Tag Archives: depression

Medication? Meditation

I always love when people ask me what my favorite position is. Why, lotus, of course. What were you thinking?

It may seem like everybody and their mom is meditating these days. And, well… my mom just took a meditation course after seven years of my incessant nagging, so there you have it. Yet I meet so many people who are wowed by the fact that I’m a longtime meditator (7 years and counting, son!) and that I have a daily practice at the tender age of 25. So often, I hear the sentence “I wish I could meditate…” and I’m always stunned by it. I seriously mean this when I say it: anyone can meditate. You don’t need to be a monk, hermit, or even have a guru or teacher to learn to meditate (though it can help).

Simply put, meditation is being still: physically, verbally, and mentally still (eventually at expert level). It is not a Buddhist practice (though it can be.) It is not a Hindu practice (though it can be.) It is literally just sitting with an intention for stillness. There are many types (even standing and walking ones), but the two most basic ones are:

  1. Mindful meditation – Taking your awareness to different parts of your body, breath, thoughts.
  2. Concentration meditation – Actively trying to concentrate on a thought, sensation or a visualization and bringing yourself back to that when your mind wanders.

 

There is no poster child for meditation. I am a rowdy hockey fan whose favorite band since 16 has been Tool and I grew up in a third world country. None of those facts have any relevance to my ability to meditate. If I can do it… so can you.

When I first started, I wondered what good could possibly come of me being still sitting in silence doing absolutely nothing. Well, let me tell you—one UNDERenlightened to another UNDERenlightened friend. I can only speak from my own experience but a lot of research backs up my positive experience with meditation.

  • I feel more energized.
  • I feel calmer and less stressed.
  • I feel more focused and clear minded.
  • I can control my emotions better (e.g. not throw my drink at the TV screen when the San Jose Sharks make a terrible play).
  • I am more aware of my own self and others around me. (This one sounds pretty new age-y and I apologize for that. What I mean is, for example, if I feel angry, it’s easier for me to pick up on the fact that I’m angry and stop to think before saying or doing something hurtful. Similarly, I am more aware of how others around me are feeling and, honestly, sometimes they don’t have to say a darned thing for me to know.)

 

I’m a true believer in this preflight safety message across the board: Put on your own oxygen mask before tending to others.

How did I get into this life-changing practice? A 5-day course called YES Plus. I took my first freshman semester in college. I had just moved back to the United States after 12 years and was having a tough time adjusting to suddenly not having any friends. After attending an introductory meeting for a meditation group, I signed up. Initially, I believed it would just help me de-stress and show me the ropes of yoga. But little did I know that it would change my life. YES Plus is a course offered to college students and young professionals to learn meditation, gentle yoga, some simple, effective life skills and finally (and mainly) breathing techniques. It ended up being the best thing I’ve ever done for myself and since then I’ve assisted with at least 10 seminars at various universities (including Stanford University’s own YES Plus chapter—my main YES Plus community, since I work at Stanford.) I learned to manage my emotions better (which we know is most difficult at the dramatic age of 19), learned to be happier and more energized, and gained a huge ever-growing group of incredibly inspiring friends. I’ve never looked back since.

The most impactful thing I learned in YES Plus was breathing. Sounds silly, right? Different breathing techniques help segue into meditation—the ones I learned helped me breathe deeper (Pro Tip: use more lung space; if you’ve taken a biology class, you know that respiration is an act of energizing and detoxing your body so breathing deeper means more of that), and made me feel awake yet calm afterwards.  It’s like having caffeine without the anxious jitters. For people like me who think it’s incredibly difficult to just sit and be… breathing as an active and engaging process helps the transition into peace of mind tremendously. I’ve found that I can get to a deeper space of meditation faster.

