Change Your Thinking, Change Your Anxiety and Depression

Catastrophizing is an irrational thought a lot of us have in believing that something is far worse than it actually is.

It can generally can take two different forms: making a catastrophe out of a current situation, and imagining making a catastrophe out of a future situation.

Decastrophizing means mentally bringing the problem back to its proper perspective.

We may end up recognizing that a situation rates only a “5” or “10” on our awfulness scale and not the “95” that we currently perceive.  Decastrophizing means more than purely acknowledging that our feared situation is unlikely to arise. It means considering the consequences if it should arise.  It means considering the consequences if it should arise, and recognizing that in any event, we would cope.

Uplift: How Pushing Weights Lifts My Depression

“Human beings are designed for regular physical activity. The sedentary nature of modern life probably plays a significant role in the epidemic incidence of depression today.”  Andrew Weil, M.D.

After a long winter and dreadful May of rain and cold temperatures, beautiful June is finally here. The sunlight is filtering through the green tree leaves and warm air blowing across my hair.

Summer’s a great time to start investing in your health again after winter’s hibernation.  People are out walking or working in their gardens.  This whole time of year screams “move!”  I have added weight training as part of my moving routine.  Maybe you can, too.

5 Good Ways to Boost Your Mood

Depression makes everything harder: motivation is low, we get little pleasure from things we normally enjoy, we have no energy, and relationships tend to be strained. Small wonder it’s the leading cause of disability in the world, according to the World Health Organization.

Several treatment options are effective in reducing depression. The majority of psychological treatments with strong research support are cognitive-behavioral (CBT) and focus on changing thoughts and behaviors to improve mood. Some forms of medication, such as the selective serotonin reuptake inhibitors (SSRIs), can be as effective as CBT, at least for as long as a person takes them.

So, which treatment option should a person choose? Obviously, it’s an individual choice and one that should be made in consultation with one’s doctor. For those who prefer to start with a psychological treatment—either because they’ve not found medications to be helpful and/or the side effects weren’t tolerable—CBT is a good candidate given the strong research support.

A recent study, the largest of its kind—showed that a simple treatment requiring less

Procrastination, Depression and the Myth of Multitasking

Most people who are depressed have a hard time being productive. Work—and here I mean everything from paid employment to child-rearing and housekeeping to the kinds of “work” we assign ourselves, like reading a good book or planting a garden—is a chore to the depressed. It drains us, leaves us feeling as bad as before, physically worn out and emotionally depleted, instead of proud of ourselves and invigorated. Other people with depression seem to work very hard all the time, but there is little payoff for their efforts.  As with so much of depression, there is a real chicken-or-egg question—is work so difficult because we’re depressed, or are we depressed in part because we can’t accomplish anything? And as with so many chicken-or-egg situations, we face a false dichotomy: the truth is, poor work habits and depression reinforce each other.

Depressed people tend to be great procrastinators. Procrastination means putting off for a later time what “should” be done now. The “should” may come from without, as with the teenager who dawdles over homework, or from within, as with me planting my garden. When it comes from without, it’s easy to see the rebelliousness that procrastination expresses. When it comes from within, it’s hard to see immediately what purpose procrastination serves—but it may serve many.

False Assumptions

Procrastinators have some big false assumptions about how work works. They assume that really productive people are always in a positive, energetic frame of mind that lets them jump right into piles of paper and quickly do what needs to be done, only emerging when the task is accomplished. On the contrary, motivation follows action instead of the other way around. When we make ourselves face the task ahead of us, it usually isn’t as bad as we think, and we begin to feel good about the progress we start making. Work comes first, and then comes the positive frame of mind.

Closely allied to this misunderstanding about motivation is the idea that things should be easy. Depressed people assume that people who are good at work skills always feel confident and easily attain their goals; because they themselves don’t feel this way, they assume that they will never be successful. But again, most people who are really successful assume that there are going to be hard times, frustrations, and setbacks along the way. Knowing this in advance, they don’t get thrown for a loop and descend into self-blame whenever there’s a problem.  If we wait until we feel completely prepared and feeling really motivated, we’ll spend a lot of our lives waiting.  See my page on developing greater willpower.

