Thursday, December 26, 2013

Combatting Depression: Strategies for Your Relationships



by: Dr. Dino Zuccarini and Tatijana Busic


Depression can be isolating, and block us from soliciting emotional or physical caregiving from others, which inevitably worsens our depression symptoms. Other people’s responsiveness toward our feelings and needs can make us feel more connected and better about ourselves.

Identify a friend, family member, or partner who you sense will be mostly available and responsive to you at this time. Good indicators would be someone you think is sensitive, a good listener, and understanding of others’ feelings and viewpoints. If you are unsure or cannot identify a responsive other in your life, or if your emotions and needs for support exceed what others can provide you, you can seek out the support of a registered clinical psychologist. Professional support can make a critical contribution to your recovery in these cases.

Sharing and Expressing Feelings and Needs to an Accessible and Responsive Other


Don’t isolate yourself! Let those closest to you know that you have been struggling with depression so that they will understand you more so. Share what you know about your own mental health. Let them know that connecting to them may help you with your depression. You may want them to participate in some activities with you, such as walking, going out for dinner or a movie. Let them know that you may need their support from time to time.

Sharing feelings with someone important to you can alleviate depressive symptoms. Prior to talking to another person, try to put your difficult feelings into words and share them with this person. The good news is that you don’t have to have things all figured out before you reach out. You can simply tell this person that you want him or her to listen or to support you to problem-solve a difficult situation or experience, or you can simply ask for reassurance or a hug. Talking things through with others can help you to clarify what you truly think, feel, and need in a way that can give you a more positive direction. Try not to expect perfect responses from others. Sometimes people close to us are trying as hard as they can to support us and have good intentions.

Confirming/Disconfirming Negative Views with Responsive Others


When talking to your available trustworthy confidante, bounce off of them some of the negative views you hold about yourself and others.

Try to figure out what some of the biases and assumptions are that you are holding of yourself and others. Share what your most difficult thoughts and feelings are about yourself or about others in your world. Ask this individual to provide you with feedback about your views and to support you to identify counter-examples of your negative views. It can feel vulnerable to open up about some of the distressing thoughts and feelings that go on inside your mind and body, but sharing with another person that you trust can help you to break the negative thought patterns, perceptions, and biases that perpetuate your depressed feelings.

Asking for Reassurance and Affirmation from Responsive Others


When we are overly self-critical of ourselves or negative about others, we may have difficulties seeing our positive attributes. Relationships are an important source of getting reassurance and affirmation for ourselves when we are having negative thoughts and feelings about ourselves, other people or the world around us.

If you are having doubts about yourself, try asking for reassurance about your lovability, your adequacy, or your competence. Be open to receiving others’ reassurances or positive affirmations of you in a way that helps to calm your sense of hopelessness about prospects for yourself in the present and future. Give yourself and others the benefit of the doubt and allow yourself to feel reassured and affirmed.

Be prepared to observe how others perceive ways in which you might be contributing to your own difficulties by how you are thinking, reacting and relating to others. Interpersonal feedback from responsive others who we trust can provide us important information to consider in our recovery process. Try to remember that being perfect is not a requirement for being worthy.

Repairing Disconnection and Creating Positive and Rewarding Relationship Moments


Sometimes, while depressed, our relationships begin to break down, which leaves us at greater risk of being isolated in our emotional distress. We all make missteps at one point or another in our relationships. Perhaps either you or someone else has said something that was offensive, frustrating, or hurtful.  Since relationships provide all of us with valuable emotional support, it is important to make some effort to repair our relationships with others.

Try to find a constructive way to repair or reconnect with others. In these conversations, it will be important to discuss you and the other person, who may have offended, frustrated, or hurt each other. Be prepared to listen and respond in a constructive manner, including empathizing with the other person’s hurt, sadness, or anger.

Take responsibility, express heartfelt regrets, and make amends if possible. Repairing difficult relationship moments or disconnected relationships can restore a positive sense of yourself and other people in your environment. This process of reparation and healing can create a sense of connection at a time when you need it the most.

Also, try to create opportunities for lightness and fun in your relationships. Meaningful connection with others does not always have to be serious and intense. Although deep, intimate conversations in which you can feel understood and supported are key, it is also important to find some balance by seeking out some frivolous and even spontaneous moments purely motivated by pleasure and some needed distraction in the company of others.

