Depression and Biofeedback

Depression is not a weakness or fatigue - it is a real illness.
It is important to point that out, right at the beginning, since, as I see it, too many people nowadays relate to depression as a personal failure. What’s more - it is quite common, and we know that about one out of five people may suffer from some depression at any given stage of life.
Depression may express itself in four aspects, one or all of them - thinking, behavior, moods and physical functioning.
Diagnosis of depression is extremely important. Not every person who feels sad, declares he/she is “fed up”, or frustrated at work, school or business - is necessarily depressed. In order to know if someone is suffering from clinical depression or not - several clear symptoms have to be observed. Depression, as diagnosed by the medical system, is totally different from those feelings of sadness or lethargy, usually reported by the patient.

Depression is considered when at least five of the following conditions persist, for more than a fortnight:

1. Extreme changes, on a daily basis, in the patient’s mood, which may worsen in the morning.
2. Lowly mood is felt most of the time. Also, decrease in the person’s functioning ability, and ability to enjoy oneself, as well as distress in behavior.
3. Outbursts of crying with no apparent reason.
4. Lack of appetite, weight loss, or sometimes - overeating and weight gain.
5. Insomnia, restless sleep, or sometimes oversleeping.
6. Lack of energy to perform even the simplest tasks, such as phone calls to friends, shopping etc’.
7. A feeling of constant fatigue.
8. Difficulties in one’s attention and concentration.
9. Negative or suicidal thoughts, failure in coping with the burden of life.
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One should remember that there are several types of depression, which vary in severity: It may be slight, moderate, severe or extreme - with psychotic characteristics.
Rebecca felt a “hollow space” in her heart when her spouse passed away, after many years of living together. His death was sudden, and after the weeks’ official mourning, she suffered deep depression, which was treated by medications. She developed a daily ritual of going to the cemetery, sitting there by the grave, talking to him and crying for the whole day. She did it every day, failing to eat or drink, and demonstrating all typical signs of depression.
One of the ways to overcome depression is to increase one’s activity, and we shall discuss it later. This is when I told her: “It is very nice for you to go there, but I suggest that next time, you buy some plants and arrange a small garden around the grave. Don’t buy them all at once; do it one at a time, and while you tend to the garden you can talk to him. After you have finished watering the plants - go home, Why stay there for the whole day?”
This way I incorporated some positive element in her depression, without confronting her directly. I also asked her to report to me at the end of each day of what she had done that day. And so it was.
Rebecca stopped working after her husband’s death. I suggested that she went back to work, and visit his grave after work. She did so, and after that it was easier for me to suggest that she need not go there every day, because the garden did not need daily watering. Later, she was even ready to accept my suggestion to go to the movies every once in a while. After she returned to her normal routine of life, I introduced her to biofeedback.
“You are the master of your body,” I told her, “and you can control your feelings as well”.
Therapy was completed three months later, when she called me to say: “You know, today I suddenly realized that I was making a face to the plants, telling them: ‘Hey you! Wait until I get to you!’”
She did not want to die, she had accepted the fact of her husband’s death, processed her grief and returned to life.
Do Men Cry at Night?
In spite of the fact that women, in general, are emotionally stronger, due to their painful experiences of menstruation, and childbirth - statistics show that they are more prone to depression than men.
The reasons for that may be mainly social: The common masculine outlook is that men should not cry, or be afraid. Women, on the other hand, are weaker, therefore - they may cry and be afraid. Women are more attentive to their own emotions, whereas men do not allow it to themselves.
In fact, the basis for depression in men and women alike is the same, but in women it expresses itself in depression, unlike men who express it by violence.
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Not every lowly mood or dejection is depression. When I was a child, Nathan Alterman - a known poet - lived on the upper floor of our house. He liked to drink, and sometimes, when he was too drunk to climb the stairs, he would stay in our house, on the ground floor, and sleep on the sofa. As I understand it today he was rather dejected, and did not suffer from depression. The two things differ significantly: The dejected person is not as sad, and is much more active, whereas a depressed person will shut himself in his corner, and will not emerge from there.
