Depression & Neuroplasticity: The Cure Within The Venom

Dear Audy,

I received a great comment on my recent post Sorry, Frustration, But I Can’t Accept That Proposal. Amongst the many beautiful and encouraging words in that comment was an issue that has inspired me to take a closer look at my coping skills and why I have come to believe strongly in having the choice to stay above or fall below the line between momentary sadness and ongoing despair.

According to the symptoms for diagnosis, I suffer from clinical depression. However, I also suffer from crippling chronic pain and I view both the anxiety and depression symptoms as my body and mind trying to cope with both the pain and massive changes in quality of life. I was not suffering depression when I developed CRPS. In the previous post, I wrote “When nothing can be done to stop whatever is upsetting me, I am the only thing that can make me feel better. How? By choosing to. It’s just a choice, that’s all. The more that I am aware of the choice, the easier it is to let go of the feeling of desolation. It’s not always easy to see the choice, but it is always there.”

It is not uncommon to be met with defensiveness or even outrage when suggesting that depression is a choice – that’s exactly how I reacted when it was first suggested to me. Why? Because to most people, that means you are implying that it is as simple as any other choice, such as what to have for breakfast, or what colour socks to wear. When I say that choosing whether or not to give in to depression is possible, I certainly don’t mean that it’s easy to do.

20100808 neuroplasticity time-illustration
(click for source)


The brain is a super lazy, super, synaptic network. If it usually responds to certain stimuli (inc. thoughts) in a certain way, then it remembers those connections, strengthens them (like a bicep in a gym) and uses them as a default setting. Over time, if a person allows negative thoughts to be accepted and regarded as fact, the mind produces more and more of these thoughts because physical and chemical connections in the brain start to change so that the route from perception to depression is the fastest and easiest one for the synaptic pulses to take. This is called neuroplasticity and means the brain has physically changed in response to how it is being used. If that word seems too complicated, think of it as I do – my brain is more like malleable plasticine than dried clay. Neuroplasticity means that the human brain is never ‘set’. It is always growing cells and creating new pathways for information to travel along.

Depression can linger long after its instigator has passed and is a bit like a poisonous snake – the cure is in the venom. Along with helping to aid depression in taking a hold of one’s mind, I believe that neuroplasticity is also the answer to both overcoming the depressive thought patterns and creating ways of recognising and responding to stimuli that are less destructive and even constructive. By recognising their existence and practising positive reactions, we can build new connections and new pathways for information to take, so that when it lands in our consciousness, it is a clear perception, rather than one tainted by its having taken the same neural pathway and acquiring the stigma of so many upsetting thoughts or sensations before it.

It is the hardest thing in the world to let go of justified anger or sadness…but that, right there, is the challenge that anyone facing depression must take on in order to overcome it. Accepting that I can choose how I react to thoughts is the most difficult mental strategy I have encountered and has arisen from years of working through my own emotions, thought patterns and responses. I don’t claim to have everything figured out, I battle with depressive thoughts every day. When I say ‘battle’, I am referring to the fight to simply let them go, rather than trying to ‘fight them off’, as the world suggests. In a way, I fight not to fight. The more negative thoughts and energy that I am able to recognise and let go, the stronger I feel. In order to get from a wheelchair to limited walking and driving, I’ve had to let go of a lot of pre-conceived notions of who I am, what I can control, what can control me and what it means to have this human body.

If someone had said to me years ago that the secret to not being depressed is to simply choose, I would have punched them in the face. Like many, I was so convinced that “No one understands!!”. It takes a lot of time and exploration to find ways to understand your own mind and I am learning a bit more about mine with each obstacle that I face. Depression is an ugly, ugly beast and manifests differently in everyone because we all have our own worries and woes for the anxiety to brew its emotional cocktails with. This can make it feel like a hugely personal thing, as though nobody has ever felt that awful before. Often people believe there is a root cause for their suffering and if they can only find and alleviate it then they will be ok. In my own experience, finding the root cause doesn’t automatically turn off the anxiety process and stop the depression.

The way I see it, root causes are red herrings when it comes to overcoming chronic depression and/or anxiety. They are valuable, but recognising them isn’t a cure, there will always be something else to be sad or upset about. I know plenty of people who claim that they are nervous people, or depressive people, or even abusive people because of what has happened to them in their lives. They can recognise where they tipped from mental stability but simply accept that as an excuse for their current behaviour, rather than challenging themselves to let the issue go so that it no longer holds influence over their life.