To this day, I have trouble meditating sometimes—I have been conditioned to be on-the-go and I feel like I’m wasting my time sitting and ‘doing nothing.’ But the fact is that you are doing something in meditation. You are giving yourself peace of mind (a mini brain vacation, if you may) and that will translate into everything you do. Trust me. You can’t knock it till you try it! Perseverance is key. Set a bar for yourself: ‘I will meditate for 5 minutes daily for a month.’ If it feels good, up the ante by increasing the time or number of times you do it in the day. If it doesn’t, then you learned what doesn’t work for you and are one step closer to realizing what does.

Now that I have gotten you stoked about the prospect of meditation (hopefully!), here’s what I tell people who ask me how to meditate. Quite simply…

1. Prep yourself – Give yourself no excuse to get up once you’ve finally settled into a meditation. Listen to mom’s advice and go to the bathroom, drink water, eat a light snack, wear comfortable clothing (yoga pants/ sweat pants, etc.; not tight jeans and a corset). Do not eat a huge fatty meal because you will sleep, not meditate.

2. Exercise (yoga is a fantastic segue into meditation) – You will be sitting very still for a while so let loose any ants in your pants. Set a gentle alarm if you need to restrict time. There are plenty of meditation apps to help. Don’t startle yourself into consciousness with loud, sudden sounds; that defeats the purpose of relaxation. The best duration is around 20 minutes—not too much, not too little (though your perception of time can vary each and every instance!). But you can meditate for as little or as long as you damn please. As mentioned above, breathing techniques are amazing and simple ways to ease you into zen mode.

3. Keep your back straight – This can be uncomfortable to begin with because we’re a species that loves to slouch, but hang tough the first few times and you’ll even begin to see a change in your daily posture. Do your best—otherwise, soon you’ll be drooling on your shirt and sleeping, not meditating. Big difference. Use a backrest, pillow or wall. If you can without a wall, you’re already semi-enlightened… oh wait, this is about being UNDERenlightened. Scratch that.

4. Sit symmetrically – This means both feet on the ground, seated on a chair, or cross-legged on the floor. Essentially, both left and right sides of your body should look the same. Palms facing up (preferred personally, but try both) or down on your lap.

5. Set the mood to be relaxed and comfortable – You can’t meditate if your body is not where it wants to be. Snuggle up in a blanket, don’t sit cross-legged if it’s not comfortable, turn off or dim the lights. Keep your cellphone on silent or locked in a safe on top of the fridge.

6. Pay attention to your body and breath – Literally what those words mean. We often don’t even realize how much tension we carry physically. I often have scrunched up brows or tightly pursed lips or my shoulders are up to my ears. When you stop and just be with yourself, you’ll start to notice these things, trust me. It’s wild. Loosen up those parts taking deep breaths.

7. Here’s where you can go two ways: you can continue to just be mindful of your thoughts and body, and every time you get too wrapped up in your head, remind yourself to bring yourself back to the breath and focus on that. No need to get mad at yourself for your brain wandering. It’s got a PhD in it! Or, alternatively, when you feel calm and settled after step 5, you can walk yourself through all your body parts gently and take deep breaths as you do so.  To give you an idea of an order to follow, this is what I do (you can say this in your head slowly as you go along): Take your attention to your right foot, right knee, right thigh and hip. (Follow that with the same on left side, and don’t forget to keep breathing; also, if needed, feel free to pause and stay on any body part as long as you wish.) Abdomen, stomach, chest, right shoulder, right arm and hand. Left shoulder, arm and hand. Neck, face, cheeks, top of the head. Throughout, you can be as detailed as you like. And finally, just take your attention to your whole body.

Now. ‘Take your attention to’ does not mean ‘pay attention to.’ You don’t need to focus like it’s two hours ‘till that O Chem exam you’ve stayed up all night cramming for. It’s just a gentle awareness, like, “Hey foot, how’s it hanging? Say hi to your mother for me, alright?” It’s really more of a “Oh, that’s my foot. Deep breath.” And if you feel like moving on to your next bit… swell. If not, just listen to what your body is asking you to pay attention to.

