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Posts Tagged ‘depression’

Every Cloud

openclipart.orgThey say “every cloud has a silver lining.”  I’m not totally convinced that’s true.  I know we all get encouraged to “look on the bright side,” but some clouds are altogether menacing and horrible.  Right?  I don’t know about you, but when I’m in a dark and stormy place, the last thing I want to hear is, “Look on the bright side…”  Nope.  Not doing it.  When you’re down in the darkness, there is no bright side, or at least it feels that way.  Could just be my stubborn side talking, but when I’m in the muck, I want to know there is someone who will hold me, comfort me, and wait with me for the storm to pass.  Sometimes life gives us storms of pain:  swirling, twisting, gut-wrenching.  In addition, life gives us unimaginable  joy and delight.  So there they are — joy and pain — forever connected in a paradoxical dance.

I got to thinking about this as I watched Silver Linings Playbook this weekend.  It was a tremendous movie that handles the subject of mental health quite well.  Except for the therapist; I really dislike the way Hollywood portrays therapists with such wild inaccuracy.  I suppose it’s a hazard of my job…  I have a hard time watching any TV show or movie with a therapist in it!  Anywho, this movie was otherwise very well done and I took away from it the message that no matter how messed up we are (or think we are), there is always the potential for deep connection and healing with others.  And another thing…  All healing happens in relationship.  We cannot heal alone.  So often in our lives, we were harmed via our relationships, so doesn’t it follow that we would need to heal via relationship?  Interestingly enough, neuroscience research backs this up; see Dr. Dan Siegel’s work on interpersonal neurobiology for more on that.  This isn’t to say that everyone needs therapy, but… Come on, who are we kidding?  We could all benefit!  Every relationship we have is a potential source of healing.  We get our issues reflected back to us quite quickly in relationships and that forces us to grow (this was one early clue that my now husband was perfect for me:  he called me on my “stuff”!).  I think that even the toxic relationships we have in our lives are a source for healing, for standing up for ourselves, and declaring that we are worth more.  So how are you learning, growing, and healing in your relationships right now?

To a joyful life!

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Be Still

I was reminded recently in a Lionheart Institute class  of this beautiful series of poems by T.S. Eliot, called The Four Quartets.   They are quite long and I learned in researching them that this body of work led to T.S. Eliot being awarded the Nobel Prize in Literature.  I particularly love the excerpt below, as it reminds us that stillness and darkness have value.  This value is often forgotten in our society and we get so freaked out and ashamed when we enter into these phases.  So I’m asking you — if you are in a dreary, slow, reserved space — stop shaming yourself for your feelings, then break your silence, and connect with someone who is willing to listen (side note: this is particularly essential if you are feeling suicidal;  isolation and hopelessness are major risk factors for completed suicide and that is a rather permanent solution to a temporary set of problems).   And so remember, you are not alone and your darkness might just need some room to shift, breathe, move, transform…  Here’s to embracing the stillness and darkness on the path to your joyful life!

Excerpt from East Coker, the second of The Four Quartets
by T.S. Eliot

I said to my soul, be still, and let the dark come upon you
Which shall be the darkness of God. As, in a theatre,
The lights are extinguished, for the scene to be changed
With a hollow rumble of wings, with a movement of darkness on darkness,
And we know that the hills and the trees, the distant panorama
And the bold imposing facade are all being rolled away–
Or as, when an underground train, in the tube, stops too long between stations
And the conversation rises and slowly fades into silence
And you see behind every face the mental emptiness deepen
Leaving only the growing terror of nothing to think about;
Or when, under ether, the mind is conscious but conscious of nothing–
I said to my soul, be still, and wait without hope
For hope would be hope for the wrong thing; wait without love,
For love would be love of the wrong thing; there is yet faith
But the faith and the love and the hope are all in the waiting.
Wait without thought, for you are not ready for thought:
So the darkness shall be the light, and the stillness the dancing.

