Mother kissing sleeping infantIn addition to adapting to the brand new experience of parenting, many new parents may also be managing preexisting mental health issues, like depression or bipolar. Others may experience postpartum depression (PPD) after the birth of a child. The American Psychological Association states that postpartum depression affects 9–16% of postpartum women, and women who experienced PPD after the birth of their first child are even more likely to experience PPD after a second pregnancy.

Online resources like GoodTherapy.org can be valuable in helping you understand issues like postpartum depression—you can find a selection of blog articles related to PPD on the GoodTherapy.org Blog—but finding others who can relate is also essential. That’s why we appreciate the many wonderful blogs by parents who have experience with postpartum or general depression. It’s comforting to find people who have documented their stories and shared their own inspiration for coping with mental health issues.

Below are some of our favorite blogs by and for parents who are experiencing or have experienced PPD or depression.

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Postpartum Progress

With a team of over 15 writers, Postpartum Progress discusses the experience of motherhood—for parents-to-be, those who have decades of parenting behind them, and everyone in between. Because so many authors are contributing, you can follow the stories of mothers who are in all stages of PPD and depression. Click on “Find Moms Like You” under the Get Hope tab to explore personal stories you can relate to and resources for moving forward.

All Work and No Play Makes Mommy Go Something Something

A wife and mother who has experienced PPD and been diagnosed with bipolar II, Kimberly has many published pieces to her name in addition to her popular blog. In her bio, she writes, “Together, my boys have guided me through the darkest times of my life and held onto my hope when I lost it. Their love saves me every single day.” The link above takes you to her posts specifically addressing PPD and recovery.

Beautiful Courageous You

Lauralee writes that her faith has been of the utmost importance to her success in dealing with mental health issues while raising her five children. “Most of what I write about is a real and raw journey through depression, anxiety, and grief, not to bring you down but to bring you UP and fill your heart to brimming over with Hope.” Many people search for a spiritual approach to overcoming hardships in life; if you’re looking for inspiration from a mother with a Christian perspective, Beautiful Courageous You is the account of a woman who has learned to embrace change and rejoice in life’s trials.

Ivy’s PPD Blog

After a failed pregnancy and an unsuccessful cycle of in vitro fertilization, Ivy gave birth to her daughter in December 2004 and experienced PPD six weeks later. Though she considers her experience with PPD over, she has continued to be an advocate for education about maternal mental health issues, perinatal mood issues, and infertility. Ivy’s blog is one of our favorites because of her dedication to reducing stigma about mental health issues that women and mothers face. She also shares insightful posts about bullying and the importance of staying wary of social media—both for kids and adults.

Farewell Stranger

Robin Farr named her blog not for the Supertramp song “Goodbye Stranger”—OK, maybe a little bit for that—but because, “In telling this story, I’m saying goodbye to a version of myself that I didn’t know and didn’t understand.” Robin has presented a TEDx talk, contributed to Huffington Post, and written for Postpartum Progress about her ongoing experience with depression and the recurrence of what she calls “blips”—those times that might make one hyperaware of mental health issues. Farewell Stranger has formed an online community around Robin, her life with her two sons, and maternal depression.

PPD to Joy

The author of PPD to Joy, Yael, had a traumatic introduction to postpartum depression: her mother committed suicide when Yael was 6. When Yael found herself having similar thoughts and motives after the births of her own children, she said the memory of her mother’s death “ignited a spark” under her. She began seeking help and finding strength through support networks and professionals. Years later, she continues her blog, hosts support groups in Ithaca, New York, and helps eliminate stigma and confusion about PPD.

While there tends to be an abundance of resources available for women with postpartum depression, the help for their partners is not as plentiful. Spouses should not only learn how to support a partner with depression; they should also be prepared for dealing with depression issues themselves. Studies have shown that fathers, too, may experience postpartum depression. We are still looking for blogs by fathers with PPD; please email inquiries@goodtherapy.org with suggestions.

Are there other blogs about depression and PPD that you read? Please let us know! Have your own blog that covers these issues? We want to find it! Leave your suggestions in the comments, so we can include them in future lists like this.

I don’t buy it, the fade-away stuff. I might go for burnout, considering that your kid just finished college, which implies many years of concerned parenting, but really, I have to say that you sound very successful—together with your wife you have created a solid marriage and seen your child graduate from UCLA. You must be doing something right, and I urge you to pat yourself on your back; you deserve it. I have the feeling you’ve been working hard for your family—long, hard work can lead to burnout—and now might be the time to take stock and then use some of that energy for yourself. You have completed an important life chapter. It’s time to turn the page and start another.

You wonder if you are having a midlife crisis, but I wonder what that means, exactly. Boredom? Dissatisfaction with where you are in the world at this particular point in time? You’ve never felt that before? Maybe you’re just tired out, finished with some things, and ready to start some new ones.

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Turning your attention to yourself is a challenge. Maybe you’d like to improve or make changes in your career, your marriage, or your health choices. Analyzing how to go about any of this, discussing different opportunities with your wife, can be rewarding. You can figure out what’s really important to both of you, your goals, and the steps you need to take to achieve them.

Perhaps you are having a “midlife crisis,” or perhaps you’re simply depressed. I recommend that you speak with a therapist to rule out dysthymia, a chronic depressive state characterized in part by feelings of hopelessness, ongoing negative beliefs, and a lack of energy for or interest in things you once enjoyed. Having a check-up with a physician is also a good idea. At 48, hormonal changes could account for a lack of zest and enthusiasm.

Whatever the case, it does sound like the spice has gone out of your life. Work. Dinner, TV, dog, bed. Boring. People in their forties or fifties often define their dissatisfactions, if they are feeling them, as age related. At the very least, unhappiness is heightened because you feel like time is running short. Your life is nearly half over, as you write. You feel internal energic changes, or see your parents aging or perhaps passing. I think it’s time for the next big thing.

People can lose their zest at any age. My prescription for people who feel that they live boring lives is to look around a bit and simply do something different. What are your dreams? What are the things you like to do?

I don’t know you, what your tastes and dreams are, but maybe you could fantasize a bit, or imagine doing your favorite things, then talk to your wife about them—she might have ideas, too—and then spin some of them out together, if they have mutual appeal.