NOTE: You may experience tingling, lightheadedness, have a movie of thoughts, or even the dreaded… nothing. Nirvana wasn’t achieved in one day. Practice is key to going deeper. Even if you do it 5 minutes a day, the quality will begin to shift. Even if you don’t experience a life-changing shift right away, maybe you’ll see a change in your energy levels or mood. Give it a fair chance before declaring yourself a meditation squib (inside joke for you Harry Potter junkies).

8. Once you’re far away in Blissville or Zenlandia, you have two more options… to stay there or to lie down on your back (bed, floor, whatever is closest and requires the least movement) until you’re happy to get back to the real world or until your alarm goes off. Or you may just fall asleep and wake up 8 hours later.

9. Repeat steps 1 – 8 as often as possible. There are apps to remind you of these too. I use a free basic meditation insight timer.

And there you have it! I like to say that meditation is my medication—my cure-all. I sure you hope you try out a dose or two to see if it’ll change your life like it did mine. If you do, I’d love to hear about it.

Your first step toward enlightenment is now complete. Your first step toward UNDERenlightenment is understanding irony. May the force be with you.

Photo by Sara Slattery

Photo by Sara Slattery

Let’s Ask: Viewing My Anxiety & OCD As An Addiction

Julia and Erin, two UE writers who have asked that their names be changed to allow for a completely honest conversation, sat down to discuss how Erin has used viewing her anxiety and OCD as an addiction to help her to find mental freedom.

Julia: A week or so ago, you referenced using Alcoholics Anonymous’ 12 Step Program as a method for fighting your anxiety, can I ask how you do that?

Erin: I don’t really use the exact 12 Step Program, but more the ideas behind it put in terms of battling an “addiction” that I see as my anxiety/OCD. So, it is sort of the backbone to my approach. It’s as much about being powerless to the presence of my anxious thoughts (the same way an alcoholic feels powerless to their craving for alcohol) and the choice as to whether or not I listen and/or react to them (like refraining from a drink).

Julia: That’s a good comparison. “How to deal with things out of your control.”

Erin: Exactly. For so long, I thought listening to my anxiety was the only way to feel like I was in “control” of my world. Then I realized I was missing out on all of these things, because the solution to feeling in control was actually letting go of the idea that I could ever be in control. A very hard lesson for a control freak to learn. The Buddhists have been teaching this idea of accepting the groundlessness of life and our situations for thousands of years. They teach that if we can learn to sit with and embrace, rather than try to run away from or control, the inherent discomfort of life, and the discomfort of our fears, we will stop fearing them.

Julia: That does not sound easy.

Erin: Nope, haha. But in her book, Living Beautifully, the Buddhist teacher Pema Chödrön talks about how the chemical response that happens in our brains during an emotional situation only lasts for 90 seconds. Any pain longer than those 90 seconds is because we are choosing to hold on to it—so while I can’t control the chemicals in my brain, I can control how I choose to react to them. Of course, it’s not as simple as just waiting 90 seconds. For me, all I want to do is react, react, react, so I have to spend the whole time trying to convince myself that (1) this will only last for 90 seconds, (2) that this whole 90 seconds thing is not bullshit, and (3) that I will actually be capable of letting go of this pain at the end of the 90 seconds.

Julia: So like, “I am experiencing an anxiety attack, and when it is over then I can be productive again?”

