depression

The Origins of Depression and What to Do with your Bad Feelings

Photo by Teddy Kelley on Unsplash

Photo by Teddy Kelley on Unsplash

Depression stats 

Did you know that according to the Anxiety and Depression Association of America, Major Depressive Disorder affects as many as 16.1 million adults in our country? That’s 6.7% of our adult population. In fact, it is such a prevalent problem that the World Health Organization made a video about depression, giving it a personality as the Black Dog:

If it’s likely that someone at work, the mom at the soccer game, or the checker at the grocery store struggles with depression, then what do we know about its origin? Perhaps you’re wrestling with the black dog yourself and you want to learn how to live with this uninvited pet.

The thing is, depression didn’t come out of thin air; it isn’t our natural state. Depression has been linked to genetics, chemical imbalances, and environmental causes, making it hard to determine the exact cause of the condition in each person. The good news is that there are things you can do to manage it.

Depression and its origin 

Depression from genes 

Depression can be hereditary. A lot of research has gone into identifying biological factors that seem to coincide with this disorder. Anecdotal evidence also supports this: depressed people often seem to come from depressed families, in a way that can go back generations. This shows there must be some genetic component.

Depression from chemical imbalances 

Depression has also been linked to chemical imbalances. The idea of a "chemical imbalance" is a rather vague one. An imbalance between what and what? No one seems to know for sure. But many of us have heard about the role that too little of the neurotransmitter Serotonin is linked to depressive symptoms. Hence, various anti-depressants are used for alleviating depression, as most of these drugs raise serotonin levels in the brain.

Depression from environmental causes 

Depression can creep in due to difficult life circumstances. A history of abuse, family conflict, bullying, oppression, social isolation, etc. can weigh on anybody. A wise supervisor once said, “Every issue in counseling can be traced to some sense of grief and loss.” Indeed, when life doesn’t happen as expected, you’re wrestling with the gap between the life you want and the life you’re living.

We all want to feel good 

It’s a no-brainer that people like to feel good. We can all agree that feeling bad is something we want to avoid. Some people are better at the game of maximizing "good" over "bad" feelings, in a way that works for them their whole lives. They’re good at “feeling good” and “looking on the bright side,” at “letting problems wash over them like water over a duck’s back”. Maybe they hang around like-minded people. But regardless of how they do it, some people make it look easy.

It’s not easy for everyone.

Advances in the field 

Science and technology constantly make improvements upon our everyday lives, but these advances are limited when trying to help us understand how people can be good at the art of managing feelings. Sure, we can identify triggers to feelings, how it shows up in our bodies, and what urges we have to say or do in response to these feelings. However, there is much more to understanding an emotion than measuring how strong or frequent it is.

The intangibility of feelings 

What is the basic nature of feelings? You can't quantify them very well. You can't show me five pounds' worth. You can talk about how it feels to have a feeling, but you can’t objectively say what one is. It doesn't do it justice to use another word like "sensation" to describe it - that just replaces one vague word with another. Feelings are very real things, but they are also intangible.

Make depression go away! 

Modern culture dodges such a question, because feelings are such poor candidates for objective discussion, especially in scientific circles. Feelings are not "rational”. It seems easier to attribute the bad feelings of depression to something that runs in families that can be treated with the right medication. Indeed, many people who suffer from depression, at best, can only guess at where it came from. They just know that they have "it". You either have "it", or you don't. The most important thing is to make it go away.

Depression is like the black dog. A constant companion, depression is made up of a collection of feeling-loaded problems that, at a certain point, qualify you for the diagnosis. These symptoms include poor mood, lack of motivation, negative thinking, pessimism, inability to enjoy the things you once did, or low self-esteem. Like all other emotions, these bad feelings come from somewhere. For each person struggling with depression, there is a story of how the black dog got there and why he’s staying.

Get to know the black dog 

In order to treat depression on an individual level, we need to delve into the feelings - messy as they may be - and set aside our need to explain our behavior with science and research for a moment. Getting to know the black dog: that part is indeed subjective and hard to define. But those feelings that make up the black dog are a huge part of who you are, a huge part of your life story. If you want to grow as a person and make the most out of life, it would be important to bring the black dog into our therapy room.

Delve into messy feelings

Depression is problematic feelings that begin to take over your life. When you learn about these feelings and how they have fit in to your life story, it makes you more aware of who you are and how you are. As the stories about these feelings get unraveled, you will be equipped with "data" as to how to better handle them. You can end up becoming more and more like those people who are "good at" knowing and managing their feelings.

Emotional life is that way; you can't put numbers to it or objectively explain it. Yet, with practice, you can learn to acknowledge your feelings, get to know them better, understand why you feel the way you do, and what you can do about them. The black dog doesn’t take up as much space in your life; you can have him on a leash, rather than the other way around.

