“The Grand essentials of happiness are: something to do, something to love, and something to hope for.” Allan K. Chalmers

Despite our best efforts to seek happiness on a daily basis, life’s challenges can sometimes be overwhelming… causing us to inevitably “feel the blues”.

Rest assured, EVERYONE experiences these challenges in their lives! It can leave you feeling powerless and overwhelmed. And your ability to cope with these challenging situations directly determines your level of wellbeing.

AND YET, as you progress through life, you rarely have the opportunity to obtain the resources required to effectively and appropriately deal with these circumstances.

To guide you through these gloomy moments, we’ve compiled a list of posts with strategies and tips to help you combat sadness, and move towards happiness.

Simply click on the links below for further information…

Coping with the Death of a Loved One

1. Common Reactions - List
2. Stages of Grief
3. Secondary Losses
4. Prior Losses
5. Coping with a Loss
6. Helpful Tips and Rituals
7. Helping Others Grieve
8. Helping Children Grieve
9. Gender Differences
10. Abnormal Grief
11. Moving Forward

Dealing with Loneliness

1. Loneliness - Theory and Facts
2. Negative Thinking and Ineffective Options
3. Dealing Effectively with Loneliness

Coping with Relationship Breakdown

1. Warning Signs
2. Stages of a Relationship
3. Communication Matters
4. Relationship Healing
5. Obstacles to Creating Relationship Healing
6. Beliefs Needed to Establish Relationship Healing
7. Intimacy and Sex
8. Relationship Goals
9. Learning From a Relationship Breakdown
10. Choosing to End the Relationship
11. Seven Tips for Dealing with a Relationship Breakup
12. Can We Be Friends?
13. Children and Relationship Breakdown
14. Recovering Gently

Understanding Depression

1. Mood Disorders - Facts and Figures 
2. Phenomenology Of Depression
3. Aetiology Of Depression
4. Assessment Of Depression, Part 1
5. Assessment Of Depression, Part 2
6. Suicide Assessment
7. Treatment for Depression
8. Humour Makes Life Easier

More on coping skills? Visit www.aipc.net.au/eguides.

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You have been retained by a company to counsel a member of staff who is currently on stress leave from her job.

During the first session with this person you discover that her immediate supervisor is a private client who has been coming to you for counselling for some time.

The staff member tells you that this supervisor is the main cause of the problems which have led to her being on stress leave.

What would you do to resolve this ethical dilemma?

(click on the comments link below to view responses)

Related Dilemmas: An Issue of Client Referral, A Sensitive Client Request, Helping a Highly Stressed Client

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Loneliness is such a subjective concept and what really is important here is the degree to which loneliness is affecting one’s life and/or a family’s life where relevant. What age is the person, because life goals and needs are often quite different for different age groups and for people with different priorities at different stages of life?

An older woman living alone may derive great comfort from a family pet such as a dog or cat and may only need occasional chats with a neighbour, friends, relatives or a community nurse to feel less lonely and satisfied with life. On the other hand a 14 year old boy confused about whether he is gay or not and so scared about being bullied at school and so lonely and depressed with no friends at all to talk to and to be comforted by, feels that death would be the only relief from all his problems.

Counselling, medical and mental health care, are important in this sort of serious situation as depression and suicidal thoughts often lead to suicide according to research findings in the literature. Family counselling or therapy may be required so that the boy does not feel alienated and think that he is totally on his own and out  of his depth. His school will also need involvement to address his learning and welfare needs at school, particularly against bullying.

Involvement with peer support groups and perhaps talking with other kids who may have had similar experiences, feelings and thoughts and who were helped to understand their problems and how to build their resilience, could also be useful. Let’s now look at some quite effective approaches to coping with loneliness and depression.

Strategies and Skills – CBT, Activity Diaries, Pleasant Activities Worksheets, Timetabling one’s activities.

One of the great things about loneliness and depression is that you can actually do things to reduce their impact and improve your health and wellbeing.

One of the difficult things with people who are depressed and lonely is that their thinking is just so negative and self-blaming. And that you give up almost immediately on doing anything that might be remotely positive to improve your life. This clearly needs challenging by the affected person, but how?

Step 1 - Learn to become aware of your thoughts and feelings and their effects on you

HOW?

Write down the negative thought and then next to it write down the situation in which the thought relates to.

Negative Thought: ‘I’m a failure’
Situation: ‘I’m finding it hard to cook properly’

Step 2 – Challenge the negative thought. When you challenge the thought you need to:

1. Accept the reality of the situation
2. Don’t go beyond the reality of the situation – stay with the facts

You then get something like this:

Negative Thought: ‘I’m a failure’
Situation: ‘I’m finding it hard to cook properly’
Challenge: ‘Cooking is not one of my strong points. I have never had any cooking lessons after all. Maybe I need some.’

Let’s look at some questions to challenge this negative thinking as outlined by The Clinical Psychology Service of Northampton Healthcare Community (NHS) Trust, 2003, Coping With Depression, Booklets 3 (Negative Thoughts), revised 09/12/03, p.8. The questions are directly recited from that source as follows:

Negative Thought: ‘No one likes me anymore’

1. Evidence: (Is there any evidence to contradict your Negative Thought belief?)

1. What evidence do I have to support this thought?
2. Does what I think fit with the facts?
3. Am I jumping to conclusions?

