Category Archives: Depression

Pain is a powerful teacher

By Nancy S Buck, PhD, RN

After falling to make a challenging tennis shot I was left bruised and shaken. My partner and I won the game but at what cost? I hoped that rest accompanied by alternating sessions of applying ice then heat on my injured arm would help me feel better. After a painful evening followed by a sleepless and painful night I knew I needed a different solution. I went to the doctor to discover I had broken my elbow and wrist in two places. Pain was a powerful teacher I could not ignore. 

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During my life not only have I experienced physical pain, I’ve also had my fair share of emotional, mental and spiritual pain. Just recently I had to put my 17-year old cat down. She was really my mother’s cat, but before my mother died she asked me to take care of Molly. The death of Molly was sad and hard. Not only was I losing my companion cat, I was also reminded of the sorrow and loss of my mother.

It has taken me a long time to understand that pain is not just part of my experience, but pain is a teacher. 

Prior to this realization, there were too many painful moments in my life that I treated as something to avoid, to relieve, to cover up or to cast off onto another so as not to feel the pain. After all, considering that pain is a teacher means that pain is my teacher offering me the opportunity to self-evaluate, learn, grow and change.

Wouldn’t life be easier if I could just cover up the pain by ingesting some legal or illegal pain reliever? The hope is that smoking enough cigarettes or dope, drinking enough alcohol or taking enough pills will diminish or temporarily mask  the pain. Sometimes this works but too often it doesn’t work well enough.  The pain still gets through. And, as too many people have discovered, there is the secondary pain that comes from using any one of these pain relievers too frequently. Now you’re stuck with two different kinds of pain: the pain from the original problem; and the cycle of pain that comes from using, abusing or being addicted to the pain reliever.

Perhaps the strategy of avoiding the source of the pain all together would work. This is often done in combination with deflecting the source of pain by blaming another person. How many times have your heard the story about a cheating partner? In an attempt to avoid the pain and avoid discussing his unhappiness, Jack decides to cheat. Of course now he feels even more pain compounded by guilt and shame of cheating on Jill even though  he experiences some temporary relief of enjoying the pleasure of a budding romance. If and when Jack gets caught, often he will blame his cheating choice on Jill’s indifference and distance from him. These attempts to avoid pain ultimately end with more and a different pain that needs to be addressed. Eventually this pain can also become a powerful teacher for those who are willing to learn from it.

Even though pain is a powerful teacher, not all of us are ready and willing to learn the lesson. For some of us the pain needs to get bigger and bigger, greater and greater, louder and louder before we consider change. And sadly, for some, their best solution to end their pain is to commit suicide.

However, a better solution when experiencing pain is to self-evaluate. Pain is a loud signal letting us know that we are out of balance. We need to take some positive action in order to get back into balance. Sometimes getting help is necessary, like when I went to the doctor for x-rays and he applied a cast to mend my broken arm. Sometimes it is necessary to spend some quiet time alone and listen to your own inner knower that directs you to apologize and work out your differences with a loved one..

Remember pain can be a powerful teacher not just an experience. When you open yourself to learning the lesson that pain can teach, you will improve your Mental Health & Happiness.

Best Antidepressant Cure

By Nancy S Buck, PhD, RN

Did you know that in the early 1800s, Americans turned to the advice of Scottish physician William Buchan for melancholy:

The patient ought to take as much exercise in the open air as he can bear . . . A plan of                this kind, with strict attention to diet is a much more rational method of cure, than                              confining the patient within doors, and playing him with medicines.

Today British medical authorities have rediscovered Buchan’s advice. The National Insitutute for Health and Clinical Excellence decided that antidepressants are not recommended for the initial treatment of mild depressions because the risk-benefit ratio is poor. Instead physicians should try non-drug alternatives and advise patients of all ages with mild depression of the benefits of following a structured and supervised exercise programme. 

That’s right, doctors in the UK may write a prescription for exercise! Andrew McCulloch, executive director of the Mental Health Foundation in London says, “The evidence base for exercise as a treatment for depression is quite good. It also reduces anxiety. It’s good for self-esteem, control of obesity, et cetera. It has a broad spectrum effect.”

In 2000, a study by James Blumenthal at Duke University revealed that it is unwise to combine exercise with drug therapy. He conducted a study with three different groups: exercise, or Zoloft, or exercise and Zoloft. Those treated with exercise alone were doing the best. And given the choice after the study, more people chose exercise alone and continued for a long time afterwards.

Hmmm. Why is this information such a mystery for those of us living in the United States? Are our physicians less well informed? Are our drug companies perpetuating the myth that
depression indicates bad brain chemistry?

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Luckily, you don’t have to worry about finding this answer. All you need to do is follow the advice of getting yourself outside and exercising to improve your Mental Health & Happiness!

*Information for this blog is courtesy of: Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs, and the Astonishing Rise of Mental Illness in America, Robert Whitaker. New York: Broadway Books, 2010, p345.

