Thursday, November 26, 2009

Positive Psychology and below the line mood

Depression and Mania come and go and we are left in the intervening times with so called normal mood. But what is normal mood. Are you as happy as you can be? Let’s do a scale of mood from Depression to Mania.

1    Severe Depression
2    Moderate Depression
3    Mild Depression
4    Not Depressed but Grumpy
5    So called Normal
6    Hypomania
7    Mania

Lets assume that number 5 above is the best possible way to be where all the happy people reside. The utopia that people with mood disorders spend most of their lives aspiring to. The reality is that I have spent most of my life at number 4. I have recovered from depression but then felt that I my mood slips back that little bit. So I would deduct that we can control or influence these smaller changes in mood. And what a difference this would make to our lives if we could shift our baseline of happiness up a little.
The problem is there little treatment out there for this malady. Once your Depression has lifted and you’re not in the manic area the Doctors don’t see it as a problem. The see their job as treating illness and being a bit grumpy is not seen as an illness. But in reality being grumpy everyday and being content everyday are two different worlds in terms of enjoying life. Enter Positive Psychology which is concerned with increasing happiness as opposed to reducing Depression. Where do we get such treatment and are there positive psychologists out there waiting for patients to treat. In my experience I don’t think there are many as it’s still a relatively new area. Here are a few tips that you can use yourself to treat this below the line mood.

  • Remove the little negative thoughts and feelings when they start at the earliest possible stage. See Prevention of Depression using Mindfulness-based Cognitive Therapy for help on this. Prevention of Depression and increasing happiness go hand in hand. It sounds obvious but it’s worth mentioning, If you are happier you are less likely to slip into Depression 
  •  Find out what your signature strengths are. These are the things that you are passionate about doing and feel most content doing. Your strength could be something like Love of learning. If it is you would need to find something to learn. You will find that when you exercise your signature strengths you will feel happy and content and positive about the future.
  •  Work on your relationships – Whether it is your spouse, friends or work colleagues. This means learning from and about the other party in the relationship and changing the old patterns which have kept the relationships from prospering in the past.
  • Work on your Self-Esteem – Very often our level of happiness is dragged down by a poor level of self esteem. Low self esteem is very common in the general population and is a big contributing factor with Depression also.  Challenge the core negative beliefs which are at the root of your low self esteem.
  • Attain and maintain a state of flow – Have you ever done something where you lose track of time, where you are totally immersed in what you are doing. This is known as flow and is one of the happy states. Get lost in your work or your pleasurable activity if you can.
  • Gratefulness – Personally I sometimes feel great because I am not depressed. It feels like everything is a bonus in life since I have come out of the Depression. If you can feel lucky to be alive and not depressed, this will contribute to your happiness

Thursday, November 12, 2009

Prevention of Depression using Mindfulness-based Cognitive Therapy

When it comes to Mental illness why do we relapse and why do we recover ?
It is said about depression for example that we can spontaneously relapse into illness and spontaneously recover despite the intervention of medication and psychotherapy.
But can we also influence when we relapse and when we recover. Better still can we influence whether a relapse occurs at all. With Cognitive Behavioural Therapy and Mindfulness meditation the focus with depression is on prevention. The trick is to become aware of the dysfunctional thoughts before they take hold of our emotions, for example the idea is to see your anger or sadness off in the distance and divert your attention away from  it. This can be achieved by taking notice of your bodily reactions such as changes in the breath or heart rate accompanied by vigorous detection of negative thoughts and feelings. When you learn to detect these thoughts and feelings you will have achieved the first major step. The reason why this is so difficult is because these thoughts occur without us being fully aware of them. They occur in a repetitive pattern everytime we are faced with stress or misfortune often without us fully realising it. For this reason they are often called automatic thoughts. Stopping these thoughts altogether is difficult but even reducing them will have significant impact on you mood and can prevent or reduce depression. The process of prevention is worth summarising as follows

  • Become aware of your dysfunctional thoughts as early as possible. If they are making you feel depressed or angry then more than likely they are dysfunctional. Bodily changes such as breath, heart rate or perspiration are good hints of changes in thoughts and emotions.
  • Recognize that these thoughts exist but divert your attention away from them and then attend to the moment to whatever is currently happening.
  • Depending on the stressful event and your tendency to ruminate your automatic thoughts will tend to come back. Don’t be concerned about this, the mind will always drift. When it happens again gently divert your attention away from these dysfunctional thoughts and back to the present moment

It may take some time and practice but you will find that if you follow these steps repeatedly as required there will be a significant improvement in your mood and you will be less likely to slip into depression.

Tuesday, November 3, 2009

Drugs and Mental Health

Drugs are synonymous with mental health/Illness whether it be the prescription variety or the street variety.
Psychiatry has come along way in the last 50 years. For most if not all psychiatric conditions there is a drug available on the market to treat it to a greater or lesser extent 
Antidepressants were introduced in the 1950’s  and anti-psychotics for the psychotic disorders such schizophrenia and Bipolar. These all revolutionized psychiatry and the treatment of mental illness to the point where the sale of psychiatric drugs is a massive worldwide business. But are we over medicated in relation to mental illness ? Are there other / better alternatives in some cases. There is no doubt that medication is a critical part of treatment for vast number of people but perhaps they don’t seek or are offered other therapies such as talk therapy.
What bugs me about antidepressants is that they can take so long to work. Sometimes it can be weeks or months and sometimes not at all. When you do start to feel better your left wondering was it the antidepressant or just the natural course of the illness or other factors such as on going psychotherapy. Personally I like to know what’s working and what’s not so that you can use the effective treatments if needed in the future. In practice maybe we never know for sure if the medication is working but I would still say to those who don’t like taking medication to take it because my feeling is if there is any chance of it working it’s worth taking. When I am depressed any prejudice towards taking medication goes out the window amidst the desperation of seeking an improvement.
In relation to street drugs and I include alcohol in this they are best avoided if possible especially during periods of depression or mania or any psychiatric episode. Alcohol is a known depressant and if you are drinking regularly and depressed it can be difficult to diagnose for a doctor. The thing to do is to stop drinking for a few weeks and see if the mood improves. If it does you can suspect that the alcohol is causing the depression, if not there maybe there is an underlying mood disorder. Other drugs such as cannabis  have known links to psychosis in younger people and cocaine and heroin have devastating addictive qualities.
Basically it comes down to this, with mental illness there is often a chemical imbalance in the Brain. Prescription medication is there to try and redress this imbalance in so far as possible and treat the symptoms of the illnesses . Street drugs upset this imbalance further and nearly always make things worse. Taking prescription drugs which has not being prescribed such as buying medication on the internet is not recommended  because  sufferers are not qualified to self medicate.