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One of the best books I have every read. I think I have read it three times now. And it's long!
You feel the way you do right now because of the thoughts you are thinking at this moment.
COGNITIVE DISTORTIONS:
1) All or Nothing Thinking : This refers to your tendency to evaluate your personal qualities in extreme black-or-white categories. If your performance falls short of perfect, you see yourself as a total failuer.
2) Overgeneralization : You decide that things that happened to you once will occur over and over again.
3) Mental Filter : You pick a negative detail in any situation and dwell on it excessively, thus perceiving that the whole situation is negative. Your vision of all reality is darkened.
4) Disqualifying the Positive : The tendency for some depressed individuals to transform neutral or even positive experiences into negative ones. You reject some good things saying "they don't count" for some reason. You maintain a negative mindset for no reason.
5) Jumping to Conclusions : Two examples of this are 'mind reading' and 'the fortune teller error.'
Mind Reading : You make the assumption that other people are looking down on you, and you're so convinced about this that you don't even bother to check it out.
The Fortune Teller Error : It's as if you had a crystal ball that foretold only misery for you. You feel convinced that your prediction is an already-established fact.
6) Magnification and Minimization : Magnification commonly occurs when you look at your own errors, fears, or imperfections and exaggerate their importance.
Minimization is when you look at your strengths and undermine their importance. As if you are looking through the wrong end of a pair of binoculars.
7) Emotional Reasoning : You take your emotions as evidence for the truth. "I feel it, therefore it must be true."
8) Should Statements : You try to motivate yourself by saying, "I should do this" or "I must do that." These statements cause you to feel pressured, guilty and resentful. Try not to say 'should' or 'must' or 'ought'.
When you direct these words towards others you feel frustration and resentment.
9) Labeling and Mislabeling: Personal labeling means creating a completely negative self-image based on your errors. It is an extreme form of overgeneralization. "I'm a loser."
Mislabeling means describing an event with language that is emotionally loaded, OTT.
Stop telling yourself you are worthless. It's incorrect and unrealistic.
10) Personalization : You assume responsibility for a negative event when there is no basis for doing so. You were not responsible.
Don't call people idiots. Idiot behaviour exists, but idiots do not.
Three steps to take when you are upset:
(1) Zero in on the negative thoughts you are having and write them down.
(2) Read over the list of ten cognitive distortions.
(3) Substitute a more objective thought that puts the lie to the one which made you look down on yourself.
Do-Nothingism/Rumination/Procrastination : How to Beat It
One of the most destructive aspects of depression is the way it paralyzes your willpower. You may refuse to answer the phone for fear of hearing bad news.
Do not cut yourself off from normal activities and interpersonal relationships. Even young monkeys slip into a retarded, withdrawn state if they are separated from their peers and confined to a small cage. Why do you voluntarily impose a similar punishment on yourself? Do you want to suffer?
The following mind-sets are commonly associated with procrastination : 1. Hopelessness. Any activity starts to seem pointless. Even life seems pointless.
2. Helplessness. You are convinced that your moods are caused by factors that are beyond your control.
3. Overwhelming Yourself. You may magnify a task to the degree that it seems impossible to tackle.
4. Jumping to Conclusions. "I would do it...but it seems difficult and I wouldn't enjoy it."
5. Self-Labeling. The more you procrastinate, the more you condemn yourself as inferior.
6. Undervaluing the Rewards. You feel the reward simply wouldn't be worth the effort.
7. Perfectionism. You defeat yourself with inappropriate goals and standards.
8. Fear of Failure. You refuse to even try at all.
9. Fear of Success. You worry that if you do well, you wouldn't be able to keep it up. You may also fear success because you anticipate that people will make even greater demands on you. They may give you more tasks, or want to meet up more often on social occasions.
10. Fear of Disapproval or Criticism. You don't want to risk rejection.
11. Coercion and Resentment. You tell yourself, "I should do this" and "I have to do that". Then you feel obliged, burdened, tense, resentful and guilty.
12. Low Frustration Tolerance. You go into a frenzied state of panic and rage when life presents you with obstacles. You retaliate against the 'unfairness' of it all when things get tough so you give up completely. But this is life! You can't argue with the way things are.
13. Guilt and Self-blame. If you are frozen in the conviction that you are bad or have let others down, you will naturally feel unmotivated to pursue your daily life.
