It is difficult to get up in the mornings, and nothing gives you joy. How should you cope with exhaustion and how not to miss the beginning of depression?

And what should you do if you suffer from anxiety and insomnia?
Taisia Sidorova | 04 September 2020

Many spent their vacations at home. Public holidays are not enough to take a break from anxiety and hardships of the distance education. It is time to get back to work, but you do not have any energy left: you find it hard to get up in the mornings and you are not in the mood. Maria Veber, a psychiatrist and psychotherapist, told Pravmir where to find the energy for new tasks, how to deal with bad thoughts and how not to miss the depression signs in yourself and your loved ones.

How can you cheer yourself up when you return to work after a vacation?

Maria Veber

The day of your return to work after a vacation is already set, and you know it. Therefore, it is better to start preparing yourself at least a week in advance on transferring to the working regime or a regime with similar conditions. If possible, fill these days with some things that are pleasant for you to do. You may plan what you are going to do in the first days after the vacation. Let’s say, mentally prepare yourself.

In the first days, you should not immediately set a high bar. You need to involve yourself in the working process gradually. You should not try to achieve everything at once in a short time. This is a main rule.

— What should you do if it is still hard to get up in the mornings, it is hard to work and you get tired quickly?

If you go to work right after a vacation and you still feel exhausted as if you did not rest, I advise you to become wary.

It is essential to understand how efficient your vacation was: whether you shifted your focus to other activities, whether you had some quality rest. That is, whether you had enough sleep, eaten good food, talked with your loved ones, changed your environment, engaged in your hobby.

Try to remember if you have been in this state before, whether it is related to specific events. Maybe, you were in some kind of emergency mode and got tired. Or you have a routine tedious work, although you think you are not very busy. Try to remember whether you are at home in the evenings or, let’s say, at your second job. Or you work out at full strength seven days a week in a gym. These are important factors to consider when you analyze your fatigue.

And be sure to pay attention to how long you find yourself in this state. Is it more than two months? You should contact a specialist.

How to recognize depression in a loved one

— Why do people have depression?

There are two types of depression. One of them is related to your reaction to certain events. A person may go into a depressed state after losing a loved one, for example. That is, the mood dampens, there may be insomnia, loss of interest in ordinary daily routine. This is called a depressive reaction (i.e., a reaction to events).

There is also a depression as an independent disease: it is not always related to some life difficulties or conflicts. This condition can occur due to a violation of biochemical processes within a person. On the outside, it manifests in unwillingness to do anything, physical weakness, fatigue, difficulty focusing at work, reduced appetite. Most often, such people lose weight quite noticeably, losing 5-8 kilograms within a month.

They may experience emotional stress and thoughts about themselves, and if they do, they often think about their future. They are concerned about what will happen to them, how they will live, and what they have achieved.

In addition, they have a sleep disorder. They either experience increased drowsiness or, alternatively, insomnia. No matter how tired a person is, they may fall asleep at 2am and wake up at 4am. They are constantly oppressed by somber thoughts.

And this is what we call depression. At the same time, a person may not have any external problems.

What symptoms should set us on alert?

First of all, it is persistent mood dampening. This is not about being sad one day and feeling good the next day. No. There should be a persistent decline in one’s mood lasting more than a month.

The second symptom is experiencing a sleep disorder. This should also be a long-term state. It is not about a couple of sleepless nights during stress or before handing in a report, but about when a person has a bad night sleep for a long time. When a person cannot fall asleep and wakes up too early.

It is important to pay attention to one’s appetite. Does a person forget to eat, and do they enjoy their food (sensitivity of taste buds)? Can they taste food or smell it? Patients with depressive disorder often say that they feel a rubber taste when eating. Tasteless, incomprehensible, and unsatisfying. “I eat because I have to”.

— How not to miss these symptoms in your loved ones?

This is more difficult because a person may hide these symptoms. There is a notion of a “smiling depression”. This was much discussed when Chester Bennington, the lead singer of Linkin Park, passed away. At all rehearsals, he joked, was active, and focused on his creative work. However, at the same time, his inner experiences did not correspond to his behavior, he did not reveal them.

