Dopamine is one of the brain’s “feel good” neurotransmitters. It induces feelings of excitement, motivation, aliveness and gratification. When we engage in certain behaviours, dopamine is released from where it is produced in the brain and enters our bloodstream to give us a feeling of satisfaction and reward.

Why Do We Need It?

From an evolutionary perspective, a release of dopamine is what incentivises us to do the things that are good for our survival, like eating, drinking and reproducing. Human beings are hard-wired to be reward-seeking and a healthy level of dopamine makes us feel happy, focused, alert and motivated.

‘Dopamining’

It may be a word right out of an urban dictionary, but the concept of “dopamining” is being increasingly used to describe the thrill of doing things that lead to a release of dopamine.

So Is Dopamine Addictive?

Dopamine itself is not addictive, but the feeling we get when we experience a flood of dopamine lights up the reward centres of the brain and compels us to want it more. The strong memory of the pleasure we felt as a result of a dopamine release is what we are focusing on and what we continue to seek.

Excessive repeated releases of dopamine can also over-stimulate our brain. In small doses this isn’t unhealthy, but arguably, some of the reward-seeking behaviours are what can be define as unhealthy and this is where things get complex.

Our iPhones for example, are like mini dopamine factories – pumping out little highs with each pick up. Modern phones have been designed with reward-seeking behaviour in mind and you just have to watch The Social Dilemma on Netflix to understand the magnitude of the problem. While it is not the phone itself that is addictive, the plethora of social media sites and apps is what has given us a positively endless supply of social stimuli in the thumbs up, likes, happy faces or messages that we receive. And, it’s not just the positive reactions we seek, it may be the negative reactions too. It can rapidly become a case of posting anything, even posting those things we know are just ideal to set us up for an online roasting because all we’re after is a response. Neuroscientists have shown that these positive and negative social stimuli activate the same neural reward pathways in the brain as a hit of cocaine would give us.

Being ‘addicted to your phone’ is just one example of how this can work. Other activities such as playing video games, drinking alcohol or infidelity can all behaviours that are based on this same reward system.

Where It Can Go Wrong

Regularly chasing a dopamine high off the back of an unhealthy behaviour can have serious implications for many areas of our life. Studies have shown there is a link between dopamine and compulsive behaviours and at an extreme level, continued and excessive dopamine hits can result in damage to the brain. Brain pathways are altered and the brain gets used to a new level of dopamine tolerance meaning that we are less sensitive to its impact. As we no longer get the same high, we may be compelled to seek increasingly unhealthy behaviours to achieve the same feeling. In the instance of alcohol use, this may look like drinking more and more. Even low dose alcohol is known to increase the release of dopamine.

In the case of infidelity, the brain’s self-control centre short-circuits and you may someone escalate from emotionally cheating to repeated infidelities or even engaging in risky sexual deviances. The thrill of the chase can be so intense it can sometimes look like a sex addiction (but that’s another blog post altogether). It’s not the sex that someone is addicted to though, it’s the dopamine release they are seeking and the sexual activity, or the chase at least, is just a way to obtain the dopamine rush.

Ultimately, the downfall is when it leads to poor impulse control and someone finds it impossible to resist certain behaviours. Instances of “It was just one more drink….” or relationships plagued by an incessant wave of infidelities rationalised as “just sexual banter” can lead to chronic problems in maintaining self-control that ends up costing someone dearly. Not only is there an impact to oneself in increases in stress, anxiety and depression and poor sleep quality, there is also collateral damage experienced in disruptions to personal relationships or in strained or dysfunctional family dynamics.

When To Get Help

If poor impulse control is something you recognise in yourself or in someone close, get help. There is work that can be done around identifying triggers and changing patterns in thinking, feeling and behaviour. Find a therapist you can talk to and one you feel you can work well with. Therapy can help improve levels of self-control and support someone in developing healthier coping strategies.

