Journaling

Depression: What It Is and What to Do about It (Part 2)

Depression: What It Is and What to Do about It (Part II)

This is the second of a two-part series on depression. In this issue, I will describe how depression is treated and prevented. If you or someone close to you suffers from depression, it is important to educate yourself about it and seek treatment from qualified mental health professionals.

There are three basic ways to treat depression: psychotherapy, self-help, and medication. Many people respond best to a combination of two or more methods.

1.    Psychotherapy: Exploring one's beliefs and ways of thinking, and learning new ways of thinking and behaving, with the guidance of a professional.
2.    Self-help: Exploring one's beliefs and ways of thinking on one's own.
3.    Medication: Altering one's brain chemistry by taking antidepressant medication.

A physician may recommend medication when four conditions exist:

1.     The patient's depression is severe.
2.     The patient has suffered at least two previous depressive episodes.
3.     There is a family history of depression.
4.     The patient asks for medication only and refuses psychotherapy.

There are four types of antidepressant medication available today:

�    Tricyclic antidepressants (TCAs)
�    Monoamine oxidase inhibitors (MAOIs)
�    Selective serotonin reuptake inhibitors (SSRIs)
�    Structurally unrelated compounds

The TCAs and MAOIs have been used for decades. The SSRIs (such as Prozac) and structurally unrelated compounds are newer and are being prescribed more and more frequently. They have fewer and less pronounced side effects than the TCAs and MAOIs.

Treatment without Medicine

One of the leading methods for treating depression is cognitive therapy. Cognitive therapists help depressed clients feel better by identifying how faulty ways of thinking are making him or her feel bad. The client analyzes his or her thoughts and beliefs, and learns to substitute more healthy ways of thinking and believing.
Many mental health professionals believe that the ideal treatment of clinical depression is medication in conjunction with psychotherapy.

Prevention of Depression

Depression can often be prevented. It is especially important to take preventive action if you are aware that you have predisposing factors such as those mentioned in the last newsletter.

1.    Identify your risk factors and be aware of where you are vulnerable. Each of us has unique risk factors, such as things we were taught in our families of origin, values we have learned, and the presence or absence of a family history of depression. Anything that has been learned can be unlearned and replaced with something healthier.
2.    Learn to manage stress. You can learn proven techniques for calming and relaxing yourself. Consider taking a stress management class or buying a set of relaxation tapes.
3.    Learn problem-solving skills. Many people who develop depression never learned problem-solving skills. They need to develop the ability to see problems from many viewpoints and to look for a variety of solutions.
4.    Build your life around things you can control. Learn to recognize what you can control and what you can't. Avoid spending much effort on situations that won't pay off for you.
5.    Learn self-acceptance. Instead of rejecting the parts of yourself you don't like, learn to manage them more productively.
6.    Become aware of selective perception. Observe how you generate ideas and opinions about people and events. Remember that these are just your views, not necessarily objective facts.
7.    Focus on the future, not the past. Depressed people tend to be focused on the past. People who set goals and focus on the future tend to be more positive about life.
8.    Develop a sense of purpose. Many depressed people lack a sense of purpose or meaning. This means they have no goals and nothing in the future drawing them forward. To prevent depression, develop your sense of purpose and meaning.
9.    Strengthen your emotional boundaries and set limits. Boundaries define your role in a social situation. They determine how you will or won't behave in a given situation. Having clear, strong boundaries is empowering, while boundary violations make you feel victimized and helpless. Setting limits means having and enforcing rules for the behaviors you expect in a relationship.
10.    Build positive and healthy relationships. Think about what you need from others in relationships. Learn to read people and trust your instincts about which people are good for you.
11.    Avoid isolation. Talk to others about what's going on with you. If you keep your thoughts to yourself, you may be unaware that your thoughts are distorted. If you share them with another person, you can become more objective.


Signs That Professional Therapy Is Needed

1.    Thinking about death or suicide. This is always dangerous and you should see a professional therapist immediately.
2.    When symptoms of depression continue for a long time, you may need professional help. Acute responses to events are normal, but they should not last beyond a reasonable time.
3.    Your ability to function is impaired by your depression. Seek help before your life situation deteriorates to a serious level.
4.    You have become so isolated that you have no one with whom to test reality. Seek someone out to share your thoughts and feelings with.
5.    Depressive symptoms have become severe.
Please call for an initial free consultation. 813-240-3237 We are here to help!

