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I am so depressed and anxious lately, I can't escape these negative thoughts or panic feelings, I cant go out, I cant work, I can do nothing. I feel like a failure, like my life has been a waste and that I'm worthless, ugly, fat, disgusting, dumb, that I cant do it. These words circle round my head constantly all day, everyday. I cant get away. Ive started therapy because I've tried everything to help myself and not need therapy, but I do and I cant help myself, and I know I'm in a really bad place right now and there's nothing I can do to help myself out, I cant crawl out of this. And death feels like the only way. Im aware of how depressing and hopeless this message sounds, and I do not want to die. I want to get better and live a life of freedom. That feels impossible.
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DBT SKILLS FOR RECOVERY POSTS Disclaimer and Intro: Soon, over time, there will be new threads about DBT posted here in One Step At A Time. IMPORTANT NOTE: I am not a qualified DBT professional. I am only sharing partial information that I have learned based on a 9-month course that I took, the materials I was given (based on the manuals written by Marsha Linehan), my notes from the course and a book entitled The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal Effectiveness, Emotion Regulation & Distress Tolerance by Matthew McKay, PH.D., Jeffrey C. Wood, PSY.D. & Jeffrey Brantley, MD. I will reference items as follows: Manuals: Man Notes: Nat The book: DBTSW Please note that Depression Forums (www.depressionforums.org) is also not a licensed DBT site. These threads are being created in order to share information, open discussions, questions, possibly help others and open doors to working through some things we need to address. Maybe there will be an exercise or two for us to share as well. DBT was originally developed by Marsha Linehan, a psychologist who suffered from BPD, for BPD patients. DBT can help EVERYONE though, even those who do not have mental health issues. The skills are helpful and useful for everybody. All of information posted in these threads will follow the format of the Skills Diary Card that was used in my course, which may or may not be the same as the one created by Marsha Linehan. I know that my course was based on her manuals, but it was also adapted to fit the needs of our local health authorities. These posts will probably be very long, as there is a ton of information to share. Please note that not all of the information will be shared because of this, and really, the detailed information should be saved for courses, and proper research. Links between this thread and the individual threads themselves will be listed for easy locating. Please check here periodically for changes, such as new links, as the threads will be created over time. One way to know that changes have been made, is to follow the thread (click follow at the bottom of this post) and you should receive notifications when changes and additions are made. PLEASE! If there is any information that is incorrect, let me know *by PM* and I will research it and make the appropriate edits. The information I am sharing in this post and the related threads is how I understand it and experienced it. Thank you, Natasha
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Some have asked me what helps me in the struggle against depression. It's taken a while, but I put together some things that have helped me. I'm not sure how much use they will be to anyone else, but just in case they are, I'll put them out here. I've tried to put them in order of how they helped me, but some are really basic psychological precepts, and even though they may be lower down on the list they are still very important. 1. Find someone to talk to; a friend who can understand and support you without judgement, or a counselor, therapist, psychiatrist, or psychologist. It is important to know that you are not alone. It is important to have someone there you can count on to help you see clearly when you cannot, and to help you recognize patterns of thought and/or behavior that you will not be able to see. 2. Learn to recognize and turn away from unproductive negative thought cycles. >Learn how to recognize negative thought cycles; learn how they affect you physically, mentally, and emotionally. Have a friend or counselor help you recognize them if necessary. >Be forceful, consistent, and persistent. This will not be easy; it will be an uphill battle, especially at first. >Negative thought cycles can be like a rut, and difficult to get out of. Either find a way to get out of the rut your mind gets into, or be ready to replace the negative thoughts with positive ones. >>I use metal music I know the lyrics to. I focus on the loudness, intensity, & the lyrics. I let the music sweep me up, and focus only on the music and the lyrics. Any time the negative thought cycle tries to start up again, I renew my focus on the lyrics. I actually made a mix track of Chester Bennington’s scream tracks from different Linkin Park songs that has been very good for this purpose. 