Fighting Depression and Anxiety: Taking Responsibility For Your Mood

As the economy tanks and our lives become increasingly stressful, it is easy to blame anxiety and depression on outside forces acting on you. It feels as though external events are controlling your mood. Even the weather seems to impact your anxious and depressed mood on a dreary day.

By giving control to outside forces three things happen:

1. You are released from responsibility for your mood.
2. You cannot be judged for your mood.
3. Your mood cannot be expected to change unless circumstances change.

The problem is that such beliefs create helplessness. Helplessness then leads to passivity. No battle is won when we believe that the outcome is out of our control. Even under overwhelming circumstance, we need to believe that we can affect the outcome.

By taking responsibility for your mood,

1. you improve your mood by using active problem solving, even when a solution is not easily had.
2. you build hope for a brighter future by believing your circumstance can change in the future.
3. you tell yourself that you are a warrior who will do all you can to survive any circumstance and come out a happier person.

Helplessness and hopelessness presume that the outcome is going to be negative. Remind yourself daily that no outcome is known until it arrives.

Depression and Anxiety: Where's the Cure?

When enter treatment for a medical condition, you want a cure. Same with depression or anxiety; you want your therapist to prescribe a cure. In most cases, you don't really care what the treatment is, you just want to know that there is an end to the pain.

While this thinking is common, it may actually be the wrong way to think about change. If you are 100 lbs. overweight, then it is unwise to consider how to lose 100 lbs. That is an overwhelming goal. Instead, you want to set smaller, more achievable goals. Instead of a goal of losing 100 lbs., it is better to choose a goal such as eating fewer carbs and increasing fruits and vegetables, taking a walk three times this week, etc. Why are these better goals than losing 100 lbs.?

Goals are better when they are achievable within a short period of time. Goals are achievable when they are in reasonably easy reach and you can measure whether you have met the goal. We measure progress toward goals when we have set specific enough goals and are accountable.

Back to mood disorders. When you think in terms of a cure, then the goal becomes vague and is difficult to measure. As an alternative use these guidelines to set goals:

1. Imagine being cured of your mood disorder. List ten changes that would be reflected in your behavior if you were not depressed or anxious.
2. Take one of those behaviors and think of five steps that could be taken toward behaving this way.
3. Rank the five steps from the easiest to the most difficult. If they are all too difficult, then think of a couple easier steps that can be taken (for instance, imagine changing your behavior in your mind rather than actually acting on it).
4. Now take a step today. Goal-setting should not be an exercise in fantasy, it should translate into action. Take that action today.

A psychologist, B.F. Skinner managed to teach pigeons to play ping pong (click here if you don't believe me). How did he accomplish this? By breaking down this goal into small bits of behavior. If it works for pigeons, it will work for you!

The Magic of Talking Therapy

Image via Wikipedia

Psychotherapy is a difficult sell. As a therapist, I am asking my clients to pay for talking to me. When they leave, they leave empty-handed - no prescription, no gifts, no immediate change in their looks or behavior. For many, I am asking them to believe in magic.

I believe in the magic of talking therapy! I know from personal experience and the results of my work that lives are changed as a result of talking to a therapist. But what is the magic source of this change? Here are some examples:

1. When someone listens to you they are saying, "You are worth my time, my attention, and my caring". It is an expression of your worth for someone to listen to you. As a therapist, I listen to the words and search for the meaning sometimes hidden beneath the words. But just as important, I am telling my client, "You have worth."
2. Feelings expressed are more easily managed. There is magic in sharing one's feelings. We all have fears, insecurities, and self-doubts that dwell within us. These feelings can weaken us as tensions and anxieties grow. When we share these feelings, we find that these feelings simply make us human.
   
3. I suspect that most of my clients expect me to offer them nuggets of wisdom that will change their lives. Yet, one magical aspect of therapy is that it acts like a mirror. Talking to someone who accepts you allows you to change your focus off trying to please the therapist and, in the process, leads you to listen to yourself. Listening to yourself talk about yourself is magical. A brief glance in the mirror typically reveals little, but a longer gaze reveals more. The magic of the mirror is that it can reveal the beauty in the eyes even when there are wrinkles around the eyes.

The magic of psychotherapy only reveals itself over time. For some, the relationship builds quickly, but for others it takes many weeks before the relationship gains the special qualities that create magical outcomes.

