Tim O'Rahilly Life Coaching

Posts Tagged ‘Cognitive Behavioural Therapy’

Mindful Monday: Men and Depression #5

Getting help and helping yourself.

In this final part of my look at anxiety, depression and suicide in men, I intend to cover what you can do once you have recognised that there is a problem. In the first four parts I tried to give an evidence-based overview of the issues. While this final part is also based on my research of the subject, it is also a quite personal view based on my own experiences.

It will surprise many who know me to learn that I have been suffering from depression for the past two years. I spent most of that time trying to convince myself that as a life coach I should be able to talk myself out of it. I finally sought the help of my GP just two months ago and now wish that I had done it a lot sooner.

Men need UHT.

No, I don’t mean UHT milk. I have stolen the acronymbigstock-depressed-man-sitting-on-top-o-48751034 to explain the process which I believe all depressed men need to go through:

  • Understand
  • Help
  • Talk

First you need to understand what is happening. You are not weak or less manly. You have certainly not failed anyone. Your depression is most likely to be the result of chemical changes in your brain. It could also be the result of your efforts to cope with life in an increasingly demanding and stressful world or it could be a mix of both of these elements.

Once you understand the nature of your depression as an illness it should be easier to seek help. If you broke your leg or contracted some disease you would seek professional help. Depression should be seen in exactly the same way and it is nothing to be ashamed about.

Talking about your feelings is without doubt the single most important step on the road to recovery. I would say that the two most important people you need on your side will be your partner or a close friend and your GP. It is important to talk openly and honestly with both of them.

My partner had no idea that I was suffering with depression until I told him two months ago. Since then he has been an absolute star and way more supportive than I had expected. I do believe that even if they are not directly part of your recovery plan it is wise to have somebody who is at least aware of what is happening. When you are ready to ask for professional help, put some thought as to which doctor in your practice you can see most regularly and who you feel most comfortable with.

Be aware that doctors are often slow to diagnose depression in men simply because the patient is more likely to describe his physical symptoms and not his feelings or anxieties.

Self-help

There is quite a lot that most men can do to help themselves. None of the following things are a cure and they should not to replace medical help.

  1. Talk to someone. Tell somebody how you are feeling and what is happening. This is especially important if there has been any kind of trauma such as a bereavement or a relationship split which has caused a major upset in your life.
  2. Sleep. For many people with depression this can be a great cause of anxiety. You need to rest and get as much uninterrupted sleep as you can. If you can’t sleep don’t try to force it. Do something relaxing that you enjoy. Try reading, listening to music or the radio but avoid watching television if possible. You might also get some positive results from light exercise, massage or even some light yoga.
  3. Treat yourself. Try to build in some regular time in your daily life to do something which you really enjoy whether it be a hobby, exercising or simply reading a good book.
  4. Drinking is not the answer. Alcohol may make you feel better for a short while but in the long run it will increase your depression. Of course, the same applies to illegal drugs, particularly amphetamines, ecstasy or cocaine.
  5. Try to get out of doors and do something active when you can. This is not just for the sake of your fitness but it can help to distract you from depressing thoughts and feelings and will also help you to sleep better.
  6. You should try to eat a balanced diet with plenty of healthy nutritional foods even if you are not feeling particularly hungry. Depression can lead to not eating and therefore missing out on essential vitamins, or it can lead to binge eating or the consumption of junk food causing weight problems.
  7. Take a look at your work load. Can you set yourself more realistic targets? Can you structure your day or your week to be kinder to yourself? Are you the kind of perfectionist who tries to lose yourself in your work in order to avoid the real world?
  8. Get away. Taking time out for yourself can be hugely beneficial whether it’s getting away from your normal routine for a few hours or better still a few days. Check out those weekend breaks.
  9. There are many books and websites where you can read about depression. Sometimes researching medical conditions online can appear to make things worse than they really are, but in the case of anxiety and depression these sites and books can be very beneficial. Not only can they give you a variety of strategies to use, but they may also help friends, relatives or colleagues to understand what you are going through.
  10. Sometimes when you are depressed, self-help is not so easy. It may be beneficial for you to seek out a support group where you can talk to other men in similar situations. Your GP may be able to point you in the right direction or you may find local organisations who can help with this.

Man-with-depressionEven if you engage in any or all of these self-help strategies you should at some point see your GP. Be completely transparent and honest since this will help the doctor to deliver the best help for you. Depending on the severity of your illness the GP may suggest one of three basic options, or a combination of these.

  • Self-help: this may be in the form of an exercise program, reading, or online therapy course.
  • Talking therapies, such as psychotherapist or counsellor.
  • Medication

Many men dislike the idea of psychotherapy or antidepressant medication but I have found both to be highly effective and neither has to be permanent.

Of course your GP is also best placed to know if your depression is linked to any physical condition which is often the case.