* * * * *


Everything I write here is just my opinion and I love hearing yours! Have you suffered or do you suffer from depression? If so, how does what I’ve written here make you feel? Please feel free to add your comments – coping with anxiety and depression aren’t set in stone things, nobody is ‘right’ or ‘wrong’, I think the more discussion about the nature of it, the more awareness and acceptance we shall breed.

Love & Letting Go,
Caf

P.S. Depression is not all that different from addiction. It’s just the mind set in its way and causing physical effects that are not easily reversed. I bring this up because VicHealth has recently released its first positive anti-smoking campaign in 20 years. The gist? Every time you quit you get a little better at it. Never give up, giving up. As well as being a brilliant concept for an anti-smoking campaign, this perspective also applies to overcoming depression. By completely ripping them off, I give you this statement:

Every time you climb back up from a fall into depression you get a little better at it. Never give up getting up.

x

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  • 14 thoughts on “Depression & Neuroplasticity: The Cure Within The Venom

    1. Denise

      Thanks for being so brave to give hope to some who may have lost it all to the monster called depression. I do not talk much about it because personally I don’t want it to become me, like you I choose to recognize my triggers and let it go! I have been to places no human should ever have to endure and it almost took my life away! I know each day brings challenges and that I have the power to handle each in a positive, productive way or a negative, destructive way…..I don’t always make the right choice I am human and make mistakes but I learn and grow from them allowing myself forgiveness to make better choices in the future! I always say the mind is a powerful tool it can either make you or break you but you ultimately have the choice!!! Thanks with admiration and support!
      A facebook friend!!!!

      1. admin Post author

        Hi Denise, Thanks so much for the comment and for being brave enough to talk about your own struggle! It is true that depression takes the mind to such dark and horrible places, I admire your strength SO much and your level of personal awareness. Nobody makes the right choice all the time and that’s often when we find ourselves too far gone into emotional turmoil to be able to make a new decision at that time, it’s never a pleasant experience but I like to think that each time I come back from tipping over that edge, I learn a bit more about where I could have taken a different perspective earlier that might have helped me to keep the raging emotions in check. Thank you also for raising the point of personal forgiveness, that is such a valuable and necessary tool when learning to let emotions or thoughts go, also one of the hardest things in the world to learn to do (of course, isn’t all the good stuff the most difficult? ;P) Much love!! xx

    2. Joe

      Very well written piece that doesn’t trivialise the problems that depression poses. It’s not easy to talk of choices to anyone in the grip of a depressive phase; the illness affects the way you perceive the comment. I know that the thought that I chose to be depressed would send me into a downwards spiral. Equally the thought that I could be better simply by choosing to be would also send me into a spiral thinking of my failing to choose to get better. I realise that this isn’t what you’re saying, but it shows an example of how depression warps the message and feeds on itself.

      It’s a complex condition, often triggered by external factors, sometimes not, but always sustained by many of the factors you mention. I think there is a necessary phase of the illness when sufferers need to understand that what is happening to their minds isn’t their fault to lead to acceptance of the condition, so that they can move onto coping strategies. Having said that, the “I’m ill” mindset can then become a barrier to eventual recovery or learning to cope.

      I have accepted that depressive thoughts will recur, probably for the rest of my life. I’m never going to be the world’s cheeriest person. Suicidal thoughts occur most days, and I’ll probably not be rid of them, but I can manage them and choose to try to not let them rule me. I think this partly chimes with what you’re saying. Whether continued mind exercise to improve mood works or not is difficult to prove, but it can’t harm. The challenge is in trying to recognise low thoughts as incidents rather than items that are my fault.

      I’ve come some way by acknowledging the role of CFS/ME in my symptoms. I know that exertion causes extreme tiredness and very low feelings. If I rest the depressive side usually abates. If my blood sugar gets low, depressive feelings often follow. If I manage to maintain a constant sugar level by eating the right foods at the right times, the effects are minimised. As yet I’ve not managed to throw off the depressive side of my illness, but I think I am managing to reduce low phases and become less of a slave to them.

      I admire your ability to cope in the face of many more challenges than I face!

