Depression is something that can affect anyone. Once, someone spirals downwards it is extremely difficult to get out of this.
While I was researching causes and especially also actions that can be taken to mitigate or negate the effects of depression I found this presentation from Dr. Michael Yapko. It resonated with me strongly and contains extremely useful and helpful information. The video is rather lengthy, therefore I decided to create a summary and bullet points of action items that you can take away.
Should you be affected by depression I hope the article and the described coping strategies help you. That being said this does not replace professional help. A good therapist is essential for recovery, especially in severe cases. Asking for help is not a weakness, it is a strength!
Here are some guardrails when you should ask for professional help:
- If you have suicidal thoughts ⇒ even remotely contemplating this! This is the first cue. Act now before it is getting too late!
- When you are feeling stuck and hopeless
- When you don’t have support or people around you that can reality test with you
- When you affect other people – every depressed person affects on average three other people negatively
What is depression?
The most simple definition is that depression is a mood disorder. However, this is not accurate as it is much more. It has a wide impact on various aspects of your life and functions such as:
- your physiology and physical health and is a risk factor for many different conditions, most notably cardiovascular disease
- impacts your thinking and decision making
- affects job performance and ability to function
- negative effect on concentration
- negative impact on relationships as it is hard to be around people with depression
It is also quite notable that someone who never experienced depression cannot really understand how it feels. The healthy brain simply is not capable of making the jump to the depths of challenges that a depressed person faces.
What causes depression?
Depression has been researched quite heavily and nowadays we know that there are many risk factors. Some of them are outside of our control. The good news is that it was identified that despite factors that are outside of your control, you can still effectively negate those factors and improve your well-being.
When looking at it from a bird’s view the two biggest key risk indicators for depression are:
- Gender
- Family
Especially family is interesting, what it means is that if you are growing up in a household with one or even two depressed parents, it is extremely likely that you will be impacted by this as well. This sounds bad and it is, but it also means that some of the reasons for depression are learned or not learned coping mechanisms. This can give you hope as it means you can work on it.
Aside from those two basic indicators, there are many more such as:
- biological factors / genetics
- psychological factors
- social factors → actual huge factor
Biological factors are playing a role and you can hardly influence them, but they are a minor part compared to psychological factors such as:
- individual history
- individual problem-solving styles and coping styles
- individual attributional style (the habitual or reflexive way of attaching meaning to life events)
- the social side of the equation
After Dr. Yapko interviewed many hundreds of people on why or why not they are depressed it became evident that the main indicator of whether someone is depressed or prone to depression is not what happens to people and more about how they interpret events in their life.
Let’s have a look at the social factor. Social structures changed dramatically in the last years which had quite an impact on depression. Especially technology like the smartphone is one of the strongest risk factors for young people. The higher amount of time you spend in front of a screen the higher the likelihood that you suffer from depression.
Why is the phone such a risk factor? It creates a superficial meaning of connectedness, but humans crave deeper meaningful connections. Furthermore, social media forces our attention to compare ourselves to others. As we only see the highlight reels of others we only see “perfect” lives which will make us feel wanting.
Basically, people are dying of loneliness, the disconnectedness plays a significant role in driving depression.
What does this mean for you?
The cause can be manifold, which is why the path to depression is different for everyone. This means for you that there is no best or “the” approach to treating your depression.
The best approach is the one that works for you! This is important, you as a consumer, who is looking for help understand that your journey is going to be different and unique. There is no standardized treatment!
Since we do not have control over biological factors and cannot immediately change social factors we will focus on internal and cognitive factors and coping mechanisms. When interviewing people that are resilient to depression, despite horrible live events, they all had one thing in common: They were able to control their internal voices. Those survivors have somehow developed a resilient inner dialog that helps to cope. This is a skill that can be learned and trained and therefore will allow you to develop a healthier way to deal with depressive thoughts and moods.
