5 Tools and Tips for Navigating Stress When You’re Depressed

Not surprisingly, stress can have damaging effects on depression. That is, “stress hormones like cortisol can exacerbate the effects of an existing depression. Or if we’re not currently depressed, we can become more vulnerable to a future episode,” said Lee Coleman, Ph.D, a clinical psychologist and assistant director and director of training at the California Institute of Technology’s student counseling center.

Depression also comes with its own stressors. We might become self-critical because we aren’t able to function normally, he said. (And because depression sinks our self-esteem and fuels our inner critic.)

We might wonder what’s wrong with us, why we aren’t as excited about life anymore, and when we’ll stop feeling so bad. As Coleman said, naturally, “all of these are potentially stressful thoughts and feelings.”

But this doesn’t mean that your situation is hopeless. It isn’t. In fact, there are many things you can do. Below, Coleman and other therapists who specialize in depression shared five ways to effectively navigate the stress in your life.

1. Assess every piece of your life.

Psychologist Stephanie Smith, PsyD, suggested examining everything and everyone in your life and asking yourself these questions: “How much do I enjoy this activity or person? How much stress does it bring me? How do I feel after I spend time there or with that person? Does [that activity or person] add to my life?”

In other words, take a step back, and reevaluate your relationships, routines, job and other circumstances. Smith also suggested asking these questions: “Is this really what I want? What’s really the best thing for me right now?”

“[I]t doesn’t necessarily mean that after the evaluation period you will change everything about your life. But it does mean that the things in your life will be more intentional.”

2. Make tiny healthy shifts.

When you’re struggling with depression, it might be tough to make big decisions and take big steps. Instead set small, specific and feasible goals, said Smith, who practices in Erie, Colo.

She shared these examples: Spend 10 minutes outside every day; make an appointment with a psychologist this week; reach out to one friend or relative today; take a walk four days out of seven; and do one thing you enjoy each day.

Taking small steps also provides momentum for making bigger changes in the future, she said. But if you don’t meet your goals, be gentle with yourself. Depending on the severity of your depression, it might be tough to take action (or get out of bed). That’s when working with a psychologist who specializes in treating depression is critical.

3. Redirect your attention.

“Depression and stress thrive on wandering minds, especially on questions that don’t really have an easy answer, like, ‘Why is this happening?’ ‘When will I feel like myself again?’” said Coleman, author of Depression: A Guide for the Newly Diagnosed. Getting caught up in these questions releases stress hormones such as cortisol, and leads to feeling sadder, he said.

One way to redirect your attention is to focus on what you’re doing right now. For instance, give your full attention to mundane tasks and activities, such as walking, picking out produce and even breathing, Coleman said.

Another way is to redirect your attention to your physical sensations, he said. For instance, name what you’re experiencing: “Right now, my chest feels tight. I notice my jaw is tense, and my fists are balled up.”

Again, try not to get caught up in thoughts like “Why does this keep happening to me?” or “I can’t handle it!” he said. These thoughts only feed your stressful reactions. (And remember your depression likes to lie.) “Focusing on the physical aspects of stress keeps you grounded in the moment without adding that unhelpful second layer of negative appraisals.”

Don’t try to change the sensations you’re experiencing. Instead, try to keep a curious, accepting attitude. According to Coleman, this might look like: “OK, stress is here again.  Where am I feeling it in my body this time?”

4. Try mindfulness apps.

Mindfulness (and exercise) “can be extremely helpful in relieving symptoms and creating the endorphins your brain needs to feel better,” said Robin Starkey Harpster, MA, MFT, a psychotherapist in Los Angeles.

In addition to Coleman’s mindfulness suggestions, it can help to listen to guided meditations. Harpster recommended trying these three apps: buddhify; Headspace; and Calm.

