Overcoming Sadness and Depression – The THRIVE Approach© Marion Aslan
******This is an extract from “The THRIVE Approach to Overcoming Sadness & Depression” available to buy
from Elemental Wellbeing. Contact marionaslan@aol.com to order a copy of this or other THRIVE materials.
This extract is freely given for use with reference to the author and remains the intellectual property of Marion
Aslan, all rights reserved. It should not be amended or redistributed without written permission.
Introduction
Depression can take many forms, and although most people feel low or unhappy at some point in their lives,
many will experience that intense, disabling, physically and emotionally painful state of depression. This affects
the life of the individual and those around them in very significant ways, often interfering with relationships,
work, and our functioning at every level. All too often it can feel as if we are screaming inside but no one is
listening. Depression can result in us seeing life as futile and pointless; it diminishes us and causes us to become
detached from the world. The overwhelming fear is that it’s never going to get any better whatever we do.
Depression affects 10% of the population in Britain at any one time, and 1 in 6 people in the UK will suffer from
depression at some point in their lives. It is most prevalent among people aged 25 - 44 and although previously
thought to be higher in the female population, recent studies indicate that depression occurs as often in men, but
women are twice as likely to be diagnosed and treated. It is argued that men tend to express their symptoms
differently, for example, through the use of alcohol and drugs, and are unwilling to admit to the symptoms of
depression. The figures for depression in men are currently rising faster than the figures for women and this may
indicate that men now are more likely to admit to feeling depressed.
According to the World Health Organisation, more than 30 million people in the world have now been prescribed
the anti-depressant Prozac. For some the medication may be useful in the short term. However, the reality is that
for the majority, in terms of “curing” the depression the drugs don’t work! They may “take the edge off things”
and some people find this useful as it gives them an opportunity to reflect upon the situation and work things
through, but if you are expecting the pills to fix you then you will be sadly disappointed. Some psychiatric drugs
including Prozac and Seroxat come with their own set of problems. For some people the side effects are
horrendous, and they may even exacerbate the original problem, making recovery a longer process.
This workbook looks at the range of alternatives that people can adopt in working through depression, stress and
anxiety. By having a range of “tools” and coping strategies that can be employed, it is possible to overcome the
disabling effects of depression and become empowered towards living a life where the depression does not
prevent or hinder living that life to the full. This work is based on personal experience and the experiences of
others who have taken power and control over their depression. It is not easy, there are no quick fixes, indeed it
requires a lot of hard work, soul-searching and commitment to change one’s outlook, but the rewards are well
worth it. Learning to live well, enjoying pleasures life brings and reaping the benefits of putting effort into life is
an art which once learned can never be unlearnt!
Many people believe or are told by some doctors that their depression has a physical cause, that imbalances of
serotonin or dopamine in the brain are to blame and that medication is essential to redress the balance. There is
no scientific substance to this theory, indeed recent research would totally refute the theory, and even the Royal
college of Psychiatry have now dropped all references to chemical imbalance causing depression. This previous
way of thinking was harmful, in fact, as it removed the responsibility from the individual to work through their
life issues and adhere instead simply to an illness entity. Some depression is a totally normal response to life
events or situations.
Depression is an emotion, just like anger or fear, not a disease or disorder, therefore the things that are helpful are
recognizing the problems, organizing and reframing them and working through them to restored health. The book
The THRIVE Approach to Mental Wellbeing ©Aslan looks in detail at these areas and how people recover from
psychic distress. This workbook specifically looks at the issues connected to depression and is designed to guide
you through the process of recovery from the grip of depression.
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Using the underpinning elements of the THRIVE Approach ( Time, Healing, Resilience, Interdependence,
Vivacity and Emancipation) we aim to help you explore for yourself the difficulties that have caused you to
become depressed, help show you how to reform and rethink these problem areas and develop coping strategies
which will increase your resistance to severe depression in the future.
The THRIVE Approach - The 6 underpinning factors
TIME is a natural healer as long as we don’t resist the process and become stuck. Think of someone you have
loved who has died. The pain of grief becomes less raw over time – you don’t forget or stop missing the person,
but over time you focus on the joy of knowing them rather than the pain of losing them. So it can be with
emotional problems. With time, you will feel differently, gain a different perspective and move away from the
distress you feel right now. In depression it is important to remember this, to have hope and belief that things will
get better. Obviously hopeful attitudes are difficult to maintain in the depths of depression but we will explore
ways of reclaiming hope, explore how to “reframe a situation” and how others can be our “holders of hope”
Time limits are not helpful to you. Don’t feel pressurised by others into making progress in a definitive way, i.e.
achieving certain things within a certain time frame. This will only increase your depression. It is more important
to work at your own pace and in your own way, building things up slowly and surely. This will sustain you in the
future, particularly in the face of future difficulties.
