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Anger Problems? Find the “Should” Behind Your Anger

We experience anger when our unrealistic demands, conceptualized in our minds as “should” or “musts,” are not met. Examples include, “I should work harder,” “People should treat me fairly,” “You must do what I tell you to do,” “I shouldn’t be angry,” etc. “Should” and “must” statements arise from either moralistic rules or perfectionistic demands that we hold ourselves and others to. Irrational should statements rest on your assumption that you are entitled to instant gratification. However, life being what it is, does not respect your “shoulds” or “musts.” Moreover, there is no law that says we should get what we want, any more than other people always get what they want.
How do you handle the “shoulds”? 1. Eliminate the words “should” and “must” when talking about expectations and replace them with “I hope,” or “I wish,” or “I prefer.”  For example, “I wish things were different,” “I hope I can do well, but I can tolerate not being perfect,” “I wish things were different,” etc. In co…
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Procrastination in Depression: The Motivation Myth

Procrastination is putting off things for another day, or doing things which are not productive as an excuse of not doing what is important. Dr. Wayne Dyer (1995) in his book, Your Erroneous Zones, provides the rationale behind procrastination as a thought process which is something like this: “I know I must do that, but I am really afraid that I might not do it well, or I won’t like it. So, I will tell myself that I will do it in the future, then I don’t have to admit to myself that I am not going to do it. And it is easier to accept myself this way.” This temporary avoidance gives you a quick relief from the anxiety associated with a task, which then reinforces this behavior. We all have procrastinated at one time or the other, but in depression, procrastination becomes more complex due to the self-defeating attitudes of perfectionism (“I can do things only if I can do them perfectly”), hopelessness (“My low motivation and low energy levels are never going get better”), and fear of …

How to Find the Right Mental Health Provider for Depression?

A right match between you and your mental health provider is key to your wellness and recovery from depression. If you are looking for a therapist, the most important thing to inquire is if they use evidence-based psychotherapy to treat depression. Cognitive-behavioral therapy (CBT) and Interpersonal psychotherapy (IPT) are two modalities of psychotherapy that have the most evidence to support their first-line use for treating acute depression (Parikh et al., 2009). There is some evidence to suggest that CBT may be more effective than IPT in individuals with severe depression, but the two are comparable for treating mild and moderate depression (Luty et al., 2007). In addition, ask the prospective therapist the following questions:
“How did you get your training in CBT or IPT?” You are not looking for a therapist whose only training was a weekend workshop.“How much experience do you have with these approaches?”“What are your professional credentials?”“What kind of methods wou…

What Depression is Not

When one is feeling low, it doesn’t necessarily mean that one is going through the throes of clinical depression, i.e., major depressive disorder. There are several conditions that may mimic clinical depression but don’t reach the severity or pervasiveness of the former condition or are symptomatically distinct. It is important to recognize these so that one may not unnecessarily get prescribed medications or started on psychotherapy as some of these conditions are time limited or may remit on their own. At the same time, some of these conditions such as complicated grief may need specialized therapy. Conditions that resemble depression but are not depression include the following:
Sadness: Depression is more than the normal pangs of sadness one gets when experiencing a stressful situation. Depression is a more pervasive and persistent change in your mood along with changes in your physiological functions such as sleep, appetite, and energy level. Although stress can trigger a depressi…

What is Treatment-Resistant Depression?

With strategies such as Transcranial Magnetic Stimulation (TMS) and Ketamine becoming more prevalent for treatment-resistant depression, it is helpful to take a look at what this entity really means. Not everyone who is being referred for either TMS or treatment with Ketamine may have "true" treatment-resistant depression and then there is what is called "pseudo-resistance."
In simple terms, treatment-resistant depression implies that depression has not reached sufficient remission after an adequate treatment. Remission is defined as clinical improvement with few signs of depression still remaining and a lower likelihood of subsequent exacerbations. About 15% of people with depression may eventually develop treatment-resistant depression (Berlim & Turecki, 2007). Treatment-resistant depression has been variously defined, but the most commonly accepted definition is as below (Souery et al., 2007):
A person with depression is considered to have treatment-resistant …

When Feeling Depressed, Don’t Defend Your Vulnerabilities with Anger

Anger, irritability, and frustration may not be the core symptoms of major depression in adults, but almost 50% of people with major depression experience these symptoms (Fava et al., 2010; Judd et al., 2013). In addition, irritability may be the main presentation of mood in children and adolescents with depression. Having irritability and anger while being depressed is a double whammy. Overt irritability and anger during an episode of major depression is associated with greater severity of depression, longer duration of the episode of depression, poorer impulse control, a more chronic and severe long-term course of depression, higher rates of lifetime substance use and anxiety disorder, and greater psychosocial impairment (Judd et al., 2013).
When feeling depressed, you may be masking your more vulnerable feelings of hurt, guilt, shame, grief, or fear with anger or irritability. Depression causes the emotions that make you feel more vulnerable not come to the surface as you are uncert…

What You Need to Tell Family and Friends When You are Feeling Depressed

Family and friends are your immediate support system. Individuals with depression may avoid sharing their symptoms with their family or close friends due to the perceived stigma. Some don’t share their feelings to avoid being a burden on others and then there is this fear of being perceived as weak and needy. Unless you have a very critical and judgmental person who is not accepting of depression as an illness, your family and friends would appreciate your efforts to reach out and be candid about your depression. It is important that you educate your family about depression using scientifically-based information. Local chapters and websites for organizations such as the National Alliance for the Mentally Ill (NAMI) and the Depression and Bipolar Support Alliance (DBSA) have information for family members and friends regarding depression. Information about depression is also available at the National Institute for Mental Health website. You also have to advocate for yourself in how yo…