Are you down in the dumps?

Depression is a common condition and can be described as a persistent feeling of sadness which affects the way we think, behave and live. While it is common for doctors to prescribe medication for depression, in this article I would like to discuss my perspectives and experience in dealing with depression.

Depression can occur from a variety of different provoking incidents such as a death, a financial loss or a failure in an examination ( Acute and chronic stressors). Whatever be the provoking cause, I look at depression as a situation where a person digs a hole in the ground jumps into it, cries for help and stays in the same hole as he refuses the help that is offered. I believe that there is a way to get out of depression without medication especially if one has the strong desire, mental strength and knowledge on how to do it. I love to quote the Eagles song “get over it” where Don Henley sings “ the big bad world doesn’t owe you a thing, get over it!” The realisation that it’s all up to you and that no one owes you anything and that it is up to you to stay happy, could be the start to your coming out of depression. So let’s look at what I think are important points to consider when you want to come out of depression.

1. Hope (work on your mind)– there is a popular saying that goes that you can live without food for up to a month, without water for up to a week, without air for a few minutes, but you won’t last even a few seconds without hope!

Your spiritual beliefs are extremely important for you to have hope in your life. Praying with the belief in God gives many people solace in times of difficulties. Belief that your prayers would be answered and that things would get better could help you overcome many challenges. Meditation could also help you focus your mind on being happy and on finding solutions to your problems.

2. Maintaining a positive mindset in the worst situations. It is very important to filter out negative thoughts, especially those that get you down and avoiding all sources of negative inputs such as television, radio, social media etc. To stay positive with a hope of finding the solution for your problems and not giving up, would keep you in the fight.

At all times, you must be able to look beyond the difficulties of the present and focus on a brighter happier future. This is crucial.

3. Change your thinking. Thinking is a mental exercise that doesn’t come naturally to most of us. If there is a problem, it’s important that we sit down in a quiet place and introspect, and think the thought right through to its best solution/conclusion. Most often, we get distracted and lose our way. It would be helpful to use pen and paper and devise an algorithmic approach to all our problems and with adequate practice this can be done entirely in the mind. Meditating regularly can help the mind focus and think better.

4. Change your situation/environment. Very often we find ourselves stuck in an environment that causes depression. We may be living with people who get us down or working in a very negative or stressful environment. If you can change this environment, you may be able to live happily again. Get out of your comfort zone, meet new people and make new friends.

5. Action steps to cure depression. Always focus on the A U C – area under control i.e., the only person you can control is yourself as opposed to A B C – area beyond control i.e. everyone and every thing that’s outside your physical body. There is a story told about a man who wanted to change the world when he was young. As he reached his middle age he realised that changing the world was going to be difficult and so tried to change his children. When he was much older, he realised that he had failed to change his children and tried hard to change his wife. On his death bed, he realised that the only person he could have changed was himself and that he could have saved himself a lot of mental turmoil and stress if only he had focused on himself instead of trying to change others.

Worrying about the future is such a waste of time, worrying about the past is also wasted time. Don’t look for problems that don’t exist. So focus on the present and spend your time in trying to find solutions for your problems. What can’t be cured must be endured. So it would give you a lot of peace to accept your situation especially if you can’t change it.

Many people find or feel that they are trapped by circumstances that are unique to them. Many people love to live in the past. They love to talk and think about how nice the past was and how terrible the present is. This kind of escapism doesn’t help them at all. Some people actually seem to get a lot of enjoyment from their suffering, and are very reluctant to change the way they look at things, many people can find happiness by chasing a worthwhile dream. Looking forward into the future i.e., chasing dreams will help them escape from the difficulties of their present circumstances.

Form new habits to change the course of your life. Each habit has a cycle where you have a stimulus, a response, a consequence and the repetition of the cycle which establishes the habit. To make new and good habits one needs to change the response to a particular stimulus and break the old habit cycle.

Exercise your body. Improving your physical fitness definitely helps your mind stay happy. Exercise releases certain happy hormones in the brain that can help you cope with stress.

6. Count your blessing and be grateful for what you have got. Being grateful immediately brings to focus all the good things in your life. Even in the worst of times, you will realize that your life hasn’t been all bad and that should give you the strength to recover.

7. A few more suggestions.

Reduce your screen time. There have been many studies that have shown that the more time that someone spends in front of the screen of an electronic device, the greater the chances of feeling low.

