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Depression A Body-Mind Condition
According to a World Health Organisation (WHO) report, Depression is a common illness which affects about 120 million people worldwide, and is growing in numbers. In Australia, according to some surveys, if one includes people who have Depression but remain undiagnosed, then the statistic may be 1 in 5 people are suffering some form of this condition. Depression affects twice as many women as does men according to the United States National Institute of Mental Health (NIMH) website. This statistic persists despite ethnic, racial or economic differences between women. The Blackdog Institute for Depression, currently notes over 1 million Australians have some form of Depression, while 2 million Australians have some form of Anxiety disorder.
Depression is sometimes clinically divided into two main types. The first type is known as clinical or Endogenous Depression, has an enduring effect and presence in the sufferer. The second type is called Reactive or Episodic Depression which is typically triggered by a major life stressor event. According to the psychiatric Diagnostic and Statistical Manual of Mental Disorders (Version IV) (DSMIV), Depression is also labelled as Dysthymia, and is characterised as being where an adult person typically experiences a depressed mood or feeling that is present in and affects the life of an individual for most days, for at least 2 years.
The Black Dog Institute website notes that Depression Can be also categorised into 4 key types. The Energetics Institute defines four broadly different types of depression, each with their own features and causes:
- Melancholic depression
- Non-melancholic depression
- Psychotic Depression
- Atypical Depression
This institute also recognises that Depression has a causal relationship with stress. Indeed a major life stressor is often recognised as having been the trigger to a subsequent onset of bouts of Depression in many of those affected.
According to body-mind researcher and M.D, Alexander Lowen, Depression manifests its key symptoms in both the body and the mind. In the mind of the sufferer the reported symptoms commonly include feeling helpless in their life, feeling fatigued to the point of being immobilised, feeling tired despite sleeping longer and longer, having a busy mind that tends to ruminate or constantly think of some past issue that remains unresolved, of being distracted, being emotional, being aggressive followed by tearful, being withdrawn from life and others into a complete “blackness”, to name a few.
In the body there is a felt sense of heaviness and lethargy, of clumsiness, of tiredness that sleep does not resolve, of tension in muscles, sleep disorders where the body will not let one sleep, and which may lead to a form of hyperactivity followed by a collapse into the tiredness again.
A recent discovery by scientist Dr Ludger Tebartz Van Elst at the University of Freiburg illustrates this bodymind connection. His research found that Depression has an effect on the eyes that makes it harder to detect the black and white contrasts, similar to turning down the contrast control on a TV. The result is that sufferers report their world appears greyer, and indeed one of the classic symptoms reported by sufferers of Depression, across the ages and across cultures, is the depiction of a felt sense of darkness, black or a grey uniformity. The retina in the eye was found to be unable to correctly convert light signals into nerve messages in the area of contrasting colours, and so a blander effect is produced. In turn this affects mood and the perception of the sufferer’s subjective experience of their world, and this then can negatively affect their cognitive processes. The key issue here is Depression is a body-mind issue that needs to be treated with both a cognitive (mind) and a somatic (body) approach.
There is also a proven relationship between our Bodymind and its interaction with our environment in the formation of Depression. The old saying that grey skies mean grey minds is not far from the truth for some people. A lack of sunlight, compounded by cold weather, grey skies, and reduced movement of the body as a result, can trigger behavioural, psychological, and biological changes that play on our moods. This is commonly called Seasonal Adjustment Disorder (SAD) that in some northern hemisphere countries such as Russia and Ireland is taken seriously in their winter lifestyles. Whilst SAD is not Depression, the ongoing low energy and mood can create the onset for Depression. In Australia only about 1 in 300 are believed to suffer a form of SAD which can also manifest in an increased desire to sleep, cravings for carbohydrates and fatty foods, a decrease in exercise and social activity, and weight gain.
Our brain has a Pineal gland which is light sensitive, and uses light cues from the eyes to regulate our Circadian rhythm, which basically affects such impulses such as sleeping and waking, and many hormonal release triggers we need for optimal health. This is why it is recommended that we all get between 30 minutes to an hour of winter sunlight, and to ensure our day time artificial lighting at home or the workplace is bright. SAD is partly explained by the fact that the deficiency in light causes the brain to increase its production of Neurotransmitter called Melatonin which induces sleep, whilst lowering the other feel-good Neurotransmitter known as Serotonin, which is often low in Depression sufferers.