      1. admin Post author

        Thank you so much for this well thought out comment, it is inspiring to read about your courage with facing your personal challenges! When I am talking about “choice”, I am not intending to imply that one has the choice to actually have depression, I actually meant to communicate exactly what you have worded so well here “[I can] choose to try to not let them rule me.” I shall write some more on this topic to clarify for any misinterpretations, I wanted this first post to be a strong perspective, because, in my own personal case, that’s how I needed to hear it to get me thinking along paths that have made it easier for me to cope. For example, when I first read about the concept of taking responsibility for my own state of mind, when I had so many external factors that I believed were causing how I felt, seemed like some sort of crazy denial technique. The very idea that I was being told that I was responsible for my condition hurt me, it hurt my pride and it made me feel weak and inadequate. Over time, I kept wondering; what are these people talking about? How can I be responsible for healing myself when I couldn’t stop how my body and mind got this way in the first place? At first, I believed that they must simply have really strong faith in whatever religious or spiritual forces they believed in. I actually felt cheated that I am not, myself, able to accept mainstream religious beliefs as absolute fact, I felt like if I could only do that then I, too, could have that advantage. Unfortunately, we can’t really force ourselves to believe in what we really don’t believe in. It’s taken quite a while, but those questions about accepting responsibility for healing, along with brain re-training exercises that I have been learning through pain rehab and Feldenkrais started to fall into some sort of pattern for me. I asked myself, “What if I did choose to believe that I am responsible for my own condition, what then?” I realised that taking responsibility for my recovery isn’t the same thing as accepting “blame” for my condition. I did not ask to have CRPS, but I am responsible for how I deal with it now that it’s here, as well as the anxiety and depression that comes along with it. I asked myself a lot of things about what sort of person I respected, what sort of person I would like to be and kept coming back to the idea that I did not want to let this illness “beat me”. That’s when I started making better choices that mean I don’t spiral down quite so often (and look, I’d settle for the breakthrough of every second day in a second!) and when I do find myself starting to feel blue, I am getting better at recognising it happening and making decisions to turn it around before the depressive episode fully takes hold and I am too far gone. Like you mentioned, I have accepted that this could go on for the rest of my life, along with that I am choosing to accept that there is the possibility that with enough hard work I could become so self aware that I am able to stop depression before it even takes a hold as the blues. I choose to put my faith in possibility, because what it, just what if, enough positive reinforcement could completely cure a depressed mind? How wonderful that would be…and nothing ever happens if nobody believes it can 😉 Thanks again for the input and discussion! I think tiny steps at a time is all anyone can ask to take and I completely admire the fact that yours are helping you to reduce the low phases, that’s all win in my opinion xx

    3. Diane

      I see your point. I’m not a mental health professional, but my understanding of depression (who has struggled with it off and on for years and also has a good friend who is a psychologist) is that sometimes we need help making those connections you discuss – whether it’s through antidepressants, supplements, therapy, behavioural changes… whatever works for the individual. I think it can take more than just a “choice” sometimes.

      1. admin Post author

        Hi Diane, thanks so much for your thoughts and the bravery to talk about your own struggle :) I absolutely agree that people need help to cope with depression, I suspect that nobody just wakes up able to cope and with complete self awareness or the ability to deal in a non destructive manner. I shall write some more on the topic of coping techniques, I definitely agree with you that medication and therapy are often a very necessary part of the process of learning to cope, I more intended this post to simply raise a concept, an idea that people can toy with in their own perception, if they so choose to. I don’t for a second suggest that it is a person’s choice to actually have depression, but I do believe that in learning to cope it’s possible to learn to recognise triggers that will provoke negative responses and then choose to adapt behaviour and focus in order to avoid that outcome. I also agree that it is very much what works for the individual, the very choice to keep trying and searching for new techniques is definitely a positive and kind of exactly what I’m talking about, we can’t choose whether or not we have to deal with this awful beast, but we do have a bit of say in how we respond and move on from wherever we are now :)

    4. Jeanne

      Hayley,

      Thank you for sharing your thoughts regarding your experiences coping with depression. Given the amount of stigma our society still sadly has for mental illnesses, including depression, it can be difficult for people to speak openly about it.

      People (in our general society) tend to use to word “depression” or “depressed” to mean many things. Heck, some people say they are “depressed” when the ice cream parlor is out of their favorite flavor. This sense of ambiguity about what “depression” or “depressed” even means can be confusing for people.

