Managing Your Depression (19 page)

Source:
Adapted in part from U.S. Department of Health and Human Services, “How to Evaluate Health Information on the Internet,”
www.fda.gov
, accessed March 2010, April 2012.

Clues in the Name

Books of Interest

Aaron T. Beck, A. John Rush, Brian F. Shaw, and Gary Emery.
Cognitive Therapy of Depression
. Guilford Press, 1979.

David Burns.
Feeling Good: The New Mood Therapy
. Avon Books, 1980.

Mary Ellen Copeland.
Living without Depression and Manic Depression: A Workbook for Maintaining Mood Stability
. New Harbinger Publications, 1994.

Mary Ellen Copeland.
The Depression Workbook: A Guide for Living with Depression and Manic Depression
. New Harbinger Publications, 2001.

Gregg D. Jacobs, Ph.D.
Say Goodnight to Insomnia
. Owl Books, 1998.

Cory F. Newman, Robert L. Leahy, Aaron T. Beck, Noreen A. Reilly-Harrington.
Bipolar Disorder: A Cognitive Therapy Approach
. American Psychological Association, 2002.

Deborah Sichel and Jeanne W. Driscoll.
Women’s Moods: What Every Woman Must Know about Hormones, the Brain, and Emotional Health
. Quill, 1999.

Jeffrey E. Young and Janet S. Klosko.
Reinventing Your Life
. Penguin, 1994.

Memoirs

Nell Casey.
Unholy Ghost: Writers on Depression
. William Morrow, 2001.

Kay Redfield Jamison.
Night Falls Fast: Understanding Suicide
. Vintage Books, 2000.

Kay Redfield Jamison.
Touched with Fire: Manic Depressive Illness and the Artistic Temperament
. Free Press, 1993.

Kay Redfield Jamison.
An Unquiet Mind: A Memoir of Mood and Madness
. Vintage Books,1995.

Martha Manning.
Undercurrents: A Life beneath the Surface
. HarperOne, 1995.

William Styron.
Darkness Visible: A Memoir of Madness
. Vintage Books, 1990.

Tracy Thompson.
The Beast: A Journey through Depression
. Plume, 1996.

Meditation

Herbert Benson.
Beyond the Relaxation Response
. Berkeley Books, 1984.

Herbert Benson.
The Relaxation Response
. Harper, 1975, revised 2000.

Jon Kabat-Zinn.
Wherever You Go, There You Are
. Hyperion, 1994.

Communication Skills

Dianna Booher.
Communicate with Confidence: How to Say It Right the First Time
. McGraw-Hill,1994.

Jeff Davidson.
The Complete Idiot’s Guide to Assertiveness
. Alpha Books, 1997.

Debra Fine.
The Fine Art of Small Talk
. Small Talk Publishers, 2002.

A. Yeung, G. Feldman, and M. Fava.
Self-Management of Depression: A Manual for Mental Health and Primary Care Professionals
. Cambridge, 2010, app. C.

Conclusion

I have presented a lot of material on managing your mood disorder in the chapters of this book. Starting with the Basics of Mental Health as a foundation for staying healthy and building new skills, I then covered how to identify and monitor your mood disorder and its symptoms. In
chapter 3
, I described how to identify your baseline healthy self, why it is important, and how it will provide you with a goal for your recovery.
Chapter 4
presented you with treatment options and many ways to manage your mood disorder, such as understanding your fluctuations, identifying and monitoring your Warning Signs and Triggers, and maintaining a routine and structure. In
chapter 5
, I detailed how to respond to your symptoms as they arise by, developing an Action Plan and following Relapse Prevention Strategies.

Chapter 6
described cognitive behavioral therapy, a type of talk therapy particularly useful in depression, with several practical exercises to reinforce the principles of CBT. These CBT exercises help you challenge negative thoughts and avoid negative behaviors, both of which are common in depression. Several strategies were reviewed in
chapter 7
to help you get through the difficult times: Coping and Stress, Mindfulness, Distress Tolerance, Communication Skills, Dealing with Family and Friends, Talking with Your Doctor, and Tips for Family and Friends. In
chapter 8
I gave you a picture of what life can be like when you follow the recommendations outlined in this book. The last chapter presented additional resources, such as useful books and guidelines for using the Internet to obtain health information.

Do not expect that you will master this material all in one reading.
It will take time and practice to learn and incorporate these approaches into your day. Managing your mood disorder means that you learn about the illness and develop strategies to respond to your symptoms. It means that each day you use the methods, strategies, and skills that I have described to deal with the symptoms you have. Managing your illness requires that you monitor your symptoms, challenge negative thoughts, use problem-solving techniques, make adjustments, and avoid negative behaviors. This is a lot to do; in fact, it may feel overwhelming to you right now. With time and practice, however, all steps outlined in this book are possible to accomplish. More important, they will make a difference in how you feel. Work with your treatment providers on this.

Do not be surprised if you need to review sections of the book periodically. Review and practice is how we all learn new skills. This book was designed to introduce the topics relevant to depression one at a time, then to help you reinforce the material by using specific exercises and examples in your life. Last, this book is a reference for reviewing the material later as needed. When you come upon a section that hits home, that is particularly familiar to your situation, sit with it and think about it for a while. Consider how it relates to you. That would be a good example of something for you to discuss with your therapist or physician.

