Beating the Blues - tips on overcoming dysthymia
A few excerpts from Beating the Blues: New Approaches to Overcoming Dysthymia and Chronic Mild Depression. I didn't notice any truly new approaches, but it's always good to revisit the old standards.
I'm leaving this unlocked in case anyone else is interested in the book or the advice.
What is Dysthymia?
"Without realizing it, you spend more time feeling down than up and soon feel too tired, sluggish, or apathetic to do anything about it or to do other things that would make you feel better. You fret about recent failures or humiliations, scold yourself repeatedly about what you should have done or said, or get down on yourself for not having the energy or drive to do what you know you should be doing. You go out less often, don't finish projects, and stop extending yourself; you don't treat your loved ones or yourself to special kindnesses. Soon, guilt and passivity set it, and because you're less productive, you feel less worthy and lousier and lousier."
"Untreated dysthymia increases your risks for heart disease, stroke, breast cancer, substance abuse, compromised immune function, and even earlier death. It's also linked to a lifetime of chronic illness, recurring major depression, and substance abuse. Your risks also spike for interpersonal problems, eating disorders, anxiety disorders, divorce, lost productivity, and job failure. For example, 8 out of 10 people with dysthymia report that their problems are so overwhelming that they have serious social problems and/or have trouble doing their jobs well. Your chances for having a longstanding, happy marriage are less than 30 percent."
Dysthymia and Depression
"Dysthymia is disabling because it gnaws at you every day, wearing away at your quality of life. It hovers and hangs for so long, often decades, that you may just come to accept your pessimistic view as interwoven into your personality. But in fact, this negative view on life is how you are responding. It's not "you," not who you are--it's just how you respond. Not a personality trait, dysthymia is a mood disorder that drains your energy and dampens your mood. You can still manage to go to work and do what needs to be done, but you are run down, apathetic, negative, passive, and self-loathing. That makes it harder and harder to function well at home, school, or work. You're unhappy and dissatisfied whether good things happen or not. Going through the motions of daily living, day in and day out, life comes to feel like a chore, a struggle, a grim grind of quiet desperation. Everything is an effort with very little positive payoff."
Symptoms: Doesn't feel like doing things and sometimes won't do them (mild functional impairment)
How Dysthymia is Diagnosed
"If we think of major depression as a spectacular brain crash, milder depression can be compared to a form of mind-wearing water torture. Day in and day out it grinds us down, robbing us of our will to succeed in life, to interact with others, and to enjoy the things that others take for granted. The gloom that is generated in our tortured brains spills outward into the space that surrounds us and warns away all those who might otherwise be our friends and associates and loved ones. All too frequently we find ourselves alone, shunned by the world around us and lacking the strength to make our presence felt...
"Still, we are able to function, a sort of death-in-life existence that gets us out into the world and to work and the duties of staying alive then back to our homes and the blessed relief of flopping into our unmade beds.
"All too often, we are told to snap out of it. That the invisible water torture we carry in our heads is our own fault. And shamed into thinking something is wrong with our attitudes, we fail to seek help....
"Some of us turn to the bottle or illegal drugs. Others seek a more permanent solution. Yes, even milder forms of depression can be lethal (experts estimate anywhere from 3 to 12 percent of dysthymics cure themselves by suicide)."
-- John McManamy, http://www.suite101.com/article.cfm/depression/17588
Who Gets Dysthymia and Why
"Depressed persons often have decreased blood flow to several areas in their brain, especially the frontal regions. Brain activity appears to be shifted to other areas of the brain involved in processing emotional arousal.... Taken together, these changes in brain activity might explain why some depressed people seem to be virtually unable to use good advice or standard problem-solving strategies to reduce their difficulties. It is as if an arousal circuit of the brain is stuck in the on position and deactivates other, more complex circuits."
"Family History. Depressions often run in families. It is possible that some of us inherit a lower set point for day-to-day moods, what some researchers used to refer to as a depressive personality temperament."
The Psychology of Feeling Good
"You think about how you lost that promotion or you were jilted and you get angry, feel humiliated and ashamed, or wronged. And you feel worse.
"You fret that your problems have no end in sight. You will never get another job. You will never lose any weight. You will always be alone. You will never make enough money. These kinds of beliefs feel 100 percent true--and that leads to more thoughts that are less and less hopeful, more pessimistic, discouraging, and helpless. And you feel almost automatically worse.
"But just because you think something doesn't mean that it's accurate or right, even if it feels like the truth. It is just a thought."
"When you feel angry, worthless, helpless, ashamed, ask yourself, "Are my thoughts about this valid? Am I exaggerating, seeing it in the worst possible way, seeing it as black and white, jumping to conclusions, or seeing the problem truly accurately? What can I do to solve this problem, whether I feel like it or not? What does the reality call for?""
"You are promoting depression by interpreting the event as a permanent, pervasive, and personal failure...."
