Depression Signs Symptoms and Causes Part 3 of 4

You. I'd like to welcome everybody to today's presentation. We are continuing to talk about symptoms of depression, and today we're really focusing on cognitive symptoms. When people are depressed, it affects their thinking. When our neurotransmitters get out of balance, it makes it harder for us to focus, to pay attention, to make decisions. All of those things are related to dopamine, norepinephrine and serotonin levels. So it makes sense that when we're depressed and our dopamine, norepinephrine and serotonin levels are out of balance, we're probably going to have more difficulty thinking. So some of the signs of depression that are not uncommon, that, you know, we talk about, those in the dsm, are difficulty concentrating. And you know, you may be cooking and, and you know, you're in the middle of trying to cook something and your mind just kind of wanders and all of a sudden it's burned. I do that a lot, even when I'm not depressed. But you have difficulty focusing. You may be working on a recipe and kind of blank out and forget where you're at. Same thing when you're reading or watching television. You may be doing it, but you may be having difficulty staying focused. I know when I have depressive episodes, I have a hard time focusing even on a half hour sitcom or something. So reading or watching television may become more difficult. That can be a sign of stress. That can be a sign of a lot of different things, but it's also a sign of depression. What it's telling you is that for some reason your neurochemicals are out of balance. Now, when our HPA axis is activated, when we're under stress, our body tells us to focus on get, getting away from the threat, to fight or flee, not to worry about, you know, what chapter two in Biology has to say. So it could be a stress reaction. We also have difficulty concentrating when we are under 50. Physical stress. For the same exact reason, physical stress can contribute to activation of that HPA axis. Likewise, sleep apnea and anything that reduces oxygenation to the brain is going to make it more difficult to focus. We may experience slowed thinking when we're depressed, but also as we age, our thinking actually does become a little bit slower. Now, this doesn't mean necessarily dementia. Everybody's thinking slows as they age, and that's just one of those things. As the body factory, as the equipment gets older, it takes a little bit longer to warm up and may not be as efficient as some of the newer models, but it doesn't mean it's broken necessarily. So I don't want you to freak out. But paying attention, if you suddenly have a significant slowing in your thinking, you know you're trying to learn something and it seems to be taking 3, 4, 10 times longer than you think it should. You know, that could be a sign of depression. You have problems with your memory, like finding the word. You may have difficulty when you're talking. There are lots of times that you just stop and there's a word on the tip of your tongue. You're trying to say something and you just can't, can't find the words. Sometimes people may not be able to remember whether they did X today and I just used X because whether they took their medication, whether they took a bath, whether they, you know, fill in the blank. When people are depressed, they don't register as much of the detail as much of the minutia throughout the day. So it may be more difficult to remember things that they have done or things that they haven't done. And again, it's more difficult to learn new things because you get the information in and sometimes it doesn't get translated over to long term memory. You can have difficulty with decision making and judgment when you are depressed, when your motivation is low, when your attention is low, which means your dopamine is low, you may just have an I don't care attitude or I don't know what to do, I don't know the best solution. And you may just jump to whatever is the, the easiest or the most prevalent. You may be more reactive than proactive. And that's not uncommon in depression because when people are depressed, they feel like, you know, everything really oppressive and difficult and takes a ton of energy. So when they're faced with a decision, if they have to make it, a lot of times they just don't have the cognitive resources to think through all the options. They're just like, whatever, I don't care, I don't, I don't even want to know all the options. I don't have it in me. People who are depressed often have a negative attitude or, or negative perceptions or pessimism. All some, any of those. And this makes sense. When we are in a fight or flight state, when we are in a depressive state where we feel hopeless and helpless and maybe even unsafe, we are in a negative mind space, we are in an unsafe place. And that means that we are going to pay more attention to the negative stimuli in the environment. You tend to pay attention to things and view things Through a filter that is colored by how you feel at the moment when you are happy. Notice the different things that you notice when you are depressed or when you're angry. You know, be aware of