How to Reframe 5 Common Depression Symptoms — Transcript

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1. 0:00Hi, I'm Arturo from Uncommon Knowledge,
2. 0:02and welcome to how to reframe the five
3. 0:04most common physical depression
4. 0:05symptoms. Why understanding how stress
5. 0:08affects the body sets your clients free.
6. 0:16[Music]
7. 0:19"I can't sleep," Angela told me.
8. 0:22"And when I do sleep," she said, "I
9. 0:24still wake up exhausted, and I just ache
10. 0:27all the time."
11. 0:28So, Angela had been diagnosed with
12. 0:30depression 5 years before coming to see
13. 0:32me.
14. 0:33And when she finally came along, she
15. 0:35just started to understand that the
16. 0:36depression she was experiencing was not
17. 0:38truly a disease caused by a chemical
18. 0:42imbalance.
19. 0:44"So, if it's not a physical illness,"
20. 0:46she said, "then why do my muscles ache?"
21. 0:48She really wanted to understand.
22. 0:52So, depression's physical symptoms.
23. 0:55I explained to Angela that clinical
24. 0:57depression is never just in the mind.
25. 1:00Emotional disturbance, especially when
26. 1:02it's prolonged, will always have an
27. 1:04impact on the body.
28. 1:07Physical factors aren't the most common
29. 1:09cause of depression,
30. 1:11but however it's caused, it certainly
31. 1:13has physical or somatic consequences.
32. 1:17And from working with many depressed
33. 1:18clients over the years, it's become
34. 1:20clear to me that some of these physical
35. 1:22symptoms of depression are depressing in
36. 1:25themselves.
37. 1:27This is even more likely to be the case
38. 1:29when we don't understand that they are
39. 1:31normal and in essence simply another
40. 1:33indicator of the same phenomenon as a
41. 1:37stressed mind and body.
42. 1:39Explaining this to people can make a
43. 1:41huge difference.
44. 1:43And of course, physical symptoms should
45. 1:45always be checked out by a medically
46. 1:46trained professional to ensure your
47. 1:48client isn't suffering from some
48. 1:50underlying or previously
49. 1:52undiagnosed physical condition separate
50. 1:54from their depression.
51. 1:56However, it's sadly true that many
52. 1:58physicians don't fully understand why
53. 2:00depressed people have these physical
54. 2:03symptoms.
55. 2:04Okay.
56. 2:05And even those who do understand may not
57. 2:08explain it very well to their patients.
58. 2:11So, in addition to using metaphor to
59. 2:13help Angela normalize her overall
60. 2:16experience of depression, I also helped
61. 2:18her reframe the physical symptoms that
62. 2:21depression was um causing her.
63. 2:23So, here are five of the most common
64. 2:26physical symptoms that often accompany
65. 2:29depression with some suggestions for
66. 2:31what to say to you to help your client
67. 2:33understand them better.
68. 2:35Okay.
69. 2:36So, number one, I can't sleep or I can't
70. 2:39stop sleeping.
71. 2:41So many depressed people report not
72. 2:43being able to sleep or sometimes uh
73. 2:47they report they're sleeping all the
74. 2:48time.
75. 2:50Worry and negative thoughts and feelings
76. 2:53increase the levels of stress hormone
77. 2:55cortisol in the bloodstream. Okay.
78. 2:58This response is really designed to keep
79. 3:00us awake and alert and safe during
80. 3:03physical danger because if we fell
81. 3:06asleep while we were in real physical
82. 3:09danger,
83. 3:10it could be disastrous.
84. 3:13After explaining this to Angela, I also
85. 3:15said to her,
86. 3:17"And of course, you're not in actual
87. 3:19physical danger right now.
88. 3:21So, we need to lower your stress hormone
89. 3:23levels by helping you relax more.
90. 3:27This will let your emergency lookout
91. 3:29system, so to speak, get the message
92. 3:31that it can switch off sometimes.
93. 3:34And if high levels of stress persist for
94. 3:36a long time, they'll eventually exhaust
95. 3:39us to the point that we can end up
96. 3:41feeling like we can't stop sleeping
97. 3:43because we're so exhausted." So, Angela
98. 3:46nodded along with this, telling me she'd
99. 3:47noticed both of these seemingly
100. 3:49contradictory symptoms during different
101. 3:51episodes of her depression.
102. 3:54I also discuss with most depressed
103. 3:56clients how sleep can be a tricky um
104. 4:00catch-22 situation since during
105. 4:03depression even sleep itself can be
106. 4:04exhausting.
107. 4:06So, number two,
108. 4:08"I have all kinds of aches and pains,
109. 4:10but the doctor can't find anything
110. 4:12physically wrong with me."
111. 4:14When a client says something like this,
112. 4:16you might tell them that there's no
113. 4:18physical test that can show whether
114. 4:20someone's depressed or not,
115. 4:22like there is for diabetes, for
116. 4:24instance.
117. 4:25And I'll often continue by saying,
118. 4:28"However, an important hormone called
119. 4:30serotonin can become depleted through
120. 4:33depression. Among other things,
121. 4:35serotonin moderates the pain response in
122. 4:37the body.
123. 4:39So,
124. 4:40what would normally feel like a minor
125. 4:42ache in normal circumstances can feel
126. 4:45much, much worse during depression.
127. 4:48As you begin to leave that depression
128. 4:50behind, you'll also notice how much more
129. 4:52physically comfortable you start to feel
130. 4:55again. And that can be a reassuring bit
131. 4:57of information for people.
132. 4:59Number three, "I've completely lost
133. 5:01interest in sex."
134. 5:03Although it's not often discussed or
135. 5:06asked about, temporarily losing interest
136. 5:08in sex is also common with depression.
