Or is this normal?
We all struggle from time to time. We all have days or even a week where we might feel demotivated, fatigued and down. However, how do you know when you need to get professional help and what does this look like?
Depression and anxiety
I often hear from clients that their medical doctor referred them to a psychologist for therapy because they have depression, and they could not understand why. “I’m not depressed” is a common sentence in my office. Or they come into my office thinking that they are just struggling a little bit, feeling a bit fatigued and “need a vacation”, when actually they are depressed and anxious.
So, what exactly is depression? Well, you may or may not be relieved to hear that you need to meet a certain number of symptoms in order to be diagnosed with depression. According to the Diagnostic and Statistical Manual for Psychiatry (5th ed), which is the manual that guides a psychiatric diagnosis, you need to meet a certain number of criteria over a certain period of time in order to be diagnosed. These include:
- A depressed mood most of the time,
- A lack of interest/pleasure in activities that you found pleasurable in the past,
- Appetite changes resulting in either a weight loss or gain,
- Difficulties with sleep,
- Feelings of worthlessness, helplessness and hopelessness,
- Thoughts of death or taking your own life (suicidal ideation).
And for the most part, the above-mentioned need to interfere with your occupational and\or social functioning. You may also experience symptoms of anxiety (tight chest, butterflies in your stomach, sweaty hands and just a general sense of unease and worry) along with these. If you do identify with some/all of these symptoms, please do not self-diagnose, rather talk to a professional.
A lot of clients may present at my rooms that are high functioning (at work and home) and struggle with depression and anxiety and may not be aware – “but this is normal”, they tend to say. They may have had depression and anxiety for some time but have masked it or used work as a means to cope. However, they still require treatment.
Depression and Burnout
Or are you maybe just feeling burnt out? Burn out, depression and anxiety can often overlap. With no real consensus on a definitive definition of burnout, for the purposes of this article, burnout will consist of the following three symptoms: (National Library of medicine, 2020)
- Exhaustion – feeling tired, drained and fatigued, unable to cope,
- Alienation from activities (sometimes work-related) – work (or stay at home tasks) might be increasingly stressful and frustrating, cynicism and alienation from colleagues
- Reduced performance – feeling very negative about day-to-day tasks, reduced concentration and feeling listless
If you are experiencing any of these symptoms, talk to a professional and get treatment. Burnout left untreated can develop into depression and anxiety. You might just need someone to talk to and validate your feelings.
You might just need some assistance with boundaries to prevent it from getting worse.
So, you have sought the help of your medical practitioner, and he has referred you to a psychologist. That’s a really great step! If you have not seen your medical practitioner/GP and would like to see a psychologist, then your GP can assist you in getting a mental health care plan.
Together we will figure out if you do have depression and the causes of it. This will take place in psychotherapy where you and your psychologist will unpack your symptoms and potential causal factors together.
Depression is an internalizing disorder which means that you likely keep very difficult emotions to yourself and may even suppress them. Psychotherapy will assist you in unpacking and dealing with those difficult emotions.
Here are a few more ways you can assist yourself:
Your medical practitioner may have already prescribed anti-depressants for you, but if not, it is good to discuss with your psychologist as to whether you would benefit from a referral for medication. You may also need a specialist referral to a psychiatrist.
These are skills that you can do to help you cope at home and in your workplace. They include:
- Exercise – often the last thing that we feel like doing, especially when we are tired and demotivated. But it really helps. Exercise is a great outlet for anxiety, and it also releases the feel-good chemicals that we need,
- Journalling your feelings – I often find clients tell me that this can make them feel worse. This could be because you are actually acknowledging your feelings now instead of avoiding them. This will pass, and your challenging feelings will not last forever,
- Routine and structure – this really helps give us some consistency and containment,
- Try to find something to look forward to, even if it is just your favorite cup of coffee on the way home, · Nature – connect with your natural surroundings, sit in your garden, go for a walk,
- Gratefulness journal – this can help you acknowledge and recognize the positives in your life,
- Talk – talk to people, share with them what is going on. You are not a burden and often those people worry about you more because they don’t know what is going on,
- Boundaries – it is ok to say No, “I can’t do that right now” “I do not have capacity to assist”, “Maybe another time, but not today”
- Ongoing therapy and counselling with your psychologist.
Author: Dr Pauline Baleta, MA Psychology (UJ) Cum Laude, PhD Psychology (UP)
Dr Pauline Baleta is from South Africa where she was a fully registered senior clinical psychologist for the past 15 years, until she immigrated to Australia in April 2023.
To make an appointment with Dr Pauline Baleta try Online Booking. Alternatively, you can call Vision Psychology Wishart on (07) 3088 5422 .
American Psychiatric Association, (2013).
Diagnostic and statistical manual of mental disorders, (5th ed.) United States of America.
National Library of Medicine, (2020), Depression: What is burnout? Available from the World Wide Web: https://www.ncbi.nlm.nih.gov>