Dealing with Depression in the Adversities of War
LARRY BEALL, PH.D.
Depression is a plague in the world today, the bubonic plague of the 21st Century. Statistics vary, but somewhere around one in five people either have depression or are dealing with it in their family. It is expected that in a war-torn country the level of depression is much higher. Clinical depression (as contrasted with the sadness that we all can have from time to time) can develop from many sources. Two categories of depression might be used: Hereditary or Reactive.
Hereditary Depression results from a genetic vulnerability to depression in your family. You can inherit this kind of depression from parents, and can witness it in grandparents, aunts, uncles, and siblings with depression. This depression may be masked by family members who use drugs or alcohol. Hereditary depression generally responds well to anti-depressants, in addition to other interventions discussed in this article.
Reactive depression often results from a loss of some kind that changes how we think about something that is important to us. In war there are many kinds of losses that can contribute to depression. The worst is probably the loss of a loved one. That’s one reason that depression and grief often go together. But there are other losses like the loss of ideals, a job, opportunities, relationships, one’s country, the loss of a friend who goes home, and the loss of control one feels one should have over life. The changes in thinking that accompany Reactive Depression contribute to chemistry changes in the brain that are linked with depression. Prolonged severe stress as well as medical problems can change the chemistry in the brain and cause depression. Traumatic events such as an accident or assault can bring about changes within us that lead to depression. Extreme anger we turn inward as well as feeling like we are losing control of our lives can stimulate depression. There is of course, the possibility that one is dealing with Hereditary Depression made worse by Reactive Depression. When this occurs a combination of interventions discussed here and medication may be needed.
If one yields to depression and gives up, the depression will grow worse. Depression must be fought like an enemy. With war surrounding you it can be quite difficult to keep your thoughts positive. Here is a brief description of how to fight the battle with depression.
Level 1 - Physical
Aerobic Exercise (jogging, fast walking, most anything that will elevate the heart rate and cause you to sweat from exertion for 30 minutes 3 or 4 times a week. For many, aerobic exercise can prevent the need for medication. Research keeps finding new benefits of aerobic exercise: endorphins (natural morphine in the brain), removing toxins, Oxygen to the brain, improving sleep, bringing deep relaxation to the muscles . . . etc. There are over 120 scientifically proven benefits of exercise.
Sleep is also important to mental/emotional health. Loss of sleep undermines functioning and performance. When these deteriorate how you feel about yourself slides. (See inclosed
Sleep Hygiene handout)
Nutrition. Good nutrition can make a significant difference in reducing depression. For example, sugar and caffeine can cause a temporary “high” followed by a state of lowered energy and even depression. Plenty of water, fruits, grains and vegetables can help maintain energy levels and strength to do what’s necessary to have a healthy lifestyle that defeats depression.
Nature Being open to and receiving the tranquility, beauty and peace of nature increases the release of serotonin. Peaceful thoughts and feelings associated with nature are serotonin boosters. Nature is all around us, but to benefit from it requires a change of perspective. Although a hike in the mountains or fishing on a river are great ways to increase serotonin, just noticing birds in flight, the clouds, sunsets or mountains around you can provide needed elevations in serotonin.
Level 2 - Behavioral
Do Things - “It is easier to act yourself into the correct way of thinking, than to think yourself into the correct way of acting.” -William James. Schedule a pleasurable activity once before noon and again before you go to sleep. Take “mini-vacations” throughout the day. Ten to fifteen minutes to renew and refocus yourself. Here the art of Zen is valuable. Zen means whatever you do, do completely in the present, stay focused. Notice the sounds around you and how your body is interacting with your environment. This help us to stay present.
Go Back to What Used to Work - We gravitate to activities that we are naturally good at, or which we did growing up. Build on skills and activities that you once enjoyed but from which you have drifted.
How do you know if you need medication? One way to determine that is if you are feeling better
after you do Levels 1 & 2 for three to four weeks. These first two levels increase Serotonin in the
brain. Serotonin is chiefly what anti-depressants give you. It may be that you can’t even get enough
energy or emotional strength to do #1 & #2. If you are unable to do them, or if you do not derive benefits from doing them, consider medication to “jump start your engine.”
Level 3 -Social
Be Assertive - Often people feel depressed because they have lost a sense of control and inner direction. They may be letting others determine too much of their lives. Assertiveness simply means standing up for your rights, needs and desires, without violating the rights of others.
Have a Friend Who is a Confidante - It is healing to ventilate our honest feelings with someone we trust. Ideally this confidante is our spouse/partner but this does not always work.
Connection with Others - Service to others and finding a sense of purpose in the larger community boosts serotonin. Such work gives us a sense of personal worth and security and connects us to others. Many depressed people who decide to do some type of volunteer work or help the downtrodden, find themselves overcoming their depression. Reaching outside ourselves expands our world, puts our problems in proper perspective and gives us the gratification of making a difference in the life of another. Many enjoy the positive bio-chemical effects of caring for a pet or animal.
