Tag: mental health awareness

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Hallo, darlings. We’re back at it today with this depression topic re-visitation. On last week’s exciting episode, we covered the relationship between depression, anxiety, and anger, and how they work together in a positive feedback loop to amplify depression. Afterword, not even Dave’s corner cowering could keep us from diving into the somatic symptoms of depression and how pain and depression work together in a… well, a positive feedback loop that can amplify depression. I’m sensing a pattern here. Anyway, on this week’s emotionally unsettling conclusion, we’re finally going to address the social implications of depression and its role in self-worth. *Spoiler alert* We’re looking at another feedback loop.

The reason I wanted to look at anger and pain in relation to depression is to highlight some of the moving pieces working against the depressed. Anger and pain are both negative experiences that one needs to develop proper coping mechanisms for in order to respond appropriately. Let’s look at two different reactions to a scenario:

Scenario: Dave walks into his living room while texting a friend. Attention divided, he stubs his toe.

Reaction one (RO): In the 15 seconds after stubbing his toe:

• Dave experiences a burst of pain
• On the heels of that burst of pain, Dave experiences anger
• Dave’s anger increases as he realizes his toe stubbing was a result of him not paying attention
• Because Dave has no one to blame, he feels a bit stupid and embarrassed (regardless of the fact no one is around)
• Dave doesn’t like to feel stupid or be embarrassed—it makes him angry
• In the midst of the pain and anger, Dave comes to the conclusion that it’s the phone’s fault he wasn’t paying attention
• Dave throws his phone
• Dave begins to feel embarrassment about his behavior (still no one around)
• Dave experiences a decrease in his sense of self-worth

Reaction two (RT): In the 15 seconds after stubbing his toe:

• Dave experiences a burst of pain
• On the heels of that burst of pain, Dave experiences anger
• Having stubbed his toe many times before, Dave realizes the pain will subside quickly, so he should just breathe and ride it out
• Dave sits on his couch and continues texting his friend, experiencing no significant changes in mood or sense of self-worth

Obviously, RT is the ideal reaction—the reasonable reaction. If you read RO and thought, “Well, that’s pretty childish,” you’re right! Spot on! Bravo, you! Individuals unable to learn and incorporate proper coping skills when it comes to negative emotions tend to react childishly to things. I think it’s important to point out here that it’s perfectly normal for anyone to have the occasional outburst. Shit happens, you might overreact, but you regroup and move on and that’s that. For someone with depression, it’s not as easy. There’s too much of a cascade effect. One stubbed toe could lead to a multiple-week-long depressive episode. Thankfully, this is an issue that can be eased with behavioral therapy and/or counseling.

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Seeking Value from Without

Before we get down to it, I just want to say that you, whoever you are reading this… You have value.

Our sense of self-worth is based on several things but can (for ease and brevity) be narrowed down to two categories: The value we place on ourselves (inside value) and the value others place on us (outside value). Ideally, there would be a balance between the two. For someone with depression, though, more stock is put into outside value. This is why some individuals with depression seek out the company of friends and family during darker times, which can be immensely helpful if the individual is in happy, healthy relationships. On the other hand, self-worth based on outside value can be crippling without those solid, uplifting relationships.

Some individuals relying on outside value, but who lack healthy relationships, tend to exhibit attention-seeking behavior. This is by no means a negative thing—although it can be. Attention seeking behavior can include: positive emotional outbursts, negative emotional outbursts, withdrawing from social situations, acting helpless, being overly helpful, being the center of conversations, and if I list any more we’re going to fall into a larger mental health topic. So, I’ll stop there. Again, these are all pretty normal behaviors when done sparingly, but it becomes problematic when someone exhibits multiple attention-seeking behaviors on a consistent basis. What’s worse is that these attention-seeking behaviors can lead to socially awkward situations, which lead to embarrassment, and… Hey! We’re back to anger! And after anger comes guilt, depression, and a lowered sense of self-worth. And, of course, how you cope (both inwardly and outwardly) with these negative emotions and situations can further devalue that sense of self-worth.

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On a Bigger Scope

**Please keep in mind that the following is a very generalized breakdown of some social implications of depression and a low sense of self-worth. While the below statements may apply to some (and in varying degrees), they won’t to others. To get more specific, we’d need to look at the different types of depression and how they affect different personality types and what’s chemical vs behavioral and on and on. You get the idea.

Building and maintaining relationships is integral to being a reasonably well-adjusted adult. How you relate to and with others helps dictate the type and quality of people who want to be around you. It also plays a major role in your career. The problem is that your sense of self-worth tends to be evident to others, whether overtly or on a more subconscious level. It’s a bit harder to like and want to be around a person who doesn’t particularly like his/herself. Because it takes more energy to be in any kind of relationship with that type of person, they’ll have fewer relationships and, likely, more contentious ones. Additionally, people with a lower sense of self-worth are more vulnerable to manipulative personalities and have a higher likelihood of ending up in long-term abusive relationships. A person relying on outside value has to be real fuckin’ careful about the company they keep, but they also have to balance how much they rely on others.

One of the biggest relationships in most people’s lives is their job. We spend a lot of time and energy there, and it’s one of the most logical places to find outside value, whether it’s from work friends, acquaintances, bosses, clients, customers, vendors, whomever. Again, it’s totally normal to desire or seek out praise and/or notice at work. But it becomes a problem when you rely too heavily on your place of work for outside value because it becomes exhausting for others. Furthermore, exhibiting attention seeking behaviors could hurt your credibility as a professional and disrupt those around you. This need for notice, the need for outside value, could end up lowering the outside value you receive, and then? Well, then you have a lowered sense of self-worth.

