Stress and Depression
13 August 2007
All of us deal each day with varying issues of mental and physical stress; and because of that it is also likely that we will deal with depression of some degree, in some form, at some time in our lives.
The Surgeon General has made it clear that major depression is a growing problem in our country, second only to ischemic heart disease; and has issued a “call to action.” He is calling for more awareness, more medical attention, better funding, less stigma, and more effort made toward self-help in the prevention, treatment, and recovery from depression (United States Office of the Surgeon General. “Mental Health: a report of the Surgeon General.” U.S. National Library of Medicine. Metadata Modified 2005. 3-4 8600 Rockville, Pike, Bethesda, MD. 30 June 2007. http://profiles.nlm.nih.gov?NN/BB?H?V/). Left untreated, depression can be life threatening. It can debilitate an individual to the point where he or she cannot work, care for family members, function socially, or fight off physical illness.
Causes of Depression
It is interesting to note that there is no dispute about the cause of depression. Doctors and the research community agree that it is brought on by mental or physical stress of some kind—and often a combination of the two—which then causes chemical changes in brain activity. Dr. Keith Kramlinger explains that severe or persistent stress, on its own, can produce changes in brain activity, which then trigger depression (Mayo Clinic on Depression. N.Y.: Kensington Publishing, 2001, p.38). The body’s normal response to stress is called the “fight or flight response.” The body pumps hormones into the system, which raises blood pressure and blood sugar. If the stress is ongoing, doctors don’t know why, but the brain chemistry may get stuck in the unhappy or depressed mode—falling either gradually or quickly. It’s as if the depressed person’s brain is hurt and is making a plea for things to change.
Recently the scientific community has begun paying more attention to the connection between body and mind. When a person takes a physical beating, the brain also takes a simultaneous mental beating; and of course the opposite is true. In time, the mind may start into a spiral of negative thinking that Francis Mondimore and the psychiatric community call the “Cognitive Triad.” In this triad, the person thinks negatively about himself; sees the future (Adolescent Depression: A Guide for Parents. Baltimore, MD. John Hopkins University Press, 2002. P. 151).negatively; and interprets his experiences negatively The person’s thinking becomes distorted, either seeing things as all his fault, or non of his fault. Neither view feels good and neither view is realistic. It sets the person up for being snowed in fault, or completely out of control to change things.
It makes little difference if a person’s stress is too much of the physical kind or too much of the mental kind, as they are linked; the one affecting the other sooner or later. Feeling out of control seems to be the key for determining when the stress is too much.
Medical Conditions and Depression
The relation between mental and physical stress is the reason why general medical conditions can cause depression such as: heart disease, diabetes, thyroid problems, and so on. Living with chronic tension, fear, or outside stress of some kind can bring on depression. Living in a state of denial, living with heavy guilt or inner conflict; or living in a way that goes against the grain of a person’s beliefs, values, or wishes also sets people up for eventual depression. The violent expression of anger not only causes stress in the system of the enraged person, but also on all those who must watch the violent display.
Researchers have found that children, as well as adults, who live in stressful homes or situations, may have the usual symptoms of depression: impaired concentration, retardation of thought processes, apathy, mood variations, insomnia, stomach pain, joint pain, or other physical problems. Stress and depression impede the immune system, making the body more prone to illness with the passage of time (David D. Burns, MD. Feeling Good: The New Mood Therapy. 1633 Broadway, New York, NY. Signet Printing, 1981). [This book is recommended reading by the LDS Family Services Addiction Recovery Program, (ARP), on page 53 in the July 2008 Ensign.]
Barbara Ganim says:
The body responds to these conflicting messages by releasing stress hormones, which
shoot the blood pressure sky high, disrupt metabolic functioning, increase muscle
tension, and send the immune system plummeting. People who live in a continual state
of inner conflict are prime targets for heart disease, ulcers, cancer, and a variety of
other stress related diseases (Art and Healing. NY. Three Rivers Press, Random House, 1999. p. 23).
Children may have various types of “growing pains” that could well be related to stress at school, or in the home, or from having too much pressure placed on them to perform. It is also likely that a build-up of stress in younger years will provide a footing for more serious illness later in life. The habitual mistreatment of children or family members contributes to the weakening of their immune systems. It also contributes to the weakening of the perpetrator’s immune system. This can create a vicious cycle because of the need for medical care, which may cause debt, which carries with it more stress.
