Self-Management of Depression

Although we have all heard the medical profession touting the health benefits of physical activity and exercise, most of us don’t regularly engage in this inexpensive health-promoting behavior. In addition to preventing chronic medical conditions, growing evidence demonstrates that physical activity and exercise improve mental well-being and have a buffering effect on depression. A review of the literature showed that a higher level of baseline physical activity was associated with decreased risk of developing depression in the future (Mammen & Faulkner, 2013). Even low levels of physical activity, such as walking less than 150 minutes per week, can prevent future depression. Another study demonstrated that individuals who engaged in physical activity for more than 30 minutes a day had a 48% lower risk of being depressed at follow-up compared to individuals who didn’t engage in physical activity (van Gool et al., 2006). Interestingly, the same study also showed that each minute of ...

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...

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 Optimism? Optimism is the belief that you can somehow accomplish your goals. Expressed in everyday life terminology, optimism is looking at the bright side, seeing the glass as half-full rather than half-empty, finding the silver lining in a cloud, feeling good about your future and the future of the world, believing that defeat is a temporary setback and not your fault, and confronting a difficult situation and trying harder (Lyubomirsky, 2007; Seligman, 2006). A simple way to look at optimism is to ask yourself, “In the face of difficulties, do I nonetheless believe that I can achieve my goals?” If yes, then you are optimistic; if no, you are pessimistic (Peterson, 2000). An important lesson here, however, is that being optimistic doesn’t mean denying the negative, avoiding all unfavorable information, or constantly trying to control situations that cannot be controlled. What is Your Best Possible Self? The Best Possible Self exercise is the most studied optimism inter...

Humor has been used both as a coping strategy and a therapeutic tool for a long time for reducing anxiety, depression, anger, and pain (Weisenberg et al., 1995). The field of positive psychology has recently brought humor to the forefront as a psychotherapy intervention, especially for depression and anxiety (Sarink & Garcia-Montes, 2023). Of the various types of humor, the one most associated with well-being is self-enhancing humor. This involves a generally humorous outlook on life, a tendency to be frequently amused by life's incongruities, and a humorous perspective even in the face of stress (Martin et al., 2003). Self-enhancing humor is associated with greater cheerfulness, self-esteem, optimism, psychological well-being, and satisfaction. People with depression may be less reactive to humor due to a diminution in their sense of humor, and they also tend to use humor less often as a coping strategy (Falkenberg et al., 2011). In addition, individuals with depression m...

Improving communication is a proven intervention for improving relationships and entails not only learning how to address negative issues in a relationship but also how to consistently express positive feelings to each other. When you communicate, you are doing one of three things: 1. Speaking: Sending a message or sharing your thoughts or feelings. 2. Listening: Hearing and paying attention to what the other person is telling you. 3. Responding: Replying or answering back to your partner after listening to them. Failure to communicate can stem from a problem in any or all of these communication processes. Below are some guidelines to improve your communication skills (Duggal, 2018): Improving Speaking Skills  Establish and maintain eye contact with your partner to ensure they know you're paying attention. Speak in a clear and direct fashion. Don’t beat around the bush and play games. Make sure that what you are communicating is in line with your non-verbal communica...

When good fortune knocks, our first response is often to contact significant others to share the news. Sharing good news with others promotes well-being by enhancing positive emotions and satisfaction in one's life (Gable et al., 2004). That's obvious. Here's the catch! It's not the sharing of good news per se, but how one responds to the good news that actually determines its positive impact on a relationship. Gable and colleagues elaborate that people respond to their partner’s sharing of good news in four different ways. Below is an exercise to gauge what your partner’s response to your sharing of good news is (or what your response is being perceived by your partner) (Gable et al., 2004): "Please take a moment to consider how your partner responds when you tell him or her about something good that has happened to you. For example, imagine coming home and telling your partner about receiving a promotion at work, having a great conversation with a family mem...

Are You Worrying About Not Sleeping? If you are prone for insomnia, then you are already going to bed preoccupied with getting to sleep quickly and obtaining as much sleep as possible. You also worry about the impact of sleep on your physical health and daytime functioning. These excessive worries and ruminations trigger in you a state of physical arousal and emotional distress through activation of the sympathetic nervous system similar to the fight-or-flight response. This arousal and anxious state then narrows your focus to attend to and monitor for sleep-related cues such as: Body sensations for signs consistent with falling asleep: slowing of heart rate and loss of muscle tone.  Body sensations for signs inconsistent with falling asleep: heart pounding quickly and muscle tension.  Surroundings for signs of not falling asleep: noises outside and inside the house.  The clock to see how long it is taking you to fall asleep: “It is 1:30 a.m….I have been trying t...

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 ...

You may have a hard time saying no to other people because you are afraid that you will hurt others, appear selfish, look as if you don’t care, or risk a relationship. You may also want people to like you and, especially if you struggle with self-esteem issues, saying "no" may be contrary to your subconscious approval-seeking tendencies. However, you may not have the energy or motivation to do what others want you to do. You then struggle to accomplish what you have said “yes” to, which drives more guilt. You can break this guilt cycle by learning to say “no.” Why is it okay to say “no”? Here are a few good reasons why it is okay to say “no”: Accept that you are not a superhuman who can do everything that everyone wants. Saying “no” doesn’t make you selfish, as you have said “yes” several times to several people in the past. By saying “no,” you are only trying to strike a balance between how much responsibility you can and cannot handle. Pleasing everyone every time b...