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Do-it-yourself techniques to improve your mood: basic therapy strategies can help with depression and anxiety.

According to the latest federal figures, about nine percent of U.S. adults are currently wrestling with depression, and more than 10 percent are coping with serious anxiety. These estimates include not only people with serious disorders, but also those whose day-to-day symptoms may not fulfill the diagnostic criteria for mental disorders, but nevertheless significantly interfere with their enjoyment of life.

Most people with severe mental disorders require professional help. But many of the individuals who face mild to moderate distress may be able to confront their mental challenges on their own, an MGH expert says. They can help themselves by learning about the underlying causes of their distress and practicing a few basic techniques used in cognitive behavior therapy (CBT, a type of psychotherapy that aims to increase an individual's understanding of the thoughts and feelings that lead to potentially problematic behaviors).

"There are effective strategies people can use by themselves to relieve anxiety, depression, or other mental distress," says Amy Farabaugh, PhD, Director of Psychotherapy Research at MGH's Depression Clinical and Research Program. "This type of self-help works best in the early stages of mental distress, when it's possible to make basic changes in thinking and behavior on your own. It's especially important for people to learn to recognize the early warning signs that they are experiencing mental distress and take action before problems get more severe. Used properly and consistently, this type of self-help can be a form of prevention."

CLINICAL BENEFIT

The effectiveness of self-help strategies was demonstrated by one recent study of more than 2,000 adults with depression. Participants in the study were encouraged to use "low-intensity" interventions for their mood disorder, such as turning to written materials or the Internet for help, with minimum support from mental health professionals. The researchers found that even severely depressed patients derived significant clinical benefit from these self-help interventions, according to a paper published in the Feb. 26, 2013 issue of the British Medical Journal (BMJ).

"Books, articles, and Web sites can greatly increase a person's awareness, and self-help begins with awareness," Dr. Farabaugh says. "You have to understand your symptoms and learn as much as you can about them before you can begin to improve them. With a good knowledge base, you will be prepared to take steps to counteract thoughts and behaviors that are adding to your distress."

TACKLING PROBLEMS

After learning about your symptoms (see What You Can Do for good CBT sources), the process of trying to improve your mental state can begin. Work steadily and patiently, Dr. Farabaugh advises.

"Remember to engage in mood-boosters such as relaxation techniques and exercise to complement your self-help efforts, and don't expect improvement overnight," she cautions. "It's like going to the gym--you have to be patient and hopeful, and eventually you will see beneficial results."

Try these self-help strategies based on CBT to help improve your mood:

1. Examine your "inner voice." Are you overly critical of yourself? Try to become aware of what you are saying to yourself and dispense with self-talk that is judgmental and discouraging. Instead, talk to yourself with encouragement--be your own best friend.

2. Observe your own thoughts. Try to become more aware of your thoughts and reactions by observing them calmly. Slow down your responses by building a sort of disconnect, or space, in your mind that facilitates this appraisal. Thinking and reacting more thoughtfully can often help you avoid problems.

3. Eliminate negative thinking. Life is challenging enough without burdening yourself with expectations of failure, loss, humiliation, and other negative outcomes--thoughts that tend to be more frequent when you are anxious and/or depressed. When these thoughts arise, try to identify them and replace them with alternative thoughts that are more neutral, balanced, and productive. For example, when your day is going badly, take a moment to focus on the things that are going well in your life.

4. Avoid too much self-focus. Try to see things from others' points of view. Centering your thinking on yourself can lead to misperceptions and undesirable reactions to events. There's a difference between thinking, "Tom hates me," and thinking, "Tom must be in a bad mood today."

5. Become aware of the consequences of your thoughts. When you begin to feel anxious or depressed, try to identify the thoughts that made you feel that way. Since thoughts are primarily what trigger feelings, ask yourself what other thought might make you feel differently.

6. Challenge distressing thoughts. Rather than succumbing to upsetting thoughts, look for rational alternative thoughts that involve less distressing interpretations of events. Thinking, "I made an error in my speech, and now everyone thinks I'm stupid" is no more probable than the more positive thought, "Even though it wasn't perfect, several people liked my speech."

7. Challenge your behavior. If you are experiencing anxiety, try to expose yourself in small steps to the source of your anxiety. For example, a person who is anxious about meeting new people might ask a friend to go with her to social events at first, before challenging herself to attend a brief event on her own. If you're experiencing depression, challenge yourself to follow through as much as possible with daily activities--especially those that involve others. An individual who is house-bound with depression might challenge himself to play golf again, even if at first he can only summon the energy for three rounds.

"Remember to reward yourself for your efforts," Dr. Farabaugh says. "And treat yourself kindly. Tell yourself, 'You gave it your best shot' and 'You did well today.'

"But don't set yourself up for failure by trying to deal with serious, intractable mental problems on your own. If self-help doesn't work, you may need to see a mental health professional who can address medical problems and provide medications and other helpful services that you may not have access to on your own."

RELATED ARTICLE: WHAT YOU CAN DO

These Web sites and books provide information about mental health symptoms and ways to deal with them:

* www.anxieties.com

* www.anxietybc.com

* Mind Over Mood: Change How You Feel by Changing the Way You Think, by Dennis Greenberger and Christine Padesky (The Guildford Publications, Inc.)

* Freeing Yourself from Anxiety: Four Simple Steps to Overcome Worry and Create the Life You Want, by Tomar Chansky (Da Capo Lifelong Books)
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Publication:Mind, Mood & Memory
Geographic Code:1USA
Date:Nov 1, 2013
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