Here is an interesting finding: Stress causes blood glucose to rise, and not only in those who are diabetic. In fact; chronic stress, certain medications that raise blood sugar, and anything that habitually raises blood sugar, can eventually be the cause of diabetes II, says Alain L. Rubin in Diabetes for Dummies (Diabetes for Dummies. 2nd Ed., 111 River St., Hoboken, NJ. p 17).
Ann Fittannte, author of The Sugar Solution, ( a book for pre-diabetics) points out reasons for high blood sugar, and explains how it can be lowered:
Plenty of research shows that stress of all varieties can raise blood sugar by boosting
levels of hormones that trigger the release of extra glucose from your liver. We looked
harder, and found that the reverse is true, too; Cutting stress and building joy can lower
blood sugar and shield you from the stress-disease-overweight cycle. Lower your stress,
boost your happiness quotient, and your blood sugar will benefit (The Sugar Solution. Rodale Inc., printed in the U.S. by Prevention Magazine. 2007. P. 188).
Help For Stress and Depression
Knowing what to do or how to get help for depression can be discouraging because the medical community is divided on issues of both understanding stress and depression and in delivering proper care. While research is being done, there is a kaleidoscope of results and controversy surrounding the subjects of stress and depression. Francis Mondimore, a medical doctor and author, tells us that “the treatment of depression can be accurately described as a hornet’s nest of controversy. It’s not difficult to find a study to support any view” (Mondimore, p. 277).
The two most common current treatments for depression are medication or psychotherapy, or both those treatments combined. Stigma, time, and the cost of treatment prevent many people from seeking that kind of help. Also, treatment may not work, nor does it mean that a person is cured for good. Depression can return again and again, or never leave.
Medication treats the physical symptoms of depression, giving the sufferer time to make needed life changes. Dr. Keith Kramlinger explains it this way: “Depressed people have fewer neurotransmitters [communicator cells] in the synapses [the gap between nerve cells]. It’s a depravation brought on by stress—and the mind and body’s inability to deal with it” (Kramlinger, p. 70). Medication acts as a reuptake inhibitor of norepinephrine or dopamine, or both. That is, medication prevents the cells from taking up as many of the neurostransmitters that do the communicating between the nerve cells, which helps the brain mimic normal function. In depression, the brain tries to protect itself from overload, by allowing fewer neurotransmitters between nerve cells. It’s as if the brain has gone on low function to allow time to heal. Just as we go to bed when our body is sick, so the mind wants to take a break to rest. A healthy brain works just like a healthy muscle. It needs both stress and release to function properly. We are good about giving our minds plenty of stress, but many of us don’t give it the release it needs, so it behooves us to find some kind of regular activity that gives the brain some release.
The psychotherapy approach to dealing with depression helps people make needed thought, or cognitive changes. As Dr. Kramlinger says, “healing seems to have to do with feeling good, less stressed, more in control—whether helped by counseling, or induced medically, so that the brain nerve cells have more neurotransmitters in the synapses to do the work of the brain and body” (Kramlinger, p. 70).
Self-Help for Stress and Depression
Outside of getting professional help, there are self-help therapies people may try. Doctor Lara Honos-Webb has some advice for people who are in the deep throws of depression, and that is to search for the vision of what you are supposed to do with your life and let it guide you (Listening to Depression. CA. New Harbinger, 2006. p. 134). Another place to start, is to work at getting out of the negative thought patterns and allow your brain to recover its normal chemistry. Talk back to negative thoughts, exercise, walk, use the time to sort out the truth. Get out of yourself and find something satisfying that you can do to be productive or creative. One problem in our current society is that people are constantly on the go, or are constantly bombarded by stimulation. We pressure ourselves, allow others to pressure us, are marathon caregivers, non-stop wealth accumulators, or are too focused on ourselves and isolated from others.
Another problem in our current society is that we sacrifice too much time in front of the TV viewing the work of others, where all the creation is done to someone else’s credit and satisfaction, but we don’t take time to enjoy life by being creative or productive ourselves.
Dr. Richard O’Connor says:
We tend to think of creativity as something only for artists—
“creative types” who write, paint, dance, or sculpt for a living.
