Welcome to All Things Health and Abundance podcast. This is the podcast where we discuss different health and abundance related issues and come with real tips and advice. Today we'll be talking about depression. What is it like living with depression? What is depression and what can we do to heal it? That's what we'll be discussing today. So today with me is Joana Paco. She is a psychotherapist having her own clinic in Tirana, and she's also teaching at the Tirana University in the Department of Psychology. So, Joanna, I'm really happy you're again here with us. We have already recorded an episode about anxiety, where Joana is coming with a lot of tips about that. So if you have missed that, just go back and listen to it. This episode, as I said earlier, is about depression. So, Joanna, can you explain a little bit, what is depression?

So depression is common and a serious medical illness which negatively affects how we feel, the way we think and how we act. It causes a lot of feelings of sadness, a loss of interest and activities we once used to enjoy. And it can lead to a variety of emotional and physical problems. It can also decrease the ability to function, to work, and also to interact in the social, everyday life.

What are the most common symptoms of depression? How do we know that, for example, someone is depressed?

So feeling sad or having, let's say, a depressed mood or being low? It's the first and the most common symptom of depression.

But this doesn't mean that everyone that is feeling low or sad is depressed, right?

It has to be also associated with other feelings, such as losing interest or pleasure in activities, having trouble sleeping or even sleeping too much. It can be associated with loss of energy, increased fatigue and also changes in appetite. Some people do gain or lose a lot of weight. Which are unrelated to dieting. People do not engage anymore in physical activity. They have an ability to sit still two ways to ride. They do slow movement of speech. Also, people also might feel worthless, guilty, like having no purpose, no meaning in their life. And of course, this is also related to doing practically nothing, just staying at home most of the time and not engaging in any activity with other people. Also, they have difficulty in thinking and concentrating on ability to make decisions, lower self esteem and self depreciation. It's a mix of symptoms which correlate with each other to decide whether a person is having a major episode of depression or not. So overall, it's sadness, hopelessness, pessimism that combined with each other and make a person unable to fully function and enjoy and interact.

But are there different levels of depression? So can someone be on level one, for example, and someone on level ten? Is there something like that or depression is depression?

No, no, there are different levels. We do not call them levels. We don't have a name or a cluster for that. Okay. We see the frequency and the duration, the frequency of the symptoms and the duration of the mood, let's say, or the symptoms that I mentioned before. And based on that, we try to establish in which degree the person is. For example, if we have like two weeks of such symptoms, we consider it normal. If it's following a trauma or an activity or something that has impacted the person's life. But this lasts for like more than a month or even 4 to 5 or to six months. Then we have depression,

clinical depression. Yeah. So it's normal to have all those feelings for a short period of time if something significant has happened in your life. But if this goes to longer periods of time, then it can be called depression.

And there are also different types of depression that we have. The bipolar disorder or major depressive disorder is the, let's say, the primary type of depression where a person experiences alternating states of depression and mania, which is an abnormal elevation of mood or hypomania, which is also, let's say, an abnormal elevation of mood in this disease. We say that the person is suffering from the disorders. We have a major depressive disorder which has severe symptoms that really disrupt the individual life, which has typically effects on appetite, sleep, work and of course, the ability to enjoy any activity. And this type of depression can occur at any age and might occur only once in life or multiple times

Can someone be born with this or can this be hereditary?

According to studies, no. But it can be modeled in the family. For example, if we have a parent who has like mental or cognitive schemas that are more directed towards negative thinking and not enjoying and complaining, then we have a child which might model this type of response which will increase the likelihood that later in life they will have depression or depressive episodes

I know someone whose mother has had and still has probably has bipolar depression. And according to this person, they inherited it from the mother. That's why they have it. So that's how this question came to me. So it's not inherited, but it's something that you can learn from a parent, right? When you are exposed to that over and over and over again.

We do not say learn from them, but let's say the way our parents will shape our environment for us. So if we are raised in an environment which is always depressed without any enjoyable activity, looking at situations and aspects of life in a negative light, of course this will impact our perception of reality also, and this will increase the likelihood that we continue to maintain this type of environment, that this type of thinking and schemas and way of approaching life.

Okay. Are there any other types of depression? You mentioned two main types type there. Any other types?

Yes. So we also have persistent depressive disorder which involves symptoms that might last more than two years or even longer, which will be from time to time marked by episodes of major depression. Then we have the postpartum depression and psychotic depression and also the seasonal affective disorder. I think you might have heard of it like depression before Christmas or before spring, for example, which will develop under specific circumstances and

also maybe depression due to winter? in Norway we have long winters

Yes, this is seasonal. Okay. A winter depression because the winters are so long and dark and cold. So that is also recognized as depression, seasonal affective disorder.

How about depression connected to some events in your life that you just can't get over?

Yes, it can develop. Also the postpartum depression, another psychotic, another type of depression that can be developed under specific circumstances. For example, the postpartum develops in women in the period of following childbirth, and they have a lack of interest in caring for the infant. And the science knows this, the doctors know this. And we from time to time expect that the new mother will somehow have postpartum depression.