Journaling For Self Discovery

33 Ways to Use Your Journal for Self-Discovery and Self-Expression

 

As a therapist, I often suggest to clients that they explore their feelings and thoughts by keeping a journal. Sometimes clients ask for a bit of direction with this process. Here are some journaling ideas if you're not sure where to start:

 

1.    Write down what happened today and how you felt about it.

   

2.    Write a letter to a person you are angry with. Say everything you are feeling and wish you had the nerve to say.

   

3.    Draw a picture of the person you wrote the letter to in #2.

   

4.    Make a list of all the things you are grateful for. List all the big things, all the small things, and everything in between that you can think of.

   

5.    Circle the three most important things on the list you made in #4. Write a paragraph for each, expressing your appreciation to the person who had the most influence over it. If possible, turn this into an actual letter and send it.

   

6.    Make a list of the things that you feel upset about right now. Write down as many as you can think of until you can't think of any more. Then choose the top five.

   

7.    For each of the top five things you identified in #6, list 10 things you can do to gain control of the situation. Circle the top three from each list.

   

8.    Make a timeline that represents your life. Fill it in with the most significant events that have shaped you: your early years, your teen years, and each decade that has followed. Draw pictures or icons next to the most important events. Use crayons or markers if you wish.

   

9.    Write a few pages about your feelings about the timeline.

   

10.    Describe how your life would be different if          had or had not happened.

    Here are some examples:

a.     If your parents had divorced

b.     If your parents had remained married

c.     If your parents had been married

d.     If your mother hadn't passed away

e.     If you hadn't moved to    

f.     If you had gone to college

g.     If you hadn't gone to college

h.     If you had gone to      College

i.     If you had never met        

j.     If you hadn't broken up with            

11.     Make a list of all the things you wish you could do before your life is over.

   

12.     Make a list of the things no one knows about you.

   

13.     Write about your junior year in high school.

   

14.     Write about what life was like before you became a parent.

   

15.     Write about what you wish you had known before you became a parent.

   

16.     Make a list of the things you still want to learn about being a parent.

   

17.     Describe what it was like when you first met your partner.

   

18.     Write about what you wish you had known about your partner before you married him/her.

   

19.     Write about what you wish your partner had known about you before (s)he married you.

   

20.     Write a letter to yourself as you were at age 10. Tell yourself:

a.     What your life is like now

b.     What you have learned since you were 10

c.     What you want him or her to know

d.     What you want him or her to beware of

e.     What you want him or her to enjoy every moment of

21.     Write a letter to your own parents. Tell them what your life is like now.

   

22.     Write a letter to someone from your childhood or adolescence who didn't appreciate you or who misunderstood you. Tell the person what you want them to know and how you feel about the lack of connection between you.

   

23.     Think of someone you never acknowledged for something important. Write that person a letter and acknowledge him or her.

   

24.     Think of someone who never acknowledged you for something important. Write them a letter and tell them what you want them to know.

   

25.     Make a list of five miracles you want to happen in the coming year. Write a paragraph or two describing each one and how your life will be better if it happens.

   

26.     For each of the five miracles, make a list of:

a.     Five barriers or forces that block or prevent it from happening

b.     Five positive influences, things that encourage or support its happening

c.     Five things you can do to reduce the barriers and strengthen the positive influences

 

27.     Write about the five things you most like to do.

   

28.     Write about the five things you most dislike doing.

   

29.     Make a list of five places you'd like to visit. Describe what you imagine them to be like.

   

30.     Write about three things you most regret doing or not doing. Describe what happened and how you feel about it.

   

31.     Write a letter to your children, even if they have not yet been born. Tell them what you want them to know about you.

   

32.     Write a letter to your grandchildren, even if they have not yet been born. Tell them what you want them to know about you.

   

33.     Write a letter to your descendants one hundred years from now. Describe what your life is like today.

   

34.     Add your own ideas here: