What is self-management?
You probably have heard the term “self-help” and may have also read a few self-help books. Most self-help books on depression focus on acute treatment of depression based on a particular model of therapy, usually the Cognitive-Behavioral Therapy (CBT). While the self-help approach tries to address a condition using a focused treatment modality over a short period of time, self-management is learning new ways to manage an illness over a longer period of time. In other words, self-management is using the resources and learning the skills to “positively manage” an illness (Lorig et al., 2006). Lorig and colleagues (2006) further elaborate on self-management; it is a “management style” wherein you are a positive self-manager who not only uses the best treatments provided by healthcare professionals, but also approach your illness in a proactive manner on a daily basis, leading to a more healthy life. For example, good self-managers of diabetes, besides taking medications, educate themselves about diabetes, learn to recognize symptoms of low or high blood sugar, monitor their blood sugar levels regularly, eat healthy and avoid foods that may destabilize their diabetes, exercise to maintain their weight, and seek professional help if their blood sugar levels are staying above or below their normal range. The same strategies can be used to self-manage depression.
What are the key components of self-management?
The key components of self-management include the following (Barlow et al., 2002):
· Educating self and family members/friends about depression.
2. Medication management:
· Taking medications as recommended by your provider.
· Overcoming barriers to adherence to medications.
3. Symptom management:
· Using various strategies (e.g., cognitive, behavioral, mindfulness, etc.) to manage symptoms of depression.
· Self-monitoring of symptoms using validated assessment tools.
· Managing concurrent symptoms of anxiety and/or substance use.
· Using techniques to deal with frustration, fatigue, pain, and isolation.
· Managing sleep.
· Managing symptoms of medical conditions that may be associated with depression.
· Using strategies for preventing relapse of depressive symptoms.
4. Life style:
· Overcoming barriers to exercise adherence.
· Leisure activities.
· Nutrition and diet.
5. Social support:
· Family support.
· Relationships with peers and friends.
· Communication strategies (e.g., with mental health professionals).
· Accessing support services.
· Creating action plans.
· Decision making.
· Goal setting.
· Problem solving.
· Career planning.
Unfortunately, most of the available self-help books on depression fall short of covering a majority of these essential ingredients of self-management. Depression cannot be treated by one-size-fits-all strategies as suggested by many of these books.
Empower Yourself with Self-Management
Healthcare is moving toward a model of client-centered care. In this model, clients are partners in decisions related to their healthcare and collaborate with their healthcare providers to prioritize and set goals and choose interventions for their illness. In this context, self-management strategies prepare you to be an active player in your own treatment rather than being a passive recipient. With self-management, you assume the primary responsibility of your treatment, though with support from your provider and your social network.
Self-management techniques enhance your confidence and give you a sense of control in dealing with depression. Depression can make you doubt your capability for dealing with stress or sometimes even mundane day-to-day stuff. Learning self-management skills is an antidote to these negative feelings and enhances your self-efficacy. Self-efficacy is your belief that you are capable of making changes to your life to accomplish a desired goal and is a key ingredient for the success of any self-management program. In other words, self-efficacy means that the stronger you believe that you will succeed in performing a task, the more likely you will attempt to finish that task.
To learn more about self-management techniques for depression, please refer to the evidence-based bestseller The Complete Guide to Self-Management of Depression: Practical and Proven Methods. This comprehensive and easy-to-read book offers the reader a menu of options to self-manage depression that go above and beyond the traditional approaches to treat depression and includes complementary and alternative medicine approaches, exercise, mindfulness, role of social support, and bright light therapy. Besides therapy techniques, the book also provides an evidence-based overview of the role medications in treating depression - when to take them, how long to take them, when and how to stop them, and what to do when medications stop working.
HARPREET S. DUGGAL, MD, FAPA
Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: a review. Patient Education and Counseling, 48, 177-187.
Lorig, K., Halsted, H., Sobel, D., Laurent, D., Gonzalez, V., & Minor, M. (2006). Living a healthy life with chronic conditions (3rd ed.). Boulder, CO: Bull Publishing Company.