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Yoga for the Blues

In a relatively recent post, I wrote about the signs and symptoms of two common depression diagnoses.  So now I’d like to approach the treatment of depression from a yoga and mental health perspective.  In Ayurveda (the sister science of yoga), we would most likely describe depression symptoms as excess kapha, the energy of earth and water that gets stuck and stagnant when out of balance.  Depending on the situation, I could also foresee a depressed individual being someone with an imbalance in another dosha (DOE-shuh) or sub-dosha, but whose primary guna (GOO-nuh) is tamasic (tah-MAH-sick):  slow, lethargic, inactive, stagnant, heavy, and dark.  I know, I know, I’m throwing a lot of Sanskrit words at you today, but stay with me  ;-)   Think about that last one for a bit…  Slow, lethargic, inactive, stagnant, heavy, and dark.  If you or anyone you love has ever been depressed, I’m sure those words ring true for you.

Ayurveda is a complex and detailed approach to health and wellness.  As such, it is far too intricate for me to go into detail here (naturally, if you’d like to learn more about your dosha, or constitution, contact me to schedule your Professional Yoga TherapyTM evaluation today).  I will say that the Ayurvedic yoga approach to depression, or any mental health imbalance, is one that is very individualized.  It is worlds apart from the “take two pills and call me in the morning” approach to health that Western medicine often takes.  That said, a variety of Western research studies have shown that yoga-based interventions are effective in reducing depressive symptoms (Wolf, 2000; Lavey, et al., 2005; Zerka Yoo, 2008).  I enjoy reading yoga therapy research, as I’m hopeful that this adds credibility to yoga therapy and reduces some of the “airy fairy” concerns that people have about using yoga in the health and mental health care fields.  Credibility is also one reason I like referring to the Sanskrit terms behind these concepts.  This isn’t a bunch of gibberish I just made up (I swear!), but a systematic and individualized approach to wellness that’s been around far longer than our current medical systems.  Consequently, taking an Ayurvedic yoga approach to address depressive symptoms could look something like this:

  1. Energetic and cleansing breathwork – In yoga, we call breathwork “pranayama” (prahn-uh-YAHM).  For a depressed individual, I would recommend breathing strategies that energize, cleanse, or even bring balance to a person’s energy (again, depending on a variety of specific factors).  These could include Victorious Breath (aka “Ujjayi”, oo-JAI-ee), Sun Breath, and Alternate Nostril Breathing.  There is also the use of Bee Breath (a sighing exhalation) for the clearing out of physical and emotional pain brought on by depression.
  2. Mudra (MOO-drah) – These are hand positions intended to focus or channel the flow of energy within the body.  Abhaya (ahb-HA-ya) Mudra builds inner strength and create a protective barrier against negative energy.  Jnana (ny-AH-nah) Mudra reminds us of our unity with all things (depression can make you feel alone and isolated, after all) and helps to focus the mind.  This is great for addressing the lack of concentration that is often present with depression.  Two more favorite mudras for depression include Pushpaputa Mudra, used to recognize the abundance that awaits us, and Rudra (ROO-druh) Mudra, which decreases heaviness and lethargy, increasing energy flow to the entire body.
  3. Asana (AH-suhn) – This is the Sanskrit term for yoga’s physical postures.  To address depressive symptoms, I would focus my client on utilizing the energizing and balancing poses.  Again, specific recommendations must always take into consideration the severity and type of symptoms present, as well as the client’s physical abilities.  There are a wide range of energizing and balancing poses that can be used here.  These include everything from gentle, supported backbends on the floor to powerful standing poses and challenging one-legged balance poses.  Even if yoga isn’t quite your style, Zerka Yoo (2008) found that both hapkido and yoga were effective in reducing depressive symptoms.  So increasing your physical activity in general could be helpful.
    Walk around the house/yard and slowly graduate to walking to the corner and back, if you’re thinking a whole exercise plan is too much.

As I said in my last post on this topic:  Please consult with a qualified mental health professional, if you think you or a loved one are experiencing depressive symptoms.  You can also take this online Depression Screening Test to help you determine whether your feelings & behaviors match up with depressive symptoms.  Psych Central hosts this screening test and has an amazing collection of resources on the depression and its treatment.  If you do seek out yoga and Ayurveda to help treat what you think are depressive symptoms, please choose your practitioner wisely.  Professional Yoga Therapists are the most highly qualified yoga practitioners trained in the use of medical, research-based yoga therapy to treat health and mental health diagnoses within their specialties.  To find an Ayurvedic medical practitioner near you, visit the National Ayurvedic Medical Association or the California Association of Ayurvedic Medicine.

