Welcome to this low mood and depression guide.
I'm here to help you to help yourself through a range of common life difficulties.
In this session, we're focusing on low mood and depression.
The aim is to help you look at the impact of low mood
and depression on different aspects of your life.
We'll help you to understand how it creates a vicious cycle that can keep you feeling bad.
And we'll point out some practical things you can do that can help make a difference.
You might want to make notes as we go through things, so that you can
see how this approach fits your own life.
Low mood and depression are really common.
Between one-in-four and one-in-five people experience significantly low
mood at some time in their life, so you're not alone.
Sometimes the symptoms are short-term and we can work them out over time.
But sometimes we can get stuck or feel down and stop enjoying things
for a number of weeks, or months, or even longer.
And when we get stuck in a period of low mood or depression,
it can affect different aspects of our lives.
It can be hard to know what to do to improve things.
So, perhaps we can't sleep, or we feel low, or our confidence is gone.
We feel stressed out, or off our food and feel like pushing people away.
These are just some of the ways low mood can affect us.
What we need is a way of breaking things down and working out how to change things.
And the great news is, there are so many treatment
options available for these problems, such as cognitive behavioural therapy,
CBT, which is a popular and evidence-based form of talking therapy.
This module adopts this same CBT approach and I'll use it to help you to understand
how your thoughts and feelings and behaviour can act together to keep you feeling bad.
People often think about depression as just being low in mood, but it's far more than that.
It can affect every aspect of our lives.
Here's a typical example of someone experiencing and tackling low mood.
Dave had a job he really enjoyed, but during a financially tough time for his employer,
there were redundancies and he lost his job.
He's now been feeling low for three months, and has recently told his GP how he feels.
His doctor was really helpful and gave him the contact details for his NHS Talking Therapies Service.
He called them up to self-refer and spoke to a psychological wellbeing practitioner (PWP).
The PWP drew out a diagram to help Dave understand how
all his different symptoms fitted together and were affecting him.
To do this, the PWP asked him about how he was feeling in five key areas of his life.
These help him think about the people and events around him and the impact of all
this on his thoughts, feelings, physical symptoms and behaviour.
The aim of this so-called five areas assessment is to help Dave to understand his situation better
and to spur him on to make some small changes that can have a large impact on how he feels.
The first of the five areas is the people and events around us.
Let's use Dave's situation to think through how this applies to him.
Dave has lots of things going on around him that are causes of pressure.
He's lost his job, he feels he hasn't got enough money to get through the month, and
also since losing his job, he's stopped seeing his friends as much and feels he doesn't know anybody.
Plus, there are other things, too.
His friend's very unwell, and he's also having rows with his neighbours.
Hopefully, that gives you an idea of the sorts of things that can go wrong around us.
And what Dave didn't know before his chat with his PWP is that the things
going on around him can cause a vicious cycle that makes him feel worse inside.
Let's move on to look at the second of the five areas, Dave's thinking.
For the past three months, on and off, he's been saying to himself,
"Could I have done more, or worked harder?"
"What if I don't find a new job?"
"I'm too embarrassed to tell my friends and family that I've been made redundant."
"I shouldn't feel like this. I should be strong and confident."
These and other unhelpful thoughts are common in depression.
For example, saying self-critical things, like "I'm hopeless.", "I've nothing to offer."
Or second-guessing and mind-reading what others around us think.
"People think I'm useless."
And blaming ourselves for things that aren't really our fault.
These are all unhelpful thoughts.
They often aren't true, and dwelling on them makes us feel worse.
And that leads on to the third area, called "altered feelings".
Have you ever noticed that what we think can affect how we feel emotionally?
Because Dave's mind is so full of so many negative
and self-critical thoughts, he feels worse emotionally.
He feels down, guilty, fed up, angry and stressed.
He also notices one of the key symptoms seen in low mood, - that life stops feeling enjoyable.
And how we feel can affect us physically.
And this is area four, altered physical feelings or sensations.
People are often surprised quite how physically exhausting low mood can be.
