This post is Part 2 in a two-part series about anxiety and depression. You can check out Part 1 here.
Because this post turned out to be so much longer than I expected, I’ve separated it by sub-topics, so you can skip ahead to any part you would like.
VERY IMPORTANT CAVEAT: I am not a doctor or other healthcare professional and absolutely nothing in this post is intended to diagnose, treat, or otherwise make any kind of suggestion to you as to how you should deal with your own anxiety or depression. I share this for informational purposes only, and as an example of what I did about my own anxiety and depression. In my own case, I never took prescription drugs and I was never suicidal. Please, please, PLEASE, always speak to your own doctor or other qualified professional before you try or change anything when it comes to these serious conditions.
My History with Depression and Anxiety
If I’m honest about it, I started exhibiting symptoms of depression almost as soon as puberty hit. A very outgoing and confident child, I became extremely uncertain, insecure and introverted when I hit 13. Part of this shift was due to a new school for the first time, where, as a late bloomer, I watched as all my friends began to flirt and socialize with boys while I remained on the sidelines.
During that year, I missed about 50% of the academic year, claiming I didn’t “feel well” (my mom just accepted that excuse, allowing me to write my own letter to the teacher so I could miss class).
It was also the year my pediatrician suggested I meet with a social worked to discuss what was bothering me. At the time, it felt like the worst, most shameful thing in the world. Looking back, I think that guy was ahead of his time.
According to therapist Nancy B. Irwin, PsyD., anxiety and depression are like two sides of the same coin. “Being depressed often makes us anxious, and anxiety often makes us depressed,” she says.
When I was first hit with panic attacks in my early 20s, I simultaneously went through a major depression and began to isolate myself in my studio apartment. Over time, the practice of sitting alone in my pyjamas all day, scarfing junk food, watching soap operas (there were no personal computers in the 1980s) and ruminating about my next panic attack rendered me even more depressed. Eventually, I began to shun even well-meaning friends who invited me to join them for drinks, dancing, or whatever we 20-somethings did back then.
Luckily, I never lost my unshakable work ethic, as my job as a TA at the university was the only reason I ever left the house. That 3 hour-per-week commitment forced me to wash my hair, put on clothing, and head out to tutor students once a week on campus. If not for that job (which provided funds for my rent and groceries), I likely would have never left the apartment at all–except for the regular taxi trips to the local hospital Emergency Department, of course (by that time, I was visiting emerg 4-6 times a week).
My rationale went something like this: I just know that this time something is different. This time, I’m sure I’m having a heart attack. If I go to the hospital, at least I’ll be somewhere that they can treat me, and I’ll have the best chance of survival.
The fact that, each time, I’d return to my apartment at 6:00 AM still breathing didn’t console me in the least and didn’t change the way I felt. To make matters worse, the concept of panic attacks was virtually unknown in the 1980s, so I was brushed off as a neurotic, or worse, mentally disturbed, young woman.
So how did things begin to change?
When I moved to Toronto to begin my PhD at the University of Toronto, I was offered a position as Floor Don at Victoria University College. This coveted appointment (there were only 7 of us) meant that I received free room and board in the heart of downtown Toronto (where rents for a one-bedroom apartment peaked at $2260 as of December, 2018). Clearly, as a student with no employment and a daughter who’d been disowned by her father, it was an offer I couldn’t refuse.
Being a don was a simple arrangement. I got to live in a spacious, comfortable room in a historic building in the heart of the city, treated to three daily meals of home-cooked food (Annesley Hall was the only residence at that time with its own on-site cooks who prepared fresh food every day, as opposed to industrial food services in other residences).
In exchange, I was expected to act as a mentor, counselor and friend to the 20 or so girls who lived on the residence floor with me. The rules were clear: be a good role model, help them when they need it, and be sure that you remained on-campus from 11:00 PM until 7:00 AM, at least 29 days per month.
Say what? I don’t know if I missed that tidbit during my interview or if my subconscious simply made me overlook it, but, practically speaking, that meant I could no longer trek to the Emerg several times a week.
The first dozen or so terror-stricken nights were, as you might guess, horrific. I got no sleep, I paced my room in a shaky, sweaty panic, and I prayed to be alive by morning. I was literally trembling, sweating, sobbing and pacing my way through the night. As soon as day broke, I’d fall into a restless slumber, toss and turn for a couple of hours, then haul myself to my classes. This pattern continued for several months.
Then, one day, I realized, there had been no panic attack the night before. Eventually, I didn’t have a panic attack for a few days, then a week. . .then a month.
Eventually, the attacks came fewer and farther between. By the end of the academic year, more than a few months had gone by without a single panic attack.
