The 10 Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It by Margaret Wehrenberg describes the following ten techniques:
- Identify Triggers, Plan New Responses
- Start Where You Already Are: Record strengths and how you use them, rating degree of pleasure
- Cool Down Burnout: get a buddy to choose changes i.e. sleep and self-care, and monitor progress
- Mobilize Your Energy
- End Isolation
- Balance Your Life
- Prevent Destructive Behavior
- Broaden Your Perspective
- Increase Flexibility
- Learn to Live Fully
Types of depression may be related to their underlying history:
- Intense despair often associated with serious loss, i.e. early life adversity. This may be a consequence of attachment problems or abuse.
- Helplessness and rumination often associated with traumatic stress requiring resolution of memory later than childhood like an accident.
- Exhaustion and isolation often associated with chronic stress requiring change in the situation. This can be hard to shake from depletion of critical neurotransmitters.
- Endogenous depression often associated with low motivation for recovery and limited pleasure in life. This type of depression is genetic and neurobiological. Sufferers complain of low cognitive energy, persistently negative mood, and irritability. “There is a tendency to be passive and hard to motivate.”
When Serotonin is Too Low
- Negativity, worry, sensitivity to threat from activity in the amygdala
- Poor planning, unable to push negativity away or find a positive frame, loss of emotional control or affect regulation, inability to feel satisfied from activity in the prefontal cortex
- Poor impulse control, irrational responses to problems from activity in the orbitofrontal cortex
- Ruminating worry and inflexible attitude from activity in anterior cingulate gyrus
When norepinephrine is too high, it leads to inner jitteriness, tension, hyper-vigilance, perfectionism, and chronic stress. If it is too low, symptoms are physical and mental lethargy and sluggishness.
When dopamine is too high, symptoms are perfectionism, overfocus on details, and too much stress response to subsequent memory. If it is too low, it may mean loss of interest or pleasure, low motivatio, and low energy.
If there is GABA and Glutamate imbalance throughout the brain, symptoms are agitation that exacerbate other problems, such as pain perception. Excess glatamate in the hippocampus can mean impaired memory while excess in the amygdala might result in oversensitivity and excess negativity.
“Although neurotransmitter imbalances underlie all types of depression, in endogenous depression, those imbalances themselves are the trigger … Therefore, the way of responding differently to this trigger is to consciously override that biochemically determined low energy by entering into positive neural networks … by purposefully thinking positive, optimistic thoughts taht will boost your motivation to do something different.”
- Improve satisfaction: review what went right
- Consciously shift away from negativity: “I can think what I want and I want to think I have many good traits”
- Make a “to do” list of simple, productive activities as distraction: music, movie, game…
- Plan to get what you want instead of planning to be hurt and hopeless, just face it when it happens
- Do more of what gives you energy: inspirational reading, walking outside, etc. and cut back on energy drainers
- Turn “I can’t” into “I won’t” because your actions and thought are in your own control
- You don’t have to like what you choose to do if there are good reasons to keep on doing it (until you get something better)
- Take a break from the problem for 10-20 minutes
- Utilize your future energy: pick a small task; create vivid image of how you’ll feel when it’s done; focus on the outcome; do the task; pay attention to the relief or pleasure after it’s done
- Time unpleasant tasks
- Exercise 5-7 days a week for 25-45 minutes at 70% of maximum heart rate i.e. brisk walking
- Make appointments for contact, i.e. tell someone you’ll call to chat at a specific time
- Break your routine and don’t spend all day doing one thing
- Plan to do one thing different in order to interrupt pattern of behavior for a new path