This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 37: Practicing your fears
In When Things Fall Apart: Heart Advice for Difficult Times, Pema Chödrön tells the story of a young warrior who asked Fear how to defeat him. Fear replied, “My weapons are that I talk fast, and I get very close to your face. Then you get completely unnerved, and you do whatever I say. If you don’t do what I tell you, I have no power. You can listen to me, and you can have respect for me. You can even be convinced by me. But if you don’t do what I say, I have no power.”
Exposure therapy is the behavioral method of choice for overcoming acute and specific anxieties. It prescribes a two-step approach: first, doing what you’re afraid to do; and second, allowing yourself to feel the discomfort without running away.
Carefully and gradually, a person is exposed to the activities or situations that bring feelings of panic so that their minds and bodies can acclimate. Social anxiety, fear of failure, fear of saying the wrong thing–even fear of not checking the door lock five times before bed–all of these respond well to simply doing them anyway … then noticing the uncomfortable feelings slowly fade.
Though exposure therapy is primarily a behavioral strategy, it is a cognitive one, too. If you’re afraid to ride on a plane and you practice doing so over and over while also practicing your distressing narrative, you might never overcome your fear. Use helpful self-talk.
When in doubt, ask a therapist to guide you through this challenging process. They will help you identify which fears to tackle first and how to coach yourself through uncomfortable moments. In addition, they might suggest a systematic approach that allows you to break down your feared experience into small steps that you can practice one at a time.
Here is a script that can be used during exposure therapy: “I feel uncomfortable right now, and that’s okay. I am allowed to feel this way. This feeling isn’t fun, but it is temporary. I am strong enough to handle it.” Edit as desired. The key here is that you don’t fight the anxiety you experience; instead, you welcome it, knowing it’s an important part of the corrective process. Each time you feel anxious while practicing your fear, then practice it anyway, you have taken another step toward defeating it.
When I was in college, I came across this quote by Ralph Waldo Emerson: “Always do what you are afraid to do.” At the time, I didn’t have many guiding principles; this became one of my first. I’ve been following it for over twenty years.
To learn more about exposure therapy, including some novel (and in some cases, hilarious) cognitive and behavioral strategies, read When Panic Attacks: A New Drug-Free Therapy to Beat Chronic Shyness, Anxiety and Phobias by David Burns.
If desired, add “practicing your fears” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 36: Practicing gratitude
Here’s a depression treatment that you can start right now: get a notebook and begin a gratitude journal. Though some people find this often-recommended strategy a tad simplistic, listing things you’re thankful for on a daily basis is shown to improve mood to a statistically significant degree. In one study conducted by the aforementioned psychologist Martin Seligman, severely depressed people were instructed to record three good things that happened each day. Within fifteen days 94 percent experienced significant relief from their symptoms.
The idea here is simple: we see what we look for. Regularly scanning our memories for positive moments and noticing our daily blessings teaches our brains to continue this practice throughout the day. Don’t worry–doing so won’t make you a crystal-carrying, aura-sensing mystic; at most, it will help you clarify what makes you happy and maybe make you a bit more pleasant to be around. And you have to be around yourself a lot.
Note that practicing gratitude isn’t the same as practicing toxic positivity, which is about ignoring or avoiding uncomfortable experiences. We can feel and honor our feelings while also moving away from unhelpful thought patterns that distort our view of reality.
If desired, add “practicing gratitude” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 35: Practicing meditation or mindfulness
Though some people use meditation as a coping skill for acute stress, for me, its true power lies in the way it trains our brains. Pema Chödrön says that meditation simulates a crisis situation (you mean I have to just sit here? for how long?) so that we can practice responding to the resulting emotions with equanimity. Put another way: meditation teaches us how not to freak out as much.
There are many types of meditation, but the main element they share is the refocusing of one’s thoughts onto a neutral object. Of course, a full discussion of the topic is outside the scope of this book, but excellent resources are widely available. In Ten Percent Happier: How I Tamed the Voice in My Head, Reduced Stress Without Losing My Edge, and Found Self-Help That Actually Works–A True Story, Dan Harris concludes that meditation increases his sense of well-being by about ten percent–an excellent return on investment. In his follow-up called Meditation for Fidgety Skeptics: A 10% Happier How-to Book, he pairs up with meditation teacher Jeffrey Warren to offer practical how-to advice on the topic.
