Very early on in my career as a therapist I was diagnosed with premenstrual dysphoric disorder (PMDD). For those of you who don't know much about it, it is not, and I cannot stress this enough so I say it again, it is not just bad PMS (premenstrual syndrome). PMDD is a severe and chronic medical condition that can be treated with both medical and behavioral interventions. It is a highly misunderstood disease due to significant stigma around the female cycle just "causing women to be too emotional."
PMDD can come in many forms, but within each their is a resilient monster hiding under the bed every. single. month. What causes this is significant imbalances in our female hormones aka progesterone and estrogen, often causing a serotonin deficiency. It's different for every woman, of course. Some women experience aggressive symptoms of irritability and rage, others, like me, experience severe depression and self-deprecating thoughts. This is only to name a few. The list of possible symptoms with PMDD both psychologically and physically is unreasonably long for one person to experience every 28-35 days for the rest of their life.
Though the exact cause of these fluctuations in our hormones is considered unknown, many women can pinpoint exactly when their symptoms began. I started experiencing many of the symptoms of PMDD following a trauma in my life that caused significant fluctuation in my bodily hormones as my body and mind attempted to cope with the extreme psychological and physical stresses that occurred. For far too long, I attempted to cope on my own, but in reality I didn't fully understand what was happening to me.
I started writing this blog in the midst of one of the depressive episodes I was ironically referring to, hoping it would give me some sort of inspiration. For weeks I'd slipped out of my usual daily habits that helped me cope with my depression and anxiety, and was seemingly unable to do anything that might help. I finally brought myself to start my favorite depression book for the umpteenth time - Unbroken by Laura Hillenbrand. The first time I read the book, I felt inspired by young Louis Zamperini's resilient pursuit of survival in the midst of the worst times of his life during WWII. However, this time something I hadn't noticed before caught my attention, giving me a vastly different perspective of his story.
After Louis was captured by the Japanese, tortured, beaten, and deprived of basic physiological needs, his captives unleashed a new tactic of torment. Slowly but surely, each day, his captors would attempt to strip him of his dignity through various humiliation tactics. He referred to these tactics as not only demoralizing, but dehumanizing. He goes on, describing human dignity to be as essential to life as food, water, and oxygen.
“This self-respect and sense of self-worth, the innermost armament of the soul, lies at the heart of humanness; to be deprived of it is to be dehumanized, to be cleaved from, and cast below, mankind. Men subjected to dehumanizing treatment experience profound wretchedness and loneliness and find that hope is almost impossible to retain. Without dignity, identity is erased. In its absence, men are defined not by themselves, but by their captors and the circumstances in which they are forced to live” (Hillenbrand, 2010).
― Laura Hillenbrand, Unbroken: A World War II Story of Survival, Resilience and Redemption
Though incomparable to the horrendous experiences of our nations soldiers like Louis, for many of us, depression can feel the same way, acting as our captors that define our lives. Depression can leave us at our core feeling worthless, helpless, and alone. I pondered on this thought, wondering why for so long, I'd allowed my depression to be my captor. And more so, why I continue to allow it to recapture my soul, wondering "why can't I just be happy and normal?".
For many of us, we consider happiness to be a state of being, rather than what it really is, just another emotion that comes and goes like all the rest. Happiness as a state of being is unrealistic and unattainable; the belief that any human in the world can "always be happy" is a bald face lie. Considering this further, I began to remember all the things I learned in school (which I often conveniently forget when in the midst of my own mental health crisis) about the workings of the brain and the hormonal deficiencies (referred to earlier) that often occur when someone is experiencing depressive symptoms. Then I thought... "what if I can control my depression and my happiness just like all of my other emotions?" Wild. I know. As if I've never been told this before...I sat down and started writing all of my thoughts about how I could "hack my depression" to regain control of my body and my mind using my happy hormones.
So... what are our happy hormones?
Serotonin, most commonly talked about in association with depression is known as the "feel happy chemical." This hormone is often significantly lacking in individuals who are depressed as the brains development of the hormone significantly decreases. Serotonin contributes to feeling calmer, happier, emotionally stable, focused, etc. We get boosts of serotonin when spending time in the sun, during exercise, with a healthy diet, during meditation, etc.