      I understand that you have indicated that you yourself fit the criteria for clinical depression. You have every right to your beliefs about what works for you. I respectfully disagree with the notion that, in general terms, patients with major depression (be it clinical depression or bipolar disorder, which is sometimes also known as manic depression) can “choose” not to be depressed (or manic, as the case may be). I disagree with this “choice theory” because of the scientific research indicating that depression (in the form of clinical depression or bipolar disorder/manic depression) is biological.

      “People with bipolar disorder have an average of thirty percent more of an important class of signal-sending brain cells, according to new evidence being published by University of Michigan researchers.

      The finding, published in the October 2000 issue of the American Journal of Psychiatry, solidifies the idea that the disorder has unavoidable biological and genetic roots, and may explain why it runs in families.

      The discovery is the first neurochemical difference to be found between asymptomatic bipolar and non-bipolar people. It could help the understanding and treatment of a disease that affects as much as 1.5 percent of the population. Bipolar disorder has in the past been known as manic depression”.

      Source:
      “Evidence of Brain Chemistry Abnormalities in Bipolar Disorder”

      In regard to your comment about the timing of your clinical depression in relation to your chronic pain, there are many, many patients who experience both chronic pain/illness and depression. The fact that chronic pain/illness precedes depression is some cases doesn’t make the depression any less real. (See Mayo Clinic’s Q&A about the link between pain and depression here: Is there a link between pain and depression? Can depression cause physical pain?)

      There is no “right or wrong” regarding your right to believe whatever you’d like to about your depression. My concern when I read your initial post (the one I commented on that you indicated inspired you to write this post) is that there is a consensus in the medical community and amongst mental health researchers. That consensus is that depression (defined as clinical depression or manic depression/bipolar disorder) is not a matter where an individual can simply “choose” not to be depressed. Does a depressed individual have some (or even many) opportunities to make “choices” that can effect their prognosis? Certainly. However, I agree with the doctors/scientists who view depression as biological. In other words, one can no more “choose” not to be depressed than one can “choose” one’s eye color. Granted, I can choose to wear colored contacts that alter the color of my eye. However, my true eye color has not changed.

      I am absolutely on board with positive thinking and with doing whatever one can to avoid sinkholes or pull oneself back from the ledges. However, honestly, I am concerned about the notion of floating out a theory that people who are depressed can simply “choose” to not be depressed (and I understand that you mentioned that this entails hard work) implies that anyone who is depressed yet not able to “choose” to opt out of that depressed state is somehow not exerting enough willpower, not “putting in the work”, or somehow weak.

      I strongly disagree with the notion that any and every depressed person can just “choose” not to be depressed. I personally know of people who have struggled with depression, who have gone to great lengths to make good choices, and who have continued to be either depressed or manic… not because they didn’t work hard enough to implement their “choice” but because they have a biological illness that is severe enough to not have been stabilized (despite medical care). It can take time to find the best medication or combination of medications and it can also take time to locate and develop a strong relationship with a therapist.

      Hayley, I love you to pieces! You know I do. The truth is that I was a bit taken aback when I read this post. Therefore, I just have to respectfully disagree with your theory that depressed patients can simply “choose” not to be depressed (if they work hard enough at it and such). This is at odds with medical research.

      As far as neuroplasticity is concerned, I saw a very interesting program on it and I’ve read about it. The program I saw gave me no indication whatsoever that the researchers conducting it subscribe to the theory that depressed patients can “choose” not to be depressed. In the reading I have done on neuroplasticity, I haven’t either. I have seen some written materials about neuroplasticity that seemed, to me, to alter what was meant by the term. (This was in the multiple chemical sensitivity – MCS – community). To me, some of what I saw in written materials seemed to take the concept of neuroplasticity out of its original context).

      My biggest concern is that any depressed patients who might be reading about this “choose not to be depressed” theory might feel quite upset at the notion. Not in the sense you described you would have been in the past (describing yourself as not having done the work to look at it as you do now). No, I’m talking about people who may follow your blog or come across it randomly and be too depressed to even dream of posting a comment explaining how they feel about it.

