Wednesday, November 27, 2013

Depression: How Your Thinking Can Lead to the 'Blues'



by Dr. Dino Zuccarini and Tatijana Busic


Are you tired of struggling with low energy, negative thoughts, and feelings that seem to absorb so much of your day? You may be suffering from the debilitating symptoms of depression.

This is part one of four in our blog series about depression. These posts have been created to help you consider what might be at the root of your feelings of depression. In the first two blogs, we write about some common causes of depression; particularly, about how you’re thinking and how the way you deal with your emotions might be causing or contributing to your feelings of depression. Finally, in the last blog, we provide you with strategies you can use to deal with depression on your own, or in your relationships with others.


What is Depression?

Depression has many different symptoms. When we’re depressed, we experience symptoms, such as, chronic negative feelings and emotions (e.g., sadness, worthlessness, guilt, irritability, restlessness or lethargy), loss of interest or pleasure in previously enjoyed activities, difficulties with attention, concentration and decision-making, changes in appetite or weight, fatigue, bodily aches and pain. Individuals suffering from depression are also typically bombarded by a chorus of negative thoughts about themselves, others and the world around them. These negative thoughts and feelings may be at the root of your depression.


How Our Thinking Paves the Road to Depression

There are several biological and psychological causes of depression. Let’s review a few ideas about how your thinking can contribute to depressed feelings.


1.  Negative Views of Our Self and Others

Your depression may be linked to negative thoughts and feelings you are having about yourself, others or the world around you. These negative thoughts and feelings can emerge from difficult life experiences at any time in our life—from childhood onward to present-day challenges we are facing in our lives. These difficult life experiences can affect how we might think and feel about our self and others (i.e., thoughts and feelings of inadequacy, worthlessness, incompetence, a sense of being unlovable and insignificant). When you think and feel negatively toward yourself and others for a long period of time, you can become hopeless. You can begin to attribute negative situations and events in your life to negative thoughts you have about your self. A sense of hopelessness about our self further blocks us from being able to achieve our goals and get our needs met. You might also believe that others think and feel the same way about you, which further deepens the hopeless feelings.

As a result of childhood or present-day challenging life experiences, we may have also developed a negative view of others. Others may have been harsh, inaccessible or unsupportive to us during some difficult life moments---and now, it may seem to us that all others are unreliable, undependable and untrustworthy, or potentially harsh and judging. These views of others may diminish the likelihood that we’ll be able to connect with friends or family for support when we are facing challenges and need others the most.

When we hold a negative view of ourselves and others as a result of past or present-day life experiences, we can begin to feel hopeless and less capable of meeting our goals, concerns, and needs, and unable to reach out during times when we are in need of others support and care. These negative views of 'self 'and 'other' cascade into feelings of depression over time.


2.  Unrealistic Standards, Ideals and Expectations Fuel Perfectionism and Self-Criticism

We all have standards and ideals that create expectations that then guide our thinking, behaviours and emotional reactions toward others. From childhood onwards, the outside world through our parents, teachers, and employers place expectations and demands on us. We also develop our own expectations about our own and other people’s behaviour (i.e., how we and others ‘should,’ ‘ought to,’ or ‘must’ think, feel, and behave). Our expectations can sometimes be unrealistic and unachievable, which can create a great deal of pressure and stress in our lives. Unrealistic expectations of others may also create difficulties in our relationships with others. When we are too overly driven by our own and other’s unrealistic expectations, we can become hopeless trying to keep up with all of these demands. We can also lose touch with what we are really feeling, preferring, desiring, wanting or needing for ourselves.

Some individuals maintain unrelenting, rigid standards and ideals about how they or others should perform in the world. In these circumstances, some individuals may have unyielding and high expectations about their performances. They may strive for perfection in their endeavours, and be self-critical and harsh toward themselves when they do not meet these expectations. A self-critical internal voice may emerge that continuously judges or berates the individual (e.g., ‘you dummy’, ‘you’re lazy’, ‘you’re weak’, ‘you screw things up all the time’). Research affirms that self-criticism and perfectionism are often cornerstones of depression.

Perfectionism and self-criticalness may initially work together inside of you to ensure that you perform well. You may criticize yourself to improve your performance so that you will see your self or others will see you in a more positive manner. The more we drive ourselves in this manner, the more we wind up feeling overwhelmed and stressed. We start living an unbalanced life that can feel overwhelming and stressful. Over time, perfectionism and a self-critical voice can create a sense of guilt for not performing adequately, and hopelessness about our self (i.e., global, negative view of your own self as inadequate, not good enough, and worthless). Some individuals can also be critical and harsh toward others for failure to live up to their demands. This can create difficulties when you are engaged in either constant conflict with others or others decide to disconnect from you and you becoming increasingly isolated over time.

CFIR psychotherapists can support you to deal with your negative views of self and other, and the unrelenting self-criticism and perfectionism that might be at the root of your depression. We integrate cognitive-behavioral, mindfulness and acceptance and commitment, and psychodynamic-based approaches to help you deal with the thinking that might be contributing to your depressed feelings.


Read more additional posts from the 'Depression' series:


Read more about our Depression, Mood & Grief Treatment Service.








Thursday, November 14, 2013

Insomnia and Sleep Hygiene: 5 Steps to a Better Night's Sleep



by: Dr. Melissa Calhoun, C.Psych.


Are you tired of having a poor night's sleep? You’re not alone. People experience insomnia when they have persistent difficulty falling asleep or staying asleep through the night. We all have sleepless nights from time to time, especially when we're under stress.

Chronic insomnia affects many people (about 10%) and often leads to daytime fatigue, decreased energy, problems with attention and memory, and irritability that can interfere with your home, work and social life. Chronic insomnia can also be a risk factor for depression, anxiety and substance use disorders. 

Psychological treatment for insomnia will involve helping you change the behaviours, thoughts and emotions that can get in the way of you having a good night's sleep. 

One of the main ways to improve your sleep is to practice good sleep hygiene on a regular basis. Here are five tips for getting a good night's sleep:

  1. Keep a regular sleep-wake schedule - go to sleep and get up at about the same time every day, including weekends. The time you wake up resets your biological clock for the day.
  2. Avoid taking daytime naps because they can disrupt your nighttime sleep.
  3. Set aside some time every evening as your "problem solving" or "worry time." Use this time to reflect on your day and problem solve. When the "worry time" is up, remind yourself that you can continue to address your problems the next day. Sleep time is not worry time! Bringing your stressors with you to bed gets in the way of becoming relaxed - a necessary part of falling asleep.
  4. Limit the bedroom to sleep and sexual activities - do not read, watch TV or use your electronic devices in bed.
  5. Turn the clock away from you so that you cannot see it. "Clock watching" simply reminds you that you are not sleeping; this awareness can increase your anxiety about the effects of not sleeping (e.g., fatigue the next day) and decrease the likelihood that you will fall back asleep. No peeking! 

Insomnia is a common condition, yet few people seek professional help to manage symptoms. Research has shown that psychological treatment for insomnia is highly effective and has longer lasting positive outcomes than medication treatment alone.

CFIR psychologists can support you to address your insomnia symptoms and to get you back to having 'sleepful' nights! 

For more information about sleep and insomnia, check out the 'Psychology Works’ Fact Sheet: Insomnia.