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Why a Website About Depression for Western New York?
Over the past twenty years of living with major depression, I’ve met many people in our Western New York community seeking help for depression. The questions are often the same: “Where do I go for help? What local resources are there? I have an adult child, co-worker, or elderly parent struggling with depression. How can I help and support them?”
As a lawyer and mental health advocate, people have asked me these questions for years because they know about my work fighting stigma. When stigma goes down, treatment goes up.
Our community has terrific mental health resources, but most folks don’t know how to find them or learn about what they do. I thought it was time, perhaps long overdue, to create a website that provides not only resources, both local and national, but more: podcasts, videos, and a place where I blog about living and working with depression. I chose the name – The Buffalo Depression Project – because it is a work in progress, an ongoing “project” that I hope will change and grow as the conversations about mental health in our community evolve, especially about depression, but generally, about any form of mental illness.
I know about the struggles people with depression face – at work, at home, and living in the world with mental illness. The two pillars of depression – a sense of helplessness and hopelessness – can darken the days of sufferers and those who care about them.
But things can get better. People can learn to manage their depression or help a loved one to do so. I have experienced this and known hundreds of people who have done so across the U.S. and in our community.
We all need help sometimes. So many of us can’t fix depression on our own.
This website is meant to answer that call.
Unpacking Depression with Dr. Margaret Wehrenberg
Dr. Margaret Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine Psychotherapy Networker and blogs on depression for Psychology Today.
Dan:
What is the difference between sadness and depression , and why do people confuse the two so often?
Dr. Wehrenberg:
Because depression comprises sadness, sadness is a response to a specific situation in which we usually have some loss—the loss of self-esteem, a loss of a loved one, the loss of a desired goal. Depression is more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.
Dan:
What causes depression? Sadness, as you say, is an appropriate response to loss. What is depression a reaction to? What are the causes of depression?
Dr. Wehrenberg:
Throughout my career, I’ve developed the idea that there are four potential causes of depression. This comes from working with people for forty years and reading a lot of research.
The first part is genetics. You are born with a brain that is going to tend toward depression because of the function of neurotransmitters in your brain. It’s a genetic predisposition towards depression. With poor self-care and poor nutrition, you may end up stimulating or starting that feeling of low energy and interest in the world around you. Then, if you pull back from the world around you, you begin to have fewer experiences that keep you interested in the world.
Another possible and probable cause is with people experiencing situational stress that goes on and on. That could be the stress of not being able to earn enough money, and you’ve got two jobs, and kids, and a life filled with stress. It could be the stress that comes on while caring for someone in your family circle who’s got a disability or a chronic illness that increases with severity over time. So, you’re stuck in stress, and you deplete yourself. And you can become depressed.
Putting Pen to Paper: Writers on Depression
That terrible mood of depression, whether it’s any good or not, is what is known as The Artist’s Reward. Ernest Hemmingway
Others imply that they know what it is like to be depressed because they have gone through a divorce, lost a job, or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow, and unendurable. It is also tiresome. People cannot abide being around you when you are depressed. They might think that they ought to, and they might even try, but you know, and they know that you are tedious beyond belief: you are irritable and paranoid and humorless and lifeless and critical and demanding, and no reassurance is ever enough. You’re frightened, and you’re frightening, and you’re “not at all like yourself but will be soon,” but you know you won’t. Kay Redfield Jamison, Night Falls Fast
That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious, and it compounds daily, that it’s impossible to ever see the end. Elizabeth Wurtzel, Prozac Nation: Young and Depressed in America
In depression . . . faith in deliverance, in ultimate restoration, is absent. The pain is unrelenting, and what makes the condition intolerable is the foreknowledge that no remedy will come – – not in a day, an hour, a month, or a minute . . . It is hopelessness even more than pain that crushes the soul. William Styron, Darkness Visible: A Memoir of Madness
They flank me-Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well. …then they frisk me. They empty my pockets of any joy I had been carrying there. Depression even confiscates my identity; but he always does that. Elizabeth Gilbert, Eat, Pray, Love
The Depression Journey: Walking the Rocky Trail with a Therapist
A friend recommended me to the man who would become my therapist for the next twenty years. Jerry was a psychology professor at Buffalo State College. From the Bronx, he has a beautiful, salty sense of humor. Not only was he brilliant, but he was also warm and engaging. I felt at home, and we quickly bonded.
Is therapy effective?
A recent article in The New York Times explored whether therapy, based on the most current research, really works. What the studies show, and this has been both my experience and hundreds of others I’ve been privileged to meet over the years who struggle, is that it’s the combination of a good therapist and antidepressant medication that is the most effective treatment. In my case, I have been on Cymbalta (an antidepressant) and Lamictal (a mood stabilizer) for the past fifteen years. The meds quieted the physical symptoms enough so that I could benefit from my therapy with Jerry. Without the medications, I found that my time with Jerry was not as effective because his insights could not penetrate the hard shell of the physical side of depression that my brain was generating.
Some have told me I was lucky to find a therapist as good as Jerry. Others have said that they’ve had therapists who have been real duds or ineffective. As The Times article points out, it’s not always the educational background that matters (Jerry had a Ph.D., but many other therapists have M.S.W.), but, interestingly, if a patient emotionally bonds with a therapist. Bonding and its relationship to the efficacy of the therapy was challenging to measure in all the studies reviewed for the piece. The article reviewed some research that suggests how therapists react to the negativity of a patient that matters. For example, while this was not the case with Jerry and me, many patients can and do blame their therapists for they find the therapy not helping. Sometimes, they outright say this to them. If a therapist responds with empathy rather than being defensive, that is the key.
The Twin Pillars of Depression
“Once you choose hope, anything is possible.” – Christopher Reeve
There are two pillars upon which depression rests.
Helplessness
When in the grip of depression, we feel helpless despite our efforts to pull out. The more we struggle, the more exhausted we become. In her book Eat, Pray, Love, Elizabeth Gilbert writes, “They flank me – Depression on my left, loneliness on my right. They don’t need to show their badges. I know these guys very well, but then they frisk me. They empty my pockets of any joy I had been carrying there.”
Hopelessness
Helplessness often leads to profound hopelessness about the future. In her book Prozac Nation, Elizabeth Wurtzel writes, “That’s the thing about depression: A human being can survive almost anything, as long as she sees the end in sight. But depression is so insidious and compounds daily that it’s impossible ever to see the end.”
What I have learned over the past twenty years of living with depression is we need to chisel away at these twin pillars. I began to discover helplessness and hopelessness are disempowering: I had no choice but to live my days under this rock of sadness. My healing involved learning that I did have options in how I related to life when depressed. And I found this power to choose empowering and life-affirming.
How did I leave helplessness and hopelessness behind?
How to Get Things Done when Depression Hits
Have you ever noticed that depression can distort time?
It’s good at making a day seem like a year that will never end.
You may think, “Only five hours until I can get in bed.” On other days, the day might rush by, and you realize you’ve done absolutely nothing. A lot of this has to do with the fact that depression tells you that you can’t complete projects anyway, which makes you not even try to focus on the amount of time you have to get something done.
If you’ve ever seen a chess match, you know that each player’s time is limited. When you have unlimited time to think, you often take as much time as possible to ponder all the possibilities. But with a depressed brain, unlimited times could easily stretch to forever.
It may take forever – or at least feel like it – to do something.
But the depressed brain won’t devote that much time to something and will likely quit well before the “something” ever gets done.
The solution.
The solution is to set limits for specific projects. Setting limits is different than time management. It’s more small-scale, like specific project micromanagement. On depressed days, micromanaging your time is good. In fact, your brain often responds to the time limits with relief. Here are some signs you need some time limits:
- You feel scattered and unfocused
- Things don’t get done or take a lot longer
- You feel overwhelmed by projects, so you don’t do any of them on time
- You’re unable to conceptualize the time it takes to do certain projects
- You waste time instead of using time to your advantage.
Something weird happens to time when depressed. It slows down almost to a minute-to-minute feeling. You think, “Three hours until lunch.” You feel time creeping by and that your life is pointless; on the other hand, you feel rushed and overwhelmed by the short amount of time you have to do your work.
The best way to deal with this is external timers. Most jobs can be broken down into sections that can be easily timed. Write down everything to do, rank them, and then get very strict about the amount of time you would spend on each project. Even time your lunch and coffee breaks.
Don’t go on to the next project until the first one is done.
Don’t start the next project until the first one is done. Think about the amount of time you have to do something, and then make sure you know how long each section will take. Do this constantly.
Write out what you have to do and put a time next to each step. Note when you start the project, work on it until you finish, and then note when you stop.
Avoiding situations that can intensify feelings of powerlessness is an ongoing concern for people who are depressed. It’s very common for depressed folks to have unproductive days and reflect at the end of the day and conclude that they have got nothing done.
That reflecting only heightens their feelings of low self-esteem and the perception of being out of control in their lives.
Establishing personal goals and deadlines can be helpful, especially if the tasks are broken down into small, realistically attainable time chunks.
Accomplishing smaller tasks and then checking them off the list is good for you. The sound of an alarm can help take the pressure off and help you focus on what you have to do instead of how long it will take.
Set a time limit, and do not get up until the time limit is up. Be aware of how long something should take so you can have a more realistic start and finish times.
Watch Jessica Gimeno in this TEDx talk as she describes how she gets things done when depressed.
Remember:
Depression has a timeline called “forever” (also known as “Never!”). You’ll always have to impose your time schedule on your projects when you’re depressed.
By Daniel T. Lukasik
Further Reading:
“Get It Done When Depressed,” Julie Fast and John Preston, Psy.D.
“How to Accomplish Tasks When Depressed: Motivation’s Mystery,” Jennifer Goforth Gregory
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