Kadri Sakala
Anne & Stiil, June 2019

Have you felt that you bustle around during the day, smile, go through your workday, but when you get home… emptiness and loneliness take over? You notice that you don’t bother or want to meet anyone and, instead, you curl up in front of the TV, computer or phone until it’s time to go to bed. And then a new day begins. And the same thing happens.

Did you know that there is a concept of ‘smiling depression’, in which a person seems outwardly happy and satisfied, but inside there is something else going on? Clinical psychologist Rita Labeaune writes in Psychology Today that a person suffering from a smiling depression can be successful at work, do sports, have an active social life and a lovely family. Still, deep down, they feel emptiness, sadness, anxiety or worthlessness and suffer from insomnia. They may feel that they cannot be themselves, that they have to perform and meet a certain standard, which is expected of them, but which they cannot meet. And it can cause anger, which stays inside. Sometimes smiling depression can be the result of a significant life change, such as a job loss or a broken relationship. But it can also be an impact of social media, wherein people’s pictures make it seem that everyone else is doing much better in life than I do.

A summertime depression, or seasonal affective disorder (SAD), is also talked about. It has generally been associated with winter when there is less daylight, but it has been found that it can also occur in summer. Paradoxically, people start to get sad when it gets lighter or darker outside. It is not yet exactly known what is causing this. Studies have shown that spring is a particularly difficult time for people suffering from depression. Most suicides are committed then.

I often see from my clients that many people either don’t know how or don’t want to recognise depression, even though it is often talked about. Many people do not admit it because they are too proud, and it comes with a way of thinking: “I am not weak. Depression is other people’s problem.”

What contributes to depression?

• Lack of sleep. The importance of sleep is the most underestimated. People watch TV or are on the phone for too long or are still working before going to bed. You should sleep 7-9 hours every night. In recent years, it has been said that the minimum need for sleep is actually 8.5 hours. If you have a poor sleep, you should deal with your anxiety and review your sleep hygiene.
• Unstable environment.

– Emotionally / physically abusive partner or family member: you never know in advance what mood they will be in, whether they will explode today or not.

– Unstable work: do not know when or how much money will come in, what tasks the day will bring, whether there will be a job tomorrow or not; colleagues or a boss create tension with their behaviour.

– There is no daily routine: you eat, you go to sleep, you work when it happens.

• Long-term stress. When you are always in a hurry, you run from one place to another and you tend to think at night, you don’t take care of your body and mind, you have bad relationships, you live lying or hiding, you do work you don’t want to do. Your needs have been unmet for a long time.
• A negative life event. Accident, death of a loved one, break-up, illness.
• Unhealthy lifestyle. Alcohol and drug abuse, not enough physical activity, poor sleep, poor nutrition.
• Childhood traumas. Emotional, sexual or physical violence, lack of attention and emotional support from parent(s), loss of a family member. It is often not understood that it is not necessary to have tragic events in a family, such as a divorce, the death of someone, or some major accident to be traumatised. The most significant trauma for a child is when they have been left emotionally alone: the parent is usually at work and does not pay enough attention to the child, is often nervous, worried, critical or ignores talking about difficult feelings at home due to incompetence or disregard and the child has to figure out how to deal with their feelings on their own. Another major trauma for a child is when a parent is emotionally violent with the child, or the child grows up seeing an emotionally violent relationship between the parents (in the case of a blended family, also the parent’s relationship with their new partner).
• Hormonal changes. Premenstrual, postpartum, as well as related to menopause. Sometimes medications can also affect.

Notice the symptoms.

The symptoms must last for at least two weeks to diagnose depression. It differs in women and men. Women experience depression more as sadness, worthlessness and guilt. Men are more prone to fatigue, irritability and anger and are more likely to behave carelessly, e.g. to abuse alcohol and drugs.

Family therapists use the word ‘symptom’ to refer to a wide range of problems, which can be physical, mental or social. It can include depression, aggressive behaviour, headaches and addiction. The classic symptom develops as follows: unmet needs lead to dissatisfaction, which causes stress. When stress becomes long-term, and the need is not met, a symptom develops, the aggravation of which can lead to disability.

The worse the person’s relationship with the parent(s), the more likely they are to suffer from depression as an adult. A poor relationship does not always mean that there were many conflicts between the parents, or between the parent and the child. The relationship can also be bad when the parent is often at work and too tired to pay attention and play with the child when they get home. Also, if a parent interferes too much in a child’s life, directing their own anxiety and energy to the child instead of dealing with their relationship or themselves. Or also in the situation where one parent is an addict, i.e. they cannot be relied on and the child must grow up and become an adult early.

Signs of depression.

Care about yourself.

Often, we even take better care of our car than our body. We ignore signals because we have not been taught to listen to our bodies. But the body tells us when it is tired and tense, what it wants to eat and drink when it needs support. The body has a certain amount of resources, and when you spend them, it all goes south.

If you cannot regain strength on a regular basis through a safe environment, good relationships, rest, good sleep, relaxation, good food and adequate fluids, you may become ill or have accidents. Anxiety builds up. You lose attention and can no longer concentrate well. You get problems sleeping, mental exhaustion and anxiety attacks occur, you irritate easily. Your body simply has no other way to tell you that your strategy for living is not working and you need help. You need to learn to respect your body and mind.

I believe that just as there is physical hygiene, there should be spiritual hygiene. It is as important to our inner world as water is to the body. It is quite naïve to hope that you will be able to push on forever with little sleep, little physical activity and poor relationships. Fortunately, we do not have to invent the wheel but follow scientific proof. Stick to these truths.

Routine. When the body does not know what is going to happen, anxiety increases. Set up a daily routine: meals, waking up and going to bed (at the same time each day), activities that bring peace of mind and joy, walks, etc.. Many fear that it will take spontaneity and excitement out of life. In fact, this is not the case – a routine does not mean that you cannot do something unpredictable.

