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Addressing Depression
1. Journey to Recovery Series
Group and Individual Interventions
for Depression
Presented by: Dr. Dawn-Elise Snipes Executive Director, AllCEUs
Podcast Host: Counselor Toolbox
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year 1
2. 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
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year 2
3. 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
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4. Global Activities
Symptom groups
Neurotransmitter groups (with handouts)
MEEPS Wellness Groups (Mental, Emotional,
Environmental, Physical, Social)
Case studies highlighting causative factors in each MEEPS
area
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year 4
5. 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
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year 5
6. Lack of Pleasure
Causes
HPA-Axis
Cortisol
Increased norepinepherine and glutamate
Reductions in
Estrogen
Testosterone
Serotonin
Increased anxiety and depression
Melatonin
Impaired sleep
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7. 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.
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8. 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?
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9. 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
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10. 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)
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year
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11. 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?
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12. 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.(Yellow, Red,
Blue/purple/black, green, orange, white/brown;
breakfast/dinner)
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.(Test sniff, handout
presentations)
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.
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13. 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
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year 13
14. 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”)
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15. 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.
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16. 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
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17. 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.
Use mindfulness exercises
Don’t take long naps during the day
Adjust lights for circadian rhythms
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18. 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. (Ain’t got enough gas)
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19. 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?
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20. 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
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21. 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?
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22. 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
Making a choice not to let anxiety run your life
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.
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23. 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.
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24. 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 10-20 minute powernap after lunch. Research shows that a
nap after lunch increases “focus chemicals” up to 200%
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25. 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
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26. Hopelessness & Helplessness
Causes include:
Poor nutrition
Lack of quality sleep
Negative thinking patterns keeping you stuck
Chronic pain
Use of opiates
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27. 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?
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28. 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
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29. 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
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30. 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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31. Connect With Us
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