To be clear, the goal is not to cure depression, the goal is to learn how to manage your moods! This needs to be done continuously just like exercising… Everybody gets depressed once, in a while, everybody is vulnerable… if you are capable of moods you are capable of disorders. Learning how to manage that aspect of yourself is critically important. In order to develop this critical skillset start by asking yourself below questions and observing your triggers and risk factors:
- Learn what your vulnerabilities are!
- What are your risk factors?
- What is very troublesome for you but not for others?
The below describes the psychological/thought pattern-based risk factors and how to cope with them. It is crucial that you understand how your mind works so that you can detect negative patterns.
Key risk factors/detrimental thought patterns:
- Internal orientation
- people use themselves as a reference point, using their feelings to make decisions. Using feelings to interpret things that happen in their life
- it drives you inwardly → self-absorption
- When you use your feelings as indicators of what to do you are going to make mistakes!
- feelings can too easily deceive you
- you need the ability to go outside yourself and learn something about what’s actually going on
- Coping strategy: Learn to reality test.
- Ask yourself: How do I go outside myself in order to know whether this is really what’s happening?
- If you have relationships, it is valuable to get their point: “Here’s what’s going on. Here’s what I think about it. What do you think?”
- Don’t jump to conclusions, try to think about what you do not know… Don’t trust your negative voice
- Stress generation — or how do people make decisions that complicate their depression
- Decisions that are counterproductive to getting better.. example not exercising, not taking advice from a doctor or going to therapy, etc…
- Your mood affects the quality of choices you make and how you remember things!
- Coping strategies:
- Learn to take actions that are consistent with your goals and independent of your feelings – feelings come and go – consequences last
- Don’t isolate, socialize
- Don’t drink! If you are depressed alcohol aggravates the same near pathways!
- Rumination – spinning the same thoughts over and over again – analyzing at the expense of taking action
- It drives symptoms of anxiety and depression
- creates difficulty with even basic things like sleep as the brain does not stop – always thinking about problems
- Thinking about a problem is ok as long as you take action – action has to be timely
- People mainly ruminate about relationships or school & work
- especially relationships from the past ← key factor of depression
- the feeling that my past controls me
- using the past to predict the future
- If your thinking does not lead to timely and effective action, you think too much and it can be a problem
- Coping strategy:
- Remind yourself: Whatever your history is, you’re more than your history. You’re more than any one characteristic. You’re more than your job. You are more than your title. You’re more than your income. You’re more than your body size. You’re more than how many likes you get on Facebook or Instagram or any social media.
- All those things don’t matter and cannot be the basis for defining yourself
- Create possibilities – there aren’t any guarantees in life, but we can take actions that create possibilities for the future
- Global thinking / global cognitive style – engaging in over-general thinking
- Example: Girlfriend breaks up and thinking “Women!”.. thinking as if they’re all the same
- Example: Having a bad day and thinking → Why is life so unfair?
- The issue with this global thinking is that it does not allow you to see the trees in the forest. It does not allow you to be a good problem solver
- You might not think global about everything → e.g you can manage your bank account and other things. But in some areas, you will apply this global thinking. Watch out for it!
- Coping strategies:
- Learn to be specific about things
- Define goals with a flow of steps that lead to the goal (without that it is just a wish)
- crucial for developing an understanding of how to go from global to linear thinking
- Example Exercise: Define the goal and flow of steps for taking a shower. Delineate every step involved in taking a shower. As much detail as possible… challenge yourself on this
- Once you do the flow chart for the shower → build the flow chart for how to be happy ⇒ typically people realize they have no clue how to be happy, and if you do not know how then you cannot succeed
- Unrealistic expectations – our expectations are the filter for how we judge everything
- Having unrealistic expectations is one of the pathways to depression as you will be hurt and disappointed constantly
- Before you ask a person for something it would be good to know if this person can do it. Is this part of the person’s makeup?
- can the person do honesty, integrity
- can they do patience or anything else you would want
- People often get in relationships with other people and are forever pulling on them for affection or attention (ignoring the true makeup of the partner and therefore making themselves unhappy)
- Coping strategy:
- Before dealing with people or walking into a situation you need to lay out your expectations. What are they? Are they realistic?
