Topic: depression

Question: How do I find out the cause of my depression and anxiety?
I have been feeling more and more down for over a month. I have started having trouble sleeping due to panic attacks, but they are almost never triggered by something that I know of.

Answer (from Kaileen McMickle, MS, LPCLicensed Professional Counselor):
The first thing I usually recommend to clients that are coming in for these issues in addition to stress management is visiting their doctor.  We really don't know if it's something psychological that's influencing your symptoms, or if there's other issues happening within the body.  Pancreas or thyroid issues can perpetuate anxiety and depression symptoms pretty intensely--these are things your doctor knows more about and can help test for (and maybe rule out).As you probably already know, lack of sleep is a giant contributor to an increase in symptoms.  We don't know too much about sleep in the research, but we do know it's necessary to function and function well.  Some suggestions here from the research we do have: creating a calming routine at night can help with your body's relationship to sleep.  This can be your normal nightly hygiene paired with some relaxing videos or soundscapes (there are apps for this--Calm, Headspace, PanicShield).  Practicing these for a few weeks can help your brain pair your routine with sleeping.  Another suggestion directly from the research is not to take naps.  Yes, your brain needs sleep, but napping messes with our circadian rhythm and our quality/quantity of nightly sleep.  When we sleep, we go through sleep stages--but when we nap, those stages aren't completed like they would be during a full night of sleep where we go through those stages multiple times.  Both deep sleep and REM sleep (typically when we dream) seems to be especially important for feeling rested.  Napping usually only offers us a small dose of that, whereas a full night can offer as many more completed cycles including both these stages.  If you are waking into a panic attack, this site may give you some info on what that means: https://www.mayoclinic.org/diseases-conditions/panic-attacks/expert-answers/panic-attacks/faq-20057984.  Here's a great information website that has tons of resources, including support groups: https://washingtoncenterforcognitivetherapy.com/problems-treated/panic-disorder/panic-disorder-organizations/.Glad you reached out here!

Answer (from Sherry Katz, LCSWCouples and Family Therapist, LCSW):
Answers about our inner lives are most successfully reached from a sense of feeling grounded in oneself.First step is to accept your nervousness and restless sleep.  As often as possible, sleep during daytimes in order for your body to catch up on its need for rest.Accept too about feeling down.  It is normal to feel down once in a while.  From this place of self-acceptance, trust any answers which come up to your mind.  Often answers about complicated topics come in small pieces, not all at once as a whole unit.Also, your description about panic attacks is also completely normal.   They often arise unrelated to particular conditions at a given moment.  They are a healthy symptom your body is trying to expel bad feelings and does this by having the anxiety erupt at times.So, self-acceptance, tolerance of being on a process of clearing out worn out emotional clutter, and sleep at odd times if possible, are all ways to stabilize yourself, which will also feel calm and good!

Answer (from Nicole StoneAnxiety, relationship crisis, and the separation/divorce experience.):
It could be really helpful to see a counselor/therapist about your increasing depression/panic symptoms. Finding out the cause of depression/anxiety isn't always as straightforward as it seems, since both issues tend to become patterns we engage in rather than solely related to a specific trigger/reason. For example, if I am feeling down about a particular circumstance in my life, then I start seeing life through this lens of feeling down, and typically I'll start to see a lot more that I get down about, and it can really build very quickly on itself. Same with anxiety. Obviously, this is a very simplified example and it can be very difficult to see how the pattern is maintained, but that's where working with a counselor/therapist comes in. I would be curious about whether you can start to notice the initial sensations of panic, and if you can (through the panic attack) continue to maintain awareness of the actual physical sensations. Even better if you can talk yourself through the sensations you're feeling - such as saying to yourself "Okay, I'm breathing really rapidly, and my heart is racing, now my palms are sweaty and my chest is feeling really tight..." Reminding yourself that it's just your body's reaction to stress, and while it might be overreacting right now, you're okay and eventually it will go away. I highly recommend the SAM for Anxiety Management app for the anxiety piece, and I wouldn't be surprised if addressing the anxiety helped to address some of the depression too.