Lewinsohn Peter - Control Your Depression

CONTROL YOUR DEPRESSION

Rockefeller Center

1230 Avenue of the Americas

New York, New York 10020
www.SimonandSchuster.com

Copyright 1986, 1978 by Peter M. Lewinsohn

First Fireside Edition 1992

All rights reserved, including the right of reproduction in whole or in part in any form.

FIRESIDE and colophon are registered trademarks of Simon & Schuster Inc.

Printed in the United States of America

18 19 20

Library of Congress Cataloging-in-Publication Data

Main Entry Under Title:

Control your depression.

1. Depression, Mental. 2. Self-care, Health.

I. Lewinsohn, Peter M.

RC537.C68 1986 616.8527 85-25570

ISBN 0-671-76242-7

To the many clients and colleagues
whoover the yearshave
helped us develop this approach
to treating depression

Since the publication of the original edition, considerable progress has been made in our understanding of depression. There is increasing recognition by the mental health professions and by the general public that depression is even more common than previously thought. Recent scientific studies indicate that between 10% and 20% of the general adult population has been depressed at some time in their lives. In some community studies, as many as 50% of participants have a history of depression. Appropriately, depression has been called the common cold of mental health. These statistics have at least two implications: a) There are many people who need help to assist them with overcoming their depression; and b) depression is not some kind of rare disease. Rather, serious depression is a relatively common problem, and feelings of depression are a universal part of human experience.

It is also becoming increasingly clear that depression occurs through the entire age span. We now know that occasionally young children become depressed, that depression is fairly common in adolescents, and that depression is the most frequent mental health problem for older people. Although we have more objective information about depression in adults than in children and adolescents, there is agreement among experts that even in these young people depression is a growing problem.

The presence of depression is often more difficult to recognize in elderly individuals. Many of the symptoms of depression, like feelings of sadness, lethargy and fatigue, difficulties with thinking and memory, and loss of interest in social activities, are often erroneously attributed to normal aging. We now know that older persons who are physically healthy show relatively little decline in their mental and emotional functioning. Older persons who feel pessimistic, tired, and unmotivated and who are worried about their memory and concentration may very well be depressed.

Depression is an important clinical problem not only because of the suffering and distress that are associated with being depressed, but also because being depressed has serious negative effects on ones ability to function in everyday life. Depression has been shown to interfere with ones ability to think and concentrate, with ones social behavior and motivation. Being depressed thus seriously reduces ones ability to function adaptively and to cope with the normal problems of daily life. It is therefore especially important to overcome depression as quickly as possible. This book is intended to help you achieve this goal.

We have also learned that most people who become depressed do not seek professional help and that people differ in how long it takes them to overcome their depression. Some are able to do so in a few weeks or months. Others may take a year or more. The methods found in this book are intended to shorten the duration of an episode of depression.

Although this book is written primarily for people who are depressed, it may also be useful for people who are not depressed now, but who have been depressed in the past. Similarly, people who have not had problems with depression in the past, but who are about to enter new situations which may be stressful, may want to become familiar with the techniques described in this book to reduce the likelihood of becoming seriously depressed as a result of the upcoming life changes.

As we recognized in the earlier edition, a substantial number of people need some help and encouragement to make use of a self-help book such as this one. It is for this reason that we have developed a Coping with Depression Course in which people meet as a group to work on each of the chapters together. These courses, which are conducted like a small seminar, have typically held twelve meetings over a period of eight weeks with five to ten participants. Each meeting focuses on a specific chapter of Control Your Depression. An instructors manual, The Coping with Depression Course (Castella Press., 1984), is available for the leaders of these groups.

Many of the techniques described in this book have been used in more than 50 scientifically controlled treatment outcome studies in which they have shown to be efficacious, sometimes singly, but most often in combination.

Coping with Depression courses, for which Control Your Depression has served as the textbook, have been evaluated in five scientific studies. In all of these studies, the experience has been associated with improvement in approximately 80% of the participants. The courses have been used at the University of Oregon, Arizona State University, the Palo Alto Veterans Administration Hospital, and Portland State University.

Work presently being conducted by the Depression Prevention Research Project of the University of California, San Francisco, is examining whether people who learn the techniques described in this book are less likely to become seriously depressed in the future. This work is being done with medical patients, who have been found to be a higher risk for depression than non-medical populations. As this edition of our book goes to press, this research project is just beginning. Thus, final results are not available. The logic of the study is as follows: if people who are already depressed can benefit from learning and using these techniques, perhaps the use of the techniques can help prevent people from becoming depressed in the first place.

Feelings of depression are part of human experience, of course, and we do not expect to prevent feelings of depression altogether. We do intend to reduce 1) the frequency of serious episodes of depression, 2) the duration of any such episode, and 3) the severity or intensity of depression during any one episode.

CONTROL YOUR DEPRESSION

Alice has been feeling low for about eight months now. Like everyone else, she has had down periods before, but they have usually not lasted this long. She doesnt feel like doing much, has had trouble sleeping and eating, has lost her sense of humor, and is starting to wonder whether she is ever going to feel better.

Her relationship with her family has her worried. She feels that she is a burden on them and that her gloominess is affecting her husband and teenage children. Her job responsibilities are also a source of concern. As a real estate agent, she finds that her pace is generally quite fast. But in the past few months, she has slowed down considerably. She is just not functioning as efficiently as she used to. And though she has tried, she cant get herself motivated.

Alice is tired of feeling sad and blue. But even worse, she is afraid that there may be something seriously wrong with her. At times shes even wondered whether she might be losing control, having a mental breakdown, or even going crazy. She just doesnt understand what is happening to her and doesnt know how to overcome her distress. Yet her doctor tells her that there is nothing physically wrong with her.