I want to help you with this process. When you're ready, I’ll be in my office.


People Bloom Counseling Bob Russell Teens Working Professionals Redmond I.png

Bob Russell recently joined People Bloom Counseling, a Redmond psychotherapy practice in WA. He helps teens and their families thrive through the adolescent years. He also helps twenty somethings figure out their place in life. Having been through rough patches during his teen and young adult years, he knows what it’s like to delve into messy feelings and come out stronger on the other side.

Sadness: a Normal Part of Life

Jordan Whitt/unsplash.com

Jordan Whitt/unsplash.com

In my last post, I wrote about managing Seasonal Affective Disorder (SAD). Sitting at a cafe by the window, the mood lighting inside is definitely brighter than the grey skies outside. The drizzle is constant and the puddles invaded by rain droplets. You can interpret this as being nice and cozy or a real dread. The thing is, if you’re affected by the rainy Seattle weather, chances are, looking outside will not give you the energy boost. It might do the opposite of inducing sadness and low energy.

We don’t like to feel sad, do we?

Ever wonder what good is sadness? Like, why bother? After all, we all want to feel good. We chase after and try to create happy moments like eat at our favorite restaurants, go on vacations and hang out with people who matter to us. On the flip side, we stay away from negative experiences like heart breaks, bad news and surgeries. We’re good at celebrating wins but as a society, we don’t do as well being with sadness.

If you look at a baby who came into the world happy all the time, it’s hard to imagine that we’re not meant to be happy, like all the time.

Sadness is a normal part of life

The thing is, with time, we become acquainted with the pains of life. From abuse to social isolation, job loss to still births, accidents to illness, could sadness and other unpleasant feelings be, sadly, a normal part of the human condition? What if we’re not meant to be happy all the time; rather, it’s about living a full and meaningful life despite our circumstances?! If sh*t will hit the fan and it’s just a matter of when, could a feeling like sadness help us navigate through life’s complexities?

You might beg to differ but Inside Out has something to say about that:

Being with sadness

Here, Joy is trying to cheer up Bing Bong, the imaginary friend who is grieving the changing relationship with coming-of-age Riley. Joy tries hard to get Bing Bong out of his sadness with quick reassurances, tickles, jokes and distractions. She doesn’t get it and thinks if Bing Bong were to feel his grief, things will only get worse.

Sadness, on the other hand, understands his loss. She sits next to Bing Bong, tells him it makes sense for him to feel this way and lets him cry on her shoulder. While in real life, the turn around is often less drastic, Bing Bong feels better after balling candies and was more ready to move on with their journey. For the first time, Joy saw that Sadness made something better.

Sadness has a place in our hearts

Sadness helps us know when something isn’t right. It validates that it’s hard to be where we are but that it also makes sense to feel what we feel where we are. Our situation may stay the same, but we can feel our way through it. And because we’ve been there or can imagine what it’s like to be there, we can empathize with others and share in their pain. We don’t have to be alone in our sorrows.

The next time you feel any degree of sadness, know that it makes sense. You don’t have to hurry up and get over it; nor do you have to be paralyzed by it. Cry your eyes out if you need to. Surround yourself with people who understand. Then still ask yourself, “What would make this moment full and meaningful?” and go do that.

If you're having trouble being with sadness or other difficult feelings and could use some help, let me know.


Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. Here at the cafe, it went from raining to pouring outside and the puddles have turned into little streams. She must go now, knowing that hiking 1.5 blocks back to the car is a part of getting back to the car.

5 Tips for Managing Seasonal Affective Disorder

Alisa Anton/unsplash.com

Alisa Anton/unsplash.com

'Tis the season to be sad

While I don’t wish this upon you, Seasonal Affective Disorder (SAD) is a thing around here. Especially with the end of daylight saving time, we’re feeling the effects of brighter mornings and less evening light. Given how much we love our Seattle summers, the shift into chilly, rainy weather, bare trees and gloomy skies is enough to make many of us want to crawl into bed and stay there.

If you are already struggling with depression, you might feel the effects of it more. If your mood is often weather-dependent or you’re a transplant from a sunnier climate, chances are it’ll affect you too. While winter solstice is less than seven weeks away, let’s help you figure out how to get through this long stretch of fall and winter months.

Before we talk about what to do, let’s address the symptoms of Seasonal Affective Disorder (SAD).

SAD defined

SAD mirrors symptoms of Major Depressive Disorder, also commonly known as Depression. You might have SAD if you:

  • feel depressed
  • don’t want to do the things you used to enjoy
  • have low energy
  • have trouble sleeping, often times oversleeping
  • experience changes in your appetite, often times crave unhealthy comfort foods and experience subsequent weight gain
  • feel agitated or sluggish
  • have difficulty concentrating
  • feel hopeless, worthless or guilty
  • have frequent thoughts of death or suicide

If you have thoughts of wanting to hurt or kill yourself, you need to stop reading this and call the National Suicide Prevention Hotline at (800) 273­-TALK (8255). If you have a milder form of SAD but you’re feeling down, struggling to get out of bed, overeating, gaining weight and saying no to social engagements, then here are some recommendations for you.

