Depression, Dysphoria and Demotivation Enigma: Causes and Treatment

Discussion: an expansion

Generally, the suggestion is that depression is a medical illness - some bio-neuro-chemical problem,

without

psychological causes (

psychological

internal responses to external events and circumstances).

However, all so-called

"psychological problems"

have some physical manifestations, and all physical

illnesses

have psychological components as well.

In fact, the chemical imbalances that occur during depression usually disa

pear

when

you

complete

therapy for

depression, without

taking any medications

correct

the

imbalance.

This suggests that the imbalance is the body's physical response to psychological

depression,

rather

than the

other

way around

- in most instances

Some types of depression do seem to run in families,

which

suggest

a biological

vulnerability.

This

often

seems

to be the

case

with bipolar

depression and, to a lesser

degree,

severe major

depression.

Studies of families, in which members of each generation develop bipolar disorder,

found that

those

with bipolar

disorder have a

somewhat different genetic

makeup

than

those who are not

diagnosed.

However, the reverse is not true.

Not everybody with the genetic

akeup that

causes

this

vulnerability

bipolar

disorder

necessarily

develops the

disorder.

Additional factors, such as stress and other psychological factors, are involved in its

onset as

well.

Likewise, major depression also seems to occur, generation after generation, in

some

families,

but

not

with a

frequency that suggests

clear biological

causes.

Additionally, it

also occurs in

people who

have

no family history

depression.

So, while there may be some biological factors that contribute to depression, the indicators are that it

often

a psychological/emotional reaction "disorder" - making the physio-biological aspect become a

sort of chicken-

egg situation (which came first?).

PSYCHOLOGICAL

A variety of psychological factors appear to play a role in vulnerability to these severe forms of

depression.

Most likely, psychological factors are completely responsible for other forms of mild

and

moderate

depression,

especially reactive

depression.

During treatment, Reactive depression is usually diagnosed as an adjustment

disorder.

People who

have low self-esteem, who consistently view themselves and the world

with

pessimism,

who are

readily

overwhelmed

by stress are more

prone to

depression.

SOCIAL ENVIRONMENT -

Culture

(Learned Behaviour)

Social learning factors are significant in the development of depression, as well as other psycho

logical

problems.

People learn both adaptive and maladaptive ways of managing stress and

respond

ing

to life

problems

within their

family, educational,

social and work

environments.

These environ

mental factors influence psychological development, and the way

people

try to

resolve

problems

when

they occur.

Social learning

factors also explain why psychological problems appear to occur

often in

family

members,

from

generation to

generation.

If a child

grows up

in a pessimistic environment, in which

discouragement is

common

and

encouragement is rare,

that

child will develop

a vulnerability to

depression as

well.

A serious loss, chronic illness, relationship problems, work stress, family crisis,

financial

setback,

any

unwelcome

life change can

also

trigger a depressive

episode

, understandably

he immediate social and intimate environments can also be the cause of the

reaction.

Also, certain

events & holidays, such as Christmas can bring on a temporary

depression. So will

bereavement

and

loss.

ANGER

ome forms of depression are actually anger that is "masked" or suppressed.

Summary:

Very often, a combination of biological, psychological, and environmental factors are involved in the

development of depressive disorders, as well as other psychological problems.

As you can see, there are more non-physical "causes" listed here, than physical ones. Yet, commonly

only the

physical ones seem to be the ones focussed on by many therapists - who prescribe drugs that

absolutely will

do nothing for the non-physical causes (at best, they are symptom treatment only, in

those instances. On the

other hand, the physiological is not my field; mine deals with the "less explored

and considered" causes. If

that is what you are dealing with, I am available for assistance.

Depression - Dysphoria: enigma
Major Depressive Uni-polar "Disorder": Causes & Treatment

To return to the Introduction to Depression,
click/tap the icon at the right

Klaas Tuinman
Dawn Cove Abbey
Deerfield, (Yarmouth County) Nova Scotia, Canada - 2008
Revised Meaford, Ontario: 2019

The general short introduction

The reality is, as with many mental/emotional/spiritual reactions, that a variety of factors may/

will be

involved. We have already

seen

, that it is not known exactly what causes depression.

And because of that,

generally the total number of things that are possible causes are not

considered, and therefore, "treatment"

and assistance often address the wrong possible

"causes" - which results in "treatment" not working, or not

working well.

Biological differences.

People with depression appear to have physical changes in their

brains:

the

significance of these changes is still uncertain. But eventually, we may discover the

cause they point

to.

