Sunday, March 24, 2013

Humour and Depression: How to Cultivate Humor

How to Cultivate Humor

If you're suffering depression, humor can change your state of mind.
by Nando Pelusi, Ph.D. via Psychology Today

Humor doesn't typically come to mind in the same breath as depression. But humor can be an important ally in getting beyond the rigidity of thinking that accompanies depression and keeps people locked into a depressed state of mind.
One goal of cognitive therapy is to change your perspective, your point of view. Humor is one way to change your view viscerally—and enjoyably.

Cultivating a humorous mindset helps you see yourself and any situation with a more supple mind so that you are not locked into a negative view. Depression is both caused by and causes the inability to see options and choices we otherwise would.

Take a common situation: someone feels very depressed in the wake of having failed at something. They cancel plans and withdraw from social opportunities. They don't feel "up to it." Under the surface, perhaps out of view of the conscious mind, the person might feel that the failure disqualifies him from the human race. However, turning around and asking out loud, "Does that disqualify me from the human race?" is humorous. It highlights the absurdity of the extreme conclusion.

We're not talking stand-up comedy, but insight-oriented commentary, achieved via anecdote and metaphor. You might feel down from a cutting remark your spouse made. But you could ask yourself: Does that "cutting" remark draw blood? Noting the metaphor puts it in its place—an obnoxious comment, but not a searing one.

Humor fosters acceptance of our humanness and our foibles. It is not sarcasm or put-downs. What we are looking for is gentle, playful perspective that embraces humanness but never at the expense of others—or of ourselves. The goal is not to take life too seriously.

So how to foster good humor?

Choose to allow yourself to laugh at your own behaviors and beliefs—but not at yourself. Make that distinction clearly.
See your life not as a distraught drama but as a romantic comedy. Recognize the inherent farce-like quality in situations including sex and relationships.

Cultivating humor not only makes life more bearable, it makes you more attractive to others. Study upon study shows that a sense of humor is high up on the list of traits that most people seek in a partner.

Insert silliness. Fill your life with one goofy thing a day. Make an unusual observation about someone. Or do something you normally wouldn't do. Wear something silly. You will learn that nothing terrible happens—and you may also discover that something good often happens.
Puncture a rigid mindset with a mental exercise called "paradoxical intention."
Suppose you have to give a speech and you are unduly anxious about looking uncomfortable. You can overcome the fear of failure by deliberately focusing on it and humorously exaggerating the very effects you fear.

Say you are worried about having to speak publicly and sweating profusely. Deliberately imagine a humorous situation where you are—literally—sweating like a fountain and spewing enough to drown the first row of the audience. Accept that you sweat like a fountain; imagine it and then think, what is the worst that could happen?

Exaggeration is funny because it skewers the falsehood. If you fail at a test or perform poorly at an audition, you could erroneously call yourself a failure. That, however, is an overgeneralization. Alternatively, you could see yourself as someone who failed at this particular thing, but in no way does that stamp you forever in this way.
Find the humor by saying, this makes me an utter wretch, a failure now and forever, a doomed and worthless subhuman, because I didn't get the part that I wanted or my partner isn't giving me the attention I want. Get into the exaggeration until you see the absurdity of seeing yourself as a "total failure."

Walk down the street remembering that people are nude under their clothes. It reduces fear of others. Such thoughts can take people of high status from deity to human. It helps to remember that everyone yells at their kids, spills ketchup, goes to the bathroom.
Play to an audience. Think of stories and items that would make others laugh.
Be sensitive to the words you use. They can rigidify or help loosen up your thinking.
Create cute, funny neologisms with your partner. Call it goofifying. Creating your own funny expressions for your experiences makes you more flexible and allows you to interpret and assess reality better.

Saturday, March 9, 2013

Depression: Coping With Anxiety Symptoms

WebMD Feature
By R. Morgan Griffin

Depression and anxiety might seem like opposites, but they often go together. More than half of the people diagnosed with depression also have anxiety.

Either condition can be disabling on its own. Together, depression and anxiety can be especially hard to live with, hard to diagnose, and hard to treat.