      The very people who might find this post the most provocative might not be well enough to engage in a discussion about it (referring here to where you encourage people to leave comments with their feedback. My biggest concern is that the most seriously depressed patients (i.e. ones with suicidal ideations) may be least able to shrug off what you’ve said here. Since my blog gets daily traffic on search strings involving suicide (to the point that I posted a suicide hotline on my blog), I am truly concerned about the public posting of a theory that depressed patients can simply “choose” not to be.

      I think there is a big difference between saying “this is what works for me” OR implying that anyone with depression can “choose” not to be. The first is your opinion and you are 100% entitled to have it. The latter is a generalized statement that stands in contrast to what medical research has found. It’s possible that I have misunderstood something in your post and what you meant by it. At the same time, if I have misunderstood something… others may do the same.

      The reason I am sharing my thoughts on this is that you asked for people to share their comments on a topic you acknowledged might elicit “defensiveness or even outrage”. I am not leaving this comment with any defensiveness. You are too sweet for me to ever be outraged at anything you say… because I do not believe you would ever say anything to be hurtful or mean-spirited. I do believe I have a fairly good understanding of what you were trying to say. My personal perspective is that you had the best of intentions when you wrote this post. The way you have worded this “choice theory”, from my perspective, could hurt readers who are depressed due to a biological condition.

      To me, it would be like me telling you that if you work hard enough at it, you could “choose” not to have RSD/CRPS. I’m guessing you’d be hurt and insulted if someone suggested such a thing to you. What I am suggesting is that some of your readers may be insulted by this “choice theory” as you would be if someone suggested you could simply “choose” not to have RSD/CRPS anymore. The neuroplasticity program I watched, which was highly interesting, featured one stroke patient who made strides far beyond what her doctors thought possible because her son (a scientist) used neuroplasticity techniques with her. He never suggested that these techniques were a blanket treatment for any and all conditions. They simply showed how it helped that particular woman (and some other patients in the program). I wouldn’t suggest that neuroplasticity has all of the answers for treating your RSD/CRPS because I don’t know of any evidence that this is the case. Can you imagine, though, if someone did suggest that to you? How would it make you feel if someone took a concept like neuroplasticity and generalized its application/efficacy to the point where they implied that if you can’t “choose” not to have RSD/CRPS, you must not being putting in the work?

      I know that you would never, ever write a post intended to upset anyone. What I am trying to express is that this whole notion of “choosing not to be depressed” by making use of neuroplasticity seems akin to if someone suggested that RSD/CRPS patients can “choose not to be depressed” by making use of neuroplasticity. I think if anyone made such a suggestion, you might well be furious, hurt, upset, etc.

      This isn’t about “right or wrong” or debating. My personal take is that putting out a theory (“just choose”) on a topic as serious as depression could literally put lives at stake. So, that concern is what fueled me to write this most long-winded of comments. It’s just because I care.

      Take care,

      Jeanne

      xo

      1. admin Post author

        Hi Jeanne, Thanks for your passionate response!

        Please don’t take this post too personally. Your comment inspired me to to take a closer look at myself, I didn’t mean to imply that you or your views were being conveyed in the content of the post.

        There has been a little misinterpretation in that you have understood that I am launching a theory that any and every form of depression is simply a choice being made by the sufferer, I am not suggesting that at all. I am putting forth the idea that there are many small choices that we make along the way the influence our emotional state. I am merely expressing my own opinion based on my own experience. Were I to express an opinion on any and every illness that effects people who might read this post, I would be writing a book that would take a lifetime to research. I am sharing my own coping techniques in the hope that perhaps others in a situation like me might benefit from it, I am not suggesting a blanket cure for mental illness. I do not expect that what works for me is going to work for everyone. I am not attempting to prove the theories behind neuroplasticity, merely to bring awareness to the fact that they exist; that there are alternative views to what the human brain can and cannot overcome and that this one in particular is helping me.

        I intended to invite people to question their own beliefs about their own condition, about how much control they have and how this level of control could theoretically change. I share these ideas because they are helping me cope every day. I kind of feel that it goes without saying that no idea is relevant to any and every form of depression or mental illness. I try to keep my mind open to any sort of theories in regards to coping and overcoming the long term blues. It’s a personal journey and I never know where a particular quote or concept will come from that will suddenly make a different perspective clearer in my mind.

        You wrote: “I am concerned about the notion of floating out a theory that people who are depressed can simply “choose” to not be depressed (and I understand that you mentioned that this entails hard work) implies that anyone who is depressed yet not able to “choose” to opt out of that depressed state is somehow not exerting enough willpower, not “putting in the work”, or somehow weak.”

