I don't know about you, but when I'm severely depressed 90 percent of my negative thinking is based on the fact that I am a failure because all my cognitive-behavioral strategies and positive thinking and mindfulness attempts aren't working. I discussed this with Dr. Smith yesterday and she reminded me, once more, that severe depression can't be treated in a mind-over-matter way. Her compassionate logic made me review the pages of my forthcoming book, "Beyond Blue," where I list the neurological and scientific reasons why.And I breathed a much-needed sigh of relief.
You deserve one too.
Here's my passage:
Trying too hard was precisely my problem. It was the mind over matter issue again. In my mind, I was failing because I couldn't think myself to perfect health. I couldn't do it all myself.
Dr. Smith salvaged the last crumb of my self-esteem with this compassionate statement:
"Mindful meditation, yoga, and cognitive-behavioral therapy are extremely helpful for people with mild to moderate depression. But they don't work for people such as yourself who are suicidal or severely depressed."
Her advice was grounded in neuroscience.
One research study at the University of Wisconsin-Madison, in particular, used high-definition brain imaging to reveal a breakdown in the emotional processing that impairs the depressive's ability to suppress negative emotions. In fact, the more effort that depressives put into reframing thoughts--the harder they tried to think positive--the more activation there was in the amygdala, regarded by neurobiologists as a person's "fear center." Says Tom Johnstone, Ph.D. the lead study author at the University of Wisconsin:
Healthy individuals putting more cognitive effort into [reframing the content] get a bigger payoff in terms of decreasing activity in the brain's emotional response centers. In the depressed individuals, you find the exact opposite.
And then Dr. Smith asked me this: if I had been in a terrible automobile accident would I be so hard on myself?
"If you were in a wheelchair with casts on each of your limbs," she said, "would you beat yourself up for not healing yourself with your thoughts? For not thinking yourself into perfect condition?"
Of course not.
When I injured my knee while training for a marathon, I didn't expect myself to visualize my tendonitis away so that I could run. I dropped out of the race to rest my joints and muscles so I wouldn't further damage them.
Yet I expected myself to think away my mood disorder, which involved a disease in my brain, an organ just like my heart, lungs, and kidneys.
"What's most important is to find a medication combination that works so that you can be able to do all that other stuff to feel even better," she said. "I will give you a list of books you should read if you want to study depression. Until you feel stronger, I suggest you stay away from the type of self-help literature you have brought it because those texts can do further damage if read in a very depressed state."
Here, then, are my three words for the severely depressed: Distract, don't think. And surround yourself with people who truly understand mood disorders until you can believe in yourself again.
At least that's what my doctor told me.
* Click here to subscribe to Beyond Blue and click here to follow Therese on Twitter and click here to join Group Beyond Blue, a depression support group. Now stop clicking.
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What do you do then when medication and ECT don't work and your depression is complicated by so many other disorders?
I'm realising that working on my mind through spirituality and in therapy is the only way I'm going to get better. So in my case, mind over matter and acceptance ARE the only things that are going to work for me.
Just goes to show we are all different.
Thank you. I print out many of your blogs and read them over and over and share them with my therapist. Your words help me explain my feelings and also help me feel not so alone. Thank you for sharing.
And, along the same lines as accepting "your" depression as a disease that you did not ask for, it just came along (whether heriditary, induced by environment, or whatever the reasons - each is different), our creator, who made us, does not make junk, he makes us unique. And especially, accepts us exactly WHERE WE ARE. If the Creator of all can accept each and every one of us and love us anyway, shouldn't we do the same, and accept ourselves as he does? My daughter developed Type 1 Diabetes Onset - the one where her body destroys all its insulin forever, so that she has no choice but to take shots for every carb she ever eats. Its cause is unknown, just like our depression is unknown, so she cannot change that she has it, can only take the shots to live, and so we need to accept our sadness and look at the gift of another day, of the wonderful things in our lives that we are blessed with (be it our loving dog, a warm home, a beautiful child, a pretty sunset, and rejoice that we have something special to be part of in this life. God doesn't make junk, and He is still molding us to what he wants us to be. Today is another step toward that perfection he sees in us, that WE cannot yet see as well. BUT HE KNOWS ITS THERE, so we should trust Him and accept that we are His diamond in the rough. And he loves us right now, where we sit today, knowing us better than we know ourselves. (Thanks, God!)
OH Please, pardon my English, but I need to say this.I hurt my self deeply when, after finish a task, i found myself evaluating me so hard. Everybody expect to feel better after a task has been done, but in my case is the opposite. I only feel relieve when I stop thinking on myself and begin to to put myself in the others feet. In this state of "extroversion" i feel safe, i don't feel pain. Introversion hurts very badly. But today, our culture push us to be in a constant state of auto-evaluation, auto-criticism. To me is so hard. I have to navigate counter-current, and put myself in the others feet to feel relieve.
What do you do when you are told "you have tried all the medications and do not respond to therapy?" This after over 20 years of constant care by a variety of doctors and 20 off and on before that. I was taught mindfulness in an out-patient program and had it reinforced as a means to deal with depression in a DBT program when I was out of my mind. I became hysterical and had to be hospitalized partly because it did not work as promised. As a Buddhist who meditated this is a disaster. I feel like I have been a guinea pig for meds and theories and have now been thrown out for not responding correctly.
What can be done when the mental health community throws their hands in the air and blames you?
Sandy
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