The Relationship Between Stress and Depression

Depression has been labeled “the silent face of stress”.

We all feel sad or down sometimes – it’s natural.

But if this low mood or intensely low feelings remain for weeks, months or even longer, sometimes without obvious reason, and are severe enough to impact day-to-day activities, this often indicates that a person is suffering from depression.

While a complex interaction between genes, physiology and environment is a significant factor in the predisposition for the onset of depression in an individual, a precursor to the onset of depression, is almost always, long term, ongoing stressful life events – or chronic stress.

Generally, depression does not result from a single situation or incident, rather from a combination of recent events and other long term, personal factors.

The good news is, that just like physical illnesses, depression can be treated, and with the right treatment, most people will recover. The sooner a person with depression seeks treatment, from their doctor, the sooner they can recover.

Researchers have now shown that in addition to prescription medication, meditation techniques are clinically proven to help ease psychological stresses like anxiety and depression.

1. Stress is not necessarily a bad thing

Severe, or clinical, depression is not a personality weakness, it’s not moodiness, it’s not something you can just “snap out of”, it doesn’t discriminate – it is a change in brain chemistry, and it is a medical illness that requires treatment. It doesn’t just “get better”.

Untreated clinical depression is typically incredibly debilitating, impacting all aspects of life. You can feel very dark and lonely, with feelings of hopelessness and thoughts of not wanting to continue.

Depression is a medical illness and if you feel that your symptoms may indicate that you have depression, you should immediately consult your doctor.

The World Health Organization has revealed that depression is now the leading cause of disability worldwide, with more than 320 million people affected – an increase of almost 20% in the previous 10 years.

Currently, it is estimated that one in six Americans take some kind of psychiatric drugs — primarily antidepressants.

The risk of getting depression at some time during our lives, is generally 10% to 25% for women and 5% to 12% for men.

According to the United Nations the global cost of depression due to loss of productivity and a sufferers inability to cope at work or function with day to day life, is more than US$1 trillion per year.

When depression takes hold and becomes long term, with moderate or severe intensity, it becomes a serious health condition, and can cause the affected person to suffer greatly, with an inability to cope or function at work, at school or as part of the family.

At its worse, depression can lead to suicide.

Suicide is the leading cause of death of men under 50, was the leading cause of death in all persons aged 25–44 and persons aged 15–24.

The good news is, that just like physical illnesses, depression can be treated, and with the right treatment, most people will recover. The sooner a person with depression seeks treatment, the sooner they can recover.

2. What Are The Symptoms of Depression?

Many of the symptoms of depression are also common signs of stress and anxiety.

While these symptoms can be just part of the everyday up and down mood swings that we all feel, the more symptoms that you have, the longer that you’ve had them and the stronger they feel, are all signs that you are dealing with depression.

It is very important that when these issues become overwhelming, and begin to impact your to day-to-day activities, that it is time to seek professional help.

The common symptoms of depression can be grouped into areas of: physical symptoms, behavior, thoughts and feelings.

Physical symptoms

You have no energy and feel tired, slow and physically exhausted – where you feel fatigued all the time and even little tasks make you tired and take forever to finish.

Your eating habits have changed – resulting in significant weight loss or weight gain.

Trouble getting to sleep – or constant waking during the night and finding it difficult to get back to sleep, or sleeping too much.

You find yourself binge drinking or escaping into substance abuse – and other compulsive, reckless behavior such as self-medication, compulsive gambling, and dangerous driving.

You find yourself getting more headaches, and other aches and pains - such as back pain, aching muscles, and stomach pain.

Behavior

You’ve lost interest in things that you used to enjoy – things that used to bring you joy and pleasure, such as your hobbies, sports, exercise, friends, social activities, or sex.

You have trouble concentrating and focusing on things and getting things done – either at work or at home, and find yourself forgetting things of having trouble making decisions.