Seeking out Professional Support: Consulting with your Physician and a Registered Clinical Psychologist or Psychotherapist


Consulting with a physician may also be an important first step to assess your current mental health status. Depression can be associated with many biological and medical causes that require medical interventions.

Seeking the professional support of a registered clinical psychologist or psychotherapist may be important to help you address the negative thoughts and feelings you are having about yourself, or others. Learning how to address perfectionism, self-criticalness, and process your emotions and clarify wants, needs, and goals can be challenging. Contact a psychologist or psychotherapist if you find that dealing with your thoughts and feelings on your own has become unmanageable.  

Contacting a psychologist or psychotherapist may also be an important first step if you continue to experience debilitating depressive symptoms that interfere with your functioning at work, home, or school. A therapeutic relationship can help you to make sense of your experience of depression and help you along on your path to recovery.  A confidential, empathic, and compassionate therapeutic relationship can help you to strengthen yourself as an individual, to improve the quality of your relationships, and provide you with further strategies to help you deal with the negative thoughts and feelings you have been experiencing.

Read more additional posts from the 'Depression' series:



Learn more about CFIR’s Depression, Mood & Grief Treatment Service.






Thursday, December 12, 2013

Combatting Depression: Strategies for Your Self




by: Dr. Dino Zuccarini and Tatijana Busic


Finding a path toward recovery from your depression symptoms can be challenging, but is doable! In this third post in our depression blogs, we provide strategies to help you deal with depression symptoms associated with your thinking and how you might be processing your feelings, emotions, and needs.

We’ve offered you some tips to help take the first few steps toward feeling better. We suggest that you start your recovery journey by employing strategies for your self first, and then once you’ve started on those, our fourth blog post offers you strategies for your relationships.


Strategies for Your Self: Develop Structure, Routine, and Self-Care into Your Life

When we are depressed, we tend to become depleted of energy. We move less and feel tired. These circumstances can drain us of important mental and physical stimulation that we need for our well-being.

Put structure and everyday routine back into your life and begin to increase your level of self-care. Create a routine. Make sure to schedule activities that are meaningful or pleasurable to you. Include 20 minutes of physical exercise each day. Prepare healthy meals that will nourish your body and mind. Get good rest. If you are having difficulties sleeping, consult resources that will assist you to develop a soothing nightly ritual that will help you to unwind and relax and ultimately improve your sleep.


Learn How to Regulate and Soothe Stress, Negative Feelings and Emotions

With depression, we can struggle with our feelings and emotions - we feel too much or too little. When we are overwhelmed by strong, intense feelings and emotions, it is important to develop practices and strategies to effectively deal with these internal reactions.

Pause before you act on your thoughts and feelings and try to restore a sense of calm and ease. Learning how to restore calm and ease within ourselves is an important life skill. Make a list of activities that are calming and soothing for you, and engage in these activities when you are emotionally distressed. For example, sipping tea in a peaceful place, going for a walk, engaging in deep body and muscle relaxation, taking a warm bath, learning how to breathe rhythmically and deeply, visualizing peaceful and tranquil settings, quietly reading a book, and listening to calming music are examples of ways to enhance coping.

Try to remember, intense feelings and emotions mellow with time. Try to reassure yourself that these feelings and emotions will pass and you will be okay once again. Once we are calmer, we can begin to think about the thoughts and feelings we are experiencing that are contributing to our depression.


Challenge Negative Thoughts and Feelings about Your Self and Others

Negative views of our self and of other people can create a deep sense of hopelessness, as discussed previously. In the midst of feeling depressed, pay attention to the thoughts, interpretations, assumptions, and beliefs you have about yourself or others. Do you notice a negative bias in how you are thinking or feeling about yourself and others?

Try to challenge these negative views and find counter-examples to these negative thoughts. Try to recognize good things about yourself and others at home, work, and in play. Practice noticing positive attributes about you and other people---at least once a day. You can also develop a list of positive things about yourself and other people in your life. Have your list handy and read it whenever you are feeling negative. Do not be surprised if your list of good things begins to grow as you start to engage in this exercise of positive appreciation.

Sometimes our negative thoughts and feelings towards others are grounded in real experiences in which others are behaving inappropriately toward us. If people are behaving toward you in a negative manner that is harmful (i.e., verbal, physical, emotional or sexual abuse), it is important to seek out support and professional help to find a way to address these circumstances.


Develop Self-Compassion in Place of Harsh Self-Criticism and Perfectionism

Sometimes a negative, critical voice toward our self and others may be at the root of our depression. When left unchecked, this voice can make life unbearable.

