A Word on

Depression

There are a few types of diagnosable depressions in the DSM.

  • Major Depressive Disorder
  • Persistant Depressive Disorder
  • Unspecified Depression
  • Honorable mention to PMDD and Seasonal Affective Disorder

Let’s get into it- Major Depressive disorder is a depressed mood that impairs your functioning (eating, sleeping, irritability, hopelessness, sadness) for at least 2 weeks. That’s right, all it takes is two weeks. When the things that normally make you happy don’t make you happy anymore, you can’t find joy or pleasure in activities that used to get you excited and you feel generally lost. This is not the same as a depressed mood, feeling a little sad, or just having the blues for a day or two. This is when there is significant impairment that affects your day-to-day life and functioning. To the point that is causes a significant disruption in your ability to go to work, school, socialize etc.

Persistent Depressive disorder is when you have all these same feelings but for at least one year so they may not be as extreme as some of the above symptoms but you have a touch of them all and can’t shake it. Sadness, loneliness, (moments of happiness) but overall a depressed mood. You might still be able to lead a “normal” life but overall there’s a cloud, a darkness and and overarching theme of sadness in your life.

PMDD are all of these but limited to your menstrual cycle and Seasonal Affective Disorder is the same but tied to the seasons (this has lots to do with activity level, vitamin D and all that good stuff that we don’t get a lot of north of the Mason Dixon line.

Why is Depression such a hot topic?

More recently, thanks to our good friend COVID-19, a lot of the activities that normally bought us happiness and pleasure were involuntarily taken away, we were all kind of lost and to be honest things were looking pretty hopeless for awhile. We were all (by these standards) somewhat forced into an environment that fostered a collective, community depression. Additionally these feelings of hopelessness and loneliness are exactly what leads to suicide and self-harm and this is when its time to seek help. People like to throw around the phrase “I’m so depressed” and this is actually one of those mental health terms that applies to a large number of people.

How do we help?

In my time during my clinicals I’ve seen quite a few patients with depression and it’s a tough thing to treat. When someone feels hopeless telling them “It’s going to be okay!” actually has the opposite effect and is not helpful at all. Sometimes just being there to listen so they don’t feel lonely, giving them hope in the form of encouraging words, and small suggestions like taking a walk, making an art piece, and other small self-care tips. I’m not saying it’s easy, but it works, it’s been working for many people and will continue to work for many others. If someone you’re close to is suffering from depression, firstly try to encourage them to get into therapy. If they’re not at that place yet, just talk with them, listen to them and help them to not feel so alone. Suggest taking a walk, coloring, drawing, doing a puzzle, yoga, stretching, getting them to laugh. Something to engage their brain and help them to break free from the fog.

*If you or someone you know is feeling suicidal or are having thoughts of self-harm call the suicide hotline 800-273-TALK (8255)

A Word on…

OCD

OCD, a word that’s been thrown around a lot these days. You might hear your friends saying “oh yes I had to clean my room before I left to meet you guys out because of my OCD”…or “I need all the books to face the same way because of my OCD”, in case you guys were wondering, this is not OCD this is called being clean and organized and it’s normal.

OCD or obsessive compulsive disorder is defined by obsessive thoughts and compulsions or compulsive behaviors. A lot of people suffer from obsessive thoughts from time to time. The need for perfection, organization and control, but what not a lot of people follow up with after these thoughts is compulsions or repetitive behaviors, rituals or actions that they HAVE to complete.

This becomes problematic with it begins to interfere with everyday life.

For example: someone with OCD might have the intrusive thought, “I’m going to get into a car crash if I leave my home and drive to work”. This thought alone is not abnormal and not a problem. A lot of people have this thought, I’ve had this thought and I’m sure at some point in your life you’ve had this thought as well. This might produce some anxiety (which is normal) and might give you some pause but after a few moments you realize that you’ll be fine because you drive to work everyday and the likelihood of you getting into an accident is low so you leave, go to work and have a great day. When you have the thought “”I’m going to get into a car crash if I leave my home and drive to work”, and the anxiety becomes intrusive, to the point where you are unable to leave your home not only to drive to work, but to drive anywhere and you begin to do compulsive activities that you think will prevent the ‘bad thing’ from happening. I might look something like this