3. Look beyond yourself. I highly recommend pursuing spirituality, or a relationship with a Higher Power. If you cannot embrace a sense of spirituality or the concept of a Higher Power, I recommend focusing on the earth: as a whole, as a collection of intricately interdependent ecosystems, and in its place in the overall universe. >If you cannot embrace the concept of a Higher Power, I’m not sure how effective or helpful this step will be for you. It may lead to negative or discouraging thoughts. My personal sense of a Higher Power has been incredibly important to my fight against depression, and is strongly related to the complexity and individuality of life on earth, and the intricate interdependence present in ecosystems, how those ecosystems interact with each other, as well as the earth’s rather minor place in the universe as a whole. 4. Practice genuine gratitude – not reluctant gratitude, but true thankfulness. Be genuinely grateful for what you can – it is important that this sense of gratitude be genuine, and not have undertones of anger or bitterness. >Be aware that this may be a trigger point for you if you are struggling with a lot of anger or bitterness in your emotional life. >Do not look at what others have or do – if you do, look at it with a healthy sense of skepticism that all is not as ‘rosy’ as it looks. If you find yourself struggling with jealousy over someone else’s supposedly ‘easy’ life, remind yourself that you are not seeing everything about their life, that they have struggles you know nothing about. >I am a skeptic at heart, so this is not something I struggle with. I’m not sure what to tell you to help you get past any anger or bitterness you may have. All I know is that I do not believe what I see on the surface of other people. When I look at someone, I do not believe the presentation I am seeing; I know that there are secrets and struggles that person does not allow others to see. 5. Focus on what you can do, on what you can accomplish. Give it extra emphasis, & deliberately spend time feeling positive about whatever you have managed to accomplish. No task is too small to include here. >Do not allow yourself or anyone else to degrade you or ridicule you for any small task you put here. Trying to focus on your accomplishments will probably trigger negative thought cycles. Fight those negative thought cycles. >Be forceful, consistent, and persistent with this. You will have to give these tasks extra emphasis for a while, in order to make sure you become ‘aware’ of them on a deeper level. > >I still have difficulty with this, as it is related to my struggle with unrealistic expectations. My spouse used to get upset with me for leaving the clean dishes out on the counter, and not putting them up in the cabinets once they were done. When I explained to him that leaving clean dishes out on the counter was my way of reminding myself I had achieved something, he was able to look past it and it doesn't bother him anymore. So now I leave the clean dishes out for a while before I put them up. 6. Help others as you can. Volunteer somewhere that has meaning for you. Learn to make things you can donate for others to benefit from. Pray for or meditate on behalf of others you care about. Be aware of how others are struggling, and think about any small action or word you can use to either help alleviate that, or let them know you care and that they are not alone. 7. Be self-aware; be aware of ‘Cognitive Distortions’, and which ones may affect your thinking. Be aware of how your life experiences shape your perception and your way of seeing and reacting to the world around you. If possible, work through what life experiences left you with these distortions, and how you can overcome them. It would be helpful to have the guidance of a counselor, therapist, psychiatrist, or psychologist. 8. Remember that depression and negative emotions don’t actually last forever. This can be impossible to remember while you are enduring them. You may even have to take this concept on ‘faith’ until you get to a point where you can see it in your own life. Journal or track your emotions throughout the day. Have a friend help you, so you can learn to recognize altered moods when you feel them. This point may be very important at first, especially if you have struggled with a depressed mood for an extended period of time. Recognize that you may no longer be able to see when and if your mood lifts, and recognize that you may have unrealistic expectations of what it means to ‘not be depressed’. 9. Develop small goals or achievable tasks that you can do or work toward each day. >Be aware of how cognitive distortions & life experiences may cause you to develop unrealistic expectations of yourself. >>This was a problem for me several years ago, and it took years for me to overcome my tendency to develop unrealistic expectations. In fact, it is something I still struggle with on a daily basis. It takes a lot of effort for me to fight this tendency, but I have seen progress and that helps me keep up the effort.
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Something I have learned from experience and my mental health module at university, is this: "With mental health, there’s two key aspects you should know about. When people say “Mental Health” they assume it only means mental ill health. In fact, “Mental Health” is an umbrella term and refers to mental ill health and mental well being. Recovery is person specific and the right meds or combo of meds plus talking therapy and social aspects all make up mental health recovery. If you struggle with recovery and well being, try shifting your focus on well being rather than illness." What does recovery mean to you?
