SECTION XIII: DEPRESSION
Therapist’s Overview
DO I HAVE TO BE DEPRESSED?
GOALS OF THE EXERCISE
1. Identify times and situations when family members tend to be feeling depressed.
2. Increase family members’ ability to self-monitor.
3. Learn to challenge the belief of powerlessness
4. Increase a sense of choice to change depressive thoughts and behaviors.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Addictions
• Anxiety
• Anger
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH FAMILY MEMBERS
This exercise is to help family members to identify and describe their experience with depression. It is designed to help individuals connect thoughts with feelings and behaviors. The more a person is aware of his/her thoughts and behaviors with regard to his/her feelings, the more empowered that person can become to make changes. The exercise is also developed to help individuals realize that they can choose to think and/or behave differently even when feeling depressed.
EXERCISE XIII.A
DO I HAVE TO BE DEPRESSED?
This exercise will help you express how you think and behave when experiencing depression. The more you are aware of your self-talk and actions when feeling depressed, the better equipped you may become to make changes. Take some time during the next week to think about times you are feeling down or depressed. Complete the statements below during such times to help you increase your awareness of your thoughts and behaviors during such times. Once you have done so, you can begin to challenge yourself to try and think and behave differently.
FOR THE FAMILY MEMBER WHO IS DEPRESSED
List what you think when you feel depressed. This should be shared with all family members.
When I think _____ I feel depressed.
When I think _____ I feel depressed.
When I think _____ I feel depressed.
When I think _____ I feel depressed.
When I think _____ I feel depressed.
List what you do when you feel depressed. This should be shared with all family members.
When I do ____ I feel depressed.
When I do ____ I feel depressed.
When I do ____ I feel depressed.
When I do ____ I feel depressed.
When I do ____ I feel depressed.
When I am feeling down or depressed I will read the above statements explaining thoughts I can have and activities I can do. I know that such thoughts and behaviors are healthier for me and will help me feel less down or depressed.
I want to feel less depressed for the following reasons:
Therapist’s Overview
MY POSITIVE SCRIPT
GOALS OF THE EXERCISE
1. Increase sense of awareness of self-talk.
2. Learn to replace negative dialogues with positive.
3. Increase sense of choice to change depressive thoughts.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Addictions
• Anxiety
• Anger
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH FAMILY MEMBER(S)
Individuals struggling with depression are often stuck thinking in negative ways about themselves, their situation, and/or their future. This negative talk is often repetitive. They can repeat it as if it was a script from a movie. The idea of this exercise is to help them create a new script to recite.
EXERCISE XIII.B
MY POSITIVE SCRIPT
If you are like most people who struggle with depression, then you probably also spend a fair amount of time beating yourself up. These negative comments can seem so repetitive that they can be like memorized lines from a movie script. Sometimes these negative scripts can be very automatic and intrusive. You may want to think in a more positive way, which is usually easier said than done. This exercise is designed to make that task a little easier. When we are feeling depressed and thinking negatively it is difficult to come up with alternative and more adaptive positive thoughts. One way to do this is to plan for such situations. By writing the “Positive Script” out ahead of time, you will not have to work so hard. You will just need to read what you write here.
Over the next week try to notice times you are engaging in a negative script.
An example of a negative script might involve the following.
“I’m such a dumb *^#^**. I can’t do anything right the first time. What a loser.” No wonder people don’t like me, I don’t even like myself.”
When you notice that you are in that spot again and thinking negatively, write down what you are thinking about and telling yourself, BUT skip lines like the example above.
Now go back and cross out the negative comments and, on the lines above, write down what you would rather say. If it helps, think of what you would want someone you care about to say.
I made a mistake. I guess I’m human like everyone else.
Now write it one more time without including the negative script.
I made a mistake. I guess I’m human like everyone else.
Keep the positive scripts and keep adding to it whenever you can. You deserve it!
Therapist’s Overview
SOMEONE IN MY FAMILY IS DEPRESSED
GOALS OF THE EXERCISE
1. Determine the family member’s understanding about depression.
2. Identify how other family members feel affected by the family member with depression.
3. Identify triggers to the depression.
4. Develop ways to demonstrate affective support to the family member with depression.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Anger
• Anxiety
• Behavioral Problems
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
This exercise is designed for all family members to complete and then to discuss, either in a family meeting or in a family session.
EXERCISE XIII.C
SOMEONE IN MY FAMILY IS DEPRESSED
FOR EACH FAMILY MEMBER
This exercise is designed for all family members to complete and then discuss, either in a family meeting or in a family session.
1.
2.
3.
4.
Therapist’s Overview
WHAT AM I THINKING WHEN I AM FEELING DEPRESSED?
