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Introduction to Depression: defining it, diagnosing it, & managing it

Introduction to Depression: defining it, diagnosing it, & managing it

Depression is a mental health condition that goes beyond mere feelings of sadness. It would be better described as a persistent and overwhelming sense of despair that can linger for weeks, months, and even years. Depression affects millions of people worldwide, oftentimes having a negative impact on personal well-being, relationships, work, school, and overall quality of life. 

Contrary to common misconceptions, depression isn’t a sign of weakness, nor is it a mere mood swing that one can easily snap out of. Rather, depression involves a combination of biological, psychological, and/or environmental factors. Physiologically, there can be multiple neurotransmitters involved, making it difficult to regulate mood. Genetic predispositions can also make certain individuals more susceptible to experiencing depressed mood. Additionally, life events such as trauma, loss, or chronic stress can act as triggers, exacerbating the condition.

Being able to recognize the symptoms of depression is essential, not only for those who experience it, but also for those close to them. Detecting depression at its earliest signs is optimal, as it allows for prompt initiation of treatment, which can prevent the condition from worsening. Common symptoms include persistent sadness, loss of interest in previously enjoyable activities, changes in sleep and appetite, fatigue, and difficulty concentrating. 

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) outlines the following criterion for depression (otherwise known as major depressive disorder or MDD). In order to meet diagnostic criteria, an individual must exhibit at least five of the following symptoms during the same 2-week period, representing a change from previous functioning. Additionally, at least one of the symptoms must be either (1) depressed mood, or (2) loss of interest or pleasure.

  1. Depressed mood most of the day
  2. Significantly decreased interest or pleasure in all (or almost all) activities
  3. Major change in weight or appetite (not due to dieting) 
  4. Insomnia or hypersomnia
  5. Excessive restlessness or observable reduction in activity levels
  6. Fatigue (exhaustion) or loss of energy
  7. Feelings of worthlessness or excessive/inappropriate guilt
  8. Diminished ability to think, concentrate, or make decisions
  9. Frequent thoughts of death or attempt to end one’s life

These symptoms must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. It’s important to note that the diagnosis also considers ruling out other medical conditions or substances that could contribute to the symptoms. Diagnosis and treatment should be conducted by qualified mental health professionals.

Seeking professional help, whether through therapy, medication, or a combination of both, is a crucial step for managing depression. It is certainly not a sign of weakness, but a courageous step towards healing. By fostering awareness, understanding, and compassion, we can collectively promote mental health treatment for those in need of support. The best thing we can do for those affected by depression is (1) listen without judgment, (2) validate their experiences and emotions, (3) connect them with a professional, and (4) continue to connect with them throughout their journey toward a brighter future.

Tips for Managing Mood During Seasonal Change

Tips for Managing Mood During Seasonal Change

As the seasons change and holidays approach, managing mental health becomes crucial. For many, these transitions can bring a mix of emotions, including excitement, stress, sadness, and more. Here are some strategies to navigate the potential impact on mental well-being during these times:

Acknowledge and Validate Emotions
Recognize that it’s normal to experience a range of emotions during seasonal changes and holidays. Whether it’s the joy of festivities or the pressure of expectations, validating your feelings is the first step in managing them.

Maintain Consistent Routines
Stick to regular routines as much as possible. Consistency in daily habits, such as sleep patterns, exercise, and meals, can provide a sense of stability during periods of change.

Set Realistic Expectations
Be realistic about what you can accomplish and what you expect from yourself and others during the holidays. Avoid overcommitting and focus on what brings genuine joy rather than succumbing to societal pressures.

Connect with Others
Loneliness and isolation can exacerbate low mood and negative outlook. Prioritize connection with loved ones, whether it be planning a fun activity together, catching up on a phone or video call, or just a quick meet-up for coffee. Be intentional about engaging in activities that help you feel a sense of community and support.

Mindful Practices
Mindfulness is a simple and effective practice for managing stress and promoting overall emotional well-being. It can be as simple as pausing for a moment to enjoy, soak in, and appreciate a nice experience. Choosing times to set your phone aside may help facilitate this, as it helps to minimize distractions that take you away from the present moment. Practicing gratitude (such as writing down an appreciation from the day), meditation (headspace is a great resource to facilitate the process), or yoga can help you stay connected to yourself and the here-and-now.

Manage Seasonal Mood Changes
Seasonal changes, particularly during fall and winter, can trigger changes in mood, from feeling tired and unmotivated, to feeling depressed and hopeless. For milder cases, exposure to natural light and engagement in outdoor activities can help reduce symptoms. If seasonal mood changes last more than one week, consider contacting a mental health professional to help you navigate to a better headspace.