Possibly the most well-known type of meditation is breathing meditation. However, if for any reason you find this difficult, you can also try visualization meditation, mantra meditation or another type. Visualizations can take many forms, from happy places to body scans. People who experience chronic pain often imagine healing elements like light and water with surprisingly good results.
Mindfulness is a type of meditation that involves bringing your thoughts back to your body and your immediate environment. Unlike some other forms of meditation, this can be done anytime, anywhere. If you don’t like the thought of sitting still for an extended period each day, look into mindfulness techniques that yuo can use during your usual daily activities.
Personally, I most enjoy mantra meditation. Repeating a calming phrase like “this moment” or “I am here” allows me to focus my mind and reduce distractions.
Jon Kabat-Zinn has helped develop meditation techniques for decreasing pain and improving mental health. In Wherever You Go, There You Are, he shares more about the science of meditation and success stories from his years in the field. He also coauthored a book called The Mindful Way Through Depression.
When in doubt, download a meditation app.
If you believe in a higher power–or even if you don’t–prayer can also be a helpful neural pathway shaper. Some experts believe that prayer affects the same areas of the brain as meditation and mindfulness practices do, which makes sense. The effectiveness might be comparable as well.
If desired, add “practicing meditation or mindfulness” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 34: Practicing acceptance
Finding new perspectives on your old, unhelpful stories is an important part of managing mood disorders like depression. Sometimes, though, after exploring a difficult thought, you might conclude that no accurate reframe exists. The horrible thing you’re thinking is simply … true. In these moments, you might consider a different strategy: acceptance.
Acceptance isn’t resignation. It’s an active, affirming choice. It involves finding the lessons and growth in difficult circumstances and reminding yourself gently that it won’t last forever.
Meditation teacher Tara Brach describes this process beautifully and in detail in one of the books I recommend most often to clients: Radical Acceptance: Embracing Your Life with the Heart of a Buddha. Whenever an uncomfortable feeling arises, Brach says, take a moment to accept and allow it. Rather than immediately avoiding it or distracting yourself, simply sit and feel the feeling in your body. See it for what it is: a temporary and manageable experience. Remind yourself to breathe. Notice that having this emotional experience doesn’t make you a bad person. It doesn’t define you. The feeling is just a feeling, and you are strong enough to handle it.
Radical, indeed.
Buddhist teacher Pema Chödrön has written about the practice of acceptance at great length. Actually, she’s famous for it. “We think that the point is to pass the test or overcome the problem, but the truth is that things don’t really get solved,” she writes in When Things Fall Apart: Heart Advice for Difficult Times. “They come together and they fall apart. Then they come together again and fall apart again … The healing comes from letting there be room for all of this to happen: room for grief, for relief, for misery, for joy.”
Open any page of any of Chödrön’s books for more.
Remember the Serenity Prayer (there’s a reason it’s so popular): change what you can and accept the rest. Behavioral modification is important. Perspective change is vital. But acceptance is a pretty good backup plan.
If desired, add “practicing acceptance” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
Catch it. Check it. Change it. This is a succinct description of the cognitive behavioral therapy (CBT) process. Catch unhelpful thoughts as they come. Check them for accuracy. Then find a helpful, balanced replacement. This can be done anytime, anywhere, but it seems to work best (especially at first) when you do it in written form.
Cognitive therapy guides recommend a variety of ways to identify inaccuracies in your thinking. Many make use of detailed worksheets for recording negative thoughts, feelings arising from the thoughts, cognitive distortions within those thoughts, replacement thoughts and more. Though these processes are shown to be effective, they’re also rather time-consuming. The method I prefer is a bit simpler.
Here is that method: Grab a pen and paper and make a list of all of the negative thoughts that are currently bothering you. Distressing experiences, personal shortcomings, difficult people, challenging situations, core fears–these are all great candidates for reframing. When you can’t think of any more, reread the list. Circle the ones that are most harmful to you or that feel the most stuck.
