Dr. Jeanette Raymond » stress and depression

Posts Tagged ‘stress and depression’

How Therapy Can Prevent Premature Aging By Tackling Stress and Depression

July 14th, 2015 Comments Off

Anger and Stress Management Tips for Satisfying Relationships

At the age of 37 Brittany, a quality control manager, woke up each day wishing the night had lasted a little longer. That awful feeling of dread permeated her body with sweat. She had been slipping at work and the factory owners had noticed that she wasn’t her usual sharp self. It didn’t seem like she was trying any less hard or with less interest in her job. But the jeans coming off the production line and shipped to stores were being sent back with broken zippers and fabric tears.

Even though she was still relatively young, she felt as if she were 20 years older, and her recent annual physical showed that her heart, blood pressure and skin were all showing signs of deterioration usually seen in older people. Her 50 year old husband Derek looked more like her son and with commensurate energy!

Too tired to cook in the evenings, Brittany’s kids ate fast food. The guilt stressed her out some more. Brittany’s husband tried to understand his wife’s reduced interest and ability to concentrate on family life. She seemed to forget even the most routine of things, like the meds their son needed for his asthma.

Stress and Depression Alter Your View of Reality

Trying to Manage Stress and Depression on Your Own Makes Matters Worse

Withdrawing into her shell to hide from this awful experience, Brittany became depressed. It was a low grade depression that lasted for years. She was too ashamed to seek help and didn’t want to take pills. Her doctor had previously noticed how anxious and stressed she was, and offered anxiety medication. But she declined, thinking she could beat it on her own.

Not able to connect with her family because of her depression, she became a stranger to her family. There was little conversation other than routine matters, because Brittany slept most of the time she was home. It was as if she was an elderly frail person who appeared to be in early dementia due to the effects of stress on her memory. Derek and their two young teenage boys felt helpless. They had lost their upbeat, energetic, sharp and funny family member who was always there to rely on. Nothing they said or did cheered her up. She complained of pain which turned out to be arthritis following early menopause.

The depression led to Brittany having to take more and more time off work. She was relieved when she couldn’t go in, but later felt self-loathing and critical of herself. Depression feeds on those two factors, making her more stressed and less able to function normally. She was often unaware of the time, and as days rolled into one another, her personal hygiene suffered. Friends stopped dropping in and calling, and her sons barely poked their heads into her bedroom door. Derek tried several times to take her to the doctor but she was too scared to face her condition, and was terrified of being told that she needed to see a psychiatrist.

Stress and Depression Accelerates the Aging Process

Brittany’s problems stemmed from having reduced levels of the hormone klotho that regulates the aging process. When women are stressed and depressed, they have lower levels of klotho, making them less cognitively proficient, adding to the risk for Alzheimer’s disease, as reported in an article in Translational Psychiatry, 2015. This hormone appears to be the link between chronic stress and premature aging diseases and death. It has a protective function in maintaining mental acuity and physical health.

What if Brittany had addressed her stress in therapy at its earliest stage?

She might have felt safe enough to talk to her family about her fear of letting them down, and being less than perfect. They probably would have reassured her, and as a family may have distributed the stress more equitably. The likelihood of depression would have been minimal. Brittany would have developed emotional intelligence skills that would have kept her stress under control.

What if Brittany had taken preventive action by attending therapy and learning the source of her stress before it led to depression?

She would have stopped the stress from becoming chronic and harmful to her memory and physical health.

In therapy she would have learned how to understand and accept that she couldn’t control everything and everyone.

She would have learned to express her feelings in the moments of uncertainty and unpredictability, freeing up space to think and use reasonable logic to manage here anxiety.

Most of all Brittany would have made the connection between her childhood relationship stress and her current relationship stress, so that she could separate them out, and use her adult intelligent mind to cope differently.

What if Brittany had gone to therapy when she became anxious about losing her job?