Given the uniqueness of each individual, it’s important to recognize that various forms of self-care and coping strategies may work better for different people. By taking a proactive and mindful approach, you can successfully navigate the challenges of seasonal changes and holiday pressures, while maintaining balance and preserving well-being.

Go Like Yourself!

Go Like Yourself!

Founders of Go Like Yourself — Cindy Martin & Bruce Coffman — believe in writing one’s own unique story, regardless of outside pressures or judgment.  Their goal is to get their message into the minds and hearts of people of all ages so they simply feel better about themselves:

This isn’t about ego. It’s about choosing for yourself who you are and what you do. It’s about directing your own life – not to get noticed or get more followers. It’s about being true to yourself. Push your limits on the trail. Go for bold strokes with a paintbrush in hand. Reach for the high note that has always eluded you. Or do none of these. Do what feels good and what feels right – just for you and no one else.

Please take a moment to reflect on Bruce’s thoughts on A Good Place to Start in liking oneself…

Okay. “Go Like Yourself”—you get it.

But now what? I mean, how do you do that?

This should help!

I love to mountain bike. Have for 20 years, even led a chapter of Trips for Kids that took inner-city youth on mountain biking day trips. Beautiful sport. I mean, what could be more fun than riding your bike like a kid on dirt trails through the woods?

Technology has changed the sport in many ways. The bike itself: lighter, stronger, better designs—simply more fun. Plus how rides are tracked and recorded: GPS, smartphone apps, helmet cams—on and on.

So. What could be more fun than riding? How ‘bout this? Not just riding, but taking photos & videos along the way, then immediately afterwards uploading ride data and blasting out to your friends. Right?

Wait. I don’t allow myself anything electronic on my bike, just a cell in my pocket in case of emergency. Why not? To live (ride) in the moment. Versus thinking ahead to the posting. Then waiting and watching—who liked? who commented? who shared?

I’m not throwing stones. I still check to see who reacts to things I post. I probably check too much. But my rides are sacred. Just for me.

So. To Go like Yourself (you’ll want to write this part down):

  1. Find one thing you love or want to do, just for you. Either a one-time thing or something lifestyle, longer-term
  2. Do that thing, but don’t let anyone know—or maybe only your mom or someone close to you
  3. Feel good about what you’re doing, then feel good about what you’ve done—not due to any reaction 

Smile about it and know that you’ve won!

Like when you were a kid, just riding your bike.

For more information, please visit Go Like Yourself!

By: Bruce Coffman, Go Like Yourself

Pain is Inevitable; Suffering is Optional

Pain is Inevitable; Suffering is Optional

The goal of Acceptance and Commitment Therapy (ACT) is to create a rich, full, and meaningful life while accepting the pain that inevitably goes with it. This is done by changing one’s relationship to their symptoms in order to live a more value-driven life. Further, the goal is to accept what is outsideof one’s control, and commit to taking action to enrich one’s life. It can be summed up in one basic premise: pain is inevitable, but suffering is optional.

Oftentimes, trying to get rid of symptoms actually results in being more bothered by the symptoms. For example, try to not picture a pink elephant in your mind’s eye. What happened? You saw a pink elephant. This is just what happens when we try NOT to focus on any particular thing!

Being too focused on symptoms impacts our ability to life a value-driven life. We’re too busy and using all our energy on “symptom-reduction” rather than choosing to focus on what is meaningful in our lives, such as family, friends, relationships, advancing career, rest, self-care, and so forth. When we instead focus on our values, our symptoms can drift to the background, rather than take center stage.

ACT asserts that problems are essentially caused by two things: cognitive fusion and experiential avoidance. Cognitive fusion is when we become inseparable from our thoughts, and then our thoughts dominate our behavior. Experiential avoidance happens when we attempt to avoid, get rid of, suppress, or escape unwanted experiences (thoughts, feelings, memories, sensations, etc.).

Trying too hard to control how we feel simply gets in the way of a rich, full life. We can’t do important, value-driven things if we are always trying to get rid of symptoms. Control is the problem, not the solution.

