Q. How may I measure the effects my treatment is having on my depression?
If one completes the following scale each week, and keeps track of the scores, one would have a detailed record of one’s progress.
Name _________________________ Date _________
The items below refer to how you have felt and behaved **during the past week.** For each item, indicate the extent to which it is true, by circling one of the numbers that follows it. Use the following scale:
0 = Not at all
1 = Just a little
2 = Somewhat
3 = Moderately
4 = Quite a lot
5 = Very much
1. I do things slowly 0 1 2 3 4 5
2. My future seems hopeless 0 1 2 3 4 5
3. It is hard for me to concentrate on reading 0 1 2 3 4 5
4. The pleasure and joy has gone out of my life 0 1 2 3 4 5
5. I have difficulty making decisions 0 1 2 3 4 5
6. I have lost interest in aspects of life that used to be important to me 0 1 2 3 4 5
7. I feel sad, blue, and unhappy 0 1 2 3 4 5
8. I am agitated and keep moving around 0 1 2 3 4 5
9. I feel fatigued 0 1 2 3 4 5
10. It takes great effort for me to do simple things 0 1 2 3 4 5
11. I feel that I am a guilty person who deserves to be punished 0 1 2 3 4 5
12. I feel like a failure 0 1 2 3 4 5
13. I feel lifeless–more dead than alive 0 1 2 3 4 5
14. My sleep has been disturbed: too little, too much, or broken sleep 0 1 2 3 4 5
15. I spend time thinking about how I might kill myself 0 1 2 3 4 5
16. I feel trapped or caught 0 1 2 3 4 5
17. I feel depressed even when good things happen to me 0 1 2 3 4 5
18. Without trying to diet, I have lost, or gained, weight 0 1 2 3 4 5
Note: This scale is designed to measure changes in the severity of depression and it has been shown to be sensitive to the changes that result from psychotherapeutic or psychopharmacologic treatment. These scales are not designed to diagnose the presence or absence of either depression or mania.
(Copyright 1993 Ivan Goldberg) DOWNLOAD SCALE PDF>>>
Q. How can I help myself get through depression on a day-to-day basis?
On a day-to-day basis, separate from, or concurrently with therapy or medication, we all have our own methods for getting through the worst times as best we can. The following comments and ideas on what to do during depression were solicited from people in the alt.support.depression newsgroup. Sometimes these things work, sometimes they don’t. Just keep trying them until you find some techniques that work for you.
Keep a journal. Somehow writing everything down helps keep the misery from running around in circles. Listen to your favorite “help” songs (a bunch of songs that have strong positive meaning for you).
Read (anything and everything)
Go to the library and check out fiction you’ve wanted to read for a long time; books about depression, spirituality, morality; biographies about people who suffered from depression but still did well with their lives (Winston Churchill and Martin Luther, to name two;).
Sleep for a while
Even when busy, remember to sleep. Notice if what you do before sleeping changes how you sleep.
If you might be a danger to yourself, don’t be alone. Find people. If that is not practical, call them up on the phone. If there is no one you feel you can call, suicide hotlines can be helpful, even if you’re not quite that badly off yet.
Hug someone or have someone hug you.
Remember to eat
Notice if eating certain things (e.g. sugar or coffee) changes how you feel.
Make yourself a fancy dinner, maybe invite someone over.
Take a bath or a perfumed bubble bath.
Mess around on the computer.
Rent comedy videos.
Go for a long walk
Dancing. Alone in your house, or out with a friend.
Try to alternate foods you like ( Maybe junk foods) with the stuff you know you should be eating.
Spend some time playing with a child
Buy yourself a gift
Phone a friend
Read the newspaper comics page
Do something unexpectedly nice for someone
Do something unexpectedly nice for yourself.
Go outside and look at the sky.
Get some exercise while you’re out, but don’t take it too seriously.
Pulling weeds is nice, and so is digging in the dirt.
If you are worried about responses from critical neighbors, go for a drive and sing as loud as you want in the car. There’s something about the physical act of singing old favorites that’s very soothing. Maybe the rhythmic breathing that singing enforces does something for you too. Lullabies are especially good.
Pick a small easy task, like sweeping the floor, and do it.
If you can meditate, it’s really helpful. But when you’re really down you may not be able to meditate. Your ability to meditate will return when the depression lifts. If you are unable to meditate, find some comforting reading and read it out loud.
Feed yourself nourishing food.
Bring in some flowers and look at them.
It is amazing how well some people can play sports even when feeling very miserable.
Pick some action that is so small and specific you know you can do it in the present.
This helps you feel better because you actually accomplish something, instead of getting caught up in abstract worries and huge ideas for change. For example say “hi” to someone new if you are trying to be more sociable. Or, clean up one side of a room if you are trying to regain control over your home.
If you’re anxious about something you’re avoiding, try to get some support to face it.
Many depressions are characterized by guilt, and lots of it. Many of the things that depressed people want to do because of their depressions (staying in bed, not going out) wind up making the depression worse because they end up causing depressed people to feel like they are screwing things up more and more. So if you’ve had six or seven hours of sleep, try to make yourself get out of bed the moment you wake up…you may not always succeed, but when you do, it’s nice to have gotten a head start on the day.
