Topic: depression

Question: Can I change my feeling of being worthless to everyone?
I'm going through some things with my feelings and myself. I barely sleep and I do nothing but think about how I'm worthless and how I shouldn't be here.
   I've never tried or contemplated suicide. I've always wanted to fix my issues, but I never get around to it.
   How can I change my feeling of being worthless to everyone?

Answer (from Kaileen McMickle, MS, LPCLicensed Professional Counselor):
You can absolutely change that feeling, which is actually a combination of thoughts and feelings.  These types of thoughts are classified as core beliefs because they are typically beliefs about who you are (e.g., I am a bad person, I am unworthy, I am incompetent, etc.).  Shame is a cluster of feelings that accompanies these beliefs (a combination of self-hatred, sadness, disgust, and guilt).  Although you can't make them go away completely, you can definitely shrink them.  These beliefs have actual neural pathways in the brain--the more you travel these pathways, the stronger the belief.  One way to fight these is by creating strengthening neural pathways that lay more dormant, such as beliefs that you are lovable, worthy, and deserve to be alive.  Even if you don't believe these thoughts, thinking them creates competition with the core beliefs you want to change.  The more you travel the new neural pathways, the stronger they will get over time.I understand this can take time and feel really tough to do.  Something you can do to deal with your feelings in a more short-term way is to focus improving your sleep.  As you are probably experiencing, lack of sleep can contribute to worsened depression.  Your primary doctor may be able to help with your specific sleep issues but there are some ways you can work on sleep on your own.  Something you can try is writing down the worries or thoughts you have before you lay down for the night.  This can help the brain to feel less inclined to ruminate as your paper/journal holds the thoughts for you. It also helps to have a nightly routine that stays the same every night.  This tells your brain to start producing chemicals that induce sleep, just like going into a restroom can signal the body to urinate.  If you find yourself lying awake in bed or waking in the night, leave the room and do something calming/relaxing if you are awake for more than 10-15 minutes.  It can be tough to change your body's relationship to sleep, so give it time--it can take a few weeks to really notice changes.One of the best strategies we have for dealing with depressive symptoms is behavioral activation. That could mean socialization, exercise, or anything that gets you doing an activity you wouldn't normally do.  If exercise seems too intimidating or unrealistic, you can just view it as movement--anything that gets you up and moving.  Taking walks outside, gardening, cleaning, etc. can count as movement.  It's easy to surrender to the lack of energy, but that also keeps the cycle of depression alive.Medications can help as well if you feel like you need something beyond what you can do for yourself at the moment.  Antidepressants are great options for depressive symptoms.  Research shows that combining psychotherapy with antidepressants can have really effective outcomes.I'm unsure if your sentence about not contemplating to attempting suicide means you don't feel that way now or that things are moving in that direction.  If they are, make note of your social supports and who you would be willing to reach out to.  If you have someone you are comfortable (enough) to let them know what you are going through, it may be worth your effort to have them plan to check in on you.  You can also contact the Hopeline by texting HOPE to 741741 or the Suicide Prevention Lifeline at 1-800-273-TALK.