Retrain Your Brain After Depression: Stop a Bad Day in its Tracks

Having a bad day sucks. Nobody likes it, but for people who struggle with depression a bad day can be really scary. The intense emotions generated can make you feel like you’re falling back down the rabbit hole of depression. The truth is when you have a history of depression sometimes all it take is a bad day to spiral you into another episode. Below are some tips to help you stop a bad day in its tracks before things get out of control.

1. Breathe: When you get upset or agitated your sympathetic nervous system gets triggered and you go into fight or flight mode as if you were in real danger. Your adrenaline starts pumping, your muscles tense up and your breath gets shallow. Taking long slow deep breaths can start to turn that around. Deep breathing tells your mind and body to relax…there is nothing to fear.
2. Do a body scan: Just sit or lay in a comfortable position. Focus your attention on each part of your body for a few moments. Notice where you are holding your emotional tension. Is it in your chest, your stomach, your shoulders? Allow yourself to feel the sensation in the body without judgment. Next imagine yourself letting it go with each exhalation. This exercise is not only deeply relaxing; it also helps you become more aware of the connection between mind and body.
3. Practice benign interpretation: You are constantly making interpretations about everything. After a bad day, your mind might start turning in a negative direction. “This kind of thing always happens to me, my life sucks, I might as well give up.” Benign interpretation is simply not assuming the worst, but rather making a neutral or even a positive interpretation. With benign interpretation the above thoughts become: “This situation will end, I can get through this, tomorrow will be better.”
4. Do something kind for yourself: After a bad day everyone needs a special treat. Get a massage, get your nails done, have your favorite treat, take a bubble bath, go out to dinner. Do something that makes you feel good. You deserve it after the day you’ve had!
5. Call your therapist: Your therapist is there to support you. Maybe you just need a brief kind word or maybe you need an extra session. Remember you don’t have to get through this alone.

Improve Your Life With DBT: Mindfulness

“Mindfulness is paying attention on purpose, in the present moment, and nonjudgmentally, to the unfolding of experience moment to moment."  Jon Kabat-Zinn When I first heard the word mindfulness it sounded like new age nonsense.  I couldn’t understand how it could help with everything from decreasing depression to increasing concentration to effectively manage pain.   But when I began to practice mindfulness, it became very clear how beneficial it could be.  The fact is that the benefits of practicing mindfulness are endless.  But you can’t just read about it.  You have to try it.  In this on-going series about improving your life with DBT Skills, this week’s topic is mindfulness.

Here are a few ways mindfulness is helpful:

Mindfulness gets us out of our heads and into our lives.  So many of us have a tape playing in our heads that is chockfull of criticisms, judgments and worries. (I’m stupid, I don’t deserve happiness, nothing will every get better).  Mindfulness helps us stop believing the negative messages in our heads, stop comparing this moment to any other, stop thinking about what should be and just be present in this moment.  This is particularly important for those who struggle with depression because those negative messages can spiral into an episode of depression.

Mindfulness helps us focus on one thing at a time.  I know multi-tasking is all the rage.  We are texting while listening to music while watching TV while talking on the phone.  Our attention is so divided and superficial that we are not really experiencing our life.  When we focus on one thing in the moment we are much more engaged, much less distracted and much more effective.

Mindfulness helps us accept reality as it.  When we fight again reality we are fighting a losing battle and ultimately creating more suffering for ourselves.  Mindfulness teaches us to stop fighting that which we cannot change.

So the question is how to you practice mindfulness? Like any other skill we learn in life, mindfulness is best learned step by step.  Observing and describing are the teaching steps that get us to the goal of participating.

1.  Observe:  The first step is observing, just noticing your experiences right now...notice sensations in your body.  Notice smells, tastes, textures, sights, thoughts, feelings, anything that may be part of you current experience.  Just notice without judgment.

2.  Describe:  Now put words to your experiences.  The idea is to clarify what you have noticed to yourself and to others.  Stick to the observable facts, and stay away from judgments.

3.  Participate:  Once you have practiced observing and describing your experiences its time to participate.  Throw yourself fully into the moment.  Participate completely and unselfconsciously, if you’re eating just eat, if you’re dancing just dance.  If you watch children at play they are always participating.  They are not worried about how they look, or what they are doing later they are completely engaged in the moment.

Try the simple mindfulness exercises: 

Taste something mindfully (a mint, gum, a cup of tea).

Play with play dough or silly putty mindfully

Notice your thoughts mindfully (watch them float by like clouds, don’t become attached to any of them).  Remember thoughts aren’t necessarily truths.

7 Strategies to Start Healing the Damage of Depression

Here's the bad news...depression damages your brain.  This is particularly true when depression goes untreated for long periods of time, and when there are repeated episodes of depression. In addition, the likelihood of relapse increases with every subsequent episode.  This damage can cause problems with memory, planning, prioritizing and decision making.

