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Tuesday, September 18, 2012

Coping with Depression - Set Attainable Gosls

Putting the GO in GOALS

By Sharon Anne Waldrop

An internal battery that's hard to boost is part of living with depression, but our 5-step program gives you strategies for overcoming inertia.

Ninety percent of respondents in the 2009 National Survey on Depression in Canada reported lack of motivation as a symptom of their illness. That overwhelming sense of inertia also feeds depression, making us feel useless and hopeless because we can't seem to get anything done.

Luckily, the cycle works the other way around, too. The more we can accomplish, the better we feel and the easier it is to fend off low mood.

Focusing on small goals and pushing yourself to meet them builds up the charge in that depleted battery. As hard as it is, taking action works as an antidote to depression.

The key is coming up with "meaningful, measurable, and attainable goals," says psychologist William J. Knaus, EdD, author of The Cognitive Behavioral Workbook for Depression (New Harbinger, 2006). "This puts change into focus." Here are five steps to get you started.

1. Keep it simple

The more specific the goal, the better your chances of success, says Dan Bilsker, PhD.

"If you want to go for a walk, write down that you will walk four blocks after lunch on Thursday," suggests Bilsker, adjunct professor in the Health Sciences Department at Simon Fraser University in Vancouver, British Columbia.

Tina, 58, of Winnipeg, Manitoba, who was first diagnosed with depression at age 12, breaks cleaning the bathroom into four smaller jobs: toilet, sink and mirror, tub, floor. Not only does each concrete task seem more manageable, but she ends up with four accomplishments to celebrate.

If you can check something off your to-do list, however small it seems, that success makes other things seem more doable. The particular goal you establish is less important than simply having one to work towards, Bilsker says.

"It's not even necessary that you enjoy it," he adds, "as long as it is something helpful to your recovery."

2. Be realistic

It's tempting to go over-board in your ambitions to make up for a period of sloth, warns Bilsker, but creating unreachable goals only sets you up for failure and feeling worse in the end. If you haven't been exercising, for example, don't imagine you'll start working out seven days a week.

Holland has learned to set just a few goals for herself each day.

"If I write down five but do only two, that's okay," explains Holland, who is director of education at the Mood Disorders Association of Manitoba. "But if I write down 20 and do only two, I'm setting myself up for defeat."

You'll also succeed better if you accommodate the ups and downs of your illness. After living with depression for the past decade, Anne Clarke has learned to accept that some days she moves more slowly. Knowing that keeps the 47-year-old from grinding to a complete halt.

"There is no sense pretending things are normal, and that I can be my usually energetic self, when I'm feeling that way," says Clarke, who lives in the San Francisco area.

"Instead, I … give myself permission to move more slowly, lean a little bit more, and do a little bit less."

3. Strive for five

Another way to make actions easier to contemplate is to set yourself a time limit. Knaus recommends this system: Pick an activity you've been putting off, but that you know is in your best interest to complete. When your five minutes is up, decide whether to stop for now or continue for five more minutes.

Do the same thing every five minutes until you complete the project or decide to take a break. Knowing you have the power to choose gives you a sense of control, Knaus says, which is an important step on the path to positive change.

Holland has found that approach useful when she needs to motivate herself—"I'll do something for five minutes and stop, or decide to do the task for five minutes more," she says—and the strategy keeps her from feeling overwhelmed.

4. Ditch the downers

Depressive thinking—for example, feeling that you're no good, that what happens to you is beyond your control and that nothing you do will make a difference—zaps the motivation you need to set and reach goals.

Holland has learned to run a reality check on negative thoughts to keep them under control. She admits that moving beyond such will-sapping beliefs does take some willpower.

"Own the illness. Understand it and don't use it as an excuse," she says. "Take responsibility for yourself because nobody else is going to do it."

That doesn't mean you can't benefit from a cheering section. Bilsker recommends engaging friends and family members to coach and support you. "Give them a sense of the goals you're working on and ask them to encourage you," he says.

