Self-Management of Depression

“Feelings of worthlessness or excessive guilt or inappropriate guilt” is one of the nine core symptoms of major depressive disorder according to the American Psychiatric Association. Guilt can be an adaptive emotion when it is appropriate to context, is not excessive, is based on altruism (acting with an unselfish regard for others), and serves the purpose of maintaining attachments. However, in depression, guilt tends to be exaggerated or is inappropriate (not relevant to context) and is called maladaptive guilt. Maladaptive guilt presents in depression in one or more of the eight types as described below: 1. Survivor guilt: Survivor guilt first gained attention when survivors from the concentration camps of World War II were noted to harbor feelings of guilt for the loved ones who were killed in the camps. These survivors, years later, developed symptoms of depression and anxiety. Besides combat and natural disasters, survivor guilt has also been observed in medical situations....

Self-Help Vs Self-Management You probably have heard the term “self-help” and may have also read a few self-help books. When it comes to treating depression, most self-help books focus on the 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 particular 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). Self-management, besides treating depression, also prevents relapse of depression and helps an individual maintain good mental health on a day-to-day basis. 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 trea...

We all like getting approval and recognition from others. Approval-seeking is good as long as it remains a desire or a want. For example, your boss approves of your work and you feel happy about it. When approval-seeking turns into a need or a necessity, then you become a victim of the “approval trap” that will either make you vulnerable for depression or, if you are already feeling depressed, will make your depression worse. If you have low self-esteem, which is not uncommon in depression, and seek approval to give yourself a temporary boost, then you are setting yourself up for the “approval trap.” The trap works somewhat like this:    Depression causes you to feel worthless → when you get approval from others, you feel better and less worthless → you try to seek more approval → in seeking more approval, you do things you don’t want to do to please others and avoid your own needs → others get used to your approval-seeking behavior and stop approving your behavior → you ...

Feelings of worthlessness and low self-esteem represent key symptoms of depression.  Self-worth is how you value yourself as a human being or your overall opinion of yourself. Self-worth has also been equated with self-respect – having respect for one’s abilities. People with depression experience feelings of worthlessness or low self-esteem in thoughts as: “I am worthless” “I am inadequate” “I am incompetent” “I am bad” “I am a failure” “I am a loser” “I am ugly” “I am no good” “I am immoral” “I am stupid” “I am a fake” In depression, most thoughts of worthlessness represent irrational thinking patterns such as all-or-none thinking, overgeneralization, labeling (putting negative labels on self), and magnification (blowing things out of proportion). For example, you get an average evaluation in one area of your job performance compared to above average in other areas and you start feeling that you are incompetent. Or worthlessness can be also be trigge...

                                SWOT is an acronym for Strengths, Weaknesses, Opportunities, and Threats. SWOT analysis is a tool businesses and organizations use for strategic planning. The tool serves as a guide for organizations to leverage their strengths, address their weaknesses, explore external opportunities, and protect themselves from external threats. You can use the same tool to strategize your life goals and treatment goals. This tool will enable you to appraise your positive and negative attributes regarding a particular goal or situation, assess the impact of external factors on that goal or situation, and guide you in making rational choices based on this analysis. SWOT is described below: Strengths: These are the tangible or intangible internal positive attributes you can control. In addition to your character strengths, your strengths include your knowledge, skills, abili...

Procrastination is putting off things for another day or doing things that are not productive as an excuse for 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 quick relief from the anxiety associated with a task, which then reinforces this behavior. We all have procrastinated at one time or another. Still, 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 ...

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 are 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, ...

Family and friends are one's 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 burdening others, and there's also a 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. You must educate your family about depression using scientifically based information. Local chapters and websites for organizations such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance (DBSA) have information for family members and friends regarding depression. Information about depression is also available on the National Institute for Mental Health website. You also have to advocate for yourself in how you want to be trea...

We live in a society where it is impossible to escape comparisons. Growing up, your parents probably compared you with other siblings and in school you compared yourself with other students. As an adult, you continue to compare yourself with your peers at work, your neighbors, your friends and relatives, and people you come across on social network sites or other media outlets. There are two kinds of social comparisons (Taylor & Lobel, 1989): 1. Upward social comparison: You compare yourself with others whose performance and abilities are better than yours. 2. Downward social comparison: You compare yourself with others who are less fortunate than you are in the attributes you are comparing. People compare themselves to others when they need an external standard against which to judge their abilities or opinions (Festinger, 1954). Comparison helps you manage your negative mood, especially with downward comparison, which makes you feel better realizing that there are people who...