5 ways to move through SAD

1. Light therapy

You know that it’s a common purchase when they sell it at Costco. Therapy lamps provide bright, artificial white light during months of diminished sunshine. Keep it in a well-trafficked area and follow instructions for use between 20-60 min. Depending on your circadian rhythm, you might find the light exposure helpful in the morning or the evening. Remember to choose a light box that emits 10,000 lux, which is equivalent to 20x that of usual indoor lighting. With lesser lux units, you might need to use the lamp for longer to get the same effect.

2. Physical activities

I don’t mean exercise. The gym is not for everybody. Rather, there are a lot of fall and winter activities that can get your heart pumping and your brain releasing happy hormones. It can be indoor climbing, yoga, laps in the pool, racquet ball, even housework. Outdoors you have a walk around your office or neighborhood, winter hikes, and snow sports.

Now I understand the fact that you feel SAD means you don’t want to move very much. However, if you wait until you want to do something before you do it, you might never do it! Instead, act the way you want to feel. That said…

3. Positive activities

What activities used to bring you alive? What did you use to enjoy? Or, what is something new you’d like to try? It can be a physical activity listed above or it can be art walks, concerts, a meetup, a good novel, a weekend away. You can be with strangers, close friends or be by yourself. Given the tendency to socially withdraw, I’d recommend doing some activities with others and developing accountability to increase follow-throughs. While there’s no guarantee that you’d feel better afterwards, it’d help you in the long run to stay active and engaged in life.

4. Medication

I don’t know how you feel about taking meds, but sometimes an anti-depressant is necessary to get you past this hump. It doesn’t mean you have to stay on this medication forever; only until you have more tools under your belt to be without it. Also, if you’re currently on an anti-depressant and you’re questioning whether it’s working properly, it’s probably time to visit your prescriber again. Remember that it can take up to 6-8 weeks for the medication’s benefits to kick in, while you might feel the side effects more immediately.

5. Take it in

While this is not the most exciting time of the year for you, can there be any beauty in taking in the vibrant colors of the leaves, the rustling of leaves against the wind, or the crunching of leaves under your feet? What about the beating of rain on pavement, the dancing flame from a crackling fireplace, and the warmth of peppermint tea against your lips?

This will pass

This season is here and it will pass. Since there’s no ushering it away, I hope there’s a part of you that can find it a friend, rather than a foe.

And if you need a therapist to help you ride out this season, I'll be here!


People Bloom Counseling Redmond Couples Cancer Ada Pang.png

Ada Pang is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples find safety and connection in their relationship. She also helps cancer thrivers and their caregivers integrate cancer into their life stories. This fall, she noticed the changing colors of the leaves more. Her favorite food group this season is all things squash and her favorite activity is baking.

When Depression & Anxiety Come with Cancer

pixelheadsphoto/stock.adobe.com

pixelheadsphoto/stock.adobe.com

Let's face it. It's enough to go through cancer diagnosis and treatment, let alone the emotional ups and downs that often come with it.

Questions that might trouble you

As a result of your cancer, sometimes you have questions about the past: "Did I do something wrong to cause this cancer? Could I have prevented it?" "What if I had __________________ before it got to be too stressful? Would that have made a difference?"

Other times you might have questions about the future: "My neck hurts. Is that cancer?" Will I be able to see my granddaughter graduate from 2nd grade?" "How will my family be without me?"

While it's normal to ask these questions, often times there really isn't a way to answer them. These questions might linger if you struggle with depression and anxiety. 

Depression and anxiety post cancer

What we know from cancer research is that depression and anxiety are common symptoms during and post cancer treatment. While depression might dissipate with time, anxiety lingers as you're reminded of your cancer everyday. 

Some of these symptoms might be treatment related, but could this be you? 

You might be struggling with depression if you experience the following: 

  • feeling down, depressed or hopeless
  • having little interests in things you used to enjoy
  • sleeping too much or too little or have trouble falling asleep or staying asleep
  • having low energy 
  • having little appetite or want to empty the fridge
  • feeling irritable 
  • experiencing mood swings 
  • having trouble concentrating 
  • withdrawing from friends and family 
  • feeling hopeless, guilty and/or angry
  • having thoughts about being better off dead or hurting yourself 

You might be struggling with anxiety if you experience the following: 

  • feeling nervous, anxious or on edge
  • feeling like you cannot stop or control your worries
  • finding yourself worrying too much about different things
  • having trouble relaxing
  • feeling restless and it's difficult to sit still
  • feeling easily annoyed or irritable 
  • anticipating worse case scenarios

