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Anxiety & Depression
What Is Anxiety?
Anxiety is what happens when we feel lots of fear. Anxiety is a disorder of fear.
It’s when the fear grips us and we start obsessing about things we’re
frightened about. These might be things from our past or future. It’s a natural
human response when we perceive that we are under threat. It can be
experienced through our thoughts, feelings and physical sensations.
Most people feel anxious at times. It's particularly common to experience
some anxiety while coping with stressful events or changes, especially if they
could have a big impact on your life. But if some people get frightened then
the fear subsides, for those with an anxiety disorder, the fear stays.
The anxiety happens when we’re in a constant ‘fight or flight’ response and our
fear becomes far-reaching, chronic and severe.
Is Anxiety A Mental Health Problem?
Anxiety can become a mental health problem if it impacts on your ability to live your life as fully as you want to. It may be a problem for you if, for example:
Your anxiety is very strong or lasts for a long time
Your fears are out of proportion to the situation
You avoid situations that might cause you to feel frightened
Your fears feel distressing
Your fears are hard to control
You regularly experience panic attacks
You find it hard to do things you enjoy.
If you see your doctor, you might be diagnosed with a particular anxiety disorder. But it's also possible to be highly anxious without having a specific diagnosis.
What Is The 'Fight Or Flight' Response?
Humans have evolved ways to help protect ourselves from danger. When we feel under threat our bodies react by releasing certain stress hormones, such as adrenaline and cortisol. These hormones help us feel more alert, so we can act faster by making our hearts beat faster, quickly sending blood to where it's needed most.
After we feel the threat has passed, our bodies release other hormones to help our muscles relax. This can sometimes cause us to tremble.
This is known as the ‘fight or flight’ response – it’s something that happens automatically in our bodies, and we have no control over it.
What Are Anxiety Disorders?
Anxiety can manifest itself in many ways. If your doctor decides your experiences meet specific criteria he/she could diagnose you with a specific anxiety disorder.
What Are The Most Common Anxiety Disorders?
Generalised anxiety disorder (GAD) – when you have chronic and uncontrollable worries about many different things in your daily life. This can be quite a broad diagnosis, meaning that the problems you experience with GAD might be quite different from another person's experience.
Social anxiety disorder – this means you experience extreme fear triggered by social situations. Also known as social phobia. Here’s an article explaining more about social anxiety: https://www.alexandramassey.co.uk/post/how-social-anxiety-affects-your-life
Panic attack disorder is when you experience regular panic attacks without having a clear cause or trigger. This means you feel constantly afraid of having another panic attack, to the point that the fear of the panic attack itself can trigger more panic attacks.
Phobias are extreme fears triggered by a particular situation or a particular thing like snakes.
Obsessive-compulsive disorder, or OCD, is when your anxiety problems involve having repetitive thoughts, behaviours or urges.
Health anxiety – this means you experience obsessions and compulsions relating to illness, including compulsively researching symptoms or checking to see if you have them.
What Is Post-Traumatic Stress Disorder?
Post-traumatic stress disorder (PTSD) is a diagnosis you may be given if you develop anxiety problems after going through something you found traumatic. This can happen even if the traumatic event took place a long time ago.
Find out more about PTSD symptoms: https://www.alexandramassey.co.uk/post/what-are-the-most-common-post-traumatic-stress-disorder-symptoms
Can I Have Anxiety As Well As Other Mental Health Problems?
It's common to experience anxiety as well as other mental health problems, such
as depression or suicidal thoughts. Prolonged anxiety can make it feel like life is extremely difficult to cope with and these thoughts can lead to feeling hopeless and depressed.
What Does Anxiety Feel Like?
“As if someone let a hive of bees into my brain and they are manically buzzing through my whole body and there’s nothing I seem to be able to do about it.”
It’s different for everyone but there are some common themes where most people experience some of these:
Unable to catch the breath
Intense fear or terror
A blank mind
What Effect Does Anxiety Have On My Mind?
Everyone is different when it comes to how the mind works when you're highly anxious. However, here are the most commonly experienced feelings and thoughts:
Feeling constantly nervous
Unable to relax
Having a sense of dread
Fearing the worst
Feeling like the world is speeding up without you
Sensing the world is slowing down
Feeling like other people can see your anxiety
Sensing people are staring at you and noticing your anxiety
Fearing if you stop worrying, bad things will happen
Worrying about being anxious
Worrying about when the next panic attack might happen
Needing constant reassurance from other people
Worrying that people are angry with you
Worrying that you're losing touch with what’s really going on
Mind racing or thinking over and over again about something that’s happened or might happen
Feeling disconnected from your mind or body, as if you're watching someone else
Feeling disconnected from the world around you
Can Anxiety Cause Me Physical Health Problems?
The human body is designed to handle one off anxiety reactions but when the body is flooded with the stress hormones cortisol and adrenaline, there’s a payback. The body isn’t built to be constantly flooded with these hormones yet this is what happens when our over active anxiety response doesn’t quite calm down.
It’s like having your car stuck in first gear when you're driving down the motorway; sooner or later there’s going to be a pay back and that could be a serious forfeit. With that in mind, here are ways anxiety impacts your physical health.
1. Heart Problems
the anxiety response includes the heart pumping out more blood, faster, to get it to the areas of the body that need to respond to a threat. While this is generally reversible once trouble passes, for those with an ongoing anxiety disorder, the heart continues operating at an elevated level which can increase the risk of heart disease, heart attack, and stroke.
2. High Blood Pressure
Similar to heart concerns, as the heart works to pump more blood throughout the body, your blood pressure increases.
3. Asthma and Breathing Problems
studies have shown a strong correlation between anxiety and asthma especially because anxiety and panic for many people includes rapid breathing and tightened airways.
4. Stomach and Gastrointestinal Issues
Feeling sick is another common symptom of anxiety. Therefore, it’s no surprise that ongoing anxiety with little relief can lead to stomach and gastrointestinal issues. They say the second brain lives in the stomach so there is a definite correlation.
