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Dealing with Clinical Depressions

Summary of Feeling Good

There is a lot of misinformation and dis-information about depressions in the public. When I was depressed and hypomanic as a teenager I didn’t know how to call these “conditions”, or how to effectively deal with them. If, after reading the description on the Wikipedia, you feel that you have been depressed in the past, read on.

The best advice I can give on dealing with clinical depressions (and possibly also as a preventative measure or just to understand what people think) is to buy the excellent book Feeling Good.

It is a self-help guide for cognitive-behavioural therapy, that was originally written in English and was recommended to me by my therapist. Just reading it helped me understand the source of my hypomanias, and I found the exercises recommended there to be helpful as well.

One important omission from an earlier draft of this essay was that I did not summarise the Feeling Good book here, while I should have tried to in order to give a taste of the book here (because I know I always hate “go read X at some place because I don’t have the nerve to explain it to you.”). So I am going to summarise Feeling Good here.

Note that if you are depressed, (and if you’re feeling suicidal even more so), you need to consult a cognitive-behavioural therapist for a session, as soon as possible. I am not a mental health professional and am not qualified to give professional therapy, and this essay is not a substitute for it.

Summary of Feeling Good

Burns starts by giving a way to diagnose your mood and determine if you are depressed or not. I didn’t focus on it because I normally can eventually tell when I’m hypomanic (or could when I was depressed). He then goes on to explain that your feelings are affected by the thoughts that go through your head, and that by challenging your irrational thoughts, you can improve your mood.

He then lists 10 cognitive errors that people make which may make people depressed. Among these errors are:

  1. Should statements - you try to motivate yourself by saying things like “I should be more careful”, or “I should not have talked to him like that.” or “I ought to be more considerate”. What these should statements do is actually demotivate, and make you feel down.

  2. Disqualifying the positive - an example for this is that when you receive a compliment, you say something like “they didn’t mean it.”, or “it doesn’t count.”, or “he doesn’t know the real me.”

  3. Mental filter - here you focus on one negative detail (a “fly in the ointment”), while ignoring the rest of the picture.

  4. All or nothing thinking - you want everything to be perfect. For example, you’ll accept no grade below 90% or so (even if it’s a passing grade), or so.

Dr. Burns then gives a simple recipe to gain self-esteem: one writes down an automatic thought that disturbs him (or her), and then the feelings that he feels (with percentages). Afterwards, he should write which cognitive errors he has made followed by a rational response to the feelings, and after that the new feelings.

Burns then discusses several useful techniques for anger management, and for dealing with criticism.

  1. Approval Addiction. - you want to be approved by other people and fear disapproval for them.

  2. Productivity Addiction - you care about your work, how productive you are, how much you achieve, etc. (Much more common among men.)

  3. Love addiction - you want to be loved a lot. More common among women.

  4. Perfectionism - you want to be perfect in everything you do.

The book Feeling Good focuses on depressions and not on hypomanias. As the psychologist I’ve been seeing noted, a hypomanic person should perform cognitive exercises on his grandiose thoughts that are running in his or her head when they are hypomanic.