Erin: In a way, yes. Amy Mina did a really good job of capturing this in her article about dealing with depression and anxiety. For me, it’s more like being in a dark room, with no lights, no doors–let’s actually make into more of a “dark abyss.” And I’m just sitting there, in the middle of this perceived infinite blackness, and my brain is basically saying, “There are no doors, there is no hope: you will never get out of this; you will always be here. You should just curl up in a ball and cry, because you are a failure, and you will never be free from the clutches of this panic. Ever.” Buying into that idea, by letting myself become the victim or by acting out compulsions to make it better, just perpetuates the situation. So, now, I try to sit with the fear, feel it, embrace, bathe in the discomfort of it, and try my hardest not to react to it. Then I try to let it go with the knowledge that I will be okay, no matter what happens. The stumbling block, of course, is that it’s hard not to believe my brain when it’s in an anxiety state, because it sounds so rational: “There are no doors.”  And even though I know that I am panicking, I look around, and I can’t see any doors, so it seems like my brain is right. My anxiety is part of me, it gets me, and we’ve been together for over 25 years, so of course it knows all the right things to say to try and get me to believe it. But if I can get myself to push past that, and  believe that I am in a room full of doors, and I would be able to see them all if I just stood up and stopped wallowing in this fear/sadness/self-pity/etc., then it’s like finding the light switch, and suddenly all the lights come back on and I can see all of these doors all around me and then my brain and I both can’t believe we ever thought any differently.

Julia: A catch-22.

Erin: Very much so.

Julia: So how does the method of the 12 Step Program help in the midst of an attack? Is it something actionable in-the-moment, or is it more of a perspective for you when you’re not in an attack?

Erin: Again, it’s really less about the 12 Step Program specifically, and more about the viewpoint that my anxiety and the compulsions associated with it and my OCD are an addiction. I’ve never viewed my anxiety as an “attack” or a “panic attack,” I usually call them “spirals,” because sometimes it can happen slowly, even over several days, but once my anxiety grabs hold, it starts pulling me down, and down, and eventually something really sets it off and I’m into that dark abyss. So it’s important that I try and address my anxiety, before I get sucked into a really bad “thought spiral.” It’s at that crossroads, when I have the choice to follow my anxiety or not–when I can feel the panic luring me in, tapping on my brain–that it’s the most important time to employ all the techniques, like the 90 second wait. Because as it gets harder and harder to fight it, I have to do whatever it takes to not give in to a compulsion even though my relief response is telling me, “This is the only way you’re going to get any relief. It’s the only way to make yourself feel better.”

That’s the “addiction,” that short-term pleasure of giving into a compulsion or a fear, instead of striving for the long-term pleasure of living an anxiety-free life. Like taking a drink even though you don’t want to be an alcoholic. So I use that methodology to enforce this idea that I can’t give into any fears or compulsions, because that just opens the door to scarier fears and bigger compulsions.  For example, I have a compulsion to pop pimples. It seems innocent, but if I let myself pop a nice juicy pimple, then it’s like a gateway drug to inspecting the rest of my face and causing more damage.  To allow the “innocent” compulsions is like swearing off hard alcohol but still drinking “just one beer”: it doesn’t work.

Julia: You have to commit to it, and not let your guard down.

Erin: Yes. Because the “little fears” pop up everywhere—like throwing out an onion because it looks a little too yellow and might make me sick—and then I’ve opened the door and suddenly I’m throwing out all the leftovers because they sat out on the stove for a couple hours. Since I’ve lived with anxiety my whole life, it was the lens through which I saw the world. So I just thought it was normal to just be panicked all. the. time. I had to learn to pay attention to what was motivated by fear and what wasn’t. Thinking, “I’m just going to double check pictures of yellow onions on Google,” when I know the onion is fine, is motivated by fear. That’s acting out a compulsion to silence a little seed of obsessive doubt in my head. Instead, I have to be confident in my belief that the onion is fine, in my choice to eat it despite the risk that it might make me sick, and in my knowledge that whatever happens, I will be able to handle it.

Julia: With all of this, you’re really self-aware.

Erin: I am now, but I didn’t used to be. My instinct was avoid, avoid, ignore, avoid, rush to continue avoiding. And, for a long time, I found my anxiety to be really effective. I channeled it into being a perfectionist and it led me to a lot of career success. But I was a complete workaholic and I ran into a concrete wall—as one is apt to do when they are constantly living in fear.  It was just unlivable. But I wasn’t depressed, I was just like “Ahhhhh, brain, why do you hate me?!” It took me a long time to learn the tools to even start to rewire it. A huge part of that was putting myself in a completely new place (because the environments we build when we are in an anxiety mindset can be a big part of what perpetuates that mindset) and paying attention to every action and habit—from the way I processed information, to the way I interacted with people, to where I found self-worth, to how I felt safe—so I could root out all the things I did that were motivated by fear and individually rewiring them. That’s when I learned to be self-aware, and it meant facing a lot of things I didn’t want to face, but it was the only way to root out the real problems. It took a lot of help though, and I can’t stress the importance of a good therapist enough.