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How to Help Someone with Depression August 1, 2014 • By Allison Abrams, LCSW, Depression Topic Expert Contributor Letting go of days tensions, watching the sunset An estimated one in 10 adults in the United States reports currently experiencing depression, according to the Centers for Disease Control and Prevention. The World Health Organization estimates that 350 million people are affected globally. If you have a friend or loved one whom you suspect may be battling depression, there are a number of things you can do to help. But first, let’s start with what not to do: Don’t Minimize Most people have experienced a case of “the blues” at one time or another. Whether caused by heartbreak, loss, or for seemingly no reason at all, symptoms may include decreased energy, sadness, or a general “down in the dumps” feeling. Clinical depression can mirror these symptoms to a significantly higher degree of severity, so it is crucial to recognize the difference. A reactive depression in response to a crisis or simply to a change in external circumstances is often to be expected. The sadness one experiences from time to time under such conditions will generally not interfere with the functioning of daily living and will pass fairly quickly in time. Clinical depression, on the other hand, is not so simple. It is not something someone can simply “snap out of,” and telling someone to “cheer up,” or that “it’s not as bad as it seems,” is not helpful. Find a Therapist for Depression The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) describes symptoms of a depressive disorder as persisting for more than two weeks with a significant impairment in daily functioning. Symptoms may include persistent feelings of worthlessness and suicide ideation. If someone expresses thoughts about wanting to hurt themselves or exhibits any other risk factors for suicide, take the person seriously. A large percentage of those who committed suicide told someone of their intentions, so such expressions should not be minimized. Other risk factors for suicide can be found on the American Foundation for Suicide Prevention website, which warns not to preach with remarks such as, “You have so much to live for,” or, “Your suicide will hurt your family.” Don’t Stigmatize Take an honest assessment of your thoughts and views on depression. Do you question its legitimacy? Do you question whether it is an issue at all, or simply a weakness that can be overcome if only the person was stronger? If this is the case, please read on. Depression has nothing to do with strength or weakness of character, any more so than cancer or any other physical ailment. Studies have shown that stigma is one of the primary obstacles in one’s likelihood of reaching out for help. By taking steps to reduce stigma, you are helping in many ways. Depression has nothing to do with strength or weakness of character, any more so than cancer or any other physical ailment. Studies have shown that stigma is one of the primary obstacles in one’s likelihood of reaching out for help. By taking steps to reduce stigma, you are helping in many ways. Now for what you can and should do: Legitimize Estimates place the risk of suicide among those with major depression at about 3.4%. If someone you care about expresses thoughts of hurting themselves, please take these seriously. According to Stella Padnos-Shea, social worker and volunteer with the American Foundation for Suicide Prevention, depression is one of the most frequently cited risk factors for suicide. If you suspect that someone is at risk of suicide, it is crucial that you take action. You can escort the person to your local emergency room or call 911 or the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Get Educated One of the best things you can do to help your loved one is educate yourself about what clinical depression is. According to the DSM-5, certain criteria must be met in order for a person to be diagnosed with a depressive disorder. These are signs that you want to look for in the person you are concerned about. They include a depressed or irritable mood for much of the day, nearly every day, for more than two weeks; changes in weight, sleep, and/or appetite; difficulty concentrating; decreased energy; and decreased interest in activities that once seemed pleasurable. Psychiatrist David D. Burns, author of Feeling Good: The New Mood Therapy (an excellent resource for anyone who would like to better understand depression), describes one of the primary indicators of someone experiencing a clinical depressive episode is the pervasiveness of symptoms and distortion of thoughts and self-image. Keep in mind the words “pervasive” and “distorted.” Unless someone has experienced clinical depression, it is very difficult to fully appreciate and understand what it feels like and how debilitating it can be. Imagine walking around wearing a pair of dark glasses; everywhere you turn, everything looks dark. This is where the distortion comes in. Those around you may try to convince you that what you are seeing is not accurate, and may even point out the beauty and the colors around you, but wearing those lenses, it’s impossible to see. When you are depressed, your perception of the world is often so clouded that it is almost impossible to see the positive in anything or even to recall that there were good times. Be Prepared Although most will not seek help unless they are ready and