Overcoming Depression For Dummies Read online

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  About the Authors

  Elaine Iljon Foreman M.Sc., AFPBSs. is a Chartered Clinical Psychologist and Associate Fellow of the British Psychological Society. She specialises in the treatment of fear of flying plus other anxiety related problems. Elaine is a Consultant Specialist in Cognitive Behaviour Therapy, accredited with the British Association for Behavioural and Cognitive Psychotherapy, a Fellow of the Institute of Travel and Tourism, and chairs the UKCP Ethics Committee. Her highly specialised Freedom to Flyä Treatment Programme for the fear of flying, and the Freedom from Fear approach for other anxiety-based problems have been developed over thirty years of clinical experience and ongoing research and development of cognitive behaviour therapy. She started research into the treatment of anxiety in 1976 at the Middlesex Hospital Medical School and her continuing interest and success have brought invitations to present her findings in Europe, the Americas, Australia and the Far East. In addition she co-ordinates international research into the field of treatment for fear of flying. Her presentations and workshops are given both nationally and internationally on an ongoing basis to professional and self-help audiences.

  Elaine’s professional views are regularly sought by TV and radio in recognition of her innovative clinical research into anxieties and phobias, international conference presentations, workshops, and published material in her specialist field. Her most recent publications are Overcoming Anxiety For Dummies, co-authored with Charles Elliott and Laura Smith and Fly Away Fear, A Self-Help Guide to Overcoming Fear of Flying co-authored with Lucas Van Gerwen, and published by Karnac in May 2008.

  Further information on the Freedom to Flyä organisation can be found by visiting www.freedomtofly.biz. The Service Brochure detailing the range of services including workshops and psychological therapy can be obtained by emailing [email protected].

  Charles H. Elliott, PhD, is a clinical psychologist and a member of the faculty at the Fielding Graduate Institute. He is a Founding Fellow in the Academy of Cognitive Therapy, an internationally recognized organization that certifies cognitive therapists for treating anxiety, panic attacks, and other emotional disorders. In his private clinical practice, he specialises in the treatment of anxiety and mood disorders. Dr Elliott is the former president of the New Mexico Society of Biofeedback and Behavioral Medicine. He previously served as Director of Mental Health Consultation-Liaison Service at the University of Oklahoma Health Sciences Center. He later was an Associate Professor in the psychiatry department at the University of New Mexico School of Medicine. In addition, he has written many articles and book chapters in the area of cognitive behavior therapies. He has made numerous presentations nationally and internationally on new developments in assessment and therapy of emotional disorders. He is coauthor of Why Can’t I Get What I Want? (Davies-Black, 1998; A Behavioral Science Book Club Selection), Why Can’t I Be the Parent I Want to Be? (New Harbinger Publications, 1999), and Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth (Prima, 2001).

  Laura L. Smith, PhD, is a clinical psychologist at Presbyterian Behavioral Medicine, Albuquerque, New Mexico. At Presbyterian, she specializes in the assessment and treatment of both adults and children with anxiety and other mood disorders. She is an adjunct faculty member at the Fielding Graduate Institute. Formerly, she was the clinical supervisor for a regional educational cooperative. In addition, she has presented on new developments in cognitive therapy to both national and international audiences. Dr Smith is coauthor of Hollow Kids (Prima, 2001) and Why Can’t I Be the Parent I Want to Be? (New Harbinger Publications, 1999).

  Dedication

  From Elaine: This book is dedicated to Helga and Nickie Iljon, and to Miriam Skelker, for always being there for me.

  From Laura and Charles: We dedicate this book to our family: Alli, Brian, Nathan, Sara, and Trevor. And to our parents: William Thomas Smith (1914–1999), Edna Louise Smith, Joe Bond Elliott, and Suzanne Wieder Elliott.

  Acknowledgments

  Elaine: So! I lied when I swore I’d never co-author another Dummies book! When the opportunity arose, I jumped at it. My most grateful thanks to the Dummies Team, in particular Simon Bell and Wejdan Ismail

  Working with Depression brings to mind elements of the fight of Good against Evil, reminiscent of J.K. Rowling’s view. Seeing depression as the loss of hope, she tells how its been her enemy. Depressions revealed as the underlying basis for her depiction of the Dementors, who suck all the joy and hope out of those they attack. Imagine a future in which you will never, ever be happy again. No hope. Emotionally destroyed and dead. An evil time, indeed.