Thoughts

You feel helpless and hopeless – with a belief that nothing good ever happens to you, that nothing will ever get better and there is nothing you can do to improve;

You can’t control negative thoughts about yourself and others – where you feel worthless, that people would be better off without you and are always finding faults with everything you and others do.

Feelings

Feeling angry, agitated, restless, or even violent – where everything and everyone gets on your nerves and you are often short-tempered or aggressive.

Feel unhappy, miserable, lacking in confidence, disappointed or guilty – no matter what people say, or do around you.

3. What are the different types of depression?

There are a number of different types of depression, with their symptoms ranging from relatively minor, although still impacting on day-to-day life, though to very severe, which can affect the ability of the sufferer to perform their normal day to day activities.

Major depression, or clinical depression

Major depression, is the most common form of depression and typically refers to episodes and symptoms of depression, that last more than two weeks. These symptoms typically affect all areas of a person’s life including personal, family and work and impacts both their relationships and their ability to operate normally.

Melancholic depression

Melancholic depression, is a severe form of depression that occurs as part of either major/clinical depression or bipolar depression and typically causes physically slowed movements, excessive guilt, and an inability to find pleasure in even positive things and events.

Psychotic depression

People suffering from psychotic depression, have symptoms of major depression, plus psychotic symptoms, such as false beliefs/delusions, paranoia and even hallucinations.

Atypical depression

Atypical depression is also a form of major/clinical depression, and is typically identified, where a person will suffer from a smaller sub-set (between 2 and 5) of the symptoms of clinical depression.

It differs from melancholic depression, in that a person with atypical depression will see their mood improve if something positive happens.

Antenatal and postnatal (postpartum)

Antenatal and postnatal (postpartum) depression, is triggered by pregnancy or childbirth and up to 10% of pregnant women and 16% in the 3 months after birth will suffer from depression.

While the “baby blues” is a common condition related to hormonal changes in the days immediately following birth, postnatal (postpartum) depression is much longer lasting and affects not only the mother, but also the child’s development, the mother’s relationship with her child and with her partner and other family members.

Bipolar disorder

Bipolar disorder is identified where the person experiences separate periods of depression, followed by periods of elated moods known as mania.

Previously known as manic depression, bipolar disorder seems to be closely linked to family history and for people with this condition, can be triggered by stress and conflict.

Cyclothymia

Cyclothymia, is where a person experiences consistent fluctuating up and down moods over at least 2 years. It is sometimes described as a mild form of bipolar disorder, where the depressive and manic moods are shorter, not as regular and less severe than bipolar disorder.

Seasonal affective disorder

Seasonal affective disorder (SAD), is a seasonal mood disorder, more commonly experienced by people during winter in cold climate countries, with shorter days, longer periods of darkness and is thought to be related to the low levels of sunlight experienced during this time.

4. What Are The Causes of Depression?

While there had been significant steps in the understanding, awareness and treatment of depression, unlike most other medical illnesses, neuroscientists still don’t have a precise understanding of the exact causes of depression.

Rather, the causes of depression seem to be a complex interaction between a person’s genes, physiology, environment and their susceptibility to developing the disease, but there is no diagnostic tool that can accurately predict where or when it will occur.

Exposure to long term, chronic stress, as a result of highly stressful situations.

Depression has been labeled “the silent face of stress”.

While this complex interaction between genes, physiology and environment is a significant factor in the predisposition for the onset of depression in an individual, a precursor to the onset of depression, is almost always, long term, ongoing stressful life events – or chronic stress.

Generally, depression does not result from a single situation or incident, rather from a combination of recent events and other long term, personal factors.

We have previously examined the physiological changes that occur to our body when we are in a state of stress, where we are subject to elevated levels of the stress hormones, such as cortisol, that are released as part of our body’s fight or flight stress response.

When we suffer from chronic stress, and are unable to switch-off our body’s stress response, researchers believe that these elevated levels of cortisol, can impact the way our nerve cells communicate within our brain.

