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Strategies for Managing Depression | Midlife Changes and Depression | Understanding Depression in Children
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Volume 1, Issue 2 - January 2004

Strategies for Managing Depression
Written by Janet Myers

Many people struggle with depression and are at odds with what to “Do” about their depression. They are looking for solutions to a challenging, but not impossible problem. Here are five useful strategies for managing depression.

1. Find some hope. Depression can feel like we're are on a sinking ship. People need to believe that there is help for their situation, that there is hope and a better future. We start to “find some hope” by examining the positives in a person’s life. Frequently, this may be a challenge because in depression the negative aspects of a person’s life become the focus. It is essential to find some blessing, some joy, some small bit of hope to help people believe that change is possible.

2. Identify support systems. When people are depressed, they frequently withdraw from others or worry about being a burden. Developing a support system is a necessary part of healing and may require effort to recognize some of the resources available to them. This expands the world beyond their own depression. Family and friends are good resources, however, support is also available from religious or community groups, and support groups.

3. Labeling the problem. Clients frequently experience relief when they realize there is a name for their issue. Naming their problem validates their struggle and provides direction, as well as, hope. Gillian Butler and Tony Hope in their excellent book “Managing Your Mind: The Mental Fitness Guide” explain this issue in the following way “Winston Churchill suffered from recurrent, short-lived depressions. He gave them a name: the black dog. Labeling the depression helped him to cope with it and to accept it, knowing that in due course it would go away.”
4. Diet and exercise. Research has shown the importance of a balanced diet rich in proteins, complex carbo-hydrates, and healthy fats. Low blood sugar frequently contributes to depression and mood swings that reinforce depressive thoughts and feelings, as well as, food cravings and binges. Exercise, as we all know, has many healthful benefits including regulating and improving mood.

Talk with your doctor before starting any diet or exercise plan, particularly if you are taking medication for another condition or have been sedentary for a long time.

5. Changing your negative thinking. We all know that negative thinking can account for a great deal of time and energy lost. People who are depressed are frequently unaware of just how much time they spend in negative thought. A fun activity to brainstorm negative thoughts is to come up with a Top 10 list. You can make it larger if need be, but 10 usually covers your most used negative thoughts. Try to be creative in making the list, ala David Letterman. Once you have a good and humorous list try to catch yourself. Keep a log of just how often you’re using each thought. You’ll be amazed at the frequency of these thoughts. Once you get an idea of frequency, try coming up for an opposite of the negative thought. For example, if your recurring thought is “Oh, I’m so stupid,” replace it with “Gosh, I’m smart!” We’re not asking you to believe it, yet, but to “entertain the possibility that it might be true” and to think about what it might be like if it were true. When we are depressed, it is essential to recognize the relationship between our thought and feeling.

6. Medication. There are times when even our best efforts and therapy alone can’t significantly alter the depression. At these times, medication is an appropriate and necessary course of action. Medication can allow you to be more available to the strategies suggested by your therapist or physician.

Resources: Gillian Butler and Tony Hope, Managing Your Mind: The Mental Fitness Guide, 1995.

Midlife Changes and Depression
Written by Mark and Janet Myers

Help for Individuals

Consider and intervene with medical issues, and, for women, seek medical assistance to stabilize hormones.
A balanced diet and exercise can boost mood and assist in stabilizing hormones, particularly for women.
Journaling is a helpful tool in alleviating depression. It offers the opportunity to evaluate and understand your experience while developing solutions.
Develop a support network of friends and mentors.
Write down your goals. Oftentimes, we have vague concepts of where we should be in life. By putting them down in writing, this helps us get a clearer concept of what we want in life. This would make our goals more doable. Make sure your goals are realistic.
Assess your priorities. Life is full of tradeoffs. If we focus on what we don’t have instead of what we have, we make ourselves miserable.
Accept your limitations. Aging is inevitable, but decline is not.
Try new and exciting things. Pick up a hobby or pursuit. Volunteering often allows one to feel better about life.
Analyze your self-talk. What are you telling yourself? Would you give your best friend the same advice.
Help for Couples

Keep the lines of communication open. Midlife presents many challenges and communication with your spouse is essential.
Rediscover your spouse. Spend time together, develop new interests as a couple.
Give each other the benefit of the doubt. Change is difficult.
Women and Midlife

During midlife which we define as the ages between 35-50 women struggle with developmental and hormonal challenges. Women begin to experience hormonal changes as young as 35 which signal the change from childbearing to menopause. This period is known as perimenopause and continues through menopause which occurs after the age of 50 for most women, earlier in women who have had a hysterectomy.

Changes in hormones which accompany midlife exacerbate our response to stress making women at midlife vulnerable to developing or experiencing recurrence of depression and anxiety. Not only do our thoughts impact our emotions, they also impact hormone levels. If you perceive your life as stressful and out of your control, this perception will result in changes in stress hormones.

Perimenopause Symptoms

Menstrual Changes
Weight Gain
Hot Flashes
Memory Loss
Urinary Symptoms
Heart Palpitations
Mood Swings
Vaginal Dryness
Night Sweats
Fuzzy Thinking
Depression
Loss of Sexual Desire
Fibroids
Anxiety
Insomnia
Migraines
Boneloss
Fatigue

These physical changes are accompanied by a variety of changes in role and expectations. Many women find that they are in need of reevaluating their priorities and making changes that will allow them to experience a sense of purpose during this new phase of their lives. Frequently, changes are tied to family, relationship, career, and self.
Resources: Gittleman, Ann Louise Perimenopause: Northrup, Christiane The Wisdom of Menopause, 2001.
Lawrence, Marcia Menopause and Madness: The Truth about Estrogen and the Mind, 1998.
Sadler, William The Third Age: 6 Principles of Growth and Renewal After Forty, 2000.

