Did you know that Alcohol and substance abuse is linked to Depression?
There are almost 24 million people dependent on alcohol and other drugs in the United States alone (Grant et al., 2004), roughly 8.6 of the entire population. The risk of depression is approximately 25 percent of women and 20 percent of men (Kessler et al., 2005).
This means that one in four women and one in five men will experience depression.
Our societal institutions have failed to provide adequate healthcare due to the increasingly high cost of medical treatment.
Depression causes mental, emotional, and physical illnesses.
The question automatically equates health with hospitals, doctors, prescription drugs, and technology. The question needs to change from, “What specialist can I go to to deal with this presenting depression?” to, “What is the nature of wellness and looking back on my life journey that caused this illness?”
This new perspective respects the patient’s story and the empowerment of everything that has meaning in the patient’s life; i.e., health, family, work, spirituality, community support, and education about improved health and functionality.
Depression has a way of “paralyzing” an individual causing chronic fatigue and loss of hope.
Comments from friends and family who don’t have an understanding of mental illnesses will say, “Just get over it.” “You have so much to offer, and you are wasting your life away.” The perception becomes “there is no way out, and I am stuck in a “cycle of contamination.”
For example, chronic pain or illness impact daily functionality causing anxiety and depression to rise. In turn, this causes more physical pain and depression symptomatology.
Therefore, It is important to understand in what ways the symptoms of depression are preventing you or protecting you from dealing with perceived personal problems.
To move out of the cycle of contamination requires a paradigm shift of perception and resulting thought patterns. The word paradigm comes from the Greek parádeigma, “pattern.” So a paradigm shift is a distinctly new way of thinking about old problems/ “patterns.”
Mental Representations of the Lived Experience
Life experiences introduce memories with some good and some difficult to remember. Memory forms of the “lived experience” are not only based on what we remember but how we remember and in turn, how we shape the narratives of our lives. Memory can be understood as the way the mind encodes elements of “lived experience” into forms of mental representations.
The way the mind attempts to integrate these mental representations is within the narrative process.
The memory capacity function denotes how our lived experiences formulate perceptions and future memory capacity function. The patient recalls past events determined by the brain creating a mental representation or image of an event or experience within the mind which is referred to as encoding memory.
The next stage of this process is memory storage, which speaks to the change in the probability of activating a particular neural network pattern in the future.
Memory is a process that alters the probability of a neuronal firing system.
Memories are the binding together of activated neuronal patterns (McFeature, 2009). The multiple sensory systems activate the memory of those experiences and reactivate during the retrieval system.
Beliefs also serve as an organizational function that allows the patient to store memories according to rules and themes (Mason & Kohn, 2001). Belief systems formulate thoughts, feelings, and behaviors.
A feeling-based memory that is at times attached to fear, for example, a child abandoned by their mother, attaches to a negative feeling state, i.e., helplessness, loneliness, or hopelessness.
This scenario may cause negative perceptions and patterns of non-attaching to others in relationships based on a fear of being hurt again. It is, therefore, critical that the “telling of the story” by the patient is complex and involves the memory recall and formation that can appear in the narrative as negative patterns and themes of unrealistic perceptions.
One very interesting line of study has looked at the impact rumination has on memory in depressed people.
In depression, rumination is the tendency to focus your attention on your depression symptoms, analyze them, and obsess about the impact of these symptoms in your life (Nolen-Hoeksema, 2000).
Rumination is a very unpleasant mental state, so depressed people tend to try to suppress negative thoughts and memories as a way of stopping rumination. In an attempt to suppress unpleasant memories the person receives more negative and intrusive memories.
This is sometimes referred to as the memory suppression effect (Dalgleish and Yiend, 2006).
Acceptance and Commitment Therapy (ACT) Treatment
Acceptance and commitment therapy (ACT) grew out of the cognitive behavioral therapy movement in the late 1980’s.