This results in a disruption with the way the mood regulating neurotransmitters function, which results in reduced levels of the “feel-good” neurotransmitter serotonin, and the “motivational” neurotransmitter dopamine.

It is the reduced levels of dopamine and serotonin in the body, which researchers believe is a contributing factor for people with clinical depression.

Serotonin is a neurotransmitters produced both in the brain and in the gut, which helps contribute to our wellbeing and happiness, and seems to help keep our moods under control by helping with sleep, calming anxiety, muscle relaxation and relieving depression.

The neurotransmitter dopamine, is generated within the brain and affects our emotions, movement and our sensations of pleasure and pain. It also is associated with motivation and reward, and helps us with our creativity and decision making.

Chronic Stress Damages and Shrinks Our Brain

One Danish research study, in an attempt to further explain how stress can cause depression, showed that stress reduced the ability for the brain to rebuild healthy brain tissue, and so regenerate and keep itself healthy.

This study used rats because they could document that rats react to stress in the same way that we humans do.

The researchers found that after exposure to stress, the subjects brain (specifically the hippocampus) shrunk in size, impacting both short term memory and learning abilities. Comparing the brains of stressed rats and healthy rats, the researchers found that the stressed subjects produced 20 % fewer new brain cells, than the healthy subjects.

Indirect factors associated with chronic stress

We’ve looked at some of the direct physiological causal/risk factors associated with stress, however changes to our normal, healthy lifestyle behaviors and patterns – also have a very significant effect.

Very often, the stress that we are under causes us to make lifestyle changes and neglect the healthy practices that we previously used to defend ourselves against the physiological effects of stress. It is these changes – the lowering of our defensive mechanisms – that can accelerate the onset of depression.

Understanding these factors and recognizing that we are at risk, is an important defensive mechanism in helping to defend ourselves and prevent depression during extended periods of high stress.

Stress impacts our normal, healthy coping strategies

Stress impacts our normal, healthy coping strategies as we often change or stop, many of the healthy habits that help us defend against stress.

For example, stress at work, means longer hours, which means we skip our regular exercise, we don’t have time to sit and relax with a book, we don’t get enough sleep, or find time to catch up with friends – all of which helps keep our mood on track.

Initial stress, generates further stress

So we’re feeling tired, flat and lacking concentration at work, and we make mistakes, or let loose with an angry or irritable outburst, causing problems with our boss, colleagues or clients – all of which increases the stress that we are under.

Relationship problems

When we’re under stress, we often become irritable and withdraw from our friends, family, partner or spouse, which creates communication problems and relationship stress, which further adds to our overall chronic stress load.

Unhealthy coping behavior

Not only do we cut back on our healthy coping behavior when we’re under stress, but we often go in the opposite direction, by increasing unhealthy behavior, with things that exacerbate the stress and health problems, such as increasing our alcohol intake, or eating badly – with more high fat, high carbohydrate and high sugar foods and snacks, both of which significant increase the damage to our body..

Genetic factors

Scientists have determined that across all depression, approximately 50% of the cause is genetic, where there is an increased risk of developing depression, if one of your parent has been diagnosed with depression.

Although, in most cases, depression is unlikely to occur without stressful life events and other psychological or physical factors.

When it comes to major/clinical depression, when a person has a parent or sibling with major depression, that person probably has a 2 or 3 times (20-30%) greater risk of developing depression compared with the average person (approx. 10%).

It’s not that someone simply “inherits” depression from their mother or father, rather, we all inherit a unique combination of genes from our parents, and certain genetic combinations can predispose us to a particular illness.

Stress-prone personality types

It has also been shown that there are certain personality types that are more at risk of developing depression that others.

Those with the competitive, time-urgent, aggressive and impatient Type A personalities, are much more stress prone than others.

In addition, those people with a codependent personality – the perfectionist, super-overachievers, who take on all tasks as crisis managers, are much more likely to suffer the effects of chronic stress.

