Everything you feel, sense, think and do is caused by communication between your nerves with the help of chemical messengers called neurotransmitters. As humans, for better or worse, our “higher order” thinking is able to over-ride sensory input and tell us there is a threat when none exists or that there isn’t a threat when there really is. Think of your brain as a computer processor. It simply does what it is told, based on the information that it has.
When you see, hear, smell, touch, taste or do something, it triggers memories—thinks you have learned in the past. For example, if the burner on the stove is red, don’t touch it because it is hot. Unfortunately, sometimes the lessons you learned were incorrect or overgeneralized. For example, if your parent abandoned you in the past, you may have “learned” that you were unlovable. After all, you were a child.  If was your parent’s job to love and protect you. As a child, you could not find an acceptable reason why your parent left you, so the logical conclusion in a child’s mind is that it must be because you are bad and unlovable.
Another example pertains to overgeneralization. Imagine you fell in love with the most amazing person, but for whatever reason it didn’t work out. Years later you meet someone who physically reminds you of that person, and all of those positive feelings are brought up again. Unfortunately, that person doesn’t have the same heart and characteristics, but you are seeing the projection of your first love, so you cannot see the flaws of the new partner.
This will hopefully help you see that your thoughts can influence your moods and your moods can alter your though processes by triggering the release of either excitatory (stress) neurotransmitters or inhibitory (calming) neurotransmitters. Too much stress or low grade stress for too long is what we call “anxiety” and/or “depression.”
The neurotransmitters responsible helping you feel happy, relaxed and motivated are also involved in the regulation of eating, sleeping, motivation, energy levels and pain. Each person may experience these imbalances differently. For example, when you experience chronic pain and have a flare up, the following scenario might occur…You start experiencing pain. A sense of frustration and helplessness begin to emerge. You get in a “mood,” because you are frustrated about the relapse. Pain causes a release of stress hormones. These hormones and the pain itself contributes to difficulty sleeping, fatigue, an inability to focus and lack of energy to do anything. Motivation wanes. Depression increases. Self-esteem starts to decrease because you are not able to be the spouse/parent/employee/friend you think you “should” be. Additionally, pain increases because you are focusing on it, and your neurochemicals are getting progressively out of whack because of prolonged stress, leading to increased apathy, fatigue, irritability and depression.
Let’s take a look at the symptoms of depression and anxiety you may be experiencing, theorize about what might be causing the symptoms, explore why the body may be producing that symptom (its function) and identify ways you have and can deal with the symptom.
You might be asking why I am covering both depression and anxiety in the same chapter. The reason is because many people experience both depression and anxiety at the same time. Serotonin and norepinephrine imbalances are often implicated in both of these. Too much serotonin or norepinephrine can cause irritability and depression. Too little serotonin or norepinephrine can cause apathy and depression. When you are stressed or anxious for a long time, your body may sensitize to the norepinephrine, so things that would normally be motivating will have little or no effect.
The interplay between the neurochemicals is not straight forward. There are other chemicals at play as well, including dopamine, glutamate, GADA and acetylcholine. Your body knows how much of what chemicals need to be made, and it strives to balance itself, so don’t get bogged down with the specific chemicals. A healthy diet will give your body all the building blocks it needs.
Other things that can cause neurochemical imbalances include lack of sleep, negative thinking patterns. Yes, your thoughts do have an actual effect on your body. If you are thinking negative or anxiety provoking thoughts, your body will respond by producing more stress chemicals. Similarly, one of the reasons meditation and yoga can be helpful is that thinking positive thoughts and being in touch with your physiological responses can train your body to release relaxation chemicals.
For now….on to the symptoms…
Form/Symptom
Lack of pleasure in most things, most days for a period of at least 2 weeks.
Cause
When the chemicals in your brain get out of balance, you can have difficulty feeling pleasure or happiness. Lack of sleep, excessive stress, drug or medication use, hormone imbalances, thyroid problems and a myriad of other things can cause this to happen. Fortunately, once you know what is causing the problem, most of these things can be addressed with some relatively simple interventions such as getting enough quality sleep, improving your nutrition, identifying and addressing what is stressing you out, and getting a physical to make sure that the cause isn't something physical like hypothyroid or chronic fatigue syndrome.