Protecting Self-Esteem With Procrastination

Procrastination can also help protect the depressed person’s precarious self-esteem. We can always tell ourselves we would have done it better if. . .. The paradigm is the college term paper rushed together in a furious all-nighter. The student protects himself from the risk of exposing his best work by never having the time to do it right. This allows him to protect his fantasied sense of himself as special and uniquely gifted.  Procrastination is also a result of the depressed person’s tendency toward perfectionism, a crippling problem.  Research has shown that the more perfectionistic a depressed person is, the worse his chances of recovery.  Trying so hard to make every single little piece of a project perfect, we doom ourselves to disappointment and frustration.

Chaining

There is a simple, useful process psychologists call chaining or making one event depend on another event’s being accomplished first. You can make chains that help you get a lot of work done. I want to go play Tomb Raider on my computer, but I’m going to let that be my reward for first going through the outdated magazines. As I go through the pile, I find there’s one I really must renew my subscription to. Now I have to do that as well before I play Tomb Raider. Renewing that subscription reminds me that I have a stack of unpaid bills nagging at me. Maybe I can’t get the bills all paid, but I can take twenty minutes to get them organized and make a commitment to myself to pay them tomorrow. Now I can go play my computer game feeling a little less overwhelmed by events and a little more deserving of some time to goof off.  As you get used to this practice, your chains can get longer and longer without getting burdensome.

Finally, there’s also the Irish way of overcoming procrastination.  Confronted with a wall too high to climb, the Irishman throws his hat over it.  Now he must find a way over the wall.  If I have to paint a room, I’ll likely get the paint and start the first coat as soon as I can, disrupting the whole household in the process.  That way I’m fully committed and have to finish quickly.

Gluing Yourself to Your Seat

Controlling procrastination is more like controlling eating or exercise than smoking or drinking; it’s impossible to never procrastinate.  For one thing, often it’s not clear which of two is the most important activity.  Study for the exam right now, or eat dinner and then study?  Or eat dinner, take out the garbage, walk the dog, call a friend, check Facebook, and then study?  But procrastination is a habit that can gradually be replaced by the habit of not putting things off.

Rita Emmett, in The Procrastinator’s Handbook, gives us Emmett’s Law:  “The dread of doing a task uses up more time and energy than doing the task itself.”  Here’s O’Connor’s corollary:  “It’s amazing what you can accomplish when you finally get down to work.”  So my first advice for overcoming procrastination is to glue your seat to the chair, ignore distractions, and work for five minutes.  Then you can take a short break if you feel it’s necessary, but put in another five minutes after your break.  The procrastinating impulse in your mindless self won’t respond to logical argument, but it may respond to a narrowing of focus.  You’ll get in a groove, start feeling productive, and the impulse to procrastinate further will dwindle.  If it doesn’t work today, try again tomorrow.

One Task At a Time

A second piece of advice:  while you’re sitting glued to your chair, you’re not allowed to do anything other than the task you’re there for, no matter what attractive distraction might come to mind.  You don’t have to work on your primary task, but you can’t do anything else.  This can be torture, but it’s great mental discipline.  You’ll quickly see how easily distracted you are, but you’re forced to develop the willpower to withstand temptation.  Eventually, you’ll get something constructive done.

Hold yourself to pre-commitments.  No television (Internet, email) until I’ve worked for a half hour.  If I get X done, I’ll reward myself with pizza tonight; otherwise, it’s peanut butter.  Be sure to keep these commitments reasonable and don’t set yourself up to fail.  If you practice and get consistent at this, you can start to up the ante.

Reward Yourself

Procrastinators don’t reward themselves for finishing.  A drink with friends, a special dessert—things that normal people might do to celebrate an accomplishment—these things don’t occur to procrastinators (partly because they’re never satisfied with their results).  But it’s important to practice these rituals because, in our minds, the pleasure that comes with the reward comes to be associated with doing a job well.  In this way, work itself becomes more satisfying.