Regardless of the cause, many people hide their Depression due to a felt sense that they will be judged as a result of being. This shame often then binds them into a deeper sense of helplessness and depression. The key point is Depression is not something to be ashamed of, or guilty about. Depression is now well recognized in our society, it is spoken openly about, and no longer is it seen as a character flaw or a sign of a weak personality. Generational change has meant that the attitude of it is something that one can just “snap out of” has been seen to be inappropriate and damaging. Your GP, your workplace, friends and family are now more than ever more conscious of this increasingly common problem.
According to trauma researchers such as Pat Ogden, Depression affects the state of the Autonomic Nervous System (ANS), and leads to the sufferer living from a “fight or flight” state of body-mind, which we called Sympathetic Nervous System. In this state the body and mind symptoms noted before, all become manifest due to the brain forcing us to be in a primitive “survival” mode that is anxious, hypervigilant, and ideally should not be sustained over any long period of time according to our body’s current state of evolutionary design.
The “fight or flight” state is designed to be resolved quickly, and not indefinitely sustained. This is the problem though for many people is they get into this state of being but their environment or their perception of their safety in their environment, keeps them unresolved and in a “fight or flight” mode, and so they start to firstly manifest anxiety, and then for some they drop into depression. The proof of this is that medically it is recognised that every person who is depressed has underlying anxiety, but not everyone who is anxious will go on to have depression. Alexander Lowen notes that anxiety is a foundation state for the onset of depression as it represents the key body-mind condition that is felt when one is in “fight or flight”.
Once a person is in a sustained “fight or flight” state, the brain via its Amygdala, starts to affect the Hypothalamus/Pituitary Gland/ Adrenal gland (HPA Axis). This key set of glands and brain functions to release key mood hormones, proteins and chemicals into the body, that then create the basis for the body-mind symptoms described previously.
Two key substances here are Dopamine and Serotonin, both of which medical studies have shown to be very low in sufferers of Depression. The “fight or flight” state of being causes the HPA axis to suppress production of these two key substances, plus other endorphin and positive mood affect substances. Currently society predominately treats Depression via counselling or Cognitive Behavioural Therapy (CBT), in combination with the prescription of a range of Depression, mood suppressant or mood affect drugs.
The key SSRI type of depression drugs show this approach. SSRI stands for Selective Serotonin Re-uptake inhibitor. Simply put this means the person taking this medication is not producing enough Serotonin, and so one way to compensate for this is to stop the body’s natural absorption of the Serotonin from the bloodstream (the re-uptake process). This approach only addresses the symptoms of the problem and does not address the “fight or flight” state of the person that creates this problem in the first place. Trauma researchers such as Pat Ogden note that CBT is also a “front brain” rational form of therapy which while helping with the mental distortions of Depression sufferers does not get into the Limbic or “emotional brain” of sufferers from where the ANS gets its impulses to switch in and out of “fight or flight” state of being. This common mainstream medical approach to Depression restricts a person for enduring periods, or perhaps for life to taking depression medication and doing counselling or therapy, without often addressing the key underlying body-mind system that sets up the condition in the first place!!
Trauma researchers and Neuroscience studies by Dispenza and others show that as Anxiety and Depression sufferers stay in “fight or flight” mode for longer and longer, the HPA Axis starts to breakdown and exhibit duress and then illness. The HPA Axis in our body designed us to live in “fight or flight” mode for short periods of time, or in “burst” mode, and not as a way of living. The HPA Axis glands produce key hormones such as Adrenaline and Cortisol in burst mode as required but when they are required to keep producing these hormones on a long term continuous basis it results in these glands suffering a form of burnout. The medical conditions of Adrenal Exhaustion or Burnout, Under or Over-active Thyroid, Pituitary Gland Fatigue, and some forms of migraine headaches are examples of this demand on the HPA Axis.
Conversely, while in “fight or flight” mode, the HPA Axis also suppresses some key hormones that we rely on for good body-mind health in this same way under these same conditions. The key mood chemicals such as Serotonin and Dopamine, plus some key feel-good endorphin chemicals are all suppressed when a person is in the “fight or flight” Sympathetic Nervous System mode. Long term suppression of each of these chemicals in the body has a causal link to Depression, as seen in the use of SSRI drugs in attempting to overcome Depression.
The resulting downside of living in “fight or flight” mode then is the impacted body then negatively affects our moods, emotions, concentration, cognition or thinking processes, which all form part of what a person needs to be operating well in their life. The body and mind work together, not apart, and both show the effects of living from the “fight or flight” mode Sympathetic Nervous system state for too long. Research now indicates that untreated Depression can be a trigger for other bodily ailments. Research has now shown that Depression can double the risk of the sufferer developing Alzheimer’s disease. US researchers tracked almost 1000 people over 17 years of age, and found that nearly 50 per cent more of those suffering from Depression went on to suffer some form of dementia than those without Depression. It is well known that Depression is common in early stages of dementia.