Function
This is your body's way of signaling that 1) there may be a problem, and 2) forcing you to address it. After all, nobody wants to be depressed for very long.
How You Cope
Think back over a few times when you have been depressed, even if it was just for a few hours. What did you do to help yourself feel better? Did you call a friend? Go on a walk? Distract yourself with something? These are all tools you already have in your toolbox that work, to some degree, to help you feel better. You want to build on these tools.
Form
Changes in eating habits, including eating too much, especially when you are not hungry and loss of appetite.
Cause
Loss of appetite can usually be attributed to an imbalance in the brain chemicals that help you feel motivated to eat, such a norepinepherine and serotonin.   With regard to eating too much, there are three primary causes: 1) Your body needing the building blocks to make the brain chemicals and rebalance itself; 2) Your circadian rhythms are out of whack so your body doesn't know when to eat or sleep, and 3) Habit/self soothing.
Function
Your body needs certain proteins and vitamins to make the brain chemicals (neurotransmitters) that help you feel motivated, excited, happy and focused. When these building blocks aren't there, or when there is an imbalance, the body goes into overdrive trying to rebalance the system. This means it needs more raw materials to make the brain chemicals; therefore, you may crave certain foods.
Another potential issue affecting your hunger/eating cues is a disruption in your circadian rhythms. Serotonin is very involved in regulating your eating and sleeping behaviors. When you sleep at all hours of the day, or don't sleep at all, your brain does not get the normal ebb and flow of serotonin (among other chemicals). This again, leads to an imbalance in neurotransmitters and mucks up the works. It is kind of like a faulty stoplight sensor. Sometimes sensors go bad and the system cannot tell if a car is waiting at the red light or not. One set of traffic constantly has the green light, while the other set of traffic is stuck with the red.
The third common reason for eating when you are not hungry is self-soothing. Certain foods actually raise the levels of pleasure chemicals in your body (although not for long). This is very rewarding, and causes you to turn to food for comfort when you are feeling bad. When the pleasurable feeling wears off, you often search for more comfort food.
How You Cope
- In the past when you have just not had an appetite or have been eating to self-soothe, how did you deal with it?
- How can you make sure you are eating a generally healthy diet, and making sure that your body has the building blocks it needs?
- What can you do to ensure you are eating due to hunger and not distress?
- What foods do you generally eat to self-soothe?
- What can you do to prevent non-hunger eating?
- What can you do besides eating to distract yourself from your distress or self-soothe?
- A few simple interventions include:
- Stop consuming caffeine at least 8 hours before bed.
- Drink enough water (even if it is sparkling water or Powerade).
- Have 3 colors on your plate at every meal.
- Eat foods you enjoy, but in moderation
- Use a plate. Don’t eat out of the bag
- Get enough sleep so you are not eating to stay awake.
- Take a multivitamin. (I take mine after dinner, so it doesn’t upset my stomach)
- Experiment with essential oils. Some will increase appetite. Some will decrease stress and cravings.
- If you just cannot stomach eating, explore a meal replacement like Ensure. This should not be done for a long period, but as a stop-gap, it usually is fine.
Form
Sleeping too much or having insomnia
Cause
Sleeping too much can indicate poor quality sleep due to stress, poor sleep habits, pain, hormone or neurochemical imbalances, allergies, dehydration or inadequate nutrition.
Sometimes you may sleep because you are tired. Sometimes you may sleep because you just have no motivation to do anything.
Insomnia can indicate an inability to relax, pain making it difficult to sleep, or insufficient serotonin (also implicated in depression) which means the body cannot produce enough melatonin to get the body into a deep sleep.
Function
Your body only has so much energy. When you are not getting enough sleep it cannot recharge as efficiently. It is like charging your phone while you are actively using it…It never gets fully charged, so you are frequently looking for a charging station.
How You Cope
- In the past when you have had difficulty sleeping, what has helped?
- What makes it hard for you to sleep?
- The first step is to identify why you aren’t sleeping well, and rule out the easy things.