the fact that your mind is filtering and creating its own sort of self fulfilling prophecy. When we're depressed, it is easier to personalize things. We can feel guilty for a lot of things when somebody is having a bad day, you know, it's easier to feel guilty for that, seeing that our depression or our actions could be contributing to that. So there's a lot more personalization and guilt when people feel depressed additionally, and these are things that they don't often talk about. When we talk about depression, rumination, unpleasant memories and nightmares, I'm going to kind of lump them all together. When we are depressed, guess what? Our brain is not going to go back on those memory pathways and find the happiest moments of our life when we're depressed. It reminds us of prior times when we were depressed. So guess what? Our brain is kind of connecting with those past memories. Which means you may not intend to, but you may have some sim memories of similar times come up and you may end up ruminating on prior situations in which you felt hopeless and helpless. Unpleasant memories may come up. You know, like I said, you may pull out some of those memories that you really didn't want to think about again. But your brain is going, hey, you've been here before. And so you may have intrusive memories if you want to think about it that way. And nightmares often occur more when people are depressed. When we are depressed, our brain again is kind of pulling out some of those unpleasant memories. It has this stress associated with it. My husband laughs at me because there are certain recurring nightmares I have and he knows that if I am particularly stressed, there is a good chance that I am going to have one of those two or three nightmares that I regularly have that recur that, you know, life as I know it isn't actually in existence. You know, I, I, and, and he thinks it's hilarious, but which I don't find the humor in it. But you know, the interesting thing and you know, God bless her, I'm sorry she got it. But my daughter has the same exact nightmares, you know. Well, almost the same exact. Mine is that I didn't actually graduate high school and they found that out and they took away my, my doctorate, which makes no sense. But my daughter has similar memories that, you know, she didn't actually pass a test and that they're going to take away her diploma. And it's just kind of weird stuff that, you know, I never really shared that nightmare with her, but she has a similar one when she gets stressed. So, you know, that. That was kind of weird and interesting, probably more than you wanted to know. My point being, and. And I have it actually hyperlinked here because there has been research that when we are in a dysphoric mood, we will tend to have more nightmares. And they don't exactly know why that is. And the nightmares aren't always exactly about what stressed about, but it sort of frees up some of those fears that you have back there in your amygdala, and they can permeate your subconscious during your nightmares. So that's kind of an interesting thing to be aware of. It's important to remember, like we've talked about in other episodes, that in this series, that depression and anxiety for frequently but not all the time co occur. Depression is, you know, you can just really generalize it as a feeling of lack of motivation, hopelessness and helplessness. Well, I'm. I'm a control freak. I will admit I'm a control freak. But for most people, even if they're not control freaks, when they feel hopeless and helpless, that is a place where you feel unsafe, where you feel threatened, and that will activate your HPA axis. That will increase anxiety. You may not have a lot of anxiety symptoms if you've been under chronic stress. You may just be at that depressed point where you're going through the flat and the furious like we talked about last yesterday. But it is important to recognize that anxiety and fears can contribute to. To feelings of hopelessness and helplessness. So it's really important, you know, in terms of cognitive interventions to evaluate your thoughts that are keeping you feeling hopeless and helpless. You know, what beliefs do you have about your personal safety, your personal power, and your hope for the future? You know, just write them down so you can get them all out there and then go through them one by one and say, what are the actual facts? Not what am I assuming, not what am I worried will happen, but what are the actual facts in this context at this point in time, you know, two weeks, a month, three years from now, it could change. But right now, at this point in time, what are the facts supporting and not supporting this belief? The next step, once you look at the facts, is to evaluate, okay, what aspects of this do I have control over? You know, there are some things that you can control and other things that you cannot. So what aspects of this situation can I control. And then if I take the initiative, if I try to use my energy and my resources to do the things that I can to empower myself to improve the next moment, what is the probability that my fear will actually come true? So it's kind of a three step