5. Make a radical change.

Sometimes, drastic measures are necessary. Recently, author and Psych Central editor Therese Borchard penned this brilliant piece about what to do when your depression isn’t improving. For instance, it’s hard not to feel depressed when you’re working in a toxic environment. So, in this case, the best stress-reducing strategy might be to switch jobs. According to Borchard:

I don’t mean putting a few less to-do items on your list. I’m talking about radical lifestyle changes — like changing jobs in order to work in a less toxic and stressful environment, moving into a smaller home so that you don’t have to moonlight, deciding against adopting a rescue dog or having a third child. It can be practically impossible to keep your mood resilient if you are under chronic stress because it increases the connection between the hippocampus part of your brain and the amygdala (worry central), impairs your memory retention, affects your cortisol production (making it difficult for you to handle more stress), and weakens your immune system.

One of the most powerful tools for shrinking stress is treating yourself with patience and compassion. “You’re dealing with an illness that’s going to take some time to work through. And you can’t rush it by criticizing yourself or setting arbitrary deadlines for meeting certain goals,” Coleman said.

Plus, what you’re able to accomplish really depends on the severity of your depression. Don’t hesitate to seek professional support from a psychologist. And be flexible with yourself and remember that the smallest steps do add up, Coleman said.

This article originally appeared on psychcentral.com and was written by By Margarita Tartakovsky, M.S. 

Massage Therapy for Mental Wellness

Knead Out Stress

We know that massage therapy is of great benefit to sport injuries and muscle soreness. But it is also an effective way to improve your mental health.

Massage therapy is a popular treatment for the relief of sports injuries, strains, and muscle soreness. But its benefits are more than just physical: it is also an effective way to alleviate depression and anxiety—and improve sleep quality.

Although life stresses are unavoidable, we can counter negative feelings and insomnia with the positive benefits that massage therapy offers.

Why massage therapy?

Massage has been practised for centuries. In ancient India massage therapists kneaded patients with herbs and oils to relieve tiredness, increase energy, and improve overall health. In fifth-century Greece Hippocrates was quoted as saying, “The physician must be experienced in many things, but assuredly in rubbing.” And it’s no secret why massage is still popular today—it feels wonderful.

For overall mental wellness

According to Heidi Ezzat, a registered massage therapist (RMT) practising in Pitt Meadows, BC, “Massage therapy is an excellent tool in treating anxiety, depression, and insomnia because it helps your body to relax, which in turn helps you to de-stress.”

She explains that massage therapy is effective in treating these disorders because “the state of calm [achieved] allows one to have a better chance of using coping skills that have been acquired in other therapies such as counselling.”

Depression
According to Health Canada, 11 percent of men and 16 percent of women will experience severe depression over the course of their lives. Studies show, however, that massage therapy can be an effective tool for dealing with depression.

In a study published in Support Care Cancer (2010), breast cancer patients who received two 30-minute massages weekly for five weeks reported significant reductions in depression and anxious depression compared to those who received no massage therapy.

In addition, a meta-analysis of 17 studies conducted by Taiwanese researchers found massage therapy was strongly associated with relieving depressive symptoms.

Anxiety
Health Canada reports that of all mental disorders, anxiety conditions top the list. They estimate that 10 percent of Canadians suffer anxiety in some form. But anxiety can be reduced by the positive effects of massage.

Turkish researchers measured burn patients’ anxiety levels before and after massage therapy sessions. Over the course of a five-week period participants showed a significant reduction of symptoms, including itching, pain, and anxiety from the first treatment to the last.

Poor quality sleep
Statistics Canada reports that 3.3 million Canadians (13.4 percent of Canadians over the age of 15) suffer from insomnia. Fortunately, massage has also been shown to improve sleep quality.

Researchers reported the positive effects therapeutic massage had on breast cancer patients’ sleep quality (Journal of Alternative and Complementary Medicine, 2009). Participants reported better sleep quality post-massage in addition to reduced anxiety and chemotherapy side effects, and increased quality of life.

Mental wellness versus muscle soreness

Massage therapy can effectively treat a variety of conditions and disorders; however, the therapist will tailor your treatment course of action based on your particular symptoms and concerns.

According to Ezzat, most massage therapy appointments begin the same way: the client fills out a case history form and an assessment is conducted by the therapist. Based on the information collected, the therapist and patient work out a plan to address the patient’s treatment goals.

