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~ Depression ~
S. Hein

Introduction

Depression as a Secondary Emotion

The Value of Identifying Specific Feelings

Questions to Ask Yourself

How to Help Someone Who Feels Depressed

Nature's Purpose for Depression

Depression, Medication, Cause / Effect and Society

Depression and Learned Helplessness


Core Topics

Respect | Empathy
Caring | Listening
Understanding

Free EQ for Everybody Book


Introduction

The ideas here are primarily those of Steve Hein and are based on a combination of research and over 15 years of direct experience in youth suicide prevention.

 
Depression as a Secondary Emotion

Depression may be thought of as secondary emotion. This means that there are other feelings which contribute to and cause it.

For example, one might feel alone, lonely, rejected, discouraged, loss, grief, unfulfilled, disconnected, uninspired, invalidated, used, abused, unproductive, unaccomplished, uncertain, misunderstood, pessimistic, powerless, etc. Together, all of these feelings drain our energy, kill our motivation.

The Value of Identifying Specific Feelings

When depressed, or preferably before, it helps to isolate each specific feeling which contributes to the over-all loss of motivation and energy. When the specific feelings are identified, you have more information to work with. From this information you will be better prepared to take action or least think about a plan to address each specific negative feeling individually. With each specific negative feeling, ask yourself, "What would help me feel less (lonely, unproductive, discouraged)"?

 
Helpful Questions to Ask Yourself

Here are some questions which might help you if you are trying to understand your own depression:

  • Have I lost something? A belief? A dream, a relationship? A vision? Is there some disillusionment? Some unmet expectation? Unfulfilled desire?
  • Am I feeling productive? Am I accomplishing anything?
  • Do I feel focused? Do I have any goals I am working towards?
  • Am I feeling pessimistic about something? About several things? Am I feeling discouraged about something? Hopeless?
  • What beliefs are helping me feel pessimistic, discouraged, hopeless?
  • Am I looking for something on the outside to happen before I will feel better?
  • Am I feeling dependent on someone?
  • Do I feel resentful about something? About someone?
  • Am I feeling disconnected from my emotional support system? Do I have an emotional support system?

Then ask yourself:

  • What would help me feel more optimistic? More encouraged?
  • What beliefs can I change?
  • What can I find to appreciate? To be thankful for?
  • What would help me feel more connected to others, or less dependent on them?
  • What could I do to strengthen my emotional support system?
  • What small goal could I achieve right now that I am sure I can do?

Taking your feelings one by one helps you feel less overwhelmed. And it helps you identify you emotional needs. When you feel better in just one area, it helps you feel more capable of handling the other negative feelings.

How to Help Someone Who is Depressed - S. Hein

Sometimes when someone is depressed and not talking people will say, "What are you thinking?" For many people, this is not a helpful question. When they are depressed it is too hard to answer that question.

When you are depressed your energy level is very, very low. To explain what you are thinking may take take too much additional energy.

That is why it is better to ask someone how they are feeling. There is a chance that they can find one word to summarize how they are feeling, or one word to tell you the main feeling. For example, they might say, "Alone." If they see that you accept how they feel, and you don't invalidate their feeling, they may feel a bit more understood. This could help give the a small emotional boost and be a start to helping them talk.

Or if it is too difficult for them to say anything you might get them some paper and a pen, or colored markers.

Or you might show them a copy of the common negative feelings and ask them to just circle the ones they are feeling.

One of the keys to helping someone who is extremely depressed and not talking is not to ask them to do anything which requires a lot of effort, or even any effort. As mentioned above, asking them to tell you what they are thinking is probably something which requires a lot of effort at that moment. Also, if you ask them what they are thinking, they might feel pressured to say something and since they can't, they only feel worse and less understood. If you get frustrated with them they will feel disapproved of on top of everything else. When someone is depressed, mostly they need to know someone cares about them and won't reject or abandon them. If they are asked what they are thinking, and they can't reply at that moment, or if they asked, or told to do anything which they can't do they may be afraid of your rejection or disapproval, which is causing even more discomfort for them.

