“It seems that you’re carrying a sense of shame,” my therapist said to me as I finished speaking. “Shame?”, I looked up, startled, confused, skeptical. For as long as I had been struggling, trying to wade through my thoughts, feelings and emotions, there were various expressions and descriptions I would have used, yet not once had the word “shame” crossed my mind. As we progressed through the sessions, peeling off layer after layer to unveil my not-so-glamorous belief system, it began to make more sense to me. Shame was indeed a theme that had repeated and manifested itself, time and again, in various aspects of my life.
What is shame?
Shame is a feeling or emotional state which comes from viewing oneself as bad, inferior or unworthy. It is often confused with guilt. However, there is a fundamental difference between the two: Guilt is an emotion of having done or not done something, so it is associated with behaviors, whereas shame is a feeling that we are inherently flawed, bad or undeserving. Just as we experience guilt, most of us feel shame to some degree, in one way or another. Shame can be borne out of guilt, but while the guilt may pass, shame can go deeper, and often has a more profound, toxic impact on us.
What creates shame?
Shame is felt and accumulated through various individual experiences. It could develop as a result of traumatic events, or it can be a product of how we are raised in our homes and cultures that each have their norms or codes of conduct. Religious conditioning can play a predominant role in creating shame. Social media adds a public dimension to it, taking it beyond borders as people inflict humiliation online, unleashing their opinions without inhibitions. Shaming as an act targets the person as opposed to their behavior. However, for many of us, shame originates without a clear, definite reason, creeping up on us even as we carry out our routine, mundane, day-to-day activities.
Shame can be healthy, for example, when we do something that could be morally wrong such as harming others, in which case it drives us to change our behavior. The harmful kind of shame is toxic shame because it is usually caused by unjust reasons and is rooted in traumatic experiences such as abuse, neglect, harsh criticism, or other emotional experiences which we may not even recognize as trauma. Depending on circumstance and experience, shame can either be felt for a short span of time, or it can last longer, often carrying over from childhood.
How does shame impact us?
“Shame corrodes the very part of us that believes we are capable of change” – Brene Brown.
The impact of shame is deep and far reaching. It makes us feel small, humiliated and unworthy, often hampering our ability to function efficiently in our daily lives and affecting our interpersonal relationships. As it is usually painful and debilitating to face shame, we often follow evasive emotional patterns to avoid it, using coping behaviors such as anger, addiction, perfectionism, narcissism, lying, suppressing feelings, self-neglect or self-harm. Persistent shame ultimately impacts our mental health, and it is common for a shame-ridden person to suffer from depression, anxiety disorders, and feelings of low self-worth. Women are more prone to feeling shame than men, and some studies have shown that it is most acutely felt by adolescents.
Dealing with shame
The very first step in dealing with shame is to recognize and acknowledge it. Notice the emotion and bring it to the surface. Become aware of your triggers and observe how shame makes its appearance. Think of it as a story and give it a title, for example, “The I am unworthy story”. This technique can help to detach the mind from getting caught up in its thought and reduce the intensity of the shame, taking away its power.
Confide in someone and share your feelings with them. Make yourself vulnerable to someone you feel safe and comfortable with. Chances are that you will find you are not alone in feeling this way. A confidante may also help you to challenge some of the self-condemning thoughts you are struggling with.
Be your own friend and advocate: What would you say to a friend who was feeling the same way? Talk to yourself the way you would talk to them. Stop bullying yourself and replace the self-berating talk with self-compassion. One way of doing this would be to use the “balcony view” approach. Take a seat on the balcony on the floor above, and observe your thoughts and feelings, placing them on the balcony below. Change how to talk to yourself and approach the self-downing talk with empathy and kindness.
Respond to the shame by changing the narrative. For example, replace the thought “I am bad” with “I did something bad”, or “I am a failure” to “This didn’t work out”. Doing this helps to disentangle the act from the person and helps us to recognize the fact that our acts do not define us.
Seek professional help: a mental health professional can help to reach the heart of the problem, equip you with tools and techniques to deal with and overcome the problem.
