Note: As a special introductory offer, this course is priced at $10 for a limited time. This price will increase in increments to reflect the actual development costs of the program. Once you have purchased the program, however, it is yours. No price changes apply or alter your access to the course.
Depression is one of the most difficult experiences in life, yet it is one of the most common of psychological complaints. Regardless of what causes it for a particular person (and there are usually multiple risk factors involved), depression will affect all aspects of a person's experience: their emotional state, their behavior, their thoughts, and their physical functioning. Unfortunately, changes in each of these areas tend to magnify changes in the others, creating a spiral of symptoms.
Cognitive behavior therapy (CBT) works to disrupt these spirals by focusing on elements within the person's control - in particular, the behavior and thoughts (not too surprisingly, given the name!). This course presents an understanding of depression, then advocates an emphasis on action to start the cycle moving in the upward direction.
Most people, during depression, want to feel better. Once that happens, they reason, their motivation will return and then they can begin reclaiming their lives. Unfortunately, this leaves them in an existence in which the depressed state is maintained. In CBT we reverse the plan: Take action, then get motivated, then feel better.
Nice idea - but how do you take action without motivation? Answer: Using a structured system of behavioral activation - essentially, gradual goal setting targeting the areas of life likely to produce the greatest payoffs in mood. Once the mood lifts, even by a tiny amount, their is a slight clearing in "brain fog," enabling a bit more action, which can improve the mood just a bit more, challenging the negative thoughts that depression brings, and raising the energy enough to do a tiny bit more. We create a feed-forward cycle that mimics the downward collapse into depression.
Great, but how do you know where to start? We review the areas that have received the most research support, and provide concrete guidelines about how to make the most of them. You will be asked to examine your life in a series of exercises designed to identify your own targets for initial work.
The ideas given in this program are taken from the research literature, as well as from the author's books Your Depression Map and How to be Miserable, as well as the Changeways Core Program, which is a CBT-based depression group therapy protocol in use around the world (and translated into six languages).
It is important to understand that depression can be a severe problem requiring care by a healthcare professional who can assess you directly. This program is not a substitute for such care. If you suspect that you have clinical depression, please see your doctor and consider enlisting the help of a psychologist or other qualified counsellor.
What if you have done so and it is clear that you are not clinically depressed, but simply in a dull, dissatisfying, or unmotivated place in your life? The techniques in this course are also recommended and helpful for many people in this situation. In fact, without the severe loss of energy that depression brings, you may be able to make use of the strategies in a more accelerated fashion.
Remember, though: Watching videos doesn't help anyone very much. Most of the course recommendations involve getting away from the computer and getting involved in outside life. You'll get a 100-page guidebook to help you in your efforts.
Depression is one of life's most difficult experiences. Those who treat it are sometimes referred to as "hell's tour guides." But there are effective treatments and self-care strategies for depression. In this course we review the strategies that have some of the strongest research support. Note, however: This course is not a substitute for care by a healthcare professional.
Every section of this course includes a workbook component that includes notes on all of the lectures in the section, and exercises to guide your practice. Print this out to follow along with the course. In subsequent sessions, the workbook material appears as the first lecture.
The course is designed for people with a variety of mood-related concerns. The concern most often seen in clinics is Major Depressive Disorder, or MDD. We briefly describe the symptoms of this disorder and its division into mild, moderate, and severe subtypes - all of which are actually quite severe. People with milder forms of mood difficulty can also benefit from the strategies described in the course. People with bipolar disorder, however, are especially urged to consult with a caregiver, as the course may be less helpful for them.
Here we take a closer look at the fine print. This course is not a substitute for professional in-person assessment and treatment - it's more of a talking self-help book. We strongly recommend you discuss any mood difficulties you may have with your physician or other health provider. If you are suffering from a mood disorder that is particularly intense, you may find the strategies recommended in the course difficult to put into practice. Finally, watching videos does not alleviate depression. Only by putting the strategies into practice can a benefit be obtained. To this end we include an extensive workbook you can print out and use as you go through the course.
You can't manage what you can't measure. In this lecture we introduce you to a weekly mood monitoring form that you can use to track your experience. We also suggest you take the form to your care provider so they can see how you're doing.
The manual includes the Mood Monitoring Form, which encourages you to record your mood on a weekly basis so that you can see whether you are making progress. Here we provide you with a free-standing copy. Make as many as you like.
This lecture reviews the sequence of topics for the course. We'll start out with the Floating Diamond model, then focus a great deal on behavioral activation, then look at a variety of lifestyle-based strategies, ranging from exercise to diet to enjoyable activity to social life to meaning.
Follow along with the exercises in this section. Ask yourself the Kidnapping Question and get started with One Small Goal (or maybe Two).
What would happen if we took a dozen people off the street and gave them your life for a month? Your sleep pattern, your activity level, your job, your social life, your boss - everything. In this lecture we consider a thought experiment that shows why a behavioral self-management strategy can be so powerful.
Here we review some content from my course "What Is Depression?" The Floating Diamond model teases apart the mass of depression symptoms into four groups: Behavior, Thought, Emotion, and Physiology. We then show how each node influences the other, and how a depressing hit at one node can reverberate through the system to create a depressive spiral.
The spiralling quality of depression sounds - well, depressing. But it's actually a positive, because spirals operate in both directions. Here we give the rationale for giving up on sudden one-step improvement and refocussing on something that actually works: Making small changes that begin to reverse the direction of the spiral.
Enough with the theory already. Let's get moving. In this lecture we introduce the mental desktop idea, and the practice of putting demands and distractions down on paper. You'll come up with your own short list of items to get to work on.
Many people with depression feel overwhelmed by their lives. Partly this may be the nature of the lives they have been leading - but partly it's because as they become depressed they fall behind and the list of chores and demands begins to pile up. This form, which also appears in the manual, gives you a place to write down the tasks that flit through your mind, distracting you but never getting done. The list will prove practical as we begin to make change.
Not sure how to improve your mood? Turn the question on its head and the answers often become clear. Print this material out and take some time to work on it as you go through the videos for this section. Although the exercise may sound odd, it is surprisingly powerful.
Most people spend much of their lives trying to figure out how to feel better. But sometimes it's useful to look in the opposite direction. What if you wanted to feel WORSE - what would you do? It's tempting to skip this little exercise, but don't. It can illuminate some of the causal factors that keep the depression going. The exercise forms the basis of my new book, How to be Miserable.
If you don't want to feel worse, why are we brainstorming about it? Sometimes getting past depression doesn't mean starting to do all-new things - it means stopping what we're ALREADY doing. Most people discover that some of the things they would do if they wanted to feel worse are things they are tempted to do when they feel depressed. And it's useful to realize that our mood isn't as completely out of our own control as we sometimes think: We could make it even worse if we wanted to.
When we consider what we might do if we wanted to feel worse, we often realize we're already doing many of those things. Why do we do this? Do we LIKE depression? Actually, no. There's a clear reason why we find ourselves behaving in a way that perpetuates a downward spiral - and it's and important key to feeling better.
When we're well, we often feel magnetically attracted to things that will propel us forward, and we avoid things that make it worse. During depression it can be as though the magnet has reversed its polarity. And we have a hidden plan for how to get better - a plan that sabotages our progress. In this lecture we suggest a replacement plan that takes away a roadblock to progress.
In this section we envision what a nondepressed life would look like and discuss the dance between setting goals and letting them go. Those sound like opposite ideas - but, strangely enough, they're not.
In this lecture we ask a troubling question: What do you want? The challenge here is that during depression we often don't know; we just want to feel better. But imagine you were feeling well, and didn't have to spend all your time struggling with your emotions and watching "UnDoing Depression" videos. What would you be doing instead? What is your best life?
Here's an exercise that your depressed mood will be more than happy to work on. In fact, it probably already does this several times a day! We invite you to list all of the problems and challenges you face. As unpleasant as that sounds, the exercise can be a bit magic: showing us that our problems are big and numerous - but not quite as infinite as we are tempted to believe.
Problems feel like roadblocks preventing our progress, but really they are Ultimate Goals showing the way forward. Turn over a problem and you find a path. In this lecture we invite you to look at some of the items on your Problem List and convert them into goals. This, it turns out, is one of the easiest things in goal setting. We also invite you to identify goals that would be nice to reach someday (like visit Argentina), but aren't really essential to your recovery - and others that seem more central to the task at hand.
Okay, we've been talking a great deal about Ultimate Goals - implying that some goals aren't Ultimate. Right! Some are Immediate Goals: Things that take only one step and can be accomplished this week. Most of our Immediate Goals are in service to one or more Ultimate Goals. If the Ultimate Goal is the destination, the Immediate Goals are the steps to get there.
For most of our life we hold certain expectations of ourselves: how clean our home should be, how hard we should work, what we should accomplish with our time. During depression we often try to keep ourselves going with this vision of ourselves. But this vision may be part of the problem, because during depression we don't have the energy to live up to it. We fail, and fail, and fail, and this erodes our confidence and motivation even further. So part of goal setting is allowing ourselves NOT to be that person for now - in effect, to GIVE UP on becoming them this week, and refocus on something that we can actually succeed at doing.
Having developed at least a preliminary set of Ultimate Goals, it's time now to focus on a few of them and boil them down to some Immediate Goals: Things you can do THIS WEEK. Then let's make those goals obey the SMART rules.
Think of something that's been on your mental or actual "To Do" list for months but hasn't gotten done. That's a cliff face: A blockage created by holding a vision of a goal that is simply beyond your reach. In this exercise we invite you to identify your usual expectation for yourself and break it down into a series of manageable steps that may actually happen.