She would have learned that it was normal but coming from a place inside her that lacked confidence and always wanted to prove herself. Treating herself as human rather than superwoman might have been a goal, together with being comfortable talking openly about her shame about not being good enough – thereby removing the harmful effect of stress on her hormonal system.

Practicing a non-judgmental and more self-compassionate stance towards herself would have kept those klotho hormones at their optimal levels, so that she looked young and kept her faculties razor sharp. That would have meant quality experiences with her family and colleagues.

AUTHOR OF:' Now You Want Me, Now You Don't! Fear of Intimacy: Ten ways to recognize it and ten ways to manage it in your relationship.

You might also like:

Five Benefits of Mindfulness

Unresolved Anger and Stress Keeps You Depressed Longer

Pull Out the Roots of Your Anger and Stress By Exercising Amid Nature

Disclaimer: this article is for educational and informational purposes only. There is no liability on the part of Dr. Raymond for any reactions you may have when reading the material or following the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Raymond.

Anger Makes You Swing From One Type of Depression to Another

March 13th, 2015 Comments Off

Anger and Stress Management Tips for Satisfying Relationships

Sadness, loneliness, lack of energy, withdrawing from the world

You may find it hard to believe that anger may be at the root of your sad and lethargic feelings when you get depressed. But the link between anger and depression has been established centuries ago by the Greek philosophers and then more scientifically by the turn of the 19th century.

Treatment with SSRI's is the most widely practiced medication route. But recent research shows that there are two types of depression and that SSRI's are at best no better than a placebo (sugar pill) and that where they are effective, they are more helpful (with psychotherapy) for one more than the other.

Depression triggered by anger at yourself

When you are down, do you find your critical and judgmental voice beating you up because you didn’t match your ideals? Do you feel like you let yourself down even though you did your best? Anger at yourself makes you more likely to experience a war within yourself that exhausts you and makes you want to step back from life so that you don’t have to fail again, and hear the self-torturing condemnation that goes on inside your head.

An article reported in 2009, Advances in Psychiatric Treatment, describes the strong relationship between anger and depression, with guilt and shame strongly featured in the mix.

Words from loved ones that attempt to make you feel good don’t work because they feel so unrealistic and therefore not worth taking in. You can’t be comforted, or allow yourself to go easy on yourself.

A 2002 study reported in Psychology and Psychotherapy: Theory, Research and Practice, found that self-critical or introjective depressioni is based on negative self-evaluation of self-imposed unrealistic standards of perfection.

In addition, growing up with at least one harsh and judgmental parent, made you fearful and mistrusting of people who supposedly want to take care of and comfort you. Not only did you internalize that harsh and critical voice but you were suspicious of anyone offering a soothing balm!

The stress of having to bear your own condemnation and wrath is painful, and chronically so. Your suffering may be so overwhelming that it becomes a pain in your body. It could be headaches, back pain, muscle or joint pains. Your type of depression is linked to stress induced physical pain because you have closed the door for emotional comfort or compassion.

Antidepressants like Cymbalta target physical pain but they don’t really work for introjective depression because the area of the brain that is responsible for rage doesn't respond to this class of drugs.

Taking the exit ramp to the empty-lonely road, tends the mental lashings and restores your sense of well-being.

Sometimes your harsh judgmental attack on yourself makes you isolate yourself from the world which is more tolerant and compassionate than you are in the moment. So you end up feeling empty and alone when the punitive voice has done its worst. The shift to a more lonely and fearful place may help you seek comfort and security in others to make you feel worthwhile again.

Ironically you have shifted to the opposite pole of depression to escape the discomfort of this one, as you will see below.

Depression based on anger at others

If you feel lost, alone and empty when you are down, it’s most likely brought on by anger at losing a relationship that you relied on. It could be a friend who doesn’t call anymore, a close family member who moved away, or a mentoring relationship that came to an end. You may find yourself trying to fill that hole with food, alcohol, work, or being busy just to numb yourself and feel stabilized again. Or you might get clingy with others, feeling unsafe and scared to be on your own.

