7 Steps to Treat Depression
Today, I'm talking about depression, what it is, and some steps that you can take to feel better. Hi, I'm Paige Pradko. Welcome to Therapy for a Better Life. 15% of us will, at some time in our life develop the symptoms of major depressive disorder. Today, I'm going to review the diagnostic criteria for depression and what are some steps that you can take to it begin to feel better.
First, in the DSM5, the diagnostic manual, you must meet five of nine criteria. The first criteria is depressed mood. The second criteria is a diminished interest in things. The third is a change in appetite or weight. The fourth is a slowing of psychomotor movement. This means that your body’s movement is actually slowing down, and people can notice. Number five is fatigue and loss of energy, and six is a feeling of worthlessness and guilt. Seven is an inability to concentrate and having difficulty making decisions. Number eight is trouble with sleep meaning either too little or too much. And number nine are thoughts of suicide. To be diagnosed with depression, one must have five or more of these criteria and have experienced them for too two weeks are longer. And it, they must be what we call “clinically significance” where it affects your daily functioning.
In addition to these symptoms, what I also see, and it's not in the criteria, is this overall sense of hopelessness in my clients. This idea that they are never going to get better, and they are somehow just irreversibly flawed. Now, depression, you can tell by these criteria, is not just sadness. It's much more than sadness and people cannot just snap out of it. I like Robert Sapolsky. He is a Stanford professor and I like his definition of depression. And he says, “Depression is a biochemical disorder with a genetic component with early exposure experiences that make it so someone cannot appreciate a sunset.”
Now we do know that depression has a genetic component and it's been proven through twin studies that early trauma and early stress in someone's life can make a big difference. It can make them more susceptible to depression. We have found out in research that four or five stressors seem to be the magic number. If you have more than four or five, the likelihood of depression is high. And these are stressors such as abuse that occurred, or your parents divorced, or living in poverty, an accident, or a major loss illness or loss. These are the kind of stressors we are talking about. Now, what can we do about it? Let's say that you happen to have the genetics for depression. Let's say you had a lot of these stressors as a child.
First of all, you have to have an intention or desire to feel better. You have to want to get better.
Number two, of course, you need to get help. And we know from research that if you combine therapy plus medicine, you are likely to have the best result. And the reason why is that if we just take medicine, if we just take an antidepressant, we may get more neurotransmitter activity in the brain, but you must have more helpful, positive thoughts mixing in with that new activity. Otherwise, if you have a lot of activity in the neurotransmitters, but your thoughts remain very negative, you're not going to feel much better. So it is important to have both therapy and medicine.
Also we know that structure helps humans do much better when they have some structure. So a consistent sleep wake work cycle is very helpful in beating depression.
Number four is we want to take just good, healthy care of ourselves. Taking care of ourselves meaning that we do the best that we can with nutrition, with sleep, with exercise, and just generally taking care of ourselves helps a great deal.
The fifth thing is I like people to really start to think about what is meaningful in their life. I recommend my clients read Victor Frankel's book, Man's Search for Meaning. He was a, a survivor of the concentration camp during the Holocaust. And he was also the founder of something called logotherapy. And in the book, he just talks about how life's life has meaning and even suffering has meaning. And I think that the book really helps to broaden people's perspectives and turn things around in their life.
Number six is I like clients to have a good understanding about what their values are. So that when we begin to choose behaviors, that we're expanding their life a little bit, they are choosing different activities and behaviors that are within their value system. What's important to them. We are happier when we are engaged in activities that meet our values.
And number seven, I work with clients on changing their personal narrative. I listen very carefully in session to what a client is telling me. What is their personal story? And if their story is one of hopelessness, then I'm going to work with them to shift that narrative to one of “I'm trying, I'm searching, I'm looking for hope”. And if they have a narrative of “I'm damaged” or “I've been victimized”, and I am going to work with them to find their strength, to turn their personal narrative from being victimized, to surviving and being a survivor, and a narrative having more strength. If their narrative is one of “I'm unlovable”, then we're going to have self-compassion and teach the client how to use self-compassion and shift the narrative to “I'm wanting to be loved”. I find that narratives are very important and relate to a person's overall mood.
I like a person to be a little bit prepared for ups and downs in treatment as progress in depression is often slower than desired. We must have patience in healing from depression. It takes time to begin to shift our narratives and shift our mood and to begin moving again and feeling better. So I would love to hear your comments and questions on the video. I'm going to begin a series of Q and a videos where I take your actual questions and I answer them right on the video. So if you'd like to submit a, a question, I would love to, to use one of your questions and I would love for you to like, and subscribe to hear more videos like this. So, until next time I will see you in session, take care bye-bye.
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