If she is not interested in doing the same things that you are, so what? Who says you have to do everything together? Many couples have different interests, and that difference can in itself be spicy and stimulating. Doing everything together all the time doesn’t appeal to everyone. A little distance can make for a better relationship.

Also, who do you know whose life seems ideal? You might ask yourself who you look up to or even envy. That can be a clue, a signal for something you might do on your own or get for yourself—your own version, of course, not a copycat imitation.

I wonder, also, if you’re not maybe a little afraid to strike out in a different direction, and whether fear is preventing you from living as you would like. All change is scary, but it’s exciting, too.

The way I see it, you’re a guy in your late forties, and the world is as open as you are. It’s a big world, too, so get started.

All my best,
Lynn

contemplationPeople think of depression as really bad sadness, but it’s actually much more complicated. To be diagnosed with depression, a person has to have several (but not all) of the symptoms from a diagnostic list outlined in the Diagnostic and Statistical Manual (DSM). Sadness is one of these symptoms, but it is possible to have enough other symptoms on the list to be depressed and yet not feel sad.

The list of depression symptoms includes:

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Most people who are depressed feel sad, but there are several reasons some people can be depressed without feeling sad. These reasons may include:

Differences between Sadness and Depression

Another important twist is that people can feel sad, even intensely sad, without depression being involved. When people experience a loss, they usually feel sad, but don’t necessarily feel depressed. Sadness and depression have similarities, but they have some important differences.

When people are sad and express their sadness, they feel better, whereas when people are depressed, expressing their pain may not give them relief.

When people are sad and express their sadness, they feel better, whereas when people are depressed, crying and expressing their pain may not give them relief. Sadness doesn’t involve mean thoughts about oneself, or hopeless or suicidal thoughts, but depression often does. Sadness doesn’t involve distortion in perception, or loss of perspective, whereas depression usually does. Finally, sadness doesn’t interfere with feeling other emotions, while depression often prevents a range of specific emotions.

In my experience, most people who are depressed have some sense that something is wrong, and if they don’t, people around them usually do. It really doesn’t matter whether suffering fits neatly into the DSM diagnosis for depression or not.

It’s not necessary to diagnose yourself or your loved ones. If you or someone you love is suffering, get professional help to assess what is causing the suffering and what would help relieve it.

Person in yellow raincoat with yellow umbrella walks through snowy forest at night

Much of the United States has had a long, harsh, and cold winter. While it seemed like it would never end, some of us are starting to see the light of spring.

Winter can be a perfect representation of the darkness and despair that we feel from time to time. Whether it is grief associated with death, a trauma that we had to endure, or the end of a relationship, we all have had experiences of darkness and despair that feel never-ending.

But when you have lived long enough and seen enough winters, you know that the despair and darkness do not last forever. There comes a time when the pain recedes, is not all-consuming, and you have a desire to live life again.

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The process of re-emerging into life can be challenging. When you have been wearing the cloak of sadness, grief, or depression for so long, it can feel strange to walk through the world without it. You may even experience a cultural shock, in a sense. Coming back into the world can seem different and even strange.

Just as it takes time to deal with a difficult emotion, it takes time to adjust to its leaving you. It is a process of recognizing that the pain is no longer all-consuming. There are steps you can take to help you navigate this re-emergence:

Reconnect

Reach out to your support system. Many people retreat into isolation when they are struggling with depression or grief; it is necessary to reconnect with people and activities you previously enjoyed. Rather than let the shame or embarrassment of being out of touch stop you from reconnecting, speak to it. Call a friend and acknowledge that you were out of touch. Apologize and tell him or her why it’s been so long since you called. Let the person know that his or her friendship is important to you.

Review

As you reconnect with people and activities, you will need to take time to review what you came through. Think about the grief and sadness that you experienced. Consider how you dealt with it. Ask yourself:

Reviewing the depression and grief can be scary; it might feel as if you will fall right back into the despair. But the contrary is true. Reviewing your sadness allows you to see your resiliency and how you survived. It also provides an opportunity to consider options you may try in the future when facing challenges.

Rest

Finally, it is time to rest. People often wonder, “What do I need to rest for? I was just in my bed/house for two months!” Grief and sadness are exhausting. Recuperating from them is a necessary part of the healing process. Allow your body to be active as you re-engage with the world, but also let your emotions rest, as they have been on a roller coaster of sadness, darkness, and re-emergence to light.

Taking the time to process and come out of the darkness is a foundational tool that you can use throughout your lifetime. When life is challenging, as it will be, you will not only survive it but come through in a way that is healing and compassionate toward yourself.

Depressed manWhile most Americans will experience some level of depression in their lives, some will experience an intense and serious depression that requires the help of friends, family, and often a mental health professional.

The severity of a depressive state will fluctuate based on a variety of factors, including the availability of a support system, treatment options such as a therapist or psychiatrist, emotional coping skills, and a history of successfully navigating previous mental health episodes. However, when depression worsens, suicidal ideations (or thoughts) may develop, and are therefore often seen together. The focus of this article is to help identify common signs and symptoms of suicidal thoughts related to severe depression and how to recognize when to seek help.

Common depressive symptoms include a loss of interest in previously enjoyed activities, low energy, changes in sleep and appetite, concentration and focus problems, and changes in libido. When depression worsens, often people will experience hopelessness, a desire to isolate and withdraw, and may begin to have thoughts about how to make the pain (depression) stop. These are symptoms most commonly associated with the onset of suicidal ideations. This is where outside help is needed. The vulnerability experienced with hopelessness and a desire to make the pain stop sometimes leads to irrational actions and decisions. Once this hopelessness manifests as a desire to “go to sleep,” “make the pain go away,” or identifying ways to die and how to obtain the means (guns, pills, etc.), the suicide risk is dramatically heightened.

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Other factors must be considered when determining how soon help should be acquired during a worsening depression. First, if a firearm is in a person’s possession or at least accessible to the person, help should be sought as soon as the depression is apparent. The firearm should be secured by a third party or by law enforcement. Next, any use of recreational drugs or alcohol limits a person’s insight and judgment, making them more impulsive and less likely to consider available resources. If a person is likely to use drugs, help needs to be called before a person becomes intoxicated and possibly makes a dangerous mistake. A previous history of suicide attempts increases a person’s suicide risk; thus, help should be attained immediately if a suicide survivor begins to experience suicidal thoughts.