The Stress of a Mess

Clutter is highly associated with procrastination.  Each of those extraneous items on your desk, workspace, or computer desktop is a distraction, a reminder of something else to do.  Mental clutter works the same way; if you have a set of nagging chores, just making a list will help you focus on the present.  The list will contain the nagging.  Every time we are distracted, we lose efficiency.  You can reduce your procrastination greatly by eliminating distracting cues.

Unplugging

Of course, personal computers and wireless communication have created many more temptations to procrastinate—games, Facebook updates, checking on the news.   Tweets, cell phone calls, and instant messages constantly break our concentration.  If we really want to focus on something, we have to remove temptation and prevent interruptions.  If you work on your computer, turn off your Internet browser and make it difficult to get back on.  Put the phone on silent.  Multitasking is a myth.

By Richard O’Connor, Ph.D.  Dr. O’Connor is the author of Undoing Depression, Undoing Perpetual Stress, and Happy at Last. For fourteen years he was executive director of the Northwest Center for Family Service and Mental Health, a nonprofit mental health clinic, where he oversaw the work of twenty mental health professionals in treating almost a thousand patients per year. He is a practicing psychotherapist with offices in Connecticut and New York and lives in Lakeville, Connecticut.

Further Reading:

Get It Done When You’re Depressed – great book!

“Three Strategies For Getting Things Done When Depressed”Psycentral website

“Ten Ways To Get Things Done Despite Depression” – Everyday Health website

Depression and Loss of Energy: A Waiting Game

Reversing the downward spiral of depression takes less energy than you think.

Depression and loss of energy — it is the beginning of a waiting game that does not end well.

Sometimes depression is born from loss of achievement, loss of goals, and loss of positive feelings about oneself. When low energy plays a role, a person who is not blessed with high drive and physical energy can see a spiral into depression start quickly. But even people with more energy lose it while bearing the weight of the losses. And, without a lot of energy, people begin to wait for things to get better around them rather than take action to make a change.

The Downward Spiral

Spiraling — the word makes it seem like a gentle way to go down, but when it comes to depression, going down is hard to stop, and once at the bottom, reversing the spiral takes intention and support. I hear about this often from my younger depressed clients — those adults who started out of high school or college ready to be successful but who found the world did not fulfill the vision they had.

Jeremy (not his real name) was one such young man. He never had to work too hard to get a passable grade point and was popular enough to have a solid romantic relationship. He was ready happy with his life. But, as commonly happens, the college romance did not last, which made him feel down in the dumps. Then the company he worked for, facing hard times, cut his hours. He now did not earn enough to live on but he expected the company, not himself, to change and he took no action. He waited for work to increase his hours, but in the meantime, he felt like a failure, and the waiting sapped him. His self-esteem, already suffering from being single again, took another hit as he saw his money dwindle to nothing. He started to isolate himself from friends without funds for fun and without a date to go along. Waiting was his enemy. Without meaningful activity beyond limited work hours, that isolation increased his depressed mood.

Waiting also intensified the mental and physical fatigue, so he slept later in the morning since he did not have to get to work early. He began to think he had a lot of time every day to work on his situation, so he did not start on possible job hunting and, as the day melted away, it was too easy to let himself decide that tomorrow was a good day to start fresh. But that waiting also increased his fear that nothing could change and his mood became very depressed. That depression and his situation robbed him of the very things he needed to reverse the spiral: meaningful work (purpose, as well as money), positive interactions with others, pride in his achievements, sense of competency, and a feeling of being loved.

This spiral is one I have seen repeatedly in young adults who have not met with easy success out of high school or college. They often did not have to work at jobs during those years to obtain phones or cars or clothes or do costly activities, such as attend concerts or sporting events. One young man I worked with as he finished high school, Casen (again, a pseudonym), felt literally terrified of applying for a part time job so that he could begin developing job skills and a resume and have some spare cash. Without classroom demands, he moved into waiting mode: waiting to apply to community college, waiting for a job that might fall into his lap. (The job that a friend would provide not that Casen would go search for since the friend said he could get his boss to hire Casen). Waiting did not bring him the job or the college acceptance letter, and he felt even more scared and more depressed. And he judged himself rather mercilessly: believing he would never succeed. That negative mindset robbed him of even more energy, and the more time he spent watching shows on his laptop, the less energy he had to reverse the downward spiral to depression.