encouraged, it would be helpful to have a list of possible referrals to offer. When someone is in the throes of clinical depression, the idea of researching and seeking professional help could seem like a herculean task, especially with all the changes in managed care. You would be removing a huge obstacle in having a few resources available to hand over. Sites such as GoodTherapy.org can be excellent sources for finding a mental health provider. If insurance will be used, you can call the insurance company for a list of preferred providers. Be There According to Padnos-Shea, one of the most important things you can do for someone you believe is experiencing clinical depression is to be there for the person and to let him or her know you are there. It is not uncommon for friends and family to avoid a depressed loved one—not out of any malice, but rather as a result of feeling impotent or not knowing what to do. The worst thing you can do for a depressed person is to abandon him or her. This only reinforces the false belief that he or she is alone in a world where no one cares. Your loved one may push you away and isolate. This is common in depressed individuals. Regardless, be sure to let the person know in no uncertain terms that, when and if he or she is ready to reach out, you will be there. It is important to note that a majority of people diagnosed with mental health issues, including depression, do not end up attempting or committing suicide. Despite the statistics mentioned above, the vast majority of those who experience clinical depression will improve with treatment. The determining factors in recovery include whether they choose to get professional help and the support they have in their lives. So, know that your support and your presence can absolutely make a difference. References: Current Depression Among Adults – United States, 2006 and 2008. (2010, October 1). Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5938a2.htm?s_cid=mm5938a2_e%0d%0a Depression Fact Sheet. (2012). Retrieved from http://www.who.int/mediacentre/factsheets/fs369/en/ Lifetime suicide risk in major depression: sex and age determinants. (n.d.). Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10628886 © Copyright 2014 by Allison Abrams, LCSW, therapist in New York City, New York. All Rights Reserved.
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I just wanted to write this to let my DF family know that I am feeling better. I guess that's the reason why I have been hanging around here less, which is both good and bad news. So many times, people leave, and i think it's because they are feeling better, but one never knows....I wanted to end the guesswork. The long and short of it is that I reached some kind of turning point around Christmastime, when I had what seemed to be a series of panic attacks that landed me in emerg. a few times. It turns out that nothing was wrong with me...yet, but i knew that if I didn't do something soon, there would be something very wrong with my health. I guess I decided that I didn't want to be sick. I'm 51 years old, and my dad died at age 56. It was also around this time that I asked my doc to supplement my imipramine with some ritalin, after ruling out, by process of elimination, that my problem was either serotonin nor norepinephrine-based. Luckily, I have a pdoc who listens to my thoughts and ideas. At the end of December, I somehow found the motivation to sign up at a local exercise circuit gym. I have gone there at least three times a week, without fail, and in between, i sometimes walk. I have lost 10 pounds thus far, but I still have a long way to go. I chat each morning with a few people I have "met" on DF. I am off from work on disability insurance, and i'm not sure what will happen in that area. I am trying to take one day at a time. I am cognizant that I could backslide at any time, and so I don't want to give advice, but being an informed patient has helped me. Doctors mean well, but they don't have the time, or the intense interest, to research things as completely as I can Thanks for your ongoing support. A.
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I feel like I've reached a mental and emotional milestone of sorts in my divorce journey. I think, ironically, that I reached it the day after Valentines Day. On an impulse, I sent her roses, as well as a passionate email beseeching her to give things another try. The next day she emailed me, thanking me for the flowers, but maintaining her position, telling me she simply can't do this anymore. Even before getting this email, I had been wondering why in the world I had done these things, when a strange thought occurred to me - it needed to be done. It was a way of confirming to myself, once and for all, that it is over. I needed to smash through the barricade of denial that was hindering the healing process and preventing me from moving on. This barricade has been demolished, I feel fairly certain of it. That isn't to say that this journey, or the attendant pain, is over. In many ways, it's just beginning. And I'm pretty sure there will be plenty of potholes, detours and delays in the months ahead. I think the difference now is that I can finally see possibilities and opportunities down the road now. A future. I think I've turned around at last, no longer exclusively focused on the rough road behind be, obsessing over wrong turns and shady mechanics who burned me. "Let the road rise up to meet you..." I like it.