In clinical studies, ACT has proven to be a good treatment for depression, and it seems to continue to produce benefits well after treatment is completed (Zettle and Rains 1989; Zettle and Hayes 1987).
ACT is focused on mindfulness and acceptance strategies which allow a person to learn to accept, rather than struggle with aspects of the inner world of emotions, memories, thoughts, and physical sensations.
The focus of ACT is to explore personal values and develop a compass which is heading towards both healthy living and a meaningful life with purpose (Strosahl & Robinson, 2008). This prescription for healthy living includes:
- “A” for Accept
- “C” for Choose
- “T” for Take Action
Recently on March 8, 2017, New Roads Behavioral Health Clinical Team participated in an intensive two-day Acceptance and Commitment Therapy (ACT) training.
The training, facilitated by Robyn D. Walser, Ph.D. from the University of California, is one more tool to combat mental illness and help patients get better (http://newroadstreatment.org/).
The core conception of ACT is that psychological suffering is usually caused by the interface between human language and cognition, and the control of human behavior by direct experience.
Psychological inflexibility is argued to emerge from experiential avoidance, cognitive entanglement, attachment of a conceptualized self, loss of contact with the present, and the resulting failure to take needed behavioral steps in accord with core values.
ACT takes the view that trying to change difficult thoughts and feelings as a means of coping can be counterproductive, but new, powerful alternatives are available, including acceptance, mindfulness, cognitive defusion, values and committed action. Life experiences form a construct of perception and beliefs.
The impact of depression on human lives, systems of care, and communities have come to the point of crisis as substance abuse appears to be the only way to numb the pain.
A new paradigm involves a principle that was present all along but unknown to us. Working out of a new framework does more than the old.
You can’t embrace the new paradigm unless you let go of the old. The new paradigm will gain ascendance as people grow up with it and work in it soon to form a consensus.
After this time, there will be other contradictions, and science, technology, culture, and medicine will continue to break and enlarge ideas.
The key word in this paradigm shift is “informed.”
Treatment for depression is ever-changing and expanding, i.e., psychotropic medication, mental health therapy, mindfulness, and other complementary medicine practices.
Also, with the rise of awareness about the causes and interventions for depression, it is increasing and helping others understand that depression is a serious illness.
Cinthia McFeature, Ph.D.
Bill McFeature, Ph.D.
Dalgleish, T., and J. Yiend. 2006. The effects of suppressing a negative autobiographical memory on concurrent intrusions and subsequent autobiographical recall in dysphoria. Journal of Abnormal Psychology 115(3):467-73.
Grant, B. F. et al. (2004). The 12-month prevalence and trends in DSM-IV alcohol abuse and dependence: United States, 1991-92 and 2001. Drug and Alcohol Dependence 74(3):223-34.
Kessler, R. C. et al. (2005). Lifetime prevalence of age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry (62)(6):593-602.
Mason, D. J., & Kohn, M. L. (2001) The Memory Workbook: Breakthrough Techniques to Exercise Your Brain and Improve Your Memory. Oakland, CA: New Harbinger Publications, Inc.
McFeature, C. & McFeature, B. (2009). HeartPath Practitioner: A Practitioner’s Guide; The Healing Journey through the Life Narrative into the Heart of the Divine, Mustang, Oklahoma: Tate Publishing, LLC.
McFeature, B. & McFeature-Herron, C. (2017). Integrated health – Heartpath practitioner assessment and intervention for the trauma-exposed patient. Melbourne, FL: Motivational Press, Inc.
Nolen-Hoeksema, S. 2000. The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology 109(3):504-11.
Pratt L. A., Brody D. J. Depression in the United States household population, 2005– 2006. NCHS Data Brief. 2008(7):1–8.
Zettle, R. D., and Hayes, S. C. 1987. Component and process analysis of cognitive therapy. Psychological Reports 61(3): 939-53.
Zettle, R. D., and J. Rains. 1989. Group cognitive and contextual therapies in treatment of depressions. Journal of Clinical Psychology 45(3): 438-45.