You should pay attention if you have the slightest suspicion that your loved one has changed: perhaps, they start avoiding communication a little more often or leave the house less often. It may not be that noticeable, but if you are alarmed, you need to act.

You need to come and talk to them, offer them your help. Perhaps, something is bothering them.

For a person in a depressed state, it is important to realize that they have someone to rely on, to ask for help. In this case, they feel that they are not alone.

Sometimes, a person is afraid to feel unwanted, to become a burden. They begin to think that their relatives will not accept them. And here, you show them that it is quite the opposite by extending a helping hand. We say, “If you need me, tell me. Talk to me, I will be there for you”.

And this is enough for a person to open to us step by step. Maybe, you will not succeed on the first try, but on the third or the fourth. Then we can really offer them help and, for example, take them to a psychotherapist.

— To a psychotherapist or a psychiatrist?

A psychotherapist is still a psychiatrist. According to Russian legislation, a psychotherapist is a psychiatrist who completed additional specialization.

They can perform diagnosis and find out what kind of depression it is or whether it is a depression. It may be a somatic pathology that manifests in mood dampening, and then the doctor will redirect the patient to the right specialist.

If necessary, a psychotherapist will help to prescribe treatment, which a psychologist cannot do.

I was prescribed antidepressants. Is it bad?

We prescribe antidepressants, sleeping pills, so that a person can start sleeping, the sleep would become deep, the body would recover at night, and the work capacity would not be perturbed.

— Many people are afraid of getting addicted to sleeping pills and antidepressants.

Yes, I often encounter this fear in patients. They say that they will not take the medicine. They say, “I will not be able to get off antidepressants later”.

Antidepressants are not addictive, unlike some powerful drugs: this is confirmed by studies. The withdrawal syndrome may be related to the incorrect course of treatment. For example, you quit it too abruptly.

Here is another situation: the patient has gradually reduced the drug dosage or has completely stopped taking it, but they are feeling worse. In this case, the antidepressant was like a crutch. As long as we have it, we move fine. We get rid of the crutch, we cannot walk without it. In this regard, psychotherapy helps well.

It is important to understand that treatment is not just about taking pills. This is also about how we treat the situation.

A psychotherapist will help to evaluate it from different angles. To understand how the patient came to be this exhausted.

When a patient both has a drug therapy and goes through a psychotherapy course at the same time, when they get off antidepressants, a pill is not a “crutch”, but patient’s skills are one. A patient knows how to react to a situation, so as not to exhaust their body. Then the cancellation of medications will be painless for them. They may never start taking antidepressants again.

How to deal with anxiety

— Now, due to the epidemic, people often expect something bad from life. How can a person distract themselves from sad thoughts?

According to my observations, the wave of anxious patients started coming in April. Their main issue is the lack of stability.

A person thinks, “I do not know where the danger will come from”. They are scared, anxious, they want to protect themselves, but do not understand what to do. They cannot wear masks and gloves all the time.

I always suggest that the patient lists things that they can and cannot influence. For example, can they make it possible to always have an antiseptic in their bag? Yes, they can, they are the ones who put things in them.

Yet, they cannot influence the virus itself. They cannot say, “Go away, virus”. This is a substance that is beyond human control. We cannot influence irresponsible citizens who do not wear masks and do not believe in coronavirus. However, we can protect ourselves. For example, by choosing routes to return home or by having an extra mask, just in case.

Do not forget that even if our life is somewhat limited by certain measures: for example, we cannot go far from home – we still need to enjoy it. To look for something that is available to us among your interests, hobbies, activities that bring us pleasure.

You can always find something to do that will distract you. For example, someone liked cross-stitching, but taking care of children and parents and working pushed that hobby to the background. Think back to a time when you read a fiction book instead of Instagram feed. Look for available opportunities to feel happy.

Translated by Julia Frolova

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