5 steps to overcome depression

the smile maker :: depression


Have you ever noticed how life and business are treated differently and each has its own set of principles, especially when it comes to change? Why is that? Aren’t we still humans at work with exactly the same psychology? So why couldn’t we apply business principles to our own life or vice versa?

Reviewing my own recovery from depression and anxiety, I have realised that it followed one change management tool called ADKAR — Awareness, Desire, Knowledge, Ability, Reinforcement.

Obviously this tool can apply to any change you want to make in your life, but here I’ll focus on how it can help you overcome depression.

1. Awareness

Many of us will go about life assuming that the way we feel is normal. Women especially will blame their extra-sensitivity or mood swings on hormones and PMS. However, chronic conditions are often a sign that something is not working the way it is supposed to and something can be done about it. For example, ongoing feeling of sadness, tiredness, or negative thinking can be a sign of depression.

How do you know if these signs are ongoing or a once-off? Start by becoming more aware of these feelings, rather than dismiss them. Then take note about how often you feel the way you feel or how often the symptoms that are bothering you flare up. A good way to do this is to keep a journal: every day, before going to bed, write how you felt or the symptoms you experienced. Bullets points are fine. You can also take it a step further and make a table: symptoms in rows and days in columns. This will help you identify patterns.

This may sound a bit tedious but have you every been to the doctor and they start asking you questions about the frequency and intensity of your symptoms and you don’t know how to answer? This will help because now you will have everything noted down.

If you do not feel confident about talking to your doctor because you fear they might dismiss you as just being sad or tired, you can take an online test on the BeyondBlue website. This test will ask you about how you have been feeling for the past month (the above will be quite helpful) and tell you whether or not you may be suffering from depression. It will also provide recommendation (the first one being to talk to your GP).

Becoming aware of what is going on inside your head or your body is not about being a hypochondriac or labelling yourself or your condition. It is about understanding what is happening. After all, how can you change something if you do not know it is broken in the first place? However cliché this may sound, becoming aware is the first necessary step for change.

2. Desire to change

Being aware that something is “wrong” or “off” is fine but what do you do about it? Have you been aware for a while that you were unwell but have not been able to take the necessary steps to get better?

Now that you are aware that something needs to change, you need to create some leverage for you to want to make the change. One useful tool to do so is the pain vs. pleasure model. The premise of the model is that we do more to avoid pain than to gain pleasure.

For example, what makes you want to change more:

  • I want to get help to stop feeling so sad.
  • I want to get help to be happy.

For me, and most people, the first one is a greater motivator. Why? Because you know the pain you are in right now. You know how it feels and the motivator to get out of it is greater than the pleasure you might gain. After all you may not actually know what happy feels like for you.

This principle is what made me want to get help. For a while I had been feeling unwell and suspected I had depression. I had even done the test on BeyondBlue that confirmed it. However, I did not do anything about it. I thought it would pass.

As I was crying myself to sleep one night, I realised how much pain I would be inflicting on my family if I was to act on my suicidal thoughts. I knew exactly what pain they would go through having already experienced a suicide in the family. Seeing my family hurt because of me was my reason to seek help.

There is no need to get to that point for you to be willing to make the change and seek help. All you need to do is ask yourself the following questions. Be specific in your answers.

  • What will depression cost you? E.g. your friends as you keep cancelling on them.
  • What has it cost you in the past? E.g. you may have lost a job because you could not handle the pressure.
  • What is it costing the people you love? E.g. they worry about you all the time.
  • What is it costing you right now? E.g. your relationship with your partner is being strained.

Please be gentle to yourself when doing this. This is not about blaming yourself for how you are feeling and what you may have lost as a result. This is about taking stock of what it has cost you so far and putting an end to it.

Thinking about what is important to you (e.g. your family), how does depression keep you from achieving what is important to you (e.g. being close to your family)?

Now let’s introduce the pleasure. Again be specific in your answers. If “I’ll be happy” is your answer, describe what happiness means to you. For example, having a supportive relationship with your life partner, having a job that you enjoy.

  • When you get better, how will your life be?
  • What will you gain?
  • What will it mean for the people you love?
  • What will it give you?

How are you feeling now about taking your first step to recovery?

3. Knowledge

This step is about learning more about yourself, your condition and what you can do about it.

The problem with depression is that we may not appreciate the good things. We may not even realise we have them. A good tool to assess where you are and what you may want to change in your current situation is the wheel of life. This tool was a real eye-opener for me. It truly made me see things from a different perspective and that not everything was bad.