For each thought that you have circled, ask yourself some of the relevant questions in the list below. If needed, you can also notice if your distressing thought contains any cognitive distortions–common logical fallacies that sometimes creep into our thinking, especially in moments of acute depression or anxiety. These include: exaggerating, using all-or-nothing thinking, overgeneralizing, mind reading, jumping to conclusions, catastrophizing, personalizing, using “should” statements, disqualifying the positive, using emotional reasoning, minimizing, labeling, blaming and more. When you notice one of these distortions in your thoughts, that’s a sign that it might not be true, or fully true. Knowing this can help you find its weakness.
Once you’ve challenged your distressing thought, find at least one helpful reframe and write it down. For example, the thought “I am sad all the time” can be rewritten as, “I am sad some of the time, but not all of the time. I have many good moments and even hours throughout my week and I am learning how to expand those good times.”
If you prefer not to use the list of questions provided, no problem–just use the last one: “What is a more balanced, more realistic and more helpful perspective of this problem–a new story that I can remind myself of as needed?” That should do the trick.
Many people benefit greatly from a daily or weekly cognitive therapy ritual, but if that idea doesn’t appeal to you, use this process during times of higher-than-usual anxiety, depression or stress. Cognitive therapy can be difficult at times. It forces you to think in ways that might be unfamiliar or uncomfortable. But it is also one of the most evidence-supported depression treatments available, and I can’t imagine willingly passing it up.
If desired, add “challenging unhelpful thoughts” to your depression treatment plan. Then add it to your ongoing to-do list as well.
Questions for Reframing
Is this story true?
What percentage of this story is true, and what percentage is not true?
What aspects of this story are true, and what aspects are not true?
If I were to put this story on trial, what evidence would there be both for and against it? Would the judge find enough evidence to declare it true?
Is the opposite story also true? Is it more true than the original story?
Does this story include all-or-nothing thinking?
Does this story include exaggeration?
Does this story include catastrophizing?
Does this story minimize positive aspects of the problem?
Does this story overgeneralize or include words like always, never, nothing, and everything? Does this story include words like should or must?
Does this story include labels like stupid or bad? Do those labels always apply?
Does this story include jumping to conclusions, worst-case assumptions or guessing the thoughts or motives of others?
Does this story imply a need for perfectionism?
Does this story feel true partly or mostly because it’s familiar?
Does this story relate to any of my triggers or past experiences?
Does this story relate to any of my fears?
Does this story include self-blame for things I’m not responsible for?
Is the voice who is telling me this story the real me, or is it someone else that I know or used to know, such as a parent or authority figure?
Does all of me believe this story, or does only a small part of me believe it, such as the wounded child in me or the rejected lover in me?
Does this story bring up underlying desires or needs? What are other, more effective ways I can meet those needs?
Does this story include blame of others? Does it focus on what another should do differently, even though I cannot change their actions? How helpful is that strategy? What is a better strategy?
Does this story include anger? If so, is this because an important boundary of mine has been crossed (for example, a boundary regarding how people should treat me)? How can I reestablish that boundary for the future?
For any aspects of the story that are true, what are the real effects of the problem, and are they manageable?
How distressing is this problem on a scale of 1 through 10, with 10 being extremely distressing?
Is this problem always a problem, or is it only sometimes a problem? How often and to what degree is it actually a problem?
If I were to ask myself three times per day if the belief was true right then, how often would it be true? For example, if my belief is that I am not smart enough, would this be true when I am in the shower? Eating lunch? Writing an email? Having a work-related conversation? Performing a work duty? Relaxing with friends?
Is this a true problem (ongoing unfixable issue) or is it merely a challenge? Will this problem still exist one year from now?
How much of my emotional energy do I want to devote to this problem?
What is the worst case scenario that could arise as a result of this problem? On a scale of 1 to 100, how likely is that scenario to come to pass?
If the worst case scenario were to happen, how would I respond? How would I handle it and what would I learn from it? After I fully went through it, what would the outcome be and would it be as terrible as this story implies?