 

Teenagers and Depression

By Nancy S Buck, PhD, RN

Are you checking your teenage girl for depression? Do you know what to do to help instead?

Recently I saw an article that was published on Parenting magazine sharing the symptoms of teenage depression in girls. I’m glad to read it, glad to see it.

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What I find disturbing is the lack of articles about what we can to with and for our teenagers to keep them from getting depressed in the first place. Do you know how to develop, improve and maintain good Mental Health & Happiness? I fear too many of us have bought into the notion that mental health is somehow a mysterious brain disturbance or disorder. In fact too often what is natural and normal upset and unhappiness is now understood as mental illness.

There was a time not so many years ago when sadness, upset and unhappiness were the words used to described feelings not depression. Now it is not uncommon to hear someone say I was so depressed that the football game I wanted to watch was blacked out in my area. Feeling disappointed or angry because of such an event is understandable, not depressed.

Choice Theory psychology explains that all emotions are the result of either the match or the mismatch between what a person wants the world to be like and what the world is actually like. When you hope for sunny day and you awaken to a sunny day you feel happy, satisfied and glad. What you want and what you are experiencing is a match. When you hope for an A on your chemistry test and receive an F you feel upset, disappointed or perhaps sad and angry. What you wanted and what you are experiencing are two very different things.

Unfortunately there are too many people believing and being told that the reason for depression has to do with a broken brain or chemical imbalance in the brain. Amazingly there is no evidence to support this claim, despite what the pharmaceutical companies claim. There are plenty of companies making the claim and selling the drugs to correct this imbalance. No one seems to question the next drug put on the market when the first antidepressant is no longer working alone and needs a second drug to boost the first. What happened to the magical drug correction from the first? Isn’t this suspicious? There are also many, many studies conducted by psychiatrists (some independent doctors, some paid by the pharmaceutical company!) resulting in worse outcomes longterm for patients taking these antidepressant and antipsychotic medications.

No one says that being a teenager is easy. It is probably the most challenging developmental period of childhood, and for some of their entire lifetime. There are plenty of times, experiences and life events for an adolescent that are different from what she wanted or he imagined. These differences result in powerful disappointing and overwhelming emotions, sometimes even depression. But the answer is not to take a drug to try and correct broken brains or brain chemical imbalances that do not exist. In fact, taking these medications too often keeps a young person from being able to learn and practice new behaviors and strategies to deal with these life events and disappointments.

The answer is to help our young people learn how to meet their genetic psychological
instructions responsibly and respectfully. We need to help our teens and young adults learn the successful and effective strategies to develop and maintain good, strong connections with the important people in their lives. This is much more effective in helping to eliminate sadness, loneliness and depression. These are the answers for teenage depression in girls and boys that lead to Mental Health & Happiness.

My journal: A lifeline from despair

By Dr. Nancy Buck

My life was falling apart. My husband of 24 years left, saying he wasn’t sure he wanted to be married to me anymore. He needed time on his own to figures things out. My twin sons had left for college. The family dog ran away.

I was alone in our home, but there was no more “our” or “we.” Was there even a home anymore?

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I didn’t know what to do. Crying didn’t help. Talking with my sisters and friends gave me only temporary relief.

Day after heart breaking day, the sadness, isolation, failure and oppression was unbearable.

My lifeline, it turned out, was my journal. Every morning I wrote my three morning pages. Every evening I listed five things I was grateful for. Most days my gratitudes consisted of:

1.    I am breathing in

2.    I am breathing out

3.    I am breathing in

4.    I am breathing out

5.    I am breathing in and out

The lessons I learned during that time were many. The most important lesson was to keep breathing no matter what.

You never know what might happen next, what internal strength will be discovered, and what gifts will be revealed in the next moment.

And if you don’t keep breathing you never will know.

So keep breathing, in and out, in and out, in and out.

Shame & Guilt: The Happiness Destroyer (Part 2)

 

By Michael Rice, LISAC

One of the necessary approaches in dealing with addicts or alcoholics is to help the person release or let go of all their shame and guilt.  You don’t have to be an addict or an alcoholic for this to be effective in your life.  Anyone who harbors shame and guilt will not know true happiness and peace of mind until they are rid of their shameful and guilt ridden thoughts.

 

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What is often amazing to both myself and to my clients is to discover that much of what they are keeping secretive, along with the fear of being discovered, is so trite in nature that if or when others did find out, the discoverers would either be understanding, bored, or not even care.  All the stress and fears of being discovered are self-imposed.  It would also appear that those who are most susceptible to shame and guilt by the manipulation of others who believe what one “should’ think or do, are the most easily taken advantage of.  These individuals have a very hard time in saying “no” to others and end up doing things that they really would rather not do only to please the person making the request.  They would create feelings of shame and guilt in themselves if they refused the requests of others.  Afterwards, they begin to feel angry and turn their anger inwardly (depression) because they would feel guilty and shameful if they let their anger out.  Continually giving up one’s own wants and needs for the sake of someone else’s wants and needs will lead to unhappiness.  Once a person shows signs of continually trying to please others, others will begin to take advantage of this trait.  No one can walk on you if you don’t lay down.