Another great resource is Change Your Thinking by Sarah Edelman. This is a book on cognitive behaviour therapy (CBT) and it explains how our thoughts and language may create anxiety and depression and what we can do about it. For me, this was life changing. It made me realised that I was not the only person thinking the way I was and also that it was possible to change and more importantly how to change.

There are many reasons why people are depressed (e.g. grief, repeated stress). The circumstances that led you to depression are specific to you. You need to understand your triggers, i.e. what caused you to be depressed in the first place and keeps you there, so that when similar events come up you know how to tackle them to avoid feeling the same way. In my case, it was just ongoing exposure to stress. Some situations were more stressful than others and discovering this helped me manage my reactions and expectations accordingly and as a result reduce my stress levels.

If you have been feeling depressed for a long time, you may have developed habits that go with it (such as watching TV for hours). Reviewing your habits and what contributes to your happiness and unhappiness is a great way to discover how you are contributing to your own state of depression and how you can end the vicious cycle right now. This tool will help you do just that.

These are just a few tools that can get you starting on your recovery journey. There are many more tools available out there. This checklist shows you what works for the treatment of depression. Your GP or psychologist should also be able to provide recommendations for you, which brings us to the next point.

4. Ability

Books and the Internet are great, but let’s be honest, how many times have you read something, thought it was great and implemented it? Rarely, right? The implementation is always the hardest part and where we may need the help of experts.

A psychologist or a coach can help you with some of the tools mentioned above. They will also help you look at things from a different perspective. They will be able to ask questions that are relevant to you (and not generic ones that you can find in books). They will be able to tailor a care plan to your needs and circumstances.

Implementation also takes commitment. How committed are you to making this change? If you are losing focus or motivation, remember the exercise above about creating leverage. If you do not change right now, what will it cost you?

5. Reinforcement

In order for wellbeing and change to be sustainable, reinforcement in the form of ongoing practices is necessary. Think about athlete. Do they only show up at the time of the big events? Of course, not. They train all the time. Training is the only way to succeed and implement long term changes. So what do you need to do on a regular basis to keep your depression in check?

The key to success is not to pick too many things to change or do at once. For example, you may decide to meditate, have a journaling practice, exercise daily and give up alcohol. How do you think you’ll go with this? Just writing it, it felt overwhelming! Pick one of these and do it every day for 40 days (e.g. give up alcohol). Then add another habit (e.g. meditating) and do it along the first one for 40 days. Now add another ritual (e.g. daily exercise).

At the end of each 40-day period, ask yourself: is this sustainable? What changes/adjustments do you need to make to make it work? For example, exercising one hour daily may be ok at first but once you add daily meditation and journaling, you may find that it is not sustainable. 30 min may be more manageable or 1 hour every second day. Make it so it works for you and to ensure you can keep doing it for a long time.

This completes the 5 steps. Remember:

  1. Become aware of your current emotional state
  2. Create a desire to change using the pain vs. pleasure model
  3. Understand yourself, your condition and your circumstances
  4. Surround yourself with experts who can help and guide you through your recovery
  5. Create a daily routine

What now?

Now, close your eyes and imagine yourself in two weeks time. You did the BeyondBlue test after reading this post and decided to consult your GP. Your GP has referred your to a great psychologist. You are just coming back from your first visit to the psychologist and you feel hopeful. Things are not so bad after all and you can see the light at the end of the tunnel.

It has now been 2 months since your first visit with the psychologist. You are feeling so much better. You still feel down every now and again but you are able to pick yourself up. You know exactly what triggers the depressive episodes. You are able to identify these moments earlier and earlier to the point where you can avoid them totally. You have been journaling daily and are about to introduce a daily meditation practice.

It’s now been 6 months since you took the test. You can’t believe how much you have changed in those 6 months. You are no longer taking anti-depressants and you feel great. Your daily practices keep you in check. You now react differently to situations that would have triggered you previously. You are now able to let go of whatever bothers you. You feel happy and at peace.

Enjoy this peaceful feeling for a few more breaths.

When you are ready, take 3 more deep breaths and open your eyes.

What are you takeaways from this article?

Want to learn more tools and techniques to help you manage and overcome depression? Join me at the Heal Your Mind weekend retreat in Yanada in July.

Disclaimer: this article is based on my own experience and is for general advice only. It does not replace medical treatment. Please seek advice from your doctor. If you feel depressed and are having suicidal thoughts, please call Lifeline on 13 11 14.

Categories: Coaching Tools.