Ask Asad: How do I deal with severe depression and suicidal thoughts?

Dear Asad,

For the past one year, I have been suffering from severe anxiety and depression. I am a shy, introvert, sensitive – and in my opinion – a boring person. I also suffer from an inferiority complex. I believe these are perhaps the reasons for me being extremely depressed and anxious.

I have been taking medications for my depression along with seeing a psychologist regularly but so far nothing has helped. With each passing day it just gets worse. I feel that I don’t have the strength to deal with it anymore. I have begun to have suicidal thoughts on a regular basis now.

My depression is also making me feel jealous of the people around me, especially my siblings. It’s also causing me to question my religious beliefs. After such thoughts about my family and religion I feel so bad that I just wish to die.

I am supposed to get married early next year but because of my condition I am thinking of calling it off.

This mental condition makes me feel fear all the time; self-esteem is gone, negative thinking all the time.

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Most of the time; I feel fearful, suffer from low self-esteem and am enveloped with negative thoughts and emotions. Each passing day is a hell.

I feel absolutely helpless and see no end to this situation of mine. Please help and guide me as to how I can overcome all this.

Depressed Person

 

Dear Depressed Person,

Please do not call off your wedding. That won’t be helpful. One should never try to make big decisions after suffering a trauma or while going through extreme depression. What would be helpful is if you develop an emotionally deep relationship with your spouse, who can then help you in your fight against depression.

You don't need to feel guilty or have low self-esteem because you are depressed. Millions of people worldwide suffer from depression. Depression is not a flaw in your character; neither does it mean you are a bad person. You deserve to feel happy and find a treatment that works for you.

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Therapy!
If you have chosen to enlist the help of a therapist, be sure you are going to one that is qualified to work with depressed people, and with whom you feel compatible. Each therapist will have his/her own unique style. You will have the best chance of being successful in therapy if you feel comfortable with your therapist.

Two of the most effective evidence-based therapeutic approaches for depression include:

1) Cognitive behavioural therapy that involves the therapist and the patient working together to point out, challenge, and change negative thought patterns. It has been proven to be just as or more effective as a treatment than antidepressant medications.

2) Dialectical behaviour therapy, a form of CBT, targets unhealthy or disruptive behaviours and teaches the skills necessary to become more adaptive to stressful situations in the future. This form of therapy is useful for treatment-resistant depression.

Try alternative therapies or remedies. In conjunction with other healing choices you have made, these can sometimes help restore your emotional balance. It's important to find a respected practitioner in any alternative therapy, and don't be surprised if you meet resistance from some medical practitioners to any reliance on alternative therapies.

1) Music is a form of self-help therapy that is known to change mood. Choose music that improves your mood.

2) Art therapy is another common alternative practice for depression. Draw, paint, or create designs that unleash your feelings on a canvas or paper. There are qualified art therapists who can assist you if needed.

3) Pet therapy can help. Pets prevent a sense of isolation, they don't judge, and studies have proven that they induce a feeling of well-being in people who are depressed. Even if you don't own a pet, try to get access to someone else's on a regular basis and spend time with them.

Medication!

Even if you are taking prescription drugs already, do not think that pills will be an easy fix. Different medicines will affect you differently. Some may worsen depression for a period or of time or increase suicidal thoughts before they start helping.

Personify your depression!

Any good therapist will tell you that an important part of recovery and care is remembering that you are not your illness. One excellent way of working your way through depression and conquering it is to put it outside of yourself. Imagine your depression is an entirely separate entity from yourself. Give it a name, a backstory, even draw a sketch if that helps.

Tip: When you feel yourself getting depressed, address your depression out loud. It might sound silly, but really unload on your depression when you feel like it. Call your disease out for what a no-good nobody it is. Get it away from you.

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Look for the good!
Sit back and try to find the good in your life. Whatever it is, it is something worth finding. Return to this list regularly and continue to update it. In your initial recovery, it might have one or two things. Over time, it should grow as you start to experience the more joyful side of life again.

Break the day into a series of small tasks!
With depression, sometimes the day can seem like a mountain you have to climb. When all your responsibilities pile up, it can start to seem impossible. To make each day a little more manageable, break things into a series of small tasks.

Seek support from family and friends!
Emotional and social support is one of the most helpful resources when dealing with depression. This is because it helps to release your emotions in the company of others instead of bottling them up, which can lead to an outburst or a breakdown. Talking can assist you in feeling that you are valued, loved, and that there are individuals who are willing to help and care for you. Crying with a friend or family member can be emotionally cathartic. It is like an internal cleansing of your soul and mind.

Note: Find the right person to talk to. Not everyone understands how you feel, no matter how much they love and care for you. Do not take it personally. It's important to find someone who will listen without judging, but whom you can still trust to give you an honest opinion when you need one.

 

There are many lifestyle factors that can help as well, regardless of the severity of depression, such as:

1) Exercise!

Exercise releases a natural anti-depressant chemical in your brain and gets you into doing something active. More physical activity is strongly associated with reduced levels of depression.

2) Eat healthy!

Diet can heavily influence your mood. Reduce your intake of sugar, high fructose corn syrup, fast foods, and processed foods. Eat more fruits, vegetables and whole foods. Drink plenty of water and do some research on foods that are said to improve your state of mind and well-being.

3) Get enough sleep!
Sleep is essential to a healthy, balanced body. Lack of sleep can aggravate negative thinking and easily becomes a vicious cycle whereby your negative thoughts keep you awake and disable your ability to get enough sleep. Waking un-refreshed and feeling tired is a common complaint during depression, and even too much sleep can leave depressed persons feeling tired. Breaking this cycle requires enforcing a strict sleep routine of the same bedtime and waking time every day.

4) Grooming!
It can be easy to let yourself go when depressed and to pay no attention to appearance and clothing. Reintroducing daily attention to grooming can help improve your mood and give you a sense of well-being.

5) Organise your space!
When life feels out of your control, sometimes it helps to organise your surroundings. A place for everything and everything in its place. Throw out or give away things you do not need or want. If something is irreplaceable but upsets you, put it away in a box.

6) Try meditation for 5-10 minutes!
It might seem counter intuitive that doing nothing could actually do something, but clearing your mind, even for a short period of time, can help center you when things seem overwhelming.
Tip 1: Find a quiet spot, set a timer, and get into a comfortable position. Close your eyes and focus on your breathing. Feel the air going into your body and nourishing it. Hold your breath for a few seconds, and slowly release it back into the air. Feel the air going back into the world.

Tip 2: Mindfulness-based meditation may help increase well-being and reduce depression. Mindfulness is all about being in the current moment, the here and now. It is focusing on what you are currently engaged in instead of ruminating over the past or worrying about what might happen tomorrow.

Believe in yourself. Be confident in your ability to cope with negative situations and feelings. Your positive thoughts about your ability to cope with depression can actually decrease your depression overall.

 

All the best!

Asad

 

Asad is a counsellor, life coach, inspirational speaker and a personal-development expert. He advises on social, personal and emotional issues. You can send him your questions for this weekly column at [e-mail] with “Ask Asad” mentioned in the subject line and provide as many details as possible.

Note: The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Express Tribune.