However, when treating a patient with a mental health issue, Ezzat says “the environment in the treatment room is especially important, such as temperature, music, and lighting.” She also encourages patients to be still and quiet for part of the treatment so that patients can “tune in to their bodies, breathe deeply, and begin to let go and relax.”

Treatment team

Although massage therapy has been shown to help effectively treat depression and other mental health issues, Ezzat suggests that those with severe problems “should be managed and treated primarily [in conjunction with] the patient’s family doctor and/or naturopathic doctor’s recommendations.”

She explains that there are many tools that a patient suffering from a mental health problem can make use of, and massage therapy is one of those tools. However, sometimes several tools are needed. Ezzat says, “I treat many patients who report benefits from receiving counselling and massage therapy at the same time.”

How often should you go?

The frequency depends on the patient’s specific treatment goals. However, Ezzat recommends, “When someone is starting massage therapy, it is best if they come for several sessions, and according to their condition and schedules that could be once a week or twice a week.”

She reports that most people experience improvements within the first three massage therapy sessions, but long-standing, chronic conditions may take longer. Once patients feel a significant improvement, Ezzat recommends they continue treatment once a month, or more frequently, if they desire.”

Finding a massage therapist

Although RMTs receive similar training across the country, therapists have their own styles and preferred areas of practice. Below are some tips to help you find the right massage therapist for you.

Word of mouth
Speak with someone who’s had appointments with a specific therapist to find out how difficult it is to get in, what approach they favour (light pressure versus deep tissue massage), and much more.

Massage therapy associations
Most provinces have their own massage therapy associations, which can often be found online. Check the websites for RMT listings in your province.

Try a few out
The first therapist you go to may not be the right fit—that’s okay. You may have to try out a few before you find someone who suits your needs. Alternatively, you may prefer to make appointments according to who is available.

This article originally appeared on alive.com and was written by Amy Wood

What is Stress? How Does It Affect Us?

Have you ever found yourself in a situation where your to-do list seems endless, deadlines are fast approaching and you find yourself saying ‘Eek! I feel stressed!’? But what is stress really, and how does it affect us?

Firstly, let’s debunk one myth: stress is not necessarily a ‘bad’ thing. Without this brilliant ability to feel stress, humankind wouldn’t have survived. Our cavemen ancestors, for example, used the onset of stress to alert them to a potential danger, such as a sabre-toothed tiger.

Stress is primarily a physical response. When stressed, the body thinks it is under attack and switches to ‘fight or flight’ mode, releasing a complex mix of hormones and chemicals such as adrenaline, cortisol and norepinephrine to prepare the body for physical action. This causes a number of reactions, from blood being diverted to muscles to shutting down unnecessary bodily functions such as digestion.

Through the release of hormones such as adrenaline, cortisol and norepinephrine, the caveman gained a rush of energy, which prepared him to either fight the tiger or run away. That heart pounding, fast breathing sensation is the adrenaline; as well as a boost of energy, it enables us to focus our attention so we can quickly respond to the situation.

In the modern world, the ‘fight or flight’ mode can still help us survive dangerous situations, such as reacting swiftly to a person running in front of our car by slamming on the brakes.

The challenge is when our body goes into a state of stress in inappropriate situations. When blood flow is going only to the most important muscles needed to fight or flee, brain function is minimised. This can lead to an inability to ‘think straight’; a state that is a great hindrance in both our work and home lives. If we are kept in a state of stress for long periods, it can be detrimental to our health.  The results of having elevated cortisol levels can be an increase in sugar and blood pressure levels, and a decrease in libido.

Fight

When your body goes into a state of stress, we may feel agitated and aggressive towards others; this can be due to our bodies’ natural reaction being “fight”. This can be a helpful reaction to ward off predators, but in unnecessary situations, it can negatively affect relationships and ruin reputations.

Flight

Some of us avoid our stressors, removing ourselves from the situation instead of tackling it. This can be a sign of the “flight” survival instinct; a function that can save our lives if we find ourselves in dangerous surroundings. However, in everyday life, this natural instinct can lead to a stressful situation escalating, and increase our stress levels when we realize that the stressor isn’t going away and we need to face it.

