Muriel Cooper
Psychologist in Mornington

Stress, anxiety and depression


Stress, anxiety and depression

Articles about the Stress - Anxiety - Depression cycle, and how to avoid and cope with these problems.

Inner voiceIn part 1 of "The voices in our head", I talked not just about unwanted voices in our head (the worry voice), but also the wise voice that brings creative ideas and solutions to problems.

Nevertheless, both these voices are still spontaneous and intrusive. Even a creative voice in your head can be a pest if it wakes you up at 3am.

However there is another voice that can override all other voices and that is the voice of Mindful awareness. I'm going to call it 'Mind voice'.

Mental health professionals often refer to self-talk and by that, they mean talking to ourselves either in a bad or a good way, but again, much of the time in a negative way. Therapies like Cognitive Behaviour Therapy encourage us to change our self-talk for the better.

I prefer to think of the voice coming from our Mindful awareness, 'Mind voice', as volitional, that is an action of our own choosing; us choosing to talk to ourselves in a deliberate, positive, encouraging and/or rational way.

When we use our mind to observe or thoughts, feelings and physical state, we can not only observe but communicate from that perspective (the Me Perspective). Self-communication is a powerful tool and can be used to dispute irrational thoughts and self-regulate thoughts, emotions and actions.

Whether the voice in our head is a worry voice or a wise voice, we might not always choose to take notice – and here is where we can go one step higher to the ‘Mind voice' – our true or highest self – the self that observes absolutely everything in ourselves and in our environment, including worry and wise voices.

From that perspective we have more ability to choose whether or not we want to have the thought, idea, feeling etc. It is the ultimate voice and yet so many of us don't find it. We are not taught to look for it and in the past 'talking to yourself' either in private or out loud, has been seen as a sign of being mentally unstable.

Actually it can be entirely the opposite.

Inner voiceThe old saying goes 'Talking to yourself is the first sign of madness' - but we all have voices in our head and that certainly doesn't mean we're mad.

These voices tell us to 'do this' or 'do that' or 'don't forget this' or 'you're fat'. This is perfectly normal.

It only becomes abnormal when the voices are external (auditory hallucinations) or obsessive (we feel we can't stop them and they play over and over again in a compulsive way).

The voices I'm referring to here are involuntary or automatic thoughts (as opposed to deliberate/conscious thoughts).

Some voices are positive, for example:

The problem solving voice (I know what I'll do!)

The voice of reason ('Come on now – be reasonable')

The creative voice ('That's a good idea!')

The Philosopher - that transcendent/reflective voice that wants us to believe there really is a God/afterlife.

Some are negative, such as:

The worrier (You have to/should/ought to')

The imp (that leads us astray – 'Go on – have that cigarette')

The critic/the judge – can be harsh and unforgiving – making us constantly doubt ourselves and put ourselves down ('You're wrong'/' they're wrong').

Man in a caveLife is scary – are you stuck up the back of the cave?

Fans of Plato will remember his allegory of people who only see life as shadows on the back of a cave – because that's the only reality they see, they believe the shadows to be reality. They can't see what is actually real because they're chained in such a way that they only see the back of the cave.

I have come to see our survival mechanism produced by the old, survival brain (the limbic brain) as a kind of chain that, in order to protect us from threats in a stressful world, can act as a kind of defence, the purpose of which is not to make us face the back of the cave, but literally force us there psychologically.

We are stuck up the back of a virtual cave, in depression and withdrawal from people and the world. The survival mechanism does this in order to protect us from threats, real or imagined.

As previously discussed, most anxiety and depression is caused by stress (see this) and when we have spent enough time stressed (ramping up for fight or flight) but we're not fighting or running away – Mind/Body/Brain says 'enough – life is too scary – up the back of the cave for you!'

So it sucks our motivation out of us, makes us tired and makes us want to withdraw up to the back of the cave where it's safe, quiet and there are no threats or demands. And there we wait, for the threat to go away. But it doesn't.

If you search for 'causes of depression' chances are you won't come across stress, and yet stress is the cause of most kinds of depression (apart from, for example Bi-Polar Disorder and Seasonal Affective Disorder).

If stress is almost always the cause of anxiety and depression – why don't we hear that? More often it's that we have a 'chemical imbalance' in our brain. This of course can be corrected with Anti-Depressant drugs right? Well in some cases. But in many cases where these drugs are prescribed for anxiety and depression – they just don't work.

Anxiety and depression can be caused by a chemical imbalance. Bi-Polar Disorder (or Manic-Depression) is – but one of the most effective treatments for this is chemical Lithium, discovered by an Australian psychiatrist, John Cade.

SSRI's do work for some people and if they've worked for you that's great. But many studies have shown that Cognitive Behaviour Therapy that tries to address dysfunctional thoughts and behaviours works equally effectively. I'd list all the studies but they're too numerous.

So how does stress cause anxiety and depression?

If we have depression caused by dysfunctional thought – why do we have those thoughts? Why do we worry? Other animals don't worry – they just instinctively act.

We have our smart brain (we've evolved to have that) so why does it sometimes seem so dumb?