        It is interesting that you have chosen to perceive this from what I have written. (Interesting – Not bad or good, no personal affront intended, it’s all just discussion) In this situation, it seems as though your interpretation is that ‘hard work’ is indicative of willpower and that not being able to overcome a problem using willpower alone is a personal failing. This is not my perspective at all, but I can see how it could be read between the lines of what I wrote, with a slight perception twist. I actually believe that willpower can sometimes be a hindrance if it is so steadfastly convinced that one course of action is ‘right’ that it can’t see any others. (Willpower is an interesting topic on its own and one that my opinion has changed about in recent times, I shall write more on this topic when the thoughts settle…)

        Raising the idea that depression can be viewed from a different perspective is in no way stating that anyone suffering from depression is “somehow weak”. I do not believe that at all. By discussing a technique that helps me feel stronger, I am hoping to share that it is possible to feel stronger using these techniques, not accusing of weakness for failing to do so. I even state this point as “feel stronger” because I don’t believe mental or emotional strength are comparable things, other than to our own previous states. Nobody’s struggles are exactly the same and therefore it would be presumptuous to assume that anyone is stronger or weaker than anyone else in this capacity.

        What I am publishing here is on a personal blog and quite clearly stated as my own beliefs and opinions, I find it a little disheartening that discussing something that is influencing my life in such a positive way would be construed as negligent because of the possibility that someone, somewhere might misinterpret it. If everyone wrote by those standards then all we would have would be one, big, singular mainstream literature mass of information that can be generalised safely – and it’d be a short book! I write for the people who want to read it, if others don’t like what I am writing about, they have the choice not to accept it, or decide that it doesn’t apply to their situation. I purposefully wrote this with a slightly provocative tone in order to see what sort of responses that elicited, sometimes reading something that you strongly disagree with can be as enlightening as reading something that all makes sense to you.

        If a person is too depressed to be able to make their own decisions about what they read then, of course, that is a terribly sad situation, however I do think it’s taking the whole thing a little bit too far to suggest that expressing my opinion on my blog could put lives at stake – especially when you consider that this statement seems to be based on the inference that the discussion of a possibility could possibly be interpreted as accusatory by those to whom it does not apply. I would definitely rather risk the possibility that someone might misinterpret what I’m writing than not express what I have to say to the people who might benefit from it.

        Thanks again for the input! I am enjoying reading and pondering the responses to this subject, I shall write again soon :) xx

        1. Jeanne

          Hayley,

          I think the line in this post that I interpreted to mean one can “choose” not to be depressed (which I later referred to as a “theory”) was this:

          “It’s not always easy to see the choice, but it is always there.” (emphasis mine on the word ‘always’)

          I am in firm agreement with you that people often DO have some degree of control (sometimes even a large degree of control) over how they react to things (including illnesses, be they physical or mental).

          The point I was trying to make is that this is not always the case. (On this point, I can see we may have to agree to disagree?)

          I can tell you this. Having witnessed a loved one admitted as an inpatient to a psychiatric unit (a traumatic scene I hope to never see again), I can assure you that she was about out of choices for just about everything under the sun. Truly, she was physically restrained and medicated. Once things reach that point, many choices have gone out the window.

          To be clear, I do not discount the power and value of neuroplasticity. If anything I said in my previous comment came across that way, it was not my intent.

          I not only believe neuroplasticity is a promising field but I personally have made strides that one might label as being due to neuroplasticity. (I could bore you with a very long story about my botched surgery from January 2008 but I won’t. Let’s just say that working with my acupuncturist to try to modify the way my brain was processing pain signals was the ONLY thing that made significant improvements occur).

          My husband and I took a mindfulness meditation class from this same acupuncturist that was very helpful. Again, I agree with you that mindfulness meditation is very powerful.

          I think we may have gotten caught up in a semantics issue here. I never meant to suggest that neuroplasticity is not of value or that people should ignore/avoid it until more scientific studies come out on it. The science I saw on neuroplasticity was quite convincing to me.

          My primary concern with the comment:

          “It’s not always easy to see the choice, but it is always there.”

          I fully understand that you wrote the post based on your own life experience. At the same time, there is a difference between journaling to yourself at home and publishing it online.