Photo (social media) by Karsten Winegeart on Unsplash

Photo (heart) by Marah Bashir on Unsplash

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It is no surprise that the current Corona pandemic is having just as much effect on people’s mental health as it is their physical health. Increased levels of stress and anxiety are being widely reported and there is already concern for the longer term implications of our lockdown.

So what is going on?

The Lockdown Effect

For those with pre-existing medical or mental health issues, there may be a spike in stress and anxiety as well as a more intense general level of emotional distress. To a certain extent, feeling anxious about what is going on in the world is normal. Under these very unusual circumstances it is actually expected that we may be experiencing stress and anxiety. After all, the world has changed in (and I’m going to say it…..) unprecedented ways.

But what happens to us when healthy levels of stress tip into the unhealthy?

The Stress Response

When we are under stress our body releases adrenaline and cortisol into our bloodstream and our body equips itself for a fight or flight response. Our heart rate picks up and our energy levels pique. Our body is preparing itself for a potentially threatening or dangerous situation. In periodic and short spurts, cortisol is useful to us as it boosts immunity by limiting inflammation. Cortisol also equips us to deal with the situation by limiting any non-essential functions. Once the threat subsides, hormone levels usually return to normal.

Sometimes, however, this doesn’t happen. We may be exposed to enduring higher levels of cortisol which can wreak havoc on a variety of body processes. We may also end up feeling quite wired and constantly on edge.

The important thing to be aware of is that this can have an emotional and a physical impact on us. To mitigate the impact, we need to be able to regulate our stress and anxiety levels. Stress is known to cause an excess of cortisol in the body and this can make feelings of depression more likely. Not only this, the synapses in our brain shrink as a result of a cortisol overload and we are less able to think clearly or be anything like our best selves. Too much adrenaline in our bodies can also have an adverse effect on our immune system. At a time when we are all seeking to be as healthy as possible, this would be a pretty unwanted result!

Currently we’ve lost control over so much we often take for granted. We cannot control when we go shopping, when we see our family or when go out for a drink with our best mate. It can be hard to acknowledge just how much we have lost control of. On the other hand, there’s a real chance to recognise where we can regain a sense of control in our lives. Essentially, we are reminding ourselves of what we have always, and continue to be in charge of.

One thing that can be really useful, is to stick to a timetable. Ordinarily, setting a time to have lunch may seem a relatively trite thing to do when our time is more our own, but maintaining a sense of structure and routine to our day is really important to general mental health during lockdown. It may have been great to see the time gained from not travelling into work as a lie-in opportunity, but going forward time structuring and a sense of security and stability is a basic human need.

Planning your own day is within your control. You can implement your own structure and routine. Pick a regular time to still have breakfast, get up in time to start your work-from-home day at the designated time. If you are not working you may find it useful to still get up at the same time as usual. Have lunch at the same time. Put time into your day for self-care. Go to that online Body Pump class and have a virtual coffee with your fitness buddy after.

Establishing and sticking to times we set for ourselves is within our control. Acknowledging this and reflecting on this can be very grounding and empowering. It can also be a useful tool in getting through a very challenging time!

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It’s usually the case however, that running away either isn’t a viable option, or, doesn’t in fact hold the answers to our problems. If you are relating to what has been mentioned so far, read on….

A fantasy

Our vision of what things could be like if we were able to just run away may seem idyllic. It may be a wonderful place of peace, calm and equilibrium we imagine we could run to. It’s a place where we don’t feel depressed. But, our vision isn’t a reality. It is highly likely that feelings of depression will move with us as we try to leave it behind in a futile attempt to start afresh.

Fed up?

So where to start?

If there’s a chance we can identify what it is that we’re wanting to run away from, there’s a chance that we can figure out what to do about it.

Identifying an issue in this way is the first step to taking action to limit the impact it is having on us. We can start to break down what the issue is until we have manageable chunks of resolvable smaller issues.