Level 4 - Life Orientation
The 3 C’s - make up an orientation to life and others that helps maintain a healthy life philosophy and balance. The 3-C’s are: Control (you need to be in control of your life), Commitment (you need to be committed to a life purpose and others), and Challenge ( you need to see life’s problems as a challenge rather than a threat). If you are part of a cause in which others are making decisions, such as a commander, by making the cause our own, we gain a sense of inner control.
Life Purpose - If our life loses meaning, if we can’t put what we’re doing into a larger picture we can become depressed. Use all the resources you can to find your purpose and this can help you overcome depression. What was important to you when you were younger? Often we can find a key to getting out of our depression by doing those things that used to be our passion.
Level 5 - Mental
Recognizing Distorted Thinking - Enclosed is a handout “12 Styles of Distorted Thinking.” These are recognized ways of thinking that contribute to depression, anxiety and anger. Read each one and rate yourself on a 1 - 10 scale. If you score 7 or more it would be helpful to focus on it. Write two or three distorted thoughts on a 3X5 card and make a tally mark each time you catch yourself thinking that way. The distorted thoughts will correct themselves automatically for the most part, simply by counting them. You can also argue against them and replace them with more realistic and less distorted ways of thinking.
Thoughts that Strengthen Among the most effective mental tools for boosting serotonin are reading inspirational, interesting and invigorating literature, prayer, meditation, vivid, positive visualizations, and enjoying peaceful, gentle music. Classical music that helps you feel transcendence is also a great serotonin booster. Self-affirmations, remembering past successes, and anticipating and hoping for desirable experiences also increase levels of positive brain chemistry. Simply replacing negative or pessimistic thoughts with positive and optimistic thoughts can make the critical difference in our serotonin levels. Do not underestimate the power meditation or “centering” has to restore balanced brain chemistry.
Learn to Let Go - “For every worry under the sun there is a solution or there is none. If there be one go and find it. If there be none, never mind it.” We burden our minds with many worries, problems and concerns that we can do nothing about. These can make us unnecessarily depressed. Learn to let go.
Level 6 - Spiritual
Live in Harmony with Your Values - Write down your roles in life, such as individual, husband or wife, mother or father, daughter or son, brother or sister, friend, employee, etc. Next to each role write two values that matter to you. For example, as an individual it may be important to you to make contact with God each day or serve another, or such. Live these values and you will have greater spiritual harmony.
Live from Your Center - Go to your heart and learn to trust what you find there. Enjoy the peace that comes from living with a clear conscience and in harmony with God. Remember the Native American saying, “In the darkest hour, the soul is replenished and given strength to continue and endure.”
12 Styles of Distorted Thinking
1. Mental Filtering: You take the negative details and magnify them while filtering out all positive aspects of a situation. When you are depressed you perceive through a lens that filters out anything that is positive. All that you allow to enter your conscious mind is negative. You conclude that everything is negative.
2. Black or White, All or Nothing Thinking: Things are black or white, perfect or bad. You have to be perfect or a complete success, or you are a failure. There is no middle ground. This lead to depression because you will never measure up to your extreme expectations.
3. Overgeneralization: If something bad happens once you expect it to happen over and over again. The pain of rejection or that you are a failure is generated almost entirely from the overgeneralization that if you are turned down or fail once this will be perpetuated endlessly.
4. Disqualifying the Positive: You transform neutral or even positive experiences into negative ones. Disqualifying the positive is one of the most destructive forms of cognitive distortion. When you have a positive experience you tell yourself, that it was a fluke, it doesn’t count, for some reason.
5. Jumping to Conclusions: You jump to a negative conclusion that is not justified by the facts of the situation. An example of this is Mind Reading. You make the assumption that other people are looking down on you, and you are so convinced about this you don’t even check it out.
6. Magnification and Minimization: Magnification occurs when you look at your own errors, fears, or imperfections, or another’s successes and exaggerate their importance. When you think about your strengths,you may tend to minimize them. You magnify your imperfections and minimize your good points.
7. Personalization: You assume responsibility for a negative event when there is no basis for doing so. Personalization causes you to feel guilt. You have a burdensome sense of responsibility that results from confusing influence with control over others.
8. Control Fallacies: If you feel externally controlled, you see yourself as helpless, a victim of fate. The fallacy of internal control has you responsible for the pain and happiness of everyone around you.
This is related to Blaming: when you hold other people responsible for your pain, or blame yourself for every problem or reversal.
9. Should Statements: You try to motivate yourself by saying “I should do this” or I must do that.” These statements cause you to feel pressured and resentful. When your behavior falls short of your standards, your shoulds and shouldn’ts create self-criticalness, shame, and guilt.
10. Emotional Reasoning: You take your emotions as evidence for the truth. Because things feel so negative to you, you assume they truly are. It doesn’t occur to you to challenge the validity of the perceptions that create your feelings.
11. Labeling and Mislabeling: Personal labeling means creating a completely negative self-image based on your mistakes. It is an extreme form of overgeneralization. You might think, “I’m a failure” instead of “I made a mistake.” Mislabeling involves describing an event with words that are inaccurate and emotionally heavily loaded.
12. Passive Thinking: You believe that your wants, needs and rights are not important enough to assert with others. Rather than assert what is important to you, you allow circumstances and others determine the outcome of events that matter to you.