Julia: As a friend, is there anything that I can do for someone with anxiety?

Erin: The thing is, even with a great therapist and a wonderful support network and, if helpful, anti-anxiety medication, the only person who can really help someone with anxiety is him- or herself. And believe me, it’s the last thing I wanted to hear and, sometimes still, want to hear. I hate telling myself, in the midst of anxiety spiral, that no one except me is going to make this better. In that moment, it seems impossible—too hard, too scary, too out of control, too everything. And I just want to look around and find something or someone that is going to make me feel better. But, that’s attacking the branches, not the roots.

Julia: What happens when you can’t?

Erin: That’s what I’ve been struggling with the most lately. If I’m in a good place, it’s easy to stay “good,” but once I slip, get stressed out, and start reacting, I can fall back into a spiral and suddenly, all of these old fears pop right back up and seem just as scary as they were when I started. It’s really hard not to look at this and let it shake my confidence and I start thinking, “All of my work has been for naught. I’ve failed and I’ll never be free.” To go back to the addiction methodology (this is another reason I like that metaphor so much), this is my version of “relapsing.” (Macklemore wrote a great song about “Starting Over” with his sobriety, that I find really helpful when I’ve “fallen off the wagon” with my anxiety or OCD.) I hate that place. It’s actually one of my bigger remaining fears.

Julia: You used that same phrase earlier.  What do you mean when you say “fall off the wagon”? How is that more than just an individual panic spiral?

Erin: When I’m having panic spirals consistently, or when my whole mindset has changed and my perspective on the world has turned back into fear, or victimization, or avoidance, I know I’ve “fallen off the wagon.” Often I find myself here because I’ve been too stressed or too tired to sit with the discomfort of my anxiety so I’ve been giving into fears or compulsions and now I’m subsisting on the “drug hits” found in those rushes of relief or from other distracting pleasures. I can usually tell because I’m feeling very anxious, or wired, and I don’t have this sort of warm, sense of patience and calm, that I have when I’m “on the wagon.” That’s really the best way I can think to describe it because it’s something I’m still working on keeping around consistently. It has to come from a sense of self, and not from outside sources (like the drug hits), and that’s really hard. Especially because that takes a while to build up, and every time you “relapse,” it feels like it’s going to be impossible to do it again. But you sum up the will to do it again and soon you find that warm feeling again, usually it sneaks up on me when I stop craving it, and it’s very similar to the moment in the dark, when all the lights come on, it’s just this pure, lasting, relief. It’s freedom. So, that’s my goal, that’s what I strive for every day.

Photo by Sara Slattery

Photo by Sara Slattery

What is “Normal”? Dealing with Depression & Anxiety

“It’s okay. It’ll get better. Everything will be all right.” I hate when people casually say those words to a distressed friend—and, usually, I am that distressed friend.

Photo by Andy Sutterfield

Looking back on my teen years, filled with moments of extreme sadness and anger over my body-image issues and my limitations, it’s tempting to say that my panic attacks and depression started then. I think, however, that I was just a regular moody teenager. But I do know that it was around this time that I adopted habits that later led to my anxiety disorder: I stayed silent, I ate my feelings, I avoided talking about it when others broached the subject, and I became resentful of my friends for their “easy” lives.