For any aspects of the story that are true, what can I do to fix or lessen these difficulties, even in part? Am I willing to do these things?
For any aspects of the story that are true but unfixable, can I accept these challenges?
Is this problem a normal part of life that many people manage well?
What image can I bring to mind when thinking of this situation that would help me feel more calm?
Can I find a place of acceptance inside of me in which to put this problem?
What acceptance self-reminder can I use when the unfixable aspects of this problem come to mind?
If I were to ask a friend for their perspective of this problem, what would they say? If a friend of mine had this problem, what would I tell them?
And finally, and most important: What is a more balanced, more realistic and more helpful perspective of this problem–a new story that I can remind myself of as needed?
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 32: Going to counseling and/or entering a treatment program
Self-help books are great, but many people find that lack of knowledge about mental health isn’t their biggest barrier to self-improvement. When major life changes like many of those discussed in this book feel too difficult, counseling is often extremely helpful. A good therapist will guide you to explore the mental and emotional roadblocks that keep you from following through on your goals.
Counseling can be expensive and time-consuming. Still, for many people, the investment is worth it as it can greatly improve your quality of life. If you choose this mode of treatment, find a counselor who specializes in depression and who you can be completely honest with. Have clear goals and commit to the process. Prepare to hear feedback that might make you a bit uncomfortable, and, possibly most important, choose a counselor you respect and feel respected by.
Group therapy classes are another option and can be more cost effective than one-on-one counseling.
In On Becoming a Better Therapist: Evidence-based Practice One Client at a Time, Barry Duncan reviews studies showing that more often than not, counseling is an effective way to manage mental health disorders like depression. Most counseling failures result from client dropout, client noncompliance, or the lack of a strong client-counselor bond. This is good news, because all three of these factors are within your control.
Mild to moderate depression can often be treated with weekly one-on-one therapy sessions. People currently experiencing severe depression, though, might need significantly more support. If you are in crisis or having persistent thoughts of suicide or self-harm, seek a higher level of care. Intensive day treatment programs and inpatient treatment programs save lives.
If you are currently in crisis or have complex mental health needs, and you need help finding counseling or other treatment, the U.S. Department of Health & Human Services has a national helpline that offers referrals at samhsa.gov/find-help/national-helpline.
If you have persistent thoughts of suicide, please call the 24-hour National Suicide Prevention Lifeline at 800-273-8255.
If desired, add “going to counseling” and/or “entering a treatment program” to your depression treatment plan. Then decide on next steps and write them on your short-term and/or long-term to-do list.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 31: Improving your sex life
Sex is a powerful emotional and physical experience: a natural, healthy high that can significantly improve your mood. It offers a peak experience and can also increase partner intimacy. Though improving your sex life isn’t a traditional depression treatment, people with mood disorders might greatly benefit from investing in this area of life.
And an investment it is. In Come Together: The Science (and Art!) of Creating Lasting Sexual Connections, sex educator Emily Nagoski discusses some of the relational improvements, planning skills and perspective changes that might be needed to build a fulfilling, satisfying sex life. “Center pleasure,” she emphasizes, over and over again. Sounds like a depression treatment to me.
Nagoski’s first book on the subject, Come as You Are: The Surprising New Science that Will Transform Your Sex Life, is equally enlightening. It discusses sexual desire, sexual functioning and sexual myths. If sex is important to you, read this one, too.
Depression can reduce sexual desire, and so can some depression medications. In either case, consult with your medical provider and find out what options are available.
If desired, add “improving my sex life” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 30: Caring for a pet
It’s easy to love an animal. And it’s easy to be loved by them. For many people, pets are a primary source of joy, affection and emotional reassurance. And according to the Anxiety and Depression Association of America, pet ownership can reduce or prevent depression in some people. Pets provide companionship, and they also encourage healthy routines. Additionally, they enhance a person’s sense of personal significance. When you care for another living being (kids and plants count, too), you often increase your feelings of self-worth, and this feeling can be highly protective during tough times.
Of course, pets come with a financial and lifestyle commitment that you might not be ready to make. Carefully consider the sacrifices before adopting. Pet ownership is a great pleasure and a great responsibility, and as with other major life commitments, timing is important.