Get out of your homes, get some fresh air and start a new exercise program.

Ask for help as the biblical saying goes “ask and you shall receive”.

Find the people who can help you and support you in difficult times.

Be flexible, negotiate with others and don’t be stubborn in holding onto your ideas and views.

While all of this is easy to write or read this in a blog, you need to be really strong to will your way out of depression. You may need to find an experienced counsellor who can guide you through your difficult times. Best wishes!

How do you fix your diet to take adequate fibre?

Fibre or roughage refers to anything that that can be taken by mouth and is not digested, bulks up the contents of the intestine and helps smooth evacuation of stools.

Having a diet that has plenty of fibre is good for health. Apart from preventing constipation, dietary fibre has a beneficial effect in lowering the risk for heart attacks and strokes, reducing the risk of diabetes, improving diabetic control in those already with diabetes and in preventing obesity. Modern dietary habits, based on the consumption of large amounts of refined cereals (grains) has very little fibre and therefore increases the risk of developing common lifestyle diseases such as obesity, dyslipidaemia, hypertension, diabetes and their complications.

What are the types of dietary fibre?

Dietary fibre comes predominantly in three forms namely, soluble fibre, insoluble, fibre and fermentable fibre.

Soluble fibre, dissolves in in water and puffs up, fills the tummy, promotes satiety (a feeling of being full, and therefore reduces hunger). It therefore helpful in those with diabetes and dyslipidaemia.

Insoluble fibre doesn’t swell up in water but tends to bulk up the intestinal contents, reduce intestinal transit times and helps quicker elimination from the body. Insoluble fibre is very important in maintaining intestinal health and preventing constipation.

Fermentable fibre can come from both the above groups and maintain a population of good bacteria in the gut. These are often referred to as pre-biotics (food for the good bacteria). Their digestion by intestinal bacteria (flora) results in short chain fatty acids (which can be used by the human host as an energy source) and is also converted to gas (methane, ammonia, hydrogen and carbondioxide.

So how much fibre do we need in our diets daily?

Most dietary institutes recommend 30 g of fibre for adults and reduced amount of fibre in children based on their ages.

While there is no upper limit to the amount of Phiber that can be consumed every day, it is recommended that any increase in dietary fibre is done gradually in order to prevent gas, bloating, constipation, diarrhoea and abdominal pain.

How do you fix your meals in order to have enough fibre daily?

This can be simply done by incorporating more green vegetables, taking more of whole fruit with skin, whole grains (instead of polished grains), plenty of lentils, and legumes(beans), a generous helping of nuts and also drinking plenty of water (upto 3 to 4 L per day).

By knowing how much fibre different foods and vegetables have, you can design your healthy meals with adequate fibre. Make sure that every meal has a fibre containing food in it just as you have proteins in every meal.

So what then is constipation?

Constipation refers to defecation that is unsatisfactory because of passing stools infrequently, needing to strain stools or with a feeling of incomplete bowel evacuation. Constipation could refer to for example, passing motions to 3 times a week only (not daily) or passing hard stools that are difficult to expel.

Why are people constipated?

People may be constipated because their diet does not contain adequate fibre or because of not taking enough fluids by mouth or because they dont exercise daily (and more so if they are elderly, bedridden or sick). Constipation can also occur due to the presence of medical conditions such as diabetes, hypothyroidism, kidney failure, high calcium levels, intestinal tumours especially cancers of the large bowel (causing partial or total obstruction), diverticular disease, neurological conditions such as Parkinson’s disease/Multiple Sclerosis etc. A variety of medications such as painkillers, antidepressants, iron tablets, antihistamines, certain antihypertensives, psychiatric medications and anti-seizure medications commonly cause constipation.

So how is constipation treated?

Before medication is tried, it is important to correct dietary deficiencies of fibre, inadequate water intake and being physically inactive. Medical conditions often stop patients from being able to do the above (patients with heart or kidney failure who can’t drink much water, patients with intestinal obstruction or inflammatory bowel diseases who cannot take fibre or those who can’t walk or exercise) may need laxatives to help them pass motions every day. Laxatives work by loosening the stools or relaxing the intestines thereby helping defecation.

So the most important thing to do would be to prevent constipation by fixing your diet by taking adequate fibre.