Risk Factors

Numerous risk factors need to be evaluated to determine suicide risk level. Below is a listing of the more serious factors warranting immediate intervention. If any of the following become present in a person’s thoughts or behavior, help should be sought immediately (note this is not a comprehensive list but rather an overview of the more common risk factors):

Treatment Options

Depression and thoughts of suicide are serious, but they are also highly treatable. The sooner a person elicits help from friends, family, or a compassionate mental health professional, the sooner they may be able to gain healthier perspectives and insight into ways they can work to handle their current state. Help may be able to instill hope and help a person begin the process of returning to a happier and stable state.

It is important to know some available resources for those experiencing suicidal ideation. First, call 911 immediately if a person is expressing they may no longer be able to remain safe on their own. Second, if safety permits, a person can be taken by friends or family to any hospital emergency department, where the person will receive a comprehensive evaluation and possible placement inside a mental health facility. Third, many therapists have after-hours support available, but this should be used only if there is not an imminent threat to personal safety. Fourth, the 988 Suicide & Crisis Lifeline (24 hours, seven days a week) can be reached at 988, where a trained person will listen and help a person decide the best route for help. And lastly, many communities have local-based suicide-prevention crisis lines and clinics. Check with your local mental health department to see what resources are available.

Developing a safety plan before depression worsens is a key element in the treatment of those at risk for suicide. Having support systems early and risky behavior identified (e.g., thinking of ways to die, acquiring means to harm self, etc.) can be a life-saver. It is best to have a plan of prevention and response in place before a crisis; trying to develop a safety plan amid an active crisis is often unsuccessful. A mental health professional can help you develop an excellent care and safety plan in your very first session.

Woman in kitchen with coffee cupThere is a range of both situational and organic causes of depression. Genetics can also play a role in depression; new studies in something called epigenetics have proven that it only takes one generation of mice to pass down a fear of something that parental mice had a bad experience with.

The theory which drives much of present-day pharmaceutical intervention, espousing that low serotonin is a cause of many depressive states, has not been proven. What we do know is that making serotonin more available in the brain can shift the depressive symptoms. However, it is now becoming clear that people who take antidepressants (most common are serotonin reuptake inhibitors) are more susceptible to recurrences of depression through their lives than people who do not use these medications.

I am concerned that this approach may be prescribing a life sentence of an ongoing struggle between depression and medication for people who take antidepressants rather than allowing a natural state to facilitate change and growth. Also of grave concern to me is the way that we have forever shifted culture by trying to rid ourselves of uncomfortable symptoms while perpetuating a belief system that only positive feelings are acceptable. This is not in sync with the cycles of nature in any way.

We forget we are of the natural world. This approach does not understand that symptoms are only a small part of what really needs our attention. Our culture’s classic symptom-oriented response leads to exactly what the word depression describes: a condition of “pressed-down energy”—-stuck energy that may be very important to look at, exploring the meaning of the situation and allowing it to influence our life choices, leading eventually to change that will re-establish and support the life flow.

The Role of Serotonin

Regarding current chemical trends in treatment, let’s look briefly at what we do know about serotonin: it (along with melatonin and other chemicals) is a neurotransmitter and neural protector that is incorporated into every neural network on the planet, as well as within the human body. Serotonin acts as an information carrier (neurotransmitter), a hormone transmitter, and a modulator of various tissues. It regulates neural networks that refine the communication between the brain and the heart, allowing them to work as a cohesive system.

Serotonin plays a huge role in neuroplasticity (growth of new neural networks in the brain), which is necessary for any living adaptive system. It helps to unify the entire brain into a cohesive biological system by modulating the brain and central nervous system, and continually altering the chemistry of target neurons. It influences form, influences sensory and motor neurons in order to track the source of stimuli from outside the system, and regulates the information that comes to us through our senses.

Serotonin neurons are in our heart, brain, digestive system, and immune system, and are activated by stimuli outside of the body. Serotonin exists (in the body) in any place we touch the outside world and the outside world touches us; it is the interface. As information touches the neural network the serotonin neurons coordinate our physiological response.

The serotonin chemical is highly reactive to any kind of change in the environment. It modulates the information received through our senses, the sensory gating channels. As sensory inflows occur it narrows or opens the gates to what becomes our awareness. In depression it would appear that these gating channels are narrowed and do not allow the sufferer to have a complete picture of his here and now situation.

The Body Connection

Over 70% of the serotonin in our body is manufactured in the gut, so I would assume this would be a good place to begin the exploration of dealing with depression—looking at the condition of the gut flora, the diet, and the overall physical health of the person with depression. Some depressions are simply caused by poor physical health which needs to be remedied.

For others, depression may be situational. In this case, I think it is important not to seek to suppress the experience, but to facilitate the cycle that one is in, so that the meaning of the mood issues can be perceived and lead to a new way of being rather than be pushed back to status quo. Herbs that can support this process as well as other etiology will be listed later in this paper.

These days, it is rare to find a person whose depression hasn’t been perceived from the perspective that to be “down” is an illness, rather than a part of the rhythm of life. And while I understand the extremely high severity and difficulty in some cases, I repeat that I think we have exacerbated depression through suppression of a natural cycle.

Situational depression happens for more reasons that we can count, and many that we don’t understand. Some causes are that a person might be recovering from loss or trauma, or dealing with unmet needs from another stage of life. Especially potent are the unmet needs of childhood that leave some aspect of the person stuck in an earlier stage of development, despite the progression of the body through time. This is seen as soul loss in some cultures.

Depression is often related to the feeling of helplessness that leads to a state of despair and of giving up. It is extremely important for the person to explore and acknowledge the meaning of the depression and take the difficult steps to remedy their situation—whether something is not working in their present day reality, or there are unprocessed stimuli from a past experience, as seen in posttraumatic stress (PTSD) or soul loss.

Often it may be a combination of the two, the present-day situation triggering the old issue and making it difficult to perceive the present accurately. When we look at the role of serotonin and how it modulates information from outside it is easy to see how, if we ignore either the difficult life situation or the old material, we can upset the inherent regulatory balance of the chemicals involved.