Do you know that virtually any meaningful activity has a decent chance of brightening your mood? Anything! If you do nothing you will become preoccupied with the flood of negative, destructive thoughts. If you do something, you will be temporarily distracted from that internal dialogue. What is more, the sense of mastery you will experience will disprove many of the distorted thoughts that slowed you down in the first place.
The Butt Rebuttal - How to Get off Your "But" (Butt):
The But : I really should mow the lawn but I am not in the mood.
The But Rebuttal : I'll feel more like it once I start. When I am done, I will feel terrific.
The But : I really should cut the grass, but it's so long it will take forever.
The But Rebuttal : It won't take that much extra time. I can do it bit by bit.
The But : I am too tired.
The But Rebuttal : So just do some of it, then rest.
The But : I'd rather rest now or watch TV.
The But Rebuttal : I can, but I won't feel good with this chore hanging over my head.
The But : I am just too lazy to do it today.
The But Rebuttal : That can't be true - I've done it on numerous occasions in the past.
REASONS TO GIVE UP SMOKING: 1) Improved health.
2) I'll respect myself.
3) I'll have greater self-discipline. With my new self-confidence, I may be able to do a whole lot of other things I've been putting off.
4) I will be able to run and dance actively, and still feel good about my body. I'll have lots of stamina and extra energy.
5) My lungs and heart will become strong. My blood pressure will go down.
6) My breath will be fresh.
7) I'll have extra money to spend.
8) I'll live longer.
9) The air around me will be clean.
10) I'll be able to tell people that I've become a non-smoker.
Individuals who procrastinate frequently confuse motivation and action. You foolishly wait until you feel in the mood to do something. Since you don't feel like doing it, you automatically put it off.
Your error is your belief that motivation comes first, and then leads to activation and success.
Individuals who procrastinate frequently confuse motivation and action. You foolishly wait until you feel in the mood to do something. Since you don't feel like doing it, you automatically put it off.
Your error is your belief that motivation comes first, and then leads to activation and success. But it is usually the other way around ; action must come first, and the motivation comes later on. For example, don't wait until you feel like getting out of bed. Take action! Get up and then you will be motivated to start your day.
Learn to identify the negative thoughts you have when you are being criticized.
Why should you be disturbed if someone else makes the mistake of criticizing you in an unjust manner? That's the other guys error, not yours. Why upset yourself?
Rather than feeling hurt, just make a joke out of it! My hair looks shit? Your mum cut it.
If the criticism is accurate there is still no reason for you to feel overwhelmed. You're not expected to be perfect.
When someone is criticizing you or attacking you :
Step One - Empathy. Ask the person a series of specific questions designed to find out exactly what he or she means. Repeat back to them what you think they are trying to say.
Step Two - Disarming the Critic. Initially find some way to agree with him or her. Find some grain of truth in the statement and agree with that, or you can acknowledge that the critic's upset is understandable because it is based on how he or she sees the situation.
You will notice you have a profound, almost irresistible tendency to defend yourself when you are (unjustly) accused. This is a MAJOR mistake! If you give in to this tendency, you will find that the intensity of your opponent's attack increases!
Step Three - Feedback and Negotiation. You can express your point of view objectively with an acknowledgement you might be wrong. For example, you can say "I understand your point entirely, and there is some truth to it. Nevertheless I have decided to stick with the situation at this time."
In many cases you will be just plain wrong, and the critic will be right. In such a situation your critic's respect for you will probably increase by an orbital jump if you assertively agree with the criticism, thank the person for providing you with the information, and apologize for any hurt you might have causes. It sounds like old-fashioned common sense (and it is), but it can be amazingly effective.
Anger : Just who is making you angry?
The bitter truth is that you're the one who's creating every last ounce of the outrage you experience.
The greatest offender when you are angry is labeling. You describe someone as "a piece of shit" for example. But when you write people off this way, you catalogue in your mind's eye every single thing about them you don't like and ignore or discount their good points. This is how you set up a false target for your anger. In reality, every human being is a complex mix of positive, negative and neutral attributes.
Instead of imagining wringing the neck of the person you are furious with, imagine that he or she is walking around in a nappy in a crowded place.
If a shop assistant or an estate agent screws up, don't create unnecessary frustration for yourself. When you insist on perfection from other, you will simply make yourself miserable and become immobilized.
Justice or absolute fairness does not exist. 'Fairness' is relative to the observer, and what is fair to one person can appear quite unfair to another. If you are convinced someone is acting 'unfairly', you must realise he is only acting unfairly relative to your value system.
