Ask a Therapist: How Can I Deal With My Depression After the Pandemic?

Six Ways to Manage Coronavirus Depression

Ask a Therapist: How Can I Deal With My Depression After the Pandemic?

Depression is increasing in the United States, in no small part due to COVID-19. According to recent reports, depressive symptoms are at least three times higher than they were before the pandemic hit, suggesting that the emotional cost of living through this time is enormous.

For those who are vulnerable to depression already, this time is even more fraught.

Al (whose name has been changed for privacy) suffered bouts of depression on and off for years, but had made the decision to go off of his medications near the end of 2019. Then COVID hit, and it was hard to keep his mood from plummeting.

“I have more depressive symptoms than I did a year ago—more negative feelings about my relationship, about friends, in general,” he says. “If your imagination runs to the negative, this apocalyptic scenario just confirms your negative bias about how things are and how things turn out.”

Similarly, Michelle was already going through relationship struggles and worrying about her child’s mental health before COVID hit. All of the changes the pandemic wrought exacerbated these stressors, making her feel depressed.

“Whatever else felt stable in my life got knocked out from under me, and there was nothing left that I felt I could count on,” she says. “My social life disappeared or changed beyond recognition, and I didn’t know what the future of my job was, either. I felt completely rudderless.”

To some extent, all of us may be at risk for depression during the pandemic, says Nancy Liu, clinical professor at the University of California, Berkeley.

“You’re going to feel down. You’re going to feel a little hopeless or helpless,” she says. “You’re not going to be as eager to connect with people and are going to withdraw.” We should expect to feel anxious and depressed, as we would in any kind of disaster.

While we are all prone to feeling down these days, depression differs from normal sorrow or anxiety and is far more debilitating, says psychologist Shelby Harris, author of the book The Women’s Guide to Overcoming Insomnia.

It persists, unrelenting, for weeks at a time and leads to an inability to function normally.

Problems with sleep, significant weight loss or gain, not being able to get bed, lacking motivation or a sense self-worth, and finding no enjoyment from everyday activities—these are signs that you may be entering a depressive state.

“If you find you have trouble focusing, concentrating, or doing what you need to do in life because of these issues, consider having it assessed further,” she says.

Depression can also be life-threatening, when it becomes a precursor to suicide. Given the high price of depression, it’s important to understand what causes it, how to identify it, and the steps we can take to counter it. Here are some of the things we can do until the pandemic ends to look out for one another and stay healthier.

1. Get professional help

When Michelle started feeling deeply depressed, she knew she should be concerned, having experienced suicidal thoughts in the past. After her partner expressed concern, she called a therapist.

“That was step one,” she says. “I needed that outlet, to be able to talk to someone who I didn’t have to worry about burdening with my depressive thoughts.”

Liu encourages people to turn to therapy if depressed, because it can be very effective for overcoming mood disorders. But she bemoans the fact that many community clinics are overwhelmed right now, and some people lack the means to reach help.

“There’s just a huge need, but not everybody has access to secure Wi-Fi and Zoom to get remote treatment,” she says. “I worry that only a certain subset of the population is getting the services they need.”

If you don’t have ready access to a therapist, you may want to contact your health care provider, if you have one. See what they have to offer and if you’re eligible for services.

Or you can simply ask friends or family if they can recommend any therapists.

In many areas, there are sites that specialize in helping people find local therapists, or you can turn to the Psychologist Locator, a site operated by the American Psychological Association.

2. Add small, good things to your life

While professional treatment is ideal, what can people do when they see their mood sinking?

Harris says that it’s important to start adding small things to your life that you enjoy, to fight off feelings of helplessness that often come with depression.

“Plan small activities daily that allow for a moderate amount of pleasure and accomplishment (e.g., reading, cleaning out your office, painting a picture, styling your hair),” she says. “Activity scheduling is very effective at the outset with depression.”

Michelle working from home with the help of her new kitten.

Of course, it’s not always easy to do that now that many of our usual pleasurable activities have been curtailed during the pandemic. Still, it’s possible to adjust our expectations and try new things.

Michelle tried several ways to help snap her her funk. One of the most impactful for her was adopting a kitten, whom she came to love.

“That kitten saved my life, because when nothing else was interesting or could grab my attention, the kitten was the one thing in my life that made me happy,” she says.

Michelle also found it helpful to pursue creative self-expression by trying to do short writing exercises prompts she found in a book—such as, “What is a time in your life when you said no?” or “What do you think you’re destined to do in this life?”

“This was something I could do that gets me doing some kind of creativity, but isn’t a big commitment; and I didn’t have to think it up myself,” she says. Plus, it brought her a little joy, which helped alleviate her difficult moods.