Anxiety disorders are the most common mental illnesses in the U.S., affecting 40 million people, roughly 18% of the population. There are a wide variety of them: generalized anxiety, OCD, PTSD, phobias, etc. If you’ve never experienced depression or a panic attack, here’s a rundown: We all experience anxiety, but those who do not have a disorder can rationalize their fears, work through them, and come out with a plan of attack for any issue they’re facing. But when you have an anxiety or panic attack, the fear takes over. You can’t step back, you can’t shake yourself out of that place of fear, and you can’t force yourself to “just not think about it.” I’ve heard people say a panic attack feels like having a rubber band pulled across their chest, or having an elephant sit on them. The first time I felt it, I thought it might be a heart attack: the shortness of breath, the erratic breathing, the tears. After the attack passes, then comes the self-admonishment, the feelings of inadequacy, the thoughts that you must be weak and inferior to those around you because they don’t go through this—all of which feed into depression. And when you’re depressed, you can’t lift yourself out.

Depressed isn’t just sad or frustrated or down. Depression is detached, and that feels worse than the sad times or the panic-stricken times. You hear people say that if you put on a happy face, the good feelings will come. It’s not true. I’m putting on the happy face, I’m being my perky self. I’m at work, I’m with friends, I’m joking, I’m laughing. But there’s a cold layer around me. I feel as though all my movements are jerky and disjointed as I’m internally debating and debasing myself. You try to pull yourself out, wanting to feel something because anything is better than nothing. You try to talk to friends and family about it but you can’t get the words out or, when you do, they don’t know what to do. So they just offer the only comfort they can—“It’s okay.”

Anxiety disorders and depression do not always go hand in hand, nor does one predispose an individual to the other. However, studies show high co-morbidity rates: in a study of 3,000 patients in clinical trials for generalized anxiety or depression, about a third of anxiety disorder patients had severe enough depressive symptoms to enter the depression trials, while two thirds of the patients in the depression trials had anxiety disorders that warranted joining the generalized anxiety trials. I’ve gone through periods of both anxiety and depression, and because I have—because I’ve sought help—I know I’m likely to go through them again. I know it’s not an instance; it’s a cycle that’s repeated and feeds on itself. But I’ve also learned I’m not alone.

When you live with anxiety or depression, you might feel like you’re the only one, until you meet another ‘only one.’ When my attacks clustered closer and closer together and I started distancing myself from friends, I was scared about where I’d end up if I didn’t get help. So, I started talking to friends who I could trust. It helped me to vent and their comfort kept me from feeling like less of a person. But I still felt disconnected from my peers who all seemed to excel, unhindered. Then, a friend confided in me and told me about her own struggles. A coworker revealed the truth about her battle with the same illness. Suddenly, I wasn’t an imperfection in a perfect world; my struggles weren’t proof of my inadequacies as a human being. I was normal, beautifully and imperfectly normal. It seemed weird and maybe even wrong to feel legitimized by other people’s struggles. But I was. And that was worth something.

I’m not saying talking about it always helps, but not talking about it never does. I’d talked to friends mid–panic attack, either calling them or tracking them down at school to explode at them. They weren’t prepared for it, nor did they have the knowledge or skills to deal with it. But as I became more comfortable telling friends about the imperfect areas of my life, they reciprocated that comfort. I found safe zones to talk and let off steam before I reached attack mode.

So, how can you tell if you’re near this precipice? If any of the above resonated with you, you may want to talk to someone (yes, actually voice the thing you’re most desperate to quell). There’s a stigma associated with “not being able to deal.” A coworker who’s faced similar struggles told one of our peers and was discouraged from telling anyone else. But what we’ve experienced is real, and so is the connection I now have with this amazingly strong and beautiful woman. If she hadn’t told me about her situation, we might not have ever had this connection.

Okay, so what should I do? Again, talk about it. I couldn’t afford a therapist, so I looked into group programs I could join, which are cheaper. The people I met there provided me with a support system. If that doesn’t help, maybe one-on-one sessions are a better fit for you. Bear in mind, however, that it can take a couple of tries to find the right therapist or support group. You have to feel as though you’re in a safe place. Don’t settle until you’ve found that.