With anxiety, the likelihood of sleep problems persisting grows exponentially. Anxiety and this can lead to the onset or increase in anxiety disorders themselves. This is often because the physical symptoms of anxiety seem to be too bad to ‘just be anxiety.’
6. Blood Sugar Spikes
When the body releases stress hormones into the body during its flight-or-flight response, the liver produces more glucose, or blood sugar, to give the body a boost of energy. After the emergency passes, usually the body can simply absorb this extra blood sugar unless you're chronically anxious then this can lead to increased risk of diabetes.
Even though studies suggest that experiencing anxiety could increase the risk of developing long-term physical health problems, there's not enough evidence to say for sure exactly what the risks are, or what groups of people are most likely to be affected. Sometimes it might be difficult to work out whether your symptoms are totally related to anxiety, or something else.
What Other Ways Might Anxiety Affect My Life?
Long term anxiety may impact other day-to-day aspects of your life, including:
- Holding down a job
- Trying new things
- Forming or maintaining relationships
- Looking after yourself
- Simply enjoying your leisure time.
What Is A Panic Attack?
A panic attack is a type of fear response. It’s an exaggeration of your body's normal response to danger, stress or excitement. It’s specifically the abrupt onset of intense fear or discomfort that reaches a peak within minutes.
How Do I know If I’ve Had A Panic Attack?
Generally speaking, a panic attack includes at least four of the following symptoms:
- Palpitations, pounding heart, or accelerated heart rate
- Trembling or shaking
- Sensations of shortness of breath or smothering.
What Do Panic Attacks Feel Like?
During a panic attack, physical symptoms can build up very quickly. It feels like you're:
- Losing control
- Going to faint
- Having a heart attack
- Going to die.
You might find that you become frightened of going out alone or to public places because you're worried about having another panic attack. This can develop into a type of anxiety disorder in which you fear and avoid places or situations that might cause you to panic and make you feel trapped, helpless or embarrassed.
When Might I Have A Panic Attack?
They can happen during the day or night. Some people have one panic attack then don't ever experience another Some people have them regularly, or several in a short space of time. Certain places, situations or activities may seem to trigger panic attacks.
Most panic attacks last between 5–20 minutes. They can come on very quickly. Your symptoms will usually be at their worst within 10 minutes. If you experience symptoms of a panic attack over a longer period of time, this could be because you're having a second panic attack.
You may find yourself in a panic attack loop where you can’t sleep due to panic attacks and nightmares. But, when you do you're awake within the hour with heart palpitations, trembling and sweating.
What Helps To Manage Panic Attacks?
Panic attacks can be scary but they won’t harm you and there are things you can do to help yourself cope. During a panic attack listen to this audio I’ve created:
What Is Panic Disorder?
This is when you have a lot of panic attacks at unpredictable times and there doesn't seem to be a specific trigger or cause. Your doctor may give you a diagnosis of panic disorder. Not knowing when you are going to have a panic attack can increase your general anxiety levels.
What Causes Anxiety?
It’s super important to understand what causes anxiety. And unsurprisingly, it all starts with fear, fear of something you’ve seen heard or thought. Something stressful or scary. The fear kick-starts a reaction and that fear is always fear of the unknown - whether it’s real or imagined.
The brain listens to our fear, and when we indicate, we feel stressed or frightened; it knows we need help. This is a normal response by a normal healthy brain. It is the brain’s job to keep us alive. By jolting us into action, it’s fulfilling its role. Consequently, it kick-starts the adrenals, which shoot out a hormone called adrenaline.
This adrenaline acts as a supercharge, giving us extra strength for either fighting or fleeing. It can make us see better, respond faster, hear better, and become more aware of everything around us so we don’t miss anything that could be a threat.
This is called the “fight or flight” response.
However, when someone experiences a stressful event and the fear sends a distress signal to the brain, the changes happen so quickly that we aren't aware of them, and we don’t have control over it. In fact, the wiring is so efficient that the brain starts all this off even before the brain's visuals have had a chance to process what is happening fully. Imagine a car has just mounted the pavement, you jump out of the way even before you’ve thought about it.
As the initial surge of hormones subside and the threat passes, the hormones fall, and the nervous system puts on the brakes and dampens the stress response.
However, for many of us, these brakes often don’t get jammed on because we’re in a constant loop of the fight or flight response.
Do Past Experiences Cause Anxiety?
Difficult experiences in childhood, adolescence or adulthood are a common trigger for anxiety. Going through trauma is likely to have a particularly big impact if it happens when you're very young. It’s in our childhood that we are most likely to form our coping mechanisms.
Things that may have affected us in childhood may be:
Physical or emotional abuse
Losing a parent
Being bullied or being socially excluded.
Can Anxiety Problems Be Genetically Inherited?
Having a parent or main carer with anxiety problems increases your chances of experiencing anxiety problems yourself simply because you learned to be anxious as a coping mechanism. This make us more vulnerable to developing anxiety as an adult; we naturally lean towards it as a coping mechanism simply because that’s what we were taught.
Can Your Current Life Situation Cause Anxiety?
Current issues or problems in your life can definitely trigger anxiety especially if you feel helpless. For example:
Exhaustion or a build-up of stress
Long working hours
Losing your job
Feeling under pressure while studying or in work
Having money problems
Homelessness or housing problems
Losing someone close to you
Feeling lonely or isolated
Being bullied, harassed or abused.
What Other Physical Or Mental Health Problems Can Make You Anxious?
Other health problems can sometimes cause anxiety, or might make it worse. For example:
Physical health problems like if you’re living with a serious, ongoing or life-threatening physical health condition can sometimes trigger anxiety.
Other mental health problems can happen if you're suffering from other mental health problems like depression.
Drugs And Medication
Anxiety can sometimes be a side effect of taking some prescribed or recreational drugs.
Can Diet Be A Factor For Anxiety?
Some types of food or drink can trigger symptoms of anxiety or panic, or make them worse, specifically sugar and caffeine.
How Can I Help Myself Overcome Anxiety?