3. Find ways to exercise your body

One of the best treatments for depression is getting physical exercise, while not getting exercise can induce depressive symptoms. Especially during this difficult time, it’s important to take care of your body.

Al is aware of how his physical health affects his mood; so, he’s made sure to maintain routines of self-care, getting enough sleep, eating well, and getting outside when possible—all of which have been tied to preventing depression. Though adjustments to his exercise routines were needed because of the pandemic, some of those changes were positive, he found.

“It may be less fun, but it’s more flexible at the same time,” he says. “You don’t have to coordinate with other people or take other people’s schedules into account.”

When the pandemic ended Michelle’s in-person yoga class, she tried the Zoom version of the class, but found it wanting. So, she made it a point to find other exercise outlets— taking walks and bicycling—which made her feel better.

“I don’t do big bicycle trips yet. But even if I just pedal across the street and around the neighborhood, I’ve at least gotten out there,” she says. “It definitely helps.”

4. Foster a sense of agency

For Al, it was important to make progress on personal goals, improving his piano playing or his golf game. While it was sometimes difficult to find the motivation and energy when depressed, he found ways to trick himself into getting started, which not only helped him get closer to his goals, but improved his mood.

“Just taking small steps, consciously having low expectations, and telling myself, ‘Don’t make a big deal it,’ helped me to go through the motions—to get to the range or to the piano,” he says. “Sometimes it’s less about the actual thing you’re doing than the fact that you are trying something—that you are taking control and taking action of some kind—that helps.”

Having a sense of agency—the sense that you have some control over what happens to you—is important for staving off depression, says Liu.

But that can be hard now, when so many people are working from home and finding blurred boundaries between their job hours, home life, and time for self-care.

She suggests it’s a good idea to create structure in your day, to make sure you schedule things that are important for your wellbeing.

“You should be making time to read that book, cook, ride your bike, or go for a walk—all the little things that make you happy,” she says.

5. Try meditation and self-compassion

Sometimes, though, negative thoughts get in the way. Maybe you feel you don’t deserve to do nice things for yourself or you aren’t good enough to reach your goals. For that, Liu suggests practicing self-compassion. After all, she says, we are going through a global pandemic and are not going to be the best, most productive versions of ourselves…and that’s OK.

“Getting a little bit of extra help or doing some things to be kind to yourself and take care of yourself is important right now,” she says.

It can also be extremely useful for people to consider doing a daily meditation practice, to ward off negative thoughts, says Harris.

“Start small, even a minute or two, and do it during times when you’re not necessarily highly stressed or anxious,” she says. “The more you practice, the more you’ll be able to notice your thoughts and be able to let them go, getting more distance from them.”

Meditation can also soothe difficult emotions, helping us focus less on ourselves and be more available for others—another depression reliever, says Liu.

“Giving to others is an antidote to the sense of helplessness that we’re all experiencing right now, and it gives us a larger sense of connectedness,” she says. “It’s definitely something that helps us even as it helps others.”

6. Reach out to other people

Both Harris and Liu emphasize the importance of connecting with others for preventing depression. Liu encourages people who are depressed to make an effort to call old friends or family members, take company on your walks (if you can take walks), or engage in other ways with people you care about.

“Social support goes such a long way, even in the face of natural disasters, because experiencing something together creates connection and understanding,” she says.

Michelle definitely feels interacting with other people helps her. But she worries about asking people who are already overwhelmed to spend time with her—and then finding herself turned down or ignored.

“It’s a little disheartening to feel I reach out a lot and don’t always hear back from people,” she says.

Al also questions socializing as a good strategy for himself.

“I have trouble reaching out,” he says. “I often think, accurately or inaccurately, that it’s asking for trouble.”

This is where Liu thinks friends, families, and communities could step up more to help.

Checking in with those who may be isolated or depressed can be hard, especially if they are a bit crankier than normal or even actively block your efforts.

Still, it’s good to let people know you are thinking of them and to be willing to listen with empathy if they open up, she says. And, she adds, you don’t have to be pushy.

“Making the space to be a listening, gentle presence and validating someone’s experience—that can go a long way,” she says. “Even leaving unimposing messages of support and understanding makes people feel less alone and that someone cares about them, which is a protective factor.”

While there is no guarantee that we can stop someone from sinking into depression, or that they can stop themselves, it’s important to try. After all, when someone is depressed, it affects everyone.

“Depression doesn’t just impact the person with depression. It frequently has a domino effect that then touches family, friends, employers, etc., in varying ways,” says Harris. “By recognizing it in others, we can be better equipped to help them at a time when they might be suffering in silence and just going through the motions.”

That’s why it’s good to be alert to signs of depression in ourselves and in others. Not only are there things that depressed people can do to help themselves, we all can make a difference if we show up for each other and express care.