The 2002 study above found that the empty sad type of depression, known as anaclitic depression was characterized by a need to get reassurance and approval from others by meeting their high standards. So if you are not ‘perfect’ as others apparently expect, you risk losing them, you get stressed and insecure, and your feelings of self-worth plummet.

Growing up trying to please your parents or other loved ones and not succeeding made you feel ‘insufficient’; and so you attempted to win their approval by trying harder to be what they wanted you to be, losing yourself in the process. Having lost yourself, you are empty and scared.

When you constant efforts to be accepted, and “good enough” for significant others fail, you fall into a depressed state. You get angry at others for not acknowledging and rewarding your efforts, but you can’t show this imperfection, and get put in the reject pile for good!

Antidepressants such as SSRIs when they work at all, are better able to alleviate anaclitic depression because the symptoms of sadness can be lifted when more serotonin is made available.

Self Criticism helps you armor up and prevent yourself feeling so sad again

You may begin blaming yourself for ever letting yourself get attached because it just ends in abandonment, so why bother? You armor up against being sad and empty again by beating the drum of strength in not needing anyone ever again.

To escape the weak feelings of anaclitic depression to move towards introjective depression, evaluating yourself harshly and engaging in a lot of critical self-talk so that you will feel strong and not need anyone.

BUT, you are still depressed and continue to shift between the self-critical to the sad and lonely and back again.

Anger at not being perfect is at the root of both types of depression, brought on by lack of adequate acceptance and nurturing in the early years.

Working in an accepting, tolerating therapeutic relationship where you can express your anger – AND your guilt and shame about it is the best long term solution.

AUTHOR OF 'Now You Want Me, Now You Don't! Fear of Intimacy: ten ways to recognize it and ten ways to manage it in your relationships."

You might also like:

Four ways to silence your self-critical voice

Six ways to avoid anger, stress and depression that ruin your relationships

Depression buries the anger that helps you connect with loved ones

Disclaimer: this article is for informational and educative purposes only. Dr. Raymond is not responsible for any reactions you may have when reading the content or using the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Jeanette Raymond.

Six Ways to Avoid Anger, Stress and Depression That Ruin Your Relationships

February 24th, 2015 Comments Off

Anger and Stress Management Tips for Satisfying Relationships

Juliette was at the end of her rope

Working as a risk management specialist for a large medical group was getting 36-year-old Juliette down. She was exhausted and had no energy left for her husband, 38-year-old Elliot and their 5 and 6 year old children Aden and Mara. She hated having to work, but was the only breadwinner. The pressure on Juliette made her depressed. All she wanted to do was to sleep. She left the chores to her Elliot who attended to them with pride, seeing them as his contribution to the family.

Even when she was awake, Juliette felt fatigued and disinterested in playing with her kids. She preferred to look on as Elliot engaged them in cycling, swimming and ball games. She was easily upset when things didn’t go right with the family, and felt useless as a mother, sister and wife. Depression had taken hold, and Juliette was steeped in a lack of self-worth. Her anger at having to be the breadwinner was buried in the depression, as was her disappointment and resentment towards her husband for not taking on that role.

The happiness Elliot felt taking care of the home and family was tainted by his anxiety about Juliette’s depression. He was scared that if she got worse and couldn’t work, he would be forced to step into the breach! Since losing his sales job three years ago, he had given up looking for other opportunities having had little response and numerous applications rejected. He had settled into being the primary care taker, but Juliette’s depression was stirring up fears again. Frantic efforts to cheer up his wife, and fix whatever problems she talked about didn’t make things any easier. She just got more and more morose and shut down, hoping that he would take up the baton and support the family.

They didn’t talk about Juliette’s depression or about Elliot’s anxiety that he would have to get a job if she didn’t pull herself together. They were caught in a vicious cycle where Juliette’s depression made her more dependent on Elliot to take care of parenting, housework and the children’s school issues. The more dependent Juliette became the more Elliot countered that he couldn’t get a job because he was burdened with all the child care and household management!

