Self-Management of Depression

What is Recovery? The dominance of the medical model in mental health often reduces recovery to merely reaching a certain score on rating scales like the Patient Health Questionnaire-9 (PHQ-9), which is commonly used to measure depression. This narrow perspective overlooks other vital aspects of recovery beyond clinical response, as shown by many studies (Andresen et al., 2003; Jorge-Monteiro & Ornelas, 2015). Some of these overlooked facets of recovery include: Hope for the future. Re-establishment of a positive identity. Establishment of personally meaningful goals. Taking responsibility for one’s life. Feeling included and connected to others. Feeling empowered. Contributing to community life. Building on this broader understanding, recovery involves managing one’s mental illness, transcending its negative impacts, and striving for a meaningful life. The concept of recovery can vary among individuals, and some common expressions people use to describe their recovery include the ...

If you have felt the urge to offer someone an opinion or solution even when one is not solicited, you have been giving in to what is called the righting reflex—the desire to fix what seems wrong with people and to set them promptly on a better course (Miller & Rollnick, 2013). Though natural and well-intentioned, this urge to fix someone else's problems can significantly damage interpersonal relationships by causing resistance, defensiveness, and resentment. It often hinders effective communication and prevents the other person from finding their own solutions. How the righting reflex negatively affects relationships Creates resistance and defensiveness: When you jump in to fix a problem, the other person can feel like you are criticizing their judgment or ability to handle their own issues. This can lead them to argue against your suggestions or defend their current choices, creating an unproductive conflict. Shifts the dynamic to a parent-child relationship: This behavior po...

Approximately 30% of individuals with depressed mood develop a chronic course as defined by the criteria for persistent depressive disorder (PDD) (Struck et al., 2021). Research shows that depressed individuals have difficulties in handling another person's negative state or suffering, getting overwhelmed in emotionally tense situations, a condition called empathic distress. This leads to an avoidant interpersonal style due to fear of interaction with others, which in turn deprives these individuals of positive interpersonal experiences, thus perpetuating depressive symptoms (Struck et al., 2021). Situational analysis is a technique used in the Cognitive Behavioral Analysis System of Psychotherapy (CBASP). CBASP is one of the few psychotherapies effective for chronic depression and PDD (Wiersma et al., 2014; Wiersma et al., 2021). CBASP combines behavioral and cognitive strategies with a problem-solving focus and emphasizes interpersonal issues. Its primary goals are to help indivi...

We have all heard the phrase “every cloud has a silver lining,” which suggests that there is something good in every outcome, no matter how difficult or challenging the situation may be. This is also relevant when it comes to using optimism as a tool to overcome depression. When going through the throes of depression with its propensity to see everything in a negative light, being optimistic can be challenging. However, one can still find optimism even in adversity and suffering as did Victor Frankl during his years in the World War II Nazi concentration camp (Frankl, 2006). Frankl describes “tragic optimism” as: Feeling optimistic in the face of tragedy Making the best of any given situation Turning suffering into a human achievement and accomplishment Using guilt as an opportunity to change yourself for the better Using the knowledge that life is transitory as an incentive to take responsible action If you can learn to identify something good in a bad situation, then finding the one...

There are some social rituals we cannot avoid, especially when interacting with people we don’t know, and nothing is more universally disliked than small talk. Small talk is a fine art that balances the use of some better questions to open the conversation and then navigate the talk without lingering on obligatory foundational topics about how one’s weekend was or discussing the weather. If you find yourself avoiding social interactions because you're uncomfortable and embarrassed about small talk, here are eight ways to improve at it and avoid making it awkward or superficial (Duhigg, 2024; Haupt, 2023; Lee, 2025). 1. Ask better questions. To facilitate conversation, avoid conversational dead-end questions that can be responded to in a single word, such as "How was your weekend?" or "How are you?" Also, avoid fact-based questions like "Where do you live?" Instead, ask questions that invite people to elaborate on their experiences: "What was t...

Urge surfing is a mindfulness-based technique to help individuals manage and overcome cravings and impulses. Developed by clinical psychologist Alan Marlatt, urge surfing involves observing and riding out the waves of urges without giving in to them (Marlatt et al., 2004). This technique is particularly useful for individuals dealing with substance abuse, overeating, or other compulsive behaviors (Bowen & Marlatt, 2009). Urge surfing is also a popular emotion regulation skill in Dialectical Behavior Therapy (DBT) (Linehan, 2015). Emotions prompt behaviors (e.g., fight in anger, flight in fear) and prepare the body for action. Urges are the precursor to action, and urge surfing curbs emotional triggers that lead to maladaptive actions. Urge surfing is based on the premise that cravings and urges are like waves in the ocean. They rise in intensity, reach a peak, and then gradually subside. By visualizing urges as waves, individuals can learn to "surf" rather than being over...

Cognitive Behavioral Therapy (CBT) is one of the most proven psychotherapies for depression and anxiety. It involves identifying, challenging, and replacing irrational thought patterns, also called cognitive distortions, with rational thoughts. However, not everyone is successful in doing so. A key reason for this is when one harbors deeper irrational thoughts, called core beliefs, which are harder to change as they sit at a subconscious level.   While identifying your superficial irrational negative thoughts, also called automatic thoughts, as a part of CBT, you may realize that some of these thoughts can be lumped under common themes. These underlying thinking patterns are called core beliefs or schemas. Whereas automatic thoughts are at the surface of your awareness and more straightforward to recognize, core beliefs are not that readily accessed or easily articulated. Core beliefs or schemas represent a set of attitudes, assumptions, conceptions, preferences, goals, and va...