GOALS OF THE EXERCISE
1. Identify the various thoughts that go through an individual’s mind when feeling depressed.
2. Identify possible triggers to the depression.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL
• Addictions
• Anger
• Anxiety
• Communication Problems
• Eating Disorders
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT
Have all family members choose the cognitive distortions they tend to engage in, and have them give an example of each one. (See the exercise “My/Our Daughter Is Depressed” (pages 119−120) for a list of common cognitive distortions.)
EXERCISE XIII.D
WHAT AM I THINKING WHEN I AM FEELING DEPRESSED?
FOR ALL FAMILY MEMBERS
At times, our thoughts can greatly influence how we feel. One of the first steps to changing how we feel is to identify how we think. By completing this exercise, you will learn how you sometimes think and perceive things.
Therapist’s Overview
WHAT DO OTHERS VALUE ABOUT ME?
GOALS OF THE EXERCISE
1. To develop a sense of value.
2. To develop a stronger sense of self-worth.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
Many individuals who suffer from depression report feeling a lack of value. To counter such negative thinking, have them complete the exercise on the following page.
EXERCISE XIII.E
WHAT DO OTHERS VALUE ABOUT ME?
This exercise is designed to help you challenge your belief or view of how valued you are by others.
Seek out at least two family members and two friends, and ask them, “What do you value about me?” Record their responses verbatim.
1.
2.
3.
4.
Share the findings with some other family members, then have those family members record times when they observe the evidence of this value (e.g., you are thoughtful, you helped Johnny with his homework).
Therapist’s Overview
MY/OUR DAUGHTER IS DEPRESSED
GOALS OF THE EXERCISE
1. Help the depressed child/adolescent identify various thinking errors (distorted thoughts) that lead to depression.
2. Begin to generate a sense of control over feeling depressed.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO DEPRESSION
• My Safe Place Page 19
• When I Feel Anxious It Is Like . . . Page 42
• Creating a Positive Outlook Page 227
• A Picture Is Worth a Thousand Words (just pictures 1−3) Page 215
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Addictions
• Anger
• Anxiety
• Communication Problems
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT
This exercise is a fun way for family members to become familiar with the various types of cognitive distortions that individuals sometimes engage in. At times, our thoughts can influence how we feel and perceive situations. This exercise is designed to help family members become more aware of cognitive distortions and to begin to aid them in identifying which distortions they tend to engage in.
EXERCISE XIII.F
MY/OUR DAUGHTER IS DEPRESSED
FOR ALL FAMILY MEMBERS
This exercise is a fun way for family members to become familiar with the various types of cognitive distortions that individuals sometimes engage in. At times, our thoughts can influence how we feel and perceive situations. This exercise is designed to help you become more aware of cognitive distortions and to identify ones you may engage in.
After reading the definition and accompanying example for each of the following thinking errors that many people make, see if you can find them in the word search on page 120.
• Catastrophizing. This is when you think about consequences and you blow them out of proportion in a negative way. For example, after striking out at bat, Joe says to himself, “I’ll never get a hit. The coach will probably cut me from the team now. I’ll never be able to play baseball again.”
• Overgeneralization. This is when you think of one example to make conclusions about a number of other things, or all similar circumstances. For example, Tim breaks up with his girlfriend Becky, and Becky thinks to herself, “Guys are scum, and Tim is just like all the rest of them.”
• Fortune telling. This is when you predict that negative things will happen to you in the future, based on little or no supporting evidence. For example, T.J. wants to play basketball for his school but begins to think, “They won’t want me to play, I won’t be as good as the other kids.”
• Black-and-white thinking. This is when you look at situations, others, or even yourself as being totally bad or totally good—without any sense of balance. For example, Susan is thinking about her parents getting on her case about her schoolwork, and she concludes, “I can never come home without having them get on my case. Every day it’s the same thing.”
• Dark glasses or mental filtering. This is when you block out all the positives and just focus on the negatives. For example, Mike brings home all As and Bs on his report card except for one D. He thinks to himself repeatedly, “I am so dumb I can’t even get better than a D.”
• Personalizing. This is when you take on the responsibility for something that is not your job. For example, Sondra arranges to have pizza delivered to her house for a party she is having. The delivery person gets lost and never arrives with the pizza. She thinks to herself, “I should have never called that place. Why couldn’t I have called the other pizza store?”
• Discounting. This is when you reject the positive things that happen to you. For example, Michelle’s girlfriend tells Michelle that her outfit looks great, but Michelle thinks to herself, “This outfit looks terrible on me. She is just trying to say something nice but doesn’t really mean it.”
• Judging. This is when you are critical of yourself or others and make statements such as, “I should be more relaxed,” “I ought to know by now,” “I have to get this right.”
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Mind reading. This is when you make a negative assumption regarding other people’s thoughts and behaviors. For example, Bryan passes a girl in the hall and when she does not say hello to him, he thinks, “She hates me. I don’t stand a chance with her.”