You may have established that a current issue is that you are in an unfulfilling relationship or stuck in a seemingly dead-end job offering little opportunity for you. Together we can start to break things down and work to find a way through.

An inability to take a step back and stop ourselves being engulfed with overwhelming emotion can often be a stumbling block to helping ourselves. An opportunity to gain perspective on our situation can help us to appreciate that there is a way to help us through.

Start now

If you’re after some simple and practical steps to get you through your darkest days, try some of the following;

• Acknowledge where you are right now

Noticing how low you’re feeling and acknowledging how rubbish things may appear for you is a first step. Before you can fix issues you’re facing, acknowledging the pain you are feeling will bring your attention to the present moment. It will be an opportunity to ground yourself and be in touch with what’s going on for you. Seeing what is there is a chance to do something about what’s there.

• Keep in touch

It may feel like the last thing you want to do, but keeping in touch with others around you is crucial to how you can help yourself out of your dark place. Finding a genuine connection we can touch base with when we’re feeling really bad, even if it’s just to make contact with, is a way we can be heard and noticed.

• Get outside

Get outside for a walk each day. Even if you have no where to go or no place you need to be, getting out of the house and walking for half hour each day will really boost mental health. Having a chance to engage with the outside world may be a useful reminder to us that it is still there. There are people around who can help and support us and who will be people we can interact with if we choose to. It may lift your mood, give you a new environment to focus on and break patterns of thinking.

Talking It Through

Talking it through is also a practical first step.

The idea of talking to someone about what is going on may itself seem like an impossible task. If all you want to do is retreat from the world, opening up and talking to a therapist may not be on your radar. But, if there’s a chance that taking that first step and getting in touch is a step you’re willing to take, it could also be the first step on a journey to feeling better about yourself.

The opportunity to really be heard by someone else may be the glimmer of hope that we need to plough on through. Sharing your problems can provide clarity on what is going on for you and how you may be able to take steps forward. It may not be immediately obvious what we can do or where you would even begin, but my role as a therapist is to be there for you and alongside you on your journey.

Together we’ll find that space in which you can take a breath and begin to make headway on that journey.

If you would like to explore options, get in touch to find out more.

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Our immediate inclination may be to want to help them out of their dark space. We want to make things better and we want whatever is troubling them to go away. If you haven’t suffered with clinical depression it may not be so clear what is useful and what is not useful to say. How can you know what it feels like if you haven’t been through it yourself? It may be an uncomfortable place to acknowledge that you’re not familiar with the depths of despair someone seems to be experiencing. Platitudes and rallying support may be met with a brick wall.

So What Is Useful To Say?

Even if you are very close to the person suffering, knowing what to say may be a challenge. The following are some starter tips for what to say to show support for someone experiencing depression.

“I Love You”

“Would you like some space?”

“You may not want to talk right now so can I just sit with you?”

“I’m here for you and I care”

“When you’re ready to talk I will be here to listen”

“Can I make you a cup of tea?”

“You are not alone”

“You matter”

“You are important to me”

“I know things are tough right now but I’ll always be here”

Getting help

Getting professional help and having counselling for depression is an important first step. Depression will affect 1 in 3 people at some point in their life so know that you are not alone in feeling the way you do.

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As a nation then, are we more depressed or are GP’s more relaxed about prescribing anti-depressants? Maybe it’s neither of these. These days, we generally have a better understanding and appreciation of our own mental well-being. We are more aware of the importance of looking after our mind. Just as much as we care for our physical health, we are now more open and pro-active about helping ourselves when we feel unable to overcome certain issues ourselves. Altogether this contributes to broader awareness and openness about going to see a therapist if we need a bit of support with our mental health. So it may seem like the problem is getting worse but in reality it’s probably the same but it’s just out there more.

