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On Depression

Feelings of despair—including grief, powerlessness, guilt, and shame—can make sense in our shifting global landscape. We can focus on each step to cope and heal.

OVERVIEW: WHAT IS DEPRESSION?

Nearly 300 million people worldwide struggle with depression. Depression—known in the DSM as major depressive disorder—is considered a mood disorder, in which someone must experience five or more of the following symptoms during the same two week period. 

  1. Depressed mood most of the day, nearly every day.
  2. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
  3. Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
  4. A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
  5. Fatigue or loss of energy nearly every day.
  6. Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
  7. Diminished ability to think or concentrate, or indecisiveness, nearly every day.
  8. Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

At least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure. It can be useful to view depression based on duration, frequency, and severity. Diagnostic codes include depressive disorders organized by single or recurrent episodes, partial or full remission, with or without psychotic symptoms, a history or no history of depression, and persistent for two years or more. 

Feelings of despair, including grief, powerlessness, guilt, and shame, can make sense in our shifting global landscape. Cultural, genetic, environmental, and lifestyle factors may alter our perceived safety and security. It may be difficult to find affirming care and professional support

NEXT STEPS: MANAGING DEPRESSION

It’s important to note that there are options to cope and heal. Therapists designed a guidebook for navigating depression and its symptoms. The book includes five evidence-based skills for improving motivation, improving self talk, and improving relationships. The goal is to direct a life worth living. 

You’ll review a list of values, select your top four, and reflect on their importance in your life. Influenced by Acceptance and Commitment Therapy (ACT), you’ll detach from unhelpful thoughts and build a life of meaning. How can you embody these values and implement them further? What challenges may arise? You’ll use this information to guide your purpose, increasing movement and motivation through the tool of Behavioral Activation. All the while, you’ll track your results and get clear on your unique needs and actions. You’ll remember that making decisions and taking action doesn’t have to be ruled by your mood. 

You’ll test the power of Cognitive Behavioral Therapy (CBT), noticing automatic thought patterns, labeling them as helpful or unhelpful, and deciding to discard or cling to them. You’ll hone this skill over time, embracing a “growth mindset,” a concept developed by Dr. Carol Dweck, in which you can believe yourself capable of more than your feelings might lead you to believe. You can slowly detach yourself from a “fixed mindset” in an attempt to experience fewer depressive symptoms. Similarly, neuroplasticity tells us we are capable of immense change by opening ourselves up to new thoughts and behaviors. Small and subtle changes create invaluable impact. 

You’ll learn the four skills of Dialectical Behavior Therapy (DBT): mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. You’ll understand what it means to “walk the middle” path: holding two opposing truths at the same time. You’ll slowly open your brain to think dialectically. For instance: we can both want to change our reality and open ourselves up to the present moment, this second, this word, right here, right now. You’ll practice scripts for expressing your needs in a respectful manner.

These concepts stress the loop between thoughts, feelings, and behaviors. How will you use CBT, ACT, and DBT to help lift your depression? This post might provide additional guidance. We can focus on each step on the path to change—places in which we feel stuck and free—all toward an end result. We can get comfortable with our definition of the end result changing, too.

Learn more about CBT's role in challenging thought patterns here.

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