- Create a good sleep routine that involves the same two or three activities (i.e. shower, read, lights out), and try to go to bed close to the same time most nights.
- Drink enough fluid. Water is preferable, but sports drinks, juices and other non-carbonated, non-caffeinated, non-alcoholic drinks will do. (Be careful about drinking excess calories which will cause weight gain).
- Reduce or eliminate caffeine at least 6 hours before bed.
- Identify and address anything that is waking you up in the night. (Dogs, coughing/allergies, snoring spouse, sleep apnea)
- Get a physical to rule out any medical issues especially thyroid and other hormone imbalances, and address anything that is causing chronic pain.
- Keep a notepad by your bed to write down things you need to remember instead of tossing them around in your head all night.
- Learn progressive muscle relaxation, so you can help your body relax.
- Finally, develop a stress management and relaxation plan.
Form
Lack of energy and/or fatigue. Sometimes you describe this as just not having the energy or desire to get up, or it feels like your body is weighted down and every movement is exhausting.
Cause
While these symptoms can be caused by insufficient or excessive sleep, they can also be caused by a lack of motivation and reward, or simply lack of movement.   When your body is sedentary it gets stiff and it feels more difficult to do daily activities. (A body in motion tends to stay in motion. A body at rest tends to stay at rest.)
Function
Keeping you calm, and minimizing energy expenditure allows the body to devote scarce resources to rebuilding and functioning.
Your thought processes can also affect motivation. Fear of failure or rejection may make you less motivated to even try to do anything. This anxiety causes your body to maintain a constant level of low grade stress. Over time it desensitizes to this stress and the fight or flight reaction is replaced with apathy.
How You Cope
- How do you get energy/motivation when you don’t have any?
- How do you get started on a task when you don’t want to do it?
- Sometimes just getting up and moving around can help. Try doing whatever it is for 15 minutes. Once you get started it usually isn’t so bad.
- In order to get motivated, you have to increase the motivating chemicals by having some successes.  Motivation is your body’s response to a reward. When something good happens it wants to do it again. So, create rewards for accomplishing small parts of larger tasks.   You can also combine things you don’t want to do (laundry) with things you enjoy (Netflix binges).
- Get an accountability buddy—someone who will cajole you into getting your butt off the couch and getting started.
- Identify any fear or depressive thoughts that may be dampening your motivation, and think the opposite. For example, instead of “Nothing I do ever turns out right.” Try identifying a few things that have turned out right and tell yourself “I am not perfect at everything, but I try, and I learn from my mistakes.” These negative thoughts that can keep you paralyzed are often called “irrational thoughts” and “cognitive distortions.” Research on the internet what they are, identify which ones you use, and address those thinking errors. (They are also covered in the section on Cognitive Behavioral Therapy later in this book.)
Form
Being sped up (agitation) or slowed down during the day.
Cause
High levels of anxiety, stimulants or unstable blood sugar can all contribute to agitation or slowing/exhaustion during the day. Both anxiety and stimulants often speed people up. However, your body cannot maintain that pace forever. At a certain point you will run out of energy, and no reasonable amount of stimulants will help you feel better. People with anxiety often report periods of being sped up followed by periods of exhaustion. Many people with depression overuse stimulants to just get through the day, again leading to a crash. When your hormones get out of whack, your body has difficulty regulating your blood sugar which can lead to hypoglycemia. Additionally, many people who are depressed, stressed or anxious reach for high-sugar foods that intensify the blood sugar crash.
Function
When you are sped up (anxious), your body is likely detecting a threat of some sort and trying to get you to fight or flee. If the stress is ongoing, eventually the body reduces the amount of “alert” chemicals it is sending out which makes you feel like you are suddenly going much more slowly. (Like driving on neighborhood roads after a 5-hour trip on the interstate).
If you are living on caffeine, nicotine and other stimulants you are causing your body to secrete stress hormones as if there was a threat.  Not only will these chemicals eventually lead to a “crash” but being overstimulated can also have negative impacts on your ability to sleep and concentrate.
How You Cope
- When you feel driven and/or anxious, how have you been able to get it under control?
- What can you do to be kind to yourself?