Depression promotes stress about not being able to cope, resulting in poor romantic relationship outcomes, says a study reported in Clinical Psychology Review, 2010.

Another study reported in Communication Monographs, 2015 monitored the communication between romantic couples where one partner was depressed. They found that depressed members of a romantic partnership avoided talking about the depression and how it impacted their relationship, as well as about the relationship itself. The uncertainty about the status of the relationship was the primary reason for avoidance. Women were less likely than men to talk about the depression, exacerbating the uncertainty in the relationship.

Depressed people like Juliette are motivated to avoid negative outcomes and often use avoidance as a way of managing their relationship problems. Although it may ease the stress in the moment of choosing avoidance, over the long term, there is a price to pay. Opportunities to practice interpersonal skills are removed. Chances to deepen bonds through understanding and empathy are neglected, leading to and interpretation of each other’s behavior in increasingly negative ways. The threats to their identity as individuals and members of a couple are never faced and resolved, adding to the stress, and deepening the depression, as reported in an article in Clinical Psychology Review, 2011

A depressed partner may take anti-depressants like SSRI’s (Prozac, Zoloft, Paxil, Lexapro, Cimbalta, Effexor, Celexa etc.) and still not get any better. A recent study reported in Proceedings of the National Academy of Sciences, Feb. 9, 2015 found that stress prevents the medication from doing its job, making the depression even worse. This study described the ‘punishment center of the brain’ (lateral habenula) that rules, making a person feel down on themselves and more depressed.

Put that together with a finding that placebo pills were as good if not better than anti-depressants in affecting mood (Psychotherapy and Psychosomatics. 2010) we have a perfect storm of bad feeling and estrangement between a romantic couple. Putting Juliette on anti-depressants won’t make her better, nor will it remove the cause for her depression. She needs to be depressed to push her husband into being the breadwinner.

So what can this couple do with this awful situation?

Attend couples therapy and begin the process of implementing these 6 essential steps

Discuss their expectations of each other.
Express their disappointments, fears and anger at one another for the roles they are forced to adopt.
Discuss the depression, it’s purpose and impact on the family, including the rage Juliette suppressed, about having to be the one supporting the family when she really wanted to be the one taken care of.
Explore coping mechanisms for the relationship stress by noticing the trigger points.
Begin the process of sharing parenting and household tasks
Shift Elliot from feeling “forced” to get a job, to “wanting” to get a job

AUTHOR OF: Now You Want Me, Now You Don't! Fear of Intimacy: Ten ways to recognize it and ten ways to manage it in your relationship.

You might also like:

Expressing anger is a pain relief mechanism

Unresolved anger and stress keeps you depressed longer

Depression buries the anger that prevents you from communicating with loved ones

Pull out the Roots of Your Anger and Stress by Exercising amid Nature

October 21st, 2014 Comments Off

Anger and Stress Management Tips for Satisfying Relationships

Anger and loathing leads to stress and depression

The Path From Anger To Stress to Depression

Anger and hatred often go together when you don't get cared for in the way you want and expect. If your expectations and hopes are dashed over and over again, the anger and loathing get bigger and more ferocious.

But you are probably too scared to let it out.

You feel love and hate for the person at the same time. These two contrary feelings put you in a bind.

You can't walk away, and you can't express your rage.

You fear that if the one you are upset with will crumble. Then you won't have anyone to be be attached to, and being alone is more frightening.

You imagine that the person you are mad at doesn't care about you – in fact they hate you and are just one step away from walking out on you!

So you keep it all in, seething inside with no room for anything else.

All that scary anger makes your body release stress hormones to cope with the intense anger that threatens your heart, blood pressure, digestive system and mental well-being.

Chronic stress not only causes several serious health problems, but often leads to a long and unrelenting depression. You may not even be aware of it, because you have got used to the exhaustion and sense of depletion that comes with being stressed. You already feel depleted, so adding demotivation and lack of vitality isn't such a change.

