Jan Fable, MS, LADC
Fairfield Connecticut
203.255.5055

Short-term Counseling for Individuals and Couples;
12 Step Recovery Support and Intervention Services;
and Career Coaching

Depression, Panic and Anxiety

What is depression?
According to the World Health Organization, major depression is the leading cause of disability worldwide among people aged 5 years and older. It is also the most common and widespread of all psychiatric disorders. Depression can range from mild to severe and takes a significant toll on individuals, families, and society. It also negatively affects the economy through diminished productivity and use of healthcare resources.

The signs of a major depressive episode include the minimum of a two-week period with 5 or more of the following symptoms present most of the day, nearly every day. Depressed mood or loss of interest or pleasure must be present.

1. Depressed mood which may include persistent sadness or excessive crying
2. Marked loss of interest in one's usual activities
3. Significant weight loss or gain
4. Insomnia or hypersomnia (sleeping too much)
5. Physically restless or agitated or significantly slowed down
6. Fatigue or loss of energy
7. Feeling life to be empty and without pleasure
8. Feelings of worthlessness or inappropriate guilt
9. Diminished ability to think, concentrate or make decisions
10. Recurrent thoughts of death or suicidal feelings or thoughts


Eight Critical Risk Factors for Suicide:
A recent research project which questioned 500 practicing psychologists identified these eight critical risk factors for suicide in patients with major depression:

Note: Dysthymia (which is defined as a sub-threshold depression accompanied by gloominess, lack of pleasure, low drive and energy, low self-esteem and a pessimistic outlook), bereavement, or stress can cause depressive symptoms to a lesser degree.


What causes depression?
Major Depression, Bipolar illness and Dysthymia are all considered biological illnesses. They are caused by certain problems in brain chemistry. Often the brain does not have enough seratonin. We understand clearly now, however, that depression and dysthymia are not purely biological in origin and, in fact, can actually be a tool for survival (see NY Times article).

Most antidepressants and St. John's Wort work by increasing the availability of seratonin in the brain. However, medication alone is seldom the solution. Learning new ways of thinking and responding to life is also an important part of treating depression (see article on Feeling Your Feelings).

Grief from a loss or some kind of major trauma or tragedy can make someone very sad. The loss of a loved one, job, home, health, mobility, and independence can all be causes of grief. If a person is biologically prone to depression, this grief can increase the chances of developing or exacerbating the illness. If you are experiencing severe grief which has lasted for more than a couple of months, you may have moved into depression. You will improve with treatment (see article on Dealing with Loss and Grieving).

Those who have experienced severe loss, trauma, neglect and abuse in childhood, or violence at any age, can also develop depression. We now understand that events such as these can actually change brain chemistry. This is why medication is can be helpful. Therapy can change brain chemistry, too and the combination of therapy and medication can be more effective than either by itself.


What is Bi-Polar Disorder?
Pi-polar disorder is a condition in which depression and mania alternate. See the American Academy of Family Physicians' web site for a full and excellent description of this disorder, including symptomology and treatment.


What is Seasonal Affective Disorder?
Sunlight affects levels of seratonin in the brain. In the winter when we spend more time indoors and there is less available sunlight, seratonin is affected in some people. These people become depressed only in the winter.


What is the treatment for depression?
Research has proven that for many people depression is best treated with a combination of therapy and antidepressant medication. However, if there is a reason that you are hesitant to take antidepressant medication, you can be helped by therapy alone. There are many different kinds of therapy available.


What is negative self-talk?
Negative self-talk plays an big part in depression. Some examples of this are:
1. The world is a terrible place.
2. I never do anything right.
3. No one loves me.
4. I am alone.
5. I will never get over this.
6. I can never please anyone.
7. Other people always do everything wrong.
8. I am worthless.
9. I don't desrve to exist.

In reality the world has both good and bad events and actions. Negative thinkers see only the negative. They are in so much pain that they can no longer see beyond it to the positive things in the world and in their lives. They need to retrain their brains to see both the positive and the negative.

Polarized, or black and white thinking sees only good or bad, right or wrong, and nothing in between. Black and white thinkers usually believe that there is only one "right" way of doing things. An important part of therapy is learning to see the gray, learning to tolerate life's ambiguities, and learning to trust yourself and the choices you make.

Numbers 8 and 9 are examples of shame. Shame-based people have a very difficult struggle to redefine themselves, but it is possible to do with good therapeutic help (see article on Shame).

Screen yourself for depression at the National Mental Health Association's web site.

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What is the difference between Panic and Anxiety?
Panic is the body's automatic response to fear or a threatening situation. It comes from the sympathetic nervous system. We sense danger and our bodies prepare for fight or flight. Panic is often be connected to a trauma that has occurred earlier in a
person's life.

With anxiety, we experience feelings of nervousness or worry. Most people experience some anxiety at some time. It is a signal that tells us we are in new life-territory and unsure, or that keeps us alert and on our toes as we perform a risky or dangerous task. However, if a person has a high level of anxiety most of the time for no apparent reason, it becomes a problem.

Often, people who experience frequent panic attacks also begin to experience a great deal of anxiety, too. In fact, the anxiety is often about whether or not the panic will occur.


What can help alleviate anxiety?
As with depression, a combination of therapy and medication can be effective in the treatment of anxiety. A natural treatment for panic and anxiety is Thought Field Therapy™, which works on the energy meridians that are used in acupuncture and acupressure. For mild anxiety or sleeplessness, some natural treatments are Valerian Root, Kava-Kava, Chamomile, and passion flower. These have been used for centuries in some cultures.

Some other suggestions for dealing with anxiety:

    1. Relaxation and visualization exercises can be very useful in reducing anxiety and worry. There are many books and tapes available (see Links).
    2. Caffeine is a stimulant. If you are drinking more than 2 or 3 cups of coffee a day, it probably is increasing your nervousness.
    3. Do not drink alcohol right before bed. While it may help you relax initially, it increases restlessness during sleep and you will not get a good night's rest.
    4. A daily gratitude list can be very helpful in changing. Write one down every day in a notebook or journal. Include all the things that you are grateful for and, perhaps, some positive affirmations.
    5. Explore the concept of powerlessness. Reading and mindfulness meditation can help you develop an understanding that you cannot change events and other people and that everything that happens is an opportunity for growth.
    6. Sometimes it helps to get the focus off of you to help someone else. You can forget your own troubles for a little while. Allow others to help you when you need it, too. It's as good for them as it is for you.

Does spirituality help?
I believe that all of life is a journey of the spirit and that everything that happens - including the randomness of grave illness, trauma, violence, and loss - is part of our spiritual path. It is often crisis - past or present - which provides us with the stimulus to find the help we need to reclaim the wholeness with which we came into the world. (see articles: Living a More Conscious Life and Living in the Moment)


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JanFable has worked as a psychotherapist for more than 25 years. She has a master's degree in counseling and is a Connecticut licensed drug and alcohol counselor. Her primary training is in Bioenergetic Analysis which deals with the whole person. She has extensive training in the treatment of dissociative disorders and trauma survivors and in using of altered states of consciousness in healing. She has also completed Level I and Level II training in Thought Field Therapy.

Jan's training and experience expanded.

Jan Fable
203.255-5055
Fairfield, Connecticut


If you want to contact me, you can email me at JFable at forhealing.org
(There's no link to avoid spam)

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