137. 5:12And unhelpfully, it's also a common but
138. 5:16often unknown side effect of consuming
139. 5:19antidepressants as well. Again, because
140. 5:21a depressed person's bloodstream is so
141. 5:23full of stress hormone,
142. 5:25then the body is on the lookout for
143. 5:29threat. So, any physical function not
144. 5:32directly connected with immediate
145. 5:33survival tends to get switched off and
146. 5:36sidelined. If your client reports
147. 5:38lowered sex drive, you might say
148. 5:40something like um now, you know, if you
149. 5:42were about to be
150. 5:44attacked by a pack of hungry wolves, you
151. 5:47wouldn't want to get distracted by
152. 5:50sexual impulses.
153. 5:52You'd need to have completely lost
154. 5:54interest in sex while dealing with the
155. 5:56wolves. Okay. So, the stress of
156. 5:59depression has misled your body into
157. 6:01feeling that it's under attack. So, in
158. 6:04an attempt to keep you safe, it's
159. 6:06responded just as it should if you were
160. 6:09really under attack. As your stress
161. 6:11hormone levels normalize and your
162. 6:13self-confidence returns, so too will
163. 6:15your sex drive.
164. 6:17Okay. So, sex drive is designed to be
165. 6:19switched off when there's physical
166. 6:21stress and threat in the environment.
167. 6:23Number four, "I seem to be catching
168. 6:25colds all the time."
169. 6:27As with sex drive, increased stress
170. 6:29hormone is designed to lower the
171. 6:30function of any physical response that
172. 6:33don't have to do with fending off an
173. 6:34immediate physical attack. That's what
174. 6:36stress is for.
175. 6:37So, cortisol has an inhibiting effect on
176. 6:40the immune system.
177. 6:41By contrast, not surprisingly,
178. 6:43relaxation enhances the immune system.
179. 6:47So, I helped Angela understand this by
180. 6:49saying,
181. 6:50"Well, you know, it may be of course
182. 6:52that there are just lots of colds and
183. 6:54viruses around at the moment. But again,
184. 6:56it's important to know that you don't
185. 6:58need to be fighting off pathogens in the
186. 7:00bloodstream
187. 7:01while you're fighting off wolves."
188. 7:04So, if you're continually more stressed
189. 7:07than you need to be because of the
190. 7:08depression, then your immune function is
191. 7:10constantly taking a backseat.
192. 7:13Therefore, you're more likely to get
193. 7:15sick.
194. 7:16But as the depression lifts and you feel
195. 7:19and sleep better, your immune system
196. 7:22will become more robust again and return
197. 7:24to its normal long-term protective
198. 7:26function.
199. 7:28Number five,
200. 7:29"I have lost my appetite and I'm losing
201. 7:32weight."
202. 7:33Or "I eat all the time and I'm putting
203. 7:35on weight."
204. 7:37Appetite changes often occur with
205. 7:39depression.
206. 7:40And just like with sleep, these changes
207. 7:42could seem contradictory.
208. 7:45On the one hand, stress suppresses
209. 7:47appetite and depression steals
210. 7:49motivation to look after yourself,
211. 7:52so eating can be neglected.
212. 7:55And on the other hand, stress can also
213. 7:56make us behave uh compulsively.
214. 8:00So, you can explain both of these
215. 8:01symptoms to your clients.
216. 8:04This is because in nature, if uh that
217. 8:07pack of wolves is on our heels, eating
218. 8:11is not necessarily
219. 8:12uh something we need to do for immediate
220. 8:14survival. Okay. You can eat later. Fight
221. 8:17or run now. So, as with sleep, sex
222. 8:20drive, and immune function, appetite
223. 8:22will be switched off in the short term.
224. 8:24But the flip side of this is that we
225. 8:26might need to genuinely, compulsively
226. 8:28check that those wolves really have gone
227. 8:31and that we really are safe. So, stress
228. 8:34would drive this useful compulsivity in
229. 8:37its place,
230. 8:38and we might compulsively eat,
231. 8:40especially if we've been conditioned to
232. 8:42associate eating with self-comforting.
233. 8:44Okay. As depression lifts, your appetite
234. 8:47should return to normal.
235. 8:49Of course, your depressed client may
236. 8:51present with other physical symptoms,
237. 8:53but there's always a good, normal, and
238. 8:56reassuring reason for stress-related
239. 8:58physical discomforts during depression.
240. 9:01These symptoms are in fact the body's
241. 9:03way of trying to help out when we're
242. 9:05genuinely in a stressful uh situation.
243. 9:09Once I'd reassured Angela that what had
244. 9:11been happening to her,
245. 9:12while hor- whilst horrible, is a normal
246. 9:14part of the pattern of depression, she
247. 9:16began to worry much less about these
248. 9:18symptoms.
249. 9:19And I ran into Angela again a few months
250. 9:21after our sessions, and she looked much
251. 9:24more rested and healthy. And she told me
252. 9:27that she was sleeping better, had
253. 9:28somehow avoided the cold that got passed
254. 9:31around her office, and was enjoying
255. 9:32cooking and eating healthily again.
256. 9:35And she told me that the real turning
257. 9:37point for her in working with me was
258. 9:39finally understanding why her body was
259. 9:42behaving the way that it was. She no
260. 9:45longer felt helpless and out of control
261. 9:48because there were very clear reasons as
262. 9:50to um what all the physical symptoms
263. 9:53were about. As Angela said, and I
264. 9:56believe this is true for people with
265. 9:57every type of mental illness,
266. 9:59knowledge is power.
267. 10:01So, I hope that you found these useful.
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276. 10:19thanks for watching.
277. 10:24[Music]