“On the rare occasions that I ask someone, ‘Hey, can we have a chat? Can we have tea? Can we go for a walk?,’ it would be nice to have people commit to that and make it happen,” says Michelle. “If I were to ask anything of my family or community, I would ask for that.”

Hopefully, we will all take note.

Источник: https://greatergood.berkeley.edu/article/item/six_ways_to_beat_coronavirus_depression

Depression and Older Adults

Ask a Therapist: How Can I Deal With My Depression After the Pandemic?

Feeling down every once in a while is a normal part of life, but if these feelings last a few weeks or months, you may have depression. Read this article to find common signs and symptoms of depression, treatment options, and if you or your loved one may be at risk for depression.

Depression is a serious mood disorder. It can affect the way you feel, act, and think. Depression is a common problem among older adults, but clinical depression is not a normal part of aging.

In fact, studies show that most older adults feel satisfied with their lives, despite having more illnesses or physical problems than younger people.

However, if you’ve experienced depression as a younger person, you may be more ly to have depression as an older adult.

Depression is serious, and treatments are available to help. For most people, depression gets better with treatment. Counseling, medicine, or other forms of treatment can help. You do not need to suffer — help and treatment options are available. Talk with your doctor if you think you might have depression.

There are several types of depression that older adults may experience:

  • Major Depressive Disorder – includes symptoms lasting at least two weeks that interfere with a person’s ability to perform daily tasks
  • Persistent Depressive Disorder (Dysthymia) – a depressed mood that lasts more than two years, but the person may still be able to perform daily tasks, un someone with Major Depressive Disorder
  • Substance/Medication-Induced Depressive Disorder – depression related to the use of substances, alcohol or pain medication
  • Depressive Disorder Due to A Medical Condition – depression related to a separate illness, heart disease or multiple sclerosis.

Other forms of depression include psychotic depression, postmenopausal depression, and seasonal affective disorder. Find detailed descriptions of different types of depression from the National Institute of Mental Health.

If you are thinking about harming yourself, tell someone who can help immediately.

  • Do not isolate yourself.
  • Call a trusted family member or friend.
  • Call 911 or go to a hospital emergency room to get immediate help.
  • Make an appointment with your doctor.

Call the toll-free, 24-hour National Suicide Prevention Lifeline: 800-273-TALK(800-273-8255) or 800-799-4TTY (800-799-4889).

What are risk factors of depression?

There are many things that may be risk factors of depression. For some people, changes in the brain can affect mood and result in depression.

Others may experience depression after a major life event, a medical diagnosis or a loved one’s death.

Sometimes, those under a lot of stress — especially people who care for loved ones with a serious illness or disability — can feel depressed. Others may become depressed for no clear reason.

Research has shown that these factors are related to the risk of depression, but do not necessarily cause depression:

Everyone needs social connections to survive and thrive. But as people age, they often find themselves spending more time alone. Studies show that loneliness and social isolation are associated with higher rates of depression.

The COVID-19 pandemic has brought new attention to this issue; however, many Americans felt socially isolated and lonely before the pandemic. If you’re feeling socially isolated or lonely, and you cannot see your friends and family in person for any reason, try reaching out over the phone or joining a virtual club. Find tips to help you stay more connected.

What are signs and symptoms of depression?

How do you know if you or your loved one may have depression? Does depression look different as you age? Depression in older adults may be difficult to recognize because older people may have different symptoms than younger people. For some older adults with depression, sadness is not their main symptom. They could instead be feeling more of a numbness or a lack of interest in activities. They may not be as willing to talk about their feelings.

The following is a list of common symptoms. Still, because people experience depression differently, there may be symptoms that are not on this list.

  • Persistent sad, anxious, or «empty» mood
  • Feelings of hopelessness, guilt, worthlessness, or helplessness
  • Irritability, restlessness, or having trouble sitting still
  • Loss of interest in once pleasurable activities, including sex
  • Decreased energy or fatigue
  • Moving or talking more slowly
  • Difficulty concentrating, remembering, or making decisions
  • Difficulty sleeping, waking up too early in the morning, or oversleeping
  • Eating more or less than usual, usually with unplanned weight gain or loss
  • Thoughts of death or suicide, or suicide attempts

If you have several of these signs and symptoms and they last for more than two weeks, talk with your doctor. These could be signs of depression or another health condition. Don’t ignore the warning signs. If left untreated, serious depression may lead to death by suicide.

If you are a health care provider of an older person, ask how they are feeling during their visits. Research has shown that intervening during primary care visits is highly effective in reducing suicide later in life.

