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Chapter 3: Handling Depression
Tools for Anger Work-Out
By: James J. Messina, Ph.D.
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Handling Depression
I. How does my depression manifest itself?
When depressed, I experience:
· a loss of enthusiasm for life.
· . a lack of energy for self?growth.
· . confusion as to what is the meaning of life for me.
· . a blue funk.
· . a lack of excitement or appreciation for my accomplishments in life.
· . lethargy, tiredness, and exhaustion.
· . an inordinate desire to sleep.
· . a flat emotional affect.
· . boredom with my life, job, family, friends.
· . the absence of spontaneity or joie de vivre.
· . a lack of desire to keep on keeping on.
· . the feeling that the world would be better off if I no longer existed.
· . the desire to run away or end it all.
· . the feeling that I am only an observer of life and not involved in it.
· . a sense of living in slow motion.
· . a feeling of energy and drive in the midst of a crises, deadline, or tragedy.
· . tearfulness and weeping for no apparent reason.
· . loneliness, isolation, a lack of being connected to the others in my life.
· . apathy, discontent, and a hollow feeling regarding my day to day existence.
II. What are some causes of my depression?
I feel depressed when I:
· experience a failure or loss in life.
· hold in my anger.
· review my past life and fail to see a meaning or reason for it.
· have a conflict, disagreement, or fight with those I either live or work with.
· feel guilty over something I have done or said.
· have been criticized or found to be lacking.
· doubt my ability to be successful.
· let myself down by not being as perfect or as accomplished as I would like to be.
· face the futility of the human condition.
· don't feel approved by someone whose approval I am seeking.
· experience a major change in my life.
· have accomplished something that has taken much energy and effort, i.e., the birth of child, a marriage, a divorce, landing a new job, graduating from school.
· have to deal with death.
· experience rejection in a relationship.
· sense that I have no control over the negative experiences in my life.
· realize that others question my competence, judgement, knowledge, ability, or worth.
· doubt my decisions, actions, or accomplishments.
· recognize that I am powerless in the face of addictive or compulsive behavioral problems.
· am on vacation or have a day off.
· experience the "holidays'' (Thanksgiving, Christmas, Hanukkah, New Year's, Valentine's Day, etc.)
· continue to respond with the behavioral role pattern I learned in my dysfunctional family.
· am ill or disabled.
· hear news that has affected others adversely.
· realize that my dreams for the future are unrealistic; fantasies with no possibility of ever being accomplished.
· am confused over my direction, goals, or priorities in life.
· learn something new about life, something which if I had known earlier would have made my life more pleasant or successful.
· continue to not know what ``normal'' is, have no idea of ``normal'' behavior, or ``healthy'' behavior.
· am unable to connect with people in healthy relationships.
· can't identify the reason for my unhappy, sad, or worried feelings.
· ignore my need to express anger in a healthy, productive manner.
· feel inadequate.
· continue to rely on crises, deadlines, or tragedies to overcome my lethargy and lack of energy.
· am jealous of those I perceive to have achieved the ``ideal'' life.
· have a chemical imbalance, physical or biological, needing medical attention.
III. What irrational beliefs lead me into depression?
· I should not make mistakes.
· People should automatically recognize my worth and value.
· It is wrong for me to show my anger.
· It is a sin to be angry at my parents behavior toward me.
· I should not disagree with others.
· People should accept me the way I am.
· My loved ones should not leave me, should not die.
· I should not get sick or disabled.
· What I do should be done perfectly.
· I should be rewarded in life for my hard work and sacrifices.
· Things should not change.
· I should be happy when I am successful.
· The "holiday'' season should be the happiest time of my year.
· I should be in control over all aspects of my life.
· I work best under pressure.
· If you want a thing done, give it to a busy person.
· I am unable to avoid the crises in my life.
· I should be able to solve problems that come my way.
· I am only worthwhile if I accomplish something visibly productive on a daily basis.
· I should not consider my current problems or behavior as a reflection of the way I was reared.
· My goals in life should be clear.
· I should not be suffering today because of the way I was reared.
· Relationships should be established and maintained with ease.
· Others should know what I need from them without my having to ask; it's perfectly clear.
· I should have been more successful, but others held me back.
IV. What are the negative effects of depression
When I feel depressed I:
· find others unwilling to get involved with me, actually avoiding me.
· have self?destructive or suicidal thoughts.
· escape into unhealthy behavior patterns.
· withdraw from life, face my problems passively.
· escape into watching TV, reading, daydreaming or other obsessive but passive behavior.
· ignore my creativity, imagination, and ingenuity in facing my problems.
· procrastinate, feeling overwhelmed by my responsibilities, duties, and tasks.
· turn off my positive emotional response to life.
· .ignore my personal health with poor personal hygiene, no weight control, and lack of proper exercise.
· get hooked on the need for the adrenalin rush that comes with a crisis, a deadline, or other pressures, even tragedies to get me through life.
· am anxious, nervous, tense, and uptight for no apparent reason.
· feel like a loser.
V. How can I overcome my depression?
In order to overcome depression I need to:
· recognize that I am depressed.