I know, right? I was asked that all the time. I still am asked that once in a while. But it was very common. After I gave birth, I was asked if I had depression. I was actually very emotional. It was due to the hormones, the fluctuations of hormones after giving birth, and I was maybe lucky that I didn't get depression. And you read about that so much online that at some point I was almost praying not to get it while I was pregnant. Do you think it is more visible online than it actually happens in reality?

No it usually happens. So it is common. Postpartum depression is common. It's very common, but it depends on the type of person because there are women who overpass it quickly and there are women who are more introverted and more emotional and more vulnerable. And this period lasts longer.

Oh, okay. But at some level, every woman more or less has some kind of depression after giving birth because their life is totally changed. I mean, I understand that.

And you are more vulnerable. You have more emotions. You feel emotions way deeper than you used to, and you are more prone to analyze and more prone to overthinking.

there isn't one specific cause?

No, no, there is no cause

that makes it more difficult from my point of view, at least, because when we know what causes something, then it's easier to deal with it.

But since there is no single cause, people who are more likely to experience depression are people that have had stressful life events which might have kickstarted it. habits of thinking negatively also, or early traumatic experiences which may have made them vulnerable to depression, which is also the hereditary part. They might be genes, but the studies in that field are not so strong that they are not. Yes, strong, which will indicate that there are specific genes who would make you more likely to develop depression or emotional problems.

It's interesting because I read from Bruce Lipton, who's a biologist and a scientist who practices psyche. I read that adopted children that don't know that they are adopted actually develop very similar diseases to their parents, thinking that it is hereditary, which means that maybe more disease than we believe is modeled from the parents rather than hereditary. So I totally believe that.

Yes, it's modeled

it’s model. Yes, that's the right word. So it's like the kid is actually modeling the parent. Then they can model any kind of depression the parent has had while the kid was growing up. Right.

If we continue on developing Bruce Lipton’s line, let's say yes, yes, it might be that way. They might model it, but not always it is like that. Yeah, people develop depression even if they have a healthy family and healthy relationships and dynamics. At some point in life they might get depression. We are all vulnerable to it, especially in this fast paced life that we are living with anxiety. Anxiety and depression are the most major, let's say, disorders that we face that derive directly from the stressful life that we do and the way we approach all the events that happen in our life.

Does it have anything to do with being disconnected from nature, being disconnected from our real self, or maybe just pushing ourselves to do stuff that we actually don't want to do, but we believe that we have to because of society or whatever? Can it be related to that?

yes, yes, that might also affected, let's say, because if a person, for example, is very committed into working and providing for the family and providing economical support and believing that he or she has to be working, I don't know, two jobs and live on this very hectic life, let's say, And they disconnect from just being and just enjoying and staying in the nature and focusing on themselves and having some mindfulness time, let's say, and reflect. Of course they can. This type of life we can and the disconnection from nature and from the self can also kickstart the depression.

wow It can be a lot of reasons. What can we do about that? Okay,

So from a psychological point of view, we can do psychotherapy, of course, and there are many effective psychological treatments. Like, for example, the act, which is the acceptance and commitment therapy, which will work on accepting the situation and not overreacting to it. And we work with some mental schemas. Also, we have cognitive behavioral therapy which works on the way we perceive and we react to our environment and we form our thoughts which will of course impact and affect the behavior we have. Problem solving therapy. The psychodynamic therapy might also help behavioral activation therapy, and lately we have also included mindfulness based cognitive therapy, which has been shown also to prevent relapse in people who have recovered from depression.

Amazing. Is there anything that someone can do on their own in case they are not ready to go to a psychologist, for example?

This is a tough question, but it's a strong one because usually people with depression do not intend to do anything to change the situation because they feel hopeless. So usually our family members who push them to come and seek professional help, if they are in the initial stages, they do reach out for help. What they might do is try to activate themselves more like engage in activities, like to go out, stay with people, interact with people, try to do some activities that they used to enjoy, starting slowly, slowly with baby steps. Because if they are in a full depressive state, this would be difficult. They would need a lot of boost from the outside environment and sometimes they also need medical treatments. So we go for antidepressants and other times in order to get out of that state to work with the neurotransmitters and to work with serotonin also. Yeah, to start feeling happier and the hormones and everything else. So there are some medications, let's say, do the the first step for us and then we are able to intervene because there are people, especially if they are in a full depression mode, that it's. Difficult for them to get out. They don't feel. t

But what can they do?

So they basically need someone to tell them, go to a psychologist, go and reach out or ask for help. But the The system of support, family members, friends, relatives, people who can push them to seek for help and to start helping themselves

what if they just don't want to hear from the family or if they don't have a support system?