Cleaning the house
This worked for some people me in a big way. When depressions are at their worst, you may find yourself unable to do brain work, but you probably can do body things. One depressed person wrote, “So I spent two weeks cleaning my house, and I mean CLEANING: cupboards scrubbed, walls washed, stuff given away… throughout the two weeks, I kept on thinking “I’m not cleaning it right, this looks terrible, I don’t even know how to clean properly”, but at the end, I had this sparkling beautiful house!”
Doing volunteer work on a regular basis seems to keep the demons at bay, somewhat… it can help take the focus off of yourself and put it on people who may have larger problems (even though it doesn’t always feel that way).
In general, It is extremely important to try to understand if something you can’t seem to accomplish is something you simply CAN’T do because you’re depressed (write a computer program, be charming on a date), or whether its something you CAN do, but it’s going to be hell (cleaning the house, going for a walk with a friend, getting out of bed). If it turns out to be something you can do, but don’t want to, try to do it anyway. You will not always succeed, but try. And when you succeed, it will always amaze you to look back on it afterwards and say “I felt like such shit, but look how well I managed to…!” This last technique, by the way, usually works for body stuff only (cleaning, cooking, etc.). The brain stuff often winds up getting put off until after the depression lifts. Do not set yourself difficult goals or take on a great deal of responsibility.
Break large tasks into many smaller ones
Set some priorities, and do what you can, as you can.Do not expect too much from yourself. Unrealistic expectations will only increase feelings of failure, as they are impossible to meet. Perfectionism leads to increased depression.
Try to be with other people, it is usually better than being alone.
Participate in activities that may make you feel better. You might try mild exercise, going to a movie, a ball game, or participating in religious or social activities. Don’t overdo it or get upset if your mood does not greatly improve right away. Feeling better takes time.
Do not make any major life decisions, such as quitting your job or getting married or separated while depressed.
The negative thinking that accompanies depression may lead to horribly wrong decisions. If pressured to make such a decision, explain that you will make the decision as soon as possible after the depression lifts. Remember you are not seeing yourself, the world, or the future in an objective way when you are depressed.
While people may tell you to “snap out” of your depression, that is not possible. The recovery from depression usually requires antidepressant therapy and/or psychotherapy. You cannot simple make yourself “snap out” of the depression. Asking you to “snap out” of a depression makes as much sense as asking someone to “snap out” of diabetes or an under-active thyroid gland.
Remember: Depression makes you have negative thoughts about yourself, about the world, the people in your life, and about the future. Remember that your negative thoughts are not a rational way to think of things. It is as if you are seeing yourself, the world, and the future through a fog of negativity. Do not accept your negative thinking as being true. It is part of the depression and will disappear as your depression responds to treatment. If your negative (hopeless) view of the future leads you to seriously consider suicide, be sure to tell your doctor about this and ask for help. Suicide would be an irreversible act based on your unrealistically hopeless thoughts.
Remember that the feeling that nothing can make depression better is part of the illness of depression. Things are probably not nearly as hopeless as you think they are.
If you are on medication:
- Take the medication as directed. Keep taking it as directed for as long as directed.
- Discuss with the doctor ahead of time what happens in case of unacceptable side-effects.
- Don’t stop taking medication or change dosage without discussing it with your doctor, unless you discussed it ahead of time.
- Remember to check about mixing other things with medication. Ask the prescribing doctor, and/or the pharmacist and/or look it up in the Physician’s Desk Reference. Redundancy is good.
- Except in emergencies, it is a good idea to check what your insurance covers before receiving treatment.
Do not rely on your doctor or therapist to know everything.
Do some reading yourself. Some of what is available to read yourself may be wrong, but much of it will shed light on your disorder.
Talk to your doctor if you think your medication is giving undesirable side-effects.
Do ask them if you think an alternative treatment might be more appropriate for you.
Do tell them anything you think it is important to know.
Do feel free to seek out a second opinion from a different qualified medical professional if you feel that you cannot get what you need from the one you have.
Skipping appointments because you are “too sick to go to the doctor” is generally a bad idea.
If you procrastinate, don’t try to get everything done. Start by getting one thing done. Then get the next thing done.
Handle one crisis at a time. If you are trying to remember too many things to do, it is okay to write them down. If you make lists of tasks, work on only one task at a time. Trying to do too many things can be too much. It can be helpful to have a short list of things to do “now” and a longer list of things you have decided not to worry about just yet. When you finish writing the long list, try to forget about it for a while.
If you have a list of things to do, also keep a list of what you have accomplished too, and congratulate yourself each time you get something done. Don’t take completed tasks off your to-do list. If you do, you will only have a list of uncompleted tasks. It’s useful to have the crossed-off items visible so you can see what you have accomplished
In general, drinking alcohol makes depression worse.
Many cold remedies contain alcohol. Read the label. Being on medication may change how alcohol affects you.
Books on the topic of “What to do during Depression”:
“A Reason to Live,” Melody Beattie, Tyndale House Publishers, Wheaton, IL. 167 pages. This book focuses on reasons to choose life over suicide, but is still useful even if suicide isn’t on your mind. In fact, it reads a lot like this portion of the FAQ.
“Do two things each day. In times of severe crisis, when you don’t want to do anything, do two things each day. Depending on your physical and emotional condition, the two things could be taking a shower and making a phone call, or writing a letter and painting a room.”
Get a cat
Cats are clean and quiet, they are often permitted by landlords who won’t allow dogs, they are warm and furry.