Depression, a lot of talk about it to this day. Yeah, but is it the end?
Paul Pancheri, well-known psychiatrist, describes it as a mode of constant human to react to a variety of causes, whether physical or mental, and psychiatry all counts among mood disorders. In fact, simplifying, depression involves a progressive lowering of mood, almost one in “switching off” the vitality typical of individual history. Generally depressed people experience feelings of sadness and lack accompanied by anxiety and possible development of real guilt. Typical is also the experience of this pessimistic, with the loss of interest and the difficulty of imagining their future, to have the “prospects.” To an outside observer the overall look of the person see an impression of neglect, the general tone is quite low and the pace is “heavy” or phlegmatic, slowed. Often there is also the combination of somatic disorders, such as decreased sleep and appetite, bowel problems and sexual dysfunction; these are frequently accompanied by a rise in blood pressure and heart rate on the one hand, and a decrease in the ‘motor activity on the other. All these manifestations are recognized indices of a general alteration of the biological life of the depressed.
We know enough about this disease and it is therefore possible to trace three characteristic features: 1) be a response to stress internal and external to the individual, 2) the “reduction” of biological and psychological functioning in response to this stress, and 3) the seasonal and familial transmission of the disorder (biological-genetic basis). More in detail, the stress surrounding acts as the “activator” of our nervous system and hormonal, sparking intense psychological and chemical reactions at the time when the individual is no longer able to cope with the environmental requirements (it is scientifically documented a substantial increase in the level of serotonin, a neurotransmitter that regulates mood, in conjunction with a depressed state).
Because only in Italy today there are about five million people who are depressed, then try to look more closely at what is depression, as enters our life, trying to identify dead ends and exits. To do this, we will borrow the example of a young man of 22 years, Joseph, nice-looking and rather nice.
When I saw him the first time it seemed like a nice guy and immediately attentive to everything around him …, a type very “quiet”. Maybe too quiet. Especially seen and considered what had happened to him.
His passion for football was great, not a day passed without training session on duty, and it was also very good. “A real talent,” said his coach a year later my knowledge of Joseph.
Unfortunately, not always in life things go as we would like, and how difficult it sometimes represents the “challenges” all our own, but they can help us grow. Should help us grow.
The fact is that Joseph, about a year before going to a psychologist for counseling, had been “rejected” in a major audition for a professional club in Serie A: among the three remaining players to only two seats available, excluded himself.
From that moment on it was a succession of events “unfortunate” because shortly thereafter he had an accident with the bike along with a friend of his in which he broke the ligaments of the knee and had had to stop with the football for about a year and a means. Also faced the end of the love story with his girlfriend that lasted for several years, a very important story for him. The sadness and despair also led to abuse drugs for about a year.
It happens that in particular moments of life, moments when one is more exposed and fragile, the occurrence of experience or of a series of contingent events negative, can act as “trigger device” of a chain reaction which often leads l ‘individual edge of the abyss. It is, as we remember Aaron Beck (1984), internationally known for his studies on depression, experiences that characterize a major loss for the individual, an experience of loss that spreads like wildfire pervading the image that the person has of herself, the world and its future (the so-called “cognitive triad”). These events may be obvious and showy, like the loss of a loved one, or more subtle and elusive as a disappointment due to the imbalance between efforts made and the final result (eg a failure or a major disappointment). The fact is that from this “negative event” the individual active cognitive models of loss, ie the preconceived negative thoughts and unchangeable (because they were considered absolutely valid) that strengthen more and more his emotional experience of defeat, contempt and mistrust. It is thus to create a “vicious circle” in which the experiences proven acting on their time on negative thoughts to structure the real beliefs. These “orient” the individual into a sort of “tunnel vision”, it is able to consider only the negative aspects of the experience and never the positive ones, or even see the negative where there is none.
It is in these moments that our defense mechanisms may come into crisis, threatening the balance staff. It is in these circumstances that human beings discover their limits and some aspects of self that until then was unknown to him or of which he had never dwelt. This puts it often faced with the difficult task of not only recognize them, but to accept them to be able to make functional changes to their personal well-being. The fact is that they are often also involved people nearest and dearest to us.