Sometimes anxiety is felt in your body. You might be struggling with panic symptoms if you experience the following: 

  • pounding heart 
  • sweating 
  • trembling or shaking
  • shortness of breath 
  • feelings of choking
  • chest pain or discomfort
  • nausea or abdominal distress
  • dizziness/light headed
  • chills or heat sensations
  • muscle tension 
  • feel out of control 
  • fear of going crazy
  • fear of dying

Life after cancer

If you identify with these symptoms that go beyond an occasional sad day or feeling stressed out about something, there is hope! You don't have to settle and let cancer drag your down. Rather than cancer driving your life, you can make meaning choices in the face of cancer. That way, depression and anxiety symptoms, even when they arise, won't bother you as much. 

If you need help putting cancer in the passenger seat, I'll be here


People Bloom Counseling Redmond Ada Pang

Ada Pang, MS, LMFT is the proud owner of People Bloom Counseling, a Redmond psychotherapy practice in WA. She helps unhappy couples and cancer patients. That can also mean couples distressed by a partner’s cancer diagnosis, or couples wishing to use their marriage as a resource during their cancer journey. When she’s not thinking about couples and cancer, she is cognizant about choices that make for a meaningful life. This often involves food. 

Sometimes, it Takes a While

Drew Patrick Miller/unsplash.com

Drew Patrick Miller/unsplash.com

Autobiography in Five Short Chapters

Chapter I

I walk down the street.
There is a deep hole in the sidewalk.
I fall in.
I am lost... I am hopeless.
It isn't my fault.
It takes forever to find a way out. 

Chapter II

I walk down the same street.
There is a deep hole in the sidewalk.
I pretend I don't see it.
I fall in again.
I can't believe I am in this same place.
But it isn't my fault.
It still takes a long time to get out. 

Chapter III

I walk down the same street.
There is a deep hole in the sidewalk.
I see it there.
I still fall in... it's a habit... but,
my eyes are open.
I know where I am.
It is my fault.
I get out immediately. 

 Chapter IV

I walk down the same street.
There is a deep hole in the sidewalk.
I walk around it. 

Chapter V

I walk down another street.

 

- Portia Nelson 

3 More Tips for Managing your Depression Outside of the Therapy Room

Luca Iaconelli  /unsplash.com

Luca Iaconelli /unsplash.com

It's hard to get off your couch. It can be hard on a day when it's nice and sunny, and even harder on a day like today. Don't let depression detour you from living your life! Here are additional tips for managing your symptoms, the last one being my favorite:

  1. Keep (some sort of) a schedule. It's Friday, what's there to do? What about next Tuesday? What makes life happen for you? Plan for it, put it on your schedule, and DO it!
  2. Connect with your social capital. Human contact is SUPER important to get us through tough times and to remind us there's a world outside of ourselves. Who's your community? Don't shut them out! Let them in...
  3. Take your thoughts less seriously! There's an average of 60,000 thoughts that go through our minds each day, and yet, we put a lot of weight on some and not on others. Having a regular meditation practice is one way to help you notice your thoughts as nothing more than just thoughts.

Here are tips from an earlier post. 

Need more and wish to come into the therapy room? Call me up!

5 Tips for Managing your Depression Outside of the Therapy Room

Arno Smit/unsplash.com

Arno Smit/unsplash.com

Everywhere you look you see the evidence of spring. The days are getting longer, there are intermittent sun breaks, and the flowers are budding. Somehow you think your depression should be lifted by now; yet you still feel crummy. When you're feeling low, chances are you'd want to watch 5 hours of Netflix, eat a gallon of ice cream and crawl into bed. It is very counter-intuitive to leave the house, go for a walk, soak up some sun, or call up a friend.

And, that's exactly what is going to help you get through that funk! If you wait until you feel better before doing something, it might never happen! And even if it does happen, it'll be sporadic and very mood-dependent.

Here are 5 tips for managing your depression outside of the therapy room:

  1. Get some physical activity. I'm not talking exercise, because when I say exercise, people think of the gym. Go for a walk, do yoga, shoot some hoops. Any activity that gets your body moving is better than no activity at all.
  2. Go do something you enjoy! Is it strolling the farmer's market, picking up your guitar, or watching a funny movie? Pleasurable activities disrupt the cycle of depression and rumination.
  3. Choose healthy food options. Eat even when you don't have the appetite and slow down your eating if you have a tendency to overeat. Food is fuel, so what you eat and how much you eat matters.
  4. Bathe in the sun. Sun exposure will help your brain release the hormone serotonin, which is a natural mood enhancer. 
  5. Have a regular waking and sleeping schedule. Get the optimal amount of sleep that's needed for your body. When you're tempted to nap, transition to a less sedentary activity.

Stay tune for more tips! Need more help than reading a blog? Give me a call!