While I’d say I was by no means “cured” of my panic attacks after my year as a don , they decreased from an almost daily occurrence to something that happened perhaps 4 times a year, when something particularly anxiety-provoking occurred (such as the breakup of my marriage or my mom’s death). Over time, they diminished to the point when they stopped altogether. These days, I can no longer remember the last time I had a panic attack.
Causes of Depression and Anxiety
According to the Mayo Clinic, the causes of anxiety aren’t entirely clear, but it is often related to a traumatic trigger event. When it comes to depression, it can be complicated. An article in Harvard Health suggests that the common conception that depression is a chemical imbalance in the brain is too simplistic, and that the causes are, in fact, multi-factoral.
I talked about the onset of my anxiety in Part I of this series, how I began to experience panic attacks during the year I studied for my Master’s degree. In that case, it seems as if the confluence of several factors worked to trigger the anxiety, as if my body and brain were able to withstand a certain degree of disruption in my life, but one negative event too many toppled that delicate balance.
As for my depression, turns out it was due, in part, to my high-sugar eating habits (see more on this below). In addition, living with a depressed mom (albeit whose depression was undiagnosed), served as a role model for depressive behavior. When faced with adversity, my mom’s first reaction was to be passive and give up; because I was close to her, it felt natural to embrace that same pattern as well.
One of the most common–and certainly best-known–treatments for both anxiety and depression is prescription drugs. I don’t know about you, but I’ve never met a person who hasn’t heard of Prozac, or has never met at least one person on an anti-anxiety medication.
While it’s tough to know exact numbers, various sources report that 25 million Americans have been on anti-depressants for over 2 years (a 60% increase since 2010), that “prescribed drugs from a group that included sedatives, hypnotics and anti-anxiety drugs,” and that 1 in 6 Americans is on some kind of psychiatric prescription medication. In 2017, it was reported that Canadians are among the highest users of antidepressants in the world, with 1 in 9 people taking the drugs (the 3rd highest percentage in a study of 23 countries in 2011).
The Anxiety and Depression Association of America suggests that “Symptoms of depression and anxiety disorders often occur together, and research shows that both respond to treatment with selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications.” Commonly-known SSRIs are Prozac, Paxil or Zoloft; commonly-known SNRIs are Effexor or Cymbalta.
There are various kinds of therapy recommended for these conditions, from Cognitive Behavioral Therapy (which focuses on changing your thoughts and beliefs, which will then change how you feel) to traditional psychotherapy or interpersonal therapy.
Although talk therapy is generally touted as effective for mild to moderate conditions, recent studies have suggested it may be less effective than previously thought.
In my own case, decades of talk therapy, while comforting to me while I was in the therapist’s office, did very little to reduce my depression (I continued to refuse medication, so I don’t know what would have happened if I’d combined the two). Many people do see improvement over time with talk therapy.
For this kind of therapy to be truly effective, the subject must be willing to delve into personal issues, fears, beliefs, and so on, and to examine her or his past in great detail. Clearly, talk therapy isn’t for everyone (I can’t imagine my hubby going through this process, for example!).
Tried-and-true relaxation techniques include meditation, yoga or breathing exercises. Of course, anything that works to relax you, from walks in nature to taking a bubble bath, can be useful as well.
Natural or Holistic Approaches
Some of the more natural approaches include exercise (which can raise serotonin levels, thereby boosting your moods), practicing gratitude, eating better, focusing on others, doing things you love, or using herbal supplements such as St. John’s Wort or lavender, all of which have shown some results in various studies.
My Anxiety Plans from Anxiety Canada
Finally, in researching for this article, I came across an incredible-looking program from Anxiety Canada. This organization offers programs for teens or adults, which walk you through a research-based course that outlines what anxiety is and how to overcome it in short, 10-minute lessons. As it turns out, I did most of what they suggest, although I didn’t realize it at the time.
What Worked for Me
Because I’d dealt with depression since my teenage years, I assumed it was genetic and that I’d have to deal with it for the rest of my life. Little did I know that candida overgrowth can cause depression symptoms (it disturbs the normal chemical balance in the brain, which can result in anxiety and/or depression).
In fact, when I first changed my diet the year I attended nutrition school, I discovered by the end of the year that my chronic low-grade depression had magically vanished! Without meds or any other changes to my daily practices, simply cutting out refined sugars and grains completely removed depression from my life. For many people, eliminating sugar and refined grains from their diets can have a similarly dramatic effect on their moods.
Exposure (or Immersion) Therapy
It seems that, unwittingly, during my year as a don I had put myself through an extreme version of what’s known as Exposure Therapy, which exposes people to their fears or phobias through progressive stages.