What is Empathy?
Empathy is the ability to comprehend with accuracy the precise thoughts and motivations of other people in such a way that they would say, "Yes, that is exactly where I'm coming from!"
I can make my wife happy some of the time, but not all of the time. Her happiness is up to her. We are not perfect. What I do will not always be appreciated.
Learn to stick to your guns:
If you feel obligated to please everyone, your family and friends will be able to coerce you effectively into doing many things that may not be in your best self-interest.
IMPORTANT : You have to risk the possibility that your wife will temporarily withdraw and thwart you by refusing to talk to you or to consider your point of view. When she does this, you have to let her storm off but you could her know that there were somethings you want to talk over with her later on when she was more in the mood to communicate.
If you choose to apply this technique, you will have to stick to your guns because the other person may to try to bluff you into believing that you're mortally wounding them by not giving in to their requests. Remember that the hurt you inflict in the long run by not following your best self-interest is usually far greater.
Antiwhiner Technique:
This works when someone (usually a loved one) makes you feel frustrated, guilty and helpless through whining, complaining and nagging.
The thing to do is to keep agreeing with her. Then they will soon realise it's no fun to complain. When you agree with them and find something positive in the complaint, they feel endorsed, and they then usually relax and quiet down.
Why I am not Worthless:
(1) As long as I have something to contribute to the wellbeing of myself and other, I am not worthless.
(2) As long as what I do can have a positive effect. I am not worthless.
(3) As long as my being alive makes a difference to even one person, I am not worthless (and this one person can be me if necessary).
(4) If giving love, understanding, companionship, encouragement, sociability, counsel, solace means anything, I am not worthless.
(5) If I can respect my opinions, my intelligence, I am not worthless. If others also respect me, I am not worthless.
(6) If I can have self-respect and dignity, I am not worthless.
(7) If I do my best to help my customers and vendors through my productivity and creativity, I am not worthless.
(8) If my presence in this milieu does make a difference to others, I am not worthless.
(9) I am not worthless. I am eminently worthwhile!
Acquiring Self-Confidence and Self-Esteem:
Self-confidence is based on the knowledge that you have a good chance of being reasonably successful in personal relationships and in your career.
Silent Assumptions : A silent assumption is an equation with which you define your personal worth. Example: (1) "If someone criticizes me, I feel miserable because this automatically means there is something wrong with me."
(2) "To be a truly fulfilled human being, I must be loved. If I am alone, I am bound to be lonely and miserable."
(3) "My worth as a human being is proportional to what I've achieved."
(4) "If I don't perform (or feel or act) perfectly, I have failed." These illogical assumptions can be utterly self-defeating.
You unearth the origin of your problems by repeating the following questions over and over : "If that negative thought were true, what would it mean to me? Why would it upset me?"
We are all imperfect, and others have the right to tell us about it sometimes.
Disapproval and criticism are uncomfortable, but that feeling will pass. Get over it.
But if someone rejects you for your imperfections, that their idiocy, not yours!
Ultimately you, and only you, can make yourself consistently happy. Nobody else.
If you love yourself, people will respond to your joy and want to be close to you.
The Love Addiction:
LOVE IS A WANT. LOVE IS NOT AN ADULT HUMAN NEED! It's okay to want a loving relationship with someone you love. But you do not need that external approval, love, or attention in order to survive or to experience maximal levels of happiness.
The proof of this is the millions of men and women who are married and miserable.
Silent Assumptions (cont.):
Another silent assumption that leads to anxiety and depression is "My worth as a human being is proportional to what I have achieved in my life."
Perhaps you know someone who is not a particularly great achiever. Would you say that person is still worthwhile? Of course, the answer is yes.
Self-esteem can be defined as the state that exists when you are not haranguing and abusing yourself but choose to fight back against those automatic thoughts with meaningful rational responses.
Remember that the majority of life's satisfactions do not require great achievement at all. It takes no special talent to enjoy an average walk through the woods on an autumn day. You don't have to be 'outstanding' to relist the loving hug of your child.
Nihilism is the belief that there is no truth or meaning to anything, and that all of life involves suffering and agony.
If you do something nice for someone or help them, you could feel that they should be grateful in some way. But things don't always work out that way. No one has a moral or legal obligation to credit you for your cleverness or praise your good efforts on their behalf.
Is depression caused by a chemical imbalance in the brain?