Aside from the importance of talking about it, I’ve also learned the value of the following:

Don’t Assume

The perception that your friends and family have it easy builds negative emotions and increases your feelings of being different. It’s hard to remember that those around us suffer too, that the grass isn’t always greener on the other side, but try. Resentment only distances you from the positive influences in your life.

Sleep

This can be hard when you lie awake at night for hours thinking of what’s to come. But if you’re prone to missing sleep, don’t go to bed when you have to be up in eight hours. It sounds weird, but budget for the freak out. You’ll cry and you’ll stress, but eventually you’ll be so drained emotionally and physically that you will drift off to sleep. However, if you suffer from insomnia, consult your physician.

Exercise

To quote Elle Woods, “Exercising gives you endorphins. Endorphins make you happy. Happy people just don’t kill their husbands. They just don’t.” I’ve always hated when people suggested exercise to help with mood, cramps, whatever. But it does help. Exercising results in an increase of serotonin and endorphins, which are chemicals that alleviate depression. But even if that twenty-minute walk around your neighborhood doesn’t do much for you chemically, it at least allows you to have some time alone. You have the opportunity to think things through, to be away from the pile of bills waiting for you on your desk, or your spouse who you just had a fight with.

Stress Less

Easier said than done, I know. But map out the major stressors in your life, talk it through with someone if it helps, and formulate a plan of attack to deal with each one in turn. Try not to think negatively. It’s hard but doable. Instead of thinking of “I can’t get a better job,” say to yourself “I’m going to revamp my resume by the end of the week.” Turn your fears into a to-do list. When you make a mistake, instead of obsessing, take a step back and see what you learned from the mistake and do your best to accept it.

Focus on the Happy

I love journaling because it’s a great way to document milestones and see how far I’ve come. However, when I’m upset and want to gain perspective, looking at old journal entries from when I was down can actually increase my feelings of anxiety or depression. For my New Year’s Resolution, a friend and I started a little yearlong project. We each bought a mason jar and pretty stationary. Every time something good happened or we stumbled upon something random that made us happy, we would write it on a piece of paper and stick it in the jar. Whenever I’m down, I open the jar and read through some of the anecdotes. Remembering those moments and how happy I was when I wrote them down helps to lift me out of my funk.

Recognizing and Helping Depression

In thinking about writing this post, there were a lot of angles I considered coming from. Do I talk about how, in my work at a university, I frequently see students who are buried under the weight of this nebulous and frightening disease? Do I talk about family members or partners or friends or other loved ones whom I have been able to help or, in some terrible cases, not been able to help? What I hope my internal editorial struggle conveys is that depression is incredibly common. According to the CDC, about 1 in 10 adults report experiencing depression in their lifetimes. The number is even higher for young adults.

Seeing a friend, family member or loved one who might be depressed can be scary and overwhelming. But depression is both recognizable and treatable. This should bolster you, knowing that if you can catch depression in yourself or recognize it in a good friend or loved one, you can go a long way toward making someone’s life better.

Depression and other mental health issues are still incredibly stigmatized in the U.S., and so it’s important to remember a few things: people are never, ever at fault for their mental health problems, and treating them like they are only alienates them and makes it harder to help them. Second, you will probably not get a bouquet of roses from someone you are helping, but that does not mean you didn’t make a difference.

Below are some basic signs that you or a loved one might be depressed. Keep in mind that depression is complex, that this is not an exhaustive list, and that this is not in order of importance. It is a good place to start, however, if you are feeling concerned. Here are some common aspects of depression:

  • Feelings of hopelessness and/or pessimism—like nothing will ever get better.
  • Feelings of guilt, worthlessness, and/or helplessness—like nothing matters or you can’t do anything right.
  • Irritability, restlessness, or being easily angered (this is especially common for men).
  • Sharp and unexplained change in behaviors, including the following:
    • Disinterest in activities, hobbies or work that were once very important or fun;
    • Feeling very tired or excessive sleeping;
    • Insomnia, early-morning wakefulness;
    • Change in eating behavior, like overeating, skipping meals, or a loss of appetite.
  • Difficulty concentrating, remembering details, and making decisions, especially if this was not an issue before.
  • Thoughts of suicide or suicide attempts.
  • Persistent aches or pains, headaches, cramps, or digestive problems that do not get better, even with treatment.

