What is the worst thing about depression?

You feel the energy has been drained out of your body. When you think about doing something, even the thought can be overwhelming. You curl up into the fetal position and try to push the idea out of your mind. There are a few things that you can drag yourself to do, such as going to the refrigerator to find food, going to the bathroom, or climbing back into bed. You remember vaguely what pleasure felt like, but it doesn’t happen any more. You are screaming to escape, but your body refuses to co-operate.

You feel you have no ability to start the engine.

The whole motivational system has shut down. And the longer you wait to start the engine, the more rusty the engine seems to feel.

Chemical Imbalance? Definitely, but…

When depressed, there is plenty of evidence of your brain chemistry is messed up. However, trying to juggle these bits of brain chemistry with medication works for some, but it seems to be of little use for many others.

How can you start the engine without waiting for the right medicine?

We get a hint of an answer by looking back to the so-called “good old days” when there were no anti-depressants around. There were certainly less people being diagnosed with Major Depression compared to today, but it is difficult to get good comparable data from those early days.

However, there is plenty evidence that many of those earlier patients spontaneously recovering from depression without the aid of medication. Some would relapse again, but many seemed to have a complete recovery.

So, it looks if their brain machinery was intact all the time. Some unknown factor seems to have accidentally got them functioning again. Nobody seemed to know what was that elusive factor.

Today, we have at least one answer: Movement

Movement is one of the best ways of restarting your brain chemistry.

More and more research is showing that the very simplest of exercises can produce massive physiological changes in the chemicals involved in anxiety and depression. For instance, simply practicing standing up straight when facing a stressful situation will change a person’s brain chemistry, with people reporting feeling much more confident.

Also, most people report feeling much more optimistic after a strenuous workout at the gym. It’s looks as if consistently moving towards goals can get the engine running again.

However, the thought of exercise when you are depressed is the farthest thing from your mind. You can’t even run to the bathroom! No matter what other strategies you may be using, such as medications or therapy, don’t just wait for the energy to suddenly appear. Start moving. Even moving towards the most trivial of goals can begin to alter the brain chemistry. And these small chemical changes will be eventually begin to feel pleasurable.

  • Start moving, but start moving without getting out of bed!
    • You need to start very easily, doing the simplest of behaviors while still lying in bed.
    • First, getting out of that curled-up fetal position which is seen in all animals when they are depressed.
    • It’s amazing how much that position tells your brain that everything is hopeless, so simply hide from the world.
    • Arch your back, trying to do the opposite to what you do in the fetal position.
    • Stretch your body in as many directions as possible, push your toes away from you, and stretch your hands over your head, making your body a long and as straight as possible.
    • At other times, stretch other parts of our body: move your neck from side to side, arch your body backwards, twist your body into as many different positions as you can.
    • In general, move your body around in bed, spending as little time as possible in that fetal position.

In other words, you can start completing lots of little tasks without even getting out of bed. You will be amazed how much your physiology begins to function once you give it a chance. Keep doing it each day.

  • When you do get out of bed, don’t slump.
    • Try to walk tall, with your shoulders back and head high. It will feel very artificial, but keep doing it.
    • Just standing and walking with head up and shoulders back will have a big effect on those neurotransmitters. You release a little bit of dopamine, the happy drug, every time you move and act in a non-depressed way.
    • That drug helps strengthen the new behavior, making it into a new habit.
    • Just get used to doing something small, where you can say “at least I can do that!”
  • Thinking and Doing. A lot of my depressed patients have also found this exercise to be useful.
    • Try to speed up the time between when you think of doing something , and actually doing it.
    • This is very important in terms of getting the dopamine to do its job at the right time.
    • If you delay too long between thinking and doing, you are simply practicing being a procrastinator.
    • You are thinking of getting a glass of water? Get out of bed and move as soon as possible. Don’t delay.
    • Try to get thoughts and actions as close together as possible.

The more often that you practice Thinking and Doing during each day, the more you will feel liberated from the depression. I encourage people to look for at least 10 easy situations a day where they deliberately follow this procedure.

  • Don’t try too hard!
    • The worst thing you need at this point is failure.
    • Trying too much too soon can exhaust you.
    • You don’t have much energy at this point, so be patient and take your time with these suggestions.

Without movement, your physiology cannot possibly function normally.

Look at these suggestions as the first step in getting you moving again. There are many other things that you eventually need to do, in terms of improving you social network, having others encourage you to get out of bed and do things, trying cognitive therapy for depression, and using medications if you found them helpful. But in order to make use of these other aids, you need to start moving.

Start Now!

What are some anxiety and/or depression hacks to cope, prevent, avoid, work with, outsmart, lessen, etc. the effects?

Actually, if you can’t calm down, its because you are acting is if you are in danger! If you want to get rid of anxiety, you must first act as if you are safe! Only then can the anxiety go to sleep.

Ask someone “How do you know you are anxious?” They will usually mention sensations such as feeling butterflies in the stomach, tightness in the chest, racing thoughts, shortness of breath, trembling, inability to think clearly, pacing, feeling frozen, or having an urge to run away. Obviously, your anxiety is actively preparing to do something!

  • It is simply preparing you to run away.
    • Anxiety is part of a very primitive survival mechanism found in the majority of animals.
    • Anxiety is your bodyguard:It is an early warning system, to help you escape physical danger.
      • And whenever you run into a situation that looks similar to a past uncomfortable situation, your bodyguard immediately revs you up to help you escape again to a safe place.
      • When you reach a safe place, you automatically relax and act as if you are safe.
      • Your bodyguard observes you relaxing and acting as if you are safe.
      • It declares “Mission Accomplished”, and goes back to sleep until you meet your next threat.