HEALING is integral to recovery and essential to everyone’s wellbeing, sometimes easier to impart to others
than to give to ourselves. There may be reasons why we block our own healing – guilt, worthlessness, shame,
lack of belief in our own worth. Part of the healing process is to acknowledge these emotions, and allow healing
elements into our consciousness. Learning to know and accept ourselves for who we are is crucial to the healing
process and the book explores ways in which this self knowledge can be accrued.
Often the reasons for depression to occur have built up over a long period of time; therefore the healing process
equally may take a long time. Different ways of helping the healing process along are considered in the
workbook – some will work for you better than others. It may be worth trying all of them, even if you are
sceptical that they will work for you – you may get a surprise!
Showing RESILIENCE is a common factor in those who have survived and rebuilt their lives. Indeed we all
have a degree of resilience, and some people are able to draw on their inner reserves and show resilience even
where the system attempts to squash it. It is also possible to build up our own resilience and to help support the
process in others. Building resilience and learning a range of effective coping strategies is a vital element of
recovery, helps to maintain wellness and may be important in preventing future setbacks. By learning how to
overcome negative emotions it is often possible to predict and avoid subsequent bouts of depression.
Often people make the mistake of striving for total independence. This is not realistic – we all rely on other
people for some things some of the time, and other people may rely on us. A healthier attitude is to look at ways
of increasing our personal connections and relationships, building circles of INTERDEPENDENCE. Many
people are great at helping others and being strong allies and supporters for others, not as good when it comes to
themselves. It may be that your depression has driven people away or you have tended to shut yourself away
from others because you are depressed. In the long run this will increase and worsen any negative feelings,
therefore it is important to acknowledge your needs for support, companionship and activity and take
responsibility to build these into your recovery.
VIVACITY is not a term we hear very often in mental health spheres, (ironically, if you show aspects of
vivaciousness or signs of enjoying life in-between periods of depression you might be mistaken for being manic
and acquire a label of Bi-polar Disorder!) Our conviction is that we should be thinking about exuberance for life
as a vital part of recovery. Although depression can be disabling and energy draining and it feels as though you
never can be interested in anything ever again, it is possible to resurrect feelings of pleasure. Having a lust for
life, being animated, full of the joys of living is possible for all. Many people who have experienced severe lows
in their lives talk about enjoying life even more after coming through illness or depression. The friendships you
forge in adversity tend to be based on mutual respect, affection and consideration, and as the saying goes, “All
that doesn’t kill us makes us grow”. Many people who recover from depression talk about feeling “Weller than
well”, that is, they appreciate their lives even more because of previous adversity.
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EMANCIPATION or liberation comes with taking control of one’s own life and celebrating your own
individuality and uniqueness. Playing a vital role in society and being valued can enhance our sense of freedom
and remove us from the constraints of being regarded as mentally unwell, maintained in the system and feeling
life happens to other people. Depression for some people can be very addictive and there may be rewards to
remaining unwell. It can be a source of comfort to have others to rely on, to look after our needs and it can also
be an excuse to stop us doing things which we secretly fear. However, it is only by moving out of the comfort
zone, the “self-imposed prison” that we truly free ourselves and take control of our lives. This involves hard work
but the benefits are well worth it. Getting started is the most difficult part! Finding motivation is not without its
difficulties; it involves hard work, determination and commitment, but if you take one step the rest of the walk
gets easier!
“In order to emerge from this state of loss and grief and begin a new life, people need not so much a therapist as
friends who are prepared to walk with them” Jean Vanier, author of “Seeing Beyond Depression”
Who do I trust to support me?
Although you may prefer to use this workbook independently, it may prove useful to discuss some of the issues
that arise with someone you trust – a friend, a family member, a worker. It is of less importance that these people
are academically qualified than it is that they share your values, put you at the centre of things and are prepared
to truly listen and support you in the way which you determine. They can be your “holders of hope” when you
feel unable to be hopeful for yourself. It is also important that these people are positive, have the expectation that
you will get better and enable you to chart your own course. If you are working together with someone there are a
number of ground rules that may be helpful for you both to agree to –
1. Be honest with each other
2. Confidence is earned, it is not implicit. Agree which elements of the book can be shared; the rest remains
confidential or the property of the individual
3. The individual needs to develop their own ways of coping with their experiences. Any support should
reflect the person’s own experience and definitions, not those of the person supporting them.
