In this episode:
Venessa, hosting the conversation
Britt
Justin Stephenson, Clinical Psychologist
Venessa: People often expect depression to look like sadness, but for many it feels more like emptiness. Things that once brought joy or interest can feel flat or distant or simply out of reach.
Britt, can you tell us a bit about your journey with depression and when you first noticed that pleasure or motivation was slipping away?
Britt: Yeah, absolutely. So my journey with depression started around about the age of 12. I had, unfortunately, a bit of a history of sexual assault, which kind of plunged me into a bit of a dark place as I think it would with anybody. And then around that time, a lot of close family members all got terminal diagnoses for one illness or another. So there was just a lot going on at one time. And I'd noticed then around that time, I'd pulled away from things, pulled away from friends. I wasn't sort of my usual outgoing, happy self.
And then it kind of snowballed when I was 16, and myself and my single-parent mother were kind of a little team, a little unit, and she received a terminal cancer diagnosis. And she was sadly taken when I was just 16, and it left me on my own. And that kind of was the point where it felt like everything went dark. It felt like the colours had just kind of become muted in this world, and I was struggling to find the joy in anything. And I'd struggled to find the motivation just to be. But it wasn't like a constant sadness. It was more of just an emptiness. Just like it had created a void that I had no idea how to fill.
Venessa: So the medical term for what Britt's describing is anhedonia. How would you explain anhedonia to patients, and why does it happen in depression?
Justin: Sure. So anhedonia is quite a core symptom in depression, and I guess the best way to understand it is it can sometimes be that loss of enjoyment or loss of sort of pleasure seeking. And those are things you'd normally really enjoy doing, and you just don't get the same feeling or response to them when you do try and do them. And it's not necessarily that you don't want to do those things.
So classic examples there might be seeing friends, a particular hobby. And often people will still go through the motions with that. They'll still want to do those things, but they notice more and more things feel slightly blunted or numb, or they're just not getting the same response to that. And that makes it really hard then because the brain's reward centre isn't really encouraging you to keep doing those things. And so people do, as Britt said, withdraw or feel a bit detached. And it can happen suddenly. It can also happen sort of over a longer period of time, and you're almost not aware of what you're losing as that's going on.
Venessa: Britt, does that sound familiar to you?
Britt: Yeah, absolutely. Absolutely. Because I've always been quite outgoing and outspoken and surrounded myself with a lot of people, and I just kind of found at the time I didn't want to be around anybody because as well, I didn't think I could be the person that they needed me to be in that time. And we were all incredibly young. Everything that happened to me was when I was in my teens. And you can't really expect other teenagers who've never been through anything to be able to understand how to be there for their friend. So as a result, I just took myself out of the situation. So yeah, it is exactly that.
Venessa: So Justin, how do you support people who feel stuck when motivation just isn't accessible?
Justin: Yeah, so that's a fair question. I think most of the time we say be quite kind to yourself because one of the big things there is people often put a lot of pressure on themselves or aren't really sure why they feel that way and still try to hold themselves to the same sort of standards as they would when they're not depressed. And that can become a bit of a vicious cycle because why would any of us keep doing something we don't get any benefit from doing? And so one of the examples there, we go, well, if you normally enjoy reading and you find that really difficult, don't put pressure on yourself to try and read, but find something else that may be more humble in its approach or maybe so it doesn't feel like it's changing the world, but it becomes maintainable, something you can do despite feeling that level of depression.
Venessa: So Britt, did anything help you reconnect with the things that you used to enjoy?
Britt: Well, just like Justin was saying, actually, hobbies, I found, and I know it sounds so cliche and so sort of obvious, but just taking yourself out of that situation mentally, even for five, 10, 20 minutes, those were the sort of things that really helped me.
So at the time, I know that I'd started baking and just that little bit of time of doing that, I was like, "Oh, this is great," because you're too busy thinking about the thing that you're doing than you are this big cloud that's over your head. It's not ignoring or avoiding it. It's just shifting your focus somewhere else, and that's what I was doing.
So hobbies, and I know it might sound really incredibly trite, but just getting yourself outside, getting fresh air, going for a walk, just changing your environment. We used to have this running joke that I had a sofa at my old flat, and I would sit on it, and I would find that the longer I was sitting on this sofa, the worse I was feeling, and it ended up being coined the sofa of depression. So it was very much getting yourself off of the sofa of depression and getting actually, I'm sure Justin will attest to this, getting yourself out of the house, that's the hardest bit. Once you've almost crossed that threshold, being out for a bit and seeing things and seeing nature and listening to birds and doing all of that, that's moving your focus, shifting your focus.
So again, not ignoring or avoiding it, but just appreciating other things that are going on at the same time as well.
Justin: Absolutely. I think also what you've said is really interesting, is you don't have to enjoy going for the walk initially. You could actually really hate going on the walk. But the fact is you've changed your environment, you've changed the pattern that depression can sort of put us into.
Britt: Mm.
Justin: And yeah, hobbies are great, and sometimes people really struggle when they're depressed to think of hobbies. And one of the key things is don't necessarily do a hobby you've always done, because you've already experienced the anhedonia in that. You're not really connected with it. But maybe something new, something sort of low intensity and so there's no risk. If I don't enjoy this, it's not something I sort of need to carry on with. But the brain quite likes that novelty in those moments.
Britt: I was about to say the word novelty. Yeah.
Justin: Yeah. That can really draw you into something, and so just experiment with that. But I would think a key thing is you don't have to feel that immediate sort of rush, that reward system being activated. That takes time to come back on line.
Venessa: So Britt, what would you want someone who is experiencing this for the first time to know?
Britt: Honestly, that they will be okay, and really to not look too far into the future.
Because the problem is, is that when you're stuck in this certain space, you might think, "Well, I'll never be okay. I'll never be over there. I'll never be over it." And I think the key is not to look that far ahead, just to focus sometimes on the next five minutes, the next 10 minutes, the next 20 minutes. Just keep putting one foot in front of the other, and then you will eventually get there.
And to seek help where it's needed. So there are so many different options available for people. There's medication, there's therapy, there's different types of therapy. And talking therapies, while they didn't work for me personally, I do encourage everyone to try it. In the end, I ended up trying different medications and chose a path that worked best for me.
But I think what you need to do is just find what works best for you.