You might ask something like, "Are you afraid of telling me what you are thinking or how you are feeling?" They might say yes. Or they might say nothing. Here is a case story:

The other day I asked someone if she was afraid to tell me what she was thinking and she said nodded her head yes. So this was a small step forward. I think she felt a little more understood, which in turn helped her feel less afraid to start opening up, which she did shortly after that.
More Suggestions

- Don't tell depressed people what you think. If they tell you something, don't disagree. Just listen.

- If they have an idea, don't discourage it. Just listen.

- Don't try to explain anything. Just listen and let them come up with their own explanations. If they want to hear your opinion about something, they will probably ask you, but even then try to keep it short and let them talk more than you.

- Don't say things like

Maybe it is because...
She probably....
I think it is because...
It could be because...
That is because...

The problem with all of these is that it puts you in a position of providing explanations instead of them. When you explain something, it gives you a bit more authority or power in a relationship, yet depressed people usually already are feeling somewhat powerless. So it would be better to help them find their own explanations. This also helps them feel a bit less dependent on someone else.

- Don't tell them what you think before you tell them how you feel. Or maybe, don't tell them what you think at all.

- Help them feel in control and cared about.

- Give them some control by asking things like "Is it okay if I stay here?"

- Show them that you care by staying with them, if that is okay with them.

- If you need to leave, tell them where you are going and when you will be back so they won't feel abandoned. If possible, ask them if it is okay if you go before you leave..

- Ask if you can sit next to them. If they can't talk ask if they could give you some signal for a yes or a no answer such as showing one or two fingers. Or if they would like you to take their hand, ask them to squeeze it once for yes and twice for no. The more in control they feel, the safer they will feel and the less pain.

- If they can't move or talk or express anything, tell them how you feel, if it is not something negative. Show acceptance, caring, understanding, patience.

- Try to reduce their fears you will abandon them.

- Do not betray their trust.

 
Nature's Purpose for Depression

Depression has a natural purpose and survival value for the human species. It causes us to slow down and rest. This provides us with an opportunity to think. If we use this as an opportunity to reflect on why we are depressed, and to identify our unmet emotional needs, we can start to get some insight into what changes we need to make in our own individual lives, and in society as a whole.

 
Depression, Medication, Cause and Effect and Society

Here is a reply to a reader's question:

Hi Dave,

You asked about medication.... generally I am not a big fan of it. The main reason is that it does not address the underlying causes of the depression, which, based on my experience have a lot to do with social and family conditions. Medication, though, doesn't help improve those causal conditions. It may even serve to perpetuate them.

For me, depression has a purpose. It causes us to slow down and rest, and think. If we use this as an opportunity to think about why we are depressed, for example to identify the specific unmet emotional needs, we can start to get some insight into what changes we need to make. I think most of us could use some slowing down. I think if we took time to really listen to each other, for example, there would actually be less depression. I also think that if we would stop and ask why we are working so hard, and reflect on what is really important, we would see that relationships, and inner peace are what are important, not money and material things. We would then invest more energy on self-growth and personal relationships.

I have gone through lots and lots of depression myself, even feeling suicidal. Always, though, I have come out of it with some new awareness. I don't believe I would have had this awareness had I taken medication, which, by the way, I never have.

I see nothing particularly wrong with depression. What I think is wrong is people who act like it is a moral flaw or something, and people who want everyone to just keep working and "getting on" with things. I have said, only half-jokingly, that if you are not depressed at least once a month, given all the really horrible things happening in the world, then something is wrong!

I think depression helps us see the pain and sadness in the world, of which there is a lot to see.

I read that depressed people are more realistic, by the way. (I don't think the study talked about which was the cause and which was the effect though!)

There was a book called The Right To Feel Bad... I have some
notes from it. If you can find the book, I'd say it is worth a look. It is out of print now but maybe you can still locate a copy. I guess too many people think it really isn't ok to be depressed and just want to know how to quickly get undepressed, rather than hearing how depression might actually be helpful.

Something else good about depression is that it can get you closer to your feelings if you don't try to numb yourself from them. This closeness helps you identify with other people. Not just depressed people but with people who might be lonely, or discouraged, or invalidated, or judged, or unaccepted, or confused or grieving the loss of something.

One big problem in society is lack of connection, so if we can connect on an emotional level with other people when they feel something like one of the many primary feelings which contribute to depression, we feel more connected and they feel less alone and more understood.

Well I hope this helps a little bit. You have helped me think through these things a bit more.