Form
Trouble concentrating and/or making decisions
Cause
Neurotransmitter, hormone or blood sugar imbalances, pain and lack of quality sleep can all make it difficult to concentrate. Sometimes when people start to feel depressed, they feel helpless to change things, and second guess themselves. You may start to question every decision wondering if it will make things worse.
Function
Concentration is a higher order process. If your body is struggling to just keep going, it is not going to divert energy to higher order thought processes unless they have a direct impact on your survival. Soldiers in a war zone are not likely to be reading “War and Peace” or trying to do something that requires a lot of focus other than staying alive. Unfortunately, like soldiers, if you have experienced trauma, your brain may always be on high alert making it difficult for you to concentrate.
How You Cope
When you are struggling to concentrate, how can you be kind to yourself? Like Stephen Covey says, sometimes you need to take a break and “sharpen the saw.” Continuing to try to “push through” when you are already struggling will make things harder and may deepen a sense of helplessness and hopelessness.
Make sure you are eating a healthfully and frequently to keep your blood sugar stable and give your body the building blocks to make your neurotransmitters.
Form
A sense of hopelessness or helplessness
Cause
Feeling empowered, motivated, hopeful and positive requires you to be physically and mentally healthy. When your brain chemicals are out of whack or you are not healthy it impacts mood and motivation. When you wake up every morning tired, stressed and unmotivated, it can feel overwhelming which can cause a loss of hope and a sense of being stuck.
Function
This is simply a signal that something is wrong. You need help.
How You Cope
What helps you feel empowered? What are you hopeful about? What are your goals? What are three things you can do today to start making things better? What are three things that have gone well in the recent past?
Form
Excessive worry or fear
Cause
Worrying about a variety of things frequently and to excess is often a sign of a neurotransmitter imbalance caused by negative thinking patterns, effects of drugs or physical issues.
Function
Fight or flight is a basic survival reaction. For some reason the body is perceiving a threat when none is there.
How You Cope
Understanding that fear is a protective reaction is the first step. The next is to identify what you are afraid of. Fears of failure, rejection, loss of control and the unknown are good places to start. Ask yourself what it is about the current situation that: 1) Makes you believe you might fail and that failure is the end of the world, 2) makes you fear rejection or abandonment, 3) might cause you to lose control of something important, or 4) frightens you because you cannot predict the outcome.
- Minimize stimulants which intensify anxiety reactions.
- Learn your stress/worry/fear triggers and identify ways you have dealt with them, or could deal with them.
Form
Hypervigilance—being easily startled
Cause
Excessive worry or fear. Sometimes the brain stays on high alert to protect against revictimization (such as in PTSD) other times, if you are already stressed out and on edge, you may startle more easily. Imagine the difference in reaction if someone slammed a door at your house versus slamming a door when you are walking through a deserted haunted house.
Function
To keep you on high alert for the perceived threat.
How You Cope
Avoid being startled. Let roommates and others know you are stressed out/on edge and try to be a little more cautious about making loud noises or startling you. My kids can sound like a heard of wild elephants, and my son often will come up behind me then start blurting something out. Most days it isn’t a problem. When I am particularly stressed out, it can make me feel like I am going to jump out of my skin.
Form
Racing Thoughts
Cause
When people are stressed or anxious, the brain wants to figure out how to make it stop.
Function
You will often run through things in your head that you need to do or that are causing you stress. Unfortunately, without being able to identify the threat, it is like playing pin the tail on the donkey, blindly stabbing at different things hoping you will hit the mark.
How You Cope
When your thoughts are racing, sometimes it helps to just write everything down on a piece of paper or a whiteboard. Get it out so you can see it, organize it and address it. Try to avoid taking on anything extra that you will need to balance. Right now you need to focus on what is going on with you. Imagine being in a room with a hundred bees buzzing around you. There is only one that will sting, but you cannot easily tell which one that is. You have to wait for them to leave, one by one.
Your thoughts are like the bees. They are buzzing around, swarming in your head. You don’t know which ones are actually threats and which ones aren’t.   By getting them out on paper, you can start letting go of the ones that are not actually threats, and protecting yourself against the rest.