  • I have the thought “I’m going to get into a car crash if I leave my home and drive to work”
  • The thought becomes overwhelming and I am unable to go about my day
  • I being to do compulsions before I leave my house to prevent the car crash that I think is going to happen
  • So when I wake up, I have to walk through the bathroom door at a certain speed, if I don’t do it correctly I need to do it again
  • I need to make my bed a certain way, in the same way every morning, and if I don’t do it correctly I need to do it again
  • When I leave and flip off the light switch, they all need to be facing down, and if I don’t do it correctly I need to do it again
  • When I get in my car and slam my door, it has to be done at a certain speed and slammed a certain way, and if I don’t do it correctly I need to do it again
  • (You see how this could be time consuming)
  • If these things are not done correctly causes tremendous anxiety, but if done correctly then the ‘bad thing’ won’t happen

You can see how these compulsions would take up a lot of not only mental time but psychical time as well. Someone could spend hours doing rituals each day and it could severely interfere with their day-to-day life and functioning.

This, is OCD.

A Word on….

Trauma.

There are typically two types of trauma we speak of in the therapy world, big T and little t trauma (although people have debates on this language).

When we think of trauma we think of it in two categories (this is a little old school but alas, it’s what we’re taught).

  • Big life events, ie. car crash, a natural disaster, war, an accident, a violent event etc
  • Long term low level stressful happenings; ie. living in poverty and not knowing where your next meal will come from, existing as a minority having racist things said to you, being followed around a store, getting bullied in school and not having any friends.

Both are bad, both affect people, both have long lasting harmful effects. One can be commonly diagnosed as PTSD (what war veterans are typically diagnosed with). When you are diagnosed with PTSD it means that you life, or bodily integrity was threatened. It means that you could’ve died, perhaps you were close to dying or almost died. Additionally it means that your life moving forward has been affected, so maybe you have nightmares about the event, maybe you avoid certain situations that remind you of the event, maybe you were never the same. For example, I was scrolling on instagram the other day and saw this girls profile who survived the White Island Volcano blast – I got lost in a rabbit hole. Its fascinating and I won’t go into it but trust me it’s crazy. Anyways, this girl was on a family vacation, this volcano basically erupted and she got burns on over 75% of her body, her dad and sister died and she had to wear a compression garment for 2 years. She has nightmares, her life will never be the same, flashbacks etc. This girl, has PTSD. Her life was threatening, she is not functioning the same as she used to and it was one major event (rather than many smaller ones). I’m really breaking this down for succinctness and clarity (trust me we spent 2, 3 hour classes talking about this) but I hope everyone gets the point.

CPTSD – so this is a newer thing and honestly we haven’t really covered it in school/it’s not officially in the DSM-V (the holy grail of therapy) but like all things mental health there are always new diagnosis being added and taken away so keep a look out for this one esepcially after COVID. But CPTSD would be classified as a little t trauma – lower level, non-threats to your life, but constant and this is the key. So imagine you go to school and every week the school bully does something to you, pushes you down the stairs, steals your library book, makes fun of your clothes in front of other people (yes these are things that have happened to me) for a year. Then you go to high school and for four years every year don’t get asked to a school dance, when all your friends do, don’t get asked on dates, when everyone else does, get told you’re not beautiful, get made fun of for your hair, your clothes, the way you talk, everything (these are a mix of examples). So you can obviously see how being subject to his kind of stuff for 4-7 years could be harmful and while your life wasn’t threatened you definitely when through some turmoil and there’s no way you weren’t affected. Additionally you might still suffer some of the same side effects of PTSD like:

  • Depression
  • Anxiety
  • Isolation
  • Sleep disturbance
  • Might turn to substances to cope
  • Shame/guilt/emotional disregulation

So, I hope you guys get the point, but essentially there are two types of trauma, both are bad, in one type your life is threatened, in the other it’s not. However, it doesn’t discount one or the other and both are issues that therapy can help with!

As always comment if you want more deets or info. I hope you guys like the new content ­čÖé