Steve

Here is another letter to Dave

 
Another letter to Dave

Hi again Dave,

You are an extremely insightful and self-aware person.

Your letter brought me to near tears. You describe things so articulately. Only an exceptionally aware and intelligent person can do that.

About therapy, I do support the idea of talk therapy, as I call it. And I like groups, not necessarily those run by a professional. For example, I started an informal men's group once with the help of a guy who had been in one. It was very helpful for me. I also went to various other support groups such as the 12 step ones, even though I wasn't alcoholic or a child of an alcoholic. The problems were similar and it helped to hear others talk so openly. I highly recommend them, as long as a person doesn't get dependent on them.

Something else, you are an excellent writer. I would suggest writing in one of the online diaries such as opendiary.com. There you can meet other people of like intelligence, emotions, issues etc. Generally the people are incredibly supportive. Writing there helped me find my best friends. I wrote honestly there and people who related to me and connected with me wrote back over time and friendships developed. I felt accepted there, which was a very powerful feeling I had never experienced in quite the same way.

I also felt supported, believed in etc. My online friends filled the emotional needs which my family left unfilled.

I don't remember you talking much about your family. I think this is important to look at. Some therapists don't seem to want to get into family stuff for some reason, maybe because they had problems in their own families they don't want to face.

It sounds like the person you are talking to is okay so far. How much do you feel understood by him from 0-10? How much do you feel cared about? I am unusual in that I think it is important for us to know someone cares about us, even a professional.

I had a lawyer once who I paid a lot of money to but I don't think he cared about me much at all. I think he could have just as easily represented the other side of the case.

Probably we need to learn to care about ourselves, accept ourselves, but it sure helps if someone else cares about us, accepts us admires us, appreciates us, values us and so on.

Best wishes, I invite you to write again.

Steve

 
Depression and Learned Helplessness

Here is a quote from the Neogenisis site about depression and learned helplessness

The theory of learned helplessness was then extended to human behavior, providing a model for explaining depression... Depressed people became that way because they learned to be helpless. Depressed people learned that whatever they did, is futile. During the course of their lives, depressed people apparently learned that they have no control.

Learned helplessness explained a lot of things, but then researchers began to find exceptions, of people who did not get depressed, even after many bad life experiences. Psychologist Martin Seligman discovered that a depressed person thought about the bad event in more pessimistic ways than a nondepressed person. He called this thinking, "explanatory style," borrowing ideas from attribution theory.

For example, let's say you fail a math exam. How do you explain why? You could think: 1) I am stupid. 2) I'm not good in math. 3) I was unlucky, it was Friday the 13th. 4) The math teacher is prejudiced. 5) The math teacher grades hard. 6) I was feeling ill that day. 7) The math teacher gave an especially hard test this time. 8) I didn't have time to study. 9) The teacher grades on a curve. Seligman found that these explanations could be rated along three dimensions: personalization: internal vs. external, pervasiveness: specific vs. universal, and permanence: temporary vs. permanent. He found that the most pessimistic explanatory style is correlated with the most depression: The statement "I am stupid" is classified as internal (use of I), universal, and permanent. This response conveys a sense of discouragement, hopelessness, and despair. On the other hand, a more optimistic person would blame someone or something else, such as "The math teacher gave an especially hard test this time." The most optimistic explanatory style is external, specific and temporary. Conversely, for a good event, the explanatory style reverses. For example, for a perfect score on the math exam, the depressive would say: "I was lucky that day," discounting his intelligence. The optimist would say something much more encouraging, such as "I am smart." We often learn explanatory styles from our parents.

 
Quotes about Depression

It is hard to be depressed and in action at the same time. S.Hein

(There are two sides to this. One is positive in the sense that if you need temporary relief from depression it might help to get busy doing something, such as cleaning the house, going for a walk or bike ride. But action is not a permanant solution because it does not address the cause of the depressive feelings. Some people use activity to avoid facing the causes of their depression and to avoid allowing themselves time to feel. In the long term, merely being active and even productive does not fill the required unmet emotional needs.)

For me, depression is a sign of not dealing honestly with my problems.

(This quote is by Patrick Wakeling's and comes from his chapter in the book Wounded Healers by Vicky Rippere and Ruth Williams)

 
Most Depressed People...

