Have you ever been really stressed for a really long time? Maybe even collapsed from fatigue? And have you ever experienced depression? If so, you probably already know that chronic stress and clinical depression share many characteristics, for example feeling unusually tired or exhausted nearly every day. At the same time, there are important differences between stress and depression, explaining why a stressed person doesn’t always benefit from depression treatment and why a depressed person doesn’t get better from staying at home resting.
What you’re doing right now is taking a big step towards figuring out what you need to feel better. Gaining some in-depth insights into how stress and depression work is an important milestone on the road to recovery
Stress and depression – a two-way relationship
Stress and depression affect each other in a complex way. Stressful life events, such as losses, conflicts, health problems, loss of control and big changes in life can trigger depression. And being depressed can make your daily life extremely stressful and make it more difficult to deal with stress. Maybe you’ve noticed that depression affects your ability to concentrate on solutions, come up with creative ideas and tackle unfamiliar situations? Yes, depression definitely makes life more stressful.
So, if you’re going through depression, you are at higher risk of developing chronic stress. And if you’re suffering from chronic stress, you’re at higher risk of developing depression. This is important information for many reasons. Here are two of them:
- It reminds you not to put too much strain on your depressed brain. Make sure to focus on meaningful and relaxing activities when dealing with depression. Cut yourself some slack! Depression affects how the brain works and you can’t expect your depressed brain to accomplish the same things as your non-depressed brain.
- It reminds you how important it is to practice self-compassion when dealing with chronic stress. Cut yourself some slack! You have been overwhelmed and overworked for many months or even years, so it’s time to give yourself some love. Try not to fall into self-blame, self-doubt, feeling guilty or ashamed about your condition. I know this is a lot to ask, but just think about it. You’re valuable. And you need some guilt-free rest.
Want to know more about the exact symptoms of chronic stress and depression and how they work? The next section will give you what you need.
The difference between stress and depression
While depression is characterized by feeling down all the time and losing interest in activities that used to feel meaningful or enjoyable, chronic stress is characterized by an ‘overloaded’ brain and extreme fatigue.
This table shows similarities and differences between chronic stress and depression:
Symptoms of chronic stress
- Chronic tiredness or sleepiness
- Sleep disturbance (too much or too little).
- Markedly reduced energy: reduced initiative, lack of endurance, needs more time to recover after mental efforts.
- Impaired memory.
- Markedly reduced capacity to tolerate demands or to work under time pressure.
- Emotional instability or irritability
- Physical weakness or fatigue.
- Physical symptoms: muscular pain, chest pain, palpitations, gastrointestinal problems, vertigo or increased sensitivity to sounds.
Symptoms of depression
- Lacking energy: Feeling tired nearly every day.
- Sleep disturbance (too much or too little).
- Loss of interest and pleasure: Markedly reduced interest/pleasure in all (or almost all) activities most of the day.
- Having difficulty concentrating and/or making decisions.
- Depressed mood: Feeling blue most of the day, nearly every day.
- Changed appetite or weight (eating more or less than usual).
- Moving more slowly than usual or making meaningless movements due to anxiety (for example twisting your hands).
- Feeling excessively guilty and/or worthless.
- Having repeated thoughts about death, suicidal thoughts, or sometimes wishing you were dead.
So, why is it important to separate chronic stress from depression? Well, even though chronic stress and depression can look similar on the surface, knowing the reason behind your symptoms may have important implications for treatment.
How to recover from chronic stress?
We can’t assume that a person suffering from chronic stress and a person suffering from depression will benefit from the same treatment. While a depressed person generally benefits from engaging in activities, such as cardio exercise and socialising, a person suffering from chronic stress may need the exact opposite.
Imagine a single mother who was recently left by her partner. She’s working two jobs to support her children. When she’s not taking care of the kids, she tends to her sickly parents. Stressful. She rarely has time to rest and it’s affecting her sleep. Imagine that this situation goes on for a long time until her body says “enough” and she physically collapses from fatigue. What she probably needs more than anything is sick leave and lots and lots of rest.