I recovered from severe anxiety without medication and I believe for many people this is also possible.
Here’s a link to my Beat Anxiety Programme which will take you through a 30-day course to help yourself overcome anxiety.
Can Talking To Someone I Trust Help Anxiety?
Talking to someone you trust about what's making you anxious might be a relief. It may be that just having someone listen to you and show they care can help in itself. However, if you are in need to share about your anxiety all the time just to get some relief, you may need to find other ways to tackle to core anxiety cycle.
How Can I Manage My Worries?
It can be really hard to stop worrying when you have anxiety. You might have worries you can't control. Or you might feel like you need to keep worrying because it feels useful – or that bad things might happen if you stop.
And then there is the mind racing which takes each worry and obsesses about it over and over again.
One technique for dealing with worry is a technique called ‘labelling.’ It’s a very simple technique. Whenever you find yourself worrying about something, note to yourself that you’re “just worrying.” You are labelling the worry with a note that says ‘just another worry.’
By doing this you become present as the witness of your thoughts instead of being completely taken over by them. You now have the power to choose to let it go. After you label it turn your focus to your breath or just simply bring your attention into the present moment and what you’re doing. Every time you catch yourself worrying—no matter how often—you employ the technique again.
How Can I Look After My Physical Health When I’m So Anxious?
Work on getting enough sleep. Sleep can give you the energy to cope with anxiety. Pay attention to your diet. Eating regularly and keeping your blood sugar stable can make a difference to your mood and energy levels. Take up a regular physical activity. Exercise can be really helpful for your mental wellbeing.
Which Breathing Exercises Can Help Anxiety?
Breathing exercises can help you cope and feel more in control. Here’s my favourite.
Pretend you have a mug of hot chocolate in your hands. Smell the warm chocolatey smell for three, hold it for one, blow it cool for three, hold it for one. Repeat three or four times.
Can Mindfulness Help With Anxiety?
However, mindfulness can help. At least, I’ve found it extremely beneficial.
It teaches you to pay attention to the moment which turns down the volume in your mind by coming back to the body.
Don’t worry, you don’t have to spend an hour’s pay on a class or contort your body into difficult positions. You likely already have all the tools you need to practice mindfulness.
Try this: set a timer for three minutes and give one task your full and undivided attention. No checking your phone, no clicking on notifications, no browsing online — absolutely no multitasking. Let that one task take centre stage until the timer goes off.
Does Keeping A Diary Help Anxiety?
It can help to make a note of what triggers your anxiety or panic attacks. By doing this on a regular basis, you tend to find a pattern in what triggers the anxiety or help you notice early signs that’s the anxiety is about to take off.
It’s also important to see the pattern for what goes well. For example, you could keep a photo diary of all the things you’ve managed to achieve. Whether you’ve attended a presentation, got yourself on and off the bus or even managed just to get outside, having a Picture diary will help you when you are feeling scared and encourage you to do it again.
Is There Any Peer Support To Help With Anxiety?
Peer support brings together people who’ve had similar experiences to support each other. Some people find this helps because listening to others who know how they feel helps them seem less isolated and unusual. However, many people find it does not help to be in a group and this might increase their anxiety.
Everybody is different and it’s a case of trying it out and seeing if it’s something for you.
Are There Any Complementary Or Alternative Therapies That Can Help Anxiety?
There are many different types of complimentary or alternative therapies that can help with anxiety. These include yoga, meditation, aromatherapy, massage, reflexology, herbal treatments, Bach flower remedies, hypnotherapy and many more. It’s a case of trying each one out to see if they work for you.
What Self-Help Treatments Are Available For Anxiety?
A self-help treatment maybe the first treatment option your doctor offers you because it's available quite quickly, and there's a chance it could help you to feel better without needing to try other options.
For example, my Beat Anxiety Programme is one you do by yourself but there’s lots of support if you need it. Here’s more details:
You might be offered a resource to work through your own, or on a course with other people who experience similar difficulties.
What Are Talking Treatments For Anxiety?
Basically, talking treatments are counselling or coaching. There are some resources through the NHS, specifically cognitive behavioural therapy (CBT). CBT teaches you how to focus on your thoughts, beliefs and attitudes and to see how they affect your feelings and behaviour. It then teaches you coping skills for dealing with different problems. In an ideal world, it can take some time to keep going back to re-condition your mind so that you think differently.
What Medication Is There For Anxiety?
There are several types of medication available for anxiety. These include:
Antidepressants. Usually this will be a type called a selective serotonin reuptake inhibitor (SSRI), but these drugs can sometimes cause side effects such as sleeping problems or feeling more anxious than you did before. If SSRIs don't work or aren't suitable you may be offered a different kind called a tricyclic antidepressant.
Pregabalin. In some cases, such as if you have a diagnosis of generalised anxiety disorder (GAD), your doctor may decide to prescribe you a drug called pregabalin. This is an antiseizure drug which is normally used to treat epilepsy (a neurological disorder that can cause seizures), but is also licensed to treat anxiety.
Beta-blockers. Beta-blockers are sometimes used to treat the physical symptoms of anxiety, such as a rapid heartbeat, palpitations and tremors (shaking). However, they are not psychiatric drugs so they don’t reduce any of the psychological symptoms. They may be helpful in certain situations, such as if you have to face a phobia.
Benzodiazepine tranquillisers. If you experience very severe anxiety that is having a significant impact on your day-to-day life, you may be offered a benzodiazepine tranquilliser. But these drugs can cause unpleasant side effects and can become addictive, so your doctor should only prescribe them at a low dose for a short time, to help you through a crisis period.
How Do I Get Some NHS Treatment For My Anxiety?
The first step is to visit your doctor who will do an assessment.
They should then explain your treatment options to you, and you can decide together what might suit you best. Before deciding to take any drug, it's important to make sure you have all the facts you need to make an informed choice.
For talking treatments, NHS waiting lists can be very long. If you're finding it hard to access talking treatments you might consider other alternatives. Again, my course Beat Anxiety Programme is a brilliant way to start calming your anxiety symptoms.