Imagine you are invited to a friend’s house and, upon entering, you see a group of people laughing loudly. You can react to this situation in a couple of ways. You might think something is wrong with your appearance, making you feel that people are laughing at you. Alternatively, you might interpret their laughter as a sign that they are having a good time, and you feel ready to join in the fun. This situation can evoke two responses: one makes you feel embarrassed, while the other makes you happy. So, what causes people to experience various emotions in the same situation? It’s all about how you interpret the scenario. Your beliefs influence your interpretation, which is the “B” in the “ABC” framework we will explore next. Albert Ellis (1962), the founder of Rational Emotive Behavior Therapy (REBT), introduced the “ABC” framework as a cognitive model for depression. “A” represents an activating event to which an individual responds. This can include current or past events, thoughts, f...

What is loneliness? Loneliness is a fundamental aspect of life; at some point, everyone will experience it to varying degrees. Even though it is recognized as a public health concern (Office of the Surgeon General, 2023), there is still a need for more discussion about what the experience of loneliness entails and how to recognize it in oneself or others. For starters, loneliness is the distressing feeling you experience when there is a discrepancy between the interpersonal relationships you wish to have and those you currently have (Peplau & Perlman, 1982). It is not the number or frequency of social contacts but your subjective appraisal of the quality of relationships and the satisfaction with the relationships that influences loneliness (Heinrich & Gullone, 2006). Moreover, loneliness is not synonymous with social isolation, nor is it an inevitable consequence of being alone. You can be in the company of others and still experience loneliness, whereas you may not feel...

Though sounding simple, learning to accept and change are powerful strategies that keep relationships intact. “Accepting” your partner means that you are tolerating your partner’s unpleasant or offensive behavior while at the same time trying to understand the deeper meaning of that behavior and putting it in the larger context of your relationship with your partner (Christensen et al., 2014). For example, an individual may become more accepting of their partner’s introverted nature or tendency to criticize. Do not confuse acceptance with submission. Submission is enduring offensive behavior from a position of weakness as one has no alternative. In contrast, acceptance is tolerating offensive behavior from a position of strength as you choose to do so while seeing the offensive behavior in the larger context of your relationship with your partner. Acceptance also doesn’t mean one cannot assertively differ from one's partner, resist one's aversive behavior, or try to limit it....

In layman’s terms, hope is the expectation that your future can somehow be better, no matter the present circumstances. In contrast, psychologists define hope in a more structured way so that they can measure this attribute. According to them, hope is the pursuit of your goals with the knowledge that you have the capacity and the motivation to achieve them (Snyder et al., 2006). In other words, hope has two key elements: 1. A sense of successful determination in meeting past, present, and future goals. 2. A sense of being able to generate successful plans to meet the goals. The first element is called the agency , and the second element is called the pathway , which, in layman’s terms, translates into the will and the way, respectively. These two components of hope are reciprocal and work synergistically but are not synonymous (Snyder et al., 1991). People with the will to achieve their goals may not have the ways to do it and vice versa. Both the will and the way are necessary...

It is difficult not to judge yourself or others or overanalyze a situation when going through challenging times. Strong emotions emerging from the cognitive processes of judging or analyzing prevent you from using your rational mind to arrive at solutions to solve a problem or use mindful acceptance if the problem is unsolvable. In these circumstances, observing ego, a skill used in many mindfulness practices, helps you increase your self-awareness and allows you to perceive an adverse event non-judgmentally.  The word “ego” in observing ego refers to your healthy, rational, logical, and compassionate self. An important function of the ego is the capacity for self-observation. This is your ability to monitor or reflect upon your feelings, impulses, and thoughts rather than impulsively acting on them (Glickauf-Hughes et al., 1996). While your thoughts, images, feelings, sensations, and physical body change, your observing ego, also called the observing self, remains the same (Harris...

Procrastination is putting off tasks for another day or doing unproductive things as an excuse for not doing what is essential. While some procrastinate in certain situations, it becomes a habit for others. They leave dishes in the sink, don’t respond to e-mails, don’t pay bills, put off completing paperwork, finish assignments just before the deadline, or ask for extensions. In the latter group, procrastination becomes a form of avoidance. Psychologists consider avoidance as a maladaptive coping style that relieves one from the mental and/or physical effort of doing a task, reinforcing this behavior. Procrastination can be driven by irrational thought patterns, and sometimes, these are associated with depression and anxiety. The common irrational thoughts that foster procrastination include: “Nothing works.” “This is boring.” “I don’t know where to start.” “I can’t do this.” “This is too hard.” "I am not cut out for this." “I don’t have the time to do this.” “I don’t have th...

With resilience promoted as a must-have skill set, individuals are bombarded with various pop-psychology iterations of what is needed to bounce back from daily setbacks, acute adversities, or chronic stressors. However, there is no proven pathway to resilience, and we don't know why some individuals are more resilient than others. The best one can gather from research are the predictors of resilience. The salient predictors of resilience include the following: 1. Demographic predictors: Contrary to the popular notion that older adults are at greater risk following a potentially traumatic event, research suggests that older adults suffer relatively lower psychological costs than younger adults. In addition, the male gender is a consistent predictor of resilience in numerous studies, with the possible explanation being that women tend to experience more significant initial threats during a traumatic event subjectively (Bonanno & Diminich, 2013). 2. Personality predicto...