“When you’re in the grip of depression and anxiety, it can feel like the misery will never end, that you’ll never recover,” says Dean F. MacKinnon, MD, an associate professor at the Johns Hopkins Hospital in Baltimore. “But people do recover. You just need to find the right treatment.”

The Symptoms of Depression and Anxiety

Depression can make people feel profoundly discouraged, helpless, and hopeless. Anxiety can make them agitated and overwhelmed by physical symptoms -- a pounding heart, tightness in the chest, and difficulty breathing.

People diagnosed with both depression and anxiety tend to have

More severe symptoms
More impairment in their day-to-day lives
More trouble finding the right treatment
A higher risk of suicide

Tips for Depression and Anxiety Treatment

Depression and anxiety can be harder to treat than either condition on its own. Getting control might take more intensive treatment and closer monitoring, says Ian A. Cook, MD, the director of the Depression Research Program at UCLA. Here are some tips.

Give medicine time to work. Many antidepressants also help with anxiety. You might need other medicines as well. It could take time for the drugs to work -- and time for your doctor to find the ideal medicines for you. In the meantime, stick with your treatment and take your medication as prescribed.
Put effort into therapy. Although many types of talk therapy might help, cognitive behavioral therapy has the best evidence for treating anxiety and depression. It helps people identify and then change the thought and behavior patterns that add to their distress. Try to do your part: the benefit you’ll get from therapy is directly related to the work you put into it.
Make some lifestyle changes. As your treatment takes effect, you can do a lot on your own to reinforce it. Breathing exercises, muscle relaxation, and yoga can help. So can the basics, like eating well, getting enough sleep, and exercising. The key is to figure out ways of integrating better habits into your life -- something that you can work on with your therapist.
Get a second opinion. When they're combined, depression and anxiety can be hard to diagnose. It's easy for a doctor to miss some of your symptoms -- and as a result, you could wind up with the wrong treatment. If you have any doubts about your care, it's smart to check in with another expert.
Focus on small steps. If you’re grappling with depression and anxiety, making it through the day is hard enough. Anything beyond that might seem impossible. “Changing your behavior can seem overwhelming,” Cook says. “I encourage people to make small, manageable steps in the right direction.” Over time, small changes can give you the confidence to make bigger ones.
Be an active partner in your treatment. There are many good ways to treat depression and anxiety. But they all hinge on one thing: a good relationship with your healthcare providers. Whether you see a GP, psychiatrist, psychologist, or social worker -- or a combination -- you need to trust one another and work as a team.

Saturday, March 2, 2013

Understanding Depression Disguises

Many people think of depression as an intolerable sadness or a deep gloom that just won't go away. Yet depression can also be sneaky, disguised in symptoms that can be hard to identify. If you've had unexplained aches or pains, often feel irritable or angry for no reason, or cry at the drop of a hat -- you could be depressed.

Fortunately, you can be proactive with depression. Learn how these less obvious symptoms can reveal themselves and when you should seek out depression treatment.

Common Depression Symptoms

Common symptoms of depression include feeling sad, hopeless, or empty or having lost interest in the things that previously gave you pleasure. But other, less obvious symptoms also may signal depression, including:

Anger, irritability, and impatience. You may feel irritated and angry at family, friends, or co-workers, or overreact to small things.
Sleep problems. You may have trouble sleeping, or you may wake up very early in the morning. Or you may sleep too much and find it hard to get up in the morning.
Anxiety. You may have symptoms such as anxiety, worry, restlessness, and tension. Anxiety and depression often occur together, even though they are two separate problems.
Crying. Crying spells, crying over nothing at all, or crying about small things that normally wouldn't bother you may be signs of depression.
Inability to concentrate. If you are depressed, you may be forgetful, have trouble making decisions, or find it hard to concentrate.
Pain. If you have aches and pains that don't respond to treatment, including joint pain, back pain, limb pain, or stomach pain, they could be signs of depression. Many people with depression go to their doctor because of these types of physical symptoms, and don't even realize that they are depressed.
Substance abuse. Having a drug or alcohol problem may hide an underlying problem with depression. Substance abuse and depression often go hand in hand.
Appetite changes. You may have no desire to eat, or you may overeat in an effort to feel better.
Isolation. You may feel withdrawn from friends and family -- right when you need their support the most.
Depression Symptoms: Men and Women May Differ

Not everyone has the same signs and symptoms of depression. In fact, men and women may experience depression differently. Women more often describe feeling sad, guilty, or worthless when they are depressed.

Men are more likely to feel tired, angry, irritable, and frustrated, and they often have more sleep problems. A man may feel less interested in hobbies, activities, and even sex. He may focus excessively on work in order to avoid talking with friends and family about how he feels. Men also may be more likely to behave recklessly and use drugs or alcohol to deal with depression. Some men with depression can become abusive. More women attempt suicide than men do, but men are more likely to succeed -- almost four times as many men die from suicide as do women.

Many men do not acknowledge feelings or symptoms of depression. They don't want to admit that something may be wrong or talk about their feelings. But men and women can both feel better with treatment.

Depression Symptoms: When to Seek Treatment

It can be hard to admit to yourself that you may be depressed, let alone ask for help. Here are two good reasons why you should consider depression treatment:

Treatment works. Even people with severe depression can find relief, and so can you.
Early treatment is better. As with many other health problems, getting treatment early on can ease symptoms more quickly. If you wait to get help, your depression can become more severe and harder to treat.
Talk to someone. There are many people willing to help you overcome depression, but the first step you have to take on your own is to let someone know how you are feeling. It may help to start by talking to a close friend or family member. Ask them for support in finding depression treatment. The sooner you get treatment, the sooner you will start to feel better. Don't hesitate -- call your doctor or a medical health professional if:

You think you may be depressed
You notice symptoms of depression such as sadness, hopelessness, or emptiness, or if you have less obvious symptoms such as trouble sleeping or vague aches and pains
Depression symptoms make it hard to function
If you have thoughts about dying or committing suicide, seek immediate medical help. You may feel hopeless now, but treatment will give you hope -- and help you see that life is worth living.

Depression Treatment: Give it Time to Work

Certain medications and medical conditions such as thyroid problems can cause symptoms of depression, so your doctor may want to rule them out. If your doctor thinks you may be depressed, he or she can refer you to a mental health professional.

Depression treatment involves either antidepressant medication, psychotherapy, or both. People with mild to moderate depression can benefit from therapy alone. People with more severe depression usually do better with medication and therapy. Note that once you start treatment, you may notice improvements in symptoms such as sleep or appetite before begin to you feel less depressed.

Antidepressants work by affecting brain chemicals called neurotransmitters that regulate mood. Antidepressants effectively treat depression in most people who take them. However, they can take four to six weeks to notice an effect, so it's important to be patient. Antidepressants can also have side effects, including weight gain and sexual problems. So it may take some time to find the right medication that works best for you with the fewest side effects.

Psychotherapy treats depression by helping you:

Learn new, more positive ways of thinking
Change habits or behaviors that may make your depression worse
Work through relationship problems at home or work
Help you see things in a more realistic way and face your fears
Help you feel hopeful, positive, and more in control of your life
It can take time to break old patterns of thinking and behavior, so give therapy some time to work.

Depression Treatment: How to Help Yourself

In addition to the help and support you get from your therapist and/or doctor, there are a few things you can do on your own that will help you feel better:

Stay physically active. Exercise helps boost your mood, and research has shown that it may also help ease depression.
Get a good night's sleep. Sleep helps us heal from many health problems, including depression. Getting the right amount of sleep, but not too much, helps you have more energy. Try to go to sleep and get up at the same time every day. Make your bedroom a comfortable place for sleeping and sex only -- banish TV and use curtains to keep out bright outdoor light.
Stay connected. Spending time with supportive friends or family will make you feel better -- even if you don't feel like it will. It may help to choose low-key ways to connect. Go to a light-hearted movie, meet for a coffee and some people watching, or take a walk in a nearby park. The contact you get from others, along with depression treatment, can help bring you out of the dark and back into the light.