If this sounds like someone you know, it’s really important that you reach out to them. Here are some basic steps for talking about depression with someone you love:

  1. Express your concern. If you see something, say something. Depression can be incredibly isolating, and so it’s very important to show that person you notice and are concerned.
    • Do this with as much care and kindness as possible, in a private and controlled environment. This is not a good discussion to have on the bus or in a crowded coffee shop. Talk about specific behaviors you’ve noticed, but don’t make the observations sound like you are accusing them of having done something wrong. Something like “I’ve noticed you’ve been missing a lot of work recently, I’m concerned that something might be wrong” is much better than “Why have you been missing so much work?” because it is less accusatory.
    • The person you are speaking with may rebuff you, get angry, or be relieved that they have someone to share with. It feels best when people are relieved, but don’t expect this reaction 100% of the time. If the person you are concerned about is angry at you, do not take this personally. Depression can come along with strong feelings of shame and anger, and this can make it easy for the person to deny the severity of what they are experiencing and lash out at you. Remember, bravery isn’t a lack of fear, it’s doing something despite your fear. Even if you are worried about their reaction, it’s still important to reach out.
  1. Listen. Give your friend the space to express themselves and really listen. Don’t jump in, don’t talk about your own experiences (especially don’t tell that story about your cousin’s friend’s brother), and don’t give advice. Also, don’t be offended if they are not interested in telling you their life story. Create a welcoming and safe space, and allow your friend to be supported by you.
  1. Refer. I know, I know, we just talked about not giving advice, but this is different. Having a resource or two on hand to give to your friend is incredibly important. This can be anything from a hotline, to the number for your therapist, to the counseling center at your university (if you’re still in school), to an article online talking about depression.
  1. Follow Up. Check back in with your friend after a day or two and see how they are doing. Again, express your concerns, and listen. You can’t make someone get help, and you shouldn’t follow up in order to make sure that they do. This is mostly to let them know that you are consistently going to be there for them, and that you are not going to bail after one (likely very intense) conversation.

Lastly, here are some resources to keep in your pocket:

  • In an Emergency: Call 911 – If someone is thinking about attempting suicide or if they have already attempted suicide,  it’s critical to get highly trained professionals on your side. Don’t hesitate to call 911.
  • National Institution of Mental Health – Information about Depression: Interested in some more information about the prevalence and effects of depression? That is provided here in a helpful way and contains much more information about the many types of depression, treatment options, and experiences of those who have been diagnosed with depression.  http://www.nimh.nih.gov/health/topics/depression/index.shtml
  • Suicide Hotlines: Sometimes it’s critical to have someone to talk to and give you strategies to not harm yourself, or to help you work through whether a friend is in need. These are free and most are available 24 hours.  They have services specifically for veterans, Spanish speaker, and teens, among others. Call if you need help yourself, or if you need help helping someone else. Sometimes friends aren’t available or don’t have the right tools, and this is where these folks come in. http://www.suicidepreventionlifeline.org/
  • Online Emotional Crisis Support: Not everyone feels comfortable on the phone or has access to a private place to have a conversation. This is the chat room version of the service above.  http://www.crisischat.org/
  • College Student Helpline: Depression for college students is very common. 18-24 year olds experience a wide range and, according to some researchers, the highest prevalence of mental health problems. These folks are specifically trained to help college students.  http://www.ulifeline.org/
  • Grad Student Helpline: Many studies have shown that for whatever reason (high stress, high pressure environment, self-selecting factors), grad students are at a very high risk of poor mental health. Like the resource above, this helpline is specifically geared to help graduate students and to understand the issues they face. http://gradresources.org/

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