Antidepressants Got You Down?

I found this fascinating quote today:

"The chemical imbalance theory, which was formulated in the 1960s, was based on the observation that mood could be artificially altered with drugs, rather than direct observation of any chemical imbalances," Leo said. "Since then there has been no direct evidence to confirm the theory and a significant number of findings cast doubt on the theory."

The researchers said the popularity of the theory is in large part based on the presumed efficacy of the SSRIs, but they say that several large studies now cast doubt on this efficacy.

A review of a full set of trial data published in the journal PLoS (Public Library of Science) Medicine last month concluded that much of the perceived efficacy of several of the most common SSRIs was due to the placebo effect.

Other studies indicate that for every 10 people who take an SSRI, only one to two people are truly receiving benefit from the medication, according to Lacasse and Leo.

Still, the National Center for Health Statistics found that antidepressants are the most prescribed drugs in the United States, with doctors writing more than 31 million prescriptions in 2005.

Both Lacasse and Leo emphasized the importance of patients being given factual information so they can make informed decisions about medications and the role of other potentially useful interventions, such as psychotherapy, exercise or self-help strategies.

"Patients might make different choices about the use of medications and possibly use alternative approaches to their distress if they were fully informed," Lacasse said.

"We believe the media can play a positive role by ensuring that their mental health reporting is congruent with scientific literature."

Ψ Dare To Dream..., Mar 2009

You should read the whole article.

So Much To Do: I Want To Go To Bed

You look around and see others being so productive. They seem to go to work, keep an immaculate home, read the latest bestseller, and still have time to go to the gym three days a week. Yet, you are overwhelmed trying to get out of bed, take a shower and get to work.

You compare yourself to others and conclude that you fall short. You must do more to measure up to what is expected! You resolve to set goals to improve your performance. You resolve to change your diet, your exercise, your use of free time...the list goes on.

Perhaps for a day or two you find that you have a burst of energy and are making progress, but then the bubble bursts. You find yourself sitting unable to muster the energy to tackle your goals. Is the problem that you are inferior to others? No!

It is important to know that you can improve and meet goals, but you must also recognize that a mood disorder makes achieving these goals more difficult. You must set smaller, more easily achieved goals. You can still aim high, but must be careful to take small steps.

As you set goals, ask yourself these questions:

1. Is my goal achievalble in a brief period of time?
2. Can I break this goal down into several more easily achievable goals?
3. Does this goal make an unreasonable demand on my time, energy, or skills?
4. Can I honestly predict a 75% chance of success for this goal?
5. Have I set a reasonable measure for success.
6. Can I tolerate falling short in my effort?
   

What Makes Depressed Folks Different?

Thursday, Mar 19 (Psych Centralhttp://psychcentral.com/news/2009/03/19/depressed-individuals-miss-out-on-good-things-in-life/4837.html) --

While depression is often linked to negative thoughts and emotions, a new study suggests the real problem may be a failure to appreciate positive experiences.

Researchers at Ohio State University found that depressed and nondepressed people were about equal in their ability to learn negative information that was presented to them.

But depressed people weren’t nearly as successful at learning positive information as were their non-depressed counterparts.

“Since depression is characterized by negative thinking, it is easy to assume that depressed people learn the negative lessons of life better than nondepressed people – but that’s not true,” said Laren Conklin, co-author of the study and a graduate student in psychology at Ohio State.

Drug Company Scandal

It may not be as big a scandal as Madoff's ponzi scheme, but it has affected many more people and involves more money.

A recent journal article paper by Eric Turner and others in the New England Journal of Medicine titled "Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy," showed that drug companies were inflating claims of efficacy by not publishing all the results of the studies done on antidepressant medications.

Instead of 94% of the studies demonstrating effectiveness for the drugs, the rate is closer to 51%. This means that the consumer's doctor is mislead to believe that the drugs he or she is prescribing are more effective than they actually are. The doctor, in turn, sets unrealistic expectations for the patient receiving the medication. When the patient fails to respond, then the patient feels hopeless because he or she has been led to expect that everyone else is benefiting from the medication.

Such disappointment can, in turn, lead to greater self-doubt, hopelessness and a loss of motivation to battle the depression. Madoff will be held accountable for his behavior and will likely spend time in jail. What is the consequence when drug companies inflate the efficacy of their medicine?