But depression is serious.

Depressive symptoms

Your self-esteem and confidence plummet.
Your sleep cycle is disrupted. You may sleep for longer periods or not get much sleep at all.
Your appetite may increase or decrease.
You lose your libido.
You are more prone to pain – headaches, back aches, joint and muscle pain.
You can't relate to people socially and curtail your activities.
Your concentration wanes and you are more ambivalent when it comes to decision making.

Depression is Anger Turned Inward

Pretending and or denying your anger and fear about the disappointment in your significant relationships alters the trajectory of the anger towards yourself. You are more willing to kill off your real-self than destroy loved ones and be alone. That is psychological suicide.

Anger turned inwards makes you false to yourself. Your pretence turns you into an inauthentic person, and your psyche can't survive under that constant murder of your true self.

Depression is often brought on when we move too far away from our true selves to be something or someone that we think we should be to gain some sort of prized place in society. Skewing yourself too far in one direction is not psychologically healthy, so depression puts the brakes on.

When you garden, your body gets rids of harmful enzymes accumulated during stress induced depression.

A recent article in Br J Psychiatry, 2014, revealed that the effect of antidepressants on allieviating depressive symptoms was largely controlled by expectations of those taking them. Given that these medications are not guarenteed to help you, why not turn to what is known to help in the short term and in the long term?

The journal Cell, Sept, 2014 published an article proving the biolgical effect of exercise in nature (such as gardening) being especially beneficial to stress induced depression. Harmful kynurenine, a substance produced by stress, is converted by muscle into a neutral chemical, detoxifying your system.

Gardening is connecting with nature in a hands on intimate way. It's as if the act of getting involved – getting your hands dirty so to speak is a way of you touching your own roots and feeling your own soul in an authentic way.

Planting and hoeing, trimming and cleaning – it's a metaphor for what you are doing inside your psyche. That's why it's so healing. And if you are growing produce you are also taking charge of feeding yourself something real rather than some arbitrary goal of reaching some status in life that may or may not be nourishing

Gardening also helps you feel good about yourself when you see your efforts bloom in a tangible way that depends on no other person. There is an immediate response from seeds when they germinate, or a plant that wilts and dies if you put it in the wrong type of soil. In addition gardening means dealing with nature that you can't control perfectly – insects, weather etc. That is something that is part of the depressive process – to mourn the loss of what you can't control and learn to adapt and be more flexible to what life brings – rather than try to fit some predetermined goal.

Gardening provides something to look forward to each day, several times a day when you go out to check how your plants are doing, and care for them in the tiniest of ways – removing a dead leaf, or dead heading a spent bloom.

Exercising in natural surroundings is the key to relieving the symptoms of depression by being in touch with nature, Ecopsychology, September 2014, and gardening is a great form of physical exercise.

So get gardening, even if it is one pot with one plant indoors or a few on a balcony. One large container can give your vegetables and edible flowers, scent and color – that you help nurture and create. When you do it you eliminate stress and create a more wholesome you. Then you can express your anger without fear of loss.

AUTHOR OF: Now You Want Me, Now You Don't! Fear of Intimacy: Ten ways to recognize it and ten ways to manage it in your relationship.

You might also like:

How to get your loved one to prove their love without using anger

Expressing anger appropriately is a natural pain relief mechanism

Unresolved anger and guilt keeps you depressed longer

ARTICLES I AM QUOTED IN

Category: Relationships

WOMEN'S DAY – TEN THINGS WOMEN HAVE IN COMMON WHO GET CHEATED ON

Brides.com Tough Talks: How to handle tough relationship topics

PGeverydady.com – Six Ways Shy Moms Can Make the Most Out of Any Social Situation

Medical Daily: Single Life: Six Scientifically Proven Perks of Being Single

LastFirstdate.com – Five Ways Women Can Let Go of Past Relationships and Date Again