What can be done about this? It is typical that an outside force will help. If you are reading this you might be saying to yourself phrases like, “Yeah — the outside force of getting evicted or starving! That would work!” If so, you would be correctly identifying motivators! At times, though, a person in a downward spiral ends up living with family or friends who are being helpful to them in averting disaster, but the pattern of waiting on something outside themselves does not change until motivation can pick up.

Reversing the Downward Spiral

How is it possible to reverse the spiral? Raising energy is a primary initial goal — with or without motivation. To start the spiral on an upward trend, simply:

Stop telling yourself negative things: you only reinforce the belief they are true. Interfere with negativity, saying, “Stop! I choose to believe I will solve this!”

Stop isolating. Get in contact with people, any interaction with others will help you also get outside of your own negative thoughts or mood.

Stop talking about your own life for a short while. When you only ruminate on your troubles, they seem larger. Ask someone else about his or her life. Hearing about another’s life, you can look at your reactions. I love the saying that troubles shared are cut in half and joys shared are doubled.

Then start the upward spiral with attention to developing a sense of purpose. Don’t assume this is a deep spiritual quest. In fact, it can be initially as simple as scheduling your day and meeting some regular commitments. An important brain change toward a less depressed mood occurs results from intentional activity. You get a blip of glutamate, an activating neurochemical, and one of dopamine, the feel-good neurochemical, and the combination is energizing. The bigger the step you take, the more you get. And any action will supply enough energy to do a little more.

My Tips

If you are underemployed — set a daily schedule that begins with a reasonable wake-up time.

Have a pattern to the day what news show you listen to or watch when you have your coffee when you feed a pet or meet a friend for tea.

Leave the house — you might have to start with leaving your room and interacting with others in your home- but forcing yourself toward less isolation is important.

At work, be sure to talk to your colleagues and ask them how they are; It improves the chance of a positive social exchange that can increase your self-esteem a bit and moves the spiral upward a fraction.

Set small goals — like walking the dog an extra 5 minutes — and notice you achieved them. There’s a bit more glutamate and dopamine!

Do something physical. When you move your depressed body you gain energy rather than lose it, so even a few minutes of tidying up can raise enough energy to do a bit more.

The above ideas tend to work best when you are working with another person who supports you, such as a therapist, a 12-Step sponsor, or a good friend who knows your goals and will help you keep track of them.

As you stop the waiting game — that passive waiting for life to change without you doing something to change it — the spiral reverses. You will be surprised that you will slowly feel your energy rise so you will be more able to take the next steps toward success.

 

By Dr. Margaret Wehrenberg, Psy.D.

This article first appeared in Psychology Today website.

Dr. Wehrenberg is the author of 5 books published by W.W. Norton, including The 10 Best Ever Anxiety Management Techniques, The 10 Best Ever Depression Management Techniques and her most recent 10 Best Anxiety Busters, an ideal book for the general public. She earned her M.A. studying psychodrama and bioenergetics, and had years of experience as a certified drug and alcoholism counselor, before earning her Psy.D. She now specializes in treating anxiety and depression and has a private practice in Naperville, IL. She is a frequent contributor of articles to The Psychotherapy Networker magazine, has contributed a chapter to Clinical Pearls of Wisdom (Ed. M. Kerman), and has produced CD for breathing, muscle relaxation and imagery for anxiety management. Check out her website at www.margaretwehrenberg.com.

 

 

A Stroll Through The Park on a Sunny Day

During my depression, my world narrowed.  I just didn’t want to go anywhere.  My life was lived inside coffee shops, on the couch watching television, sitting in my office with the door closed.  There was something deadening about this.  In hindsight, I guess I felt that doing something else wouldn’t make a difference anyway.

I have learned over the years that nature is a powerful antidote to depression.  Being in nature does make a difference.  Maybe it’s because there is such power in nature.  It’s always in motion, isn’t it?  There isn’t any clinical depression in nature.  Humans evolved from the natural world, not from concrete and office towers.  One study found that a walk in a park or countryside reduced depression whereas walking in a shopping center or urban setting increased depression.  This summer, I am going to reconnect with nature by taking my daughter on nature walks.  During these times, I just want to let my incessant conversation with my depression go and let nature speak to me.