Carl Jung described shame as a “soul-eating emotion”. However, shame will only gnaw away at us if we allow it to. The power to take back control lies within us.
In the words of Jennifer Edwards – “The beauty of life is, while we cannot undo what is done, we can see it, understand it, learn from it and change so that every new moment is spent not in regret, guilt, fear or anger but in wisdom, understanding and love”.
We often hear the term “depression” thrown around lightly in conversation. We may come home from a stressful day at work and tell our family at dinner that we are depressed. We may have received some bad news about a loved one and tell ourselves that we are depressed. And sure, we may be depressed, but often we are confusing sadness with depression. Sadness is a symptom of depression, and because we associate these together, we often struggle to differentiate between these two common psychological states.
This creates a significant problem.
The inability to differentiate between sadness and depression can lead us to neglect a severe psychological condition (depression) and overreact to a normal emotional state (sadness). If we overuse the term depression when we are describing our emotional state of sadness, we are simplifying a major mental health disorder. Depression is a serious mental health disorder that has vast implications on our personal lives, professional lives, and society as a whole. As of 2017, 300 million people around the world have depression.
What is sadness ?
Sadness is a normal emotion that is triggered by a specific adverse event or bad experience. In other words, we become sad about something specific. This emotional state dissipates after some time or after something good, replaces the hurtful event that triggered the initial sadness. Sadness is temporary. We may feel sad for a moment, an hour, or even a couple of days. Every individual will experience sadness, probably more than once, in his/her lifetime. You may become sad because you ended a romantic relationship, or you did not do well on an exam, or you spent the night fighting with a friend. We can often find some relief from our sadness by crying, venting, or talking about our situation.
What is depression?
Depression is a mental health disorder, an abnormal mental and emotional state, which affects how we think and feel about everything. Depression leaks into every aspect of our life, and when we are depressed, we feel numb or sad about everything. Everything in our life is less enjoyable, less interesting, and less important. The things we once loved and were passionate about no longer bring us meaning or purpose. Depression, unlike sadness, does not have to have a specific underlying trigger. Individuals are often depressed “for no specific reason.” On the surface, they may seem like they have their life together. A great job, a loving family, a beautiful home, but in reality, they are hiding their emotions behind a mask. They may be barely able to get out of bed in the morning. They may be struggling with their relationships. They may be lonely. They may no longer find satisfaction or purpose in their job. Depression makes us less patient and quick to anger. Unfortunately, many individuals assume that one can snap out of their depression. They misinterpret that depression is not a choice or a state of mind. Depression is a mental illness.
Signs and symptoms of Depression
To be formally diagnosed with major depressive disorder (MDD) an individual must experience a depressed mood or loss of interest or pleasure in almost all activities for at least two weeks as well as at least five other symptoms including the following:
Change in sleep: Either difficulty falling asleep or sleeping too much.
A decrease in energy or feelings of fatigue daily.
Change in appetite or weight: Gaining weight, losing weight, overeating or eating much less.
Sadness (depressed mood) is just one symptom of depression.
Treating sadness versus treating depression
Sadness can be overcome within time. You can express your emotions, “cry it out”, go out with friends, or spend time outdoors. Expressing sadness over the loss of a loved one may take some time, but you can still find happiness in other aspects of your life. Engage yourself more with these happy aspects.
Depression is best treated with a combination of medications and psychotherapy. The most common medications used to treat depression are selective serotonin reuptake inhibitors (SSRIs). All medications, including SSRIs, come with side effects, and therefore it is essential to have a conversation with your healthcare professional before starting this treatment. Cognitive Behavioral Therapy is the mainstay psychotherapy approach in treating depression. Treatment for depression does not happen overnight; this is a process and can take some time, and different treatment approaches. Depression is a prevalent mental illness, and many treatments benefit most individuals.