Oxytocin, aka the bonding chemical, or the love hormone. This hormone can aid in sleep regulation, compassion and generosity, connection with others, positive social skills, etc. This chemical is absolutely necessary to strengthening bonds with other people. We can increase our oxytocin levels through spending time with our loved ones, engaging in intimate conversation, hugging, kissing, cuddling, and sexual intimacy.
Dopamine, known as the reward hormone, fosters reinforcement of rewards allowing us to feel enjoyment and excitement. It's important to focus on healthy forms of this hormone as we may become fixated on unhealthy tools for increasing dopamine in excess such as, online shopping, video gaming, and drug abuse. Ways to healthily increase dopamine include meditation, exercise, dancing, task completion, listening to music, solving puzzles, and engaging in bucket list activities.
Lastly, we have endorphins, the pain relieving hormone. These neurotransmitters are released in the brain, the pituitary gland, and throughout the nervous system to fight pain and distress. Endorphin release can be highly pleasurable with healthy habits such as vigorous exercise (ever heard of a running high? This is why!), pregnancy (yes, ladies! Pregnancy can feel good!), physical intimacy, and certain types of food such as chocolate, chili peppers, and vanilla.
Now that we know what the happy hormones are, how can they be used to hack our depression? I asked myself the same question. So I came up with this simple "happy action plan" to help.
I separated my action plan into individual goals, followed by a tracker to help keep me accountable in actually engaging in this because I'm one of the worst procrastinators!
Goal 1: Put down my electronics for the night and engage in a 5 minute meditation before getting into bed. Reminder: DO NOT TURN ON THE TV OR CHECK YOUR PHONE!
^ The reminder is critical. I usually sleep with my TV on due to severe anxiety at night, though I know it can and does significantly interfere with my sleep.
Goal 2: Go to bed and wake up within (no more than)1 hour of the same time each night and morning, except on special occasions.
Goal 3: Drink a full 8 ounces of water first thing when I wake up.
Goal 4: Engage in a 5 minute meditation to get my day started. Reminder: YES, MELANIE. YOU ARE EXPECTED TO DO ALL OF THIS BEFORE CHECKING YOUR TEXTS, EMAILS, ETC.
Goal 5: Do a journal prompt while drinking your coffee and before starting any work.
Goal 6: Engage in 30 minutes or more of physical activity.
Goal 7: Get outside for 10 minutes or more.
Goal 8: Engage in 1 "happiness activity" for 15 minutes or more. Reminder: This can include anything that triggers one of the 4 happy hormones. It's helpful to make a list for yourself.
My goal is to do these things every day, or as often as I can. Heres' my chart for the week. Check out how I'm doing thus far!
Morning water Intake
Mindfulness of thoughts
What I'm grateful for
Happy memories with my family
Missed it today. Get back on it tomorrow. You got this girl!
Weight lifting + walk ~1.25 hr
Weight lifting + walk ~1 hr
Facetime with family
I know that sounds like a lot. But, have you ever heard the saying "if they cared enough, they'd make the time for you." Well... if we care about our mental health enough... we'll make the time for it. As I mentioned before, I'm making it my goal to engage in these habits each day, giving myself compassion for habits not met instead of criticizing myself. How I manage this: I remind myself of a friend and colleagues wise words: "at the root of our anxiety often lies the relentless and unrealistic pursuit of perfection." The purpose of this of course is to create these daily acts into daily habits, giving my brain healthy and regular doses of my happy hormones. At the beginning of this blog I discussed my own mental illness and the impacts my hormone fluctuations have on my body and mind each month. As uncontrollable as that all may sound, healthy habits like those seen above can help combat the fluctuations in your hormones too. It can't entirely cure us of our depression of course, and there will always be good and bad days, weeks, months, maybe even years. But always remember, your depression is not stronger than your dignity. Your depression does not define you. You choose how to define yourself.
So, that said, let's do this together. It's never too late to start.
Hillenbrand, Laura (2010-11-16). Unbroken: A World War II Story of Survival, Resilience, and Redemption (p. 189). Random House Publishing Group