Solo Working
If you feel at this stage that there is no-one you wish to share your thoughts and feelings with, rest assured that
simply writing things down and reflecting on them yourself can prove very therapeutic. There may be some
advantages to solo working in that you can express yourself in ways which are private to you, use your own
language and terms to describe things and write down very intimate details knowing only you will read them. It
may still be advisable however to have someone to talk to about your depression as it may be a difficult process
for you and trigger unpleasant memories.
An important message
Take breaks regularly. There are no time limits. You dictate the pace – you may not complete the book or you
may find some parts more useful than others. It will be hard work and requires a degree of ongoing
determination. It also requires a lot of thought and time regarding your responses. The more detailed the
response, the more you will gain from the workbook. At first you may not see the benefits, but over time you will
come to understand yourself and your experiences of depression better and this will enable you to develop better
coping strategies to ward off future depressive episodes. Take heart that others have trod the path before you and
gone on not only to recover but to thrive.
“Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did.
So throw off the bowlines. Sail away from the safe harbor.
Catch the trade winds in your sails.
Explore. Dream. Discover."
Mark Twain
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Time
Identifying your depression
Time can be an important factor in assisting or detracting from one’s ability to identify the problems or
difficulties creating feelings of depression. Too close in time to a problematic event or difficulties it may be too
painful to step back and have a balanced view, too long after an event, particularly one that was traumatic, the
self destructive emotions resulting from that trauma may have become firmly embedded in self. With time,
however, there often comes wisdom and a learned ability to cope. We know this to be true for people, for
example, who hear voices or who self harm. In time, if left to their own devices, they naturally develop good
coping strategies, the exception to this being where mental health services intervene in non helpful ways. As with
any distress, our belief is that you can work through depression and come out the other side. It does take time and
it also takes courage, but it is possible to control and overcome. How do you view your depression?
Metaphors for Depression
Metaphors for depression often fall into four categories – descent, darkness, weight and capture. We see
depression in terms of being dragged down by heaviness, bound by unseen chains or caught up in a vicious cycle
of despondency. In a pit, In a dark tunnel, Black hole, The blues, Black dog, Weighed down, Down in the dumps,
Cornered, are just some of the words used to describe the feelings of despair and despondency associated with
depression.
There are cultural differences around the world for how people view depression. Some cultures do not even have
a name for it although the symptoms of depression exist across all cultures. For example, a direct translation for
the word depression does not exist in Chinese. In Filipino culture, which is predominantly Catholic, depression is
often viewed as a "test of one's faith." In Italy it is referred to as “thinking through clouds” whilst the Innuit
people describe it as “Soul Disorder”
Which words describe how you feel? Are your problems related to past or current difficulties? Consider whether
any of the following apply to you.
Have you experienced a bereavement and not gone through a grieving process?
Are you going through or have you gone through a divorce or separation?
Do you feel stressed or undervalued in your work?
Have you lost your job or been made redundant?
Have you been or are you being bullied?
Are you anxious about exams?
Do you spend a lot of time alone?
Do you feel angry because of something you have not been able to resolve?
Are you lacking in self esteem and self confidence?
Is someone making unreasonable demands on you?
Do you feel generally “run down” or exhausted?
Have you experienced significant loss or change in your life?
Often, depression is a messenger that something is not quite right with our lives. It is perfectly natural to respond
to any of the above with feelings of sadness, irritability, loss of interest or pleasure in things you once enjoyed
inability to concentrate or to “think straight”. There may be feelings of worthlessness or guilt.
Do we all experience depression? When is it more than just feeling low or downhearted?
The following elements may indicate when it becomes more than just a natural dip in our wellbeing and turns
into something more problematic –
The degree of control the depression exerts over your life
The intensity of the experience
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The level of distress it causes you
The degree of helplessness you feel
When there is no obvious reason to feel this way
The length of time you experience the feelings of depression
The way it impacts on your daily functioning
Which are currently true for you? How does this show itself on a day to day basis?
Aspects of Depression
You may be experiencing some or all of the following aspects of depression. There may be other aspects you are
experiencing which we have not listed. It may be worth taking a little time to consider; how prevalent these
aspects are in your life, what percentage of the time they are present and how much they impact on your life at
the moment.
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Low mood for most of the day, nearly every day
Being restless and agitated.
Loss of enjoyment and interest in life, even for activities that you normally enjoy.
Abnormal sadness, often with weepiness.
Blaming yourself
Using more alcohol or tobacco than usual
Feeling numb, empty or despairing
Feelings of guilt, worthlessness, or uselessness.
Crying a lot
Distancing yourself from others, not seeking support
Experiencing a sense of unreality
Poor motivation. Even simple tasks seem difficult.