Brain chemistry.

Neurotransmitters are naturally occurring brain chemicals that may well

play a role

in depression. Recent research indicates that changes in the function and effect of

these

neurotransmitters

and how they interact with neurocircuits involved in maintaining

mood

stability, may

play a significant

role in depression and its treatment.

Hormones.

Changes in the body's balance of hormones may be involved in causing or

triggering

depression. Hormone changes can result with pregnancy and during the weeks or

months after delivery

(postpartum) and from thyroid problems, menopause or a number of

other conditions.

Inherited traits.

Depression is more common in people whose blood relatives also have

this

condition. The search is on to find genes that may be involved in causing depression.

Reaction to life circumstances and events

- and therefore often related to such

conditions/emotions" as "Post-partum Blues (a combination of hormonal and emotional

factors)",

Grief

Guilt

Fear

and suppressed anger, among others.

Similar to the manifestations on the Anxiety spectrum, Depression is a Reaction, called a

mood

"disorder"/reaction to life circumstances as indicated above

(UNLESS it is directly caused

by a physiological condition)

. It is one that is characterized by a persistent

feeling of sadness,

and loss of interest (in almost everything). It is also known as "major

depressive

disorder" or

"clinical depression".

It permeates and affects virtually everything in life: how you feel, think and behave, and

generally leads to a variety of emotional and physical problems. You may have trouble doing

normal day-to-day

activities, and sometimes you may feel as if life isn't worth living.

is more than just a bout of the blues:

depression isn't a weakness, and you can't

simply "snap

out" of it. Depression may require long-term treatment. But don't get discouraged.

Most people with

depression feel better with the right medication, therapy (or both).

NOTE: "right" treatment requires the right diagnosis ... so here are other less frequently

considered

possible (probable) causes.

Extended inventory of possible causes

(there may be others yet . . . this is open-ended:

It can be a result of a neuro-chemical problem, as a result of an illness, or some other rogue

(unknown)

biological imbalance, which has negatively affected the body's chemistry.

And if

that's the case, there are

medications that can help; as can taking Vitamin D3, and Omega-6

supplements, and getting out in the

sunshine, or using a special lamp that simulates the sun.

But at other times, which are more common (and likely):

it can also be a reaction to some

thing, things

like: stress, certain events (such as the death of a loved one, or a pet - see

Grief/Bereavement

, and

certain upsetting or painful circumstances.

It can also be due to

social (and more intimate)

environments in people's lives (see "Environment" below).

The Not Commonly Considered or Explored ones:

but very relevant in many cases.

Indecision: the "hidden"one.

This is one that is often overlooked -or not mentioned

- because it

isn't

generally considered by many health-care providers. That "hidden" cause is,

indecision

. Indecision

resulting from being faced with actually knowing what you are reacting

to, and knowing

what you can

do about it, BUT, there are two (or more) options you need to

choose between, and you

don't like any

of them. And consequently you hover between them,

without making a decision or

choice.

It could be

that they contradict your values, morals,

ethics, etc., or because of more mundane,

but important

reasons, you are unable to do so,

perhaps for financial reasons, or whatever (which

would result in

feeling trapped). It is when

they avoid the choice or defer it, that the problem arises -

for some reason,

human emotional-

mental functions do not handle indecision well - especially if on a

prolonged basis -

and the

condition we know as depression often results. That inability to choose,

whilst knowing what

the right choice to make is, creates an inner dis-balance, and our minds do not

handle that

well; it

creates what is called

cognitive dissonance.

Cognitive dissonance and the

Double Bind

is the mental discomfort (psychological

stress)

experienced by a person who is simultaneously faced with having to

somehow (balance/

juggle),

hold two or more

contradictory

beliefs, ideas, or values

, in a way that makes sense -

except that no matter how hard they try - it is impossible to reconcile the two - and so a major

uncertainty results

And we humans do not handle "uncertainty" well - always trying to "second-

guess" the situation, or reality: "what, or which one, to believe".

Cognitive dissonance is the resulting consequence of

having to chose between

performing two

actions

that contradict personal beliefs, ideals, and

values; it also occurs when

confronted with

new information that contradicts those beliefs,

ideals, and values. It is also known as

being in a

Double Bind situation where a person is

confronted with two irreconcilable demands, or a

choice

between two undesirable courses

of action.