Alternatively, there are charities and specialist organisations that may offer therapy or be able to put you in touch with local services.
Finding a private therapist is another option some people choose to explore, but it's not suitable for everyone because it can be expensive.
Yes, But What If My Anxiety Stops Me From Getting Help?
It may be hard for you to access treatment if leaving the house or attending an appointment makes you anxious. There are alternative ways you can get help.
You can ask your doctor if they will assess you by phone or even come to your house. You may want to get someone else to make the appointment for you but you will have to give your consent to make that happen. Alternatively, you can self-refer for talking therapies at a local Improving Access to Psychological Therapies (IAPT) service. Some IAPT services are delivered over the phone.
What If My Anxiety Doesn’t Get Better?
If you are seeing your doctor, they should offer you regular appointments to check how you're doing. They should also be looking at how well any treatment is working for you. Different things work for different people, so if a particular medication or talking treatment doesn't work for you, your doctor should offer an alternative.
If you've tried a range of treatments and none of them have helped, you may be referred to a different department like the community mental health team (CMHT). This is made up of a number of different healthcare professionals, such as psychiatrists and clinical psychologists. Your CMHT can assess you separately and offer you a personalised treatment plan.
It's important to remember that recovery is a journey, and it won't always be straightforward. You might find it more helpful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of every symptom of your anxiety problem.
How Can I Help Someone With Anxiety?
First and foremost, don't pressure them. It's really important to be patient, listen to their what they're asking for and take things at a pace that feels okay for them.
It's understandable to want to help them face their fears or find practical solutions, but it can be very distressing for someone to feel they're being forced into situations before they feel ready. This could even make their anxiety worse. Their fear is not necessarily your fear.
Try to remember that being unable to control their worries is part of having anxiety, and they aren't choosing how they feel. Trying to argue the case with logic does not help. What does help is accepting that they are anxious and they are suffering with anxiety symptoms.
Compassion and listening goes a long way.
What is depression?
Here’s how I describe depression in my book ‘Beat Depression And Reclaim Your Life”:
Depression is described in the dictionary as being ‘low in spirit; downcast’. What it actually feels like is that a cloud of lead particles has settled on the soul. It is the heaviest weight we are ever going to feel. It is also the most stubborn of feelings and it can drive a person to despair. It sears our very essence and dirties our vision. It has the lightness of a gas but the weight of a concrete overcoat. It seeps into every crevice of our being.
When we are depressed we cannot be bothered with our own potential. We cannot lift our heads enough to see that we have true value in the world. We cannot give ourselves in close relationships because we become absent in the company of those we love. We care less about how we look, or else we overdo it when we go out to act as a mask to the world. We stumble through the day trying to find some meaning to the feelings that ravage us. We lose our motivation to pursue our true vocation and, in so doing, compromise our soul.
We feel like victims – buffeted by the rough winds of life. We cannot grasp onto anything that is solid in order to pull ourselves out of the storm. Either we see nothing but unfairness or we stoop to self-loathing and believe we deserve nothing better. We lose our sense of reason and we are unable to take an objective view on our circumstances and address what is fact and what is fiction.
When Does Low Mood Become Depression?
There’s a line you cross from ‘low mood’ to depression. When you suffer from a low mood, it may feel all-encompassing at times. But you will also have moments when you are able to laugh or be comforted. Depression differs from low mood. The feelings you have will affect EVERY aspect of your life. It may be hard or even impossible to find enjoyment in anything, including activities and people you used to enjoy. You’ll experience constant feelings of sadness. Suicidal thoughts are also a sign of depression, not low mood.
What Are The Symptoms Of Depression?
Some symptoms of depression that I included in my book “Beat Depression And Reclaim Your Life” are:
• Overwhelming tiredness
• Immense sadness
• Inability to do anything worthwhile
• Feeling dead
• Feeling stuck
• Feeling isolated
• Harming ourselves
• Feeling lonely
• Thoughts of suicide
• Not caring whether others like us or not
• Having no feelings – numbed
• Eating junk
• Sabotaging friendships
• Behaving violently
• Drug and alcohol abuse
• Gambling to excess
• Being obsessive about sex
• Losing all interest in sex
• Abusing children
• Compulsively cleaning
• Self harm
How Does My Doctor Determine If I’m Depressed?
Doctors use the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (DSM-5 criteria) to help determine if someone has low mood or is depressed. You may receive a diagnosis of depression or persistent depressive disorder if you meet the criteria.
The DSM-5 criteria include nine potential symptoms of depression. The severity of each symptom is also weighed as part of the diagnostic process. The nine symptoms are:
Feeling depressed throughout each day on most or all days
Lack of interest and enjoyment in activities you used to find pleasurable
Trouble sleeping, or sleeping too much
Trouble eating, or eating too much, coupled with weight gain or weight loss
Irritability, restlessness, or agitation
Unwarranted or exaggerated feelings of guilt or worthlessness
Inability to concentrate or make decisions
Suicidal thoughts or actions, or thinking a lot about death and dying
What Are The Risk Factors For Me Getting Depressed?
Early childhood or teenage trauma
Inability to cope with a devastating life event, such as the death of a child or spouse, or any situation that causes extreme levels of pain
Family history of mental illness, including bipolar disorder or depression
History of substance abuse, including drugs and alcohol
Lack of family or community acceptance for identifying as lesbian, gay, bisexual, or transgender (LGBT).
Trouble adjusting to a medical condition, such as cancer, stroke, chronic pain, or heart disease
Trouble adjusting to body changes due to catastrophic injury, such as loss of limbs, or paralysis
History of prior mental health disorders, including anorexia, bulimia, post-traumatic stress disorder (PTSD), or anxiety disorder
Lack of a support system, such as friends, family, or co-workers
Are There Different Types Of Depression?
Seasonal affective disorder (SAD) – depression that occurs at a particular time of year, or during a particular season. See our page on SAD for more information.
Dysthymia – continuous mild depression that lasts for two years or more. Also called persistent depressive disorder or chronic depression.
