Nov 15, 2008

How a depressed person can self-help; how friends can help

Clinical depression has a physiological component but also a behavioral one. The way someone thinks and acts can affect mood and alleviate symptoms of depression. A very destructive symptom is inertia, the inability to 'get going,' to keep swimming through the cold oatmeal. Friends and family can help by overcoming the inertia, for example, by suggesting "Let's go for a walk" or "let's chat to put things in better perspective."

Two "erroneous thinking" processes to recognize and change:
  • Exaggeration: a bad external situation such as a serious illness or loss is exaggerated into "I am a bad person, everyone is bad, the world is doomed and nothing will ever get better."
  • Magical thinking: "My life is terrible because I was born during a thunderstorm," or "If I got that job, my life will be perfect."
Buy or borrow the paperback "Feeling Good" by David Burns. Its companion workbook will help the depressed person analyze his/her thinking and behavior and build a plan to change it.

Some behavioral changes that the depressed person, friends and family can help to make:
  • Get medical, dental and vision checkups to discover and treat any problems. Physical illness can trigger or worsen depression.
  • Deliberately structure a varied daily schedule, a different schedule every day. Plan at least one activity for the day. Be realistic. Can be something pleasant like 'send a note to a friend' or a pragmatic task like 'change the bedding.' Cross activities off the list when done.
  • Exercise three times a week for 30 minutes in each session. It doesn't matter what exercise you do or how vigorously, do something continuously for 30 minutes.
  • Prepare regular, diverse meals with some each of protein, carbohydrates, fat. Many depressed people feel it's not 'worth it' to cook for themselves. I say "who is more worth the effort than yourself? Who would appreciate your effort, properly?"
  • Maintain personal grooming: shower, shampoo, brush teeth, comb hair, trim nails.
  • Improve the immediate environment: adjust temperature to slightly cool (68-70 degrees), pick up clutter, clean house and do laundry, add more light (use timers to make sure lights come on and stay on), add good stimuli such as music, pleasant scents, visual cues such as flowers, photos of loved ones and good memories, a pet
  • Meet people, even if passively: sit in a coffee shop and people watch, stroll through a shopping mall, attend church, go to the library or a park. Joining a volunteer group will give a regular occasion to meet people. The goal is to distract depressive thoughts.
  • Sleep. Make it a habit: go to bed at the same time, get up at the same time. Timers that automatically turn off lights will give the cue "go to bed." When going to bed, go to sleep, don't read, watch TV... Keep the room dark and quiet (wear eye mask and ear plugs if you have to). Get up at the same time even if you haven't slept enough.
Most important: get a treat every day. Write a list of treats and choose one everyday, even if it was not a good day:
  • Build ego by giving a compliment or citing an achievement: "I helped somebody," "I cooked a good meal," "I cleaned the kitchen," "I improved my mood."
  • Increase interests by doing a favorite activity: toss a few hoops, hit a few balls, talk to a friend, read a novel, watch a movie, do a hobby. Browse a new shop (fancy or ethnic supermarkets can be interesting).
  • Increase relaxation: get a massage (you can give yourself one), take a long hot shower, use a back brush or defoliating glove to stimulate your skin, play music and dance, sing in the shower, do stretching (borrow from the library books or DVDs on Yoga or pilates)
  • Bost mood: Eat a favorite food, an exotic fruit, new flavor of sorbet. Find a happy story; ask friends, read blogs or from TV -- find a nice story.
  • Pamper yourself: try on your own nice clothes, jewelry, perfume... or ones in a shop. Take yourself out for breakfast. Try a temporary hair color. Play music and/or read during a bath. Get a nice soap, body wash, hand lotion. Use the hot tub (someone you know might have one, or get a one-time pass at a health club)...


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