process, but thinking it through can help. Now, if you are really depressed, thinking it through may be as far as you can get because you're like, okay, yeah, if I had the energy to do any of that, then set micro mastery experiences. What is the first baby step you can take toward improving the next moment? It may be getting out of bed, opening the blinds and putting on your day clothes, you know, getting out of your jammies. For me, when, after both my kids were born, I had postpartum depression really badly. And one of the things that was essential for helping me set my circadian rhythms and get moving, get any sort of, you know, oomph to my day was to actually get up, open the blind, so it was bright in our house and get out of my PJs. Um, because there was just something about staying in my jammies all day long that kept me feeling tired and wanting to go back to bed. So it is important to recognize that anxiety and depression often go hand in hand, often contribute to feelings of unsafeness. One of the first places to start in recovery from a cognitive standpoint is evaluating your beliefs about your safety and your personal power and then trying to figure out how to create an environment where you feel safe and empowered. You know, that's where you want to go. So what steps do you need to take? What are the facts in the current situation, in the current context, that you are truly unsafe and disempowered? You know, there are some things you don't have power over, and there's going to be an element of having to deal with that, but those things are important. If you've had trauma in your past, trauma in and of itself takes people's power and takes people's sense of safety. So it's important when trying to recover from trauma to, again, just like you're doing with anxiety and depression, to examine what thoughts am I having that are keeping me feeling unsafe and disempowered, and how can I start feeling safer and empowered? That's the cognitive aspect. Okay? Now remember that recovery and humans are holistic. Changing your thoughts is great, but it's not going to give you a burst of energy, like, you know, some sort of energy drink or something. And energy drinks probably won't even work anymore anyway because you done been there and they're not even working anymore. Not recommending energy drinks. So just. So it's important to recognize that one of those beginning mastery experiences or micro mastery experiences, maybe to start getting those circadian rhythms re synced so you can have the energy to take the steps to improve the next moment. Okay. So you may need to start by recognizing that there are some things that you need to do physically to help yourself, help your body factory function more efficiently and effectively. So it can make the products, the neurotransmitters and the hormones that are necessary for you to feel happy, healthy and energized and that can support clear headedness, decision making, optimism, happiness and all those things that we really want to focus on. Are there questions. On the YouTube channel? You know, I have a lot of videos that I have talked about distress tolerance skills, coping skills, problem solving skills, cont. Contextual cognitive processing. There are a lot of tools that you can use and, and I refer you to the playlist 100 plus practical tools to address your depression. And that provides some tidbits. You know, it's obviously not a comprehensive guide, but it provides a bunch of tidbits and suggestions for things that you might consider to add in as, you know, some of those mini mastery experiences to help yourself move toward health and happiness. Well, I appreciate everybody being with me today and I look forward to seeing you tomorrow and hopefully the video issues will be resolved. My tech guy just got here, so we'll take a look at that. I will be posting the recording of this later, probably at the end of the day today, so hopefully that actually recorded and looks appropriate so it's not all mishmashed, at least like I'm seeing. Oh. Sheila asks, what are some things family members can do to help loved ones who exhibit depression symptoms? Be consistent, be responsive to them if they're feeling depressed. Okay, they're feeling depressed. It's important to validate how they're feeling, recognizing that it's not just all in their head. You know, they may have some negativity, but they also probably have some physiological symptoms. And those symptoms are caused by changes in hormones and neurochemicals and you know, the functioning of body systems. So it's important to not minimize how they're feeling and then ask them, you know, one, one of the easiest tools is to say, okay, I, I see you're feeling really depressed right now and you know, it, it hurts my heart to see you suffering so much. What can I do to help you improve the next moment? What might make you feel a little bit better. And they may struggle with coming up with an answer for that. And if you know who they are, you know, obviously you know who they are. They're a family member. But if you are really intimately familiar with the things that make them happy, you may propose three or four things and say, okay, choose