"On the other hand, if you view a setback as due to something specific, leave it in the past, and consider what you can do now to produce a different outcome, you help immunize yourself against depression...."
"The technique is to
-- adapted from Albert Ellis, The Essence of Rational Psychotherapy
"Free yourself from the past--it doesn't have any power over you. In the present, you have the opportunity for a fresh start or another try. Keep your attention on the here and now, free from the baggage of past mistakes and expectations. Then accept the current circumstance or reality and focus on what you can do now to make things better."
"Rather than berating yourself, what can you do to offset the problem? Can you make amends? Understand your actions: Are there mitigating circumstances? What can be done differently in the future? Responding to these questions will make you feel better."
"Research proves that if you change your behavior--whether you feel like it or not--you will almost always feel better as a result. On the other hand, if you wait until you feel like it or feel up to it, you may end up waiting eternally."
To Feel Better
Accept the reality.
Accept your feelings. (You can't always be happy.)
Listen to your thoughts. (What would you tell a friend who was recycling your thoughts?)
Consider what you can control (your behavior) and what you can't control (almost everything else).
Identify your purpose and make a small, manageable goal.
Then do something toward that goal whether you feel like it or not.
Then do the next thing that needs to be done.
Don't wait until you feel like it. Once you get started, your feelings will follow your behaviors and you will feel like it.
When dealing with others: put yourself in their shoes and consider the impact your behavior has on them.
"Remember what activities used to bring you joy, feelings of self-worth, or a sense of well-being? Make time to pursue these activities more often, whether you feel like it or not.... They may not boost your mood a lot at first, but they are almost always better than doing nothing."
In the depth of winter,
I finally learned that within me
There lay an invincible summer.
-- Albert Camus
Exercise and Nutrition
"If you don't want to exercise, try the following approaches.
Conclusion
"To recap:
Resources
National Alliance for the Mentally Ill
www.nami.org
National Foundation for Depressive Illness
www.depression.org
Cognitive Therapy
www.cognitivetherapy.com
I'm leaving this unlocked in case anyone else is interested in the book or the advice.
What is Dysthymia?
"Without realizing it, you spend more time feeling down than up and soon feel too tired, sluggish, or apathetic to do anything about it or to do other things that would make you feel better. You fret about recent failures or humiliations, scold yourself repeatedly about what you should have done or said, or get down on yourself for not having the energy or drive to do what you know you should be doing. You go out less often, don't finish projects, and stop extending yourself; you don't treat your loved ones or yourself to special kindnesses. Soon, guilt and passivity set it, and because you're less productive, you feel less worthy and lousier and lousier."
"Untreated dysthymia increases your risks for heart disease, stroke, breast cancer, substance abuse, compromised immune function, and even earlier death. It's also linked to a lifetime of chronic illness, recurring major depression, and substance abuse. Your risks also spike for interpersonal problems, eating disorders, anxiety disorders, divorce, lost productivity, and job failure. For example, 8 out of 10 people with dysthymia report that their problems are so overwhelming that they have serious social problems and/or have trouble doing their jobs well. Your chances for having a longstanding, happy marriage are less than 30 percent."
Dysthymia and Depression
"Dysthymia is disabling because it gnaws at you every day, wearing away at your quality of life. It hovers and hangs for so long, often decades, that you may just come to accept your pessimistic view as interwoven into your personality. But in fact, this negative view on life is how you are responding. It's not "you," not who you are--it's just how you respond. Not a personality trait, dysthymia is a mood disorder that drains your energy and dampens your mood. You can still manage to go to work and do what needs to be done, but you are run down, apathetic, negative, passive, and self-loathing. That makes it harder and harder to function well at home, school, or work. You're unhappy and dissatisfied whether good things happen or not. Going through the motions of daily living, day in and day out, life comes to feel like a chore, a struggle, a grim grind of quiet desperation. Everything is an effort with very little positive payoff."
Symptoms: Doesn't feel like doing things and sometimes won't do them (mild functional impairment)
How Dysthymia is Diagnosed
"If we think of major depression as a spectacular brain crash, milder depression can be compared to a form of mind-wearing water torture. Day in and day out it grinds us down, robbing us of our will to succeed in life, to interact with others, and to enjoy the things that others take for granted. The gloom that is generated in our tortured brains spills outward into the space that surrounds us and warns away all those who might otherwise be our friends and associates and loved ones. All too frequently we find ourselves alone, shunned by the world around us and lacking the strength to make our presence felt...
"Still, we are able to function, a sort of death-in-life existence that gets us out into the world and to work and the duties of staying alive then back to our homes and the blessed relief of flopping into our unmade beds.
"All too often, we are told to snap out of it. That the invisible water torture we carry in our heads is our own fault. And shamed into thinking something is wrong with our attitudes, we fail to seek help....
"Some of us turn to the bottle or illegal drugs. Others seek a more permanent solution. Yes, even milder forms of depression can be lethal (experts estimate anywhere from 3 to 12 percent of dysthymics cure themselves by suicide)."