If desired, add “caring for a pet” to your depression treatment plan. Then decide on next steps and write them on your short-term and/or long-term to-do list.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 29: Attending a community group
Positive psychology researcher Sonja Lyubomirsky reports in The How of Happiness: A New Approach to Getting the Life You Want that people who actively participate in spiritual communities are physically healthier, live longer, enjoy better marriages and experience less stress overall. The 2000 classic Bowling Alone: The Collapse and Revival of American Community by Robert Putnam covers the topic in more detail, arguing for the importance of community to mental health.
If your life isn’t quite peopled enough, consider joining a group. The choices are many: spiritual groups, religious groups, crafting groups, therapy groups, volunteer groups, writing groups, hiking groups, book clubs and more. If you can’t find one in your area that interests you, consider starting your own. Just keep in mind that the benefits of doing so might not come right away; it takes time to build community.
If desired, add “attending a community group” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 28: Practicing healthy assertiveness and boundaries
When your sense of well-being is consistently and significantly affected by someone else’s behaviors, choices or moods, depression can sometimes result. Neglecting to create proper boundaries, even in healthy relationships, reduces your felt power over your activities, environments, time, energy and needs.
Boundaries aren’t just for extreme situations, like toxic relationships and demanding bosses. They’re everyday tools for everyday needs. Increased self-advocacy, for example, and reduced emotional exertion spent on someone else’s problem–these might not seem like boundaries, but they are.
A cautionary note: even slight changes in the dynamics of your relationships can lead to destabilization and conflict. A capable therapist can assist you in determining healthy and appropriate boundaries and in communicating them effectively.
Like boundaries, assertiveness can be tricky at times. Located at the halfway point between passivity and aggression, it can be hard to detect at first (the middle ground often is). Early attempts at this skill might be less than graceful, but practice helps. As confidence grows, communication is smoother. Much of the time, people respond less to what you say and more to how you say it, and standing up for yourself or for someone else isn’t always as difficult as your primal brain fears it will be.
One of my most frequently recommended therapy homework assignments is keeping a list of occasions on which the client practices assertiveness and confidence. Taking the time to note down these moments of growth not only encourages you to find more opportunities to build this skill, but serves as proof that you can do it. Don’t forget to give yourself credit for the small stuff: paying your way, choosing the restaurant and limiting phone calls with a difficult family member all count.
Liberated Love: Release Codependent Patterns and Create the Love You Desire by husband and wife team Mark Groves and Kylie McBeath emphasizes the deliciousness that boundaries create between romantic partners. Mutual respect, affection and sexual desire increase as partners advocate for their needs. Opportunities for resentment decrease, and couples no longer feel the need (or are allowed) to “fix” each other’s feelings or behaviors. Personal growth and fulfillment is each person’s own business.
In other words: boundaries are sexy.
Flexibility is important. Some boundaries are negotiable. But they exist in some form in every healthy relationship. Anytime you start to feel responsible for another person’s choices, or act against your inner wisdom due to fear of another person’s reaction, consider ways to take back your power. People with chronic mental health concerns like depression might have an even greater need to protect their emotional energy and maintain healthy levels of independence.
If desired, add “practice assertiveness and boundaries” and/or related strategies to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 27: Learning communication and conflict management skills
A good day can go bad very, very fast when a conflict arises, especially one that isn’t managed well. Seeing the improvements that the skills of listening, deescalation, finding agreement and the like bring to an uncomfortable conversation will make you a believer in corny couples counseling exercises forever.
If you haven’t read anything by John Gottman, one of the most well-known relationship researchers, skim (or pour over) one of his many books. Online summaries are also available, and his sound bytes are widely shared in every format.
Some of my favorite communication tips are as follows. First, aim for a 7-to-1 (or higher) ratio of positive-to-negative interactions–the ratio Gottman found that happy couples maintain. Second, during an argument or difficult conversation, find something you can agree on–anything at all. Most of the time, doing so significantly reduces defensiveness and tension. When in conflict, stick to one topic; otherwise, fights become unfocused and unhelpful. Also, keep the discussion either solution-focused or feelings-focused–don’t switch back and forth between the two. When in doubt, validate, then validate some more. Finally, when anger or frustration levels mount to an unhealthy level, take space and try the conversation again after a good night’s rest.
