323 -Depression Group and Individual Interventions
Counselor Toolbox

 
 
00:00 / 63:17
 
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Journey to Recovery Series
Group and Individual Interventions for Depression
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs
Podcast Host: Counselor Toolbox
Objectives
~ Identify the common symptoms for anxiety and depression-based disorders
~ Learn how a positive change in one area or symptom can have positive effects on all symptoms or areas.
~ Explore
~ The function of each of those symptoms
~ The potential causes of each of those symptoms
~ Interventions for each of those symptoms

What are symptoms
~ Symptoms are your physical and emotional reactions to a threat.
~ Symptoms are designed to protect you.
~ They are not bad or good. They just are.
~ Instead of trying to make the symptom go away, it may help to:
~ Understand the function of them
~ Identify alternate, more helpful, ways to deal with the threat
Global Activities
~ Symptom groups
~ Neurotransmitter groups (with handouts)
~ MEEPS Wellness Groups
~ Case studies
Lack of Pleasure
~ Form/Symptom
~ Lack of pleasure in most things, most days for a period of at least 2 weeks.
~ Cause
~ Neurochemical imbalance (insufficient dopamine, norepinephrine?) caused by:
~ Lack of quality sleep
~ Excessive stress
~ Drug or medication use
~ Hormone imbalances including thyroid problems
Lack of Pleasure
~ Causes
~ HPA-Axis
~ Cortisol
~ Increased norepinepherine and glutamate
~ Reductions in
~ Estrogen
~ Testosterone
~ Serotonin
~ Increased anxiety and depression
~ Melatonin
~ Impaired sleep

Lack of Pleasure
~ Function
~ This is your body's way of
~ Signaling that there may be a problem
~ Conserving excitatory neurotransmitters for a “real” crisis
~ Forcing you to address it. After all, nobody wants to be depressed for very long.

Lack of Pleasure
~ How You Cope
~ Think back over a few times when you have been depressed or just haven’t found pleasure in anything, even if it was just for a few hours.
~ What did you do to help yourself feel better?
~ What makes the depression/lack of pleasure worse?
~ What can you do to prevent triggering your depression/lack of pleasure?

Lack of Pleasure
~ Simple-ish Interventions
~ Don’t expect exhilaration, but try to do some things that make you mildly happy. (Alphabet, happiness box, weekly appointment)
~ Get plenty of quality sleep. You need to stabilize your circadian (sleep-wake-eat) rhythms.
~ Think back to when you didn’t feel this way.
~ What was different? (MEEPS sheets)
~ What changed that started you feeling depressed (Review the MEEPS)
~ Remember that depression is a natural part of the grief process and also very normal after a trauma. Be compassionate

Eating Behaviors
~ Form
~ Eating too much or loss of appetite
~ Cause
~ Imbalance in the brain chemicals that help you feel motivated to eat, such a norepinepherine and serotonin.
~ There are five primary causes of over-eating:
~ Your body needing the building blocks (Food diary)
~ Low serotonin
~ Your circadian rhythms are out of whack (HR/energy monitoring)
~ Habit/self soothing (Food diary)
~ Thyroid Issues (Physical)
Eating Behaviors
~ How You Cope
~ In the past when you have just not had an appetite or have been eating to self-soothe, how did you deal with it?
~ How can you make sure you are eating a generally healthy diet, and making sure that your body has the building blocks it needs?
~ What can you do to ensure you are eating due to hunger and not distress?
~ What foods do you generally eat to self-soothe?
~ What can you do to prevent non-hunger eating?
~ What can you do besides eating to distract yourself from your distress or self-soothe?

Eating Behaviors
~ Some simple-ish interventions
~ Stop consuming caffeine at least 8 hours before bed.
~ Drink enough water (even if it is sparkling water or Powerade).
~ Have 3 colors on your plate at every meal.
~ Eat foods you enjoy, but in moderation
~ Use a plate. Don’t eat out of the bag
~ Get enough sleep so you are not eating to stay awake.
~ Experiment with essential oils. Some will increase appetite. Some will decrease stress and cravings.
~ If you just cannot stomach eating, explore a meal replacement like Ensure. This should not be done for a long period, but as a stop-gap, it usually is fine. Ask your doctor.

Sleeping Behaviors
~ Form
~ Sleeping too much or having insomnia
~ Cause
~ Sleeping too much can indicate poor quality sleep due to:
~ Stress
~ Poor sleep habits
~ Pain
~ Hormone or neurochemical imbalances
~ Allergies/Apnea
~ Poor nutrition
Sleeping Behaviors
~ Cause
~ Insomnia can indicate:
~ Activated HPA-Axis/An inability to relax
~ Pain making it difficult to sleep
~ Insufficient serotonin/melatonin (also implicated in depression and “stress”)

Sleeping Behaviors
~ Function
~ When you are not getting enough sleep, you cannot recharge as efficiently, so you are more tired.
~ When you are getting too much sleep your body doesn’t secrete melatonin at the right times leading to poor quality sleep and feeling exhausted all the time.
~ When you cannot sleep it typically indicates that your HPA-Axis/Threat Responses System is activated so it doesn’t want you to be vulnerable.
Sleeping Behaviors
~ How You Can Cope
~ What do you usually do to help yourself
~ Get to sleep when you can’t sleep
~ Wake up when you have been sleeping too much?
~ Create a good sleep routine that involves the same two or three activities.
~ Identify & address anything waking you up in the night.
~ Dogs
~ Coughing/allergies
~ Snoring spouse
~ Sleep apnea

Sleeping Behaviors
~ Simple-Ish Interventions
~ Get a physical to rule out any medical issues especially
~ Thyroid and other hormone imbalances
~ Chronic pain
~ Apnea
~ Reduce or eliminate caffeine at least 8 hours before bed.
~ Keep a notepad by your bed to write down things you need to remember instead of tossing them around in your head all night.
~ Use progressive muscle relaxation, to help your body relax.
~ Develop a stress management and relaxation plan.