Most depressed people think a lot. And they have a lot to say. But for too many years no one has listened to them.

Most depressed people are also intelligent, both intellectually and emotionally.

 
Advice or commands from "well-meaning friends and family for him to 'snap out of it' provide only frustration for he can no more "snap out of it" than the diabetic can will his pancreas to produce more insulin.

Also, the depressed person will then feel more alone and less understood.

First quote from depression.about.com/cs/amidepressed/a/sadness.htm

 
The Right to Feel Bad, Leslie Hazelton

Note from EQI - Hazelton uses the term the "right" to feel bad. It might be also be helpful to say there is a natural and evolutionary "need" or "purpose" for feeling bad or depressed.

--

Feeling good is no longer simply a right, but a social and personal duty. We have become convinced that if we do not feel good, we are at fault - weak or ill, dysfunctional or wrong. The right to feel good has been exaggerated out of all proportion - to the extent that we now have to reclaim the right to feel bad.

We have to reclaim the right to the whole range of feeling, including the right to mourn the vast range of loss that we are prey to. This is the right to react as human beings instead of as automatons who keep to the one path of happiness with grim determination, ignoring the realities of their lives.

-

It occured to me that if I could write down how I felt, I might even be able to write it out of me. I turned, went home, and wrote all night and into the morning, then went to bed and slept the first really restful sleep in weeks.

Some months later I read through those impassioned notes for the first time. I began to trace what I could not see at the time - the pattern and the logic behind my depression. Tentatively, since the subject was still shameful, I began to talk to others about it, and that was the first time that I realized I was not alone, that almost everybody knew these same feelings firsthand. That relaxation determined me to write this book.

Chapter 2-4 of this book look at what has been done to depression - the numerous ways in which it has been stigmatized and invalidated, and the vast number of ways in which we have been persuaded that to feel bad at all is unacceptable. This means looking at the social and psychiatric pressures which have tried to determine how we should feel while ignoring the yawning gap between their "shoulds" and our reality.

Chapters 5-8 take a close look at the experience of depression itself, at what really happens in depression and why. This means exploring it not as an illness or malfunction, but as a healthy reaction to various kinds of loss and to the very real problem of existing in a complex and difficult world. Depression can then be seen not as a waste of time, but as a valuable process in which we think about the terms on which we exist, reexamine our values and our selves, and find the way to a renewed sense of purpose and meaning. Without such times, we would be the lesser people.

Chapters 9-11 explore ways in which we can come to terms with depression - accepting it, tolerating it, facing it without fear, and thus giving it a chance to fulfill its role in our lives. No magic pill will do the work for us. The new antidepressant drugs, though effective in severe depression, are of questionable use in normal depression. And though other drugs can be used to escape awareness, they also limit us as human beings.

To be fully alive means to experience the full range of emotions, to struggle with the downs as well as to enjoy the ups. Life is certainly difficult and even unpredictable - full of meaning and purpose at one time and utterly meaningless and purposeless at another; sometimes so desirable that we wish to freeze it at a certain point and remain there forever, and at other times so undesirable that we may find ourselves wishing we had never been born. But it also has it own dynamic. There is no real happiness without the experience of depression to balance it. If we are not capable of depression, we are not capable of happiness either. In a very real sense, depression keeps us alive.

Instead of fleeing it, then, we need to shed our shame and terror and see depression for what it is - not an ogre or enemy, but an integral part of life itself.

 
Some Journal Notes by Steve H.

- We can learn from depressed people

- We can learn from depression

- A teen once said "Depression makes you think about important questions"

.- When I am depressed, I sleep. Sleeping restores my energy. I need un-interrupted sleep without anyone forcing me to do something else, or invalidating me. But depressed teenagers don't have the freedom to sleep. To rest. To think. They are ordered to get out of bed. Told to "cheer up", go to school, smile. Thus they don't have time to heal from whatever it was that depressed them. Depression comes from emotional wounds, emotional pain. Time and sleep can heal those wounds naturally if people don't interrupt the process, and if the person hasn't been taught to think self-destructively.

- Teenagers also don't have enough privacy. There is almost no privacy in schools. Many teens I have known tell me they go cry in the bathroom, but I have heard that in the USA teens are now being followed to the bathroom by an adult who waits outside and will come in after them if the adults think they are taking too long.