Mike George

    Chronicle Books, San Francisco, 2003

 

    Tucker, Evans, Hudson, and MacDonnell

    Lorenz Books, New York, 2002

 

    David D. Burns, M.D.

    Harper Collins Publishers, Inc., New York, 2000

 

    Michael Powell

    Gusto Company, New York, 2004

 

Pumping Ions: Games and Exercises to Flex Your Mind

    Tom Wujec

    Doubleday, New York, 1998

 

SAMHSA's National Mental Health Information Center

    Online Mental Health Publications

    www.mentalhealth.org

 

    Sarah Brewer, M.D.

    Ulysses Press, Berkeley CA, 2000

 

"The Science of Happiness" (cover)

    TIME, Special Mind & Body Issue

    January 17, 2005

 

 

 

 

 

Familiarize yourself with the medications prescribed.  Take the pills as directed.  Discuss beforehand what to do in the event of certain side effects.  Don't change your dose or discontinue the medication without first discussing this with your physician; stopping meds abruptly can lead to dangerous results.

 

 

The fewer the number of pill-swallowing sessions, the more likely people are to stick to medication regimens.  So, if you're taking pills 4 times a day, talk to your doctor to see if there's a way to adjust the timing so that you can condense them into 2 or 3 sessions.   

 

 

Make sure there is sufficient light in the room to double-check the name of the medication on the bottle.  Also verify that you have taken out the correct number of pills.

 

 

Especially if working with a handful of medications simultaneously, consider mapping out a medication schedule for yourself--possibly even color coding the medications to better visualize the routine.  If the medication allows for it, try taking the medication at meals or as part of your bed time routine, so that you know each time you sit down to eat breakfast, for example, you also swallow your pills.

 

 

Keep the pill cases all in one place.  Set aside the day's pills beforehand.  Consider purchasing a daily or weekly pill case with divided sections.  Know ahead of time (perhaps even create a "medication calendar") when you will run out of pills, so that you can either refill the bottle or obtain a new prescription.

 

 

If you're afraid people will find out which medications you're taking, carefully place the correct pills in either a discrete bottle or a deceptive bottle (for example, an otherwise empty bottle of aspirin).  Excuse yourself from their company, take the pills, then return.

 

 

Have someone living with you hide the medications somewhere, maybe even in a home safe if you have one; they can distribute the meds to you on a daily basis and also watch you take them (to prevent you from hoarding pills for "later").  If you live on your own, consider asking a friend, neighbor, and/or co-worker to assume this role temporarily.  If that's not possible, try placing the meds in a hard-to-get-to location, so that it slows you down if you want to give in to impulsivity.  Also, speak to your psychiatrist about increasing the number of refills (while also lowering the number of pills in each refill) so that you have access to fewer pills at any given time.  (For example, instead of having one refill of 30 pills, you might have 3 refills of 10 pills each.)  If you find yourself pill hoarding, let someone you trust know so that they can help you monitor the pill situation. 

 

There are many reasons why people like to snuggle under the covers during depression. 

 

Examples of common self-defeating statements include:

"I'm not gonna feel better anyway, so what's the point?" 

"There's too much to accomplish; I'll never finish!"

"I'm just lazy and a good-for-nothing.  This proves it."

"What if I try and fail?"

"I don't have to do this just because you say so!"

 

If you find yourself stuck in this pattern, there are some techniques to try if you're having trouble getting started with your day.

 

 

You might not feel like doing the things you once enjoyed, but what you might find is that, even if motivation and interest are not present initially, they can actually develop as a result of the activity itself.  Giving yourself the permission to do something you enjoy each day will help give you something to look forward to.

 

 

Separating the whole task into parts will make the "impossible" seem less overwhelming.  It allows you built in breaks to spread out the chunks over the course of time.  It also fosters a sense of accomplishment at each stage, rather than having to first wait until the entire task is completed.

 

 

Structure is a helpful element in accomplishing tasks.  Placing activities in time slots prior to the day eliminates the need to decide if and when to do something.  Also, tackling even one small task can lead to a sense of accomplishment.

 

You might wish to start of simple.  At the end of your day, analyze which parts of the schedule were most successful and why. 

 

The following is an excerpt from a daily schedule:

9am        Wake up

9-10am    Morning routine (shower, breakfast, etc.)

10-11am  Light exercise

11-12pm  Pay bills

12-1pm    Lunch

 

 

If you're having trouble getting started because you are anticipating an activity will be too difficult or unrewarding, try this little experiment: Select an activity (for example, grocery shopping) and break it down into its components (i.e. creating the shopping list, driving to the store, putting food in the cart, checking out, driving home, and putting the packages away).  For each of the components, predict how difficult and satisfying you think they will be (percentage from 0-100%).  Then, after you complete each sub-task, write down both how difficult and satisfying it actually was (also a percentage). 

 

For example, it might look something like this:

 

Component     P. Diff.   A. Diff.   P. Satisf.  A. Satisf.

shopping list      90%       10%       10%         60%

 

Compare the predicted (P) to the actual (A) values.  Was it as difficult and unrewarding as you guessed?  Chances are it wasn't.

 

 

 

 

 

 

 

 

 

 

 

 

Depression, which can lead to loss of productivity, is often associated with a loss of self worth.  Poor self-esteem then feeds into it by discouraging the individual to take healthy  risks and simply be him or herself.  The journey towards enhanced self-esteem will not take place overnight; however, the rewards of a renewed sense of worth can be signficiant, including increased general happiness and satisfaction with life.  The following are some basic strategies in tackling low self-esteem:

 

1)  Create positive affirmations for yourself by replacing

     negative self-talk with more supportive thoughts. 
     (Examples of affirmations include, "I am a wonderful

     person" and "I deserve to be happy and healthy.")  Even

     make your own affirmation tape to play during car rides.

 

2)  Don't limit your self worth to career success.  Aside

     from the fact that you have the power to determine what

     "success" means to you, happiness and confidence

     are just as likely, if not more so, to arise from

     relationships with friends and family.

 

3)  Do things on a daily basis that can help boost

     confidence.  For example, listen to your body's needs,

     do personal hygeine tasks, dress comfortably in

     clothes that make you feel good about your

     appearance, treat yourself to a nice meal

     by candlelight and with background music, etc. 

 

4)  Set aside more time to do the things you're good at. 

     Chances are you enjoy these activities, anyway.  Even

     if you're not the best at a particular skill, don't let that

     stop you, if it's something that brings you joy.

 

5)  If you have been procrastinating about completing 

     one task in particular, take a deep breath and just get

     through it.  Chances are, it won't be as bad as you've

     been building it up to be, and the sense of

     accomplishment upon its completion will be welcomed

     relief.

 

6)  Do nice things for people--yourself included!  For others,

     consider everything from volunteering through an

     organization to smiling at the person next to you in

     line.  For yourself, you may wish to buy yourself

     something nice (a new CD, flowers, etc.) or allow

     yourself to take that course you were always interested

     in.  As a spin off of a quote: Kindness is contagious. 

     Infect others. 

 

 

 

 

 

 

 "get well" card, etc.) 

 

 

Part 2 touches upon such topics as medication management, procrastination, motivation,

self-esteem, future goals, anger management, and happiness.

Navigating through the storm...

The Depression Guide