Of course, the process of learning communication and conflict management skills is a highly complex and individual one, and will likely continue throughout your life. If needed, make use of professional resources, such as couples counseling. Early intervention works best.
If desired, add “learning communication and conflict management skills” or a related strategy to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 26: Establishing and maintaining strong relationships
Psychologist Daniel Gilbert writes in Stumbling on Happiness that if he were to guess at a person’s level of felt well-being based on only one fact of their life, he would choose to know not about how healthy they were or how successful, but about the quality of their relationships. One of our most basic human needs is secure attachment, and if you don’t have enough of it, it might be time to increase your social efforts. Go on dates with your partner. Reach out to a friend at least once a week. Plan a standing walk or coffee date with a friend. The alternatives to secure attachment are anxious attachment, disorganized attachment and avoidant attachment, and if you notice a pattern of insecurity in your relationships, it’s worth learning more about these concepts.
It can be challenging to find your people. If you’re feeling discouraged by the process, know that the difficulty is more common than many people suppose. Commit to the effort. Follow through with your social efforts on a regular basis. Open up to others in a genuine way and allow them to do the same.
Adored author and researcher Brené Brown has made a career of convincing people to deepen relationships through vulnerability. Sharing the parts of yourself you’re least proud of with a nonjudgmental loved one can be a powerfully healing and bonding experience. Some group therapy classes focus almost exclusively on sharing and relating, with great results. You’re not alone. Someone else has been there, too.
In Love Warrior: A Memoir, best-selling memoirist Glennon Doyle puts it well: “We can choose to be perfect and admired or to be real and loved. We must decide. If we choose to be perfect and admired, we must send our representatives out to live our lives. If we choose to be real and loved, we must send out our true, tender selves.”
If desired, add “find more friends,” “regularly reach out to friends,” “try new social activities” and/or related strategies to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 25: Resting and taking time off
When former National Chess Champion Josh Waitzkin drew close to an important competition, he did something surprising: he rested. Unlike many of his competitors, Waitzkin took several weeks away from the board during the crucial pre-game months to sail with his family–a mental rest that counter-intuitively sharpened his game once he returned. The Art of Learning: An Inner Journey to Optimal Performance follows this author’s road to mastery of two very different pursuits: chess and Tai Chi. A key insight: sometimes, extended breaks allow the subconscious to process and integrate previously learned strategies and other relevant data in a way that the conscious mind is incapable of doing.
Screen-based entertainment might not provide the kind of rest that Waitzkin’s game, and our brains, need most. While screens can offer a welcome distraction and even some relaxation, we also benefit from creating mental gaps in our days. Quiet walks. Long baths. A cup of coffee on the front porch. Find a few minutes of true rest every day.
Of course, taking time off work, including personal days and vacations, can also provide much-needed time to recharge.
If you are experiencing chronic stress or are frequently overwhelmed, you might like Burnout: The Secret to Unlocking the Stress Cycle by Emily and Amelia Nagoski.
If desired, add “taking time off work,” “adding rest breaks into my days” and/or related strategies to your depression treatment plan. Then decide on next steps and and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 24: Staying busy
Though relaxation and self-care are undeniably important, sometimes, staying busy helps, too. Some psychologists assert that people often overestimate the amount of enjoyment they will derive from an increase in free time and underestimate the amount of pleasure that challenging, competitive and creative pursuits provide. Many video games even include work-like tasks.
At times, staying busy can distract you from overthinking and allow you to put some space between your more contemplative, emotionally heavy moments. Of course, the benefit of staying busy largely depends on the activities you choose to fill your time. Consider engaging in a variety of healthy work and personal tasks–some of which are mentioned in this book–during a given week in order to reduce monotony, increase your sense of accomplishment and find balance.