· have a complete physical exam to rule out a physiological cause for my depression.
· determine whether the depression is situation specific (related to a current situation in my life) or chronic (a part of my behavior for a long period of time).
· identify the causes of my depression.
· change my irrational thinking and develop a more realistic perspective.
· accept that anger is the basis for my depression, and make a concerted effort to do anger work-out sessions daily to lessen its impact.
· realize that depression is a fact of life, that it accompanies loss, grief, and even success.
· find a place in my life for relaxation efforts such as self?hypnosis, meditation, and progressive muscle relaxation.
· use visual imagery to see my life without depression and put my energy into the pursuit of a positive goal.
· develop a crisis prevention, time management, and catastrophic intervention plan of action.
· develop a balanced lifestyle with good nutrition, a balanced diet, aerobic exercise, adequate sleep and stress reduction.
· work at self?esteem enhancement, self?affirmation, self?reinforcement.
· commit myself to a specific plan of action to overcome my depression.
VI. What steps can I take to handle depression?
Step 1: I will review this chapter, then answer the following questions in my journal
1. How effectively do I cope with life?
2. How can I recognize depression in my life?
3. What symptoms of depression do I currently experience?
4. What current life situations contribute to my depression?
5. What explanations clarify my chronic state of depression?
6. How does my current situational depression exacerbate my chronic depression?
7. How do I feel about admitting that I am depressed?
8. What hinders my efforts to overcome my depression?
9. What feedback do I get from others that alerts me that depression is a problem for me?
10. How is my depression related to my low self?esteem?
Step 2 Once I have explored the symptoms of depression and admitted that I am depressed, I will attempt to identify the causes. I will answer the following questions in my journal
1.How did life in my family of origin result in my current depression?
2.What losses have I experienced in the last five years to explain my current depression?
3.What successes or achievements in the past five years have I experienced that might explain this current depression?
4.What does my family doctor or psychiatrist say about the physical, biological or chemical contribution to my depression?
5.How do I feel about the need for medication to keep me in chemical balance?
6.What is my family history of depression?
7.Which relatives had depression or had ``breakdowns?''
8.What is my family history of suicide?
9.How do I feel about the concept of having a geneticpredisposition to depression?
10. What are the causes for both chronic and situational depression in my life? (Put these in your journal in separate lists.)
11. How does my need for excitement in crises, deadlines, pressures, and tragedy relate to my depression?
Step 3: Once I have identified the causes of my chronic and/or situational depression, I need to identify my irrational beliefs that contribute to my depression. I can work to refocus my thinking. To do this I will answer the following questions in my journal:
1. How rational or realistic is my current thinking?
2. What beliefs contribute to my current depression?
3. What is the source of these beliefs?
4. What is the worst thing that could happen if I no longer hold on to these beliefs?
5. What rational beliefs could I substitute to overcome my depression?
Step 4: Once I have begun to rethink and rewrite my irrational beliefs, I need to address the negative effects of depression in my life by answering the following questions in my journal:
1. What effect does my depression have on my relationships? In my marriage? My family? My friends? My co?workers?
2. In what self?destructive behavior do I currently engage?
3. How withdrawn or passive have I become? How can I become more assertive?
4. How does escapism defer my personal growth and happiness?
5. What keeps me from taking control of my time, eliminating procrastination, and facing my depression?
6. What positive aspects of my life do I seem to ignore?
7. How does the condition of my body reflect the state of my depression? What positive steps would improve my physical response to depression?
8. How is my anxiety and tension manifested? How can I reduce its impact on me?
9. How often do I feel like a loser? At what am I a ``winner''? How much do I work at being a winner? How deeply can I commit to the following belief: To be a winner in life you only need to be a winner at what you do best and admit that you are a winner.
10. How committed am I to overcoming my depression?
Step 5: Now that I have reviewed the negative impact of depression in my life, I will record my plan of action to overcome my depression.
Action Plan for Overcoming Depression
1. I am depressed.
2. I have the following forms of depression:
a. Chronic depression:
b. Situational depression:
3. The causes of my depression are:
a. Chronic:
b. Situational:
4. The irrational beliefs that contribute to my depression include:
5. The new beliefs I need to help lessen my depression include:
6. I will work on the following anger to uproot my depression:
a. Chronic:
b. Situational:
7. I will perform the following anger work-out activities to reduce my depression:
8. I will use visual imagery daily in the following ways:
9. My plan for a balanced life includes:
a. nutrition and diet
b. exercise, aerobic and other
c. adequate hours of sleep
d. relaxation activities
10. My plan for building self-esteem includes:
a. self-affirmation
b. self-hypnosis
c. visual imagery
11. I will take the following steps to determine if there is a physical, biological, or chemical basis for my depression:
a. appointments with family doctor for complete physical exam
b. lab work as needed
c. prescriptions as needed
d. therapy as needed
12. I commit to this plan and will review it on a monthly basis.
Step 6: I will lessen my depression using the tools I have been given. I will assess the status of my depression. If it has not improved, I will go back to Section VI and begin the steps again.
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