Prenatal depression – depression that occurs during pregnancy. This is sometimes also called antenatal depression.
Postnatal depression (PND) – depression that occurs in the weeks and months after becoming a parent. Postnatal depression is usually diagnosed in women, but it can also affect men.
Premenstrual dysphoric disorder (PMDD) a severe form of premenstrual syndrome. PMDD is not a type of depression, but most women who experience PMDD find that depression is a major symptom.
How Will I Feel If I’m Depressed?
You will feel some of the following:
Restless or irritable
Down on yourself
And unable to relate to other people
No pleasure in life or things you usually enjoy
A sense of disconnection from normal life
How Do People With Depression Behave?
They may do some or all of the following:
Avoid social events and activities they usually enjoy
Exhibit suicidal behaviour
Can't make decisions
Can't think clearly
Lose interest in sex
Difficulty remembering things
Using more alcohol or other drugs than usual
Sleeping too much
Feeling exhausted all the time
Eating too much and gaining weight
Physical aches and pains
With no obvious physical cause
Severe depression can include experiencing some psychotic symptoms. These can include delusions, such as paranoia or, hallucinations, such as hearing voices.
These are likely to be linked to your depressed thoughts and feelings. For example, you might become convinced that you've done something terribly wrong. These kinds of experiences can feel very real to you at the time, which may make it hard to understand that these experiences are also symptoms of your depression. They can also be quite frightening or upsetting, so it's important to seek treatment and support.
You might feel worried that experiencing psychotic symptoms could mean you get a new diagnosis, but psychosis can be a symptom of depression. Discussing your symptoms with your doctor can help you get the right support and treatment.
How Do I cope With Suicidal Thoughts?
Here’s an excerpt from my book “Beat Depression And Reclaim Your Life”
Thoughts of suicide
“Some of us are frightened that if we surrender then we may not survive. These words are for you.
In our most depressed state of being we can experience thoughts of suicide. We may feel ravaged by the world and think that the only way out is to stop living. Surrendering to our depression in this state may seem like a foolish thing to do. But running from these thoughts may harm us more because it is the running that wears us down. We become too foggy- headed to make clear judgements.
Thoughts of suicide can hit us for two main reasons: either the pain is too much for us to bear or we are so enraged with other people that we want to punish them. In either case we have given up trying to protect ourselves because we have failed in the past. We feel backed into a corner and there seems no other alternative. All reason has gone and we are at a loss to see any other option but to take our life and end the suffering.
It is at this point that we don’t want anyone else to try to talk us out of the way we feel. When we have suicidal thoughts, people may say things like this:
‘Oh, come on, it’s not that bad’
‘Don’t be silly, you don’t really want to do that’
‘Pull yourself together, you’re talking like an idiot’
When we hear those kinds of comments we want to show them exactly what we mean. It can fuel the desire to commit suicide even more and become very, very unhelpful.
If you have thoughts of suicide, surrender to the feelings that lay behind the thoughts. A technique to help you do this is to look down to the floor. This will help you to ‘feel’ whereas looking upward helps you to ‘think’.
Behind your thoughts lies the utmost pain that any human has to bear. You might feel the intensity of human degradation, the devastating pain of loss or the wretchedness of a lifetime’s neglect. You might feel your spirit has dried up and your essence has been ripped away. You might feel like a ‘nothing’ or a ‘very bad person’. You might sense that everything you touch, you damage. You will probably be living in a dark tunnel. You might hate every part of you as much as you hate others. You might feel a desire to injure others as you have been injured. You might want to destroy others as you have been destroyed.
You might simply be lost.
Whatever the passion is, then just for today stay with the feelings and ignore the thoughts or the action.
Just for today hold yourself around the tummy as you recognise the emotions behind the thinking.
In this moment acknowledge that you feel so bad that you want to end your life. Don’t do anything else except surrender into it. Tomorrow you can take action, but just for today, surrender. Hold your hands up and give in to the feelings.
Say out loud, ‘I surrender’.“
Here's a link to a blog post about this: https://www.alexandramassey.co.uk/post/what-causes-suicidal-thoughts
Is Self-harm Normal When You Are Depressed?
Self-harm is very common when you are feeling depressed. Self-harm can be classified as behaviour that’s not good for you. For example, you may start smoking more or eat more junk food.
In terms of actually harming yourself, through cutting yourself, this is a behaviour that is often trying to get the same effect as smoking pack cigarettes or eating a tub of ice cream. These are all things we do to cope with difficult feelings by attempting to numb them. Of course, these behaviours bring us temporary relief from our depression but only add to our distress in the long-term.
Please read more about self-harm here: https://www.alexandramassey.co.uk/post/is-self-harm-attention-seeking
If you're worried about acting on thoughts of suicide, you can call an ambulance, go straight to A&E or call the Samaritans for free on 116 123 to talk.
How Can I help Myself While I’m Isolating Through Depression?
It’s really normal to feel like isolating when you are depressed. For some people this can be a life saver because curling up in bed and being alone with the depression can feel very soothing. For others, however, this can feel like cutting yourself off from available support.
If you feel you need support but you’re isolating, it is really important to reach out. There are loads of options available and you will find a list of organisations to contact at the end of these questions.
Is My Depression A Symptom Of Another Mental Health Problem?
Depression can be a part of several mental health problems, such as bipolar, borderline personality disorder (BPD) or other personality disorders or schizoaffective disorder.
If feelings of suicidal thoughts or depression are the reason you first speak to your doctor about your mental health, he/she might offer you treatment for depression without realising that you are also experiencing other symptoms. It’s important to tell your doctor about this to make sure you're getting the right treatment to help you.
What Causes Depression?
There are several ideas about what causes depression. It can vary a lot between different people, and for some people a combination of different factors may cause their depression. Some find that they become depressed without any obvious reason. However, I maintain that if you experience a persistent depression, the roots may well live in your past.