The helpless-hopeless personality types are also stress prone, with traits associated with those of someone with low self-esteem, with poor self-motivation, emotional dysfunction, high perceptions and expectations of failure and feelings of frustration, despair or futility.

Physical illness

Chronic illness and pain can cause significant disruption in our lives and lifestyle.

This chronic illness can limit our mobility and independence, and force us to adjust our future plans, lifestyle and employment, impacting our self-confidence and often making it impossible to continue with the activities that we enjoy.

The grief and resulting stress, can easily become chronic, and for many patients, develop further into depression or anxiety.

As a result, depression is one of the most common complications of chronic illnesses, where it is estimated that between 25% and 33% of patients with a serious medical illness or injury, experience symptoms of depression.

The research on chronic illnesses and depression indicates patients with chronic illnesses experience depression at the following rates:

• Heart attack: 40% – 65% experience depression
• Coronary artery disease (without heart attack): 18% – 20
• Parkinson’s disease: 40%
• Multiple sclerosis: 40%
• Stroke: 10% – 27%
• Cancer: 25%
• Diabetes: 25%
• Chronic pain syndrome: 30% – 54%

How is depression different to anxiety?

While anxiety and depression are different conditions, and they have their own causes and emotional and behavioral symptoms, they also share some of the same causes and symptoms.

It’s also common for someone to suffer both anxiety and depression at the same time – with more than 50% of those with depression, also experiencing symptoms of anxiety. There is also a causal relationship between anxiety and depression, where the onset of anxiety, can lead to the development of depression. In fact, having an anxiety disorder, is the most significant single predictor of a person suffering depression.

Current research suggests that anxiety treatment should begin with first treating the depression, as the symptoms of depression can trigger anxiety. So reducing the symptoms of depression, will often lead to reduced feelings of anxiety,

The Stress => Anxiety => Depression cycle

While not a fixed rule, you can think of the relationship between the three elements as a cycle:

stress can lead to anxiety => anxiety can lead to depression

where, if you are unable to manage and dissolve the feelings of stress that you feel, then you can find yourself living in worry of the stress returning.

You may then find that these feelings of worry, can become a persistent anxiety and this long term anxiety, can then develop further into depression.

Depression and suicide risk

One of the symptoms of depression is a sense of hopelessness and worthlessness and a feeling that nothing will ever get better and nothing will ever improve.

Depression carries a high risk of suicide and people with depression commonly have these thoughts.

Anyone who has expressed these or similar thoughts, must be taken seriously and help must be immediately sought, through national support hotlines and local medical professionals and support groups who are set-up to advise both the person suffering and concerned family and friends.

5. Meditation as a Treatment for Depression

General Health Benefits of Meditation

With an estimated 4,000+ peer reviewed scientific studies conducted and published on the topic, the dozens of proven physiological and psychological benefits of meditation have been well documented.

Clinical published research has proven that the benefits of meditation include:

• Benefits in cardio-vascular health, including reduced blood pressure, resulting in significant risk reduction (48%) in clinical studies, for all-cause mortality, heart attack and stroke.
• Strengthening of our immune function, making us more resistant to viruses and infections, together with decreased inflammation at the cellular level;
• Helps to prevent auto-immune diseases including asthma, rheumatoid arthritis and inflammatory bowel disease
• Reducing the risk of the onset of Parkinson’s disease and Alzheimer’s ,
• The capacity to reduce both mental and physical pain;
• Improves the quality of sleep, and the ability to fall asleep faster and stay asleep during the night;
• Improves our emotional well-being, through reduced worry, anxiety and impulsiveness, increases our self-esteem and optimism, helps prevent emotional eating and smoking
• Reduced symptoms of, and occurrence of depression and anxiety disorders,
• Improves brain function and physiology, with increased grey matter, increased volume in areas related to positive emotions, emotional regulation and self-control, plus increased cortical thickness in areas relation to concentration, focus and memory function; increasing our information processing decision making, problem solving and creative thinking.

