Tips for Understanding and Working with Depression

By David Robbins, MA – Boulder Counselor and Psychotherapist

March 24, 2009

Having the blues for a few days at a time is normal. Usually these feelings are temporary and will pass after a few days. If you experience low mood, sadness, and hopeless for weeks, or even months at a time, there is a good possibility you are dealing with depression.

Some of the common signs/symptoms of depression are:

    * Persistent sad, anxious or “empty” feelings
    * Feelings of hopelessness and/or pessimism
    * Feelings of guilt, worthlessness and/or helplessness
    * Irritability, restlessness
    * Loss of interest in activities or hobbies once pleasurable, including sex
    * Fatigue and decreased energy
    * Difficulty concentrating, remembering details and making decisions
    * Insomnia, early–morning wakefulness, or excessive sleeping
    * Overeating, or appetite loss
    * Thoughts of suicide, suicide attempts
    * Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment

If you are experiencing these symptoms, over the period of two weeks or more, it would be a good idea to see a counselor or mental health professional. Medication can be a very valuable part of treatment for depression, but studies show that the most effective outcomes for those suffering with depression come with the use of counseling and medication. Counseling has also been shown to be at least as effective, or in some cases more effective than medication alone.

Often, when we are depressed we have lost touch with our inner world. We have numbed out and are wrapped up in ruminations, or persistent thoughts that often have a flavor of despair, desperation, and hopelessness. We often feel lethargic and heavy in our bodies, without much energy.

Despite this lethargy and exhaustion, getting out of the house and moving can often be one of the most effective forms of treatment for a depressive state or low mood. I often recommend 3-5 days a week of a half hour of aerobic exercise, such as jogging, or a vigorous walk. Even a short walk can make steps towards elevating our mood.

When I work with clients who feel depressed, I stress the movement away from the hopeless (and often non-stop) train of thoughts that run through one’s mind when we feel low. We cannot stop the thoughts, but we can loosen their hold on us and question our belief in the negative things that our thinking may be saying to us. If we can feel the body, we can start to dis-believe and let go of negative thinking patterns that are perpetuating depression. We can also reconnect with our body and awareness of the sensations of our body. In doing this we naturally move away from negative thoughts and energy starts moving in the body. When we begin to re-engage with our bodies we become more present in ourselves and our lives – this is a movement towards health and healing.

Below is a simple mindfulness exercise to start loosening the hold of negative thinking and re-connecting with the body:

    Sit in a quiet place where you will not be disturbed, allowing 5-10 minutes
    Begin to feel your feet on the floor (you may only be aware of a slight pressure or the flow of blood etc.)
    Notice when your attention has been drawn away from the sensations in your feet
    When you notice this gently let go of whatever you’ve been paying attention to.
    Gently come back to noticing your feet and the sensations in that part of your body. (we are not trying to stop our thoughts, just to move our awareness to the body allowing the thoughts to continue in the background without paying attention to them.)

This sounds incredibly easy, but if you try it you will find how hard it is to stay concentrated just on the sensations of the feet. Our thoughts are very distracting and seductive; particularly when we are in a low mood or depressed state. If you practice this once or twice a day it will become easier to be aware of the negative thinking that perpetuates depression, and you will be able to quickly move away from them, and into your body. This will loosen the hold of your negative thoughts and usually your sad and hopeless feelings will begin to subside as well. Give a try.

You are more than your thoughts and fears.

Through this simple mindfulness exercise it becomes apparent that we can choose whether or not we believe negative and self-critical thoughts. Often our thoughts are simply a habitual script we learned at some point and are repeated in our minds during an associated mood or feeling state. These thoughts lose their power over us when we choose not to believe them by moving our concentrated awareness back into the body (as in the exercise above).

In the case of depression, negative or self-critical thinking can often perpetuate low moods and disturbing feelings. If we loosen the hold of our negative thinking often sad, hopeless, or despairing feelings will merely arise and pass away, rather than becoming a solid and perpetual state.

If you believe you are experiencing depression, do yourself a favor and seek out counseling. A therapist or counselor can help you learn to skillfully work with depression and re-connect to your life so your depressed feelings will lift and you can get back to living the life you want.

A researched model of treatment for depression, that works with mindfulness of the body to break through ruminative thinking patterns and relieve depression is Mindfulness-based Cognitive Therapy MBCT. I use this model of therapy (as well as other therapies) to help clients struggling with depression to regain equilibrium and feel better about themselves and their lives.

For additional resources on the depression, types of depression and treatment visit NIMH page on depression.

Warm Regards,


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