Depression Management Techniques

Understanding how your brain makes you depressed and what you can do to change it.

Ready! Fire! Aim!

Appreciate yourself more! Know your motivations and set goals before you act!

It happened again. She was in tears because she did not get the approval she expected after writing the article for the school paper. She asked, "Why didn't my friends text me on what a good piece it was?" "Why didn't the editor send me a congratulatory email?" "Why write if no one would tell me it was really good?" "Well," I said, "There is the right question. Why did you write it?" Jess was a bit startled that I did not go into a discussion reminding her she is indeed a good writer. She wanted to wallow just for a bit in how let down she felt and she wanted to discuss the hidden motives of her editor and friends, which I know she had already done with her best friend. But neither she nor I knew what others' motives truly were, so speculation was wasted time.

When I short-circuited that discussion and asked her to look into herself, her mood shifted quickly.  "I love to write!" she exclaimed. "I write about what I am interested in. It helps me focus my ideas and opinions." She went on to talk about the process of researching and writing and how it was just fun for her. So when I reworked my question and asked, "Then why do you care about what others think of it," she frowned. "I want to know I am good at it." Her reason to write because it is fun did not seem enough. She needed a boost to motivation to do it. And in her way of looking at it, praise from others would boost her motivation. She also has trouble believing she is good without outside confirmation. Jess got to feeling worse the more she thought about how her editor let her down. She started to think that maybe she is really inadequate and no one is telling her to stop writing even though they may wish she would figure it out and stop contributing without being told. And in that process Jess goes through we can see the trouble for someone with depression: Taking action before knowing why you are acting and what you want makes it harder to feel good about what you are accomplishing. 

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1. A depressed brain typically does not generate enough activity in the reward circuitry of the brain. Either something does not register as pleasure or it does not register as pleasurable enough to create motivation. For most people doing what we are good at is a source of genuine pleasure, but Jess did not feel good enough doing what she is good at doing.

2. The depressed brain has trouble seeing things that are positive. Activity in a part of the brain that is responsible for noticing threat and planning for trouble is excessive so too many negatives weigh in. It contributes to seeing everything as a problem.

3. Self-esteem is challenged by those kinds of depressed thoughts. They typically begin revolve around themes of worthlessness or inadequacy. When you start to think about a success, the thought "Maybe I am not good enough," seems to raise its ugly head. It is part of how low self esteem is generated and maintained in depression. Jess showed that issue in spades.

4. Pushing back against negativity is too hard. Your 'thinking brain' gets low on energy when you are depressed and has a hard time generating more positive options such as, "This will pass." "It could be worse." "You can figure it out." "Even if some of it is wrong, parts of it are right too." 

Getting Your Brain to Help Change Your Brain 

First of all, making a deliberate decision to change the depression is helpful. You are engaging the part of your brain that directs emotion and thought to go in the direction of positive expectation, making it more likely that you will see the positive. But when that part of the brain is low on energy, you can bolster by borrowing the energy of people you trust. By talking first with her best friend, Jess began to push that negative attitude away, and then in therapy she thought maybe she would get more encouragement. Those actions helped to some degree, but Jess still felt upset. As we talked, she realized that ultimately, if she wanted to get out of the depression trap she needed to recognize the trick of negative thinking and prepare to stop it almost before it starts. 

Here are some ideas we came up with: 

1. Before you start something, decide your reasons for doing it. This applies to everything you undertake, even widely diverse things: running for a political or organizational office, writing a blog, applying for a new job, or starting a course of study. Anticipating what you want improves the chance you will feel good about it. Jess knew that when she starts to write the first reason will always be, "Because I like to write." This will engage her positive expectation. 

2. Decide before you start what will make you content with the outcome. This increases the likelihood that you will see yourself as adequate because you know what  basic level of success will be a good outcome. This is an important challenge to yourself, because you can rarely guarantee outcomes. You can only guarantee the effort you put in. So be careful how you explain your motivations to yourself. For example, you want to win an election, but can never guarantee the vote. Can you be proud of how you campaigned? Can you believe you presented your ideas as well as you are able? Can you focus on what you learned from the experience? If you will only be satisfied if you win, then you better be darned sure winning is likely. In her writing projects, Jess needs to remember that she will be content if she clarifies her thinking on a subject. But she also wanted to believe she had done well. So she considered the next point. 

3. Decide how and when to evaluate the outcome. If you want to get a degree in biology to get a job in science/tech field, waiting until graduation and employment is a long time before feeling content with your choice for a field of study. At what points can you look at what you are doing and tell yourself this is a good choice? For example, can you check in at the end of every semester and ask yourself if you enjoyed the course and also did well in it? How about at the end of an internship? Jess wanted to know she was good at writing, but was set up for distress by basing her evaluation on whether her acquaintances praised a piece. A better choice will be if she can decide that a good indicator of whether a piece was good enough is if the editor asks her to do another. And if praise comes from other sources she should notice and appreciate it too. 

4. Record your goals and motivations and what you want most from the experience. Then keep that record where you can see it during the course of your activities. Focusing along the way will keep your brain in the path of what is rewarding.  

Have someone  you trust to check in with once you are working toward your goals: Jess realized that this method would result in her writing more and making her own assessment of whether it was worth it to write. If commendations came her way, it would add to her success and feel very good. Recognizing that her goals will be met is not easy though, because a depressed brain can have some trouble noticing or feeling pleasure. If you can, get help from a friend or family member to set up the 4 points and ask them to check with you about how you are doing on fulfilling those. In this way you can get others to help your brain to help itself.  Getting ready, aiming for her goals and then taking action, will make it moreIt is easier to fight depression before it sets in, and if you do, you will benefit and so will benefit others around you. Family or friends will feel better too, since they will be on the positive side of helping you meet your goals. 

Margaret Wehrenberg, Psy.D., is a licensed psychologist in private practice and a popular public speaker. Her latest book is The 10 Best-Ever Depression Management Techniques.

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