Depression: Physical, Psychic, or Both?

My main orientation to mental health and depression grows from a Reichian perspective—anything that is suppressed will come out in other ways, because energy needs to move. Energy is just information, something that comes to do the work of informing us of something. This is similar to the way electric currents run through a wire or water through a hose. Its nature is to move.

In my work at Body-Psychotherapy of Seattle, I look to open the compromised system and restore the flow of life on the five levels of existence: the body, emotions, thinking mind (thoughts), actions (will/ behavior) and the “big mind” (spiritual/etheric influence of a person). The point is to create an integration of a person’s life experience between these five realms so they work in coherence with one another rather than, for example, overusing the thoughts to justify one’s actions or to deny one’s difficult emotions.

Working physically with the body is important to me because whatever physiological and muscular reaction we have to the external environment become involuntary reaction patterns wired into the nervous and muscular systems. These responses are set into motion when the body senses something that remotely resembles a past compromising situation, even if that is not happening in the present. Over time, chemical reactions and the associated muscle memory create strong, overused muscles that become an actual physical armoring that keeps us stuck reliving our early life experiences over and over again.

One of the major challenges of depression in our culture is the necessity to be high functioning all of the time. I would approach depression very differently if we had a society that had built-in flexibility to allow people to adjust to these natural cycles when they beckon. Chronic stress and feeling a lack of meaning in life contribute to, if not cause, depression. This creates a real dilemma in finding healthy responses.

Putting Phytotherapy into Practice

Herbs can play a major role in supporting a person’s entire system to meet the demands placed on it while undergoing a difficult change process. It is important that an herbalist refrain from trying to be the sole health care provider for someone with serious depression. It is important to have a guide (or several) working together to negotiate all levels (body, emotions, thinking, behavior, etc.) into synchronicity.

I am less and less comfortable giving out lists of herbs for certain conditions. I think that an herbalist must have his or her own allies to call upon in order to promote health in another. It is our relationship and our experience with the plants that that charge the treatment. But I can suggest some approaches to choosing herbs.

First, be sure to think about the person’s constitution and match herbs to the unique disposition. In Ayurvedic medicine, there are three dosha, which are elements that make up a person’s composition. Everyone has a different combination of these elements, which may become unbalanced to unhealthy levels. Different substances can affect the traits of the dosha in different ways, so it’s important to tailor the remedy to the person.

For example, do not give a drying herb to someone with an aggravated dry (Vata) state; this is a person who might have dry mucous membranes and an airy personality, and be easily distracted. Nor should you give sweet herbs to a Kapha, a person who is overly earthy, lacking expression, and slow moving. They would do better with spicy or bitter remedies, those that might confuse and exacerbate the symptoms of a Vata person.

As you can see, the symptoms of depression will manifest differently in different constitutions; basically each constitution will be exaggerated in its imbalanced state. A Pitta person may be agonizingly irritable and restless, a Vata will demonstrate confusion and lack of concentration, and a Kapha will cover all of the windows and stay in bed for months.

All of these are common symptoms and may co-occur in one person, but look closely to see the subtleties and with practice you will be guided in choosing appropriate herbs. Overall, herbal remedies for depression need to be stimulating (to get things moving) as well as nourishing to the body and soothing to the nervous system.

More Tips for Internal Stability During Depression

People in any depression should avoid as many environmental toxins as possible; eat organic foods; and avoid caffeine, sugar, and processed foods. They should surround themselves with a natural, nonstimulating environment.

Promote healthy gut flora through the use of probiotics and regular elimination practices. If one’s feces smell strongly, be sure to take this as a warning sign from the gut.

For a period of time, promote good elimination through the use of herbs like Aloe, Rhubarb, Licorice, and Pasqueflower, or use bitters such as Dandelion or Gentian Root. This is going to be especially important in working with people with the cold, damp constitution, as they will tend toward a slower metabolism. But the Pitta and Vata may also have absorption problems for different reasons.

After creating a well-functioning environment in the gut, use alteratives (a category of herbs with tonic effects) to support the liver in removing toxins from the body. Dandelion and Pasqueflower, as mentioned above, are also categorized as alteratives. Many good blends are available. One I make for myself includes Ashwaganda, Burdock, Red Clover (for the blood), and Yellow Dock.

Extremely important is the use of nervines—beneficial plants—throughout the treatment course to soothe the nervous system and calm anxiety. Some of my favorites: Lemon Balm, Scullcap (especially helpful for racing or obsessive thought patterns typical of a Vata or Pitta person), Rosemary, Passion Flower, and Milky Oats (which would be good for a Pitta person, as it is so cooling and damp). And, of course, the use of St. John’s Wort should also be considered in depressive states—although studies suggest it works best in moderate cases. The sun herbs, like St. John’s Wort, Hawthorne, Rosemary, and Frankincense (as aromatherapy), are especially good in seasonal depressive states.

All depression treatments must include getting out into natural light on a regular basis; even if it is dark and cloudy, this will have a positive effect. Moving the body through walking or exercise is also crucial, but especially hard to facilitate in the person with a Kapha constitution.

After supporting the liver and the nervous system, look to adaptogens—stabilizing herbs—to put some zing back in the kidney and adrenal systems, as these are heavily taxed in depression. There are many wonderful adaptogens; I vary my blends regularly to get a sense how the different herbs work and work together.

Always use herbs you are familiar with, so you can sense how they are affecting you or, if you are a therapist, your client. I love Schisandra, Ashwagandha, Polygonum, Gotu Kola, Astragalus, Rhodiola, Dong Quai, Ginseng, and Motherwort.

Wisdom in Worldly Healing

For me, the most important treatment guidance is taken from the practices of other cultures. In South America and Africa, shamans travel between the worlds to resolve soul loss, some of which is described above. Much of the work I do involves treating soul loss of several types, but, different from the indigenous practices, I like to make sure that I have fully prepared all aspects of a person’s system so that they can retain the results long after the treatment ends. I do the scouting and the guiding, but my style also puts the onus of the work on the client: with my help they bring awareness to their old patterns and interrupt them via interventions (for example by thought-stopping, a cognitive behavioral therapy intervention).