Here is a section of my book “Beat Depression And Reclaim Your Life” which may help you to determine the cause of your depression:
“The very word ‘de-pressed’ suggests that something is being pushed down. We are depressed because we have pushed down emotions that we cannot allow to come to the surface. We constantly experience a range of emotions; how we handle them determines the level of our mental health. If we feel angry but don’t express that anger in a healthy way, we will either act it out in ways that are detrimental to us, or we will ignore it and push it down.
If we feel sorrow but don’t let it out, we hold back the tears until they are too ‘pressed down’ to be released. We all face adversity in our lives, yet how we respond to it is a direct response to the way we have been taught to react.
Most causes of depression are seated in the past. Research has shown that our personalities are moulded in the first six years of our lives and it is the quality of the care we receive in our early years that makes us what we are. It also dominates our choice of friends and lovers, shapes our interests, determines our careers and even changes our brain patterns and our body chemistry. It can also trigger mental illness, including depression and/or criminal behaviour later on in life.
When our life is wonderful, we don’t question the way we tick. But when we hit a bad patch, if we don’t have a compassionate, in-built method of dealing with trauma we can easily fall into a depressive state.”
Is Depression Caused By A Chemical Imbalance?
The evidence for this is weak. However, there is evidence to suggest the flip side of this: depression causes a chemical imbalance. My personal belief is that depression is a result of numbing or pressing down uncomfortable emotions.
We are not designed to ‘stuff’ our emotions so when we do this, it creates a blockage.
Why do we do this? It comes from being taught as children that are expressing anger, frustration, sadness, pain or hurt or other negative emotions, was wrong. We learnt to bury those feelings as children and we continue to bury them as adults. That is a perfect recipe for depression.
Have My Childhood Experiences Made Me Depressed?
There is plenty of evidence to show that going through difficult experiences in your childhood can make you vulnerable to depression in adult life.
These difficult experiences can include any type of sexual, physical or emotional abuse. Being neglected. Losing someone very close to you through death or absence. Dysfunctional families. Living in unstable family situation.
These experiences, and all other experiences like them, can have a huge impact on your self-esteem. It impacts the way you cope with your life’s ups and downs. If these old childhood traumas go untreated, depression is often a way to cope. By being depressed, you are able to numb out from those old childhood memories and feelings.
Here’ a blog post to further explain family dysfunction and mental illness: https://www.alexandramassey.co.uk/post/the-dysfunctional-family-and-mental-illness
How Do Life Events Make Me Depressed?
Depression can be triggered by a stressful or traumatic event. This might be losing your job, the end of a relationship, bereavement, major life changes like moving house, physical or sexual abuse or being bullied.
it’s the way we deal with these experiences that cause depression. Some people will turn to their support network for help. But others will isolate and not get help. If you don't have much support to help you cope with the difficult emotions that come with these events, or if you're already dealing with other difficult situations, you might find that a low mood develops into depression.
When Does Grief Become Depression?
Here’s an excerpt about the link between grief and depression from my book “Beat Depression And Reclaim Your Life.”
Grief becomes depression when:
We have lost someone close to us
We can become depressed if someone we love has died
We can also become depressed if a close relationship has finished
We feel we have no control
If we are trying to control other people. Attempting to change another person only leads to frustration and disappointment, because we can never really have that power. This can occur in our intimate relationships, at work, with our children, in dealing with our parents or with friends. This is the unexpressed frustration and disappointment at others not behaving as we want them to
Incapacity. Depression can set in if our body has let us down, through illness or incapacity. Many people who find themselves physically disabled become depressed because they cannot function like everyone else. This is also prevalent in elderly people whose physical bodies cannot move them around as they used to. Feeling physically helpless can be a major trigger of depression and hopelessness.
We are in a dead-end relationship. We may be in a relationship that we simply can’t see a way out of. We feel trapped by circumstances and have fallen into the belief that we cannot move away from this dead-end place because we have no money, we have children to think of, or we simply would not be able to cope on our own. We feel that the relationship is the root cause of all our misery, yet we are stuck.
We feel powerless. We find ourselves depressed when we feel powerless or victims of circumstance. We are allowing someone else to dictate to us as if we were children. We may feel bullied and violated by another and feel that we are in a hopeless situation.
We are broke. There is nothing like struggling financially to feed our depression through feelings of anger and frustration, especially if we are powerless over our circumstances. If we have no way out we turn the feelings inwards and blame ourselves until we are full of shame and end up treating ourselves, and those around us, badly.
Post-natal depression. If someone is prone to depression, giving birth can trigger off a chronic bout. There is a lot of conjecture about why women become depressed after having given birth. Reams of medical papers are devoted to the theorising of post-natal depression and the role that hormonal change plays. However, there are some very simple explanations for it: being physically shattered; the overwhelming responsibility of caring for the baby; a feeling of isolation at home with our partner having returned to work, and maybe giving up our own job with all its support system. When we are depressed the last thing we want is to have to take care of a new baby, regardless of how much we adore it, but we feel we have no choice.
Retirement. Just sitting still with ourselves can be a traumatic experience if we’ve spent years being busy. Whatever we have been running from catches up with us when we stop. We are not experienced in sitting still and taking time to do what we want. We also give up the power and the glory of being needed and fulfilled in our previous role. Once we are retired, it can seem like our raison d’être has gone.
We are competing with everyone. The very nature of the ‘civilised’ world lends itself to many people feeling like a failure. In our better/best world, it is not hard to feel that we will never be good enough. We are constantly bombarded with ideals, images and stories about how we should live our lives. Icons are held up as examples of what we should achieve. Tales of others’ perfect lives come at us every way we turn and it takes a strong character not to buy into these fantasies of what we need to buy/earn/sell in order to achieve happiness.