Depression and Anti-depressants

While the use of anti-depressants definitely has a place in the treatment of depression, they actually have little or no benefit in treating mild depression. The National Institute for Health and Care Excellence (NICE) guidelines state that for mild to moderate depression, psychotherapy is the preferred treatment. In many cases, psychotherapy is a perfect partner to anti-depressants. Medication supports us through certain stages and psychotherapy for depression takes us forward for longer-lasting changes.

So how does psychotherapy help with depression?

For a persistent low mood, studies have shown that medication alone does not tackle the underlying issues which may be causing the depression. Medication can of course be quite a saviour for many and they can be effective in keeping us afloat when we’re unable to cope nor do something else about our problems. However, the use of medication alone may result in high instances of relapse if stopped.

Depression can affect a person in many different ways spread over multiple different aspects of functioning. Psychotherapy for depression can help in many ways across these aspects by systematically tackling key issues that may be causing it. For example, psychotherapy can support someone with ways of thinking about themselves, their world and others. It can help with ways of processing emotions and also with the strategies we use to cope with problems. Psychotherapy actually has the potential to change our ways of looking at ourselves and our situation so that we are better able to see the wood for the trees. It enables us to make fundamental changes to how we feel, think or behave about certain things and to see where we could make improvements.

Talking to a therapist about issues you’re facing may ease stress and offer a new perspective on the source of your problems. By helping you to recognise problematic ways of thinking, feeling or behaving, psychotherapy supports you in finding new ways of being. Early intervention and having the chance to talk over your problems may also prevent depression worsening. Psychotherapy is also a tool that can have a lasting and profound impact on mental well-being.

Transactional Analysis psychotherapy and depression

Transactional Analysis is a systematic approach to psychotherapy and an excellent tool for diagnosis and treatment planning. TA makes use of a diverse range of concepts that can help therapist and client formulate a treatment plan that is tangible, clear and effective. Importantly, TA tools can also aid understanding of depression. It is also an empathic and a proactive approach that clients can find very useful.

As an example, Transactional Analysis can help you identify the ways in which you spend your time and whether those ways are getting your needs met. Are you perhaps spending your time withdrawing? Or are you perhaps still engaging with people but are finding it very unfulfilling with little prospect of enjoyable intimacy with anyone?

Research into Transactional Analysis has also shown that it is as effective as cognitive behavioural therapies in treating depression.

To find out more about psychotherapy for depression, get in touch with Alana for an initial no-obligation appointment.

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For many, anger is a problem feeling. It gets a bad name and is considered tricky and challenging to address and acknowledge within ourselves. This often comes down to a confusion between the two emotions. Identifying anger vs. aggression may support someone to understand more about the origins and triggers. Anger and aggression which have different purposes and come from different places and knowing which is which for us is a positive starting place.

If our boundaries are jeopardised in any way or if our needs are not appropriately met, feeling angry is a way of attempting to change our environment and to get those needs met. Anger is an acceptable feeling and functional response to desire to change or do something in the present. It can be problem solving and a ‘vehicle for change’, i.e. a healthy way to get things done. It is also a primary emotion and a survival tool if it is in direct response to an active stimulus at that point in time.

Aggression is how we choose to behave in response to a stimulus and involves forcibly and harmfully attempting to get others to behave differently. Exerting ourselves over others in any way is an unacceptable way of dealing with our emotions and can be bullying and harmful.

When anger feelings are confused with aggressive behaviours it can result in any healthy anger being denied. We may box our “angry feelings”, deem them unsafe and leave them to fester in a repressed box of emotions. This is the point we may have mixed up healthy anger for unhealthy aggression. On the other hand, if we accept and deal with angry feelings as and when they arise we are more likely to get our needs met. Embracing our anger is a perfectly acceptable and healthy way to articulate our feelings towards our need not being met or having our boundaries crossed.

Understanding the origins of our anger can tell us a lot about how we deal with anger and what purpose it serves us individually. During an assessment your therapist may ask you questions around how you deal with anger and what happens when you are angry to establish an appropriate treatment plan.

To work on anger management issues, ask any questions or make an appointment, please get in touch.

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