Psychological Self-Help

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If you've read parts of the chapter relevant to you, you probably
already have some ideas about how and why you have responded with
sadness. Therefore, certain self-help methods in this section will seem
more appropriate for you to use. Fine, try two or three and see if they
work. If not, try something else. In general, gaining some optimism
about getting better, having an easy going disposition, and utilizing
family support, along with selected self-help methods, will lead to a
better recovery from depression. 
The methods for depression are arranged by levels in this section.
Quickly read or skim the entire list of methods before you select a few
to use. This is a preview: 
Behavior--increase pleasant activities, avoid upsetting
situations, get more rest and exercise, use thought stopping
and reduce your worries, atone for wrong-doings, seek support,
and use other behavioral changes, 
Emotions--desensitize your sadness to specific situations and
memories, vent your anger and sadness, try elation or
relaxation training, etc., 
Skills--learn social skills, decision-making, and self-control to
reduce helplessness, 
Cognition--acquire more optimistic perceptions and attributions,
challenge your depressing irrational ideas, seek a positive self-
concept, become more accepting and tolerant, select good
values and live them, and 
Unconscious factors--read about depression, learn to recognize
repressed feelings and urges that may cause guilt, explore your
sources of shame (perhaps even going back to childhood). 
The Use of Anti-depressants
Anti-depressants have been a major part of the pharmacological era in
psychiatry. In the last twenty years, psychiatric practice has changed in major
ways, namely, the shift from talking to giving pills. Many factors have
contributed to this treatment revolution: (1) the development of safer drugs
with fewer side effects, especially the SSRI anti-depressants. These
medications may not reduce depression better than older drugs but they are
less likely to kill you when an over-dose is taken. (2) The pharmaceutical
companies have advertised intensely, turning consumers into drug advocates
and permitting drug sales representatives to target primary care physicians
rather than the much more rare psychiatrists. Moreover, (3) HMOs have
realized their profit-margins can be greatly increased when the drugs are
dispensed by a family physician requiring only brief and occasional follow-up
visits rather than by expensive psychiatrists. The distribution of drugs got
much easier: just tell your regular doctor that you have been feeling down or
tired and have had some crying spells, and you immediately get a prescription
for anti-depressants paid for without question by your health insurance.
Millions have started taking anti-depressants and while they may have shifted
from one brand to another, many have been satisfied. Nevertheless, it is
generally recognized that anti-depressants take about 30 days to work and
about 30% of depressed patients get little benefit from anti-depressants.
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