Sometimes that encouragement can simply be helping you feel less low. Holly Rodriguez, 36, of Richmond, Virginia, has a reliable way to boost her mood enough to get moving: "I reach out to a friend whom I know will make me laugh," says Rodriguez, who was diagnosed with major depression in 1999.

5. Praisedon't punish

Berating yourself when you don't reach your goals won't help you move forward. Positive reinforcement will, so be sure to recognize each success, however small.

"Don't shame yourself, ask what's wrong with yourself, or tell yourself that you are overweight or horrible," says Bilsker.

To get out of the downward spiral of self-punishment, he advises, consider whether you would ever say something that harsh or demeaning to a friend in the same situation.

By the same token, give yourself the kind of encouragement and praise you would offer a friend who has
done something worthwhile.

Stan Tolpen of Las Vegas, 56, has a goal to walk at least a mile each day, but he's kind to himself when he doesn't make it.

"Some days I can't do it, but every day I try. I don't let it get me down when I can't do it," says Tolpen, who has lived with severe depression for 30 years.

When Tolpen feels he can't make the whole trip, he'll at least walk up to his front gate and back, then go inside and read a magazine or do something else that he enjoys as a reward for trying. He reminds himself that tomorrow will be a new day and another opportunity to complete the whole walk.

Reminding himself that there is a chance to meet his goal tomorrow is enough to keep him going, he says. His favorite mantra sums it up perfectly: "With hope one can think, one can work, one can dream. If you have hope, you have everything."

Sharon Anne Waldrop lives in rural Georgia. Her work has appeared in Good Housekeeping, Woman's Day, Health and many other national consumer magazines.

SIDEBAR: Turn off the TV

That tempting TV screen is another motivation zapper. Kathryn J. Fraser, MD, an associate professor of psychiatry at University of New Mexico School of Medicine in Albuquerque, says studies suggest that planting yourself in front of the TV can actually worsen depression.

One study of adolescents, published in the Archives of General Psychiatry in February 2009, found that the risk of developing depression as an adult rose significantly with each additional hour of television watching—a correlation that did not hold true for computer games or listening to the radio.

Fraser points to the inertia cycle as one possible factor: You sit around and watch too much television because you're depressed, but you end up feeling more depressed because all you've done is watch television.

"Besides, people aren't meant to just sit," she says.

Given the well-documented physical and mental benefits of exercise, Fraser suggests that if you are going to watch television, do it while working out on a stationary bike, treadmill, or rowing machine.


Author:Sharon Anne Waldrop,      Published in Esperanza, Fall 2012

DBSA Jackson announces a special presentation on The Patient Protection and Affordable Care Act as it impacts Tennessee

DBSA Jackson






 Brad Palmertree, Tennessee Health Care Campaign (THCC)


The Patient Protection and Affordable Care Act:  How Tennessee is Moving Ahead on the Tennessee Health Insurance Exchange and Medicaid Expansion


Monday, October 8th, 2012—6:30 pm-8:00 pm



The Supreme Court recently ruled the Patient Protection and Affordable Care Act constitutional and now the action is at the state level: who is going to be doing what and when in Tennessee?  Join Depression Bipolar Support Alliance Jackson in welcoming Brad Palmertree, Interim Executive Director for the Tennessee Health Care Campaign, as he updates us on the latest activities around the Tennessee Health Care Exchange and Medicaid (TennCare) Expansion.

Brad Palmertree was formerly the Director of Communications for Tennessee Health Care Campaign. He has tracked and researched the Patient Protection and Affordable Care Act from its inception, and uses his knowledge of the law for public education: working with policymakers, legislators, medical providers, social workers, and community leaders to help them better understand provisions of the new health care law.  He holds a Bachelor's of Social Work from Lambuth University and is the current Practicing BSW Representative for the Tennessee Chapter of the National Association of Social Workers. Prior to his work with THCC, Mr. Palmertree worked with at-risk youth in New York City and in Jackson, TN in various capacities. He now lives in Nashville in a house currently occupied by two cats, Rocky & Isabella.