Sometimes, when the physiological balance is disrupted, which is quite normal, it may cause dejection and foul mood, as during menstruation. In some of such cases, biochemical changes may be detected, such as lack of Vitamin B-12 or Folic acid, faulty functioning of the thyroid or the adrenal gland. Such deficiencies can cause, directly or indirectly, severe changes in mood, which may be interpreted as depression.
Besides, sometimes sorrow is inevitable. “Emotional constipation” is not very welcome, as already described in a previous chapter. Emotions, in general, exist, have to be experienced, thought about, and expressed. Emotions held back may erupt uncontrollably, especially when they are related to another person. Thus, depression is legitimate, but its duration has to be controlled - we can decide how long we wish to be depressed.
“Bonjour Tristesse”
Emotional pain deserves the same attitude as physical one: “Enjoy your ability to feel sad, make sadness your friend, have a dialogue with it and invite it to stay - for a limited period of time, during which you may converse with it. Talk to your pain, ask questions, imagine the answers - don’t fight it. Allow yourself to live with the emotional pain as long as you wish; but don’t make it permanent”.
There is reason for the period of seven days’ mourning (Shivah) in the Jewish religion. These days make a “concentrated”, limited, period of time in which we are allowed to mourn and grieve, and after them we have to get up and move on with our lives. Other cultures have each their own periods of mourning as well.
Entering a period of grief is a ritual, just like any other thing we do during the day, including using the toilet, eating our breakfast, washing our hands and praying. Every time we enter this sad mood, we do it in the same manner. Our sadness has a beginning, middle and end;
We are engulfed in it - alone, or in the company of other people. One important thing should be understood: We are sad because we chose to be sad. We have to react authentically to various situations in life, but we can control it!
When we are positive that it is indeed nothing but foul mood, and not some clinical problem, we must remember that it is in our power to change things. In states of dejection, just as anxiety or any other negative emotion, we must acknowledge the power of our own decision, and our own capability to choose our thoughts. If we understand, believe, and know that it is our call, whether to be depressed or not, and if we exercise our ability to think positively - then we will be able to overcome a significant part of our depressing thoughts, without any medication whatsoever.
Instead of thinking, “There are so many unpleasant people in the office, and I have got so much work today, I’m bored and I don’t feel like going to work today at all!”, we could think different thoughts, such as, “I want to go to work today because this is how I make my living, even if the boss is obnoxious and work is boring. I have no better choice right now, and I am prepared to pay the price, so that later I will do all the other things I like to do. I am going to make the best of my work”.
This is precisely what I told Anat, after she had decided she was depressed. Her depression had a name - Itamar. She has been seeing him for the last two years, during which he has been in the middle of a divorce procedure. Twenty four months and nothing has changed: He is still ‘working’ on his divorce, his relations with Anat are kept secret and no one knows about them, not even his kids; and what’s more - Anat is already 31 years old, and starting to feel time tapping on her shoulder.
I asked her several questions:
What do you get out of your meetings?
“I think I love him”.
Think? But what do you gain from it?
“I have a boyfriend”.
It means a lot to you - being able to say you have a boyfriend, does it? You want everybody to know you are not alone? Have you asked yourself one simple question: Are you happy when you are with him?
“Yes”.
This, I told Anat, is what you must remember: You are happy with him, and unhappy without him. In such a case, where the relations consist of a few brilliant moments in a dull reality, and the future is not clear - you should make the most of it. Like a child with an ice cream cone; as long as he has it - he’s happy. Then he must wait for the next time he has ice cream to be happy again. Anat should draw her power from the good moments, and these will help her through the daily dullness, until the next time she is happy and satisfied again.
If her times with her boyfriend were not good - I would not give her this advice. But her meetings with him, sometimes as brief as half an hour, one night, or just going to the movies together - these are her ‘ice cream’. She should be happy for having it once in a while, though she does not have it all the time.