The Energetics Institute has designed Depression resolution programmes in both its personal Psychotherapy as well as its organisational Corporate Energetics faculties. These have been adapted from the various body-mind traditions of Somatic Therapy, Yoga, Mindfulness, Meditation, CBT, Human Biology, Neuroscience, and the Bioenergetic understanding of the body and mind. The clinical effect has been to create a tailored range of exercises which address and intervene into the body-mind, resulting in the creation of the relaxed and beneficial Parasympathetic Autonomic Nervous system state, as well as taking a person from “out of their head”, and into a truly embodied state, where the person is present and primarily free from distracting thoughts and anxieties.
We treat people who are already medicated and those who are not under medication. We work with the natural processes of the body-mind to create and sustain over time a Parasympathetic ANS in a Depression sufferer, as well as using Analytical and Behavioural Body-Mind Psychotherapy to deal with distorted perceptions, realities, traumas and events which are often the triggers and underlying basis for depressive disorders.
Using our capability to firstly ground a person in present time, then work with both the body-mind, the emotional state, the energetic state, and the suppressed material under the various possible layers of a sufferer’s collapse, Anxiety, and other depressive energetic masks, healing is both possible and lasting under this approach. Many Depressive sufferers have unresolved parental issues like parental withholding of love, parental ambivalence, chaotic or addict parental behaviours, that may have existed since childhood, and which may have been reactivated in adulthood by dynamics similar to that original childhood traumatic dynamic. Trauma can also lead to a Depression outcome in the long term.
The Energetics Institute also sees Depression from a positive psychology and a spiritual perspective. Our observation from seeing clients is that for many Depression sufferers, theirs is a result of unsustainable lifestyles and practices in their lives, which have isolated sufferers from others, life, and their inner self. We believe that it is only when we reach “rock bottom” or face what we call in spirituality a “Dark Night of the Soul”, that most of us are prepared to truly change our lives. The great myths of all societies express this as the “hero” myth, where the person must go in search of a treasure or “holy grail”, but must first undergo trials, tests, dragons, demons, and tormentors. This is speaking to us of Depression. The true “illness” is of our spirit and how we have neglected, abandoned and debased our true spiritual self. Depression is the resulting sickness of body, mind and spirit. Joseph Campbell, the great authority of myths and their relevance to our human condition, states in his book MYTHS TO LIVE BY, that unless we face ourselves and see Depression as a calling for renewal of the self, we will be lost and defeated.
The Energetics Institute promotes the examination of the Self from a spiritual, reflective place as part and parcel of how we define ourselves as humans. We do not promote or prescribe any one religious dogma, tradition or thought. We simply see that a spiritual dimension in a person’s life provides meaning and a framework to one’s existence, and allows one to deepen oneself within and with the outside world. Depression is both a contraction, a shutting down, a giving up, from a place of hopelessness in this view. Depressed people are angry people, angry at life and their part in it. The anger of depression has been turned inwards against the self, and now tortures the sufferer and leaves them in a victim state. Once addressed from a body-mind perspective, this state lifts and the positivity and curiosity and hope of life starts to emerge again, as renewal takes roots in the person.
- THE BLACK DOG INSTITUTE: www.blackdoginstitute.org.au
- NATIONAL INSTUTE OF MENTAL HEALTH (NIMH): www.nimh.nih.gov/index.shtml
- WORLD HEALTH ORGANISATION: www.who.int
Article and Book References
- Depression And The Body; Lowen Alexander, 1976, Penguin Books.
- The Noontime Demon – An Anatomy of Depression; Solomon Andrew,2002,Random House Publishing Group.
- The Feeling Good Handbook, Burns David, M.D., 1999, Plume Books
- Trauma and the Body – A Sensorimotor Approach to Psychotherapy; Ogden Pat etal,2006, W.W. Norton &Co Publishers.
- Mapping The Brain: Carter Rita;2003,Phoenix Books.
- The Quantum Brain; Satinover Jeffery,2001,John Wiley & Sons
- Evolve Your Brain – The Science of Changing your Mind; Dispenza Joe,2007, HCI Books.
- Diagnostic and Statistical Manual of Mental Disorders (Version IV) (DSMIV), American Psychiatric Association, 2006.
- Myths to Live by, Campbell Joseph, 1990, Harper & Collins.
- Depression Literally Makes World Greyer, Scientists Say, Von Radowitz, Irish Examiner, July 2010.
- Depression Can Double The Risk of Dementia, Hennessy Mark, UK Alzheimer’s Society website.