Keep in mind that those patients who participate actively in their care have a better chance of recovery and staying well. So keep working at it. It may take a while for you to notice a change in your mood, and this may understandably affect your motivation to follow the recommendations outlined in the book. Doing so may feel like a struggle. Just remember that action precedes motivation: take that step whether you feel like it today or not.

Good luck!

Glossary

Action Plan for Relapse Prevention
• An intervention Action Plan for Relapse Prevention is a written self-care plan to help you deal with a worsening or recurrence of depression. It is a strategy you create with your doctor. You create it in advance and have it ready for the times when your depression symptoms start getting worse. The Action Plan helps you to identify your Symptoms and Warning Signs. It outlines the steps you will take to manage, cope, and distract from the high intensity of a depression or manic episode. The Action Plan also lists the people you will ask to help you during these times: health care providers, family, and friends.

Automatic Negative Thoughts
• In depression, the mind quickly jumps to negative thoughts, which usually cause distress. These are the thoughts that are biased in an extreme negative direction, such as “I’m a loser” or “I can’t do anything right.” This happens because (1) in depression, negative events dominate your thinking, and (2) the depressed mind tends to interpret and distort or twist things negatively, thus creating the negative thoughts. These thoughts happen automatically, not on purpose. Automatic negative thoughts are not an accurate reflection of reality. They are a distortion.

Bipolar Disorder
• Bipolar disorder, or manic-depressive disorder, is a relapsing and remitting, treatable mood disorder that has a major effect on daily life. Relapsing and remitting means that the episodes come and go. As with major depression, it is thought to be caused by a dysfunction in the network of neurons (brain cells) in the brain. Bipolar disorder is characterized by periodic episodes of extreme elevated mood or irritability followed by periodic episodes of depression.

Cognitive Behavioral Therapy
• Cognitive behavioral therapy (CBT) is a kind of talk therapy (psychotherapy) that addresses the connection between your thoughts, feelings, and actions. In CBT you learn to identify and change thinking patterns that may be distorted, beliefs that are inaccurate, and behaviors that are unhelpful.

Cognitive Distortions
• Distortions in your thoughts are errors in thinking that twist your interpretation of an event in different ways. This happens commonly in depression. Cognitive behavioral therapy uses a series of exercises to challenge and replace the negative and distorted thoughts that accompany depression.

Coping
• Coping strategies are the steps you can actively take to lessen the effects of stress and decrease your vulnerability to stressors. Coping includes problem solving, self-soothing, relaxation, distraction, humor, Mindfulness meditation, and other techniques.

Depression
• Depression is a relapsing and remitting but treatable illness. Relapsing and remitting means that the episodes come and go. It affects your thoughts, feelings, behaviors, relationships, activities, interests, and many other aspects of life. Depression is thought to involve a dysfunction in the network of neurons (brain cells) in the brain. This may happen when certain life experiences occur in a susceptible person.

Distorted Thinking
• Distortions in your thoughts are errors in thinking that twist your interpretation of an event in different ways. Cognitive behavioral therapy uses a series of exercises to challenge and replace the negative and distorted thoughts that accompany depression.

Distress Tolerance
• Distress Tolerance is the ability to tolerate extreme distress for a short period, until the crisis of the moment passes. It is a strategy to get through a brief difficult time when you cannot change the situation. Distress Tolerance strategies include using skills to distract yourself, soothe yourself, provide solace, and improve the difficult moment.

Mood Disorders
• Mood disorders is a term that includes major depression and bipolar disorder, conditions of the brain that involve a disturbance in your mood or state of mind.

Psychomotor Agitation
• Psychomotor agitation is a symptom best described as a combination of excessive physical and mental (or cognitive) activity occurring at the same time. It is usually without purpose and is nonproductive. This agitation can be a symptom of some mental health conditions, such as in the mania or hypomania of bipolar disorder.

Relapse Prevention
• Relapse Prevention is an effective daily approach to help you minimize the chance of a relapse, or return of symptoms, occurring and to help you stay well. Relapse Prevention means that you identify and respond promptly to changes in your Warning Signs, Triggers, or Symptoms. This helps you to intervene when an important change in your emotional health may be happening. Early identification and intervention can prevent your episode from worsening.

Sleep Hygiene
• Sleep Hygiene refers to the personal habits, behaviors, and environmental (home) conditions that can help you get the sleep you need. Attending to these habits can help improve the quality and the quantity of your sleep. It is important to pay attention to Sleep Hygiene principles during episodes of depression, when your sleep patterns are likely to be disrupted.

Triggers
• Triggers are events or circumstances that may cause you distress and lead to an increase in your symptoms of depression.

Warning Signs
• Warning Signs are distinct changes from your baseline that precede an episode of depression or mania.

References

Introduction

T. Bodenheimer, K. Lorig, H. Holman, et al. Patient self-management of chronic disease in primary care. JAMA 2002;288(19):2469–75.

E. Ludman, W. Katon, T. Bush, et al. Behavioral factors associated with symptom outcomes in a primary care-based depression prevention intervention trial. Psychol Med 2003;33:1061–70.

William Styron.
Darkness Visible: A Memoir of Madness
. Vintage Books, 1990.