If you are a family member or friend, watch for clues. Listen carefully if someone of any age says they feel depressed, sad, or empty for long periods of time. That person may really be asking for help.

Knowing the warning signs for suicide and how to get help. It can help save lives.

Signs and symptoms of depression can look different depending on the person and their cultural background. People from different cultures may express emotions, moods, and mood disorders — including depression — in different ways. In some cultures, depression may be displayed as physical symptoms, such as aches or pains, headaches, cramps, or digestive problems.

Supporting friends and family with depression

Depression is a medical condition that requires treatment from a doctor. While family and friends can help by offering support in finding treatment, they cannot treat a person’s depression.

As a friend or family member of a person with depression, here are a few things you can do:

  • Encourage the person to seek medical treatment and stick with the treatment plan the doctor prescribes.
  • Help set up medical appointments or accompany the person to the doctor’s office or a support group.
  • Participate in activities the person s to do.
  • Ask if the person wants to go for a walk or a bike ride. Physical activity can be great for boosting mood.

It’s important to watch for signs and symptoms of depression or suicide. Don’t shy away from asking if a family member or friend is feeling depressed or suicidal.

It may be an uncomfortable conversation, but it is important. Asking if someone is having thoughts of suicide will not make them more ly to act on those thoughts.

Your questions may help the person open up about how they’ve been feeling and encourage them to seek treatment.

How is depression treated?

Depression, even severe depression, can be treated. It’s important to seek treatment as soon as you begin noticing signs. If you think you may have depression, start by making an appointment to see your doctor or health care provider.

Certain medications or medical conditions can sometimes cause the same symptoms as depression. A doctor can rule out these possibilities through a physical exam, learning about your health and personal history, and lab tests.

If a doctor finds there is no medical condition that is causing the depression, he or she may suggest a psychological evaluation and refer you to a mental health professional such as a psychologist to perform this test.

This evaluation will help determine a diagnosis and a treatment plan.

Common forms of treatment for depression include:

  • Psychotherapy, counseling, or “talk therapy” that can help a person identify and change troubling emotions, thoughts, and behavior. It may be done with a psychologist, licensed clinical social worker (LCSW), psychiatrist, or other licensed mental health care professional. Examples of approaches specific to the treatment of depression include cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT).
  • Medications for depression that may balance hormones that affect mood, such as serotonin. There are many different types of commonly used antidepressant medications. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants commonly prescribed to older adults. A psychiatrist, mental health nurse practitioner, or primary care physician can prescribe and help monitor medications and potential side effects.
  • Electroconvulsive Therapy (ECT), during which electrodes are placed on a person’s head to enable a safe, mild electric current to pass through the brain. This type of therapy is usually considered only if a person’s illness has not improved with other treatments.

As you get older, body changes can affect the way medicines are absorbed and used. Because of these changes, there can be a larger risk of drug interactions among older adults. Share information about all medications and supplements you’re taking with your doctor or pharmacist.

Use this worksheet to help track your medications.

Treatment, particularly a combination of psychotherapy and medications, has been shown to be effective for older adults. However, not all medications or therapies will be right for everyone.

Treatment choices differ for each person, and sometimes multiple treatments must be tried in order to find one that works.

It is important to tell your doctor if your current treatment plan isn’t working and to keep trying to find something that does.

Some people may try complementary health approaches, yoga, to improve well-being and cope with stress.

However, there is little evidence to suggest that these approaches, on their own, can successfully treat depression.

While they can be used in combination with other treatments prescribed by a person’s doctor, they should not replace medical treatment. Talk with your doctor about what treatment(s) might be good to try.

Don’t avoid getting help because you don’t know how much treatment will cost. Treatment for depression is usually covered by private insurance and Medicare. Also, some community mental health centers may offer treatment a person’s ability to pay.

Depression is common in people with Alzheimer’s and related dementias. Dementia can cause some of the same symptoms as depression, and depression can be an early warning sign of possible dementia.

Suicide attempts may also increase in people recently diagnosed with dementia. It is important to have support systems in place to help cope with a dementia diagnosis and possible depression symptoms that follow.

More research is needed to determine effective depression treatment options for people with dementia.

Can depression be prevented?

Many people wonder if depression can be prevented and how they may be able to lower their risk of depression. Although most cases of depression cannot be prevented, healthy lifestyle changes can have long-term benefits to your mental health.

Here are a few steps you can take:

Participation in clinical trials and studies can help advance research to better diagnose, treat, and prevent depression. Talk with your doctor if you’re interested in participating in a clinical trial or study about depression. Find clinical trials on depression here.

For more information about depression

Administration for Community Living (ACL)202-401-4634

https://www.acl.gov

Источник: https://www.nia.nih.gov/health/depression-and-older-adults

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