We all know we live in challenging and uncertain times. The Renée Crown Wellness Institute at the University of Colorado Boulder was established with a commitment to the vision of a world in which every young person thrives, supported by the caring relationships and inner resources required for a lifetime of wellness. The last few months have challenged this vision in profound ways. The pandemics of the coronavirus and systemic racism call upon us with urgency to attend to our individual and collective mental health and wellness.

PAY ATTENTION TO YOUR MOOD

It is normal to feel sad, at times, given the state of our world. However, it’s important to notice if you start to move from occasional times of feeling down into the territory of depression. Depression is defined by the presence of specific symptoms: feeling down or sad, loss of interest or pleasure, changes in sleep, appetite or eating, fatigue or loss of energy, feelings of worthlessness or guilt, problems with concentration, restlessness or moving slowly, or thoughts of death or suicide. It is important to pay attention not only to the presence of these symptoms, but also how frequently they occur, how long they last, and the extent to which they get in the way of carrying out everyday activities.

 

If you notice that you or someone you love is persistently experiencing several of the symptoms listed above, know that help is available. Good science is our guide. My team has been doing research on how to treat and prevent depression for the last twenty years. The good news is that the lessons learned are very relevant to the challenges we face today.

 

ACTION AND CONNECTION CAN HELP

One of the approaches that we and other researchers have studied widely is Behavioral Activation (BA). BA is indicated as a primary treatment for major depression and – in one of our early studies –  its efficacy was comparable to antidepressant medication, even among people with more severe depression. Many studies also suggest that BA is effective even when provided by lay or community counselors, and we are studying an approach that has been collaboratively designed with our community partners, Valley Settlement and El Centro Amistad, in Colorado. This approach, called “The Alma Program,” is based on BA and delivered by peers. The strategies of BA are highly applicable to taking care of our mood now.

 

At its core, this approach is based on the idea that we can change how we feel by changing what we do. The context of our lives is stressful right now. It is important to emphasize that it is valid and understandable to experience suffering in this context. Feeling sad, overwhelmed, fearful, tired, frustrated, and more is understandable. Often, when people are feeling these ways, they tend to pull away, withdraw, avoid, and become less active. Initially, pulling away might provide some relief or distraction. The challenge is that, over time, a downward spiral can be set into motion in which the less you do, the worse you feel. What is required is the opposite of pulling away. But how can you do this?

Here are a few key strategies to use to change how you feel:

• Experiment with tracking. Write down what you do and how you feel, each hour, for a few hours. Notice connections between what you do and how you feel. You’re looking for activities that tend to pull down your mood, and those that can boost your mood. Tracking is important because it allows you to personalize or customize activities that make sense for you. What boosts one person’s mood may have little impact on another (or even the opposite effect). When feeling down, it’s important to use your energy in the most targeted ways possible. Tracking helps you do so.

• Make a list of the activities that improve your mood, even if just a little bit. Notice, in particular, which activities give you a sense of pleasure or enjoyment, and which give you a sense of mastery or accomplishment. Think of pleasure and accomplishment as essential nutrients for your mood. You need some of each in your daily diet of activity. Schedule one pleasure and one mastery activity each day.

• Start small. Getting active is not an all or nothing endeavor. If an activity is rewarding but challenging, break it down into smaller steps, and start with just one. Vigorous exercise may be out of reach in this moment and that’s okay. Taking a walk around the block is a great place to start. Doing so counters the downward spiral of depression. Over time, small steps build on one another.

• Pay attention to ways in which your routine may have been disrupted in recent months. Schedule predictable and consistent times for activities that support your mood, including times for sleep, eating and exercise. Structure is your friend during this pandemic.

• Connect with others. Social distancing is important for our community health, and it is hard to do. It is especially hard if you are depressed or vulnerable to depression. The support of others is essential. Schedule times to connect, even if only for a brief phone call with a family member or friend.

• Watch out for what your mind tells you. The mind, when depressed, will tell you that these strategies won’t work, or that they won’t work for you. Your mind will tell you that it’s too hard. One of my clients wisely wrote a note and posted it in her kitchen that said, “Your mind will tell you that this isn’t worth the effort. Do me a favor--don’t listen! Do one activity, no matter how small.”

At times, it is possible to use these strategies on your own. More often, support is required. These skills are simple and backed by science, but that doesn’t mean they are easy. The support of a therapist, coach or mentor can be essential when you are struggling with depression. This is especially true in the context of stressors that are not easily or quickly solved. We need one another more than ever these days. And we need to stay active in ways that are linked to our mental wellness. Staying connected and active are essential to staying well.

Sona Dimidjian, PhD
Director, Renée Crown Wellness Institute
Professor, Department of Psychology and Neuroscience
University of Colorado Boulder

Mind the Brain Podcast

Dr. Neill Epperson and Dr. Sona Dimidjian discuss behavioral activation and how it can be helpful when struggling with depression. 

Mind the Brain CME Information:
CME Survey for the June 30, 2020 Edition

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