If desired, add “staying busy” or “creating a balanced weekly schedule” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
A rather obvious treatment option, but one that is highly deserving of inclusion in this book, is exploring high quality self-help resources. There is no shortage of excellent self-improvement books, podcasts, channels and the like that seek to encourage, inspire and educate. I love research-backed how-tos as well as memoirs of people who have learned from their challenges. Book by book, my life has been unalterably changed.
Read everything that interests you, and some stuff that doesn’t. Keep in mind, though, that self-help materials are not a replacement for professional treatment for depression, and the other treatments listed in this book aren’t, either. If you have depression, please seek the help of a mental health professional, and use other resources in a supplemental and informational fashion.
Finally, note that many self-help resources contain inaccuracies and can cause harm. Use caution.
If desired, add “explore self-help resources” to your depression treatment plan. Then decide on next steps and write them on your to-do lists.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 22: Traveling
A surprising treatment option, one that I include in this book with some qualifications, is travel. For some people, adventuring to a new place (even one that’s just a car ride away) can be an effective way to get out of a mental rut and improve mental health. By stepping outside of our familiar routines and environments, we’re able to gain fresh perspectives, break free from negative thought patterns, and experience new and stimulating activities.
In Self-compassion: The Proven Power of Being Kind to Yourself, author Kristin Neff recounts a physically and emotionally taxing journey through Mongolia that she took with her young son, who has a severe form of autism, and the benefits he received. It might have been the religious rituals that did the trick, but my guess is that the fresh air and the complete change in his environment altered certain neural pathways that had developed over the course of his short life.
I’ve always loved to travel, but not because it’s easy or comfortable. I love it because when I’m somewhere else, I’m more present. I have much greater appreciation for a hot bath, a cold drink and a soft bed, and I pay close attention to interesting details in my surroundings.
Travel isn’t for everyone. It can be costly and physically and emotionally challenging. If you think travel might have a positive effect on you, and you feel emotionally stable enough to take on the challenge, consider planning a trip in the near future. When you return from your trip, continue bringing more gratitude and awareness home with you.
If desired, add “traveling” to your depression treatment plan. Then decide on specifics and next steps and write them on your short-term and/or long-term to-do list.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
***
Treatment option 21: Maintaining clean and organized living spaces, simplifying your life and keeping up on other tasks of adulting
I’m often surprised by how many of my clients cite home cleaning and maintenance as one of their primary personal goals. People say that when their dishes are done and their laundry is folded, they feel more productive, more powerful, and just … better about themselves. The book How to Keep House While Drowning: A Gentle Approach to Cleaning and Organizing by KC Davis offers some tips for effectively managing your adulting load. If you’re a person who struggles with daily to-dos, this book might be of help.
While you’re at it, consider simplifying your life in other ways. Do less. Organize your spaces. Pare down your wardrobe to your favorite essentials. Have a meal schedule that you repeat on a weekly or bi-weekly basis. Use lists, shop only a few times a month, and find other ways to minimize your mental, physical and emotional expenditures on a weekly basis. Create a weekly schedule that includes all of your ongoing tasks and stick to it. All of these practices can increase feelings of productivity and reduce emotional exhaustion and decision fatigue.
Adulting can be a bore, but adulting is also powerful. Small daily tasks lead to major life accomplishments. As previously mentioned, many people find that completing just two items from their to-do lists per day can be enough to keep them on top of home-, health- and finance-related needs. (Work- and kid-related tasks are not included in this estimate, of course.)
If desired, add “maintaining clean living spaces,” “organizing my home,” “creating a weekly schedule,” “keeping up on tasks of adulting” and/or related strategies to your depression treatment plan. Then decide on next steps and write them on your to-do lists. As previously discussed, resist the temptation to overcomplicate your list system: a single much-used list is greater than a set of forgotten ones. Consolidate. Most important, consult the lists often.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
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Treatment option 20: Reducing screen time
Research has shown that social media use can negatively impact mood and self-esteem. It encourages FOMO (fear of missing out), imposter syndrome, bullying and unhealthy comparisons between peers. Doom scrolling leads to heightened anxiety, and entertainment media like shows and video games can reduce productivity and encourage procrastination.