Poor concentration. It may be difficult to read, work, etc.
o Sleeping problems - Sometimes difficulty in getting off to sleep, Sometimes waking early and
unable to get back to sleep, Sleeping too much sometimes occurs.
Lacking in energy, always tired.
Difficulty with affection, including going off sex.
Poor appetite and weight loss. Sometimes the reverse happens with comfort eating and weight gain.
Irritability, agitation, or restlessness.
Taking a pessimistic view of the future
Self harming
Symptoms often seem worse first thing each day.
Physical symptoms such as headaches, palpitations, chest pains, and general aches.
Recurrent thoughts of death. This is not usually a fear of death, more a preoccupation with death and
dying. Some people get suicidal ideas such as ..."life's not worth living".
Which of these aspects are the worst for you? How is this impacting on your life?
Female depression
Ranked as the number one mental illness in the world by the World Health Organization, depression affects twice
as many women as men. Factors that may contribute to women’s increased vulnerability to depression include the
stress of multiple work and family responsibilities, sexual and physical abuse, sexual discrimination, lack of
social supports, traumatic life experiences, and poverty. Although men and women may have many of the same
symptoms when they're depressed, they're likely to perceive them differently. Women are more likely to notice
that they're more tired all the time.
There may also be feelings of very low self-esteem, helplessness, and hopelessness. Sometimes, women with
depression may report a worsening of previous PMS symptoms. Although men are more reluctant to admit to
depression than women, women may also feel stigmatized and feelings of shame or embarrassment may prevent
them seeking treatment. Equally, women often exert high expectations on themselves to be “superwoman” – to
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be able to multi-task, to juggle the demands from different sources and to keep everyone happy, often forgetting
themselves in the process.
Postnatal Depression
The most common form of postnatal disturbance is the ‘baby blues’ which is said to be experienced by at least
half of all western mothers. This usually lasts between 12 and 24 hours, generally occurring between the third
and sixth day after the birth. This is a natural response to childbirth for many women, and thankfully is temporary
and fleeting. However, in a small percentage of women the depression will continue and become severe with the
potential for psychotic experiences developing. Puerperal psychosis is a severe and relatively rare form of
postnatal depression affecting between 0.1 and 0.2 per cent of all new mothers. Feelings of being alienated, out of
control, “not of this world” or having an altered reality in addition to feelings of lethargy and depression may be
indicators of puerperal psychosis.
Male depression
There are some symptoms of depression which may be more common in men than women, for example sudden
outbursts of anger, aggressive behaviour, greater risk taking, and although more women than men attempt
suicide, men are more likely to commit suicide due to the methods used. Seventy-five percent of all completed
suicides are men (Office for National Statistics (ONS) 1996). Indeed risk indicator number one, and one often
overlooked for suicide, is clearly gender (ONS 1996). Within male suicides, however, the picture has changed
from one where the over 75’s are the high-risk group to one where the under 25’s have considerably overtaken
them in the suicide stakes (World Health Organisation (WHO) 2002). Suicide is the biggest killer of young men
in the UK. One in four of all UK suicides are young men under 25 years of age (General Register Office
Northern Ireland 1996; ONS 1996, Registrar General for Scotland 1996). Young men, however, are not often
considered to be at such a high level of risk by their families, the media and mental health professionals. Because
men are still more reluctant to ask for help for their problems their coping mechanisms tend to be alcohol and
drugs which can exacerbate the problems in the long run. Often it is the perceived stereotypical view (by
themselves as much as other people) that it is a weakness for men to admit that they a problem so their depression
may go unrecognized
Eating problems
According to the Mental Health Foundation current estimates suggest that up to 1 per cent of women in the UK
between the ages of 15 and 30 suffer from anorexia nervosa, and between 1 and 2 per cent suffer from bulimia
nervosa. As many cases of eating disorder are unreported or undiagnosed, the actual figures are likely to be much
higher. Eating disorders are much more likely to occur among women than men. However, for anorexia, there is
also evidence to suggest that in the younger age group (7–14 years), up to 25 per cent of cases are boys.
Emotional shutdown
Are your problems related to past or current difficulties? Consider whether any of the following apply to you and
write down your thoughts about the situation.
Have you experienced a bereavement and not gone through a grieving process?
Are you going through or have you gone through a divorce or separation?
Do you feel stressed or undervalued in your work?
Have you lost your job or been made redundant?
Have you been or are you being bullied?
Are you anxious about exams?
Do you spend a lot of time alone?
Do you feel angry because of something you have not been able to resolve?
Are you lacking in self esteem and self confidence?