His low mood leaves Dave feeling physically exhausted.
He also isn't feeling hungry any more and has lost some weight.
He's tired and feels run down.
He also aches all over and has headaches.
Other physical sensations can include feeling sick,
palpitations, pain, losing your sex drive and noticing a churning stomach.
And all these things, the altered thoughts and feelings and physical
symptoms all add up to affect what Dave does, his behaviour and activity levels.
And that's the fifth and final area of the five areas assessment.
And this creates a vicious cycle where the worse Dave feels, the less he does.
The less he does, the worse he feels.
He starts to stop looking for jobs and stays inside much of the day.
Because he feels guilty that he hasn't got a job, he's also stopped visiting his family.
And when his sister calls him,
he shouts at her when she asks how things are going looking for work.
He's also stopped cooking meals, something that he had a keen interest in and enjoyed doing before.
Finally, Dave's avoiding phone calls from his friends and is cutting himself off
from this important possible source of support.
Other common unhelpful behaviours include drinking too much, oversleeping,
comfort eating and putting important things off, like paying bills or doing the housework.
And all of these can worsen how we feel.
The good news is that this vicious cycle can spin both ways.
And that by making a helpful change in just one area,
things may change helpfully in the others, too.
So, for example, Dave and his PWP both agree that
his altered behaviour's a good place to start making changes.
As a small first step, Dave therefore decides
to say yes to an invitation to go to his friend's for Sunday lunch.
He also decides he'll plan to start speaking to his friends and family on the phone again.
And will really listen to how they are.
He also cooks himself a meal and really enjoys it.
He does all these things bit by bit over the next few days,
so the activities are planned, realistic, small and achievable.
They're all things that get him going again, will give him a sense of
pleasure and achievement or closeness to others.
Dave had a great day at the lunch,
and then came home and chatted to his family to tell them more about it.
Did this help you understand how you're feeling right now?
Why not work through your own five areas assessment,
and see if there are any changes you can make to help you feel better.
Writing this down is a good idea.
So firstly, what's going on in your life?
Are there any pressures or problems?
Secondly, what's been going through your mind recently?
Any thoughts, or memories, or pictures, or predictions about what will happen in future?
Thirdly, how does this make you feel emotionally?
Low or sad, anxious, guilty, ashamed or angry?
Fourthly, have you noticed that you've been feeling different physically?
And finally, fifthly, are there any changes in your activity or behaviour?
Have you stopped doing things you used to enjoy?
Or are you avoiding anything?
Or have you started doing new things that are becoming unhelpful?
What impact has this altered activity had on how you're feeling?
Are you trapped in a vicious cycle?
If so, here's how to get out of it.
Firstly, your thinking.
Watch out for upsetting thoughts that worsen how you feel emotionally,
or physically, or unhelpfully affect what you do.
These are often just an unhelpful thinking habit, rather than actually being true.
So, sometimes just noticing the pattern will help you take a step back and change things.
Secondly, physical symptoms.
If you notice new symptoms that concern you,
get them checked out by your doctor to find out what's happening.
And thirdly, in your behaviour, getting going again is one of the best things you can do.
Planning things that give you a sense of achievement, pleasure and closeness
to others and make sure you re-establish a structure to your day by getting up and
going to bed at a reasonable time and eat three reasonable meals a day. Plan to keep
up with the essential-things. Things that if they build up will make you feel even worse.
And say "yes". Negative thoughts tell you to say "no" and decline invitations,
so watch out for saying no to things or avoiding things you might enjoy because you feel scared.
The more you avoid things, the more it saps your confidence and the
smaller your life becomes. And that vicious cycle starts spinning again.
Here are some final tips:
Don't drink too much, or smoke or eat too much to block how you feel.
Or push people away, or hide away or isolate yourself.
Making changes can really help improve your mood and confidence, and help you feel better,
which in turn will really help you tackle whatever life's throwing at you.
So, go on, go for it, and live your life to the full.
You've made a great start here by completing this session.
Thanks for listening.