Do you notice a highly critical or perfectionistic inner voice that pervades your life? How do you feel while and after you have berated, attacked, or criticized yourself? -- probably not very good. Try to develop a more compassionate and understanding counter-voice at these times. Making mistakes and not meeting expectations and demands are bound to happen throughout our lives. It is part of being human. Remind yourself that no one is perfect nor do we need to be in order to be worthy, lovable, and valuable as human beings. Ask yourself if you would be as harsh toward others, such as a family member, partner or friend if they had not met an expectation? Would you be more understanding of others? Try to develop a kind, gentle, understanding and reassuring voice toward yourself in these moments.

Try to lighten the impact of this oppressive voice by reframing the self-criticism in positive terms. For example, ask yourself what you can learn from the present situation that may help you grow as a person in the future as opposed to harshly attacking yourself. Try to find constructive solutions to your mistakes or problems, rather than senselessly depleting your energy and berating yourself.

Try to find ways to challenge harsh self-criticism. Ask yourself, “How realistic are the expectations and demands that I hold of myself and others?” Remember that human beings are limited in terms of what we can achieve. We can’t always meet all of our or others’ expectations or needs. In addition to negotiating our needs with those of other people in our lives, we also have to balance a lot of competing needs in different contexts, including work, family, and play.

Find counter-examples that contradict the extreme and global way you are putting yourself down. Create a more balanced and accurate view of yourself. Think about what is good enough and possible in your current life situation rather than how things should be in order to be perfect.


Be Mindful, Build Awareness of the Present Moment


When we are depressed our thoughts are often focused on worrying about the future or ruminating about the past. Depression impedes on our ability to live in the present moment, which often further aggravates the cycle of worry and negative rumination.

Try to notice these moments as they are happening without any judgment. Simply notice your 'self' thinking or feeling something that is connected to worry about the future or rumination about something that happened in the past. As you notice what is happening, try to gently shift your attention to your body. For example, if you are walking notice how the soles of your feet feel with every step you take. Practice using your senses to notice how things look, feel, taste and smell around you.

By gently shifting your attention to the present moment, you rest your awareness in the here and now of being alive. This mindful practice can help you to build an inner sense of refuge from the stresses of life. Also, this practice can occur under any circumstances and over time, will help you to develop greater resilience and freedom from the negative thought and emotional patterns associated with depression.


Identify, Label, and Access Emotions and Needs and Make a Plan of Action

Emotions provide us with important information about what our concerns, goals, and needs are for ourselves and in our relationships with others in the world around us. Depression is a signal, calling for us to listen to what our feelings are telling us about what concerns or goals have gone unmet, or what we might want or need for ourselves or in our relationships with others.

Being able to identify, label, and express these feelings in words is important if we are to appreciate what our concerns are and what we might need as individuals and from our relationships. When we figure out what our emotions are telling us, we can then develop a plan of action toward taking care of ourselves more effectively. We can develop strategies to address our goals and concerns, and meet our wants and needs in a manner that does not create further difficulties for us.

Try to identify and label your emotions. Pay close attention to the feelings that underlie what you are experiencing. For example, you may be feeling numb, but masked underneath resides hurt and sadness. Or you may feel outwardly sad, but are also angry deep down. This may not be easy to do at first and takes practice.

Also, try to tune into what the concerns, unmet goals or needs are that come with these feelings and emotions. What do you need for yourself in your sadness or anger? Write about your feelings in a journal with a particular focus on what these feelings are telling you about what you might need for yourself or in your relationships with others.

Begin to plan and create strategies of how you can go about meeting your goals, wants, needs, or desires in a manner that is constructive for you and for those around you. You may require support from others to help you organize your thoughts and to develop plans to have your goals, wants, or needs met.


Seek out Professional Support: Consulting with your Physician and a Registered Clinical Psychologist

Consulting with a physician may also be an important first step to assess your current mental health status. Depression can be associated with many biological and medical causes that require medical interventions.

Seeking the professional support of a registered clinical psychologist may be important to help you address the negative thoughts and feelings you are having about yourself, or others. Learning how to address perfectionism, self-criticalness, and process your emotions and clarify wants, needs, and goals can be challenging. Contact a registered clinical psychologist if you find that dealing with your thoughts and feelings on your own has become unmanageable.

Read more additional posts from the 'Depression' series:

Learn more about our Depression, Mood & Grief Treatment Service.