Depression: Part 3 - Solutions
​
Negative Thought Management
​
Look at the damaging childhood situations listed above and the dysfunctional patterns that flow from them. Those patterns all come with negative thoughts/assumptions. A person compliments us and we assume they are lying. A person is quiet and we assume we're unlikable when, in fact, they are simply shy. When the brain perceives a pattern similar to our childhood traumas it automatically churns out a thought pattern to affirm it. If brainwashed to believe we're bad, the created thought is, “I'm no good—so that person must be lying.”
Not only are these negative thoughts, they are completely untrue. They are the imprints of a bad childhood imposing themselves on present reality. In people battling depression, the flood of negative thoughts is often so constant that they don't recognize it. To become more free, however, recognize it we must. For this reason, noticing thought patterns, understanding and adjusting them are essential.
​
Thoughts are labels. They are not the real things they refer to. A sign that says “apple” is not an apple. The thought “I'm bad” doesn't mean I'm actually bad. The thought, “I'm going to fail this test,” is not proof that I'm going to fail. So, in comparison to real events, thoughts are not real. They are real neurologic patterns—but these patterns are not the real things they label.
​
Thoughts are more like images in a movie. Watching a movie safely at home, we still jump when a dangerous image appears. The bodybrain—which does not deal in time —treats all incoming images as if they are really happening now, whether they are images in a movie, thoughts in our minds, or even traumatic memories. Since many, many negative feelings are based in painful and/or depressive childhood situations and events, those stored traumas convince the bodybrain “child” mind that we are still powerless in an oppressive world. The child mind needs to be guided gradually out of that past nightmare and into the adult world of greater agency.
​
Cognitive Behavioural Therapy (CBT) is a popular modality that attends to negative thoughts, their recognition and control. CBT theory states that negative thoughts— unrealistic and destructive ideas—are solely responsible for triggering depression. However, since feelings of powerlessness originate in children long before rational thinking, I believe that negative thoughts are not the origin, but that thoughts and depressive feelings trigger each other in circular fashion. Regardless, understanding and avoiding negative thinking is an important part of a complete therapy process.
​
The practice of understanding and managing thoughts is ancient, and essential to Zen theory and practice. Although much of CBT is useful, Zazen and other forms of meditation have a longer, more successful history.
​
The general process is as follows:
​
1) recognizing thoughts
2) reality-checking thoughts
3) deciding if they are useful, useless, or negative
4) learning to avoid useless thought patterns
5) learning how to disrupt negative thought patterns
6) learning how to return attention to this moment in reality
​
This is simple—but not easy. When people begin this practice, most are surprised at just how busy their minds are. As with all things—from learning a language to learning guitar—it takes time and repetition.
​
​
Reality Checking
​
The first step in managing depressive feelings and conclusions is to observe our behaviours and objectively understand what is reasonable and what is not.
​
We may recognize the excess of heavy depression ourselves, but the trickery of negative feelings and attitudes often require feedback from others we trust— including our therapist. When, for instance, childhood brainwashing has made us feel that the things we do are no good, it may take many, many concrete examples from quite a few people for our eyes to open. And often we have created a number of classic self-fulfilling prophesies of failure by choosing unrealistically difficult challenges, not really trying, giving up, and telling ourselves there's no point. But all of those mechanisms are there to be dredged up and challenged, one by one. This not only requires support, but the support of people and professionals who truly see the innate goodness, value and special talents that we have—and keep reflecting them to us.
​
​
Being Active
​
As mentioned above, the word “depression” is a broad label for a state of mind and feeling that is often unique to the individual. It can be strong feelings or a lack of feelings. It can be a cloud of negative thoughts about ourselves. It can be the conclusion that the difficult situation we are in—at work, at home, in relationship, in the world—is a massive trap we cannot escape. Such a tangle can be unravelled, but often the dark feelings, fogginess of mind, and lack of motivation are so heavy we just can't start.
​
Some people wake up full of energy and enthusiasm for the projects of the day. Others wake up with no energy and want to curl up and hide. This “attitude” is not just an idea to be thrown aside, it's a biochemical state—but not a permanent genetic condition. This is what the “chemical imbalance” theory gets wrong. If I'm down (a biochemical state) and I watch something funny and my “mood” changes, I have just adjusted my biochemistry—without drugs! Or to be more precise, I have shifted the organic “drugs” in my own system. The old magazine, Readers Digest used to say “laughter is the best medicine,” and in a way they were right.
One of the first steps in treating depression is activating our physiology. If the central problem of depression is powerlessness, then taking physical action is a solution. The body language of depression—curling up, staying inside, slumped posture—is a reflection of negative thoughts of defeat. The body language of action— gardening, yoga, tai chi, walking the dog, biking, swimming, jogging, tossing a ball— is a reflection of the positivity of living. Activity tells the body and mind that things are okay.
​
It's like a body-language conversation. The trauma-conditioned-child-mind—with inaction—says, “the world is too hard.” The aware, adult mind replies (with action) “No, I'm doing things and it's okay.” Just as a toddler tumbles, sees his mother smile, and is reassured he's okay, our inner child can be assured of the freer adult reality by assertive action.