          Since the topic of depression is such a heavy one and since there could be readers who interpreted the post in a similar fashion to the way I did (before posting my initial comment, I actually ran it by a couple of friends because I wanted to see if they were interpreting it in a similar manner to how I did).

          Also, in regard to the “quit smoking” video, it was a great video for the topic of quitting smoking. Unfortunately, for certain types of depression, this adage “every time you climb back up from a fall into depression you get a little better at it” is not really medically accurate.

          Let me explain. There is something called the kindling effect for bipolar disorder. The watered-down, un-scientific explanation of it is that every episode (whether depressed or manic) that a bipolar disorder patient has has the potential to cause further damage (yes, I mean brain damage). So, subsequent episodes can actually make additional episodes more likely to occur.

          So, the “every time you climb back up from a fall into depression you get a little better at it” phrase sounds good but, sadly, it is too often not applicable for a fair percentage of patients who struggle with depression.

          Currently, I have a loved one who has completely estranged herself from the immediate and extended family. I’m not 100% sure where she is living. She just blew off a family reunion. Many loved ones are very concerned about her. Her illness has all but taken over.

          Does she make some negative choices? Yes. Is a large part of why she is struggling so horribly related to her illness? Yes. Is it 100% responsible for where she’s at now? No.

          The sad fact is that she has made some choices that have sabotaged herself. What the future holds for her, I really don’t know. The sad fact is, though, that if her condition had been stabilized and had enabled her to make healthier choices than the ones she has made, things could be much better off for all concerned.

          Do I think any negative choices she has made are even 65% responsible for the mess she’s in now? No. Her illness is too severe for her to make solid, positive choices much of the time.

          So, I understand much better now what you meant with this post after reading your comments. Please understand that the post as it was written sounded to me like a general case was being made for it “always” being a choice.

          You owe zero explanation to anyone about whatever belief system works for you. My concern when I read your post was that someone might interpret your words as implying that “anyone” can choose not to be depressed.

          I totally understand what you have since said about what works for you. When it comes to the topic of depression (and with the frightening number of blog visitors I get who have searched a phrase with “suicide” in it to reach my site), I am ultra-cautious because I never really know who might be reading it or what state of mind they might be in.

          Sending positive thoughts and energy your way!

          Jeanne

          P.S. I never thought you were saying anyone had chosen to have depression. What I took out of the initial post was that you were suggesting that “anyone” can choose to stop being depressed.

          1. admin Post author

            Thanks for your thoughtful response, Jeanne! I love the different perspective and additions that you add. You are completely right, the things that I write don’t apply to every form of depression, or disorder that causes depression, I would love to be able to offer insights into more but I can only really write about what I’ve experienced. I am with you now on the ‘always’ comment, I wasn’t focusing on the previous post before, just the neuroplasticity one, sorry!

            I can understand that people could have misinterpreted my comment as a generalisation, however, I personally think I did enough to express it as in relation to my own personal experience, the full context of the comment being: “Whenever I feel depressed, I also feel a little bit guilty. There is a difference between sadness and depression. When nothing can be done to stop whatever is upsetting me, I am the only thing that can make me feel better. How? By choosing to. It’s just a choice, that’s all. The more that I am aware of the choice, the easier it is to let go of the feeling of desolation. It’s not always easy to see the choice, but it is always there.”

            It’s awful if somebody reads that and chooses to apply it to their own situation in a negative manner, or think of it out of context, however there is also the positive aspect that someone might read it and start questioning why I am viewing my own situation in this way and be driven to make their own realisations about themselves. Reading about someone else’s self exploration was what got me thinking along these lines and really, my life is so much different than it was a few months ago! I suppose there are always two (or a million) ways to look at things, thanks for sharing more different perspectives for me to ponder!! :) xx

    5. Jeanne

      Hayley,

      This was a typo on my part:

      What I am trying to express is that this whole notion of “choosing not to be depressed” by making use of neuroplasticity seems akin to if someone suggested that RSD/CRPS patients can “choose not to be depressed” by making use of neuroplasticity.

      What I meant to say was:

      What I am trying to express is that this whole notion of “choosing not to be depressed” by making use of neuroplasticity seems akin to if someone suggested that RSD/CRPS patients can “choose not to have RSD/CRPS” by making use of neuroplasticity.