Jackson-Madison County General Hospital


                                                                                        J. Walter Barnes Auditorium

                                                                                       620 Skyline Drive  - Jackson, Tennessee

                                                                            (auditorium entrance inside the main hospital entrance)


                                                                -HELP US BY PASSING THIS ANNOUNCEMENT TO OTHERS -

For additional information, contact Steve Brannon, State Director, DBSA Tennessee

Bus. 731-215-7200

Sunday, September 16, 2012

Self-awareness can help us maintain wellness

The following article was first published in the zine Esperanza, 2010.

 Fighting for self-awareness

By Bruce Clark

It may be a little theatrical to claim that being diagnosed with depression in my early 30s was my road to Damascus, but it was the instigating incident that led me to talk therapy. That therapy gave me a newfound self-awareness that has been an invaluable asset in managing my well-being.

The catalyst for depressive episodes can vary, but it's generally accepted that the stress associated with major life changes can coax the sleeping black dog from his cozy den.

My depression manifested itself after my wife and I moved to Palm Springs, California, from the prairie city of Winnipeg, Manitoba, in 1993. It seems ridiculous to think that moving from a city with the same weather patterns as Siberia to a verdant desert oasis could bring on any negative psychological indications, but the stress of leaving family and friends while venturing into uncharted career territory likely had a great deal to do with it.

I began experiencing typical symptoms; sleeplessness, fatigue, irritability. I was unable to concentrate on my work, and the things that normally gave me pleasure began to seem pointless.

I became frustrated easily and I could feel the anger I had caged up deep inside escaping from the metaphoric bars now weakened by the depression. Growing up in a working-class neighborhood where fighting and aggression were part of the landscape had equipped me with a quick temper and a potential for violence that began to flare up.

I started snapping at my wife. Then, during a recreational hockey game, I went after an opposing player who was using his stick as a weapon. I broke my hand by repeatedly punching the steel cage that protected his face. I know that fist fighting, even during a hockey game, is shameful and ridiculous for a so-called mature adult, but I was out of control. At the time, you couldn't have pulled me off the guy with a team of Clydesdales.

My anger was getting the best of me and I knew I needed help.

With the gentle encouragement of my wife, I found an excellent psychiatrist and began weekly psychotherapy sessions. The formal talk therapy forced me to take more than a passing glance at my life. In answering the doctor's seemingly simple questions about my wife, my parents, and where and how I grew up, I began to realize why I made certain choices and began to understand the mechanics of my behavior.

My doctor prescribed an antidepressant and a stimulant, a combination that gives me a feeling of well-being that had been persona non grata in my life for far too long.

The medication enabled me to get back to work and mitigated my anxieties, but it was psychotherapy that gave me much-needed insight into my own personality, warts and all.

My temper and my anger issues were learned behaviors. My father was a caring, community-oriented man who abhorred injustice and sometimes took the law into his own hands. When I was 11 or 12, a menacing neighborhood dog bit two of my friends. Incensed, my father had me lead him to the house where the dog lived. He confronted the dog's uncaring owner and threatened him physically while I stood beside him.

I was laughing as I recalled the story for my psychiatrist, who didn't crack a smile and said seriously, "You must have been very frightened."

I'd never admitted it to myself but it was, in fact, terrifying to see my father in this potentially violent situation. I defended my father's actions as honorable and said that I thought my dad was doing the right thing by protecting the neighborhood.

When my doctor told me the plot was familiar, it took me a while to understand he was referring to my hockey fight. It became clear that the opposing player hacking away at my teammates was the dog's owner and I was my father.

That realization and many other nuggets of self-discovery have empowered me. Knowing more about what drives me gives me more control over my actions, which in the past were governed by emotions instead of common sense and reason. Being in control is good for my self-esteem and, in turn, good for my psychological well-being.

Depression isn't a prerequisite for introspection, but it did lead me to the psychotherapy that has given me a greater understanding of myself. And I can honestly say, I haven't punched anyone since.

Bruce Clark, a writer and standup comedian, is lucky enough to split his time between Winnipeg, Manitoba and Palm Springs, California.