The more we find out about depression, the clearer it becomes: Depression has many causes, not just one. For example, the depression someone experiences after a period of loss is different to the depression that someone experiences after a period of stress.
The four types of depression
According to experts, there are four different types of depression:
- Endogenous depression
This type of depression is genetic and neurobiological — the type of depression people are ‘born to have’
- Depression as a consequence of attachment problems or abuse
Due to an early life loss or adversity, or failure of parents to provide a secure base and safe haven for the developing child
- Situational or stress-induced depression
Serious stress, often chronic, can deplete the brain of critical neurotransmitters and thus over-sensitise it to stress, the outcome of which is hard-to-shake depression
- Post-traumatic stress depression
Depression emerging in post-childhood after accident, injury, natural disaster, medical trauma or combat-related trauma.
What to do to help relieve these different types of depression
Consciously shift away from negativity. Try saying the following sayings to yourself (these will help with other types of depression, too):
- I can think what I want. And I want to think I have many good traits.
- I don’t have to leave my negative brain on auto-pilot. I can override it to think something positive.
- What I think affects what I do. I will think about using my strengths.
- Even if I don’t feel the energy to do something, I can choose to do it anyway.
Making a ’To Do’ list helps, too. Prepare a list of small, easily-manageable tasks in advance of you actually needing to do them.
Tasks like put a photo in a frame, sort out a closet, read a magazine article, call a friend you haven’t spoken to in a while, clean out the car, weed a section of the garden, clean out the fridge, watch that documentary or tv episode you saved for a quiet hour, sort out the recycling, take bottles to the bottle bank, take a bath — the possibilities are endless. The only requirement is that the task must be easy to accomplish; forget about grouting the shower or cleaning all the windows in the house. Small and easily manageable are the keys. Something that doesn’t require you to shift into a positive frame of mind before you start — although you might find that your mood shifts into positive territory by the time you’ve completed it.
Depression as a result of attachment problems or abuse
People with this type of depression tend to plunge into depression at the slightest upset. And when they plunge, they do so spectacularly, with risky, impulsive and potentially suicidal behaviours.
- Set up rewarding activities before the crisis hits
Make an effort to set up regular activities that you are obligated (perhaps pre-paid) to attend, such as tennis lessons, or a sports group, or regular volunteer shifts. Then, if you are hit with a plunge, you might be lifted up by the obligation to participate whether or not you want to.
- Build positive brain circuitry
When describing something, describe only the good parts. This helps train your brain to short-circuit the negative traits your brain has. Try noticing what was good about a recent event. As an experiment, see what happens when you tell someone only the good stuff, leaving out the bad stuff. What is their reaction? How do they respond? What lessons could you learn from this?
- Join a self-help group
People with this type of depression tend to self-soothe through risky behaviours, including smoking, alcohol abuse, substance abuse, sexual indiscretions, and more. Self-help groups will address your behaviours and provide you with literature to help you understand why you engage in those behaviours, and what you can do to change your responses to stress.
Situational or stress-induced depression
‘Burnout’ precedes stress-induced depression. People who suffer from situational depression may have some predisposition to it — in other words, the depression was essentially just waiting for the right situation to trigger it. When people feel like they can’t change a situation or the way they handle it, they may try to escape the stress and ‘recharge’ by isolating themselves from people and activities they previously enjoyed. However, isolation rarely succeeds in recharging the person, especially when the stress is ongoing. Indeed, contact with social groups is a major salve to the wounds of stress.
- Re-establish good self-care
The triggers for stress-induced depression include letting go of self-care. Addressing personal care is a good place to start. Make some lifestyle changes, such as ensuring your sleep habits are sound, getting some gentle exercise, reducing the amount of tv and YouTube you watch, cutting back on caffeine, alcohol, tobacco, technology and sugar.
- End isolation
Getting back to social contact is very useful. It’s doubtful that your burden of depression will be lifted if you don’t engage in some form of social contact.
Helplessness is often a feature of depression, but it is remarkable in someone suffering from PTSD. Victims of trauma may even feel helpless about having depression, which may be a replay of the helplessness they experienced during the initial trauma. They have a hard time believing anybody can help them, much less that they will ever be able to help themselves. Overcoming or ignoring feelings of helplessness is especially difficult because the feeling is so believable — it’s hard to get motivated when you believe that any effort you make to try to feel better will be futile.
What helps: Recovering from depression associated with PTSD involves a two-pronged approach, including becoming aware of what is triggering the trauma associations, and therapy to work through the traumatic stress.
- Bring it to your conscious attention
You just got triggered by something and your anxiety shot up. What was it about that situation that induced your stress? If you like, write it down. If you are a talker, phone a friend and talk it through. Describe the situation, don’t try and fix it. Don’t get into the why’s of the situation, either, just focus on describing the events and your reaction. What is your brain trying to alert you to?
In the long run, you will need to work through the traumatic stress. Cognitive therapy concepts such as reframing, observing actual outcomes, and working with neural-integration techniques (such as journalling) have been proven to be invaluable. Also, social support is key to regaining balance, and a good therapist helps provide some social support.
Useful resource: The 10 Best-Ever Depression Management Techniques by Margaret Wehrenberg. If you live in South Australia, why not order the book through Dymocks Adelaide. The excellent staff there will look after you.