Is someone making unreasonable demands on you?
Do you feel generally “run down” or exhausted?
Have you experienced significant loss or change in your life?
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It is perfectly natural to respond to any of the above with feelings of sadness, irritability, loss of interest or
pleasure in things you once enjoyed inability to concentrate or to “think straight”. There may be feelings of
worthlessness or guilt, whether that guilt is true or false.
Healing is a concept often underrated in mental health spheres where treatment, usually in the form of
medication is seen as the answer. There are many complimentary therapies which help in depression, and these
can have a beneficial effect both short and long term. But it is the ability of the individual to self heal which is
frequently overlooked. Part of this healing process comes from self knowledge and understanding, leading to
greater self esteem, self confidence and self worth.
Resilience is the component of recovery which, thankfully, is often innate and therefore can be nurtured! Most of
us are driven with a desire to survive. This can often result in the desire to thrive! Unfortunately, the
discrimination by many within society towards mental distress and the self imposed stigmatisation can quash this
resilience. Building resilience allows people to see themselves in a new light, encourages self determination, and
helps to maintain balance and flexibility to life events thus providing resistance to succumbing to future crises.
You may not be familiar with the concept of interdependence. It is usually independence which people in
mental health spheres are told they must strive for, but none of us are completely independent of other people in
our lives. Sometimes we need other people to give help, provide a service, offer us companionship, and, in the
same way we need to feel valued and provide this for others. This is interdependence.
The emphasis is on “togetherness” and relationships. In our experience, people who become depressed find it
easier to recover when these are the themes that are explored and nurtured. Having a purpose, social networks,
decent housing and looking outwards rather than merely inwards are the cornerstones of recovery. These give us
hope, which is the key to reclaiming one’s life.
Vivacity - or a purpose and lust for life is a very difficult thing to find and is often missing or stolen from the
lives of those who succumb to depression. Often the difference between those who recover and those who go on
to thrive are summed up by the next two elements, Vivacity and Emancipation, that is to find purpose in life and
to emancipate yourself from the restrictions of mental distress. Vivacity or Vivaciousness encompasses a natural
vigour for life, a spirited approach that embraces the vital force of being alive. It could also be said to be having
tenacity and hope for life and living.
We all have the choice to merely exist or to actually embrace life, but sometimes negative thinking and lack of
perspective ties us into the former. This in turn leads us to deny ourselves simple pleasures and valuing ourselves,
then the greater pleasures of life become something we choose to repel.Vivacity, that feeling of really being alive
and having a purpose to be here, to carry on with passion, can remain elusive even when people feel that they
have recovered from mental health difficulties. There is no denying that it is difficult to retain a positive outlook
in a world that many find incomprehensible.
A number of factors will help achieve this vivacious state of being. Resurrection of interests and hobbies,
enjoyment in new activities and friendships is helpful. Enjoying simple pleasures, walking along the canal path,
walking in the country, sitting in the park – we all have our own individual pleasures.
One of the things in common cited by those who have moved on in their lives is that they have developed a
range of coping strategies and resources which enables them to deal with difficult periods, times of stress etc.
Others talk about the importance of being in a valued role. It seems to be that finding purpose and meaning to
one’s day is the motivator and incentive to live life vivaciously!
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The last stage of reclaiming your future is to emancipate yourself, which means to reclaim the power and control
that may have been eroded over time. One of the important things to do is to change your relationship with your
depression from one of toxicity to one of growth and breaking through. It helps to be clear about what you are
recovering from, and get clarity about what the real problems in your life are. Depression is the messenger,
remember, of something you lack in your life. Are there issues of loss and lost opportunities or “what could have
been?” Is it to do with stigma or lack of respect from other people?
Once you start to move on and THRIVE, you will learn to trust your own instincts regarding your wellness and
will find your own unique solutions to keeping well. There are many other ways of doing this that we can only
suggest briefly here today. You can get political as many do in finding their survivor mission. On a personal
level you can see depression as a prison you build or as a consequence of others behaviour and your responses
and learning. On a wider level seeing depression as a label, as a concept and a construct, as a power issue that is
used to trap you as a victim in a system within which others profit from your continued sadness can also be an
emancipatory or motivating construct.
"If there is no wind, row." Anon
If you are being supported or getting help from people make sure you are at the centre of this process and that
any support is around your needs and requirements with a structure that moves you through an emancipatory
route instead of a process of maintenance and dependency.
All that we are is the result of what we have thought.
The mind is everything.
What we think, we become
Buddha
For more information on Recovery and Thriving or to know more about The THRIVE Approach visit
www.elementalwellbeing.org.uk
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