Behavioral Medicine Associates, Inc.

Education Pages

Depression

People who get depressed have often been exposed to situations that have led them to feelings of helplessness (despair, feeling like there's no way out, feeling trapped, fearful) and beliefs that they are helpless to escape painful circumstances and feelings. Some people may have genetic predisposition toward one or another kind of depression. Some people worry and ruminate more, others feel more anxious aroused body sensations.

Assessment: We discuss your personal and family history, sleep patterns, diet. We discuss events or situations that may have led to your developing beliefs that you can't control important outcomes. Later we help you change those habits.

With very persistent depression that has not cleared up despite previous treatment attempts with medicines and therapy, a quantitative EEG study may provide useful information. The research of Richard Davidson at UW Madison over the last 25 years points to very distinct EEG patterns in people with recurring depression. These patterns predispose you to depression and are inherited. If you have this form of depression you really need serious, practiced skill at keeping your thinking adaptive and optimistic. You may also benefit from "training" your brain activity in ways that fight depression.

Treatment:    As with primary anxiety disorders, learning to relax your body is a helpful part of treating depression. In fact one recent study showed 50% reduction in depression symptoms just from making a habit of breathing at a very slow rate (5-6 breaths per minute).  Challenging depressing thoughts and beliefs, inventing new and more constructive patterns of thinking is another tool. The range of things that have to be addressed in the cognitive behavior therapy of depression is highly varied, but the common theme is learning to take control of what you can be in control of, to exercise intelligent influence on levels to which your influence genuinely extends, and to worry less about things that are truly not for you to control.

When we have QEEG evidence that patterns in the EEG predispose you to depression, we may suggest training to change these patterns with neurofeedback. Medications can be very helpful to some people, but we don't see them as long term solutions. We see training and practiced skill in problem solving, optimism, assertiveness, anxiety management, social connection, the development of focused, meaningful (to you) activity, good nutrition, solid sleep as the long range answers to depression. As these various skills have their effects, patients can work with their prescribing physician to wean off and often stay off medications.

Overcoming Depression: Lessons in cognitive therapy for depression on a CD

Depression is a complex topic. There are probably many varieties of depression, ranging from natural discouragement when bad things happening, all the way to ill moods that come on for no obvious reason. that are likely result from a genetic tendency and neurochemical imbalance. The present discussion will not address "bipolar disorder" - manic depressive illness, as this is a very complex issue. Some depression results from sustained, untreated anxiety. After a while, your system just won't sustain the on-going arousal, so it shuts down. The belief that you are helpless, worse yet hopeless in the face of life's demands plays a big role in most depressions.

Most forms of depression can be managed by psychotherapy, medications, or a combination of these ingredients. Our audiotape "Overcoming Depression" teaches the central ideas of what is called a "Cognitive Behavioral" approach to getting rid of depression. The tape should in no way be considered a substitute for professional help. Depression can be very dangerous. If you believe you may be suffering from a clinical (significant, interfering with your life) depression, please contact a competent health care provider or mental health specialist.

"Overcoming Depression" can be a useful adjunct to in person work with a therapist. You will be asked to stop the tape and make notes on your own thoughts, feelings and behaviors. The basic ideas in the tape are easy to understand:

You can recognize the effect your thoughts and actions have on your mood; You can learn to decide whether thoughts you're having are helping you or hurting you; You can begin to change the hurtful, discouraging things you may be saying about yourself and the world; You can create deliberate thought and action that will get you going again; You can mentally rehearse realistic, "one small step at a time" success patterns that will gradually return your self esteem and sense of control.

Replacing maladaptive, negative self talk with constructive, deliberate, self instruction elevates your mood and puts you back in control. I am not talking of simple platitudes or "affirmations." Those thoughts are fine, but they do not have the personal relevance and power of really well designed self talk. This audiotape teaches how you can develop the skills and habits of "anti - depressant" self talk and imagery.

BMA Homepage     Order the recording

.