from one of these. Let's go do one of these. And, you know, I'll share. That worked for me. When, you know, I would get really depressed, my husband would be like, okay, we need to go outside and go for a walk, or we need to go out so you can weed in the garden for a while. That makes me happy. It's not a choreography. And I. I would hem and ha and dig my feet in and, no, I'll do it later, or whatever. And he would be like, why don't we just go. And we have a rule or a. Whatever you want to call it. In our household, that's called DO15. And that. I learned it when I was working on my dissertation, actually. But do 15 means get up and whatever it is, try doing it for 15 minutes. If you still actually hate it, if you are still miserable, then, okay, stop doing it. But most of the time, once you get that shoehorn and pry your butt off the couch, you find that it actually, you know, isn't so bad. And I can't think of a single time. Well, I can think of one single time, with the exception of that one. The all the other times when I got up and I started doing something, I ended up continuing to do it and really enjoying what I was doing and feeling grateful that I did it later. So, you know, recognizing that sometimes it's a matter of trying to get yourself off the couch or get yourself motivated to do something, which is really hard when you're depressed because you have no motivation, which is why other people can be so helpful. So that would be my first suggestion. My second suggestion would be to try to modify the environment to promote happiness and healthy circadian rhythms, like open the blinds. You know, maybe I can't get you to go out, but we're going to open the blinds and let some light in. And obviously, with their permission, but that can be helpful as well. There are a lot of different things. Everybody's depression is a little bit different. So, you know, without knowing a particular person, it's impossible to make a exact recommendation. But I let the person with depression be my guide, and I try to let them have as much power. You know, remember hopelessness, helplessness, unsafeness, and disempowerment are characteristics of depression. I want to help them feel like they've got power and they've got the ability to move forward. Yev asks, can reproductive hormones fluctuate, fluctuation contribute to depression? And the answer is yes. Male and female reproductive hormone fluctuations, testosterone, progesterone, estrogen, any of those fluctuations can contribute to mood symptoms. In some cases it's anxiety. In other cases it's depression. Remembering that that as we get older, our body makes less of our primary reproductive hormones. Like for, for men it's testosterone, for women it's estrogen. And we also see a corresponding increase in depression and depressive symptoms. So there is a direct correlation between mood and even some cognitive processes and, and our gonadal hormones. And I actually have a video on the YouTube channel that specifically talks about the impact of gonadal hormones on mental health and mood. I think I did it about two weeks ago, so you may want to check in on that one. All right, everybody, let's see one more. How can we feel hopeful when we can't see an end to the COVID situation? And we need to see and be with friends so badly. And it is a huge challenge. And it, like I was saying earlier, what you want to do or what might be helpful is to write down your feelings like, or your thoughts like this Covid thing is never going to end. All right? So we need to step back and look at the facts for and against that. And we know that there are certain areas in the United States, for example, that are opening up. I'm not sure where you're at. And we are making progress. There are vaccines available. It's not happening as quickly as we'd want to. We need to be with friends and family. You know, I'm an extrovert. I get that. And I have had to alter my way of being with other people. You know, I would prefer to be face to face. Oh yeah. But during this time, you know, I've had to alter to more zoom meetings and things like that, which is, you know, not as cool. And there's, you know, you can't go out and go to a rock climbing gym or something and feel like you have as much fun if you go at all because there are so many restrictions. And I get that. And the important thing right now is recognizing. We've talked in before before about hardiness, recognizing that, okay, this part of your life, the fact that we're on lockdown socks right now, taking notice of some of the things in your day to day that are Going well, yes, you don't want to be doing this. However, right now you don't have Covid. So that's a good thing right now. You know, what do you have? And try to use your energy to nurture the things that are important to you instead of fighting against something you can't change, which is Covid, which are those regulations right now. What can you modify in your environment? What can you nurture in order to better meet your needs? It's not going to be exactly the way you want it. You know, I get that. But that is one of the challenges that we are, you know, really working toward figuring out how to