Take a deep breath in and out. It allows you to relax, become aware of your body and reduce anxiety. Take at least two minutes each morning and evening to sit down, take a deep breath in and out and relax your muscles. If you notice during the day that you are tense, it is enough to take a few deep breaths. As you exhale, imagine that you exhale all fear, restlessness, and fatigue. If you can, do this exercise with your eyes closed.

Movement. You should walk for at least 30 minutes every day. During this activity, the brain begins to produce endorphins, which are short-lived happiness hormones. Depressed people stay put, which contributes to the depression, anxiety and fatigue getting worse. If possible, go for a walk in the woods or on the beach and set the phone to silent. Bring family or friends if you want.

Contact with nature. Nature heals and soothes. Go for a walk in the woods or on the beach at least twice a week. A study at Harvard University showed that flowers also have a healing effect on us. So bring flowers inside.

Sleep. Many sleep only six instead of the required 7-9 hours of sleep and do not follow a proper sleep regime where they wake up and go to bed at the same time each day. Sleep problems often occur as early as childhood. Studies show that it is beneficial for children’s physical, emotional and cognitive development to be put in bed early (between 6 pm and 8 pm). Not only can they sleep longer, but the quality of sleep is better. The later a child goes to bed, the more time it takes them to fall asleep and the more often they wake up during the night or they sleep longer to make up for the deficit. Studies have also shown that those children who had a fixed early bedtime in childhood have better memory and concentration at school, they are less aggressive and have better sociality. Studies with adolescents show that those who go to bed before 10 pm are 24% less likely to be depressed and 20% less likely to have suicidal thoughts than those who go to bed later.

By the way, there is a link also between bedtime, sleep duration and metabolic health; the later you go to sleep, the greater the tendency to be overweight.

Limited time on phone, TV, computer. More and more people are spending their free time alone at home watching the screen or on social media, rather than interacting directly with other people. This, in turn, creates a feeling of loneliness, which in turn, increases depression. In the United States, adolescent depression and suicide rates have risen dramatically since 2011. Studies suggest that it has a direct link to smartphones. People communicate by exchanging messages rather than actually talking. And even when getting together, they constantly peek at the phone.

The more time is spent on the screen, the unhappier people are and the more likely to experience depression. The less time looking at the screen, the happier people are.

Food. Ask your body before eating: what do you need right now? Also, take the time to listen to what your body responds, so don’t automatically grab a sandwich or porridge. Also, pay attention to how you eat. It is not wise to eat in front of a TV, computer or phone. Why? Because your body just doesn’t register that you are eating because the focus is elsewhere. This, in turn, poses a risk of overeating.

Breathe, eat calmly and slowly, enjoy the good taste. Focus on the food, its smell, appearance, taste, texture, and the sound that chewing makes. By involving all the senses, you practise being present, reducing anxiety and increasing peace of mind.

Joy. When I ask my clients what they do after work, most of them describe spending time on a screen. They don’t realize that screens take energy, not give it. True, some excellent movies can really improve your mood, but how many good movies are on TV? Make a list of things you enjoy. This could include good sleep, food, meeting friends, playing, singing, drawing, dancing, swimming, massage, going to the spa, reading a good book, walking in nature, swinging… every day you should do at least 15 minutes of something you really enjoy. It would be good it varies a bit from time to time to bring new energy to your life. If you don’t do something nice every day, then it’s no wonder that you feel empty. Joy is a resource that helps you meet challenges. Joy makes life worth living.

Relationships. Besides sleep, we are most affected by relationships. Relationships with family, friends and the community are important. Many have one or two true friends, but good ties to family or community are missing. For life to be balanced, all three should exist. True, you cannot choose relatives. However, this does not mean that you cannot work on relationships. You need to be able to build both friendships and a community and to establish and maintain good relationships with family members. These skills didn’t suddenly appear. If you notice that you cannot manage by yourself, seek help. Gather your family and go to family therapy. If they refuse to come, go alone – if your tooth hurts, don’t you go to the dentist? The same could be done with emotional pain. If your soul hurts, look for a therapist and deal with it. Antidepressants can help reduce symptoms, but they do not eliminate the causes. You only have one life. Don’t waste it waiting, be active.

Reduce negativity and seek peace of mind. If the news is alarming, turn off your computer, TV and radio. If your neighbour only gossips, it’s worth talking to someone else for a change so you can talk about nicer things. Surround yourself with beauty and peace. Be close to animals or listen to music that soothes and uplifts.

Gratitude. The primary function of the brain is to keep us alive. That’s why the brain wants to constantly think about what to say and do next. This is also the reason why we notice and remember bad things rather than good ones.

We need to learn to draw attention to and notice what is good and practise gratitude. Psychologist Martin Seligman has discovered that if you wake up every morning saying three things you are grateful for then, according to research, even 80-year-old pessimists’ levels of happiness are going to rise. Exercise should be done for 21 days in a row and there should be new things every morning to be grateful for.

Gratitude changes our vibrations and what we draw into our lives. Express your gratitude also to others. It’s best to do it face to face by telling the person what you value in them or what you are grateful for. If it is not possible to do it directly, then by phone or e-mail.

We create our own lives. You can always wonder why nothing can be done – only a fool cannot find excuses! But the question really is, “What do you really want?” You should live like life is an art, not just survival, so that you are happy with your life and choices.

A depressed person can no longer see their choices and, therefore, mistakenly thinks that their life is destined to be empty or chaotic, or that they cannot change anything. But we always have a choice, and we are actually capable of more than we think. Sometimes we just need someone from outside to help us see these opportunities and believe in ourselves.