Self-Management of Depression

A right match between you and your mental health professional is key to your wellness and recovery from depression. If you are looking for a therapist, the most important thing to inquire about is whether they use evidence-based psychotherapy to treat depression. Cognitive-behavioral therapy (CBT) and Interpersonal psychotherapy (IPT) are two modalities of psychotherapy that have the most evidence to support their first-line use for treating acute depression (Parikh et al., 2009). There is some evidence to suggest that CBT may be more effective than IPT in individuals with severe depression, but the two are comparable for treating mild and moderate depression (Luty et al., 2007). Questions to ask yourself during your first visit with the mental health professional “How did you get your training in CBT (or other therapy modality)?” “How much experience do you have with these approaches?” “What are your professional credentials?” “What kind of methods would be used during the therapy?”...

When one is feeling low, it doesn’t necessarily mean that one is going through the throes of clinical depression, i.e., major depressive disorder. There are several conditions that may mimic clinical depression but don’t reach the severity or pervasiveness of the former condition or are symptomatically distinct. It is important to recognize these so that one may not unnecessarily get prescribed medications or started on psychotherapy as some of these conditions are time limited or may remit on their own. At the same time, some of these conditions such as complicated grief may need specialized therapy. Conditions that resemble depression but are not depression include the following: Sadness: Depression is more than the normal pangs of sadness one gets when experiencing a stressful situation. Depression is a more pervasive and persistent change in your mood along with changes in your physiological functions such as sleep, appetite, and energy level. Although stress can trig...

With strategies such as Transcranial Magnetic Stimulation (TMS), Ketamine, and psychedelics becoming more prevalent for treatment-resistant depression, it is helpful to take a look at what this entity really means. Not everyone who is being referred for either TMS or treatment with Ketamine may have "true" treatment-resistant depression, and then there is what is called "pseudo-resistance." In simple terms, treatment-resistant depression implies that depression has not reached sufficient remission after adequate treatment. Remission is defined as clinical improvement with few signs of depression still remaining and a lower likelihood of subsequent exacerbations. About 15% of people with depression may eventually develop treatment-resistant depression (Berlim & Turecki, 2007). Treatment-resistant depression has been variously defined, but the most commonly accepted definition is as follows (Souery et al., 2007): A person with depression is considered ...

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...

The acronym “ABCDE” refers to certain types of communication behaviors that increase conflict and marital/intimate relationship distress. These behaviors get heightened when one is depressed, as depression rekindles negative, irrational thought patterns such as all-or-none thinking, overgeneralization, jumping to conclusions, blowing things out of proportion, taking things personally, disqualifying positives, and negatively labeling oneself or others. Here's what you need to avoid during communication with your partner (Beach et al., 1998; Christensen et al., 2014; Starr & Davila, 2008): A ccusation:  Accusations usually are “You always …” or “You never…” statements. Accusations may have some kernel of truth in them, but that gets exaggerated and dramatized by the heat of the argument. Accusations lead to counteraccusations and defensiveness, taking the focus away from one’s own shortcomings and from resolving the conflict at hand. B lame:  Individuals may b...

If you are human, you will be on the receiving end of criticism. Criticism can be helpful, especially if it provides you feedback for improvement whereas at other times it is tantamount to bullying. Therefore, criticism needs to be handled depending on its type (Lazarus & Lazarus, 2000). 1. Irrelevant criticism: This kind of criticism comes from an individual who is critical of everyone or everything to the extent that they would make critical comments about something that is totally out of context and not relevant to the situation. For example, you are talking to your neighbor about an upcoming vacation you are planning and in the midst of your conversation, your neighbor states “….by the way you appear to be gaining weight.” Irrelevant criticism doesn’t deserve your response and is best ignored. Say, “OK, I appreciate you letting me know” and shift back to the conversation on hand. 2. Vague criticism: In this type of criticism, you are not sure if the person critici...

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...

You probably have heard or read a few self-help books on depression. Here's a new book  The Complete Guide to Self-Management of Depression ,  which to date is the most comprehensive self-help book on depression, and will change how depression is treated in the future. What makes this book different from others is highlighted by the following features unique to this book: 1. Depression is a complex illness, which presents in a myriad of ways and almost 60-70% people treated with antidepressants fail to achieve a symptom-free state when first treated with these medications. The treatment of depression cannot be pigeon-holed into one or two kinds of treatment modalities. This book offers the reader a broad menu of options for self-management of depression above and beyond medications. 2. Self-management is increasingly becoming the standard of care in people with long-standing medical conditions. Self-management puts one in the driver's seat with regards...

People with depression often have negative or irrational beliefs, which continue to fuel their depressive thinking. According to the cognitive model of depression, the emotions in depression such as sadness, guilt, hopelessness, worthlessness, helplessness, anger, frustration, and anxiety are triggered by a dysfunctional thought process. This dysfunction involves misinterpretation or misattribution of situations, past events, memories, and even feelings leading to irrational thoughts – also called cognitive distortions – that in turn perpetuate depressive symptoms. These irrational thought patterns are described below: 1. All-or-None Thinking: This type of irrational thinking is also called black-and-white thinking or dichotomous thinking. This is thinking in extremes or absolutes with no consideration for any alternatives in between the extremes. For example, if you get a below-average performance evaluation and feel that you will never get a good performance evaluation in th...