In such cases, the situation gets more complicated. It also depends on the person. If it's a person who is more open minded, that might start a bit of, I don't know, meditation or to start changing their routine because they have like this very rigid routine, which is very, very poor as the routine is very poor because they don't do much. They just stay at home. There are times where they don't even wash themselves and they don't care for their hygiene and their body and only do the basic needs and that's it. But changing the routine a bit might help them getting out of this states, trying to make small activities, just maybe just going by the grocery stores or just taking a small walk even for like five minutes in a park nearby or. The small steps. Small changes and small steps. But getting out of the house is very important because you need to get into the community. You need to connect with the people and the society. So this is like the hardest challenge that we face in trying to change the routine of patients with depression because they don't want to.

There's a lot of resistance there.

Yes. they feel hopeless, too. Usually with this type of client state is that why would I change like it's useless? There is no point in doing it and meaning in it. Why can it be about finding meaning in something that's doing something that gives them meaning? But what they usually state is that they cannot identify anything that will be meaningful for them. That's why I say that maybe we should start with some small steps. Just getting them to move

Do women suffer more than men?

Okay. They say that, yes, because it's thought that women do tend to suffer from depression more than men. But we cannot fully state it. Or that is not to say that men do not suffer from the condition, but women tend to be more in touch with their feelings and they tend to be more sensitive than men. So that's why it's thought that they do suffer a bit more, and especially women under the age of 30.

Isn't this sad that women that have all their life in front of them under the age of 30 suffer from depression? I just felt so sad when I heard that. So there must be something really wrong with our society.

Depression is a condition which is difficult to treat, not because we do not have the tools, but because it depends so much on the client. Also, it depends on them and there are moments, for example, I've had moments in therapy where I felt hopeless that I would be able to make a difference in my client's life.

Okay, you have been in that place where you think, okay, I can't make a change here

I tried, let's say, almost every technique and tried to do my best. But there are times when you just don't succeed and you have to be patient with them because they need comfort. They need to feel like they are moving in a space that is safe for them and that will prevent the change they need.

And what has happened in those cases, or in one of the cases at least, that you have worked with, and that it felt like nothing was working out?

Yes, we made minor changes. And there are also times when I worked with psychiatrists in order to help them with medications

Okay. So sometimes they have to go to medications because knowing you a little bit, I know that maybe you're not a big fan of meditation, but sometimes you have to go to that. Okay. And that helps?

of course. Of course.

But other than this medication, really addictive.

Addictive. Yes and no. What it means is that when they are necessary, they are necessary and that's it. But together, doing a common let's say an interactive plan with the psychiatrist and the group of supportive family, also, we get to have excellent results. Is the psychiatrist who lowers the doses as we progress with therapy and the client progresses getting out of this stage. So what they do is that they combine the medications and they lower the doses until the patient or the client is that's free.

So it's not like the client will go on taking the pills for one year or two years.

It might, it might, depends on the client and the progress. It might take offices when they have prolonged medical treatment with antidepressants.

And are there any affirmations one can say that could help with depression?

Okay, so I am worthy is one. I am not my thoughts. I will get through this time of my life. Maybe I deserve to be happy.

So, Joanna, any last messages for someone with. Suffering from depression

depression. So, yes, first of all, is that we need to remind these people that they are not alone. There are people who might not exactly understand how you feel but care about you and are willing to help. So they need to know that asking for help is not a sign of weakness rather than it's a sign of strength. And depression can be treated. People who are suffering from it can overcome it. They need to talk about it as much as possible, or at least confine with someone they trust at the end. Try to reach out to a professional, of course. But even if they are not ready to reach out to a professional, they can still try to talk about it with baby steps, get out a bit in nature, try to start small, small and share. What are they feeling and what is their perception of the world at this moment?

And lastly, how can people come in contact with you? I know you don't have a website yet and you you are not really a fan of social media.

Yes. Yes. Even though it's like growing at a very fast pace, I'm still not fully convinced to get myself in the social media yet. People who would need my help and I am very willing to provide it can reach out through my WhatsApp number. I think you have it and you might put it under the link so it can be available. And anyone who wants to like even book a session or even reach out to say hi or have something to share, I'll be glad they respond and willing to be present and show up

Well, you can say the number here for the ones that are not. Maybe, maybe don't have the time to just go in the transcript and find the number.

So the prefix is +355 - 694826118.

Perfect. Thank you so much and thank you for being here with us today.

Thank you very much. I hope this podcast will be useful and that it will provide some insight and information for people who who need it.

Now it's your turn. Let us know what health and abundance subjects you want us to cover in the future. Do that by commenting on the post on Instagram. Thank you so much for listening and thank you so much to Joanna for being here with us today. If you liked it, please leave a review at Pod chaser.com. Just search for the podcast and write to do the review. If you have questions or if you want to book a session with me, please do let me know on Instagram. The next episode is actually a double episode. I will be sharing the yoga and mindfulness program for depression and anxiety as well as a yoga nidra.

And remember, you are always creating your health and abundance. What do you choose to create today?