In A.A., members who seek recovery along with their sobriety do more than merely attend meetings.  They put the twelve steps into action with the help of a sponsor.  Ridding one’s self of shame and guilt is like having the weight of the world taken off one’s shoulders.  It’s like being able to exhale after holding your breath for years.  I have even witnessed some individuals break down in tears of joy after letting go of their shame and guilt.  It is truly a sight to behold and an experience one never forgets once they release it.  The process involves making amends wherever possible, forgiving one’s self, and realizing that they are humans who are prone to make mistakes and yet still be loved; feeling worthy of giving and receiving love. 

One’s lack of self love is due to their perception about themselves which is laden in shame and guilt. The second genetic need for Love and Belonging is so powerful that when adequately acquired, all of the other genetic needs seem to be more easily attained.  Not only does one need Love and Belonging from others but from one’s self.  How can you expect others to love you if you don’t like and love yourself?     

Personally, I contend that when a person finds love through someone else’s acceptance, they are actually feeling love for themselves as much as for their partner.  It is the concept of, “I like me better because you love me.”  Love for another person enhances our need for love of our self.

In the movie, “As Good As It Gets,” Melvin Udall (Jack Nicholson) begins to realize he is miserable without love and belonging?  He finds himself being attracted to Carol Connelly (Helen Hunt) and on a casual date he says to her, “You make me want to be a better man.”  Melvin has reached an epiphany and realizes that if he wants love and belonging, he needs to stop being such a jerk that drives others away.  He’s beginning to deal with his shame and guilt.  And what does this all mean?  If you want things in life to be better, the first person who needs to change is one’s self.

Symptoms or Causes?

By Dr. Ken Larsen

Imagine a situation where a man, wounded and in pain, staggers into your local emergency room.

The ER doc begins the intake workup.

“Are you in pain?” the doc asks.

“Yes, it hurts a lot” the patient replies.

“When did it begin?” the doc asks

“When I got shot with the arrow in my back–that really hurt.” the patient replies

ER doc strokes his chin, “Hmmm”

“So you’re in pain because of that arrow in your back?” The doc proclaims with great insight.arrowinback

“Yeah, that’s what I said” The patient looks a bit puzzled as he replies.

Doc says, “I’ll be right back.”

The doctor returns in a short while, gives the patient a prescription for Motrin and has the nurse give him instructions for how to put on his shirt over the arrow.

Admittedly this scenario is a bit preposterous but I use it to illustrate a point.

Your immediate reaction is to recognize that the cause of the patient’s distress was not effectively dealt with.  He left with the problem that he came in with.  The arrow in his back.  What’s wrong with this picture?

There is a growing concern that this sort of event is happening far too frequently with the diagnosis and treatment of mental health issues.

I’ll tell you of a personal experience.  About 20 years ago I was unhappy.  I talked to my personal physician who asked me some questions.  I met the criteria for a diagnosis of depression.  I was given a psychiatric referral.  When I met with the psychiatrist he asked me some questions and gave me a prescription for Prozac.  This meeting took 20min.  The fee was $250 plus the cost of the prescription.

What was I to conclude from that experience?  Was I suffering from a Prozac deficiency?  Was that the cause of what had been labeled “depression”?  I didn’t have enough Prozac in me?

Dr. Wm. Glasser, author of “Choice Theory” and “Reality Therapy” has stated that “many people are diagnosed with a disease they don’t have and given brain drugs they don’t need.”

Unhappiness is the most common presenting complaint for depression.  That unhappiness usually has a cause and that cause is most often associated with a close relationship that is not working right.  I have to ask if giving drugs that allow the accumulation of serotonin in the brain changes the circumstances that caused the unhappiness.

There is growing concern that this is not the answer.  In fact there is growing concern that some of these brain drugs that have been so freely administered have made the problem worse or have caused more serious problems.  And most importantly, they leave the person with the arrow in his back.

The issue of mental health looms ever more urgently in our culture, reinforced every time we read about another senseless act of violence.   One report suggested that some of these guys are not necessarily loners but failed joiners.   This is one possible explanation.   All too often these are people who want to be connected in caring relationships but somehow have not been successful.

helpinghandsAs a civilized society we are at a crisis point.  Do we continue to dispense drugs that are non-solutions to lonely, isolated people in distress or do we focus our attention and energy on reaching out with care and love to those we see that are not able to get their needs met.    

The pharmaceutical industry and many psychiatrists have tried to convince us the solution lies in brain altering drugs while ignoring the causes.  I believe this is like the guy who was given Motrin for the arrow in his back and instructed on how to put on his shirt over the arrow.    I appeal to all of us, ordinary folks and especially those we trust with our health care.  Let’s shift our focus from medicating symptoms to discovering and dealing with causes.