People who struggle with depression often spend a great deal of time ruminating, which starts as trying to figure things out, but ends in triggering the fear responses in the brain.  This causes the depressed person to remain stuck and hopeless.  Plus, this pattern of negative thought becomes more and more solidified the longer it continues.

Here's the good news...the damage can be undone.

Below, I've outlined several strategies that can help begin to reverse the damage that has already been done. Remember that healing comes over a period of time with daily effort.

1. Fish oil:  Research shows that taking fish oil can improve the mood and stave off repeated episodes of depression.  This is because low levels of Omega-3 Fatty Acids in the system are connected with many mental disorders, including depression.   Dr. Andrew Weil recommends taking between two and four grams of omega-3 fatty acids daily with a meal for optimal results.  Its Important that the product you choose be guaranteed to be free of harmful contaminants.  If you are a vegetarian omega-3s can be found abundantly in eggs and flax seed.  Of course, check with your doctor before adding this or any supplement to your diet.
2. Breath:  When we are tense or anxious our breath has a tendency to be short and shallow.  This sends a danger message to the brain, adrenaline is released, and we become more tense, more anxious, more likely to increase our depression.  To counter this, try spending some time each day focusing on your breath.  Breathe in and out slowly and deeply.  When you find your mind beginning to wander just return it to the breath...again and again.  Doing this for just 3 minutes a day can begin to greatly increase your overall feeling of relaxed calm.
3. Talk:  Studies show that we get as much of an endorphin boost from talking as we can from sex.  When problems live in our heads they often feel much more overwhelming.  Getting them out in the open is often a huge relief.  So when you feel yourself starting to worry or ruminate, call a friend, call a family member or call a professional.
4. Walk:  I know you've heard about the benefits of exercise again and again, but that is because it’s true.  Thirty minutes of cardiovascular exercise most days is as effective as antidepressant medications for treating depression.  If you have never exercised before maybe 5 minutes is all you can manage at first, maybe fewer.  Do what you can do, and remember it’s the action that precedes the feeling.  You may not feel like working out, but you will likely feel better once you do it.  Please check with your doctor to get the ok before beginning an exercise routine.
5. Yoga:  Like exercise, the benefits of yoga are too many to list here.  But for people who struggle with depression, yoga gets you out of your head and into the moment.  You focus on where you hold tension in your body, and you work to let it go.  Yoga also offers a profound sense of relaxation and well-being particularly when practiced over time.  Again, check with your doctor before beginning a new exercise routine.
6. Write:  Keep a journal of your emotions.  Take note of how you feel several times throughout the day.  This will help you pay attention to what triggers your emotions, and how often your emotions fluctuate during the day.  Emotions always come from somewhere.  When you learn to pay attention to you these triggers you can have more control over your reactions.
7. Seek Help:  If doing this on your own feels overwhelming, its important that you seek out a qualified therapist to help you.  Feel free to contact me, 917-721-2257 or rebekah@rebekahshackney.com  Together we can undo the damage that depression has done.

Facts About Adolescent Suicide

“A child born today will live to be about 80 years old, on average. But the challenge is getting them through 16, 17, 18, 19 – the most hazardous time of their lives. A kid with a car, a kid with a gun, a kid with a bottle – any one of these combinations is much more of a risk than a terror attack or a flu from [overseas].”Timothy Egan, NY Times, 6/09/14 OpEd, P. A15

FACTS ABOUT ADOLESCENT SUICIDE Annually: - 19% of high school students seriously consider suicide (1 in 5). - 8.8% attempt suicide. This adds up to 1 million teens, of whom 700,000 require medical attention. - Up to 11% of teen suicide attempters will eventually die by suicide. (Diekstra, 1989; Shaffer et at., 1988) - In a typical US high school classroom, two girls and one boy will make a suicide attempt this year. - Between 31-50% of all adolescent suicide attempters re-attempts suicide (Shaffer & Piacentini, 1994) - 27% (males) and 21% (females) of adolescent suicide attempters re-attempt within 3 months of their first attempt (Lewinsohn et al., 1996). - The risk of suicide increases significantly as an adolescent accumulates more problem behaviors (violent behavior, substance use/abuse, self-injury, risky sex, etc.)

WHAT IS THE ANSWER? Dialectical Behavioral Therapy (DBT) is designed to treat patients who are struggling with multiple problem behaviors that make them at high risk for suicide.

In initial studies DBT with Adolescents is more effective than treatment as usual at the following: - Decreasing inpatient hospitalizations - Increasing treatment retention (many teens drop out in the early stages of most other treatment programs). - Reducing suicidal ideation, depression, anger, anxiety and emotional sensitivity - Reducing symptoms common in a borderline personality disorder (confusion about self, interpersonal chaos, emotional dysregulation, impulsivity). Rathus & Miller, 2002