      Jeanne

      1. admin Post author

        I understand what you are saying, however this notion isn’t offensive to me at all…in fact, I strongly believe that neuroplasticity is the answer to overcoming CRPS. In fact, any technique that has so far been developed to help people cope with chronic pain links back to the theory that the brain can form new connections in response the the stimulation that we give it. Pain rehabilitation involves strengthening and working through pain to be able to complete more activities and movements than are available in one’s current state, the purpose of this is to ‘overcome’ the pain by learning to do activities anyway and that over time you can teach your body to allow more movements by strengthening the positive neural connections associated with movement, rather than allowing the brain to go on believing that ‘everything hurts’. Feldenkrais is a movement based method that aims to ‘teach the brain’ that the body can move in ways that aren’t painful and are even pleasurable. I have experienced the benefits of this myself and ‘teach the brain’ is just another term for neuroplasticity. I am encouraging my brain to respond in different ways than its default pattern because CRPS has made the default a bit wonky. Even the medication options available for CRPS patients, most notably the ketamine options, are based on the theory that a chemical interruption can allow the brain to reconnect in the fashion that it did before the chronic pain reaction. This is an attempt to chemically bring about neuroplasticity.

        I am not saying that neuroplasticity is a “cure” for depression or CRPS, it is a physical process that science does not know exactly how to replicate or explain. Science might not be able to control neuroplasticity, but the discovery of its existence can offer hope to people who are open to hearing about it, especially those who hold old-school beliefs that the brain is a fixed organ. Neuroplasticity has offered a lot of hope for me. I don’t have to believe any longer that I must simply put up with uncontrollable levels of pain for the rest of my life, like the doctors told me I did. I have already made improvements, so I have plenty of motivation to keep me practising on positive reinforcement to try and influence changes in my own brain. In order for anything major to change, someone first has to believe it can.

        Had I made no physical improvements using these ‘brain retraining’ techniques, I doubt that I would have realised that I could apply the same method to my depression patterns. Having experienced positive physical results, even though medical science told me there’s nothing that could be done to cure me, has helped to reinforce my faith in myself and the belief that I always have the choice to choose how to interpret a situation. When I fall down, I have the choice to learn the lesson (even if it’s a tough one) and apply that knowledge the next time I am in a similar situation.

        I am not saying that I have chosen to have CRPS, just as I was never saying that anyone has chosen to have depression. What I am saying is that I have the choice to decide how to handle my life from here. And, if I have that choice, maybe, just maybe, someone (not everyone) reading this will realise that they have that choice too.

    6. Missy/Raven

      I know this is an old entry but wanted to comment anyway. I am choosing to comment with my thoughts, before I read any of the comments which have already been received. I have suffered with depression off and on for years. I am not bi-polar, but I am genetically predisposed to become clinically depressed in the right situation. Thanks to my chronic pain, depression has now become a regular thing for the past 9 years or so.

      There are biological reasons for depression but, like you, I believe that what I think affects how I feel, as does what activities I engage in. We do have a choice. For example, when my pain is bad my mood goes down which makes the pain seem worse. If I allow my brain to think negative thoughts such as “this is horrible” “this will never end” “I hate this!” etc etc., I am reinforcing the negative mood which increases the pain perception and increases the negative self-defeating thoughts. This can be a very difficult cycle to break because, as you said, the more the brain does something the better it gets at it and the more sustained effort it takes to forge a new path for the brain to follow.

      I’ve been reading your blog for a while, but decided to go back to the beginning and read from the first post. I have also viewed your YouTube videos which is how I found you.

      Thank you for putting your experiences out on the net, they do help others even those who do not have the same diagnosis causing their chronic pain.

      1. Hayley Cafarella Post author

        Hi Missy! Thanks so much for your comment, I’m sorry it’s taken me a while to reply. I was very excited to hear from you, I have been having a read through your blog and I can relate a lot to the struggle so you are facing. Pain management is such a complicated, ever-changing beast! It’s wonderful to find other writers with attitudes about it that are similar to mine. The way that you have described your thoughts around depression above is so very right how it is for me, but I am so grateful that these days I have the awareness to see what my brain is doing even if I can’t always control it being aware of what’s going on makes it easier to ride out the downtime. Wishing you much luck on your journey to recovery (I’m positive thinker ;P) I will be looking forward to your updates in my Google reader! 😀 x

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