But when does the support of the other no longer enough, no longer able to console and convince us that everything will pass and better days will come? Because at some point does not “feel” more than the advice of his friend or family member that until then we have always addressed? Let us return for a moment to our case to try to answer this question.
When, in the first interview, he sat down in front of the psychologist Joseph said two things: the first was that it came from a cognitive-behavioral psychotherapy lasted two years and the other, bringing quote, “I am an unfortunate by nature.” This statement is indicative of the “underground” that supports a depression, which is only the tip of the iceberg.
Significant exclusion, compromising an accident, a “mourning” sentimental and a consequent dependence on substances …, all this had justified the earlier diagnosis of “Reactive depression strong, but without weeping with fatigue.”
Joseph had actually passed the strictly clinical phase of his depression, he had no more symptoms, but the impression was that refers to an extreme tranquility, if not bordering on indifference real, much closer to a form of motivation pervasive. It is worth noting that the risk in these cases becomes to consolidate a “psychological position of healing” that does not correspond, however, to return to a real health condition prior to the event significant.
When Joseph came to the psychologist had already started to play soccer for a year in a division clubs, from which, however, had just been sent away for poor performance and to make room for another player, finding himself thus start from the series D: asked to “find himself”, to help him to play good football again, to get out of its crisis of return.
The interesting fact is that while it appeared dejected, on the other hand was eager to show everyone what it was worth. It is in this experience was the crack for his “recovery.”
Each of us, even as a function of the moments that crosses in life, have different capacities to respond to the difficulties encountered: some knock down, some people even lose the “road”, while others continue to struggle until the end. The resilience coincides precisely with that particular skill, partly innate in part to acquire, to draw lessons from negative experiences, is in other words the ability to remain lucid in difficult times, without confusing the current experience with the previous ones, using effective strategies and ever new. It is the “do not ever let go” even when all seems lost (A. Oliverio Ferraris, 2002).
However, resilience is not only linked to the individual and its ability to react, there are also other variables that contribute to creating favorable conditions for recovery. In particular, five factors were identified in emergency management: 1) the nature of the task, and 2) the skills necessary to carry it out, and 3) personal characteristics (resources, psychic defenses), 4) social support; 5) personal history. Earlier, the type of attachment and educational style in which it is grown are all “ingredients” of resilience. A case in point in this regard is that of the well-known contemporary physicist Stephen Hawking, compared by many to Einstein. At age 21 he was diagnosed with the disease that still afflicts him and prevents him from living normally, amyotrophic lateral sclerosis. He can not move independently, it is not self-sufficient and is not able to speak, would have had to survive for three years at most. But it is still alive. It provided a unique contribution to science and has recovered from a serious depression. All thanks to the love of knowledge and a woman who supplied him with the love and understanding he needed.
But back to Joseph. After about six months of counseling, it is now back in business with himself, plays in a society of series C after a very successful season in the D series, in which he won the ranking of the top scorer with 60 goals and was awarded the best player of the tournament. His first official recognition!
What happened to him? How come that guy who no longer believed in himself was once again “turned back”? Where is the player who got angry with opponents if provoked and was then promptly sent off for foul reaction? What has changed? A distance of time it is easier to re-read its interesting case.
In fact, Joseph had to face the typical stress condition for competition, pressure from successfully faced several athletes who play sport at a certain level. Similar cases are also known to the general public through the media , see those, however recent, Marco Pantani and Diego Armando Maradona. Two former champions of cycling and football who have had to deal with stories of disqualification for doping and drug problems. Their extraordinary careers, although very different, have had an epilogue to a certain extent common, at least similar. Now we learn from the newspapers that the last people close to Pantani describe him “depressed and dejected”, telling a man crushed by the system of which it was a part; Maradona know that, after having been hovering between life and death, is detoxification phase at major clinics. The point is that both of these characters have lived in one way or another a sudden “career break”. Their lives, like others in the sports world, have known the experiences and consequences of depression.