Self-harm and suicide are tragic consequences of untreated depression. As we have already seen, men are three times more likely to kill themselves than women. It is also more likely among men who are separated, widowed, or divorced. Suicide is much more likely among men who drink heavily too.

This is where the support of a friend, colleague, or partner may be vital. If you suspect that somebody is harbouring suicidal thoughts, then ask him. You will not be putting the idea into his head, but you may just save his life. If your depressed man talks, then listen and take what he says seriously. There is nothing more demoralising than a man plucking up the courage to talk to somebody only to find himself not being believed or not supported.

Finally, maintain hope. Things will get better and many men come out of depression much stronger than they were before. You may even have a better understanding of yourself, of relationships and of stressful situations. It is true that some people continue to suffer periods of depression but they become more resilient and learn to live with them. Remember that anxiety and depression are very common you are not alone and you can get help. Just ask for it.

As for me, counselling and medication are helping. I have to accept that some of the root causes of my depression will not go away overnight. What I am learning to do however is to manage the way I feel about them. For those of you who know me by the positive messages which I post on Facebook every morning, you should know that they are helping me as much as they are my readers. Yes, things are getting better.

Mindful May: Mindfulness Meditation

Many people have mixed feelings about the idea of meditation. Some see it as a form of escapism where you sit and empty your mind and think of nothing at all. Others view meditation as a mystical, quasi-religious activity. I was originally a sceptic and I still believe that there is a lot of misinformation about meditation and its uses. Mindfulness meditation however, has been studied closely for around thirty years now and has been well tested in clinical settings.

ccf0200a80a63ec85056662998e0a58eAlthough rooted in the Buddhist tradition, Mindfulness meditation can be used in a completely secular way without any reference to mystical behaviours. Far from training you to think of nothing, Mindfulness meditation teaches you to pay very careful attention to whatever it is that you have chosen to focus on. The first subject is usually your breathing, but once you can experience this attention you can move on to any of your other senses or body parts. As the technique becomes easier you can also begin to focus on your feelings and emotions.

There are two distinct types of Mindfulness meditation: Formal Meditation and Informal Meditation. The second of these may be the more useful technique for long term daily use. I would however suggest that you start with Formal meditation in order to train the mind in the habit of meditation.

Before embarking on any explanation of the two forms I want to clarify my use of the word ‘practise’ in this context. Setting aside all confusion about the use of ‘practice’ or ‘practise’, use of the noun or the verb, or the differences between English or American versions, I am more concerned with the meaning of the word. Yes, at first we will need to practise meditation in order to make the practice of meditation easier. In the first instance we are using the word to imply repeated training to reach perfection in the way that we do something. In Mindfulness meditation there is no requirement to achieve perfection. It is the quality of your experience which matters most. Therefore in this context I am using the word to describe the ongoing use of a technique where you actually engage with your own experience of the meditation.

Formal Meditation

In order to engage in formal meditation you will need to set aside some time to carry out the activity. Only by taking time out from your everyday life can you become more attentive to your own mind. Over time this will train you to be mindful for longer periods of time and to focus more deeply on any habitual behaviours with greater curiosity, tolerance and kindness towards yourself and your current experiences.

Formal meditation is best practiced sitting alone in a quiet,11f003ed73be04af584f36c8b8d03b48 comfortable place with your eyes closed. As previously mentioned it is usual to start by giving attention to your breathing. Focus on how your abdomen moves in and out as you breathe, or how the air flows in and out through your nostrils. Of course other thoughts will pop-up in your mind but you simply return to focusing on your breathing. Try to do this for 10 minutes each day to begin with and the more you do it the easier it becomes to really become attentive to your breathing. Once you are satisfied that you can regularly focus in this way, then you can expand your awareness to include thoughts, feelings or other actions in a mindful way. Formal Mindfulness meditation should be seen as mind training.

Informal Meditation

This is a very different style of meditation where you need no special time or place to enter the meditative state. You can focus your attention in a mindful way while you are carrying out your normal everyday activities. Whether you are walking the dog, cooking the family dinner, or pushing a trolley around the supermarket you can enter the meditative state at any time and in any location. This further trains your mind to stay in the present moment focusing your attention on the here and now instead of drifting back into the past or forward into the future. Informal Mindfulness meditation gives you the means to rest in a mindful state at any time and in any situation.

Now, at the start I mentioned research and those of you who know me will know that I am very much a science guy. If I am to believe in something like Mindfulness meditation I need to at least know a little about how and why it works. Mindfulness has been the subject of study for some thirty years now. It is however in the last decade that advances in imaging techniques have enabled an explosion in neuroscience and have allowed researchers to more accurately observe what the brain is doing during meditation.