We have lost our childhood. For some of us, none of the above had to happen for us to feel depressed. We have always felt depressed and we don’t really know what it’s like not to feel that way. This is because we didn’t have the childhood we were entitled to. The child-hood we are entitled to is one that is full of fun and happiness; where we feel safe and warm knowing that, however naughty we are, we are still cherished. We should be fed and washed, be able to sleep soundly, and be nurtured and guided through life’s lessons. If we are disciplined, it should be in a way that feels firm but fair. Those of us who did not experience this may have grown up feeling isolated and uneasy with others, especially authority figures. We constantly seek approval and have lost our identity in the process. We get guilt feelings for standing up for our- selves and we put others before ourselves. We fear criticism and take it as a threat. We feel victimised and are attracted by this weakness in others. We judge ourselves harshly and have very low self-esteem. We have become dependent personalities who are terrified of abandonment and willing to do anything to hold on to a relationship.
Grieving for our loss
All of the above scenarios are about people having lost something and being unable to process it. Depression happens when we are stuck in this process. We may sit in the denial because we do not want to cry out the pain. We may push our anger down and be determined that we have no feelings. We may feel too guilty and believe we don’t deserve to heal.
Even if we do not feel as though we lost our childhood, and are depressed for other reasons, how we deal with life’s more difficult challenges – such as those listed above – is directly related to how we learned to deal with them as children. Negative influences from our past hinder our ability to function competently in the adult world and can lead to periods of depression and mental illness. People who do not deal with their unremitting depression can run the risk of ending up in prison, a mental institution or even dead. But there is hope for everyone to recover and many of us have recovered.
Can Other Mental Health Problems Make Me More Depressed?
If you experience another mental health problem, it's common to also experience depression. This might be because coping with the symptoms of your mental health problem can trigger depression. You may find you experience depression if you also experience:
Post Traumatic Stress Disorder
Can My Physical Health Problems Contribute To My Risk Of Depression?
Poor health can contribute to your risk of developing depression. Many health problems can be quite difficult to manage and can have a big impact on your mood. These may include:
Ongoing, long-term, physical health problems
Life-threatening physical illnesses
Physical health problems that significantly change your lifestyle.
You might be offered support for your mental health at the same time as you are treated for a physical health problem, as part of your overall treatment.
There are some specific physical health problems that can cause depression:
Conditions affecting the brain and nervous system
Hormonal problems, especially thyroid and parathyroid problems
Symptoms relating to the menstrual cycle or the menopause
Low blood sugar
If you think any of the above conditions apply to you, make sure your doctor knows about them. Some can be diagnosed by some simple blood tests and your doctor may suggest these are done to help make the right diagnosis. Or, you can ask for blood tests if you think they may be relevant.
Can I Inherit Depression If It’s In My Family?
Although no specific genes for depression have been identified, research has shown that if you have a close family member with depression, you are more likely to experience depression yourself. This is because it’s learned behaviour. We, unwittingly, learned to deal with life by becoming depressed.
How Do Medication, Recreational Drugs and Alcohol Cause Depression?
Depression can be a side effect of a lot of different medicines. If you are feeling depressed after starting any kind of medication, check the patient information leaflet to see whether depression is a side effect, or ask your doctor. If you think a drug is causing your depression, you can talk to your doctor about taking an alternative, especially if you are expecting your treatment to last some time.
What’s important to be aware of is one of the side effect of antidepressants is depression.
Both alcohol and recreational drugs can also cause depression. Although you might initially use them to make yourself feel better, or to distract yourself, they can make you feel worse overall.
How Does Sleep Or Diet And Exercise Effect My Depression Levels?
A poor diet and lack of sleep and exercise can affect your mood, and make it harder for you to cope with difficult things going on in your life.
Although a poor diet, or not getting enough sleep or exercise, cannot directly cause depression, they can make you more vulnerable to developing it.
What Can I Do To Help Myself If I Suffer From Depression?
Experiencing depression can be very difficult, but there are steps you can take that might help. This section has some suggestions for you to consider:
ï Talk to someone you trust
ï Try peer support
ï Try mindfulness
ï Look after your physical health
ï Try to keep active
ï Keep a mood diary
ï Spend time in nature
ï Practise self-care.
Some people find these ideas useful, but remember that different things work for different people at different times. Only try what you feel comfortable with, and try not to put too much pressure on yourself. If something isn't working for you (or doesn't feel possible just now), you can try something else, or come back to it another time.
If I Suffer From Depression Which Doctor Should I See To Get Help?
If you suffer from depression and you take the decision to get some help, it can be confusing as to which doctor you should see.
Should you go to you your primary doctor first?
Maybe you should see a specialist doctor.
Or perhaps look at an alternative doctor?
Many, many questions arise when you look at different types of specialists. It’s difficult to know whom to contact first. It’s also difficult to know where to find the doctors who specialize in depression.
Check out this blog can help take you through some of the available options which could allow you to make all informed decisions about which doctor to see when you suffer from depression.
What’s The Best Medication For Depression?
When we go to the doctor because we’re unable to cope with life, the doctor’s first treatment choice is antidepressants. Antidepressants are widely used for depression. However, doctors will admit that they although they may not cure depression, they could reduce symptoms like low mood or insomnia.
There is definitely a difference in the way certain antidepressants work and you might find that you have to try one or two before you decide which one works best for your particular symptoms.
Read this blog for further information:
How Can I Help Myself When I’m Depressed?
Start by talking to someone you trust because although it may feel hard to start talking about how you are feeling, it may make you feel so, so much feel better. It may be that just having someone listen to you and show they care can help in itself. If you aren't able to open up to someone close to you, the Samaritans run a 24-hour helpline that you can call to talk to someone confidentially.
Can Peer Support Help Me With My Depression?
Peer support brings together people who’ve had similar experiences to support each other. Some people find it helpful to share how they're feeling with likeminded people. There’s lots of peer support groups online.
Can Mindfulness Help My Depression?
Certainly, it’s been shown that practising mindfulness can help to manage depression. Mindfulness is a way of giving your full attention to the present moment.
Some structured mindfulness-based therapies have also been developed to treat these problems more formally. It's not the cure and it won't work every single time, but it might help to alleviate your depression by centring youself in the present moment.
Can My Diet Help My Depression?
Yes, food matters. We all know that alcohol ‘slows you down’ while coffee ‘picks you up’. Despite all the evidence suggesting that good food can provide huge benefits to our emotional wellbeing, we continue to eat foods that offer a short-term comfort but inject a longer-term setback.