  Some very special people in my world have been key players in the fight of Good against Evil – Sharon, Sandy, Zhenya, Graham, Michele, Gill, Jake, Tony, Zenobia, Martin, Corinne, Diz, and Charles. With people like you in the world, Good can only triumph.

  Laura and Charles: Okay, we broke our promise and wrote another book. We may have to join Authors Anonymous! We thank our family and friends for putting up with our moans and complaints. We send our heartfelt appreciation to the Rodriquez family, especially Melodie and Adriana, who shared their home and table on holidays so we could write until the last second.

  Thanks also to our agents, Ed and Elizabeth Knappman, who have supported our writing. We applaud and appreciate the professionalism of our editors at Wiley Publishing; special thanks to Mike Baker, Norm Crampton, Greg Pearson, Jennifer Bingham, Chrissy Guthrie, Esmeralda St. Clair, and Natasha Graf. Thanks to our technical editors, Cory Newman, PhD, and Howard Berger, MD.

  We also appreciate Audrey Hite for taking good care of us. And thanks to Scott Love, computer geek extraordinaire, for designing our Web site and keeping our computers up and running. In addition, we thank Diana Montoya-Boyer for keeping us organized, Tracie Antonuk for her optimistic support of our writing, and Karen Villanueva, our personal publicist.

  Finally, we’re especially grateful to have been invited into the lives of our many clients over the years. We have profited from what they have taught us about the problems they face. They have provided us with a greater understanding of depression as well as their brave struggle.

  Publisher’s Acknowledgements

  We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/.

  Some of the people who helped bring this book to market include the following:

  Acquisitions, Editorial, and Media Development

  Acquisitions Editor: Wejdan Ismail

  Development Editor: Simon Bell

  Content Editor: Jo Theedom

  Publishing Assistant: Jennifer Prytherch

  Developer: Charlie Wilson

  Copy Editor: Christine Lea

  Technical Editors: Howard Berger, MD, Cory Newman, PhD, and Dr Daniel McQueen BMedSci MBBS MRCP MRCPsych

  Publisher: Jason Dunne

  Executive Project Editor: Daniel Mersey

  Executive Editor: Samantha Spickernell

  Cover Photos: Dimitri Vervitsiotis/GettyImages

  Cartoons: Ed McLachlan

  Composition Services

  Project Coordinator: Lynsey Stanford

  Layout and Graphics: Reuben W. Davis

  Indexer: Ty Koontz

  Foreword

  Have you
ever had a tune playing over in your mind that you couldn’t get rid of? No matter how hard you tried, it kept coming back? Now imagine that what’s going round and round in your head is not a tune, but a thought such as: I’m no good, I’m a failure; people would be better off without me. Very soon, you’d feel under attack, exhausted by trying to fight it off. You’d find you couldn’t concentrate on anything else. You’d feel guilty and totally defeated, uninterested in life, and unresponsive to your family and friends’ attempts to get you to feel better.

  If you have felt like this, you’ll know the agony of such mental pain. You’re not alone. This is depression, and it affects 5 per cent of the population at any one time. It seems to be becoming more common. Fifty years ago, people were most likely to suffer their first major episode of depression in late middle age. Now we find serious depression can strike much earlier: in late teenage and early adulthood. What is more, once a person has been depressed once, there is a risk of the depression returning in the next few months or years, even after a period when it seems to have gone away for good.

  What can we do about it? Years ago, it was thought that there were only two approaches to dealing with depression: antidepressant pills, or long-term analytic psychotherapy.But over the last thirty years things have changed.

  First, there is a larger range of medication available to choose from, and the pills have become kinder, with fewer side-effects.

  Second, there has been a revolution in psychological treatment.Newer, briefer ‘talking therapies’ such as cognitive and behavioural therapies have been developed. They’ve been found to be as effective as medication. What’s more, the effects of these new psychological treatments last; they prevent you becoming depressed again long after you have stopped coming to therapy.

  This book provides a much-needed map to these new ways of approaching depression. Written by experts for everyone, it gives you an excellent guide to the most up-to-date approaches to depression and shows how you can weave your own therapy. Drawing on the latest research, the authors act as trusted guides: with gentleness and good humour, they take us by the hand and explain without preaching, guide without forcing.

  This book can be read, but, more importantly, it can also be used.

  It offers you a new way to think about yourself, other people and the world around you. It offers many alternatives to fighting endlessly with the thoughts that go round in the head. It offers freedom.