There are no shortcuts to recovery when a person has experienced such a large amount of stress for a long period of time. Antidepressants would probably be of little or no use. This woman experienced her collapse as a sudden event, as if she ‘hit the wall’. Initially, her treatment should focus on helping her understand what happened to her and what her body needs to recover (probably more rest than she could ever imagine). Later on, the treatment should be focused on finding a natural balance between rest and activity and helping her to set clear boundaries. It’s common for people with chronic stress to have low self-esteem, thinking they’re not valuable if they don’t perform or overachieve. That is another thing to address in therapy. Hopefully, she can find important people in her life to ask for help with daily chores.
(See the last section for advice on how to cope with both stress and depression.)
Paying close attention to warning signals from your body will help you prevent chronic stress. Also, learn to recognise the three phases of chronic stress:
- The first phase may be characterized by having too much to do, too many demands and not enough time to rest. In this phase, you may experience both physical and mental symptoms, such as headaches, forgetfulness and sleeping problems, but you can still manage your daily life with relationships and chores. Most people in this phase realize that their symptoms are caused by excessive stress and try to change their lifestyle or seek professional help. If they don’t, they risk entering the next phase.
- If the first phase goes on for more than 6 months, you risk entering phase two. This is the acute phase where you ‘hit the wall’. This can be experienced as if the body just stops working. It may be difficult to get out of bed and impossible to think clearly or to concentrate on simple tasks. This phase may last for a few weeks. Of course, this is very frightening and can produce feelings of despair and anxiety. Many misinterpret these symptoms as having a severe depression.
- The third phase is the recovery phase. You slowly get back on your feet, even though you’re still extremely tired. This phase is characterized by being sensitive to stress and having difficulty concentrating and remembering. It’s important not to go back to work too quickly or to expose yourself to very stressful situations during this phase. The recovery can take several months and you may be sensitive to stress for many years ahead. Another piece of advice: when you’re strong enough to return to work, start small. Just being in a work environment will be a challenge for your brain.
How to recover from depression?
So, let’s take a look at depression treatment. What would a depressed person need to recover?
Normally, we do enjoyable things when we feel like doing them, for example having coffee with a friend. But when depressed, that feeling of enjoyment fades away. Perhaps you don’t experience a coffee date as pleasurable anymore. Naturally, you may stop meeting friends or doing other meaningful things because nothing really seems to make you happy. When this happens, you start missing out on positive experiences, making matters worse. This is a common vicious cycle of depression.
One of the most popular psychological techniques for depression is called behavioural activation. It helps you engage in important activities. Even though you don’t feel like doing anything and don’t enjoy the things that usually bring you pleasure, doing things anyway will actually get you out of depression. Initially, it’s not super-important whether you enjoy it or not. Doing stuff is what matters most. The feelings of pleasure and enjoyment will increase with time.
Take a look at this video, showing you the depression cycle and how to reverse it:
Luckily, there are many ways to treat depression:
- The video is a part of a free app-based treatment programme for depression. It’s developed by psychologists, includes over 50 virtual therapy sessions and teaches you all about behavioural activation for depression. Inside the app, you’ll meet your virtual therapist, Flow, who will guide you through the treatment, offer you homework assignments and track your symptoms as you progress. Did I mention it’s 100% free? You can download it here.
- Another option is antidepressant medication, which you can discuss with your physician. Just make sure to be well-informed about side effects and withdrawal symptoms before you try any kind of medication. Read more about antidepressants here: What are the side effects of antidepressants? And here: Do antidepressants work?
- A third option is tDCS. tDCS is a gentle and medically approved form of brain stimulation that you can use at home to treat depression. Don’t confuse it with electroconvulsive therapy or ECT, which can only be used at hospitals. TDCS is much gentler. It’s administered via a bluetooth headset and gives basically no side effects.
It works like this: you put on your tDCS headset and mild electrical signals are sent to your Dorsolateral Prefrontal Cortex (DLPFC) – a part of your brain important for mood regulation. Depressed people have a lowered activity in the DLPFC and the brain stimulation helps the brain cells become more easily activated. When your DLPFC is back to normal, your depressive symptoms decrease.
Flow Neuroscience will deliver a tDCS headset to your home. The headset is controlled by the Flow app to make sure your treatment is safe and follows the recommended protocol for depression.