I teach them how meet the old underlying need, building relationship and nurturing the young parts of themselves from within. Over time and with vigilance, the information that once ran through neural network systems in predictable, outdated, and problematic patterns can begin to pool as if in a dam, and finally overflow to form new neural networks that better fit the current reality.

Another model that I always have in mind with depression is from ancient mythology involving the underworld. Persephone is a Goddess who was abducted to the underworld by Hades. She faced many challenges there. But up above her mother Demeter searched and held ground for her until she was returned. Innana of the Sumerians traveled the same journey, having to face the fierce Goddess Ereshkigal in the underworld until her time came to be released. This is this same journey that one takes through the belly of depression. An herbalist working on these levels might consider using Spagyric Essences, alchemically prepared herbal remedies which can positively affect depressive states. They are prepared by first distilling the essential oil, the Soul, out of the plant; then leaving the hydrosol and plant matter to ferment and distilling the alcohol from that. This is the Spirit level of the plant. The remaining plant matter is purified through fire until it is reduced to white ash from which the mineral salts, the Body of the plant, is extracted. All three are put back together to form a remedy that works on the etheric levels to create change beyond the body. That change trickles down to the body and facilitates health. Organic Unity carries a line of Spagyric Essences that are made from wildcrafted plants, prepared according to corresponding astrological influences and infused with healing prayers and love. In my experience, this care makes a huge difference in the potency of the remedy and its impact on the client. I highly recommend them.

Finally, I think that the most important thing to keep in mind when working with a severely depressed person is that they must not be left on their own. Like Demeter, someone must hold space for them and watch for them from above, creating an anchor to the larger world. This space must be held by someone who is not afraid of the dark. Someone who is patient and kind, wise and strong. A practitioner with knowledge of the territory, a big loving heart, and good boundaries!

Van Gogh Self PortraitIs it so strange to want to chronicle and capture your changing visage through the years in the form of artistically altered photographs? There has been a lot of conversation in recent months surrounding people who obsessively photograph themselves and post those pictures online for all to see, otherwise known as the selfie trend.

Even we jumped on the bandwagon of speculation about what’s really going on with this phenomenon. The self is fascinating; after all, it’s who you are. We seek a deeper understanding of this inward being in a variety of ways: journaling, creative expression, conversation, counseling, and, yes, the self-portrait.

Throughout history, artists have devoted themselves to this eye-catching craft of self-understanding. Vincent Van Gogh and Frida Kahlo are just two examples of the myriad artists who became renowned for their ability to capture the self in compelling portraits.

From 1886 to 1889, Van Gogh painted over 30 canvases of himself, and Kahlo, who began her work in self-portraiture while recovering from a debilitating accident in a full body cast, produced 55. She is quoted as having said, “I paint myself because I am often alone and I am the subject I know best” (Frida Kahlo Foundation, 2002–2013).

These days, though the painted canvas is still prevalent in self-portraiture, the artistic rendering of the self via photograph is being snapped and shared by the millions—on Facebook, on Instagram, and in the professional photography world, as well. Depression, grief, loss, injury, and navigating the rises and falls of the human journey have inspired countless works of photographic art involving the photographer as subject. Following are just a few examples of this self-centered form of modern artistry—and healing.

Self-Portrait for Depression

[fat_widget_left]One man, 20-year-old Christian Hopkins, uses photography as a way of dealing with depression. His self-portraits include surreal images of several hands being trapped inside his skin, wings made with fragile materials protruding from his shoulder blades, one showing his left wing broken and in pieces, the other very sparse but intact.

He is also shown with a fabricated slit through the throat made of a zipper with strands of black yarn mimicking blood. The photos are haunting, but most importantly, Hopkins says they help him process the complicated emotional experience of his bouts of depression.

Self-Portrait for Feeling Powerless and Stuck

Ben Zank, a New York-based photographer, chronicles his feelings of “being powerless, stuck, being free again, etc.” in a series of self-portraits featuring natural elements colliding with the confining aspects of human existence. In one of these, he is shown lying face down on a paved road with the two yellow stripes running directly over his head; in another, he is trapped between two icy rocks, struggling to break free.

He also photographed himself with his head wrapped in twine and tied to a tree, as well as with lengths of twine tied around his fingers and anchored to the ground. Both of these scenes seem to reflect the experience of being stuck.

Self-Portrait for Debilitating Injuries

Following repeated knee injuries, former-dancer-turned-photographer Ingrid Endel photographs herself in stunning dance-oriented poses. The Australian artist creates surreal imagery that beautifully captures the sense of loss associated with no longer being able to perform as a dancer, as well as the joy of discovering another art form through which she can express herself.

The photographs show her body in a variety of outdoor scenes: lifting off the ground with legs wrapped in vines; leaning (or falling?) backward in a dancer’s pose with electric red cords protruding in all directions from her chest; and being enveloped in cocoon-like cobwebs while contorted on the forest floor.

Endel includes photographs of her moments of stillness in which she appears to be accepting and embracing her body as-is; one in particular shows her looking perfectly content while engaged in a stretching pose in the middle of a body of water.

Self-Portrait for Personal Change and Transformation

Another way to use the self-portrait is to process normal, yet significant, changes in life, which can become stressful if not handled healthfully. One woman, Sophia Starzenski, a photographer based in Buenos Aires, took photos of her near-naked body as she moved through pregnancy.

The photographs reveal her steadily expanding belly throughout the nine months of being with child, and the final shot shows her with two-month-old babe in arms. By capturing the raw beauty of this commonplace transformation, Starzenski presents the changing female body as a work of art—something to be celebrated and shared rather than hidden and shamed.

Self-Portrait for Illness and Grief

Still others use the self-portrait as a means of coping with insurmountable changes in the lives of their loved ones, which inevitably affect them, too. When his wife Jennifer was diagnosed with breast cancer, Angelo Merendino chose to document the experience through photographs taken mainly of his wife, although he appears in a few of them.

The series starts with the couple looking healthy and happy, drinking while sitting on a front stoop, and then lying in bed together with serene smiles and an intimate embrace. The photographs grow increasingly bleak, however, as Merendino captures his wife’s physical deterioration and eventual death on camera.