Productivity isn’t everything, and a balanced schedule can contain plenty of relaxing screen time. Do what works for you. I find that I get more screen time overall, and enjoy it more, when I wait till the end of the day to indulge after my tasks are completed.
Life is an experiment. Consider drastically (or not-so-drastically) reducing your screen use for a time, and noticing if any mood improvement occurs. I often recommend that clients refrain from social media, games, internet surfing and other distracting screen activities for part or all of their work day. Admittedly, this is not a popular strategy.
If hours of phone-free time feels too drastic for you, consider turning off your phone for just a one-hour stretch each day. Blast through some of the items on your to-do lists or complete especially difficult work tasks. Try it for a day, or a week. This one change can lead to dramatically improved focus, attention and productivity. At the very least, check your phone time each week and attempt to reduce it gradually.
If you are currently experiencing a severe depression episode, don’t try this right now, and if your loved one is severely depressed, this isn’t the time to reduce pleasurable activities. Scroll away.
If desired, add “reduce my screen time” to your depression treatment plan. Then decide on a specific screen use strategy and write it on your ongoing to-do list.
This is an excerpt from my upcoming book, We Get Better: 48 Treatment Options for Chronic Depression.
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Treatment option 19: Engaging in long-term projects and hobbies
According to a study cited in The Happiness Advantage: How a Positive Brain Fuels Success in Work and Life by Shawn Achor, having an activity to look forward to raises endorphin levels significantly. This is especially true when projects and hobbies include creativity, a sense of accomplishment and long-term involvement, such as gardening, crafts, writing, teaching, cooking, sports and many more. Bonus points if the hobby is social and screens aren’t involved.
I am often surprised (and encouraged) by the incredible variety of ways people come up with to entertain themselves. A friend of mine teaches himself tricks on the trampoline, for example. Others plant flower seeds in public urban areas as random acts of kindness. Author David Sedaris has been picking up litter nearly daily for years, and a garbage truck has been named after him. If you don’t have an awesome, fulfilling hobby, consider trying something new, then something else after that. Recreation isn’t just recreation; it’s a deeply meaningful part of the good life.
Volunteer work can be especially satisfying. Psychologist Sonja Lyubomirsky, author of The How of Happiness: A New Approach to Getting the Life You Want, found that people who did five random acts of kindness in a single day were much happier than control groups. The aforementioned Martin Seligman, one of the founders of positive psychology, agreed that acts of kindness increase happiness more reliably than any other exercise he has tested. In Learned Optimism: How to Change Your Mind and Your Life he writes, “Depression … stems partly from an overcommitment to the self and an undercommitment to the common good.”
If desired, add “finding a long-term project” or “engaging in my hobby regularly” to your depression treatment plan. Then add it to your ongoing to-do list as well.
Financial stability means many things to many people. However, positive psychology research clearly shows that people living above the poverty line are significantly happier than people who live under it, while wealthy people are only marginally happier than middle class folks. For optimal mental health, then, getting your needs met–not continually wanting more–should be the goal.
In Happy Money: The Science of Smarter Spending, authors Elizabeth Dunn and Michael Norton explore the ways we can use our money to increase our happiness and well-being. They argue that while money can bring happiness, it’s not just about how much money you have, but how you spend it. They offer five principles for spending money in ways that increase happiness, including buying experiences instead of things; buying time; investing in others; paying now and consuming later; and designing your environment. The authors also explore the limitations of money in terms of increasing happiness and the importance of non-monetary factors, such as strong relationships and a sense of purpose, in fostering well-being.
Two other personal finance books that I recommend are Dollars and Sense: How We Misthink Money and How to Spend Smarter by Dan Ariely and Jeff Kreisler, as well as the classic Rich Dad, Poor Dad: What the Rich Teach Their Kids About Money That the Poor and Middle Class Do Not! by Robert Kiyosaki. The latter discusses investing, while the former coaches the reader through spending traps they do best to avoid.
If desired, add “maintaining financial stability” to your depression treatment plan. Then consider specific ways to improve your finances, such as creating a budget, and write them on your short-term and/or long-term to-do list.