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It’s a Lot

Over the course of this series, we’ve barely scratched the surface of depression in all its un-glory. If you know someone with depression or are just looking to understand more, I hope this helps. For those of you dealing with depression, reach out for help when you need to. Discover ways to increase inside value. Work with a behavioral health specialist. And, please, if you or anyone you know is or may be contemplating harm to themselves or others, get help immediately.

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Hallo, you fantastic beauties. I haven’t written for myself—or for you—in a long while. But here we are! Together again! Now, ahead of National Condom Month, I want to talk about depression. I’ll wait while you investigate whether that’s an actual thing. The condom part, I mean, not depression.

All joking aside, I’ve been wanting to talk about depression again for a while. The problem lies in how to address something so large and weighted with so many layers. I want to talk about depression in terms of self-worth and social implications, but to get there I feel like we need to walk through the various psychosomatic effects of depression, and to get there we need to touch on the relationship between depression, anxiety, and anger …

Well, fuck, let’s give it a try! What say you, Dave? Dave? Dave, why are you cowering in the corner?! Sorry, guys, I think Dave is going to sit this one out. Let’s dive in, shall we? And, don’t worry, darlings, this will be a two-parter.

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The Fanning of the Flame
(or if you’re southern: Adding a Little Lighter Fluid)

If you pop back over to my series on Mood and Anxiety Disorders, you’ll notice that depression and anxiety often go together … But anger? I’ve only recently thought about the relationship between anger and depression, but according to Fredric N. Busch’s article, Anger and Depression, “The oversimplified concept of depression as ‘anger directed inwards’ was a commonly held belief over many years in psychiatry.” Though today anger is more often considered a symptom of depression, there is little denying some type of correlation. Busch goes on to discuss defense mechanisms as applied to the anger-depression relationship. These mechanisms include denial, projection, passive aggression, reaction formation, and identification. Since denial, projection, and (everyone’s favorite) passive aggression are pretty familiar terms, I want to cover the other two in more detail:

• Reaction formation (as presented by Busch citing Freud): The individual denies their anger and instead increases their efforts to help others. Since the underlying issues causing anger aren’t addressed, feelings of rage intensify and can become directed inward, exacerbating depression.
• Identification: The individual links their self-image with someone who is aggressive and has made that person or others feel disempowered, frequently triggering guilty feelings which can exacerbate depression. This mechanism can help the individual with assertiveness, coping with anger, and creating boundaries but also has a lot to do with the idea of perceived power and can lead to abusive and controlling behavior.

While these psychoanalytic mechanisms are dated, more recent studies have also shown a correlation between depression and anger, whether that anger is outwardly expressed or not. According to Depression is More Than Just Sadness: A Case of Excessive Anger and Its Management in Depression: “Previous studies have revealed that patients with anger attacks are significantly more depressed, anxious, and have ideas of hopelessness compared to patients without anger attacks, and they were more likely to meet criteria for [histrionic, narcissistic, borderline, and antisocial] personality disorders in comparison to depressed patients without anger attacks.” The relationship between depression and anger causes a sort of feedback loop wherein anger can lead to depression and depression to anger. And, ultimately—obviously—the Dark Side.

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Depression: It’s a Pain in the Ass

Fun fact: not only can depression itself be debilitating, it can also lead to major chronic health issues and be a hindrance to rehabilitation and healing. Okay, okay, so it was a not-so-fun fact. According to Depression and Other Common Mental Disorders: Global Health Estimates released by the World Health Organization (WHO) in 2017: “The consequences of [depression and anxiety] disorders in terms of lost health are huge. Depression is ranked by WHO as the single largest contributor to global disability (7.5% of all years lived with disability in 2015); anxiety disorders are ranked 6th (3.4%). Depression is also the major contributor to suicide deaths, which number close to 800,000 per year.” Spoiler alert, the situation hasn’t gotten any better.

Depression can play a role in immune, cardiovascular, and gastrointestinal health—among others. According to Depression as a Risk Factor of Organic Diseases: An International Integrative Review, “Depression often predisposes individuals to physical illness and disease.” The review assesses findings from 23 studies that consider depression in relation to various physical illnesses, including cardiovascular disease, metabolic syndrome, diabetes, Alzheimer’s, anxiety, and asthma. While the review “offers evidence that depression can be a risk factor for physical illness and disease,” even more intriguing is the study of depression-related pain.

Some studies on depression and somatic pain have shown a correlation between the two, although causation proves difficult to identify. In some cases, individuals suffering from depression may experience such issues as low back pain, jaw pain, and acid reflux. While causation is unclear (it’s kind of a “chicken or egg” situation), the Depression as a Risk Factor review states that there is “a strong association […] shown between severe depression and somatization, and the somatic effects of depression were unrelated to organic disease (Aguilar‐Navarro & Avila‐Funes, 2007; Drayer et al. 2005).” If I’m citing something citing something, is that reverse inception? Anyway, the review goes on to say that “depression and pain are independent processes that share a common mechanism that can lead to the onset of each other.” Furthermore, individuals suffering from depression tend to experience a decrease in pain tolerance and increase in origin-less pains.

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Next Week’s Titillating Adventure

Now that we’ve covered the relationship between anger and depression and the psychosomatic effects caused by the unholy trinity (just assume anxiety is a habitual lurker), we can dive into the self-worth and social implication side next week.