In November 2011 a group of researchers published a paper in Perspectives on Psychological Science 6 . Here they suggested that Mindfulness meditation affected some components of attention regulation, emotional regulation, body awareness and changes in our perception of self. The group went on to say that neuroimaging techniques suggest that there were observable “changes in the anterior cingulate cortex, insula, temporo-parietal junction, fronto-limbic network and default mode network structures within the brain”.

Don’t panic. You have not wandered into an episode of Bones, nor do you need to know this stuff. I am simply using this research exemplar to show that Mindfulness meditation does seem to cause observable changes in the brain. It is these kinds of neuroplastic findings which are now feeding into much more in-depth research relating to treatments for mental health disorders.

The current clinical point of view would appear to be that Mindfulness meditation is more effective than some supportive therapies  but perhaps not as effective as traditional Cognitive Behavioural Therapy. This of course assumes that there is some existing condition which needs treatment. I cannot help thinking that just like exercise or healthy eating, making Mindfulness meditation a part of your everyday life will contribute to the mental and emotional aspects of a healthier you.

Mindful Monday: What is Mindfulness?

In the first Mindful May blog I looked at why I am a positive thinker.fd5202fbe18d1012d71d0450af419a99 In this second posting on that theme I want to look at mindfulness as an important element of that. If you follow my ramble through this coming month of positive musings, you will see that I do not subscribe to any one philosophy in isolation. Instead I draw on a lifetime of self development and pull together a variety of disciplines which help me not just to cope with the modern world but to live in it from day to day. I also firmly believe in moving forward using action oriented goals to work for a better future.

I do not subscribe to the way that mindfulness has been marketed in recent years as some kind of self help commodity. It is not the banal, all encompassing therapy that some practitioners would have us believe. It is no surprise that some critics have labelled it ‘McMindfulness’.

So what is mindfulness? My preferred definition was coined in 2009(Zgierska) as “the intentional, accepting and non-judgmental focus of one’s attention on the emotions, thoughts and sensations occurring in the present moment”. The word itself is actually derived from the ancient Indian word sati meaning  awareness, attention and remembering, and it is an essential element of Buddhist practice.

In this context, awareness is that aspect of being human which makes you conscious of your experiences. Awareness is what makes things actually exist for you. This awareness is then channeled by attention. This is the element of mindfulness that can be trained so that you are able to sustain your attention however and wherever you choose. The term remembering in this context literally means ‘to be mindful of’ (Latin, re = again and memorare = be mindful of). It is about remembering to pay attention to your experiences from moment to moment.

The practice of mindfulness is now being employed by psychologists to help with a variety of mental and physical conditions. These include stress, anxiety and obsessive-compulsive disorder. I’ve seen mindfulness wheeled out as a ‘cure’ for depression and for drug-addiction. It is not. In these particular cases, what mindfulness seems very good at is preventing relapse.

It would be fair to say that there are as many definitions of mindfulness as there are scholars studying it and for that reason the results can be somewhat subjective. Historically, mindfulness is associated with Buddhism and certainly the training has centred around mindfulness meditation. I do believe that this has an important role to play. However, the association with more esoteric beliefs and even religion may put some people off and put the benefits of mindfulness beyond their reach.

In order to make mindfulness more accessible to all, especially within the field of psychotherapy, researchers have sought to interpret the term into a more measurable form. David S. Black (2011) arrived at three possible domains for mindfulness which might make it more acceptable:

  1. A trait. a dispositional characteristic (a long lasting habit) which enables someone to easily enter a mindful state and to sustain it.
  2. A state. this is an outcome such as being in a state of present moment awareness (usually as a result of mindfulness training).
  3. A practice. This being the actual practice of mindfulness meditation.

So we see that the practice of mindfulness can be perceived as paying attention in a very specific way, as follows:

  • Paying attention: Whatever you choose to be mindful of, you must pay attention to it.
  • In the present moment: Grounding yourself in the here and now by being aware of the way things are, as they are, at this particular moment.
  • Non-reactively: We are conditioned by learning and past experiences to react to anything that we experience. This reaction is automatic and we have little or no choice in the matter. Mindfulness trains you to respond to an experience rather than react to it. Response is a much more considered and deliberate action.
  • Non-judgmentally: Past conditioning also leads us to judge our experiences as good or bad. We either like a thing or we don’t. Mindfulness removes these personal filters and allows us to see things as they are, without judgement.
  • Open-heartedly: This is probably the domain of mindfulness which many have difficulty with when we say that mindfulness is not just about the mind but about the heart too. Importantly mindfulness looks at our emotions and so this is as good a label for that as any other. Being open-hearted in this context simply means bringing warmth, compassion, friendliness and kindness to your experience.

I’ve found many overlaps between mindfulness and other philosophies and disciplines. This is especially so with Cognitive Behavioural Therapy (CBT), Neuro-Linguistic Programming (NLP) and other ‘talking therapies’. In the blog posts which follow I will look at a variety of tools and practices which I have found conducive to a positive outlook on life and a ready smile.