How is this related to depression?
In the anxious person, this defensive mechanism is working overtime! And chronic anxiety leads to depression. Get the anxiety under control, and the chances are you will get the depression under control! This anxiety mechanism is fully developed at the time you are born.

  • At birth, your first response is fear, as you are suddenly dragged into a hostile world of lights, noise, cold, and uncertainty, as you struggle to breathe for the first time.
    • Gone is the serenity of that safe, relaxing, womb.
    • As a newborn, you suddenly have to face a lot of discomforts that you never experienced before: hungry, discomfort of a messy diaper, loud noises, horrible glaring lights. Your reaction is to go back to your safe place. But that has gone for good.
    • Somehow you have to make the new world safe, but you have no control over your environment. However you soon learn that crying usually results in some response from the world, where your discomforts are somewhat relieved.
    • So the next time you are in a similar uncomfortable mess, your bodyguard remembers what you did the last time, and gets you crying again, hoping to get similar magical relief.
    • Before long, you are using these types of agitated responses to escape from all sorts of discomforts.
  • This is the one point you need to remember about anxiety
    • When you feel anxiety, your are feeling a primitive part of your body preparing to escape from where you are, and to help you find a safer place.
    • And the strength of that anxiety is directly related to how often you have escaped from similar situations in the past.
  • So what is a safe place?
    • It is any place where you where you can relax, and act as if you are no longer in danger.
    • Once you are relaxed, your bodyguard believes it has done it’s job, and the whole defensive mechanism goes to sleep.

Unfortunately this primitive anxiety mechanism has little else to offer in terms of survival. It simply prepares you to run away, and find a safe hiding place. That’s it!!
But in this modern world, running away is the wrong response if you are:

  • Feeling trapped in the boardroom.
  • Worrying about your financial future.
  • Feeling uncomfortable in social situations.
  • Being afraid of flying,
  • Working for an angry boss.
  • Giving a speech,
  • Taking an exam.

Anxiety is actually counterproductive in these situations. So how do we stop these rather mentally bodyguards from pressing the panic button in these situations?

The only way you can do this is by acting as if you are safe! Easier said than done!
After treating anxiety patients for many years with a variety of techniques, I find the most effective way of teaching people how to feel safe in stressful situations is by using Exposure Therapy, or, to use its full name:

Graded Exposure and Response Prevention (ERP)

  • This technique has been around for 65 years, and it teaches you how to gradually walk towards slightly anxiety-provoking situations, where you increase the anxiety a little bit, but practice tolerating the discomfort.
  • Your bodyguard will fight you initially, because it is still trying to get you to run away.
  • However, if you keep acting as if the situation is safe, your bodyguard will eventually get the message, and then it actually has no choice but to go to sleep.

So how would you use this ERP technique with an angry boss?

  • It is helpful to learn some good relaxation and breathing technique before you start the procedure, as these skills can help you to act as if you are safe.
  • This is why there are so many disciplines that emphasize the importance of relaxation, whether it is meditation, mindfulness, yoga, Zen, Buddhism, just to name a few. Obviously, these disciplines know that there is some connection between having a relaxed body and gentle breathing that can counteract fear and anxiety.
  • So, if possible, try to learn some basic relaxation and breathing skills as mentioned above. These are useful lifetime skills to help you find your safe place.

Next, ERP in imagination:

  • Then, do this simple ERP exercise in the safety of your own home.
    • Imagine yourself at work, with your boss is in his usual bad mood. Create the image as strongly as you can, trying to scare yourself as much as you can, while staying as relaxed as possible despite the fear.
      • Do this imaginal exercise for several days in a row, for about 20 minutes each time!
      • This can feel quite scary the first couple of times you do it. But after about 7 days, you will notice that it gets more and more difficult to experience the anxiety.
      • You bodyguard is beginning to get bored.

Then, use ERP in the real world:

  • Now start trying to relax in the work situation.
    • Start with easy situations, where you practice relaxing when your boss is not around.
      • As the workplace begins to feel a little more safe, try deliberately holding that relaxed state when your boss is around.
      • Later you practice the same behavior when he is ranting and raving.
      • With time, you will notice that the anxiety is getting weaker as you act as if you are not in physical danger.
    • At the same time as you are practicing the above exercises, you will probably notice that you have other defensive behaviors going on. Use the same ERP strategy with these as well. For instance, use the strategy to:
      • practice making eye contact with your boss;
      • looking for ways to approach him, rather than hiding and avoiding;
      • talking to him earlier, rather than delaying:
      • standing up straight when you are around him, and so on.
    • Each day, try to approach some slightly scary situations, feel the bodyguard suggesting that you avoid the situation, but just relax and walk towards the discomfort. Notice that with consistent practice the anxiety gets weaker and weaker, and that you feel more and more secure. In general:
      • Behave in a way which is the opposite to your old defensive way.
      • Make the tasks relatively easy.
      • This technique take patience and perseverance.
      • You need to win most of these battles.
      • If you fail too often, you are pushing yourself too hard, and the bodyguard will not be convinced that you are in a safe place, and begin to take over.
      • Finally, watch how your other colleagues act around your boss. If some are acting in a more relaxed way, perhaps you can learn from their techniques.

In summary, if you keep acting as if you are safe, and not pushing yourself too hard, your bodyguard all eventually get the message that you are in a relatively safe place, and will stop preparing you to run away.