But a sense of creativity is something we all need in our lives.
Creativity is the antithesis of depression. It is a way of saying that
what I think and feel matters. Depression isn’t just an illness, but it
is a failure of creativity (Undoing Depression: What Therapy Doesn’t Teach You and
Medication Can’t Give You. NY: The Berkley Book Publishing Group, a Division of Penguin
Putnam Inc., 1997. P. 323).
Jeannie Wright and Man Cheung Chung say that one of the best ways to de-stress is to write about and process live’s experiences in a journal or a series of essays. Some healthy focuses in a person’s writing include: sorting out the realitites and truth in our lives, searching for positive solutions, and finding positive lessons to be learned (British Jorunal of Guidance & Counselling. Vol. 29, No. 3, 2001. University of Sheffield, UK. p. 277-291).
Other authorities, such as Catherine Whipple and Christin Snyder, advise both drawing and writing together as an even better method of self-help for depression, stress, and the processing of life experiences. The combination of “expressive” drawing and the written word complement each other because each method draws strength from the opposite side of the brain. The right side of our brain is our first processor. It grasps for images and immediately sends those images over to the left side of the brain to be assigned meaning. Back and forth working together in rapid exchange, the two sides of the brain process information. Pictures help in clarifying issues that are hard to explain in words. Words, because they themselves have to be sorted out, help us to process and make sense of our thoughts on a more concrete level.
Expressive art isn’t necessarily an artist’s art, though it can be. It is any kind of artistic expression that helps to show how we feel. It can be images formed in mud or clay or stick drawings or splashes of paint. Anything that can be used to say, “this is how I feel.”
Here is how art and writing therapy might work: For instance, one lady might draw a heart on her paper and put cracks in the heart. This would communicate to herself and others that her heart was damaged or broken. Then she would write about her broken heart and share more of her feelings with others as well as process and clarify her feelings for herself. The next step in the art and writing therapy process would be to draw a second picture—a healing picture. The lady might draw a band-aide over the cracks in her heart to show that her broken heart could heal. This image would be a reinforcement of something she probably already knows deep inside, that damaged emotions can heal, but which she has been unable to feel yet. To visually see the band-aide on the heart, changes the focus from negative to positive, and is a clear and hopeful message; a tangible piece of evidence that healing can be near. Having made the second drawing to look at and even cling to each day is the first positive step in the healing direction. Being able to write words and chart daily feelings and progress marks the turning point in recovery.
In this way, good comes of bad; healing and growing comes from pain. Each time a person’s resolve weakens, she needs only to go back and look at her positive picture and re-read what she had written, and again feel inspired.
The few studies that have been done in art and writing therapy for illness and depression have had wonderful results. A person who is in the habit of keeping a journal needs only to add some stick-figure drawings, or simple collage or cut-out illustrations, and he is using one of the strongest methods of self-help therapy so far discovered for the healing or maintenance of good mental health (“A Visual Journaling Guide.” 2006. 25 June 2007. The Self-Help Healing Arts Journal. http://www.self-help-healing-arts-journal.com/visual-journaling.html).
We live in an age of stresses. We are tethered to our stresses through technology. The light bulb has made it possible for us to stay up all night working. In addition, our cell phones keep us on call twenty-four hours a day, and we can spend large amounts of time just clearing out and answering email messages on our lap-tops from people all over the globe who we may not even know.
Moms, who used to keep the home fires burning, and stayed at home to act as family anchors and coordinators, are now lined up right along with the rest of the family in the school and work forces. Ideally, everyone comes home in the evenings to share the work of maintaining the home, but more than likely one or another of the parents act as the sacrificial lamb becoming a prime candidate for depression and illness. Otherwise, the work of the home doesn’t get done. Things pile up; a visual reminder that needs are unmet and piling up as well. The piles add to the feeling of being out of control, and soon the whole family is on anti-depressant medication.
One good solution to processing stress is to write and illustrate our daily or weekly feelings in a journal. It may not change our situation, but if we can stay in the game mentally, we have a much better chance of accepting the inevitable in our lives, of managing what can be improved in our lives, and of coping with our daily stresses.
Start now finding ways to put joy into your life on a regular basis. Find that thing you love to do and do it regularly. It will save you.