The physical symptoms of severe depression support the notion that organic changes are involved. These symptoms include agitation (increased nervous energy) or enormous fatigue (you can't get off the couch). You may also experience a 'diurnal' variation in your mood. This refers to a worsening of the symptoms of depression in the morning and an improvement towards the end of the day.
Could depression be inherited?
Even such personality traits as a tendency toward shyness or sociability appear to be partly inherited.
ANTIDEPRESSANTS:
There is a myth that antidepressant drugs are extremely dangerous. Wrong. There is nothing to fear if you have a good doctor. Adverse reactions are rare. And what's the alternative? The antidepressants are safer than the depression itself. After all, depression if left untreated can kill you!
Combining medication with a good form of psychotherapy will give you more weapons in your arsenal and speed recovery. Drugs alone will not cure you.
You should usually try to come off your antidepressants if the treatment has left you feeling very good. But many people experiences relapses in depression. Doctors are becoming more aware of this and the use of antidepressants is gaining greater favour.
It's possible that they could even be taken indefinitely.
Do SSRI's give you sexual problems?
As many as 40% of men develop sexual problems, including a loss of interest in having sex as well as difficulties having an orgasm. Delayed time to orgasm is also common.
Your doctor could add several drugs to your SSRI (bupropion - Wellbutrin, buspirone - BuSpar, yohimbine, or amantadine) to try and combat these sexual side effects. Be careful about interactions.
The bottom line is that the level of any drug you are taking might become too high or too low if you are also taking another drug at the same time.
If you are taking an SSRI and are over 65, you will need a lower dose.
Trazodone (Deprax) is an antidepressant (a serotonin antagonist) which has calming, sedative properties. It can be given in doses of 50mg or 100mg at bedtime to patients who are already taking SSRI's.
This has three potential benefits :
(1) The calming effects of trazodone will reduce the nervousness caused by SSRI's.
(2) The trazodone can be given at bedtime to improve sleep.
(3) The trazodone may sometimes boost the antidepressant effects of the SSRI and increase the likelihood of recovery.
Basically it works great with Zoloft. It's hard to come off the Sertraline, so you should come off half of the Deprax first, then half of the Zoloft, then a quarter of the Deprax and a quarter of the Zoloft and finally the last quarter of Deprax and then the Zoloft.
So, a major side effect (potential benefit) of Trazodone is that it makes you sleepy. That is why it is best taken at night. If you are taking an SSRI, your doctor may also prescribe a small amount (50mg or 100mg) of trazodone at bedtime in order to promote sleep.
Some SSRI's and other antidepressants tend to be stimulating and can interfere with sleep.
Trazodone is NOT addictive and it will not cause dependency or addiction the way some sleeping pills do. The calming, sedative effects of trazodone also help to reduce anxiety. If you tend to be worried and high-strung, this may be a good drug for you.
An adverse side effect of trazodone is called 'priapism' which is an involuntary erection of the penis. If your penis stays hard for too long, you might need to go to hospital as it is a potentially dangerous condition and could cause impotence.
Bupropion (Wellbutrin)
It is an antidepressant that has a number of useful side effects. It may help with smoking cessation, social phobia and attention deficit disorder. This indicates that the drug has widespread effects throughout the brain.
A new use for bupropion is to enhance the effects of SSRI antidepressants. Your doctor may add a low does of bupropion in an attempt to enhance an SSRI which is not quite working adequately enough.
Bupropion (in doses up to 300mg a day) has been added to SSRI antidepressants in an attempt to combat the sexual side effects of SSRI's such as loss of libido and difficulties having orgasms or delayed orgasms.
BENZOS:
I usually do not recommend Benzos because they can be quite addictive, and the sedation that they produce might make your depression worse. In my opinion, anxiety can almost always be treated without these drugs.
Benzos can have wonderfully calming effects almost immediately after you take them, the main problem is that these relaxing effects do not last. As soon as the drug leaves your body a few hours later, there is a high likelihood you will feel nervous again.
If you take these drugs daily for a few weeks, you may experience withdrawal effects when you try to go off them. The most common withdrawal symptoms are nervousness, headaches and trouble sleeping. The exact reasons you are taking them in the first place!
Drug dependency can develop.
Here is the main reason to stop taking Benzos : Anxious individuals must face their fears and surrender to their fears in order to overcome them. Anxious individuals who face their fears often feel tremendous relief because they discover their fears were not realistic in the first place. This realization may not occur if you are simply taking tranquilizers and not facing your fears.
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