10 Summer Depression Busters

Ten percent of those diagnosed with seasonal affective disorder suffer symptoms at the brightest time of the year. The summer’s brutal heat, bright light, and long days can affect a person’s circadian rhythm and contribute to depression for the opposite reasons that winter conditions do. If you’re a Summer Hater, or just notice that your mood is affected negatively by the heat, here are some summer depression busters that may help you better tolerate these months — maybe even enjoy the

The Ten Best-Ever Depression Management Techniques: An Interview with Dr. Margaret Wehrenberg

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I’m Dan Lukasik from Lawyerswithdepression.com. Today’s guest is Dr. Margaret Wehrenberg. Dr. Wehrenberg is a clinical psychologist in Naperville, Illinois. She is the author of six books on the treatment of anxiety and depression published by W.W. Norton, including, “The Ten Best-Ever Depression Management Techniques: Understanding How Your Brain Makes You Depressed and What You Can Do to Change It” and “Anxiety + Depression: Effective Treatment of the Big Two Co-Occurring Disorders.” An international trainer of mental health professionals, Dr. Wehrenberg coaches people with anxiety via the internet and phone. She’s a frequent contributor to the award-winning magazine, Psychotherapy Networker and she blogs on depression for the magazine Psychology Today.

Dan:

What is the difference between sadness and depression and why do people confuse the two so often?

Dr. Wehrenberg:

Because depression comprises sadness. Sadness is a response to a specific situation in which we usually have some kind of loss. The loss of a self-esteem, a loss of a loved one, the loss of a desired goal. Depression is really more about the energy – whether it’s mental energy or physical energy – to make an effective response. So, sadness is an appropriate and transient emotion, but depression sticks around and affects all of our daily behaviors and interactions.

Dan:

What causes depression? Sadness, as you say, is an appropriate response to loss.  What is depression a response to?  What are the causes of depression?

 Dr. Wehrenberg:

Over the course of my career, I’ve developed the idea that there are four potential causes to depression.  This comes from working with people for forty years; it comes from reading a lot of research.

genetics-at-work2

The first part is genetics. You are born with a brain that is going to tend toward depression because of the function of neurotransmitters in your brain. It’s a genetic predisposition towards depression. With poor self-care, poor nutrition, you may end up stimulating or starting that feeling of low energy, of low interest in the world around you. Then if you pull back from the world around you, now you start to have fewer experiences that keep you interested in the world.

Another possible and probable cause is with people who are experiencing situational stress that goes on, and on, and on. That could be the stress of not being able to earn enough money, and you’ve got two jobs, and kids, and a life filled with stress. It could be the stress that comes on while caring for someone in your family circle who’s got a disability, or a chronic illness; that increases with severity over time. So, you’re stuck in stress, and you deplete yourself. And you can become depressed.

The state of the depression is a lot like the state of being sick. If you had the flu, you wouldn’t feel like sitting around eating and drinking; you wouldn’t feel like playing a round of tennis. If somebody says, “Let’s watch a really interesting T.V. show” and you say, “No, I want to go to sleep instead,” that’s pulling back from the world is healing.  People have the same feeling when they’re depressed, but those feelings don’t lead toward healing because they’re persistent.

Two other causes that people would certainly be aware of are trauma or coming from early childhood adversity where early in your childhood you were not treated well, you were neglected, had some other abusive situation, and those two very difficult situations can lead people to function in a depressed way.

Dan:

Let’s talk about the issue of stigma. As a person who’s had depression for the past 15 years, it’s something that I’ve had to deal with. Why is there so much stigma surrounding depression?

Dr. Wehrenberg:

Part of it is because we have this mentality in this country that you should be able to pull yourself up by your bootstraps. And we look at people who are low energy, who aren’t completing tasks, and we judge them as doing it on purpose. People who aren’t depressed are of the impression that you could just decide to do it differently.

