Psychotherapy helps people with depression to change behaviours and thoughts that maintain it.
When the depression began and anything that has added to it needs to be explored to work out the best ways to change and what things need to change.
People with depression experience many of the following:
- Loss of interest
- Loss of energy
- Problems concentrating
- Difficulties with decisions
- Memory problems
- Changes to sleep patterns – difficulty sleeping or staying awake
- changes in weight – either significant loss or gain in weight
- Relationship problems with partners, friends, family, colleagues
- thoughts of death, suicide
- unusual fear or feeling panic.
Psychotherapy has been found to be as effective as antidepressant medication in the short term and better in the long term at reducing these negative experiences.
Tips on how to help manage the symptoms of depression
from the Australian Psychological Society’s webpage, see here.
Loss of interest in pleasurable activities and daily routine
There is evidence to show that increasing activity levels and participating in pleasurable experiences can help reduce depressive symptoms. The following points provide guidelines for increasing pleasurable activities and the sense of accomplishment you experience.
- Make a list of activities you need to complete as well as some that you find (or used to find) enjoyable. Make sure you write down as many activities as you can. Remember to also list activities that are only marginally enjoyable.
- Plan to take part in an activity each day. Activities should be achievable and should provide a sense of accomplishment when completed. Include enjoyable activities and try to increase the amount of time each day available for these.
- Think about what you have accomplished once you have completed a daily task. When participating in pleasurable activities, think about their enjoyable aspects. Talk to others about activities they enjoy and reflect on positive experiences.
- Remember that during a depressive episode you often lack motivation to work through daily routines and things you enjoyed previously may not seem as enjoyable. Focus on the positive, no matter how small, and remember that as you recover, the enjoyment you experience will increase.
Worrying and negative thinking
Changing negative thinking patterns and reducing worry is not as easy as it may seem. This is an area where people often require the assistance of a psychologist or other mental health professional. Below are some suggestions for learning to control worry and reduce negative thinking.
- Take time to think about how realistic your negative thoughts are. Try to find some different and more helpful thoughts and explanations for circumstances. Write down some of these more helpful ways of thinking.
- Avoid excessively discussing negative thoughts and feelings with colleagues, family or friends. Instead, try to focus on positive aspects of situations. Negative thinking and dwelling on negative topics will not help you feel better.
- Keep yourself busy and your mind focused on tasks. Avoid unstructured time where you have nothing planned, as your mind may wander and dwell on negative themes.
- Try to think positively. There are many things you can do to address the cognitive (thinking) component of depression. These include: making a list of your skills, talents, and achievements; identifying the three most beautiful things in your environment; reminiscing about a time when you were really happy, successful or content.
- Set aside a daily “worry time” of 15 minutes when you do nothing but ruminate about your problems. Once this time is finished, leave all your concerns behind and begin working on thinking more positive thoughts. If during the day you begin to focus on your worries, remind yourself that there is a designated time for this and move your thoughts away from your problems. After some time of practising this, people often complain that they have difficulty filling 15 minutes with their worries.
- Keep a journal of your thoughts. Identify negative and unhelpful thoughts and try to correct them.
- Do not make any major life decisions, such as quitting your job or breaking up a relationship, while depressed. Remember, you may not be seeing yourself, the world, or the future in a clear way when you are depressed.
Irritability, agitation and fatigue
Being irritable or agitated is a normal part of depression. It is important that people close to you are aware of this so that they can be more patient and understanding, rather than annoyed and unsupportive. Below are some tips to help you deal with irritability and agitation.
- Make sure you take the time to educate and advise key support people, such as close friends, family and colleagues, of what you are going through. Help them to understand that if you appear irritable or agitated it is not because you are unhappy with them, but rather because you are recovering from depression. Thank them for their support and provide feedback on how they can best continue to support you.
- When you are feeling irritable or agitated, stop and settle yourself down. Ask yourself what is driving your emotions. If it is negative thinking, then use strategies outlined previously to tackle negative thoughts. If you are tired, pace out your workload to allow for this. If you feel unmotivated, try and incorporate some enjoyable activities into your schedule.
- Practise regular relaxation and meditation activities and organise regular times to talk with a support person about how you are coping and implementing new coping skills. By taking time out to relax regularly and to communicate with supportive people, you greatly reduce the impact of potentially irritating and frustrating experiences.
- Be as active as possible despite fatigue. Try to schedule activities to fill up the spare hours of the day. Activities may include exercise, social interaction or even routine household chores. If activity seems impossible, try to force yourself to do three things each day, such as getting out of bed, getting changed out of your pyjamas and brushing your hair. Even the smallest amount of activity is better than no activity at all.
Changes in sleeping patterns
Regular healthy sleeping patterns are extremely important for people recovering from depression. Listed below are a few key points to assist you in establishing healthy sleeping patterns.
- Make sure you get up around the same time every morning regardless of how tired you feel.
- Avoid sleeping during the day or taking naps in the early evening.
- Reduce tea and coffee intake to a maximum of four cups per day and do not have any tea or coffee after 4pm.
- If you wake up during the night, do not lie in bed trying to sleep for more than 30 minutes at a time. Get up, go to another room and engage in a relaxing activity, such as reading, listening to music or a relaxation exercise. When you feel sleepy, return to bed and sleep.
If you feel that your situation is hopeless and particularly if suicidal thoughts are present, it is essential to seek help and to speak to someone about how you are feeling.
- Speak to someone you trust who you know will listen and try to understand how you are feeling. It is important to be honest with this person about any plans you might have to harm yourself. It is in your best interests to allow them to protect you.
- As much as possible, spend time with others so that you are not alone.
- Call a crisis line or seek help from a mental health professional.
- If urges to act out the suicidal thoughts become overwhelming, a brief stay in an inpatient clinic might be extremely beneficial.
- Remember that these feelings will pass.