2. What Alternative Views are There? (There is always other ways of seeing a situation)

1. How would someone else view this situation?
2. What advice would I give to a friend in this situation?
3. Would I be as negative to someone else who was in my situation?

3. What is the Effect of Thinking Like This?

1. Does it help me?
2. Does it make me feel better?

4. Am I Making an Error in My Thinking?

1. Am I thinking in an extreme ‘all-or-nothing’ way?
2. Am I condemning myself as a person on the basis of just one event?
3. Am I concentrating on my weaknesses and not my strengths?
4. Am I blaming myself for something that is not my fault?
5. Am I taking something personal when it really has nothing in particular to do with me?
6. Am I expecting myself to be perfect?
7. Are my standards I set for myself too high?
8. Am I using a double standard – one for me and another for everyone else?
9. Are my expectations the same when I am depressed as compared to when I am fine?
10. Am I setting realistic or impossible tasks?
11. Am I only focusing on the dark side of things?
12. Am I exaggerating the importance of just one event?
13. Am I being open or closed minded about the future?

What we have just explored entails some critical elements of Cognitive Behavioural Therapy which has been proven to be successful in the treatment of some people with depression. However, there are some important tips that you will need to take on board if you chose to use this approach.

1. Use a positive (or negative) Data Log with columns that outline the following headings:
1. The Negative Thought
2. Initial Degree of Belief
3. Situation Involved
4. Challenges to the Negative Thought
5. Later Degree of Belief in the Initial Negative Thought
2. Decide to use the Data Log for just a short period of time.
3. Note down negative thoughts as soon as they occur
4. Challenging negative thoughts will be easier with constant practice
5. Eventually you will test your challenging thoughts - testing against the evidence.

Source: www.aipc.net.au/eguides

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In the previous post we explored some aspects of both loneliness and depression. The causes of each often have their basic roots in the way that modern life has progressed, particularly where ways of protecting oneself against being alone, feeling down and worthless and so on have been eroded.

Isolation from others (geographic, social, emotional), small and one parent families, being single and male, stresses of unemployment or working far too hard, the fast pace of life where there is little time free for reflection, pleasurable activities and forming meaningful relationships, financial hardship, lack of social networks and friends especially (but not exclusively) with men of all ages are all reasons why people may succumb to feeling lonely and depressed.

We have also discussed the sort of faulty negative way of thinking (constant self put downs and blaming self for any mistakes or faults*) that many people who are depressed become habituated to.

*Self-limiting thoughts are ingrained processes of thought that impact on the way in which we appraise, interpret or analyse a given situation or event. Self-limiting thoughts can take many forms, such as:

Black and white thinking - The tendency to interpret events in extremes (no shades of grey). This means that anything less than perfect is interpreted negatively and limits our ability to see the positives.

Unrealistic expectations - The tendency to pre-empt an event with unrealistic ideas of what should occur. This is a clear sign of setting yourself up for failure.

Selective thinking - This is the tendency to hone in on the negative aspects of a situation and ignore any of the positives, leading to an unbalanced perspective.

Catastrophizing - Imagining the worst possible outcome. This can discourage action and stall change.

So if we know that these are some of the causes, then it would be reasonable to assume that simply accepting these things and not challenging them in any way, represents ineffective options. To understand this concept, read the case study below.

Case Study – Dempsey

Dempsey is a sole parent aged 37 years, divorced with two sons, Tyson aged 10 and Jason aged 12. He has been living alone with the kids for six years now and lives atop a small grocery corner store in town which he runs as a sole trader.

He works from 8am until 7pm each day except Sundays when he closes at midday. He is just so busy. He has no idea how the kids are going at school but always tells them to do their homework when they are not helping him in the shop, watching TV or playing video games.

The kids find their own way to and from school and sport. Dempsey is always whinging to the kids that he never gets time to do anything, which is undoubtedly true and he often says that he would like to sell out if he could find a buyer and go up north to the tropics.

Dempsey knows that his life is just work, work, work, a bit of sleep and television when he gets a chance. He feels so lonely and depressed at times, and is still bitter about his wife leaving him and her kids for another man.

Dempsey has taken to drinking alcohol as a way of easing the pain of loneliness for the past couple of years, but it has been affecting his behaviour so much that he is yelling at the kids and even being rude to customers and business has dropped off. He hasn’t been on a proper holiday for over ten years and he is having lots of difficulty sleeping and concentrating and he often can’t be bothered eating properly on most days.

He has very few friends and acquaintances except for a few regulars to the shop who say “hello” and have a brief yarn occasionally. He has dated one other woman since his wife left, but when together he was totally impotent and so nervous that she finally left and told him to see a psychiatrist. He felt totally deflated to say the least.

Dempsey feels like there is not much to live for anymore except for the kids and life is like a prison. He feels so tired sometimes that he would rather just shut up the shop and walk out under a bus. Sex is always on his mind, but he is so frustrated and depressed about not getting any or at least having intimate relations with a woman.