  Mark Williams, Professor of Clinical Psychology, University of Oxford.

  Author of The Mindful Way Through Depression

  Introduction

  World-wide research shows that the number of people suffering from depression is increasing alarmingly. Depression is now so common that one in five people suffer from it at some point in their lives. Yet depression’s still stigmatised, with sufferers often afraid to tell families and friends, let alone their employer.

  Everyone gets overwhelmed sometimes, but when you descend into depression, the level of misery can feel unprecedented. It can take an inordinate effort to admit to the problem and accept help. But if you choose to admit you have depression and try to combat it, we trust you’ll be amazed by the level of support you receive.

  Of course, the million-dollar question is ‘What can I do about depression?’. Thankfully, this book shows you that the answer is . . . LOADS!

  About This Book

  We have two primary goals in writing this book. First, we want you to understand the nature of depression. Understanding depression makes the idea of dealing with it less frightening. Second, we present what you’re probably most interested in discovering – how to overcome your depression or help someone you care about who has depression.

  We leave no stone unturned in our quest to bring you every possible means for battling depression. We draw strategies for defeating depression from the fields of medicine and psychotherapy. We tell you about the newest arsenal of medications that can combat depression. We show you how focusing on your overall health with exercise and nutrition can pay off. Plus, we extract elements from the psychotherapeutic approaches that have stood up to the tests of rigorous research and been verified as highly effective treatments for depression. These approaches include:

  Behaviour therapy

  Cognitive therapy

  Interpersonal and relationship therapy

  Then we go one step further. We turn to the new field of positive psychology for ideas on navigating your way from feeling good again to feeling even better. We want you to make your life more joyful and more meaningful.

  Overcoming Depression For Dummies offers you the best advice available based on scientific research. We believe that, if you practise the techniques and strategies we provide in this book, you’ll very likely feel better. For many people, this book may be a complete guide for defeating mild to moderate depression. Numerous studies show that self-help often works.

  However, depression frequently needs more care and attention than you can receive through self-help. If your depression significantly hinders your ability to work or play, you need to get professional help. No book can completely replace therapy. Start by seeing your family doctor. If you’re seeing a therapist or counsellor, you may find that Overcoming Depression For Dummies can help augment your therapy. Be sure to discuss that possibility with your therapist. Depression can be conquered; please don’t give up.

  A Note to Our Depressed Readers

  We’re keenly aware of the pain and profound despair you may be experiencing. Your sense of humour is probably depleted. With this book, we attempt to lighten a sombre subject with titbits of humour. Some of you may take offence with our attempts or even feel diminished or discounted by this decision. We can understand that reaction. At the same time, your long-term goals need to include rediscovering laughter. Thus, we hope you can try to take our occasional use of wit in the manner we intend it – as another way to help you lift yourself out of the fog of depression.

  In addition, we realise that the title Overcoming Depression For Dummies may seem offensive to some, especially because when people are depressed, they’re prone to make negative, personalised interpretations (see Part II for more information on this topic). However, we assure you that the content of this book is as serious and in-depth as any book on depression. The For Dummies format simply enables us to present important material in easily digestible segments. We leave it up to you to determine whether we succeed in doing so.

  Conventions Used in This Book

  In this book, we avoid the use of professional jargon as much as possible. When we occasionally find it necessary to use a technical term, we pop it in italics so that you can easily spot it, and then we clearly define that term. In addition, recognising that there are a number of useful resources available on the Internet, we put web addresses in monofont.

  We also include numerous stories to illustrate the information and techniques we present. The people you read about aren’t real; however, they represent composites of the many wonderful people we’ve known and worked with over the years. We use an Anecdote icon to indicate where these stories appear in the text.

  Finally, if you’re reading this book because you want help in defeating your own depression, we recommend that you purchase a notebook. Use that notebook to write out the exercises we present throughout the book. We call these exercises Antidepression Tools and highlight them with an icon. Use your notebook often and reread what you’ve written from time to time.

  Foolish Assumptions

  Who’d want to read this book? We assume, perhaps foolishly, that you or someone you care about suffers from depression. We also figure that you want to banish depression from your life. Finally, we imagine that you’re curious about a variety of helpful strategies that can fit your lifestyle and personality. If these descriptions strike a chord, then this book is for you.

  How This Book Is Organised

  We organise Overcoming Depression For Dummies into 7 parts and 22 chapters. Here�
�s a little about each part.

  Part I: Discovering Depression and Designing Defences