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Solution-Focused Therapy For Depression

Gain an in depth understanding of depression based on Solution-Focused Therapy for depression and the Human Givens Approach, both integral to my experience and training.

Firstly I am going to discuss the depression cycle before outlining strategies to break free of it, including an exercise you can do at home.

 

Understanding The Depression Cycle

If you have been depressed you may have noticed that you can ruminate or worry a lot during those periods. This type of worrying is typified by taking an all or nothing thinking style. This is because when we are stressed and emotionally aroused beyond a certain point the mind takes the fight/flight approach and looks at the worst, most extreme, scenario. We don’t look at our situation from a rational perspective; taking in all the possibilities like we might do when we are more relaxed.

We interpret the reality of our situation very quickly to make sense of what is going on; the events that happen, what people say, the experiences and feelings we have.

The problem with these types of extreme introspective thoughts is that they cause strong unpleasant emotions, with no opportunity for the emotions to be released. When this doesn’t happen it leaves an incomplete loop in the brain’s limbic (emotional) system. By the onset of sleep, if this emotional cycle remains incomplete, then the brain needs to ‘do something’ with the emotional loops that have been started. Dreaming is the minds way of completing these loops.

The dream acts out, in metaphor, a situation that will flush out the emotion from the brain. In other words an imaginary experience whose pattern resembles the ‘real life’ one is enough to create the same emotional reaction. Normally this system works well and everything stays in balance. However because we typically have an excessive amount of daytime introspective worrying/rumination when in a depressed state, the brain has to increase the amount of dreaming done. Typically someone who is depressed will dream three times more than someone who isn’t depressed.

The problem with lots of dreaming is that it is a state that uses up almost the same amount of energy as if we were awake, releasing stress hormones and adrenaline. If too much of these are released at night your body and mind will begin to feel very tired during the day. In fact depressed people often report that the worst time of the day for them is first thing in the morning.

Excessive dreaming also means the body misses out on some of the much needed, physically rejuvenating, Slow Wave Sleep, resulting in a depleted hormonal system and exhausted orientation response- a crucial brain activity that allows changes in your focus of attention and so motivates you. It also is a key part of concentration. So it is important to note that although depressed people might sleep a lot, they are often still not getting enough of the rejuvenating sleep, which leads to more exhaustion during the day. The more exhausted we are the more likely we are to interpret reality in negative ways, as outlined before. This then leads to more dreaming and the cycle continues, progressively worsening for those people that don’t take the necessary action to break out from it.

So one of the most important things someone who is depressed can do is to cut down on the amount of emotionally arousing rumination during the day and also challenge any negative thinking.

Now that you know the why lets focus on the how. Below I have covered off one particular exercise that is particularly helpful for people with depression that can be done at home. Following this I have then detailed some more important tips that are also of importance to consider in alleviating the depressed state.

This is an exercise to be done at home, on your own. To be in the right frame of mind for this I would like you to think of taking on some of the qualities of a defense lawyer; imagine building your case by looking at the evidence and considering all options and the reasoning’s to back up your thinking.

1) Give yourself an opportunity during your day to sit down and have what I call a constructive worry, for 15  – 20 minutes.  Ideally at about midday or late afternoon/early evening, but not before you go to bed. This needs to be a quiet space for you to take out of your day, which can then become a routine.

To start with, focus on and write down specific things you have been worrying about over the last 24 hours. Grade each worry out of 10 based on how you feel about it at this precise moment- 10 being you feel the most concerned and 1 being the least.

2) Going through each worry, look for and make a note of the evidence supporting why this is a worry for you; your own reasoning that defends this as a worry. Now try and come up with at least three alternative interpretations of the events or situation that made this a worry in the first place! These can be both realistic and also silly and wacky, as long as there is a vague possibility they might be true. Allow yourself to think outside the box on this.

So it might be that you are certain you are not going to get a job and that leads your thinking to how terrible your life is. Your task is then to look at your reasoning behind why you don’t think you will get a job, the situation or events that were the originators of the reasoning and to then consider and agree on three possible alternative interpretations from those events.

3) The final part of this task is to then go though each worry and your alternative interpretations and re asses how you are feeling about it and give it a mark out of ten again. Then take it down two grades- so if you decide it’s an eight take it to a six. Now make an agreement with yourself that you are going to act as if it’s a six for the next three days. On the third day you can then reassess how you feel about it during your appointed time that day.

Further tips:

1. Evaluate how your emotional needs are being met. The Human Givens approach has identified nine essential emotional needs that are crucial to balancing our emotions. 

2. Maintain a regular sleep pattern. Do not lie in if you feel exhausted in the morning. All that happens is that you dream more, as your REM periods get longer the more you have been asleep. Keep to regular times for going to sleep and waking, making sure you spend no more than 8-9 hours in bed, regardless of how tired or how much sleep you think you have had.

3. Find a relaxation method or therapy that you can practice at home or in a class. Meditation, Yoga or Tai Chi are all very good or just a simple breathing technique. This is one of the most important things you can do as by having regular time to relax the mind ideally every day, even for 10 minutes, you are allowing the rational mind to function more effectively and the emotional mind to quieten down a bit.

4. Keep busy by finding tasks that you know you can complete easily and quickly- even mundane tasks like cleaning the bathroom can give a sense of satisfaction when you are feeling depressed!

5. If possible, decide to put difficult decisions on hold for 1 or 2 weeks while you get back your energy.

6. Try and spot when you are running black and white negative thinking styles. Instead really force yourself to look at all other possible options to specific events or circumstances and allow the possibility for the unknown. These options don’t need to be entirely optimistic just not an extreme negative.

7. Keep your mind occupied by doing things such as reading an exciting novel, listening to a play on the radio or an audio book and TV if it’s upbeat. Ideally make sure if it’s a book that its’ small enough to read in a week or less.

8. If you can stay working, do, as it will help keep your mind busy.

9. Keep yourself occupied as much as possible in ways that stop you thinking too much!

10. Exercise is so important if possible. Ideally enough so your heart rate is raised so that you feel slightly out of breath.

11. Do what you enjoy, even if it’s a bit of a struggle.

Contact me for your free consultation and to discuss my therapy for depression approach.

By Lawrence Michaels

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