Freeze

Unknown by many, there is a third mode that stress can cause; freeze. For some people, becoming stressed sets the stage for ‘dysregulation’. The energy mobilized by the perceived threat gets “locked” into the nervous system and we ‘freeze’. This  response sometimes reveals itself when we breathe. Holding our breath and shallow breathing are both forms of freeze. The occasional deep sigh is the nervous system catching up on its oxygen intake.

Understanding Stress

Stress is a condition or feeling experienced when a person perceives that:

“Demands exceed the personal and social resources the individual is able to mobilise.”

Here at The Stress Management Society we use a bridge analogy to approach the topic of stress.

When a bridge is carrying too much weight, it will eventually collapse. It is possible to see the warning signs before this happens, the bridge would bow, buckle and creak.

The same principle can be applied to human beings, with excessive demands and challenges placed on our bridges. There may be early warning signs. However stress can creep up on some of us, resulting in an unexpected breakdown.

That ‘bridge collapse’ in a human being could take many forms:

• Mental and Emotional Breakdown
• Taking one’s own life
• Serious health issues including:
   
  • Cardiovascular disease: The heart is the first organ in the body to experience stress. The No. 1 killer on the planet today is heart disease and it’s no coincidence that as we find ourselves living under higher and higher levels of stress the instance of heart disease is increasing.
  • Stress has a profound impact on how your body’s systems function, Health experts are still sorting out whether stress actually causes cancer. Yet there’s little doubt that it promotes the growth and spread of some forms of the disease. Put simply, stress makes your body more hospitable to cancer.
  • Stress can cause a rise in blood pressure – the main cause of haemorrhagic stroke is high blood pressure, which can weaken the arteries in the brain and make them prone to split or rupture.

The key message is that if we are able to recognize when we have too much demand on our bridge then we can take action to prevent ourselves from getting anywhere near the bridge collapsing which thankfully most of us will never experience or see.

How It Affects Us

One of the difficulties with stress is that people experience stress in different ways. This contributes to stress manifesting itself differently. So it would be wrong to over generalise when giving advice on how to identify stress in others. However, what we can say is that because stress has negative effects, it will usually manifest itself one way or another.

Stress targets the weakest part of our physiology or character; if you are prone to headaches or eczema, this will flare up.  If you have low levels of patience or tolerance for others, this will be the first area to present under times of stress.

Stress isn’t avoidable but it is manageable. A key action in order to minimise risk is to identify stress-related problems as early as possible, so that action can be taken before serious stress-related illness occurs.

There will be changes in the stressed person.

These changes may be emotional, physical or behavioural, or a combination of all three. So, the key thing is to look out for negative changes of any kind. Bear in mind that the negative changes are also likely to have knock-on effects e.g. reduced performance at work.

Of course, we all experience ‘bad days’, so we are really talking about situations where people display these negative changes for a period of time (e.g. 5 days in a row).

Prolonged stress undoubtedly makes people ill. It is now known to contribute to heart disease, hypertension and high blood pressure, it affects the immune system, is linked to strokes, IBS (Irritable Bowel Syndrome), ulcers, diabetes, muscle and joint pain, miscarriage, allergies, alopecia and even premature tooth loss.

Cognitive

• Memory Problems
• Poor Judgement
• Inability to Concentrate
• ‘Brain Fog’
• Indecision
• Starting many tasks but achieving little
• Self doubt

Emotional

• Depression
• Moodiness
• Irritability
• Fatalistic Thinking
• Panic
• Cynicism
• Anxiety
• Feeling Overwhelmed
• Frustration

Physical

• Chest Pain
• Rapid Heartbeat
• Aches and Pains
• Frequent Colds
• Skin Complaints
• Indigestion
• High Blood Pressure

Behavioral

• Increase Intake in Alcohol, Cigarettes and Caffeine to Relax
• Isolating Yourself from Others
• Sleeping too Little or too Much
• Demotivated
• Loss of sense of humour

10 Step Stress Solution

• Prioritise Your Health
• Get a Good Nights Sleep
• Practice Deep Breathing
• Stay Hydrated
• Eat for Wellbeing
• Get Moving to Combat Stress
• Adopt a Positive Mind Set
• Master Your Time
• Don’t be a Slave to Tech
• Learn to Say No

This article originally appeared on stress.org.uk

The Busier You Are, The More You Need Quiet Time

In a recent interview with Vox’s Ezra Klein, journalist and author Ta-Nehisi Coates argued that serious thinkers and writers should get off Twitter.

