What is Depression?
Dr. Sunitha Chandy was interviewed by Jed Brewer on The Bridge LOUD Radio Program addressing the realities of naming and dealing with depression. Read the full interview below or listen here (starting around the 9 minute mark).
Jed: Dr. Chandy, thank you for joining us. It is a pleasure to have you. Dr. Chandy, if you would, to begin - what is depression?
Sunitha: I think sometimes when people talk about depression it’s easy to get confused because we use that word all the time in everyday life. So, you’re buddy’s going to say “man I feel so depressed.” Ok. What does that usually mean? It usually means that they’re feeling down, they’re feeling sad, that something’s bothering them.
But in the clinical world when we talk about depression with a capital D, we’re talking about something more specific. This isn’t just feeling bummed out or sad. Clinical depression is usually related to sadness. But when we think about it, it’s the intensity level - how intense does this feel, and how long does it last? It’s one thing to be super bummed because your favorite show was canceled. Uh, yeah, I get sad about that too. But when it’s been 3 weeks, 8 weeks, and I’m still not over that, I’m still frustrated and upset, and struggling to get my life going - that’s a little bit different than just being bummed out that something ended.
And so when we talk about depression, what we’re really thinking about is the sadness that’s affecting you more than just, “man I feel bummed,” but, “man I can’t get out of bed. I don’t feel like doing anything.” It’s affecting how you think. It’s affecting how you relate to people. It’s affecting how you feel. And it’s not just this hour long, day long, week long thing. It’s something that can sometimes last for a while that we struggle to shake
So, for some people depression is very biological. It’s very much based off of how the neurochemistry in their brain works. The problem is that if you are depressed based off a situational thing - I lost my job, my partner left me, something really bad has happened to my family or to me personally - that can also trigger the same sort of reactions in your brain. A third of people are mostly benefited by medication and typically we see that those are people who have a biological predisposition. So that’s something like you’ve got a family history of depression. It’s something that runs in your family.
You have this other side that’s much more situational, like, something has happened and it’s really shaken up how we see the world - how we see ourselves. And In those cases, medication could be helpful, but therapy can as well.
Jed: What do we do when we’re afraid to dig in because we’re afraid we’re going to wind up being mad at people we’re not allowed to be mad at.
Sunitha: First thing I would say - anything left in the dark is scarier than anything in the light. So anything we keep hidden is scarier. When you bring things into the light, yeah, sometimes there are things there that we don’t want to see.
But I also want to challenge the part that says you can’t get angry at someone. Those feelings are telling you something and by ignoring them it’s like having a pot that’s boiling and taping the lid shut. Eventually the pressure of the water boiling will blow that lid off. And it’s much safer for you to choose when you lift the lid off, to let the pressure release. But the water’s still boiling. A lot of what you want to learn to do is like - why is the water boiling and what can I do to turn that off. Or use this hot water to create something good.
Jed: For someone who’s dealing with depression I’m gonna guess that “shrug it off” and “just cut it out” is bad advice. But why is it bad advice?
Sunitha: I think it’s bad advice because - how do you do it? So just stop being sad. Just stop. Just don’t do it. Just turn it off. Awesome. If I could have turned it off I would have done it a while ago. The problem is, things like depression, anxiety, trauma - we don’t see it on someone’s body, but it’s there.
We just can’t stop feeling something. What I would actually say to the friend who says “just snap out of it. Just shake it off” - I’d be like “how?” That’s partly what we do in therapy. How do I shift my feelings? How do I stop feeling this? What do I do to feel different, to get back to the place I want to be?
Jed: Can a person really learn to think differently and, if so, can that change their emotional reality?
Sunitha: Absolutely. Our thoughts are tied to our behaviors. How we think shapes how we feel. How we feel changes how we think. It also changes how we act. Often times when we feel really down, we’re having thoughts like “I’m so horrible. This sucks. Things will never get better”, we don’t challenge those thoughts. We don’t think about them. We don’t look to see if they’re accurate. And we aren’t actually that accurate because we don’t have all the information. When you’re interacting with your beahaviors or thoughts, it’s about how you change your relationship with those thoughts. And how to move closer to the person you want to be through how you act and how you think, knowing that you can’t always turn off those thoughts.
I might have that thought, like, “you’re a horrible person,” but how do I interact with that? Do I remind myself of the way that I’m working to the treat the people I love well, that I’m working to make a difference in the world? And, yeah, sometimes I might feel like a horrible person. But whenever I reel like a horrible person, instead of just staying in my bed and bingeing Netflix, I could get out and try to do something that would counteract that or move me to a better place.
So, when we’re thinking about coping skills, it’s anything that helps us get through life - get through the day. So there are maladaptive and adaptive coping skills. Which is pretty much coping skills that work and coping skills that don’t. Things like substances often fall under maladaptive coping, because they work in the short term. As a therapist I’m looking at the long haul. I’m looking at the big picture. Like, how long is that going to help you? And what often happens for most of you who know about addiction and substance use - the amount you start with isn’t going to work with you forever. It’s more and more and more. And then that cycle kicks up. And all the problems and issues that come with it start kicking up. And so now you’re also adding more fuel to the fire for your depression. When we talk about those adaptive coping skills, we’re talking about things that actually tie into what makes life worth living, what gives you meaning, what builds your health.
Jed: There is undoubtably a person listening right now who is dealing with depression in their life. What would you say directly to that person who’s listening right now?
Sunitha: Don’t suffer alone. Depression really is a very lonely disease. Everything about how we want to respond is to keep things secret. To keep them hidden. “It’s bad. It’s horrible. I can’t trust people. I need to pull away.” It can get better, and it is hard work. Part of the reason why it’s worth telling someone that you are close to, or reaching out for help, is because it’s the hope that something can get better. One of the things I’ve found that fights depression is hope. What and where could hope be? And if you’re reaching towards hope, you’re reaching closer to help.