Low Energy
~ Form
~ Lack of energy and/or fatigue.
~ Cause
~ Insufficient or excessive sleep
~ Lack of motivation and reward
~ Lack of movement
~ Fear of failure or rejection
~ Poor nutrition
~ Thyroid or hormone imbalances
~ Function
~ The body is devoting scarce resources to rebuilding and functioning. (Aint got enough gas)

Low Energy
~ How you cope
~ What (besides caffeine) helps you get energy?
~ What drains your energy?
~ Mental
~ Emotional
~ Environmental
~ Physical
~ Social
~ When you have felt lethargic in the past, how did you help yourself feel better?

Low Energy
~ Simple-ish Interventions
~ Get up and move around. Try doing 15.
~ Stay hydrated
~ Focus on stabilizing your circadian rhythms
~ Try to stay off the stimulant rollercoaster
~ Increase the motivating chemicals by having some successes.
~ Get an accountability buddy.
~ Identify any fear or depressive thoughts that may be dampening your motivation or draining your energy and deal with them

Agitation
~ Form
~ Being sped up (agitation) during the day.
~ Cause
~ High levels of anxiety
~ Stimulants (to self-medicate depression)
~ Unstable blood sugar/poor nutrition
~ Function
~ When you are sped up, your body is likely detecting a threat (real or chemically induced).
~ How You Cope
~ When you feel driven and/or anxious, how have you been able to get it under control?
~ What can you do to be kind to yourself?

Simple-ish Interventions
~ Reduce anxiety (worry) by:
~ Addressing unhelpful thoughts that are stressing you out
~ Using distress tolerance skills to feel the anxiety and let it pass
~ Practicing good time management so you don’t feel pressured.
~ Pay attention and reduce how many stimulants you are taking including caffeine, nicotine, diet pills, and decongestants. These can all cause you to feel revved up.
~ Unstable blood sugar/poor nutrition can make you feel jittery, so try to eat healthfully and regularly.

Concentration
~ Form
~ Trouble concentrating and/or making decisions
~ Cause
~ Neurotransmitter, hormone or blood sugar imbalances caused by lack of sleep, poor nutrition, excess stress
~ Feelings of helplessness causing you to second guess yourself
~ Function
~ Energy conservation. If your body is struggling to just keep going, it is not going to divert energy to higher order thought processes unless they have a direct impact on your survival.

Concentration
~ How You Cope
~ What helps you focus (small chunks, working in the morning..)
~ Simple-ish Interventions
~ How can you be kind to yourself? Like Stephen Covey says, sometimes you need to take a break and “sharpen the saw.”
~ Make sure you are eating a healthfully and frequently to keep your blood sugar stable and give your body the building blocks to make your neurotransmitters.
~ Make sure you are hydrated.
~ Get adequate, quality sleep
~ Take a powernap after lunch. Research shows that a nap after lunch increases “focus chemicals” up to 200%

Hopelessness & Helplessness
~ Form
~ A sense of hopelessness or helplessness “I can’t go on like this.” “Nothing seems to ever work.”
~ Cause
~ When your brain chemicals are out of whack it impacts mood and motivation.
~ Normal relaxation chemicals like serotonin and GABA may be insufficient
Hopelessness & Helplessness
~ Causes include:
~ Poor nutrition
~ Lack of quality sleep
~ Negative thinking patterns keeping you stuck
~ Chronic pain
~ Use of opiates
Hopelessness & Helplessness
~ Function
~ This is simply a signal that something is wrong. You need help.
~ How You Cope
~ What helps you feel empowered?
~ What things do you have control over?
~ What are your goals?
~ What can you do to start achieving those goals?
~ What are three things you can do today to start moving toward recovery or happiness again?

Hopelessness
~ Simple-ish Interventions
~ Identify things that give you hope or make you happy and do one of those each day
~ Get adequate sleep (Are you sensing a trend here??)
~ Drink at least 8 glasses of water and eat a relatively healthy diet
~ Talk with a friend and create a plan to get un-stuck

Summary
~ Most depressive symptoms are caused by changes in people’s neurochemistry
~ These changes can be caused by:
~ Emotional upset/stress that triggers the HPA-Axis or grief
~ Unhelpful or unpleasant thoughts that trigger the HPA-Axis
~ Pain
~ Poor quality sleep
~ Poor nutrition
~ Medication side effects
~ Lack of pleasure (yin and yang)
~ Behaviors that alter brain chemistry such as bungee jumping, gambling, sex or viewing pornography
Summary
~ Coping with depression requires an understanding of
~ What triggers it for the person
~ What has helped in the past to prevent or cope with it
~ The function of the symptom in order to meet or prevent the need.
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