It wasn’t a critique of the 140-character medium or even the quality of the social media discourse in the age of fake news.

It was a call to get beyond the noise.

For Coates, generating good ideas and quality work products requires something all too rare in modern life: quiet.

He’s in good company. Author JK Rowling, biographer Walter Isaacson, and psychiatrist Carl Jung have all had disciplined practices for managing the information flow and cultivating periods of deep silence. Ray Dalio, Bill George, California Governor Jerry Brown, and Ohio Congressman Tim Ryan have also described structured periods of silence as important factors in their success.

Recent studies are showing that taking time for silence restores the nervous system, helps sustain energy, and conditions our minds to be more adaptive and responsive to the complex environments in which so many of us now live, work, and lead. Duke Medical School’s Imke Kirste recently found that silence is associated with the development of new cells in the hippocampus, the key brain region associated with learning and memory. Physician Luciano Bernardi found that two-minutes of silence inserted between musical pieces proved more stabilizing to cardiovascular and respiratory systems than even the music categorized as “relaxing.” And a 2013 study in the Journal of Environmental Psychology, based on a survey of 43,000 workers, concluded that the disadvantages of noise and distraction associated with open office plans outweighed anticipated, but still unproven, benefits like increasing morale and productivity boosts from unplanned interactions.

But cultivating silence isn’t just about getting respite from the distractions of office chatter or tweets. Real sustained silence, the kind that facilitates clear and creative thinking, quiets inner chatter as well as outer.

This kind of silence is about resting the mental reflexes that habitually protect a reputation or promote a point of view. It’s about taking a temporary break from one of life’s most basic responsibilities: Having to think of what to say.

Cultivating silence, as Hal Gregersen writes in a recent HBR article, “increase[s] your chances of encountering novel ideas and information and discerning weak signals.” When we’re constantly fixated on the verbal agenda—what to say next, what to write next, what to tweet next—it’s tough to make room for truly different perspectives or radically new ideas. It’s hard to drop into deeper modes of listening and attention. And it’s in those deeper modes of attention that truly novel ideas are found.

Even incredibly busy people can cultivate periods of sustained quiet time. Here are four practical ideas:

1) Punctuate meetings with five minutes of quiet time. If you’re able to close the office door, retreat to a park bench, or find another quiet hideaway, it’s possible to hit reset by engaging in a silent practice of meditation or reflection.

2) Take a silent afternoon in nature. You need not be a rugged outdoors type to ditch the phone and go for a simple two-or-three-hour jaunt in nature. In our own experience and those of many of our clients, immersion in nature can be the clearest option for improving creative thinking capacities. Henry David Thoreau went to the woods for a reason.

3) Go on a media fast. Turn off your email for several hours or even a full day, or try “fasting” from news and entertainment. While there may still be plenty of noise around—family, conversation, city sounds—you can enjoy real benefits by resting the parts of your mind associated with unending work obligations and tracking social media or current events.

4) Take the plunge and try a meditation retreat: Even a short retreat is arguably the most straightforward way to turn toward deeper listening and awaken intuition. The journalist Andrew Sullivan recently described his experience at a silent retreat as “the ultimate detox.” As he put it: “My breathing slowed. My brain settled…It was if my brain were moving away from the abstract and the distant toward the tangible and the near.”

The world is getting louder. But silence is still accessible—it just takes commitment and creativity to cultivate it.

This article originally appeared on Harvard Business Review & was written by Justin Talbot-Zorn.