Clinical Studies on Meditation Research

In 2014, researchers from Johns Hopkins University in Baltimore, MD, undertook a systematic review and analysis of almost 19,000 published meditation studies, to determine how effective meditation programs were, in improving stress-related health problems related such as anxiety and depression.

In analyzing this evidence, they found 47 trials across more than 3,500 participants, that satisfied their criteria for randomized clinical trials, comparing the relative difference between groups from a baseline.

Their findings, published in JAMA Internal Medicine, show that meditation techniques are clinically proven to help ease psychological stresses like anxiety and depression.

Different Meditation Techniques

In achieving these benefits, in the same way that there are dozens of different physical fitness exercise styles, formats and techniques, there are also a wide range of different meditation techniques.

Scientists typically classify meditation into two main groups, according to the way that they focus attention – Focused Attention meditation and Open Monitoring meditation.

When practicing Focused Attention meditation, you focus on a single thing, such as an object, an image, a sound, the breath or a sensation.

Examples of Focused Attention meditation techniques include Pranayama (the style we use with OnCalm); Kundalini and Chakra meditation; Buddhist meditation and some Zazen and Qigong styles; Loving Kindness (or metta) meditation, Sound and Mantra Meditation, including Transcendental Meditation, amongst others.

In contrast, with Open Monitoring meditation, you are not focussed on anything – rather you are open to anything that is taking place in your thoughts or enters your awareness at any given time during the experience, without judgement or attachment.

In meditation you are simply observing, becoming aware of, but not attached to thoughts, feelings, memories, or external sounds and smells. This conscious awareness often referred to as mindfulness and with practice you will notice that whatever comes into your awareness will naturally pass.

Examples of Open Monitoring meditation include: Mindfulness meditation, Vipassana, as well as some styles of Taoist meditation.

The key question is not “what is the best meditation”?

Rather, it is “what is the best meditation for you?”

At OnCalm, our exercises have been built based on the Pranayama techniques, as we have found that they give us the best balance of range of benefits (calm, energy, focus, sleep); offer great flexibility (can be done almost anywhere, at any time, for any duration), and importantly, are quick and easy to both follow and stick-to!

However, we do suggest (like any physical exercise program), that once you become comfortable and proficient with one meditation style, that you also explore other areas, that may also provide additional or more focused benefits.

6. What happens if I suspect that I or someone close is suffering from depression or anxiety?

Because depression and anxiety are mental illnesses, they can be a lot harder to understand than, say, other physical illness.

People who are depressed or who have anxiety may be at risk of suicide or self-harm, and if so, they need urgent help.

If you or someone you know needs support, talk to a doctor or another health professional about getting appropriate treatment.

So, if you know someone struggling with anxiety or depression, there are things that you can do, to support them.

• Let the person know if you’ve noticed a change in their behavior.
• Spend time talking with the person about their experiences and let them know that you’re there to listen without being judgmental.
• Suggest the person see a doctor or health professional and/or help them to make an appointment.
• Offer to go with the person to the doctor or health professional.
• Help the person to find information about anxiety and depression from a website or library.
• Encourage the person to try to get enough sleep, exercise and eat healthy food.
• Discourage the person from using alcohol or other drugs to feel better.
• Encourage friends and family members to invite the person out and keep in touch, but don’t pressure the person to participate in activities.
• Encourage the person to face their fears with support from their doctor/psychologist.

It would be unhelpful to:

• Put pressure on them by telling them to “snap out of it” or “get their act together”
• Stay away or avoid them
• Tell them they just need to stay busy or get out more
• Pressure them to party more or wipe out how they’re feeling with drugs and alcohol.
  
  

Important Disclaimer

Please note, that the OnCalm course is different from taking medication or seeing a clinician. It should never replace any medication or treatment program prescribed by your doctor, unless agreed to by your doctor.

This information is not intended to replace the advice of a doctor. OnCalm disclaims any liability for the decisions you make based on this information.

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