Men and Midstage of Life

In Football, players and coaches take a break in the middle of the game. This is called half time. The time is used to assess the initial game time strategy and make adjustments to our game plan.

Although there is much debate about whether there is a MidLife Crisis, there are times where we may reflect more on our accomplishments and failures. We may experience more limitations physically, changes in responsibilities with children and aging parents, and careers could feel stagnant. Individuals may feel disappointment about where they are in life. Most research supports that this is not an actual developmental stage we all go through. Many people take stock of their lives without going through any type of “crisis.” However, that does not mean that individuals cannot turn this time into a crisis.

Men may undergo physical changes such as a loss of hair, weight gain, diminished physical output, and drop in testosterone level. Careers and income may have leveled off, friends and family members may have become sick or parents die, and children may leave the house. There may be a lot of self-questioning that we do as we realize our own mortality.

Individuals who feel "stuck" or "in crisis" should take the time to make an honest and fair assessment of their life. Just as they do in football, we could look at this time as an opportunity to make adjustments to out original life plan.

Resources: Kruger, A. (1994) “The Mid-life Transition: Crisis or Chimera?” Psychological Reports, 75, 1299-1305.
Myers, David G. (1998) “Adulthood’s Ages and Stages.” Psychology, 5, 196-197.
Pesmen, Curtis When a Man Turns Forty: The Ultimate Midlife Manual, 1999.
Sheehy, Gail Understanding Men’s Passages, 1998.
Shek, D.T.L. (1996) “Mid-life Crisis in Chinese Men and Women.” Journal of Psychology, 130, 109.

Understanding Depression in Children

Depression in children is an extremely disturbing condition. Several studies report that up to 2.5% of children and up to 8.3% of adolescents in the United States struggle with depression (Statistics provided by the National Institute of Mental Health).

Recognizing the symptoms of depression in children can pose a problem because depression may look like a variety of other mental health issues. In addition, children who are depressed frequently also have another psychiatric diagnosis and are more likely to have a family history of depression, particularly their parents. Carol Watkins, M.D. notes that “parental patterns of irritability and withdrawal lead to low self-esteem in the child that this predisposes the child to depression.” Other contributing factors include: stress, cigarette smoking, loss of a parent or loved one, a break-up, attention problems, behavior problems, or learning disability, chronic illness, abuse or neglect, or other trauma.

The signs of depression in children are similar to those found in adults, though frequently less obvious. Here are some things to look for:

Extreme Irritability/anger outbursts
Sadness, sad drawings
Withdrawing from activities, not finding pleasure in things they used to enjoy
Feelings of worthlessness
Excessive or inappropriate guilt
Difficulty concentrating
Feelings of hopelessness
Trouble sleeping or sleeping too much
Recurring thoughts or verbalizations about wanting to die or be dead
Significant weight loss or gain
Withdrawing from social contact
The most appropriate treatment for depression in children and adolescents involves short-term counseling, school and home interventions, and may or may not include medication. Medication can generally be considered a treatment of last resort unless symptoms are severe and make the client unavailable for therapy.

While depression in children is a serious concern, it is treatable and need not result in a recurrence of symptoms later in life. The earlier you seek treatment for your child’s depression, the more likely that symptoms will not return.

Resources: NIMH. Depression in Children and Adolescents: A Fact Sheet for Physicians, Sept. 2000.
Watkins, Carol E. "Depression in Children and Adolescents."

FOCUS Group provides information and education on substance use\abuse concerns to family. It is designed to increase participant’s awareness of issues related to drugs and alcohol. FOCUS helps families understand more about drug and alcohol use and it’s impact on them.

Anger Management Group is designed for individuals who experience problems in their life areas as a result of mismanaged anger, frequent anger outbursts, and difficulties in appropriately communicating their feelings to others

Step Forward Group is designed to introduce independent living skills to adolescents and/or young adults. . Participants will learn about life skills that will benefit them towards becoming autonomous adults. This group is designed for individuals who will need help in the transition to living on their own, who may not be prepared to live on their own, who lack the ability to be self sufficient, and need additional tools to become independent.

Girls Support Group is an eight week group designed to provide support, information, guidance, coping strategies, and feedback for teenage girls dealing with a variety of issues. This group is designed for teenage girls who struggle with depression; have behavioral concerns; problems with families or others; experience anxiety; or have a history of poor decision making.

Women’s Group is for women who are experiencing conflict in major life areas; depression, anxiety, stress, relationship problems, divorce/separation, loneliness, and/or lack of confidence. The group will address improving problem solving skills, conflict resolution, relaxation skills, decreasing anxiety, as well as, decreasing feelings of loneliness and depression.

Children’s Therapy Group is for children, ages 4-6, 7-10, & 11-13, who are experiencing difficulties due to Attention Deficit Disorder, developmental delays, autistic spectrum disorders, emotional, behavioral, or situational challenges. This is an eight week group designed to: improve behavior in social situations with peers, increase ability to handle anger and frustration, and increasing problem solving skills.

For information or to schedule an intake assessment contact Mark Myers at
(847)263-1269 x10

In the next issue:
Managing Depression and BiPolar Disorder in Adolescents
Strategies for Helping Your ADHD Child or Adolescent
Parenting the Special Needs Child
Summer Planning for Children