I once ate a large tin of Quality Street when I felt too depressed to move. That night I felt drugged and the next morning I felt worse than ever. I knew I would feel like that yet I ate them anyway. Which is insanity. I recommend my book “Beat Depression And Reclaim Your Life” which has a whole section on eating to beat depression.
What Treatments Can I Find For Depression?
There are many treatments that have been found to help with depression. These include talking therapy, medication and alternative treatments. You have a right to be involved in your choice of treatment. The treatment you're offered will depend on how much your symptoms are affecting you, and it should take into account your personal preference for what sort of treatment you find helps you.
What Are Self-help Resources For Depression?
A self-help resource might be the first treatment option your doctor offers you, especially if your depression is mild. This is because it's available quite quickly, and there's a chance it could help you to feel better without needing to try other options.
These are programmes, for example a self-help manual. A healthcare professional should provide you with support and check your progress, either face-to-face or over the phone. It may be an online CBT programme for depression known as computerised cognitive behavioural therapy (CCBT). Some people find CCBT helps them understand their depression and challenge negative thoughts. You may be offered a physical activity programme like an exercise class specifically designed for people with depression and run by qualified professionals.
What Are The Different Talking Therapies For Depression?
These are cognitive behavioural therapy (CBT), group-based CBT, interpersonal therapy (IPT), behavioural activation, psychodynamic psychotherapy or behavioural couples’ therapy – if you have a long-term partner, and your doctor agrees that it would be useful to involve them in your treatment.
Your doctor will talk through the options available in your area and help you find the right kind of talking treatment for you. Unfortunately, we know that in many places NHS waiting lists for talking treatments can be very long.
Should I Stop Therapy If My Depression Starts To Lift?
If you're currently receiving a talking therapy, you don't have to stop just because you're feeling better. It’s best to discuss this with your therapist and talk about what options might be right for you.
What Medication Is There For Depression?
You may be offered an antidepressant medication, either on its own or in combination with a talking therapy. There are different types of antidepressants available and it’s important to talk the options through with your doctor as well as understanding what the side effects can be. The most common types of antidepressants are selective serotonin reuptake inhibitors (SSRI’s), serotonin and norepinephrine reuptake inhibitors (SNRI’s), tricyclics and tricyclic-related drugs and monoamine oxidase inhibitors (MAOI’s).
How Can I Safely Come Off Medication?
it's important not to stop suddenly if you are taking medication for depression. Withdrawal symptoms from antidepressants can be difficult to cope with, and stopping suddenly can be dangerous.
If you decide to try coming off your medication, it's very important to get support, preferably from others who have come off successfully and from a professional who understands the process.
What Are The Alternative Treatments For My Depression?
There’s lots of things you can try to make yourself feel better and I have written a book about how to do this called “Beat Depression And Reclaim Your Life”
What If I Don't Feel Better?
This is what I did to beat depression, I surrendered. Here’s how to do it.
When you are in a full depression, there is really no point in trying to fight it. It is like riding a bicycle with a flat tyre.We keep getting off and pumping it up only to find that the tyre is flat once more minutes later. We are better off just accepting the status quo instead of fighting a battle we can’t win.
The harsh words we tell ourselves are akin to falsely pumping up that tyre again, only to feel deflated soon after. ‘What’s wrong with you?’ – ‘Pull yourself together, you idiot!’ – ‘You’re a useless piece of shit!’ – are admonishments that won’t help. At times like this, just stop, breathe out and notice the release of tension in your stomach. Accept the depression for that moment. Know that you are depressed and, just for that moment, are completely powerless to change it.
This acceptance will bring you a sense of relief. It will calm you down in the knowledge that you don’t have to sort it out there and then. You can just relax and sit with the feeling of being depressed. It is not self-indulgent; it is honest. You are entitled to feel depressed if that is how you feel. You can still function and be depressed. Being depressed does not mean you are going to die; it means you feel depressed. You can cope with that for one day at a time, one hour at a time, one minute at a time. You are not a freak, you are not unnatural, you are not worthless – you are simply depressed.
You are better off surrendering to your depression than trying to fight it. Like pushing wet sand, the more you push, the harder it gets. By surrendering you are putting your arms in the air and saying just that: ‘I surrender.’ Go on – try it. Just do it. You will feel the differenc
e as you do it and you will feel some acceptance of your current state.
Useful Contacts For Those Suffering From Depression
03444 775 774 (Monday–Friday 9.30am–5.30pm)
Advice and support for people living with anxiety.
Big White Wall
Online community for adults experiencing emotional or psychological distress.
British Association for Counselling and Psychotherapy (BACP)
01455 883 300
Provides a directory of therapists.
Campaign Against Living Miserably (CALM)
0800 58 58 58 (5pm-midnight daily)
Offers support for men who are feeling down or in crisis.
Cruse Bereavement Care
0808 808 1677
Charity providing information and support after someone you know has died.
A self-help organisation made up of individuals and local groups.
UK volunteering opportunities, including environment and conservation options.
The National Association for People Abused in Childhood (NAPAC)
0808 801 0331 (Monday-Thursday 10am-9pm, Friday 10am-6pm)
A charity supporting adult survivors of any form of childhood abuse. Provides a support line and local support services.
National Institute for Health and Clinical Excellence (NICE)
Information and clinical guidelines on treatments for depression.
0300 330 0700 nct.org.uk
National charity for parents, providing information and support for all parents.
0800 068 41 41 (weekdays 10am-10pm, weekends 2pm-10pm, bank holidays 2pm-5pm) 07786 209697 (text message service)
Confidential support for under-35s at risk of suicide and others who are concerned about them.
116 123 (Freephone)
24-hour emotional support for anyone feeling down or struggling to cope.
Sane Support Forum
Mental health forum for discussion and mutual support.
United Kingdom Council for Psychotherapy (UKCP)
020 7014 9955
Provides a directory of accredited psychotherapists and psychotherapeutic counsellors.