Addressing Depression

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

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 (Mental, Emotional,
Environmental, Physical, Social)
 Case studies highlighting causative factors in each MEEPS
area

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
Copyright 2018 AllCEUs All Rights Reserved. Unlimited CEUs for $59/month or $99/year
9

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)
10

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.(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.
12

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
16

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

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)

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
 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?
21

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.

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..)
 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%

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

 Causes include:
 Poor nutrition
 Lack of quality sleep
 Negative thinking patterns keeping you stuck
 Chronic pain
 Use of opiates

 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
 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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Addressing Depression

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