Surviving a Depressive Episode

Amber Mourning

The Dark Night of the Soul, which is often a precursor to cognitive or spiritual awakening, manifests as a major depressive episode—a silent storm ravaging the mind and spirit, leaving those afflicted feeling isolated, overwhelmed, and desperate. In the darkest moments, when hopelessness becomes all-consuming, finding a way to cope can seem impossible. During one such time, Amber, a client who bravely shared her struggles, inspired the development of a technique designed to survive the death of the ego. This ego death dismantles an individual's old identity and belief systems, making way for a new, more integrated sense of self by providing solace and strength when it is most needed. Amber's words encapsulate the profound despair many individuals face:

"I'm in complete meltdown and don't know what to do anymore. I want to escape my life; I wish I could get hypnosis and forget any of this life ever existed. But realistically, I want to go into my house and lay down and wait for death. If I didn't know my kids would hate me, I probably would eat a bullet, but they keep that thread cut so it's not a path. This doesn't feel temporary. I don't feel like this suffering will ever end until I am dead. I have no strength. I'm so done. I had one last shot at happiness and that was stolen from me. I never sleep good anymore unless I get ‘shit face’ drunk, which happens a lot less now than it did 2 months ago. My drinking was incredibly dangerous for someone who never really drank. I try not to drink anymore, but there are still overwhelming times when it's the only thing that numbs the hurt and ‘shuts up’ the voices in my brain. I get intrusive thoughts that turn so dark sometimes it puts me into a panic attack because it feels like it's really getting ready to happen (death). I feel like I'm going crazy."

In this section of the book, we have discussed the necessity of 'Heaving To' during a crisis to prevent situations from worsening by riding out the storm. But how do you handle the overwhelming despair? Sailing offers another useful insight… to “Hold Fast.”

Historically, “hold fast” was a command given to sailors when approaching a storm, warning them to grip tight to the ship's rigging to avoid being washed overboard by the waves and rain as the ship plunged through the sea. This method, when facing an emotional, ego-crushing storm, is crafted to help individuals navigate through the depths of despair, offering a lifeline when everything seems lost. It provides practical steps to take when alone and in the grip of a major depressive episode, helping to restore a sense of control and hope.

"Amber Mourning" is a testament to resilience and the human spirit's capacity to endure and find light even in the darkest times. This section will guide you through the steps of the “Hold Fast” method, empowering you to manage overwhelming emotions and regain a sense of stability and peace.

BRIEF OVERVIEW – 3 methods to grasp

1.    Grounding Techniques [Thought – Deep Breathing – Body Scan]

• 5-4-3-2-1 Technique: This simple exercise can help distract from negative thoughts by focusing on the immediate environment. Identify 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell, and 1 thing you can taste.

• Deep Breathing 4-7-8: Practice deep breathing exercises. Count slowly to FOUR as you breathe in (through your nose), hold for SEVEN, and then exhale (blowing out the mouth) for EIGHT.

• Body Scan Meditation Routine: Sit comfortably. Take a deep breath in through your nose and out through your mouth. As you exhale, close your eyes. Notice how your body feels. Starting from the top of your head, gently scan down through your body. Observe any areas of comfort or discomfort without trying to change anything. Continue scanning evenly through each part of your body, all the way down to your toes.

2.    Challenge Negative Thoughts [Stop Thought – Switch Thought]

• Interrupt Negative Thoughts: When you catch yourself engaging in negative self-talk, use a thought-stopping technique. This could be saying "stop" out loud or visualizing a stop sign.

• Redirect Attention: Shift your focus to a more positive or neutral activity, like visual-mental imagery, listening to uplifting music, or engaging in a hobby.

3.    Cognitive Restructuring [with Mirror Affirmations]

• Identify Negative Thoughts: Recognize the negative or distorted thoughts about yourself. These could be related to self-worth, abilities, appearance, or any other aspect of self-perception.

• Create Positive Affirmations: Develop positive, affirming statements that counteract these negative thoughts. For example, if you often think, "I am not good enough," you might create an affirmation like, "I am capable and worthy of success."

• Use the Mirror: Stand in front of a mirror, make eye contact with yourself, and say the positive affirmations out loud. The act of looking at yourself while affirming positive beliefs can reinforce the message and make it more impactful.

• Consistency: Repeat this practice daily, ideally multiple times a day. Consistency helps reinforce the new, positive thoughts and beliefs.

• Reflect and Adjust: Reflect on how the affirmations make you feel over time. Adjust them as needed to ensure they remain relevant and powerful for you.

