Self-Management of Depression

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...

“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 ...

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...

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...

Change is not easy, especially when trying to break bad habits or desiring to keep the good ones going beyond a few days. Most people blame this on lack of motivation. Researchers have written at length about types of motivation such as intrinsic and extrinsic motivation, but most of these discourses fall short of realistic ways to enhance motivation. In this context,  DARN offers a simple yet practical tool to increase one's motivation to change.  DARN  is an acronym which stands for: Desire , Ability , Reasons , and Need . These represent four types of self-talk that people contemplating change engage in (Miller & Rollnick, 2013). Use this approach to ask yourself evocative questions that tap into your intrinsic motivation.  Desire:   Desire is wanting to have something or wanting a change. Examples include, “I want to exercise more” or “I would like to eat healthy.” Ask yourself the following questions to elicit your desire to change. What am I h...