Besides, she should focus on her other good moments. They might consist of the music she loves, a nice talk with a friend or deciding to complete her Ph.D. studies. What I mean by all these is - one must see the full half of the cup.
It is because of these few moments of happiness that we manage to endure all the rest.
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Eran had been unhappily married for many years, during which he grew fat. After his divorce, examining his life until then - he realized that eating was a result of his depression. No one was aware of it but himself, and he found refuge in eating non-stop. He chose food to compensate for the things he lacked, and indeed, for a short while after eating he felt better. But later, realizing how fat he got because of his overeating, his depression worsened. People like Eran may, sometime be unaware of their depression, but still this depression will be the driving force for their behavior.
Stress and nervousness also send people to the fridge - which is a bad solution. Instead of eating, one can try and imagine tasty food, or some beautiful place to be in. As I have already mentioned, imagination is an important channel. Buying something new to wear, a small gift, or playing one’s favorite music - will help too. Music, in general, has extraordinary power. It penetrates the thalamus in our brain directly, without passing through the cortex, where the intelligence lies. This is the reason we move with the music unconsciously - it is a direct reflex of the thalamus (“thalamic reflex”), and it is involuntary.
Laughter Will Cure Everything
When someone close to us is depressed, we should try to cheer him up. Laughter is the best remedy for depressed people; it releases chemicals into the brain, chemicals that fight depression.
When we are somewhat lowly, laughter is the only medication, even if we have to force ourselves to laugh. Making faces in front of a mirror is one way to do it - sooner or later it will make us laugh.
Besides, we can attach colorful stickers to all sorts of places, like our watch, telephone, purse, etc’, which will remind us to smile. Smiling causes positive sensations to emerge, even when we are in pain. Smiling at someone who has been our enemy may make him smile back at us. Pain and depression are easier to fight if we keep smiling, they will go somewhere else.
Another way to fight depression is physical exercise or sport. Jogging, doing pushups, dancing to rhythmical music, anything that will make us move and actually do something - will reduce our depression.
The Cheering-Up Waltz
Depressed? Put on some rhythmical music to move by. Samba, Waltz or some Brass percussion band music - they all have an intensity of their own. Better to listen with earphones, move with the music and dance to it. Let your body lead the way, and our psycho-physiological system will cure itself.
Physical exercise changes the internal system of our body: Blood flow is faster, the brain secretes Serotonin, the body receives Adrenalin - and the depression is not what it used to be. When depression decreases, we are suddenly more concentrated, more confident, and the world looks nicer.
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No one is ever born depressed, except in hereditary cases, which are not discussed in this book. Still, depressed moods may affect us all - men, women, elderly people, and even children. Depression in children and adolescents are dealt with in a separate chapter.
During our lives we may eventually have periods characterized by depression, mainly periods of transition from one phase to another. As adults, we may be affected by depression once in every ten years or so.
Depression may appear during middle age, due to hormonal changes. Therefore, one should first have his hormonal level examined, to see whether or not hormonal treatment should be administered. If this is not enough -psychological cognitive therapy is to be added.
Other common reasons for feeling low are a sudden feeling of emptiness, like after retiring from a demanding job which has kept us very busy for years. Moving from a very intensive, busy life to quiet retirement may cause a crisis followed by depression.
What About Biofeedback?
All along, the Biofeedback method makes visible on a computer monitor what our spirit and soul can do to our body .It serves as a mirror in which a person can see and hear how he can control his physiological, emotional and mental systems. In other words, our body could reveal thoughts and feelings hidden in our subconscious during biofeedback monitoring. The instruments do not show us how happy we are. Instead they demonstrate to us how we can do something we have thought impossible. Success makes us feel confident and happy. A person can attach to a channel giving him information of the physiological tension. He can play basketball using his facial muscles, and when he activates them right - he will win the game. Success itself is the reward, gratifying him and enabling him to cope better with depression. He can even eliminate it altogether.

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