What is problematic here?

1. Dempsey is a sole parent and therefore at risk of loneliness and depression according to the research findings.
2. Dempsey works long hours without any relief or backup for virtually 7 days a week and has little time for anything else.
3. Dempsey has few friends to provide emotional and other support and friendship.
4. Dempsey still harbours bitterness towards his wife and his life has hardly moved on (unresolved issues and emotions).
5. Dempsey is anxious, not sleeping well, has suicidal thoughts and his concentration is getting poor at times.
6. Dempsey is drinking alcohol as a crutch to ease his loneliness and frustrations. Instead of making him feel better it has simply made him aggressive and bad mannered.
7. Dempsey appears to have little to do with his kids and this could prove problematic for the kids’ welfare and education once they reach adolescence.
8. Dempsey has no life outside of the shop – he doesn’t exercise, eats poorly, has no real friends, can’t relax and hasn’t had a holiday in years.

Dempsey is in a very difficult position. It would seem that if he continues with his business the way it is and his current poor lifestyle, that things will end up very badly indeed and his physical and mental health will suffer. He certainly needs some counselling and probably needs to seek business and financial counselling as well to see what options there are to support him with his business or to sell the business. At the moment the business is making his life miserable.

Given that he has resorted to drinking alcohol and has been having suicidal thoughts it is imperative that Dempsey seeks medical help or counselling as soon as possible, since research evidence indicates that such people are at high risk of suicide. His constantly thinking about sex may also be a compensation for feelings of emotional loneliness, depression and poor self-esteem - when he did have a romantic date with a woman, he became impotent and nervous, to the degree that it became a failure. 

Source: www.aipc.net.au/eguides

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According to Michael Flood’s report (2005) titled ‘Loneliness in Australia’, the following facts are relevant about loneliness:

1. Men of all ages are more likely to suffer from loneliness;
2. Among men between the ages of 25-44 and who live alone, they report significantly lower levels of support and friendship than men who live with others. Interestingly the same is not the case for women.
3. Men rely on their wives or partners for social and emotional needs. Women generally have a broader social network to draw upon to meet their needs.
4. Single mothers with children report the highest levels of loneliness among women respondents.
5. Divorced or separated men experience the same levels of loneliness as other men who live alone.
6. Divorced or separated women particularly by one year afterwards, indicate the same levels of loneliness as other women who have not been through separation or divorce. Women have greater social and emotional networks and contacts than men.
7. Men rely much more on paid employment as a source to provide personal support and friendship. As paid employment increases for men, so does personal support and friendships.
8. Women who live alone do find increased support and friendship through work irregardless of the amount of hours worked.
9. Both men and women single or otherwise experience increased loneliness during financial hardship and if they lose their paid employment.
10. About one third of men living alone stated that they ‘often feel very lonely’
11. About one quarter of  lone fathers with children stated they ‘often feel very lonely’
12. 13% of men in childless couple families also stated they ‘often feel very lonely’
13. This pattern of ‘often feeling very lonely’ is also similar in women.
14. Men who live alone are often confronted by unsociable neighbourhoods (low level of neighbourhood cooperation and interaction) and they have poorer physical, emotional and mental health.

Below we identify some of the risk factors and protective factors that are related to loneliness and depression as identified in the literature.

Summary of Risk and Protective Factors

Risk Factors

Environmental and Social:

1. Social disadvantage (poverty, unemployment, member of marginalised group (e.g. gay and lesbian communities)
2. Family discord (relationship break-up, conflict, poor parenting practices)
3. Parental mental illness
4. Child abuse (physical/sexual, neglect)
5. Exposure to adverse life events (bereavements, family separation, trauma, family illness)
6. Caring for someone with a chronic physical or mental disorder
7. For older adults, being in residential care

Biological and Psychological:

1. Parental mental disorder and family history of depression
2. Being a female adolescent (more recently a male)
3. High trait anxiety and pre-existing anxiety disorders, substance abuse, conduct disorder
4. Temperament – reacting negatively to stressors, and personality trait of neuroticism
5. Negative thought patterns (pessimism, learned helplessness)
6. Avoidant coping style

Protective Factors

Environmental and Social:

1. Good interpersonal relationships (supportive relationship with at least one person/parent, perceived social support)
2. Community tolerance of difference and diversity
3. Family cohesion (positive parent-child relations
4. Social connectedness
5. Academic/sporting achievements

Biological and Psychological:

1. Easy-going temperament
2. Optimistic thought patterns
3. Effective coping skills repertoire (social skills, problem-solving skills

Loneliness, depression and suicide are often associated with one another. The statistics in Australia and elsewhere are interesting as there appears to be a degree of ambiguity between data for depression and data for suicides. It is interesting to note that women over 18 years report symptoms of depression far more than men. Yet episodes of suicide in all age groups from early adolescence are far higher in men than in women.

Why is this so? It is suggested that men do not seek medical help nearly as much as women do and therefore episodes of men who may well be depressed but not seeking help is not reported. This is especially the case in rural and remote communities where men typically avoid seeking health care interventions. It may well be that men do suffer depression as much or maybe more than women but all we can do at this stage is speculate.

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