What can we do about this? Practice defusion to get stuck from our thoughts and gain distance from them. Defusion is taking a step back and seeing our thoughts for what they are: nothing more or less than words and pictures. As I like to say, look AT your thoughts, rather than FROM your thoughts.
Thought Defusion PICTURE for blog post - Copy

Here are some ways you can attempt to defuse from your thoughts:

  • Say “I’m having the thought that…”
  • Use a silly voice to say the thought
  • Sing the thought like a song
  • Repeat the thought nonstop for 30 seconds until it sounds like gibberish

Another way to defuse from unhelpful thoughts is to practice mindfulness. What is mindfulnessMindfulness means paying attention with flexibility, openness, and curiosity. It allows you to be aware of your experience in the moment as opposed to being “caught up” in your thoughts. Mindfulness involves an attitude of openness; being curious about your experience rather than fighting with it. This is helpful because often times the more we try to fight the way we feel, the more we end up feeling it.
hexagon-4
 
The goal of ACT is referred to as psychological flexibility, which entails being present, opening up, and doing what matters. An important facet of psychological flexibility is acceptanceallowing thoughts and feelings to be present, regardless of whether they are pleasant or painful.

The fun part of ACT (in my humble opinion) is valued living: doing what we want to be doing with our lives. What’s important to us? What do we want to stand for? How do we want to behave and act on a daily basis? Our values are our compass; they guide our decisions and behavior. A good way to figure out what your values are is to imagine your retirement party or funeral — Who would you want to speak about your life and what would you want to hear them say?

Once you have figured out what your values are, then final step is to take committed action (effective action motivated by your values). One helpful way to do this are to make a public commitment; tell someone about it. This will create some level of accountability for you. Another thing you can do is create an action plan worksheet. Last, but not least, simply take the first, tiniest step. The first step is often the hardest, but if you can manage to get started, the rest will follow.

For more on Acceptance and Commitment Therapy, click here and here!

How to Dispute Irrational Beliefs

How to Dispute Irrational Beliefs

Albert Ellis is known as the grandfather of Cognitive Behavior Therapy. He combined humanistic, philosophical, and behavioral therapy to form Rational Emotive Behavior Therapy (REBT) in 1955. A main assumption of REBT is that people contribute to their psychological problems by the way they interpret events. Further, our emotions stem mainly from our beliefs, evaluations, interpretations, and reactions to life situations. REBT assumes that cognitions (thoughts), emotions, and behaviors interact significantly and have a reciprocal cause-and-effect relationship. Additionally, REBT postulates that people are born with a potential for both rational and irrational thinking.

According to Ellis, we have an inborn tendency toward growth and actualization, yet we often sabotage our movement toward growth due to self-defeating patterns we have learned. We originally learn irrational beliefs from significant others during childhood, and we actively reinforce these self-defeating beliefs by repetition, and by behaving as if they are useful. But it is not useful to blame ourselves and others; instead, it is important that we learn how to accept ourselves despite our imperfections. Therefore, a major goal of REBT is to achieve unconditional self-acceptance and unconditional other acceptance; the more one is able to accept him or herself, the more likely he is to accept others.

The therapeutic process involves identifying irrational beliefs, and replacing such beliefs with more rational and effective ways of thinking. Changing one’s thinking results in changing one’s emotional reactions to situations. Ellis succinctly puts it this way, “You mainly feel the way you think.” Some examples of irrational beliefs that lead to self-defeat include: I must have the approval of all the people in my life, or else I am worthless. I must perform all tasks perfectly, or else I am a failure. It is better to avoid life’s difficulties than to try and end up looking foolish.

The A-B-C framework and method of disputing irrational beliefs is central to REBT theory and practice.

A = an event, behavior, or attitude
B = belief about the event
C = emotional & behavioral consequence or reaction (can be healthy or unhealthy)
D = disputing irrational or self-defeating beliefs
E = effective philosophy of replacing unhealthy thoughts with healthy ones
F = a new set of healthy feelings

A (the activating event) does not cause C (the emotional consequence); rather, B (the person’s belief about the event) largely causes C. D is the application of methods to challenge irrational beliefs by detecting, debating, and discriminating irrational (self-defeating) beliefs from rational (self-helping) beliefs. E is the new and effective belief system that consists of replacing unhealthy thoughts with healthy ones. In doing this, F (a new set of healthy feelings) is created.ABC Framework 11

In summary, Rational Emotive Behavior Therapy entails the following steps: (1) acknowledge that we are largely responsible for our own emotional problems, (2) accept that we have the ability to change these disturbances significantly, (3) recognize that our emotional problems often stem from irrational beliefs, (4) accurately perceive these beliefs, (5) see the value of disputing such self-defeating beliefs, (6) accept that we need to counteract our dysfunctional beliefs/feelings/behaviors, and (7) practice these methods to improve current and future circumstances.

References:
Corey, Gerald. Theory and Practice of Counseling and Psychotherapy. Belmont. Thomas Learning, Inc. 2005.