The Double Bind:

Originally, it referred to a no-win kind of communication that Gregory

Bateson

and

his colleagues believed was a contributing factor in schizophrenia (but it can be a

contributing

factor in

depression, as well. One example of double bind communication is a

mother giving her child

the

message: "Be spontaneous." If the child acts spontaneously, s/he

is not acting spontaneously

because

s/he is following his mother's direction. This leads to an

inner cognitive dissonance.

Similarly, if a child's father continually said, "I love you, and cherish you" to the child, but then

was

constantly verbally (and/or physically) abusive to that child, the child would be confused by

the actions

and words not "adding up"

- it creates a Cognitive-Emotive contradiction that the child

is unable to ever

reconcile - and the effects of that often stay through life to interfere with

happiness and joy, until, or

unless dealt with at some point

And that is a no-win situation for the child. If a child is subjected to this kind of communication

over

long period of time, it's easy to see how he could become thoroughly confused - with

depression as

strong possible consequence. It is virtually impossible for humans to be able to

"balance" two

contradictory states, actions etc in a positive, constructive and wholesome way.

There is a Zen story that is a good illustration of the double bind and also of a unique solution.

A Zen master says to his pupils:

"If you say this stick is real, I will beat you. If you say this stick

is not

real, I will beat you. If you say nothing, I will beat you."

There seems to be no way out.

One pupil,

however, found a solution by changing the level of communication. He walked up to

the teacher,

grabbed the stick, and broke it. Thus "breaking" the bind.

The double bind concept is applicable to many of our life situations - and in instances of

mental/

emotional challenges (dis-ease), not only Zen teachings.

If you wish to explore this (Double Bind-Cognitive Dissonance) further, there is a link to

another

page at

the bottom of this one

(on another site).

Anomie/Alienation: Normlessness

Anomie is a "condition in which society provides little moral guidance to individuals".[1] It is

the

breakdown of social bonds between an individual and the community, e.g., under unruly

scenarios

resulting

in fragmentation of social identity and rejection of self-regulatory values. It is

also known as

"normlessness".

This concept was introduced by Emile Durkheim in his classic study

on Suicide.

"Normlessness" refers to a state of confusion and inner disorientation that occurs when it

feels/

seems

like nothing is connected, nothing is "logical, nothing is ethical/moral - that every thing is

a chaotic,

random, made-up-on-spur-of-the-moment hodge-podge. When that occurs, humans all

have

negative

reactions/responses - one of which is depression

- and a state of feeling

"alienated"

Hopelessness:

(having given up, or lost, hope

)

ometimes, when our life circumstances have

changed drastically, or are faced

with a

seemingly hopeless situation, that it's sheer, seemingly

overwhelming dimension results

in feeling no

hope, and the result of that is very similar to

Anomie/Normlessness above.

#1: Get active. Dealing
with depression requires action:
your participation. Yet, taking
action when you’re depressed
is hard.

Sometimes, just thinking about
the things you should, or could,
do to feel better, like exercising
or spending time with friends,
can seem, and feel, exhausting
or impossible to
actually get in gear.

That's the dilemma and enigma of Depression: the things that help the most being the things that are the
hardest to do. But remember, there's a huge difference between difficult and impossible.

It takes will-power (often a tremendous amount), and a strong desire to heal, and while you may not have
much energy, you can draw on all your reserves: enough to take a walk around the block, or pick up the
phone to call a loved one.

Baby Steps
Taking the first step is always the hardest. But going for a walk or getting up and dancing to your favorite music,
for example, is something you can do right now. It can substantially boost your mood and energy for several
hours. That's long enough to put recovery step two into action; something like preparing a mood-boosting meal,
or arranging to meet an old friend.

There’s a reason that most therapists suggest taking it slow when trying to treat depression. If you feel good one
day, and decide to try and start a new venture, or make a new friend, and you don't succeed, it could be a
powerful setback in overcoming depression.

Instead, try things out slowly, and experiment with change one step at a time (save the leaps for when you’re
feeling fully recovered!).

When you do take steps into your renewed future, trying out new behavior strategies or relationship skills,
reward yourself for your successes. We're all quick to compliment others for doing something nice, but not
ourselves. Give yourself a compliment and a reward for accomplishing some goal you have set for yourself in
your depression recovery.

Avoid solitude - even though retreating "into the cave" will be your first inclination.

Avoid dark rooms - open the curtains, have lights on, go outside - a dark environment feeds and encourages
dark, depressive, and defeatist thoughts and emotions/feelings.