- How do you know if the expectations are realistic? Well, you get good at trying to estimate if this is realistic and learn over time. Practice makes you good.
- Practice laying out your emotions and challenge yourself whether they are realistic for the person or situation
Rules & Actions for fighting depression
The most important skills to fight depression are problem-solving and social interactions. To get good at those you need to practice them. What is even more important is that you need to be able to be: Build a compelling future for yourself – Ask yourself: How do I want my life to be?
The Do’s
- get a thorough physical exam – check there is nothing medically going on that gives rise to depression (starting point to exclude this)
- Avoid alcohol completely, yes you!
- Strive to learn about your vulnerabilities and develop ways to manage them –
- What makes you think negative thoughts or have negative emotions?
- What are your specific risk factors?
- What are things that you’re reactive to that other people are not particularly reactive to?
- Learn to distinguish facts from feelings, beliefs from facts
- Challenge yourself 50 times a day. Here is what I think. How do I know?
- Reality testing
- Practice watching your thoughts
- Avoid global thinking – if you generalize stop
- Keep your expectations in check – practice laying out your emotions before going into a situation and ask yourself if those emotions and expectations are realistic
- Stop ruminating if it does not lead you to action – the past does not define you
- Create possibilities – there aren’t any guarantees in life, but we can take actions that create possibilities for the future
- watch your internal orientation and don’t let emotions dictate actions
- try to reality test, think about the things you do not know
- push yourself to actions that you know are good for you, even if you do not feel like it (exercise, socialize)
- Sleep is critical – take it seriously
- no sleeping with a smartphone or computer on
- be careful about the environment you create
- Exercise!
- easy, available, works – not only because of neurochemical reactions but also because gains are to be made quickly
- good for people with low frustration tolerance, good way to get ahead relatively quickly
- Do fun things and do them often
- Humor
- At least some of the time, dare to be superficial
- Get and stay connected to other people
- Learn to relax
- Relaxation processes
- Meditation
- visualization
- guided imagery
- any relaxation process is going to be beneficial
- be goal-oriented in the important areas of your life – realistic goals
- a goal needs to have a flow of steps that you can come up with, otherwise, it is just a wish
- prioritize and problem solve. Get help and don’t wait
The Don’ts
- Don’t dwell on the past – it’s gone but tomorrow hasn’t happened yet!
- Focus on what you can do that’ll be different in the future that’ll change how I feel about the past
- Don’t compare yourself to others!
- This is the biggest issue with social media
- If you feel depressed, maybe take a break from social media
- Avoid global thinking, avoid catastrophizing
- it helps to understand probabilities
- Don’t leave important things unsaid or unresolved
- Closure counts for a lot
- Don’t analyze too deeply. Move on
- Don’t ignore reality – get the facts
- Don’t ignore your own needs. Self-care is not the same as being selfish
- Don’t give up or be passive
- Try again but do something different
- Don’t isolate, find good people to be with
- Don’t leave time unstructured
Additional helpful pointers
Managing your emotions and taking the above-mentioned actions are key to pulling yourself out of a depression, taking action is the first step. In general, there are some additional points that are feeling useful for me that I wanted to share:
- Understand: Screen time does not bring you happiness
- You will not be liked by everyone, accept this. This is ok. Instead, build your tribe of people and be the best person you can be for those people that like you.
- The human is a social animal and needs meaningful connections.
- Build and maintain human relationships. Yes this is effort but it is worth it
- Getting to know other humans opens up their own universe for you
- A career is not everything, live and be in the moment
- Acknowledge your nomadic itch / your desire to experience new things
- can be in the small day-to-day things
- Try new things and find what is fun for you and makes you happy
- Watch your surroundings and work on a positive environment
- Get rid of negative influences
Depression is a topic that affects many. It can have various forms and intensities but one thing is always the same! The person that is affected suffers. I hope that the findings from Dr. Yapko and this summary help in any way.