-- John McManamy, http://www.suite101.com/article.cfm/depression/17588
Who Gets Dysthymia and Why
"Depressed persons often have decreased blood flow to several areas in their brain, especially the frontal regions. Brain activity appears to be shifted to other areas of the brain involved in processing emotional arousal.... Taken together, these changes in brain activity might explain why some depressed people seem to be virtually unable to use good advice or standard problem-solving strategies to reduce their difficulties. It is as if an arousal circuit of the brain is stuck in the on position and deactivates other, more complex circuits."
"Family History. Depressions often run in families. It is possible that some of us inherit a lower set point for day-to-day moods, what some researchers used to refer to as a depressive personality temperament."
The Psychology of Feeling Good
"You think about how you lost that promotion or you were jilted and you get angry, feel humiliated and ashamed, or wronged. And you feel worse.
"You fret that your problems have no end in sight. You will never get another job. You will never lose any weight. You will always be alone. You will never make enough money. These kinds of beliefs feel 100 percent true--and that leads to more thoughts that are less and less hopeful, more pessimistic, discouraging, and helpless. And you feel almost automatically worse.
"But just because you think something doesn't mean that it's accurate or right, even if it feels like the truth. It is just a thought."
"When you feel angry, worthless, helpless, ashamed, ask yourself, "Are my thoughts about this valid? Am I exaggerating, seeing it in the worst possible way, seeing it as black and white, jumping to conclusions, or seeing the problem truly accurately? What can I do to solve this problem, whether I feel like it or not? What does the reality call for?""
"You are promoting depression by interpreting the event as a permanent, pervasive, and personal failure...."
"On the other hand, if you view a setback as due to something specific, leave it in the past, and consider what you can do now to produce a different outcome, you help immunize yourself against depression...."
"The technique is to
- Recognize that you're experiencing a disturbing emotion.
- Notice your thoughts.
- Identify negative or distorted automatic thoughts.
- Challenge your negative thoughts.
- Reframe your thought so it is not negative, personal, or pervasive. What would you tell a friend? We tend to be much more critical (unrealistically) with ourselves than our friends."
-- adapted from Albert Ellis, The Essence of Rational Psychotherapy
"Free yourself from the past--it doesn't have any power over you. In the present, you have the opportunity for a fresh start or another try. Keep your attention on the here and now, free from the baggage of past mistakes and expectations. Then accept the current circumstance or reality and focus on what you can do now to make things better."
"Rather than berating yourself, what can you do to offset the problem? Can you make amends? Understand your actions: Are there mitigating circumstances? What can be done differently in the future? Responding to these questions will make you feel better."
"Research proves that if you change your behavior--whether you feel like it or not--you will almost always feel better as a result. On the other hand, if you wait until you feel like it or feel up to it, you may end up waiting eternally."
To Feel Better
Accept the reality.
Accept your feelings. (You can't always be happy.)
Listen to your thoughts. (What would you tell a friend who was recycling your thoughts?)
Consider what you can control (your behavior) and what you can't control (almost everything else).
Identify your purpose and make a small, manageable goal.
Then do something toward that goal whether you feel like it or not.
Then do the next thing that needs to be done.
Don't wait until you feel like it. Once you get started, your feelings will follow your behaviors and you will feel like it.
When dealing with others: put yourself in their shoes and consider the impact your behavior has on them.
"Remember what activities used to bring you joy, feelings of self-worth, or a sense of well-being? Make time to pursue these activities more often, whether you feel like it or not.... They may not boost your mood a lot at first, but they are almost always better than doing nothing."
In the depth of winter,
I finally learned that within me
There lay an invincible summer.
-- Albert Camus
Exercise and Nutrition
"If you don't want to exercise, try the following approaches.
- Force yourself to do something: start with easy stretching and strolling on a regular basis
- Build up gradually to walking and fast walking
- Do what you enjoy--choose a form of exercise you like
- Find someone to do it with
Conclusion
"To recap:
- Stay in the present.
- Accept the present circumstances and accept your feelings. Acceptance doesn't mean that you like something... but to realize that since you can't change the circumstances that have occurred, switch your attention to deciding what you will do next.... Acknowledge but do not dwell in the emotional reaction....
- Focus your attention on what you can control. Your thoughts, which create an either optimistic and positive or pessimistic and negative attitude, and your behavior. Thoughts create and sustain the attitude that shapes your behavior.
- Monitor your thoughts. What are you telling yourself? Are you dwelling on something negative? Are you seeing only black and white? Are you making assumptions? Catch yourself. Challenge the validity of your thoughts.
- Choose to respond rather than react. Think about what it is you really want to achieve. Keep your focus on the present and on your purpose."
Resources
National Alliance for the Mentally Ill
www.nami.org
National Foundation for Depressive Illness
www.depression.org
Cognitive Therapy
www.cognitivetherapy.com