As always, thanks for reading and take good care of your Self!
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References

Lavey, R.; Sherman, T., Mueser, K.T.; Osborne, D.D.; Currier, M., and Wolfe, R. (2005). The effects of yoga on mood in psychiatric inpatients. Psychiatric Rehabilitation Journal, 28, 399–402.

Wolf, D.B. (2000).  Effects of the hare krsna maha mantra on stress, depression, and the three gunas.  Dissertation Abstracts International: Section B: The Sciences and Engineering, 60(7-B), 3584.

Zerka Yoo, Christine (2008).  Hapkido vs. yoga: Analysis of choice, persistence and psychological benefits.  Dissertation Abstracts International: Section B: The Sciences and Engineering, 68(12-B), 8441.

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Exploring the Inner Darkness

I have found myself having a lot of conversations about depression lately.  From clients to friends to colleagues, sadness and disappointment have many people in their grasp these days.  I imagine that local, national, and global events are major contributing factors.  Whether you call recent U.S. economic challenges the Great Recession or the 2nd Great Depression (hmmm, there’s that word again), unemployment & stagnant wages & cuts to services to our most vulnerable are crippling the nation.  Then there’s the Haiti earthquake, the BP Oil Spill, the Japan earthquake, tsunami, and nuclear crisis, and the various wars the U.S. is participating in.  Lots of reasons to be bummed, especially if you watch mainstream news on a regular basis.

Sadness is a normal human emotion and while it may not be pleasant to feel, it is an essential part of our experience.  I think it is important to be sad about the above laundry list of alarming events…  Sadness — like all our other emotions — can be a messenger, if we let it.  Sadness alerts us that something important, significant, meaningful is happening.  Whether sad at the end of a fun experience or about living far from family or about the loss of a job or loved one, sadness is part of our collective story.  In addition, one cannot be happy all the time.  In fact, we call it mania when someone’s mood is excessively positive for too long.  Think about the cycles of nature…  There is birth, growth, death.  Plants require both sunshine and rain to grow, so how can we expect only sunshine in our own lives?  As the book of Ecclesiastes notes, “To everything there is a season and a time to every purpose under heaven.”

While personal challenges and socio-political factors have a huge impact on a person’s mood, there is a significant difference between general sadness and clinical depression.  True clinical depression is deeply painful (both emotionally & physically) and makes it difficult for a person to function normally.  The disorder takes over a person’s thoughts, turning them almost exclusively to the negative (or at least making it really hard to think anything positive).  There is huge body of research on what is happening in the brain on a neurochemical level in a depressed person, but that’s beyond my purpose here in this article.  I’ll focus instead of the different types of depression, their symptoms, and some resources for more information. 

There are different types of depression, but when most people use the word they are probably referring to Major Depressive Disorder.  From the Diagnostic & Statistical Manual of Mental Disorders, the symptoms of Major Depressive Disorder include:

  • Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feeling sad or empty) or observation made by others (e.g., appears tearful).  Children and adolescents may present with irritable mood.
  • Markedly diminished interest or pleasure in all, or almost all, activities most of the day
  • Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite.
  • Insomnia or hypersomnia
  • Psychomotor agitation or retardation
  • Fatigue or loss of energy
  • Feelings of worthlessness or excessive or inappropriate guilt
  • Diminished ability to think or concentrate, or indecisiveness
  • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide

As you read through this list, you may have found yourself thinking, “I’ve felt that way before!”  It’s true, many of us have had these signs or symptoms at one point or another for a short time.  It is important to note that a person with true major depression will have at least five of these symptoms and experience them nearly every day for at least two weeks.   In addition, the above symptoms must be significantly impairing a person’s daily functioning.  This means that the person’s behaviors are causing them to have significant difficulties at work (e.g., can’t complete important tasks), school (e.g., sudden drop in grades), or in personal relationships (e.g., emotional withdrawal from or frequent arguments with one’s partner).

Another form of depression is called Dysthymic Disorder (from Greek, quite literally “bad mood”).  This is more of a low-grade depression that lasts for an extended period of time.  Two or more of the following symptoms must be present for at least two years in adults and one year in children (with no more than two months being symptom-free).