I was speaking with a 21-year old client of mine the other day who said, “I can’t make myself do the work, and I hate it that I am that lazy.” So, he judges himself as lazy, even though it’s the depression that’s robbing him of energy and mental tenacity. So, even depression sufferers judge themselves to be wrong, lazy, and bad and believe they should do better. So, I think the cultural expectation that you should be more productive. Also, people don’t see it as the medical problem it is. It’s just that it’s not a very “visible” medical problem.

Dan:

In the past 40 years or so that you’ve been a therapist and have treated people with depression, what have you observed about the rate of depression in our country and our understanding of it?

Dr. Wehrenberg:

I think the rate of depression, everybody would agree, is growing. More and more people are suffering depression.

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There are different reasons why when we look at this.

Culturally, one of them is that American culture is a highly stressed culture.  But it’s stress not over life and death, but that’s certainly the case for many living in poverty who have to worry where their next meal is coming from, but usually, what we look at is the stress of always needing to be more, to do more, to get more status and money. That’s not a very good way to feel good about yourself because there’s a limit, a human limit of time, a limit of money, a limit of talent or ability, a limit to resources or access to achievement.

Dan:

Following up on what you just said earlier, you talked about some possible causes of depression including genetics and family of origin issues. Now you’re talking about American culture and its connection to depression. What is the connection?

Dr. Wehrenberg:

We have a culture that values productivity, money, and status, and not everybody can achieve goals of status or financial success and it gets depressing to see how valuable those seem to be in our country.

We don’t value something everybody can do. Like, be a person of good character. We value how much status you’ve got, which is very different.

Dr. Andrew Weil, who is a real guru of physical health and mental health, says he thinks that stress equals inflammation in your whole body and that inflammation is a trigger for depression.

Dan:

Why did you write the book, “The Ten Best-Ever Depression Management Techniques?” It’s a great read. I recommend all my listeners and readers at lawyerswithdepression.com to pick it up.

Dr. Wehrenberg:

I wrote it because I believe both consumers and therapists need ideas for what to do right now other than to investigate, in some more general way, a life history, what do you do today that will make you feel somewhat better, to start you moving out of the depression. I wanted to present as many practical ideas as I could that would help people start to lift out of depression with the help and advice of a therapist and also for the general public that could read this book and say, “Oh, there are things I can do that would make me feel better.” And they’re simple; they’re not complicated.

Dan:

Can you share with our listeners some of the techniques you recommend in your book?

Dr. Wehrenberg:

Let’s start with somebody with low energy. Almost everybody who is depressed is doing something even while they are depressed. Playing a game on their phone, watching T.V. or watching Netflix.  They are doing something. Unless, they are sleeping, of course.  But I want to use what you’re already doing to help motivate you to do something you think you should do. So, for example, I often see people with depression that aren’t doing good health care, they’re not doing good care of their environment, they are not doing dishes, they are not doing laundry, stuff like that. So if you just think about household stuff for a second, what I want my clients to do is to break down the task into its parts.

woman-worried-stressed-150821

If you’re going to do laundry, the first thing you have to do is pick it up off the floor. So, I don’t want you to think, “Oh, I’ve got to get all the laundry done.”  If you’re depressed, that won’t work. What I want you to do is think is, “All I have to do is pick up the dirty clothes in the family room and then I’m going to sit down for 15 minutes and do what I’m willing to do anyway – play a game on the phone, turn on Netflix. Set a timer for 15 minutes of enjoyment of your show and then when the timer goes off, you just get up and pick up the clothes off the floor of your bedroom. Little pieces, okay.

What we know about depression is those small accomplishments are perceived in the brain as positive and encouraging, and you start to feel, “Oh, I can do something for myself.” You begin to have just a little rise in your overall energy. If you can do that consistently, then pretty soon, you get the task of doing the laundry over with. It may take a few days, but it’s done. Then you have a positive self-appraisal. That’s what I’m going for, for example, with a very simple way to think about raising your energy through small increments.

Dan:

So the small steps and small behaviors affect neurochemistry?

