Depressed or Defeated?

In my work as a psychiatrist, I see again and again that clarity of thinking and precision of language make a difference in fighting emotional suffering.

The term depression doesn’t offer much meaning beyond the idea of suffering with sadness. I prefer to think of depression as a problem of “defeat.” Depression means a troubled (yet changeable) state of engagement with our world, not just a sad mood. In people who suffer from depression, I see a kind of personal surrender in important areas of living. Our goal is to get back to life’s challenges and gifts. The feeling and behavior of defeat can be transformed.  Even in a depressed state there is a strength within that can be used to cope. No matter how exhausted we may feel in depression, we never entirely lose the capacity to move forward.

The emotional pain of depression or defeat might feel like it is irreversible but there are two powerful forces that can reverse it.  First, talk therapy can offer a person a lifeline out of depression.  Second, in severe, prolonged or genetically driven depression, the anti-depressant power of prescribed drugs can be combined with the talk therapy to provide relief and to speed recovery.  I cannot emphasize enough that anti-depression drugs are not magic or instant, and they are not for every patient.  But when these drugs are used, they are best directed by a therapist who understands behavioral treatment.

Founding Father Ben Franklin was a genius in many fields, including physical and mental health.  His wisdom is still available to us in a best seller from the 1700s, “Poor Richard’s Almanac.” Once a part of everyone’s education, it ought to be so today. For people who are in the midst of depression, his advice, “Early to bed and early to rise, makes a man healthy…,” is terrific medical advice, even if it must be enabled with proper medication.

It is painful for people in depression to get up and face the challenges of the day.  But it is many times more painful – and will worsen the core sense of defeat — when depressed people do not. Staying in bed past wake up time is harmful in many ways:

  • It opens our minds to a flood of negative and defeatist thinking that drives depression.
  • The bed itself physically and mentally traps the depressed person in a pattern of defeatist thoughts and feelings of unworthiness.
  • It exposes us to feelings of shame for running away from our duty to cope with the day.
  • It reinforces our (false) belief that nothing can be done for our pain and for our situation.

In depression it can helpful to make a simple daily morning schedule that includes:

  • gentle physical movement
  • perhaps some tea or coffee
  • simple, brief  tasks
  • writing down troubling thoughts so as to spot the negative exaggerations that depression spawns and aggravates

Depression, although it can feel as if there is no ending, is not a permanent state and getting out of bed everyday –no matter what– is the best gift you can give yourself if you are depressed.

I hope this helps.

Copyright 2011, Jerrold Bonn M.D., Psychiatrist.  All rights reserved.

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The Magic of Movement

Moving our bodies – getting some physical activity every day — seems like such a simple or even trivial idea. In fact, movement has powers that are beneficial and almost magical.

How often you move your body and what kind of movement you perform is up to you. Your age, physical condition and mindset will determine what you can hope to do. At one extreme, there is the person who has been sitting or lying down for years, avoiding the slightest physical exertion. At the other end of the pole is a person who already has a daily exercise routine or a regular game of tennis or golf. Find your spot on the continuum and challenge yourself to do a bit more, on a regular basis.

When we move gently and in an easy flow that we can sustain for many minutes at a time, we are coaxing our bodies to perform a host of benefits:

Positive chemical reactions within us:

  • The release of energy
  • The creation of physical warmth within us
  • The burning of our stored fuel (fat) and creation of stronger muscles.

Elimination of physical tightness and tension:

  • Moving muscles that were tight makes them stop aggravating our tension and our tendency to worry about everyday matters; it may relieve dull aches and pains
  • Moving muscles that were tight reduces negative accumulated emotional energy such as sadness and anger or shame; it makes us feel better physically

Improved self-image and personal empowerment:

  • We feel more able to face and overcome situations and tasks in front of us.
  • We feel less vulnerable.

We can bring these magic benefits to ourselves if we simply choose to walk, or to rock (in a chair or in any position), or to move to the beat of a song.

Of course movement doesn’t eliminate our problems and conflicts, but it is a simple way to cope with them, anywhere and anytime. Movement is always a friend–it helps to prolong life. In a sense, movement is life.

I hope this helps.

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