© 2012 WebMD, LLC. All rights reserved.

Friday, March 1, 2013

How Well Do You Function When Depressed?

WebMD Feature
By Denise Mann

You go to work every day and even make time to see your close friends and family on weekends. But for the most part, you’re really just spinning your wheels. Nothing seems to excite you anymore, and you look forward to climbing back into bed at the end of the day.

Sound familiar? Are you or a loved one able to function well every day, despite feeling depressed?

“These are people who are having symptoms of depression, but are able to get through tasks lifelessly,” says Scott Bea, PsyD. He is a psychologist in Cleveland Clinic’s Center for Behavioral Health in Ohio. “You are basically just going through the motions without any enthusiasm.”

WebMD asked mental health experts to weigh in on how to manage depression proactively in order to thrive -- instead of just survive -- each day.

If you have severe depression, it can be difficult to get out of bed and you may withdraw from your friends and family. You may even become preoccupied with thoughts of death and dying, but this doesn’t happen overnight.

Many people with depression are able to work, maintain relationships, and manage their lives for a long time before it catches up with them. How can you tell if your symptoms are related to depression? The first step is to talk with your doctor and get help for depression.

Typical symptoms of depression may include:

Sleep problems
Physical aches and pains, such as headaches or back problems
Lack of energy
Difficulty concentrating
Feelings of guilt or worthlessness
Loss of interest in activities you previously enjoyed
Eating too much or not enough
Depression: This Too Shall Pass?

But ongoing symptoms of depression will pass eventually, right?

Not necessarily, Bea says. It may be tempting to just write these feelings off, but it doesn’t work that way. The first step is to own what is going on with you and take proactive steps to get out of the “funk.”

Some people ignore continuing depression symptoms and figure there’s nothing that can help. “We think we must merely endure these feelings and that something will give and we will feel better,” he says. It doesn’t work that way. “It will more likely get worse before it gets better,” he adds.

What can you do to cope? The next step is to shake things up a bit and make some lifestyle changes, Bea says.

Yes, it can be hard to make changes -- especially positive and healthful ones -- when you are feeling down. It is much easier to settle in on the couch and get lost in mindless TV than to go out for a walk or join a team, but you have to push yourself, he says.

“Create an obligation,” he says. “Sign up for a gym with a friend.”

For further motivation, reward your new habit by doing something that you like afterward.

“Get plugged back in to life,” Bea says. “Maybe even revisit something that you loved to do as a child, as a way to kick-start your engine.”

Be creative. “Think about the things that you loved at different times in life,” he says. You likely didn’t start feeling like this overnight, so it may take a while to get back in the game.

Depression: Taking Steps to Feel Better

When you’re depressed, it’s OK to “behave as if you are enthused and stop saying how difficult everything is,” Bea says.

Although lifestyle changes and picking up an old hobby can help, sometimes it’s simply not enough. Medication and counseling are also part of the solution, adds Bryan Bruno, MD. He is the acting chairman of psychiatry at Lenox Hill Hospital in New York City. “If you are in therapy and things are getting worse, this is an indication that you should consider medication.”

Depression: Getting Support

You may already be on medication and still not feel like your usual self. If that’s the case, talk to your doctor if your current medications and treatment plan aren’t working.

“Sometimes more aggressive therapy is needed even if you are on medicine already,” says Bruno. Other options to help you cope with depression include:

Finding a depression support group. It can help to talk with others who are experiencing similar challenges.
Connecting online with other people who have depression.
Spending time with friends instead of being isolated and feeling alone.
Keeping a journal to help you monitor your moods and sharing it with your doctor.
Getting active. If you dread the thought of going to a gym -- and many people who feel depressed do -- consider trying a yoga class or taking a walk in the park to boost endorphins.
You don’t have to pretend that you feel good when you’re depressed. Talking to your doctor about ways to manage your depression -- and being honest about how you’re functioning -- can go a long way in feeling better long-term.