Though they depict illness, grief, and loss, the photographs also show the beauty of family coming together in trying times and of final moments treasured and savored. Following his wife’s passing, Merendino published a book of the images, The Battle We Didn’t Choose: My Wife’s Fight with Breast Cancer, and went on to start a non-profit called The Love You Share (theloveyoushare.org) as a means of providing financial assistance to women battling breast cancer.

The Tutu Project (thetutuproject.com), which “began in 2003 as a lark,” is another instance of a man using self-portrait photography to deal with life in general and eventually, with his wife’s breast cancer. When his wife Linda was diagnosed in 2006, Bob Carey began taking his ongoing photographs of himself wearing only a pink tutu to a new level. As a means of alleviating his own emotional distress and lifting Linda’s spirits, he traveled the United States—and Italy—snapping pink tutu photos in various places.

Their story inspired a video created by Deutsche Telekom in Germany (below); in it, Linda says, “It just makes me laugh, to see my husband dancing around in a pink tutu. It helps me be positive. The more I laugh, the better I feel.”

To help support other women who are in need of funds beyond what insurance provides as they navigate the breast cancer experience, the couple established The Carey Foundation in 2012 (careyfoundation.org), and they continue to spread the simple pleasure of the pink tutu in Ballerina, a hardcover collection of Bob’s self-portraits and the stories behind them.

PhotoTherapy: How Self-Portraits Heal

Judy Weiser, director of the PhotoTherapy Centre in Vancouver, British Columbia, as well as psychologist, art therapist, and author, has spent over 35 years exploring, developing, and implementing “PhotoTherapy” techniques. On the PhotoTherapy Centre’s website (phototherapy-centre.com), Weiser details extensively the therapeutic benefits of photography in its various forms.

Regarding the self-portrait as a mode of healing, she says, “Since issues connected to self-esteem, self-knowledge, self-confidence, and self-acceptance lie at the core of most clients’ problems, being able to see themselves for themselves, unfiltered by the input or feedback of others, can be a very powerful and therapeutically beneficial encounter.” She goes on to explain how this in-depth confrontation and exploration of the self through photography is known to catalyze “deep process work in therapy situations.”

Though the PhotoTherapy Centre now exists primarily as an archival collection of online information and resources, Weiser still provides training opportunities for mental health professionals in the techniques of PhotoTherapy, as well as social media support and guidance via the Centre’s Facebook group.

References:

  1. Frida Kahlo Foundation. (2002–2013). Frida Kahlo biography. Retrieved from http://www.frida-kahlo-foundation.org/biography.html
  2. Weiser, J. (2001–2013). The techniques of PhotoTherapy. Retrieved from http://www.phototherapy-centre.com/self_portraits.htm

For those dwelling in climates prone to the dark, chilly days of fall and winter, it is widely understood that along with changes in the natural world, seasonal shifts in mood and temperament are also likely to occur. These shifts may be more drastic and debilitating for some than for others, and when seasonally induced woes weigh too heavily on a person, he or she may be diagnosed with conditions like depression or seasonal affective disorder (SAD). While such diagnoses have become quite common, people are just recognizing consensus among researchers that a person’s season of birth appears to increase the chances that a person will develop these or other mental health conditions.

Typically, a person’s birthdate is given astrological significance in the form of a zodiac sign, but not necessarily predictive powers when it comes to psychological well-being. There was a time not so long ago when the study of astrology was considered to be of scholarly and scientific value in treating physical maladies, but few modern-day doctors still refer to the celestial bodies when determining diagnoses and treatment conditions (Wolfson, 2013). However, a connection between season of birth and certain mental health conditions has been observed by a number of researchers in recent years. The primary finding of this vein of research is that being born in the fall, winter, and spring increases the chances of mental and emotional instability.

The most widely researched correlation is the heightened likelihood of developing schizophrenia if a person is born in the darker, colder months of the year—winter, primarily. Over 200 studies have confirmed this correlation since 1929 (Wolfson, 2013), including one study which revealed that being born in the Northern Hemisphere in either winter or spring may increase the tendency toward schizophrenic symptoms (Davies, Welham, Chant, Fuller Torrey, and McGrath, 2003).

In this particular study, researchers compared winter/spring versus summer/autumn births using data from eight preexisting studies of 126,196 people who had been diagnosed with schizophrenia and 86,605,807 “general population births.” The subjects were located in 27 sites across the Northern Hemisphere, and the positive correlation between schizophrenia and winter/springtime birth as well as latitude-based weather conditions was reported as “small but significant” (Davies et al., 2003).

Further studies reveal that a similar connection exists between season of birth and SAD. Pjrek et al. (2004) discovered a notable link with being born in the fall and winter and experiencing “melancholic depression” during those times of year as an adult. This finding inspired additional research that explored and confirmed the apparent correlation of SAD and season of birth (Pjrek et al., 2007).

Yet another study conducted in England examined the correlation between season of birth and schizophrenia, bipolar, and recurrent depression in “the largest cohort of English patients collected to date” (Disanto et al., 2012). Once again, they found that those born during darker days and colder temperatures were more likely to develop these conditions later in life. Specifically, cases of schizophrenia and bipolar were found to be at their peak in those born in January, and at their lowest rate of occurrence in July, August, and September births. A slight deviation from the fall-winter-early spring correlation was their discovery that those born in May appeared to be particularly susceptible to recurrent episodes of depression.

Overall, the message seems to be that a large portion of the population is primed to experience what are commonly known as mood disorders from birth; ultimately, the only ones who are not at a high inborn risk of developing these conditions are those whose birthdays are in the sunshine-rich summer months. This has led some researchers in England to theorize that vitamin D deficiency—whether in the biological mother or in the child after birth—factors in to these findings (Disanto et al., 2012). So the explanation for this phenomenon could be as simple as less exposure to sunlight depriving a person of sunnier brain chemistry from birth. These same researchers also posit that environmental exposure to viral or bacterial strains on the part of the mother during these times of year may play a part in their children’s psychological development.

Another widely held theory, shared by neuroscientist Chris Ciarleglio in a recent article published in The Atlantic, suggests that “developing in a certain season seems to imprint your circadian clock,” which is known to have a strong influence on mental and emotional well-being (Wolfson, 2013; Foster and Roenneberg, 2008).

