of reacting to your anxious thinking takes practice. You will build up your resilience the more you learn to challenge your initial fearful reaction and put it in perspective. It will not happen overnight but the more you practice, the more you are reinforcing those neural pathways in the brain that build more helpful ways of thinking, feeling and behaving.

I specialize in helping people overcome anxiety and I work in #York. I can be reached via my website at: http://www.mindmakeoveruk.com/contact.html

In my next blog you can read about techniques you can use to effectively deal with anxious thoughts and feelings.

#Anxiety – what is it and how do I make it go away? Part 5


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Have you noticed the sorts of thoughts you experience when you are particularly stressed or anxious? We all have unhelpful thoughts but when you are feeling anxious or worried these thoughts seem to occur much more often. If you are feeling anxious now then stop for a moment and notice the sorts of thoughts that are going on in your mind. There are some typically unhelpful ones to watch out for:

  • Thinking about things in all or nothing terms, such as “ I am useless”
  • Blaming yourself for things which may have nothing to do with you, such as “The computer is going wrong – I must have broken it”
  • Seeing everything in catastrophic terms, such as “If I go out today I might have an accident”
  • Mind-reading what other people think about you, such as “They think I am stupid”
  • Focusing on any negative aspects, such as “I messed up that bit” rather then seeing the whole picture
  • Thinking in extremes and strict rules, such as “I always get it wrong” or “I must look perfect”

When you think like this all the time, even the simplest things can become daunting because you are automatically setting off the threat activation system in your mind. When you are constantly on high alert, those symptoms of anxiety never calm down, and to make it worse you begin to interpret everything that happens through this negative filter – constantly on the look out for what could go wrong.

One of the biggest challenges in overcoming your anxiety is to learn to tolerate uncertainty. When you are anxious, you are not focused on the here and now, you are focused on the future – what might or might not happen. You don’t know yet what that might be, but you are on high alert, and predicting events in your mind, using all those unhelpful thoughts. When you are prone to thinking like this, constantly trying to predict the future, and unable to tolerate uncertainty, #mindfulness techniques can be very beneficial. #Mindfulness teaches you to shift your focus into the present moment. It helps you to notice that what you are worrying about is not what is happening in the here and now, but something that may or may not happen later on. In the here and now, you are probably ok and there is no immediate threat to your safety. Being grounded in the here and now allows your mind to relax and experience calmness. Once your emotional mind is calm, your rational thinking mind has better clarity and can weigh up the evidence and facts pertaining to a situation. In this way you can often gain a fresh perspective on what is going on, and on your own thinking.

You may also have noticed that when you are anxious you tend to focus on yourself and what’s going on inside your own body. Many years ago, despite being outwardly confident, I began to notice a feeling of flushing red in the face and neck when speaking in public. Eventually I became so focused on going red that I realized I was anxious about the flushing rather than the public speaking itself. The solution was to stop focusing so much on the bodily reaction and instead to focus outwardly on the audience and the information I wanted to share. #Self-hypnosis is a great way to train your mind to work in this way for you.

Overcoming your anxiety is achievable but it does take some effort on your part. Remember that anxiety is a natural reaction and it’s quite normal to feel a little anxious in new situations or doing things that seem a bit frightening. It is when that anxiety becomes more extreme and starts to impact on your everyday life that you should seek some professional help. Sometimes people go along for therapy thinking a therapist will just sort out their problems for them. No therapist can wave a magic wand and make things change for you. A good therapist will work in partnership with you to help you achieve your goals. Therapists are skilled at helping people change their faulty thoughts and behaviour and if you see your doctor for help with anxiety you will probably be referred for CBT or cognitive behavioural therapy. CBT recognizes that our thoughts, feelings and behaviour all work together. When you learn to change the way you think about things and the way you act in certain situations then it is inevitable that your feelings or emotions will change too. Over a number of weeks you will be given help to challenge your negative thoughts and subsequently change the way you act and behave, following a plan.

Therapists working in the private sector have the freedom to use a variety of psychotherapeutic techniques to help you overcome your anxiety. I personally use a combination of #CBT ideas, #Hypnotherapy and sometimes #EMDR Eye Movement Densensitisation and Reprocessing, depending of the needs of the particular client. The therapeutic plan is always designed to fit you, based on your needs and goals, rather than you having to fit any prescribed plan.

I specialize in hypnotherapeutic techniques for overcoming anxiety and I work in #York. I can be reached via my website at: www.mindmakeoveruk.com/contact.html

In my next blog you can read about techniques you can use to effectively deal with anxious thoughts and feelings.