Dr. Wehrenberg:

They do, indeed. Because when you take action and it has a positive outcome, you have just changed the level of the neurochemical called dopamine, which I call the “James Brown” of the brain.  It’s the “I feel good,” when dopamine is released in your brain you feel better. We know that people who decide, “I am going to do this,” and do it, they get a rise in dopamine and change your neurochemistry.

Dan:

I want to discuss your second book, “Anxiety + Depression: Effective Treatment of the Two Co-Occurring Disorders.” I struggle with both anxiety and depression with depression being the primary diagnosis. Many people I meet struggle with both.  Why do the two co-occur together and sometimes not?

Dr. Wehrenberg:

Very often, if you are looking at brain function and structure, what you see in people who have both anxiety and depression, which, by the way, is about fifty-percent of the time, is that people who have one, have the other. Often, the anxiety comes first, and it’s not treated well. There’s a neurochemical called serotonin which is related to something called rumination or you might think of it as “brooding.” When people brood, when they go over and over a failure or fear, they get stuck mentally. It raises anxiety because it’s hard to solve a problem that you’re just brooding about and it raises depression because you don’t feel like you’re moving very much in your behavior or your thinking. That’s a pretty simplistic statement. And people will say, yes, but there are far more theories about the underlying neurochemistry.  That’s true, but the chemistry that relates to brooding is related to both anxiety and depression, the repetitive, negative thinking.

Dan:

Regarding your history as a therapist treating people with anxiety and depression, are there some techniques that work better with anxiety versus depression? Or, do all these techniques work equally well with both conditions?

 Dr. Wehrenberg:

I think you have to look at the energy level. Some people with anxiety and also depression have a fair amount of energy to cope with the depressive quality of repetitive, negative thinking. And you use the energy of that anxious person to be more assertive with yourself to say, “I’m going to take charge of this.”

But what I also find that works very well with anxiety and depression together is to work on mindful awareness, to try to stay in the moment, not to try to predict a negative outcome, but rather to pull yourself into the moment. And mindfulness, which can be done by meditating to stay in the present moment, but you can also just keep pulling yourself back to this moment by saying to yourself, “What’s happening now?” This pulls you back from predicting negative outcomes and then getting upset about what might happen. If you stay in the now, you can say I can do this activity now, this action now, and all I have to worry about is now. And then you tend to get better outcomes. So, that’s good for both for anxiety and depression.

Anxiety is “I worry about the future; I fret about the past.” And depression includes, “I think the future will be grim.” So if you stay in the moment, you’re addressing both of them.

Dan:

As a psychologist and therapist who’s worked with people with anxiety and depression for decades, tell us a little bit why a person struggling with depression and anxiety should see a psychologist, a therapist? What benefit could be obtained from seeing someone such as yourself and how does that work?

Dr. Wehrenberg:

We know that medication, which is often people’s first choice, can be extremely helpful. But what I say to my clients is that medication can help you feel somewhat better, but it doesn’t teach you anything about managing your life. Psychotherapy, when it’s practical, when I’m looking at it through the “The Ten Best-Ever Depression Management Techniques,” what it’s teaching you is how to handle your negative mood, what to do when you don’t have energy. It’s teaching you behavior that will rewire your brain. It talks about how and why exercise and nutrition are important.

But also why taking even a small action on your behalf changes your neurochemistry.  So, psychotherapy immediately affects brain function. But, you usually need a psychotherapist to give you ideas, help you find ideas of how you stop yourself, how you block yourself, and to help you find the most effective tools for you in your specific situation. A psychotherapist can be very helpful in teaching you how to get rid of these negative symptoms and feel better for life.

Dan:

Dr. Wehrenberg, what’s the best way for our listeners and readers to get in contact with you?

Dr. Wehrenberg:

Well, if you’re able to spell my name, you can look me up on Margaretwehrenberg.com.  I work in Naperville, Illinois. But my website has my telephone contact and a link. And if you went to the Psychology Today magazine website, you can look at my blog on depression, and you would be able to contact me through there as well. I have a really good “Contact me” on my website.

Dan:

On behalf of your listeners at Lawyerswithdepression.com., I want to take the time to thank you for this insightful interview. I think it’s going to help many people.

Dr. Wehrenberg:

Thank you for having me. I appreciate it.

 

 

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