Of course, it remains to be fully understood how much of our mood-related makeup and behavior is hardwired at birth, and how much of it is determined by outside factors like family, childhood experiences, education, and financial lack or privilege. Regardless, the findings of these studies spark intriguing inquiries regarding what, exactly, it means to experience depression, schizophrenic hallucinations, and swings in emotional state characteristic of bipolar—plus how much can or should be done to prevent these conditions if they are, in fact, imprinted at birth.

References:

  1. Davies, G., Welham, J., Chant, D., Fuller Torrey, E., and McGrath, J. (2003). A systematic review and meta-analysis of Northern Hemisphere season of birth studies in schizophrenia. Schizophrenia Bulletin, 29(3), 587-593. Retrieved from  http://schizophreniabulletin.oxfordjournals.org/content/29/3/587.full.pdf
  2. Disanto, G., Morahan, J. M., Lacey, M. V., DeLuca, G. C., Giovannoni, G., Ebers, G. C., Ramagopalan, S. V. (2012, April 4). Seasonal distribution of psychiatric births in England. PLOS One. doi: 10.1371/journal.pone.0034866. Retrieved from http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0034866
  3. Foster, R. G., and Roenneberg, T. (2008, September 9). Human responses to the geophysical daily, annual, and lunar cycles. Current Biology, 18(17), R784-R794. doi: 10.1016/j.cub.2008.07.003. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18786384
  4. Pjrek, E., Winkler, D., Praschak-Rieder, N., Willeit, M., Stastny, J., Konstantinidis, A., and Kasper, S. (2004, October). Seasonality of birth in seasonal affective disorder. Journal of Clinical Psychiatry, 65(10), 1389-1393. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15491243
  5. Pjrek, E., Winkler, D., Praschak-Rieder, N., Willeit, M., Stastny, J., Konstantinidis, A., and Kasper, S. (2007, October). Season of birth in siblings of patients with seasonal affective disorder. A test of the parental conception habits hypothesis. European Archives of Psychiatry and Clinical Neuroscience, 257(7), 358-382. Abstract retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17902009
  6. Wolfson, E. (2013, November 15). Your zodiac sign, your health. The Atlantic. Retrieved from http://www.theatlantic.com/health/archive/2013/11/your-zodiac-sign-your-health/281358/

Major depression (MDD) is known to affect numerous cognitive and behavioral domains. People with MDD often have pessimistic attitudes about future events and guilt over past events. They tend to isolate and withdraw, and choose to engage in activities that provide immediate reward over those that promise future enjoyment. This leads to impulsive and even risky behavior, like overeating and substance misuse.

Posttraumatic stress is an anxiety condition that has some similarities to MDD, but is unique in that risk/reward choices tend to be quite different. Understanding how people with MDD, PTSD, and MDD+PTSD value risks over rewards is an important area of clinical research and can provide insight into the behavioral and cognitive processes that take place in people with these mental health problems.

To get a closer look at the differences in decision making that occurs in these conditions, Jan B. Engelmann of the Department of Economics at the University of Zurich in Switzerland recently conducted risk/reward decision making experiments on 20 individuals. All had either MDD or MDD+PTSD. Engelmann compared their choices to those of 16 control (HC) participants.

The results showed that both MDD groups discounted long term rewards compared to controls. For gains, both MDD groups selected immediate versus long-term gains more than controls. However, when Engelmann looked at the subgroups of MDD participants, the findings revealed significant differences. The MDD only group demonstrated a preference for taking larger losses in the long term if it meant decreasing immediate losses. This was in contrast to the HC and MDD+PTSD groups, who chose smaller immediate losses over larger losses in the future.

Engelmann believes this difference in the MDD and MDD+PTSD group is due to anxiety. The PTSD group may be more willing to accept minimal losses today if it means avoiding larger losses later. This avoidant behavior is a symptom of anxiety and in the case of risk/reward may actually benefit individuals with respect to decision making.

For people with MDD+PTSD, although anxiety may decrease antidepressant efficacy, this negative consequence may be offset by the positive effect anxious symptoms appear to have on risk/reward processing. “Together,” added Engelmann, “These results inform future research investigating the underlying affective and cognitive processes, as well as related neural mechanisms, of the observed choice distortions in patients with MDD.”

Reference:
Engelmann, J.B., Maciuba, B., Vaughan, C., Paulus, M.P., Dunlop, B.W. (2013). Posttraumatic stress disorder increases sensitivity to long term losses among patients with major depressive disorder. PLoS ONE 8(10): e78292. doi:10.1371/journal.pone.0078292

The personality traits of neuroticism, agreeableness, openness, extraversion, and conscientiousness, known as the “big five,” have been studied at length in relation to nearly every psychological condition. Several of the big five traits have been linked to suicide, but only in the presence of other comorbid conditions or only when viewed through a limited lens.

To get a more comprehensive picture of how these personality traits affect the risk of suicide in the general population, Victor Bluml of the Department of Psychoanalysis and Psychotherapy at the Medical University of Vienna in Austria recently conducted a study involving community participants. Bluml assessed 2,555 adults for measures of past, present, and potential suicidality as well as for the big five. He controlled for other risk factors such as anxiety, depression, PTSD, and socioeconomic status.

The results revealed that specific big five traits influenced risk for suicide for men differently than for women. For women, Bluml discovered that high levels of openness and neuroticism increased suicide risk. For men, low levels of conscientiousness and extraversion elevated the risk of suicide.

Bluml believes that neuroticism, which is a risk factor for depression, could increase depressive symptoms in women, making them more vulnerable to maladaptive coping and impulsivity. This could explain the link between neuroticism and suicidality in women. However, women are more likely to have nonfatal suicide attempts than men.

When Bluml looked at the big five scores for the male participants, he found that there was no direct association between openness or neuroticism and suicide. But extraversion, which is associated with positive affect, was found to be linked to suicide risk when scores were low. Likewise, low scores on conscientiousness, which directly impacts hopefulness, were also shown to be predictive of suicidality for males. Bluml also found that these trends persisted even when other factors such as anxiety, unemployment and stress were considered.

These results clearly show how specific personality factors impact suicide uniquely for each gender. Bluml also added, “Different personality dimensions are significantly associated with suicide-related behaviors even when adjusting for other known risk factors of suicidality.”

