Self-Care

January 21, 2012  

Q. How may I measure the effects my treatment is having on my depression? If one completes the following scale each week, and keeps track of the scores, one would have a detailed record of one’s progress. Name _________________________ Date _________ The items below refer to how you have felt and behaved **during the past week.** For each item, indicate the extent to which it is true, by circling one of the numbers that follows it. Use the following scale: 0 = Not at all 1 = Just a little 2 = Somewhat 3 = Moderately 4 = Quite a lot 5 = Very much 1. I do things slowly 0 1 2 3 4 5 2. My future seems hopeless 0 1 2 3 4 5 3. It is hard for me to concentrate on reading 0 1 2 3 4 5 4. The pleasure and joy has gone out of my life 0 1 2 3 4 5 5. I have difficulty making decisions 0 1 2 3 4 5 6. I have lost interest in aspects of life that used to be important to me 0 1 2 3 4 5 7. I feel sad, blue, and unhappy 0 1 2 3 4 5 8. I am agitated and keep moving around 0 1 2 3 4 5 9. I feel fatigued 01 2 3 4 5 10. It takes great effort for me to do simple things 0 1 2 3 4 5 11. I feel that I am a guilty person who deserves to be punished 0 1 2 3 4 5 12. I feel like a failure 0 1 2 3 4 5 13. I feel lifeless–more dead than alive 0 1 2 3 4 5 14. My sleep has been disturbed: too little, too much, or broken sleep 0 1 2 3 4 5 15. I spend time thinking about how I might kill myself 0 1 2 3 4 5 16. I feel trapped or caught 0 1 2 3 4 5 17. I feel depressed even when good things happen to me 0 1 2 3 4 5 18. Without trying to diet, I have lost, or gained, weight 0 1 2 3 4 5 Note: This scale is designed to measure changes in the severity of depression and it has been shown to be sensitive to the changes that result from psychotherapeutic or psychopharmacologic treatment. These scales are not designed to diagnose the presence or absence of either depression or mania. (Copyright 1993 Ivan Goldberg) Q. How can I help myself get through depression on a day-to-day basis? On a day-to-day basis,separate from, or concurrently with therapy or medication, we all have our own methods for getting through the worst times as best we can. The following comments and ideas on what to do during depression were solicited from people in the alt.support.depression newsgroup. Sometimes these things work, sometimes they don’t. Just keep trying them until you find some techniques that work for you. Write Keep a journal. Somehow writing everything down helps keep the misery from running around in circles. Listen to your favorite “help” songs (a bunch of songs that have strong positive meaning for you). Read (anything and everything) Go to the library and check out fiction you’ve wanted to read for a long time; books about depression, spirituality, morality; biographies about people who suffered from depression but still did well with their lives (Winston Churchill and Martin Luther, to name two;). Sleep for a while Even when busy, remember to sleep. Notice if what you do before sleepingchanges how you sleep. If you might be a danger to yourself, don’t be alone. Find people. If that is not practical, call them up on the phone. If there is no one you feel you can call, suicide hotlines can be helpful, even if you’re not quite that badly off yet. Hug someone or have someone hug you. Remember to eat Notice if eating certain things (e.g. sugar or coffee) changes how you feel. Make yourself a fancy dinner, maybe invite someone over. Take a bath or a perfumed bubble bath. Mess around on the computer. Rent comedy videos. Go for a long walk Dancing. Alone in your house, or out with a friend. Eat well Try to alternate foods you like ( Maybe junk foods) with the stuff you know you should be eating. Spend some time playing with a child Buy yourself a gift Phone a friend Read the newspaper comics page Do something unexpectedly nice for someone Do something unexpectedly nice for yourself. Go outside and look at the sky. Get some exercise while you’re out, but don’t take it tooseriously. Pulling weeds is nice, and so is digging in the dirt. Sing If you are worried about responses from critical neighbors, go for a drive and sing as loud as you want in the car. There’s something about the physical act of singing old favorites that’s very soothing. Maybe the rhythmic breathing that singing enforces does something for you too. Lullabies are especially good. Pick a small easy task, like sweeping the floor, and do it. If you can meditate, it’s really helpful. But when you’re really down you may not be able to meditate. Your ability to meditate will return when the depression lifts. If you are unable to meditate, find some comforting reading and read it out loud. Feed yourself nourishing food. Bring in some flowers and look at them. Exercise Sports It is amazing how well some people can play sports even when feeling very miserable. Pick some action that is so small and specific you know you can do it in the present. This helps you feel better because you actuallyaccomplish something, instead of getting caught up in abstract worries and huge ideas for change. For example say “hi” to someone new if you are trying to be more sociable. Or, clean up one side of a room if you are trying to regain control over your home. If you’re anxious about something you’re avoiding, try to get some support to face it. Getting Up Many depressions are characterized by guilt, and lots of it. Many of the things that depressed people want to do because of their depressions (staying in bed, not going out) wind up making the depression worse because they end up causing depressed people to feel like they are screwing things up more and more. So if you’ve had six or seven hours of sleep, try to make yourself get out of bed the moment you wake up…you may not always succeed, but when you do, it’s nice to have gotten a head start on the day. Cleaning the house This worked for some people me in a big way. When depressions are at their worst, you may find yourself unable todo brain work, but you probably can do body things. One depressed person wrote, “So I spent two weeks cleaning my house, and I mean CLEANING: cupboards scrubbed, walls washed, stuff given away… throughout the two weeks, I kept on thinking “I’m not cleaning it right, this looks terrible, I don’t even know how to clean properly”, but at the end, I had this sparkling beautiful house!” Volunteer work Doing volunteer work on a regular basis seems to keep the demons at bay, somewhat… it can help take the focus off of yourself and put it on people who may have larger problems (even though it doesn’t always feel that way). In general, It is extremely important to try to understand if something you can’t seem to accomplish is something you simply CAN’T do because you’re depressed (write a computer program, be charming on a date), or whether its something you CAN do, but it’s going to be hell (cleaning the house, going for a walk with a friend, getting out of bed). If it turns out to besomething you can do, but don’t want to, try to do it anyway. You will not always succeed, but try. And when you succeed, it will always amaze you to look back on it afterwards and say “I felt like such shit, but look how well I managed to…!” This last technique, by the way, usually works for body stuff only (cleaning, cooking, etc.). The brain stuff often winds up getting put off until after the depression lifts. Do not set yourself difficult goals or take on a great deal of responsibility. Break large tasks into many smaller ones Set some priorities, and do what you can, as you can.Do not expect too much from yourself. Unrealistic expectations will only increase feelings of failure, as they are impossible to meet. Perfectionism leads to increased depression. Try to be with other people, it is usually better than being alone. Participat
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