Good Immediate Goals obey five core rules, summarized by the acronym SMART. In this lecture we discuss the SPECIFIC rule, and why it is particularly important during depression. The keyword here is HOW: Do you have all the resources and information you need in order to complete the goal. If not, the Immediate Goal pivots to the blockade to move you forward.
We'd love to control other people, but regrettably we only have control over ourselves. So a good Immediate Goal must also be MY OWN, meaning that it does not depend on the cooperation or participation of another person. As well, the goal should be something you genuinely want to do or get done - not something someone else wants you to do.
We have better control over our feet than our head. So a good Immediate goal must be ACTION ORIENTED. It must involve doing something, not thinking or feeling a certain way. If we do it and feel awful, that's fine: In fact, because it felt so awful it was an even bigger accomplishment than if we enjoyed it.
In order to win a race you have to cross the finish line. This means there has to BE a finish line. The REALISTIC rule states that you have to set a very clear finish line for your goal, and it has to be well within reach of your depressed self - not something that "should" be in reach or that your nondepressed self could accomplish. There should be no ambiguity that would allow the depression to argue that a success is really a failure.
A goal without a timeframe is just a dream. A good Immediate Goal involves a timeframe for completion. Sometimes this is "within the next 7 days," sometimes it's "On Thursday at 8 pm." In this lecture you'll go back over all five rules and ensure your Immediate Goal is clear and unambiguous.
The rubber has now hit the road. Every week, write down a set of SMART Immediate Goals for yourself, and check them off when you have done them. This will help you get things done and, more importantly, overcome the sense of inertia that depression almost always brings. You can always stop doing this when you are out of the depression, but I recommend keeping it up. I do this every Monday. So print a bunch of these.
Now that you're well on your way with goal setting, time to sharpen up your technique a bit. In this section we'll address the thorny issues of whether you have to stop once you've achieved your Immediate Goal, how to respond to success experiences, and how to cope with failures.
Time for some additional suggestions for good goals, including not waiting for motivation, breaking repetitions into separate goals, what to do when the finish line isn't obvious, the trap of wanting it to "feel right," and the benefits of feeling overwhelmed.
What do you do when you reach the finish line of an Immediate Goal? Can you keep going? Yes, for most goals. But when the goal involves overcoming chronic pain or approaching something you fear, the finish line is also the stop line. Here's why - and how.
Obviously if you reach your goal you can just relax, right? Well, depression can still dismantle any feeling of achievement you may have. Here we have some strategies to maximize the mood-boosting impact of success.
What happens if you set a goal and don't accomplish it? You really have two choices: Beat yourself up for being so lazy, or recognize the REAL problem. After all, if you're going to feel bad anyway, you might as well feel bad about the right thing. In this lecture you find out what it is.
It's hard to get organized when you're depressed, and often our lives have less structure than usual. Unstructured time if often great for a while, but it's usually not a great idea during depression. Here we introduce the Three Periods form and the idea of scheduling one appointment or goal per period to form the framework for the rest of your life to build on.
The Three Periods Schedule appears in your guidebook, but you may want to use and re-use it. Print several of these, and use them in your quest to build the non-depressed life.
Exercise is one of the most potent anti-depressant strategies we've got - and the research bears this out. Here's the workbook for this section on a critically important element of most people's recovery plan.
So what's the evidence for a link between exercise and mood? Twenty years ago it was pretty sketchy. Now it's excellent. In this lecture we discuss the correlation between the two, and how fitness at Time One can predict mood at Time Two. We'll also look at the Blumenthal studies on depressed volunteers, in which exercise was compared to antidepressant medication. We'll ask the obvious (and so far almost unanswerable) question: How does the effect work? Hint: Endorphins are not the answer. And we'll consider the types of impact on mood.
Okay, so despite your best efforts you have woken up in the middle of the night. Your mind, naturally, has decided to play an anxiety-producing mental movie for you, and to remind you how CRUCIAL it is that you get back to sleep. Both of these are great techniques for staying awake, but what if you just want to get back to sleep? Here are the principles and some concrete strategies. The print section for this lecture also includes some bonus material on hypersomnia and shift work.
Depression is perverse: It takes away your desire for almost everything - except the desire for sugary or salty snacks. And you guessed: Those are among the few desires that you should avoid during depression. In this lecture we talk about sugar and depression, and some simple strategies to limit your sugar intake. In the print materials for this section we add a bonus supplement and worksheet on caffeine.
Randy Paterson is a psychologist and author in Vancouver Canada. His most recent book is the popular How to be Miserable: 40 Strategies You Already Use. He is the Director of Changeways Clinic and writes a blog called PsychologySalon. His work emphasizes the treatment of problems related to stress, anxiety, depression, and significant life change. His previous books include The Assertiveness Workbook, Private Practice Made Simple, and Your Depression Map, as well as a variety of resources and protocols for mental health practitioners. He conducts workshops on mental health issues for the public and for mental health professionals within Canada and internationally.