Do you want even more tips on how to treat depression? These articles can give you what you need:
So, depression treatment and treatment for chronic stress can differ quite a lot. But what if you’re dealing with both conditions? The last section will give you strategies proven to be helpful for both stress and depression.
Dealing with both stress and depression
What if you suffer from both stress and depression? In that case, you and your health care provider need to address both issues and decide which type of treatment will benefit you the most. If you experience the first phase of chronic stress, you may be too tired to do anything but rest, but if you’re in the third phase, regular therapy sessions may be exactly what you need. Perhaps you decide to combine treatments. You could for example use antidepressants or tDCS while engaging in talk therapy focused on finding a balance between activity and rest.
Additionally, there are many things you can do at home to cope with both stress and depression.
- Ask for help. It’s difficult. I know. Asking for help when going through depression or dealing with chronic stress is a challenge. One reason may be that you’re so used to managing everything on your own that asking for help makes you feel like a failure. You’re not. Sharing your burdens with your friends and family and seeking help from a professional is extremely beneficial when dealing with chronic stress and depression. In fact, not talking about stressful experiences increases the risk of depression.
If you want to know more about why it’s so difficult to ask for help when depressed and how to make it easier to communicate with loved ones, check out this article: How to help someone with depression.
- Meditate. Regular mindfulness meditation practice can help you manage strong emotions and negative thoughts. Another benefit of mindfulness meditation is that it teaches you how to detect early signs of stress or early symptoms of depression. That’s why regular meditation prevents people from falling back into depression a second time.Don’t know where to begin? Don’t worry. There’s an app for that. Flow’s depression app includes a complete meditation module with lots of practice for beginners. The following exercises are included in the programme and helpful when dealing with both stress and depression:
Do you want to know more about how to start your own mindfulness practice at home? These articles will give you what you need:
How to use mindfulness for depression in 5 simple steps – quick guide to medication-free mindfulness treatment and Top 3 beginner meditations for depression.
- Search for the meaning of life. You could think of chronic stress as a severe lack of rest. Life has probably been all about chores, tasks, to-do’s and must-do’s for many months or even years leading up to this point. Most people with chronic stress report that they rarely spend time doing things just for the joy of it. Similarly, people with depression find it difficult to enjoy life and they lose interest in things that give life meaning.
Acceptance Commitment Therapy (ACT) is probably the number one treatment when it comes to finding the meaning of life. ACT can basically be described in two steps:
- Identify what is important to you.
- Take concrete steps in that direction.
The commitment part of ACT refers to the idea that we can achieve mental health by committing to actions that are consistent with our values. So, let me ask you:
- What made you feel happiness and pleasure before getting depressed or chronically stressed?
- What are the most important things in life? (Family, friends, painting, writing, nature, work, politics, football etc.)
- If you lived on a paradise island with lots of food and water and absolutely no to-do’s, how would you spend your time?
Answering these questions will help you find your values and perhaps a few antidepressant activities that can bring you both pleasure and meaning.
Another way to explore the most meaningful things in your life is doing this ACT-inspired audio exercise. It helps you reflect on what kind of life you want to live.
If this short introduction to ACT triggered your curiosity, this next article offers you in-depth information on how to find your values, create a life compass and set value-based goals: How to cope with depression by finding the meaning of life.
Also, all of these tools are included in the free therapy programme from Flow Neuroscience with over 50 virtual therapy sessions.
- Sleep. Having trouble falling asleep or staying asleep is one of the first signs of chronic stress. It’s also a common symptom of depression. Luckily, improving your sleep quality is one of the most effective ways to recover from stress and it reduces your symptoms of depression. There are many things you can do at home to improve your sleeping habits. Small changes can have a major impact on your overnight therapy.
Chronic stress and clinical depression share several characteristics, for example unusual fatigue and concentration difficulties. However, there are differences between these conditions that can have important implications for treatment.
While depression is characterized by feeling down all the time and losing interest in activities, chronic stress is characterized by an ‘overloaded’ brain and extreme fatigue. In the acute phase of chronic stress, you may be too tired to do anything but rest and it’s important to understand what happened to your body. In the case of clinical depression, behavioural activation is one of the most popular ways to recover.
Asking for help, meditating regularly, searching for the meaning of life and improving sleep quality will help you cope with both chronic stress and depression.
Thank you for your attention!