Depression is a mood disorder that involves a persistent feeling of sadness and loss of interest. It is different from the mood fluctuations that people regularly experience as a part of life. Major life events, such as bereavement or the loss of a job, can lead to depression. However, doctors only consider feelings of grief to be part of depression if they persist. Depression is an ongoing problem, not a passing one. It consists of episodes during which the symptoms last for at least 2 weeks. Depression can last for several weeks, months, or years.
Reduced interest or pleasure in activities once enjoyed.
A loss of sexual desire.
Changes in appetite.
Unintentional weight loss or gain.
Sleeping too much or too little.
Agitation, restlessness, and pacing up and down.
Slowed movement and speech.
Fatigue or loss of energy.
Difficulty thinking, concentrating, or making decisions.
The medical community does not fully understand the causes of depression. There are many possible causes, and sometimes, various factors combine to trigger symptoms.
Factors that are likely to play a role include:
Changes in the brain’s neurotransmitter levels.
Psychological and social factors.
Additional conditions,such as bipolar disorder.
Depression is treatable, and managing symptoms usually involves three components:
Support: This can range from discussing practical solutions and possible causes to educating family members.
Drug treatment: A doctor may prescribe antidepressants.
Psychotherapy: Psychological, or talking, therapies for depression include CBT, interpersonal psychotherapy, and problem-solving treatment, among others.
For some forms of depression, psychotherapy is usually the first-line treatment, while some people respond better to a combination of psychotherapy and medications.
CBT and interpersonal psychotherapy are the two main types of psychotherapy for depression. A person may have CBT in individual sessions with a therapist, in groups, over the telephone, or online.
Interpersonal therapy aims to help people identify:
Emotional problems that affect relationships and communication.
How these issues also affect their mood.
How all of this may be changed.
Aerobic exercise raises endorphin levels and stimulates the neurotransmitter norepinephrine, which is linked with mood. This may help relieve mild depression.
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If you love someone who struggles with a mood disorder, chances are you’re often confused or challenged as to how to best help.
One of the first things to know is that friends and family members can be a lifeline for someone who lives with depression. And second, that, there are many things you can do to help.
Tips for Supporting a Loved One
1) Listen Compassionately: One of the most important things you can do is just listen to your loved one. Ask how they’re feeling, but don’t force them to talk if they aren’t interested. When they do share, allow conversations to flow in an easy and open way. Don’t tell them how to feel better or what to do to feel better. A good way to be a great listener is to know that the word listen contains the same letters as the world silent. And great listeners are quiet. They listen to hear what the other is experiencing. They listen to offer support. After you listen to your loved one, ask what things you can do to help them when they’re feeling depressed.
2) Understanding Depression: It’s also important for you to understand the illness of depression, its symptoms, course, and treatments. This will help you understand your loved one better. It will also help you know if your loved one is improving in a timely way, if they need different treatment, or require more assistance.
3) Supporting Their Treatment: One critical area of support for loved ones with depression is helping them maintain their treatment plan. This includes taking medications as prescribed, seeing healthcare practitioners as recommended, and seeking additional support as necessary. You may need to be the person to remind your loved one to take medication every day. You may also help by setting up and/or taking them to healthcare appointments.
4) Help with Day-to-Day Living: Often, people with depression have difficulty with some of the basics of day-to-day living. If severe enough, depression can leave a loved one completely immobilized, unmotivated and unable to do many of life’s simplest tasks. During these times, a person with depression will need support in ordinary activities. You may need to encourage them to shower, to eat, or to get some fresh air. And sometimes people might need help going to the grocery store, cleaning the house and paying bills.
5) Supporting Regular Activities: Try to encourage your loved one to maintain the activities he or she regularly does when they’re not depressed. Be it work, school or socializing. Don’t force them to do things if they aren’t ready, but do try to help them stay involved in their lives.
6) Recognizing Warning Signs forSuicide: It’s important to know that people with depression are more likely to attempt suicide or die by suicide. Take any comments about not wanting to wake up, wishing to die, never feeling any more pain or you’ll be better without me as requiring immediate attention. So, too, is the giving away of items, feeling suddenly better and other suicide warning signs.