In my case, because I had no choice but to sit through my panic attacks, eventually I realized that they followed the same pattern each time, and that it always ended with me still there in the morning. This is not to say that panic attacks disappeared forever once that year ended, but over the following decades, they became less and less frequent until there came time when I couldn’t remember how long it had been since the previous panic attack.
Self-Talk (CBT and variations thereof)
Cognitive Behavioral Therapy, or CBT, was the first therapy I encountered that suggested a connection between my thoughts and feelings, and that my feelings might, in fact, follow from thoughts. In other words, change your thoughts–change your feelings.
One of the beauties of CBT is that it requires you to challenge the reality of your beliefs. If you believe that the world is flat, for instance, CBT would have you conduct research to see which experts (if any) supported the idea, and if so, what percentage; study the physical evidence around you to determine if the laws of physics in your world supported a flat earth; and so on. As a result, you change what you tell yourself so that you subsequently also change the way you feel.
Again, though I wasn’t aware of it at the time, I put these principles into practice every time I had a panic attack and was unable to visit the emergency room. Like a mantra, I’d silently repeat to myself over and over, “nothing happened last time, it all turned out fine, you’ll be fine this time too. . . nothing happened last time, it all turned out fine, you’ll be fine this time too. . . ” and so on, until I lulled myself to sleep.
Similarly, despite the heart pounding or shooting pains in my chest, I’d remind myself, “It’s only anxiety, this happens every time, you’re going to be okay, 20-somethings don’t have heart attacks.” (Though sadly, these days, that’s not entirely factual any more). Again, the repetition of these thoughts delivered a modicum of comfort and reassurance that sometimes propelled me through the night.
Finally, as the years went on after I left the university residence, I’d often call my sister in the throes of a panic attack, hoping for some reassurance (since she was a nurse, I figured she’d know when the symptoms were truly serious). Eventually, though, even she tired of reassuring me, and finally suggested, “If you are truly that worried, why don’t you just accept the way you feel, go to the emergency room and then you’ll know for sure that you’re fine? Then you can go back home and go to sleep.”
Somehow, that alternate interpretation of my trip to the emerg–that it merely provided reassurance that I needed–allowed me to, paradoxically, stop going. As long as I held on to the thought that I could go if I truly needed to, somehow that knowledge gave me the fortitude to stay home, reassure myself that this had happened countless times before with no ill results, and I was able to ride through the period of anxiety. The anxiety always subsided eventually, I reasoned. Once I was clear on that fact, I was so much better able to handle it.
I’ve tried a variety of herbal supplements and homeopathic treatments over the years. The ones that seemed to work best for me weren’t specifically geared toward easing anxiety, but rather at supporting my adrenals. Since constant stress can put a real strain on your adrenal glands, support can help to alleviate those symptoms as well. I’ve used a tincture called Strest from St. Francis with good results, as well as this adrenal support.
One other natural supplement I’ve used with good results is passionflower, specifically this one from Pascoe. It was extremely mild and wouldn’t be appropriate for the severe anxiety I had in my 20s, but it does offer long-term calming effects if taken consistently over time (and please be sure that you’re monitored by a professional when using it).
There are many forms of meditation out there, and I’ve found a few that have worked for me.
Initially, I practiced a relaxation technique known as progressive muscle relaxation, in which you move up your body from the feet to head, or down the body from the head to feet, focusing on each muscle group individually, tensing it, then relaxing it. Since that was the first technique I ever learned, it’s the one I still find most comfortable to use today.
Over the years, though, I’ve also tried traditional meditation techniques that require you to focus on a mantra and/or your breathing, and those have also served to help induce calm. Meditation doesn’t produce an immediate result, but it does work over time.
Moving Forward Once You’re Happier and Calmer
These days, I’ve come to accept a certain degree of melancholy or anxiety in my life. I still experience the occasional bout of mild anxiety, but it’s nothing like it used to be, and generally doesn’t last.
Another thing that’s changed is how I perceive anxiety and depression in our lives in general. Previously, the very fact that I felt anxiety at all was enough to throw me into a downward emotional spiral, certain I’d never be free of those disturbing feelings and wondering what was, fundamentally, wrong with me.
In contrast, today I believe that most of us hold unrealistic expectations when it comes to how often we should feel “happy,” and that we are far too quick to assume something is dreadfully wrong if we aren’t joyful all the time.
When I do experience these emotional dips nowadays, I ride through them, reminding myself that they are natural feelings, that they will pass, and that they are simply part of being human. Ultimately, they always do go away, and then I can get back to living my life–a life in which I’m generally in a pretty good mood. Seems like a positive conclusion to me.
Have you dealt with anxiety and/or depression? What worked for you?