Due to a recommendation from one of my friends, I decided to read “Leaving the Shadowland of Stress, Depression, and Anxiety” by Dr. Pamela Coburn-Litvak, a former member of the Andrews biology faculty. Having experienced stress-induced depression in her childhood and adult years, Dr. Coburn-Litvak succinctly demonstrates how stress, depression, and anxiety are related, while sharing the lessons and techniques she has learned in dealing with them.
As stress both related and unrelated to Covid continues to accumulate, I thought the contents of the book would be pertinent to us today. Even if this book is not meant to diagnose nor treat depression or anxiety, and anyone reading it may not feel stressed at all, we can definitely benefit from building stress-reducing skills before we are shocked by sudden stressors.
Dr. Coburn-Litvak begins by asserting that “depression is the silent killer in our midst,” not because people do not know they have it but because we tend to avoid talking about it, especially in personal settings. As uncomfortable as they are to address, mind-brain disorders such as major depression increase the risk of suicide, cost people and economies financially, and degrade close relationships. I think we may know these broad trends because of greater efforts to talk about mental health, but I urge you to take a look at the statistics–they are staggering.
Stress, the second central concept Dr. Coburn-Litvak explains, can lead to depression, and vice versa. The worst type of stress is persistent, psychological, perceived stress, which creates chronic strain, stays with us longer than physical stress, and affects us even when it is not present. “Phantom stress,” a subset of perceived stress, is fake in the sense that it is not meant to be a stressor, but it still has real effects. For example, misconstruing someone’s stare as contempt (when they are just daydreaming) can cause phantom stress. What is important is not whether something should cause us stress or not but whether we perceive it to be stressful.
Along with the risk factors that make an individual vulnerable, stress adds another burden that skews the mind towards depression or anxiety. This is especially likely to occur if the stress involves a psychological loss, such as the loss of a relationship, health, self-worth, or belief system. An imbalance in the mind can then initiate a positive feedback loop where it leads to a chronic stress response and negative emotions, releasing stress hormones that contribute further to the imbalance. To combat this, antidepressants and psychotherapy, particularly cognitive behavioral therapy, can be used to treat stress-induced depression.
According to Dr. Coburn-Litvak, what really helped effect lasting change in how she dealt with stress and depression were the principles of cognitive behavioral therapy (CBT). In cognitive behavioral therapy, our beliefs, perceptions, mental interpretations (all categorized as cognitions) mediate between the stressful event and our emotions. How we react to an event depends on how we interpret it, and we can use distorted beliefs about ourselves and the world to make something stressful for us. For example, getting a “C” on a test can make one person frown and vow to do better on the next test, but another person can feel that they are a complete failure who will never be able to be employed in the future. What makes the difference between these two is that the second person believes that they must always do well or else they are not worthy enough.
What I found the most helpful about this book is that four main techniques, the Four R’s, can be used to combat negative cognitive distortions that devastate our sense of self-worth. Doing your research, being a realist, finding the right ratio, and using the golden rule involve thinking about the evidence you have for your negative beliefs, thinking realistically about how the worst outcome and also possible good aspects, analyzing the costs and benefits of the distortions you are making, and seeing if you would hold other people to the same strict standard you hold yourself to. For example, when “finding the right ratio,” you can ask yourself, “what is advantageous about thinking I am a terrible person that I keep thinking this way, and what are the disadvantages of doing so?” Perhaps an answer would be that you are lowering your expectations of yourself so you do not feel disappointed, but this thinking also makes you more inclined to avoid social interaction.
You may have the preconception that relieving stress is all about letting the emotions out by writing with a fountain pen in a color-coded journal with fancy lettering. Although this can be a valid form of stress-relief for some, you can also be more structured and systematic in targeting the thoughts that make you interpret potential stressors in a negative way. By breaking each of your core beliefs down using the four R’s and answering the guiding questions given in each chapter, you may be able to see how your underlying assumptions are increasing your stress. I highly recommend that you use the examples provided in the book, and I hope that you can add this to your arsenal of stress-relieving strategies for whatever the future holds.
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