  • Poor appetite or overeating
  • Insomnia or hypersomnia
  • Low energy or fatigue
  • Low self-esteem
  • Poor concentration or difficulty making decisions
  • Feelings of hopelessness

Due to the training & experience required to properly diagnose a depressive disorder, I encourage you to refrain from diagnosing yourself based on the information presented here.  If you suspect that you or a loved one are experiencing depressive symptoms, please consult with a qualified mental health professional.  You can also take this online Depression Screening Test to help you determine whether your feelings & behaviors match up with depressive symptoms.  Psych Central hosts this screening test and has an amazing collection of resources on depression and its treatment.

In my next post, I’ll be exploring various treatments for depression, with an emphasis on how mindfulness, meditation, and movement can be used in depression recovery.  Be well and stay tuned!

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Happy Holidays?


Over the past few weeks, my motivation to write has been low.  First, there was Thanksgiving.  I had a wonderful time celebrating with my family & friends.  One of the side effects of feasting, though, is a sleepy lethargy!  So I gave myself permission to just enjoy the relaxation that I don’t usually make time for.   Then in the week after Thanksgiving, one of my friends passed away.  She was about a month younger than me and her death was entirely unexpected and shocking.  I think I spent that first week feeling numb and in complete denial.  As the most basic defense mechanism, denial comes in very handy.  Information that our minds cannot process is blocked out because to take in that information might require a complete reorganization of thoughts, feelings, and information that we currently have.  If you think organizing your desk is challenging, try reorganizing your mind!  About a week after I got the news, I was able to really feel the sadness my defenses had blocked out.

Dealing with this sadness got me to thinking about how the holidays are not always “happy”.  With smiles on our faces, we encourage one another to have “Happy Holidays!”  And while Halloween through Christmas is easily my favorite time of year, it carries with it reminders of both past joys and past sorrows.  Then, there are the current joys and sorrows.  I was reminded of this recently while watching the movie Parenthood, where one of the characters gives an apt description of life as a rollercoaster, noting that she prefers the rollercoaster to the merry-go-round.  Whether we like it or not, life is rollercoaster… a sometimes intense series of ups and downs and all-arounds, with (hopefully) moments of rest in between.  I don’t know about you, but I am looking back on a year that zoomed by in true rollercoaster fashion.  There were a whole lot of amazing times and a whole lot of hard times.  There were times when I thought I couldn’t be happier.  There were times when I couldn’t imagine how I would get through the day.  Here I am…  sad, content, worried, joyful, eager…  all of the feelings that make up this life.  But most of all, I feel lucky to just be sitting here writing about it.

Still, at this time of year, we can sometimes feel pressured to be happy.  As if, when we are not happy, we are somehow upsetting the natural order.  Sometimes, we might even actively become angry with each other because someone wants to honestly express their discomfort or discontent.  When we are the accusers, it’s usually a sign that we are denying, ignoring, or avoiding our own difficult feelings.  It’s far simpler to blame others, versus doing the hard work of looking inward and coming to terms with the stuff we’ve been ignoring.  While denial and avoidance are great forms of self-protection in the short-term, they don’t tend to serve us well in the long haul.  What we deny or avoid comes back to haunt us in strange ways.  Just because we choose not to be conscious of something does not mean it just goes away.  It can come to settle in the subconscious, from which we act out our fears & desires without conscious awareness.  Have you ever been completely shocked by an observation that someone else has made of you, only to later realize they were right?  It’s rarely pretty, but try saying hello to the junk buried in your subconscious with gentleness and curiosity.  Remember that self-blame only creates stagnation and keeps us repeating the patterns we don’t like.

If you are one of the people for whom the holidays are not so happy (or are perhaps a mix of happy & sad & other stuff), know that you are not alone.  I also hope that, as you experience the wide range of human emotion during this holiday time, you can honestly share that with someone who is willing to listen.  Whether you are grieving a recent loss or a more distant one, many people are feeling exactly the same.  Maybe it’s time to reach out for a little social contact, maybe it’s time to stay home and rest, or maybe you need a smidge of both.  Only you can figure that out for your Self.  Denying your Self the right to feel what you feel can have all kinds of negative effects.  So pick your favorite self-care strategy or engage in some self-reflection to get you back to your Soul center.  It’s right there waiting patiently for you to return.  While we struggle with our losses, let us also call to mind the people still here to walk through this life with us.  Whatever your Soul is handling right now, I’m wishing you the  grace to let yourself heal and let others in your life know what you need.  Be well!

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