Performing HOLD FAST Methods

#1. Grounding Techniques

5-4-3-2-1 TECHNIQUE

The 5-4-3-2-1 method is a grounding technique used to help individuals manage anxiety and bring their focus back to the present moment. It involves using the five senses to become aware of your surroundings. Here's how to do it:

• 5 Things You Can See: Look around and identify five things you can see. They can be objects, people, colors, or anything in your environment. Take your time to really notice these items.

• 4 Things You Can Touch: Focus on four things you can touch. This could be the texture of your clothing, the surface of a table, your hair, or anything else you can physically feel. Pay attention to the sensations.

• 3 Things You Can Hear: Listen carefully and identify three things you can hear. This might be the sound of traffic, birds chirping, the hum of a computer, or any other ambient noises. Concentrate on these sounds.

• 2 Things You Can Smell: Find two things you can smell. If you're in a place where it's difficult to identify scents, you might carry a small item with a pleasant smell, like essential oils or a piece of fruit.

• 1 Thing You Can Taste: Finally, focus on one thing you can taste. This could be the lingering taste in your mouth or you might take a sip of a drink, chew gum, or eat something.

Steps Recap

• 5 Things You Can See

• 4 Things You Can Touch

• 3 Things You Can Hear

• 2 Things You Can Smell

• 1 Thing You Can Taste

This method offers several benefits, including reducing anxiety by focusing on the present moment and engaging the senses, which helps decrease stress and tension. It also serves as a distraction, interrupting negative thoughts and overwhelming emotions, and encourages mindfulness by promoting awareness of the current environment. The technique can be used whenever you feel overwhelmed or disconnected from the present moment, and its adaptability allows it to be practiced anywhere and at any time, making it a versatile tool for grounding.

Incorporating the 5-4-3-2-1 method into your "heave-to" strategy will provide a practical and immediate way to regain control and reduce anxiety during emotional crises.

ANCHOR WITH BREATH TECHNIQUE

The 4-7-8 breathing technique developed by Dr. Andrew Weil, also known as the "relaxing breath," is a simple and effective method to promote relaxation and reduce stress. The extended ‘exhale’ helps activate the parasympathetic nervous system, which can calm the body and mind. Here's how its performed:

1. Exhale Completely: Start by exhaling completely through your mouth, making a whoosh sound.

2. Inhale Quietly Through Your Nose: Close your mouth and inhale quietly through your nose for a count of 4 seconds.

3. Hold Your Breath: Hold your breath for a count of 7 seconds.

4. Exhale Completely: Exhale completely through your mouth, making a whoosh sound, for a count of 8 seconds.

Steps Recap

1. Exhale: Through the mouth, completely (whoosh sound).

2. Inhale: Through the nose, quietly, for 4 seconds.

3. Hold: Hold your breath for 7 seconds.

4. Exhale: Through the mouth, completely (whoosh sound), for 8 seconds.

Tips for Practice

• Posture: Sit or lie down in a comfortable position.

• Consistency: Practice this technique at least twice a day.

• Repetitions: Start with four breath cycles and gradually increase as you become more comfortable.

The 4-7-8 breathing technique is designed to help calm the nervous system, promote relaxation, and improve sleep. It's a useful tool for managing stress/anxiety, and can be incorporated into your "heave-to" strategy for emotional crises.

BODY SCAN

Body scan meditation is a well-established mindfulness practice that can help increase awareness of physical sensations and reduce anxiety. It involves focusing attention on different parts of the body, noticing any sensations, and fostering a sense of relaxation and presence. Here is a simple routine you can follow to perform the Body Scan Meditation Routine:

Preparation:

• Find a Comfortable Position: Sit or lie down in a comfortable position. You can sit on a chair with your feet flat on the floor or lie on your back with your arms resting by your sides.

• Close Your Eyes: If you feel comfortable, close your eyes to minimize distractions.

• Take a Few Deep Breaths: Start with a few deep breaths to settle into the practice. Inhale deeply through your nose and exhale slowly through your mouth.

The Body Scan:

1. Focus on Your Breath: Spend a few moments paying attention to your breath. Notice the sensation of air entering and leaving your body.

2. Feet: Direct your attention to your feet. Notice any sensations in your toes, the soles of your feet, and your heels. Observe any tension, warmth, coolness, or tingling. Allow your feet to relax.

3. Legs: Move your attention up to your ankles, calves, knees, and thighs. Observe the sensations in these areas without judgment. Notice if there is any tightness or relaxation. Allow your legs to relax.

4. Pelvic Area and Lower Back: Shift your focus to your pelvic area and lower back. Notice any sensations of pressure or discomfort. Breathe into these areas and allow them to soften and relax.

5. Abdomen and Chest: Move your attention to your abdomen and chest. Notice the rise and fall of your breath in these areas. Observe any sensations of tightness or relaxation. Allow these areas to relax.