Intellectually knowing the benefits of activity may not be enough to motivate depressed people to move. Often the encouragement of friends and family is necessary to get the “ball” rolling. Although coercion is not recommended, some people ask friends to take the initiative to push them. I have also known people who have pulled their spouse up from the bed and taken them for a walk. Then a longer walk. Then a bike ride. Then a game of tennis. The boundaries of consent in these cases must be worked out, knowing that literally remaining down is not a solution.
​
Activity changes chemistry. More oxygen, greater blood flow, muscular flexing, lymphatic action, hormonal production, nerve firing—the movement of life uses energy, creates energy, releases tension, and leads to clearer thinking, better digestion and deeper sleep. It is well known that if a person can choose a balanced routine of activity and maintain it for at least three weeks, the pattern will be strong enough—like a wave—to have its own momentum going forward. The body usually loves the feeling and wants more. If a depressed person has the right encouragement and non-judgmental support for an activity regimen that is not too aggressive (injury/exhaustion) or too lenient (uninspiring/lethargic) the clouds inevitably begin to lift.
Another aspect of human biochemistry is the ability to adjust our own hormone output. Two important hormones that affect depression are endorphins and dopamine. The word endorphin literally means “endogenous (self-created) morphine.” That's right, we can produce our own custom doses of painkiller. When we exercise and stress our system slightly, our brains release endorphins which can be experienced as a type of “high.” Even though it's possible to abuse this dynamic and get addicted to extreme exercise—and even physically injure ourselves—a judicious use of strenuous activity can completely shift a depressive system.
​
Dopamine, which is released with pleasurable experiences and goal achievement, can lead to an upward-moving cycle of action-success-motivation-action. If we develop a daily structure that sets simple, achievable tasks with recognition and reward, we are literally giving our bodies regular boosts of dopamine. Every time a cat sees a moving object, jumps and makes the catch, it gets a little “hit” of good feelings. This creates the biochemical loop that motivates the cat to do it again and again, which hones its hunting skills. So every time we set a small doable task and achieve it, the same positive pattern is strengthened. And the more we solidify the benefit of activity, the more depressive feelings will fade.
​
​
Resolving Origins
​
The section, “The Root Causes,” identifies the situations that lead to depressive states in adulthood. The sections, “Medication,” “Negative Thought Management,” “Reality Checking,” and “Being Active,” all offer ways to mitigate and adjust depressive feelings, thoughts, and behaviours. These approaches, though important, may not address and/or resolve the root causes that exist in the brain. The definition of trauma is held pain—a powerful pain that entered the system and was never allowed to exit.
​
When we eat bad food our system is designed to vomit it out. If a thorn gets lodged in our skin it needs to be pulled out. When my dog Rupert bit a porcupine, some of the quills eventually travelled through the roof of his mouth and out the top of his nose! His body found ways to squeeze them out.
​
When children have painful situations that are not resolved by emotional expression and loving support, those held pains—now traumas—are waiting for any safe opportunity to be ex-pressed (pressed out). If they are not, those traumas force the system to develop patterns of behaviour to both hide the pain and adjust to the traumatic environment. Those patterns become dysfunctional to adult life until we resolve them.
​
If the therapeutic methods above are helpful but certain depressive symptoms remain it may be necessary to explore and resolve the traumatic origins.
​
​
Feeling Expression
​
Many modern therapy modalities avoid any kind of feeling expression, falsely stating that clients will be “retraumatized.” As children we were shut down and forced not to cry, which locked in (created) the trauma state. For therapists to now block a natural release is simply a repetition of the oppressive behaviour that caused the trauma in the first place.
​
We all know that grieving the death of a loved one is natural. We also know that if we don't cry, the suffering and pain will linger on. In fact, much of therapy is a grieving process. We were hurt, we held the pain in, and now it's time to let it out— to grieve.
​
People with depression do cry, but often on their own, because they don't want to burden others or be criticized and advised to “snap out of it.” What they need is a friend or therapist who is wholly understanding, supportive, and not upset by strong feelings. A therapist who has personally done this work—not just studied it—will be able to hold that position and act as a guide to resolution.
​
Often depressive people will say, “what's the point? What good will it do?” which, of course, is a statement coming from the essential hopelessness at the heart of the trauma. It may seem paradoxical, but crying deeply, authentically, and honestly is a courageous action, that is empowering—the exact opposite of powerlessness. If people feeling confused and depressed can truly let the pain out, relief and mental clarity often follow. When the depressive “fog” lifts it can be possible to see solutions and feel the energy to take action. In cases like this, crying is not a symptom to be avoided but the healing process itself. If traumatic pain is the thorn, expressing the emotion is the removal.
​
Every therapeutically responsible emotional release is also a neurochemical event. When a person starts a session feeling flat and distant, and then goes into deep grief or anger, the chemistry of the brain is changing. And when that person leaves session feeling more alive and vibrant, brain chemistry has safely and naturally changed. Responsible psychotherapy is a full body-brain endeavour.
​
​
Integrating
​
The process of exploring difficult patterns and feelings is unique to the individual, and requires an experienced professional who creates a safe environment and manages the focus and pace. Each present difficulty has a thread that leads to its origin. We only need to follow the path from feeling to expression to understanding, one item at a time.
​
During the process it's helpful to integrate these experiences, discoveries, and changes by reflecting, writing, and talking things through with your therapist. Over time the old dysfunctional patterns can transform into a new, empowered way of experiencing and living in the world.