Stay Connected:

Talk to one person about your feelings
Help someone else by volunteering
Have lunch or coffee with a friend
Ask a loved one to check in with you regularly
Accompany someone to the movies, a concert, or a small get-together
Call or email an old friend
Go for a walk with a workout buddy
Schedule a weekly dinner date
Confide in a clergy member, teacher, or sports coach

Make face-time a priority. Phone calls, social media, and texting are great ways to stay in touch, but
they don’t replace good old-fashioned in-person quality time. The simple act of talking to someone face to
face about how you feel can play a big role in relieving depression and keeping it away.

Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels
more comfortable to retreat into your shell, but being around other people will make you feel less
depressed. Meet new people by taking a class or joining a club.

Find ways to support others. It’s nice to receive support, but research shows you get an even bigger
mood boost from providing support yourself. So find ways—both big and small—to help others: volunteer,
be a listening ear for a friend, do something nice for somebody.

Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship
into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give
you a sense of being needed—both powerful antidotes to depression. Take a dog for a walk. If don’t own a
dog, you can volunteer to walk homeless dogs for an animal shelter or rescue group. You’ll not only be
helping yourself but also be helping to socialize and exercise the dogs, making them more adoptable.

Join a support group for depression. Being with others dealing with depression can go a long way in
reducing your sense of isolation. You can also encourage each other, give and receive advice on how to
cope, and share your experiences.

Exercise is something you can do right now to boost your mood. Start Exercising and Stick to It:
Creating an Enjoyable Exercise Routine. Pair up with an exercise partner. Not only does working out with
others enable you to spend time socializing, it can also help to keep you motivated. Try joining a running
club, taking a water aerobics or dance class, seeking out tennis partners, or enrolling in a soccer or
volleyball league.

Eat a healthy, depression-fighting diet. Minimize sugar and refined carbs.

Get a daily dose of sunlight. Sunlight can help boost serotonin levels and improve your mood.
Whenever possible, get outside during daylight hours and expose yourself to the sun for at least 15 minutes
a day. Remove sunglasses (but never stare directly at the sun) and use sunscreen as needed.

Challenge negative thinking. Do you feel like you’re powerless or weak? That bad things happen and
there’s not much you can do about it? That your situation is hopeless? Depression puts a negative spin on
everything, including the way you see yourself and your expectations for the future.

When these types of thoughts overwhelm you, it’s important to remember that this is a symptom of your
depression and these irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic. When
you really examine them they don’t hold up. But even so, they can be tough to give up. You can’t break out
of this pessimistic mind frame by telling yourself to “just think positive.” Often, it’s part of a lifelong pattern
of thinking that’s become so automatic you’re not even completely aware of it. Rather, the trick is to identify
the type of negative thoughts that are fueling your depression, and replace them with a more balanced way
of thinking.

Let go of Negative, unrealistic ways of thinking that fuel depression. All-or-nothing thinking – Looking at
things in black-or-white categories, with no middle ground (“If I fall short of perfection, I’m a total failure.”)

Overgeneralization – Generalizing from a single negative experience, expecting it to hold true forever (“I
can’t do anything right.”)
The mental filter – Ignoring positive events and focusing on the negative. Noticing the one thing that went
wrong, rather than all the things that went right.
Diminishing the positive – Coming up with reasons why positive events don’t count (“She said she had a
good time on our date, but I think she was just being nice.”)
Jumping to conclusions – Making negative interpretations without actual evidence. You act like a mind
reader (“He must think I’m pathetic”) or a fortune teller (“I’ll be stuck in this dead-end job forever.”)
Emotional reasoning – Believing that the way you feel reflects reality (“I feel like such a loser. I really am no
good!”)
‘Shoulds’ and ‘should-nots’ – Holding yourself to a strict list of what you should and shouldn’t do, and
beating yourself up if you don’t live up to your rules.
Deal with the "hidden causes".

.
Other Depression Treatment:

Medication
Lifestyle Changes
Therapy

If you’ve taken self-help steps and made positive lifestyle changes and still find your depression getting worse,
seek professional help. Needing additional help does not mean that you are weak.

Sometimes the negative thinking in depression can make you feel like you’re a lost cause: you aren't
- depression can be treated and you can feel better!

Here is the link to the Double Bind article mentioned above. You'll have to copy it from here and paste it into
your browser: it won't load directly from here:
https://www.psychotherapy.com.au/fileadmin/site_files/pdfs/TheDoubleBindTheory.pdf

_________________________________________
Klaas Tuinman M.A.
Life Self-Empowerment Facilitation
at Dawn Cove Abbey
Comments and Questions are welcomed