6. Upper Back and Shoulders: Direct your focus to your upper back and shoulders. Notice any tension or sensations. Allow your shoulders to drop and your upper back to relax.

7. Arms and Hands: Shift your attention to your arms, from your shoulders down to your fingers. Notice any sensations in your arms, hands, and fingers. Allow your arms and hands to relax.

8. Neck and Throat: Move your focus to your neck and throat. Notice any sensations or tension. Breathe into these areas and allow them to relax.

9. Face and Head: Finally, direct your attention to your face and head. Notice any tension in your jaw, cheeks, forehead, and scalp. Allow these areas to soften and relax.

Conclusion

• Whole Body Awareness: Spend a few moments sensing your entire body as a whole. Notice the overall state of relaxation and presence.

• Gradual Reawakening: When you are ready, slowly bring your awareness back to your surroundings. Wiggle your fingers and toes, and gently open your eyes.

Tips for Practice

To build mindfulness and reduce anxiety, practice body scan meditation regularly, ideally once a day. Approach the practice with a non-judgmental attitude, simply observing sensations without trying to change them. If your mind wanders, gently bring your attention back to the part of the body you were focusing on.

Incorporating body scan meditation into your routine can help develop a deeper awareness of your physical sensations, which can be particularly beneficial during times of emotional distress. This practice can complement the "heave-to" strategy by providing a calming and centering activity to use during moments of crisis.

#2. Challenge Negative Thoughts

STOP THOUGHT - SWITCH THOUGHT

On Feb. 11, 1965, Lt. Cmdr. Bob Shumaker was shot down and taken prisoner over North Vietnam and spending the next 8 years at the infamous Hanoi Hilton. To survive the mental/physical torture, he would stop his negative thoughts by replacing them with a visualization. He imagined the house he wanted to build for his young wife and their infant son; having no paper or pencil, he built the house in his head, brick by brick. Over the next 8 years of his imprisonment, he would work out small design issues, like putting an intercom in every room, or a chute for the laundry. Over time, he worked out the mathematical equations for load bearing making the building structurally sound. He would imagine moving the fireplace from one part of the house to another, and would have to recalculate everything all over again, storing a new set of parameters and equations in his memory.

I did a similar activity when battling my own intrusive unwanted thoughts, but mine was for building a boat. I determined building materials, cost, strength, weight, ballast, displacement, etc. Whenever I needed to stop a thought, I would tell myself, “It’s time to get back to the boat", and I begin the mental imagery... whether driving my car or lying in bed, whatever the situation, I inwardly when “back to the boat”.

The mental coping strategy you are referring to is known as visualization or mental imagery. This technique involves creating detailed mental images or scenarios to maintain mental focus, reduce stress, and cope with difficult situations. In the context of POWs in Vietnam, they used visualization to build a house in their mind, nail by nail and board by board, as a way to occupy their minds, stay mentally active, and endure the hardships of captivity.

Here are some types of imagery that the average person might find accessible and methodical for visualization:

1. Gardening: Visualize planting a garden, preparing the soil, planting seeds or plants, watering, and watching them grow.

2. Cooking or Baking: Imagine preparing a favorite recipe step-by-step, from gathering ingredients to mixing, cooking, and presenting the final dish.

3. Walking in Nature: Picture a detailed walk through a forest, along a beach, or in a park, noting the sights, sounds, and smells.

4. Building a Simple Structure: Visualize assembling a basic structure, such as a bookshelf or a birdhouse, even if you don't have detailed knowledge of construction.

5. Painting or Drawing: Imagine creating a piece of art, focusing on each brushstroke or pencil line and the development of the image.

6. Decorating a Room: Picture designing and decorating a room, choosing colors, arranging furniture, and adding personal touches.

7. Organizing a Space: Visualize tidying up and organizing a cluttered room, systematically sorting items, and putting them in place.

8. Crafting: Imagine engaging in a craft activity like knitting, crocheting, or making jewelry, step by step.

9. Playing an Instrument: Visualize playing a musical instrument, focusing on each note and the feel of the instrument.

10. Exercise Routine: Picture going through a favorite exercise routine, such as yoga, Pilates, or a gym workout, paying attention to each movement and breath.

These activities are relatively simple and can be methodically performed in one's mind, providing a constructive and calming focus for visualization.

By consistently applying these strategies, you can gradually change your thought patterns, reduce negative self-talk, and develop a healthier, more positive mindset.

#3. Cognitive Restructuring

MIRROR AFFIRMATIONS

When performing mirror affirmations, addressing yourself directly with "You are..." statements can often feel more personal and impactful, especially when looking in the mirror. This approach can create a sense of receiving encouragement and validation from a supportive and caring presence. Here are some recommended "You are..." mirror affirmations:

Recommended "You Are..." Mirror Affirmations

1. Self-Worth and Self-Compassion

   • "You are worthy of love and compassion."