Reference:
Blüml, V., Kapusta, N.D., Doering, S., Brähler, E., Wagner, B., et al. (2013). Personality factors and suicide risk in a representative sample of the German general population. PLoS ONE 8(10): e76646. doi:10.1371/journal.pone.0076646

woman hiding behind maskEven the most honest people are faced with lying when they are depressed. This is yet another indignity adding to the suffering of depression. The most obvious and pervasive example is the frequent, daily question, “How are you?” It is a social convention to greet friends, strangers, and acquaintances with this question. Frankly, most of us lie in response to this question, or at least shade or limit the truth, because people generally don’t want to hear the true answer when they ask. Convention tells us to answer, “I’m fine, thanks; how are you?” For most people most of the time, this isn’t a big deal. It’s just a formality that facilitates greeting people, and is understood as a friendly hello. It’s not generally a problem because mostly people are fine, and don’t need to tell someone about the rash on their butt or the dog poo they stepped in.

But for a depressed person, the lies required for social convention are constant, and they create more and more isolation and separateness from other people. They reinforce a sense of having a shameful secret that no one wants to know or help them resolve. It reinforces a sense of being a burden or unlovable. All of these thoughts are common in depression, and to have them reinforced all day long by multiple people is crushing. Many people deal with it by isolating themselves from others if they can.

Of course, we all expect to lie to store clerks and other strangers, or even coworkers or neighbors, when they ask how we are and the truthful answer is too personal. But what about when a doctor asks—or clergy, someone we’re dating, our parents, our children, or our friends? What if what we are thinking is, “I hate myself,” “I’m disgusting,” “I’m a failure,” “Everyone would be better off if I were dead,” “I can’t stand the emotional pain anymore,” or even “Day after day I can barely get out of bed, and when I do, I can’t do anything—I’m neglecting my children and spouse, doing a terrible job at work, and have no interest or joy in anything”?

[fat_widget_left]If people say these thoughts aloud, they are likely to get an upsetting response. Some will tell them they don’t really feel that way, or shouldn’t feel that way. Some will try to cheer them up. Others will shame or blame them for how they suffer. Many will get scared; some may laugh. Some will distance themselves. Even some inexperienced therapists may get distracted by their fear of suicide and shift focus to keeping the person alive rather than addressing the pain. Good friends may listen and care, but if the condition is chronic, they get tired of listening to the same scary, depressing point of view that is their friend’s experience.

Here’s an example of the kind of conversation depressed people have all the time, in this case between friends. The italics indicate unspoken thoughts.

Friend: “Hi, how are you?”

Depressed person: I feel like crap, but if I say that, she’ll think I’m being negative and tease me about being Eeyore. I don’t want to alienate her or make her depressed, and I also don’t want to answer a lot of questions to explain or justify how I feel. I’d better act like I’m OK. Maybe she won’t notice. “I’m fine, how are you?”

Friend: She doesn’t look good, but I don’t want to pry, and I don’t know what to do if I find out she’s not OK, so I’ll just wait for her to tell me what’s wrong. Exercise would probably help her—maybe I can inspire her. “I’m good—just had a great workout.”

Depressed person: Oh, god, she thinks I’m a fat slug. I don’t have the energy to brush my teeth, much less work out. I’m a worthless piece of crap. I’ll never be a normal person like her. Everyone else just goes on with their lives, and everything would go on the same way without me. I’m really not a participant in life; I’m just dead weight. “Wow, that’s awesome. I have to get back to the gym, too. How’re the kids?”

Friend: If I entertain her with stories, maybe it will cheer her up …

Depressed person (tuning in and out of stories): I’ve told her how crappy I felt—or some of it—both times I’ve seen her recently. If she knows I’m still depressed, she’ll probably be bored and overwhelmed and won’t want to see me again until I feel better. Maybe I can just talk about one problem. “Yeah, I really worry about my kids. Henry punched a kid at school the other day …”

The depressed person walks away from the visit feeling alone in her secret life and drained from keeping the secret.

This is one of the most important reasons to find an experienced, qualified depression therapist when depression lasts longer than a few weeks. It’s essential to be able to tell someone the whole truth about how much you’re suffering, without concern that the person will discount you, disbelieve, judge, get distracted by fear about what you are saying, or respond with boredom, irritation, or impatience. As obvious as that may sound, not many people can do this for others.

Spontaneous remission refers to the achievement of subclinical levels of physical or psychological symptoms of a specific condition without the aid of psychological, medical, or pharmacological treatment. In depression, spontaneous remission has been the topic of recent research, with an emphasis on the role and necessity of treatment. Some research has suggested that intervention is not necessary to achieve remission in all cases, while other research has underscored the importance of mental health treatment for depression.

To explore this issue further, Harvey A. Whiteford of the Policy and Evaluation Group at the Queensland Centre for Mental Health Research in Australia recently conducted an analysis on 19 existing studies to determine the rate of spontaneous remission in untreated major depression. Whiteford found looked at adults, children, and elderly individuals with depression that were waitlisted or who served as controls in clinical studies. He evaluated remission based on symptom severity over a one year period.

The results revealed that 23% of adults will experience remission of depression without treatment in three months, 32% in six months and 53% in a year. Whiteford found that children and adolescents were more likely to achieve remission without treatment than adults. They also achieved remission sooner than adults did during the 12-month period.

When symptom severity was examined, it was revealed that individuals with severe symptoms were 25% less likely to remit than those with only mild symptoms of depression. Factors that affect symptom severity, along with personal treatment preferences and barriers to treatment, could also affect remission and choice to treat. Although not explored in this study, these factors should be examined in future work.

The findings presented here provide new direction for clinicians working with depressed clients. The results support a wait and see approach for treating some cases of depression, and in particular, cases with mild and moderate symptoms. Doing so could make critical resources more available to high risk clients.

Whiteford added, “Resources should be directed towards those with greatest need, for example those experiencing more severe depression and those whose symptoms are likely to persist or reoccur.” These findings are novel and because this research is a relatively new avenue of exploration, these results should be further validated before suggestions are fully implemented in clinical settings.

Reference:
Whiteford, H. A., et al. (2013). Estimating remission from untreated major depression: A systematic review and meta-analysis. Psychological Medicine 43.8 (2013): 1569-85. ProQuest. Web.

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