Self-Management of Depression

Rumination is a maladaptive style of responding to stressful situations in which a person repetitively and passively focuses on the symptoms of distress and the possible causes and consequences of these symptoms. Ruminators mistakenly believe that by focusing on their past feelings, they can somehow better understand their emotions, and this will help them solve their problems. The opposite is true: rumination makes people more fixated on their problems and feelings without leading to any active problem-solving to change the circumstances around these symptoms. Research shows that women are more likely to engage in rumination compared to men, which also makes them more prone to depression (Nolen-Hoeksema et al., 2008). Rumination fosters inactivity and can come in the way of getting things done. Many people confuse rumination with worry, but these two entities differ in the following ways (Lyubomirsky et al., 2015): Rumination focuses on the past, while worry focuses on the futur...

Too often we come across quotes in social media on the lines, "The older I get, the less I care about..." or the "The older I get, the more I appreciate..." Do we have to really wait for our golden years to find meaning in life? The answer is a resounding no. Since the dawn of time, poets, philosophers, theologists, and scientists have tried to make sense of the concept of meaning in life. As much as meaning in life is viewed as an amorphous psychological concept, there are tangible ways to explore one's meaning in life. Here's where values come into the picture. Value-focused exercises give you an insight into what really matters in your life.  These exercises also make you aware of the discrepancies between what you are pursuing in your life at present and what you really want your life to stand for. This discrepancy generates the drive and motivation to pursue goals that are more in line with your values. Also, these exercises help you reconsider the imp...

Anger is a normal emotion that we all experience in our daily lives. Not all anger is bad; it can help you focus on self-defense, mastery, and control, especially when you perceive that your goals are being blocked (Linehan, 2015). But anger can also become problematic if it is disproportionate to the triggering situation, leads to aggression or destruction, or occurs too frequently. People differ in how they express anger. What may make one individual angry may not be perceived as anger-provoking by another individual. In Aristotle's words, which ring true even today, "Anybody can become angry-that is easy, but to be angry with the right person and to the right degree and at the right time and for the right purpose, and in the right way-that is not within everybody's power and is not easy."  While it may not always be possible to predict when one may get angry, trying to understand the reasons behind this variation in the expression of anger would help one become mor...

If you are human, you will have problems. Having problems means that you are normal, and solving them means you are a happy normal! While the traditional therapy approaches focus on the “why” of a problem, Solution-Focused Brief Therapy (SFBT) moves the focus from the “why” of a problem to “how it can be solved.” Evidence suggests that SFBT is effective for treating mild or moderate depression and has also been widely used as a life-coaching strategy (Gingerich & Eisengart, 2000; Kramer et al., 2014). Here are five questions used in SFBT that you can ask yourself to find solutions for problems that impede your goals (Grant & Greene, 2001; Simon & Berg, 1997). 1. The miracle question: The miracle question goes like this: “Suppose one night, while I am asleep, there is a miracle and the problem that I am facing is solved. However, because I am asleep, I don’t know that the miracle has already happened. When I wake up in the morning, what will be different that will tel...

What is Measurement-based Care? Measurement-based care is extensively used in medical conditions and involves matching treatment interventions with the outcomes for those treatments. For example, a provider would periodically measure fasting blood glucose or glycosylated hemoglobin in an individual with diabetes to make adjustments to the treatment plan, including medication and lifestyle changes. Measurement-based care fosters self-management by making the individual aware if they are on the right treatment plan or if they need to modify it in collaboration with their provider. While measurement-based care has been proven to improve outcomes for medical conditions, mental health, unfortunately, has lagged behind in adopting it as a regular practice. Measurement-based care in depression is an algorithmic application of published, accepted, clinical guidelines and consists of four steps (Morris et al., 2012): Step 1: Screening: Your provider may use one of the several available tools ...

What is Behavioral Activation? When it comes to treating depression, most mental health professionals talk about either medications or therapies such as cognitive therapy. These are, no doubt, clinically relevant treatments for depression. However, with the recent emphasis on treating the "chemical imbalance," simple treatments for depression such as behavioral activation have been sidelined. Behavioral activation is an evidenced-based treatment for depression and complements other treatments of depression (American Psychiatric Association, 2010). In fact, research demonstrates that in individuals with severe depression, behavioral activation is comparable to antidepressant medication and better than Cognitive Behavioral Therapy (Dimidjian et al., 2006). Avoidance is a key target for change in behavioral activation. The lack of energy and motivation in depression can result in people with depression either cutting back on pleasurable activities or not enjoying them as they ...

If you are receiving mental health care, the treatment plan is a key document that you will develop in collaboration with your treatment provider. The treatment plan lists your treatment goals, the types of interventions that will be used, and how outcomes will be measured. In addition to these generic elements of a treatment plan, a personalized treatment plan also incorporates your strengths, needs, vision of your own recovery, and desired quality of life.  6 key elements of a treatment plan A successful personalized treatment plan has the following six attributes (Adams & Grieder, 2005): Is centered on your goals and values Respects your experience in dealing with your mental health issues Addresses not only managing symptoms but also learning to successfully cope with life’s challenges and building resilience Empowers you to move toward self-management of your mental illness Focuses on positive functioning in a variety of roles and building positive relationships Is oriente...