Back in ’87 Ferruccio Antonelli and Alessandro Salvini rintracciavano in psychopathology sports real specific syndromes and nonspecific (see box), indicating, among the causes, feelings of inferiority or superiority, humiliating experiences (such expulsions, replacements, reprimands , criticism of the press or coach ..), obstacles to the achievement of objectives (injuries, transfers, exclusions from team owner …), sports extra factors (family problems, commitments …) and minor factors (environmental pressures, difficulty acclimatization, role changes, unpopularity …). Among these, depression is one of the manifestations of the success nikefobia or fear of success. Defined as a maladaptive reaction to events satisfactory, this syndrome appears to depend on reaching the top in the career of an athlete, this goal becomes a limit beyond which the individual is not able to go, not allowing them to establish new goals to be achieved . At the same time, having to maintain the high status achieved, put under pressure to “what should be” a successful athlete who wears down and knocks it down and gave him a feeling of loss.
Now, as he says EH Erikson, the crisis staff is a necessary step in the transition from one phase to another phase of the life cycle of an individual, and the suffering that accompanies it is an indispensable ingredient for its growth. Sometimes, however, the block can occur in one of these phases from which it is unable to exit, in which we fail due to the occurrence of those experiences, we have seen to be capable of triggering chain reactions very strong and to which we attribute meanings of my own. Our reactions are therefore a response to these frustrations significant for us. As in the cases of Pantani and Maradona. As in the case of Joseph.
While the sport has given Joseph a field in which to try to explore its resources and know each other better, the other has taught him to again have confidence in their abilities and above all in its possibilities. Through psychology applied to sport, Joseph could understand that, despite the unfortunate events that had occurred, however, had psychological resources and human resources to pull off and channel it effectively to achieve their athletic goals and personal. In his brief journey, Joseph felt growing within her confidence in their own abilities, he has learned to love yourself for what it was, rediscovering self-esteem. Not only the sport has allowed him, thanks to the races, to improve self-control personnel, but also gave him the opportunity to build and experiment with a better self-image, more mature and real. This process of positive change has allowed him to relativize the excessive weight that attributed to others, until then experienced as real “judges himself” now no longer needs to prove to them that failure to prove that he was not to signify the his inability, his little value. It is clear that this was only his conviction.
The case of this young man who in a few months he had the strength to change their condition, greeting the boy discouraged, irritable fragile and who was and who in the past had “pulled tricks”, should make us reflect. And ‘well known that sport produces a wide range of both physical and mental effects on the individual. While the physical benefits associated sporting activities are now under study for some time, especially in recent years is that the psychological benefits are beginning to be understood. It is recognized as a constant exercise of moderate intensity and reduces nervous tension, with effects that can last up to 4-6 hours after the activity through association with an increase in the level of endorphins in response to exercise ( endorphins are “natural tranquilizers” produced by the body that can positively alter the pain threshold, self-perception and mood) (C. Bazzano and M. Bellucci, 2001). Further confirmation comes from an interesting recent study, which showed how physical activity can even have an antidepressant effect, reducing the symptoms of non-psychotic depression (Moore, ’99). Some scientific studies have documented the correlation between psychological well-being and physical activity (Nieman DC, ’95) as shown in Fig 1.
Certainly the sport, according to current knowledge, has a beneficial effect on anxiety predominantly transient than on personality already laid out, but the “medicine of physical exercise” (C. Bazzano and M. Bellucci, 2001) could be one of the ways future to reduce the indiscriminate use of analgesics, antidepressants, sleeping pills or tranquilizers, promoting instead the opportunity to regain their physical and psychological health, “mens sana in corpore sano.”
And this is what happened to Joseph. He discovered a psychology that through sport made him embark on a new challenge that perhaps will never end: that of continually put to the test to overcome difficulties and continue to grow. And if it is true that a sport too exaggerated in the pursuit of victory puts the individual under stress, bringing it close to the robot more than the human being, it is equally true, as shown by recent scientific data, which is in the same sport that we can find the elements of the care and treatment of certain emotional disorders: Depression is one of these disorders.
C. Bazzano, M. Bellocci “Efficienza fisica e benessere psicologico”, EMSI – Roma, 2001
A. Oliverio Ferraris, “La forza d’animo”, Rizzoli – Milano, 2002
P. Pancheri, “Manuale di Psichiatria Clinica”, Bulzoni Editpre – Roma, ’74
A. Beck, “Principi di terapia cognitiva”, Astrolabio – Roma, ’84
F. Antonelli, A. Salvini, “Psicologia dello sport”, Edilombardo – Milano, ’87