   • "You accept yourself just as you are."

   • "You forgive yourself for past mistakes and embrace your imperfections."

2. Strength and Resilience

   • "You are stronger than you think."

   • "You have the power to overcome any challenge."

   • "Every day, you are becoming more resilient."

3. Hope and Positivity

   • "This too shall pass."

   • "You are capable of finding joy in the midst of pain."

   • "You trust that better days are ahead."

4. Calm and Peace

   • "You are calm and at peace."

   • "You release all negative thoughts and welcome positivity."

   • "You are a vessel of peace and tranquility."

5. Empowerment and Control

   • "You are in control of your thoughts and emotions."

   • "You have the power to change your story."

   • "You are the author of your life and can rewrite your path."

6. Gratitude and Appreciation

   • "You are grateful for the good in your life."

   • "You appreciate the small moments of joy."

   • "You find something to be thankful for every day."

7. Growth and Learning

   • "You are growing and evolving every day."

   • "Each challenge is an opportunity for growth."

   • "You learn from your experiences and become wiser."

8. Love and Connection

   • "You are connected to the love and support around you."

   • "You are surrounded by people who care about you."

   • "You are deserving of all the love and happiness life has to offer."

How to Use "You Are..." Mirror Affirmations

1. Choose a Quiet Time: Find a quiet time in the morning or evening when you can stand in front of a mirror without distractions.

2. Make Eye Contact: Look into your own eyes in the mirror to create a deeper connection with yourself.

3. Speak Clearly and Confidently: Say each affirmation slowly, clearly, and with conviction. Believe in the words you are saying.

4. Repeat Regularly: Repeat each affirmation several times, ideally daily, to reinforce positive thinking patterns.

5. Personalize Your Affirmations: Customize these affirmations to fit your personal experiences and needs. The more they resonate with you, the more effective they will be.

Example Routine

1. Start with Breathing: Take a few deep breaths to center yourself.

2. Select a Few Affirmations: Choose 3-5 affirmations that resonate most with you.

3. Speak and Reflect: Say each affirmation three times while maintaining eye contact with yourself.

4. End with Gratitude: Finish by expressing gratitude for the moment of self-care.

Using "You are..." statements can make affirmations feel more like a supportive dialogue with oneself, enhancing their effectiveness during times of emotional crisis.

EXPOSURE AND RESPONSE PREVENTION

(and the science behind it)

You might be surprised to learn that no matter how hard you try to stay upset during a ‘situation’ and resist letting yourself calm down, the intensity of emotions will ultimately subside on their own. Have you ever had a “good cry” and then felt better? This is not a challenge to try and make things worse, or suggest you “cry it out”, rather this is an explanation of how the body responds to high levels of anxiety during the Dark Night of the Soul. The chemistry of the body plays a crucial role here, involving several hormones like cortisol, adrenaline, and noradrenaline. When anxiety hits, these hormones are released, preparing the body for a "fight or flight" response. Cortisol increases blood sugar levels and brain glucose availability, but prolonged high levels can harm physical and mental health so after a period of time the body works to decrease these quantities. Adrenaline and noradrenaline raise heart rate and blood pressure, but the body can only produce so much adrenaline at one time. As adrenaline levels decrease, so does your emotional response, helping you regain control over your psyche. This principle is foundational to Exposure and Response Prevention (ERP), a treatment for Obsessive-Compulsive Disorder (OCD) that gradually exposes individuals to anxiety triggers while preventing their usual compulsive behaviors, promoting habituation and reducing anxiety over time.

ERP and similar therapies leverage the body's limited capacity to sustain prolonged anxiety. Continuous exposure without avoidance or compulsive behaviors leads to autonomic nervous system fatigue and habituation, where repeated exposure diminishes the anxiety response. Neurochemical depletion also plays a role, as the brain's neurotransmitters, like norepinephrine and serotonin, temporarily deplete with prolonged anxiety exposure, reducing emotional intensity. Additionally, chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis results in adaptations that lessen its responsiveness over time.

Cognitive restructuring occurs as individuals realize feared outcomes are not as catastrophic as anticipated. Thus, the body’s inability to maintain a prolonged state of heightened anxiety is why ERP is effective. Through repeated exposure without avoidance, the intense anxiety response diminishes, supported by both physiological mechanisms (neurochemical depletion, autonomic fatigue) and psychological processes (cognitive restructuring, habituation). This approach (and knowledge of the process) helps endure the overwhelming emotions experienced every time the Dark Night of the Soul happens until the calm returns, allowing a healthier, more positive recovery journey.