adapt to right now. Because, you know, without being around other people, we actually have had a precipitous drop in our oxytocin levels. I would be willing to say that right now without actually testing 300 people and seeing what their oxytocin levels are. Oxytocin is our bonding hormone. Oxytocin makes us want to be with other people and encourages dopamine and positive feelings and those sorts of things. They've actually found in some studies that treatment with intranasal oxytocin can improve mood. So we know that oxytocin is associated with mood, and oxytocin depletion can be associated with depression. So that is a whole lot of jibber jabber about the fact that your feelings of isolation and frustration and powerlessness about the, the virus are very valid. And people are. A lot of people are really experiencing that right now. And it's challenging. It's really challenging to try to figure out, okay, how can we, how else can we live a rich and meaningful life and conform to these measures that are being put in place by, because of the virus right now and, and in acceptance and commitment therapy? Hayes talks a lot about living in the. And. And that's exactly, you know, the. The phrase he uses is, how can I have a rich and meaningful life and experience this at the same time? And only you can answer that. I would encourage you, if you need to, to reach out to colleagues, to spiritual guides, to counselors if you need to, because there are a lot of resources that are out there that may be able to give you some more personalized advice on what you can do. Obviously, here I'm just kind of spitballing and providing education, but for true assistance, for clinical guidance, it would be important to reach out to a doctor or a counselor. A lot of insurance companies have nurses that are on call that you can call and talk to a nurse and you know, ask them, you know, for suggestions as well, Actionable, practical tips that help shake off low mood and low energy, especially in the evening. Again, that really depends on the person in the evening. Remember, in the morning your cortisol levels are at their highest, and throughout the day they're supposed to decline and they're supposed to be at the lowest when it's time to go to sleep. So one of the first things would be to really look at the health of your circadian rhythms, because in the evening you are supposed to be tired and, and foggy. But if your mood is sad and depressed, that could indicate that that is a time of day where when you're not busy, your mind goes to unpleasant thoughts and focuses on the things that you feel hopeless and helpless about. So, you know, depending on I'm hearing you talk a little bit about energy, but also about mood. So really asking yourself or thinking about what it is that you are really trying to defeat, whether it's low energy or low mood. One activity that they've studied has been that for people who have depression in the evenings, at the end of the day, if they spend 20 minutes journaling on the positive things or talking about the positive things that happen that day, not the negatives, just the positives, it helps make them more aware of the totality of life instead of just focusing on the negative. Now, this isn't to be confused with toxic positivity. This is taking 20 minutes and saying, okay, for this 20 minutes, this is going to be a positivity zone. And then after that, I can go back to focusing on the problems if I want. But they found that people who spend 20 minutes a day focusing on positivity actually do have improved mood over the long haul. Remembering. So that can be another one of those quick tips. Remembering that a lot of our depressive symptoms, again, are caused by a variety of factors. So it's important to make sure that you attend to the physical, the affective, the cognitive, the environmental, and the relational triggers for your depression in order to make sure that you're addressing all of the underlying issues. One other thing that I might suggest, I'm just kind of brainstorming here. You're asking for quick things. Nature therapy has been found to be very beneficial at increasing serotonin and dopamine. So even watching something like the Curiosity stream shows where, even if. So if you can't get outside into nature, immersing yourself in that sort of environment might be helpful because it can promote some feelings of calm. If you can get out into nature, all the better. And aromatherapy, there are certain aromatherapies that are also associated with increasing dopamine and serotonin. So that could help as well. So I would encourage you, there's a bunch of videos on the YouTube channel that talk about different aspects of addressing mood issues, aromatherapy, feng shui, exercise, nutrition, sleep, circadian rhythms. You know, there's a lot of stuff. So I would encourage you to think about, you know, what is one thing that I might be willing to explore to help myself feel better right now. And welcome to Bronze dm. Thank you for joining us. Okey dokey, everybody. I think that does it. I will see you guys tomorrow. I thank you so much for all of the questions and interactions today. And we will do our last episode in.