UnDoing Depression

Take Action and Feel Better using Cognitive Behavioral Principles Designed to Reclaim Your Life
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  • Lectures 71
  • Contents Video: 4.5 hours
    Other: 2 hours
  • Skill Level All Levels
  • Languages English
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About This Course

Published 11/2015 English

Course Description

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.

What are the requirements?

  • If you suspect that you may have depression, and have not yet done so, please consult your physician. This course is not psychotherapy, and cannot be considered a substitute for professional care.

What am I going to get from this course?

  • Understand the relationship between behavior, thought, and emotion.
  • Identify Ultimate Goals associated with their own nondepressed state.
  • Create and carry out Immediate Goals which serve their Ultimate Goals.
  • Use a series of nonpharmacological strategies to enhance their sleep cycle.
  • Appreciate the relationship between exercise and nondepressed mood.
  • Enhance their diet to improve energy and mood.
  • Prioritize social contact and build their social network.
  • Elevate the importance of enjoyable activity in their hierarchy of activities.
  • Identify potential avenues for personal meaning by examining their own past.
  • Reduce the risk of relapse using structured planning strategies.

What is the target audience?

  • This course is suited to individuals with depressed mood wishing to take concrete action to reclaim their lives and feel better. This may include people with clinical depression, but also those with less intense mood disturbances, including a sense of inertia, boredom, or dissatisfaction with their lives.
  • Those with possible clinical depression should take this course only after consulting with a qualified healthcare professional. Some depressions may be symptomatic of other ailments best treated medically. As well, depression can be a serious problem that requires personalized attention that a course such as this cannot provide.
  • This program is not intended for those individuals diagnosed with Bipolar Disorder, Schizophrenia, or those experiencing psychotic symptoms.
  • Individuals with unusually severe clinical depression may find that even with assistance from a physician or counsellor, they are unable to make use of the strategies in this program until the episode lifts to at least some degree.

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Curriculum

Section 1: Setting Sail
04:47

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.

9 pages

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.

08:59

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.

07:49

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.

03:54

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.

1 page

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.

03:21

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.

Section 2: Understanding the Behavioral Approach to Depression
7 pages

Follow along with the exercises in this section. Ask yourself the Kidnapping Question and get started with One Small Goal (or maybe Two).

05:46

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.

05:27

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.

04:51

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.

02:52

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.

1 page

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.

Section 3: Finding the Path - The Influence of Action on Emotion
4 pages

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.

01:58

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.

02:47

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.

04:06

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.

03:44

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.

Section 4: Ultimate Goals - The Elements of a Better Life
8 pages

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.

05:58

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?

03:27

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.

04:19

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.

03:39

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.

07:59

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.

Section 5: Setting Immediate Goals - The Steps to Your Destinations
7 pages

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.

04:38

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.

03:05

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.

02:16

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.

03:09

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.

05:30

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.

01:38

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.

1 page

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.

Section 6: Fine Tuning Your Goal Setting
10 pages

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.

06:37

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.

03:19

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.

03:46

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.

03:16

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.

06:25

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.

1 page

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.

Section 7: Get Moving! The Influence of Physical Activity on Mood
6 pages

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.

08:25

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.

04:50
Maybe it comes as no surprise that exercise is a good idea during depression. But how can you increase the amount of exercise you get - and get the greatest benefit? Here we provide a set of recommendations to help you set up a program that works for you.
06:08
Motivation is always a challenge during depression. In this lecture we discuss two central principles to help you get started and keep going. One of these is familiar: Don't wait to feel like it. The other involves setting your expectations properly so that you don't lose your interest quickly.
Section 8: Stop Moving! The Importance of Restorative Sleep
8 pages
Depression disrupts almost everyone's sleep in one way or another, but problems with sleep can also bring on symptoms of depression. Getting our sleep on track is central to the task of recovery. Here's the workbook section on sleep for you to use when following the lectures to come.
05:18
Sleep is more than just an on/off switch in the brain. During sleep we go through a variety of sleep stages, some of which are more critical to feeling rested than others. In this lecture we show you the sequence, talk about the distinction between REM and non-REM sleep, and describe the top four mood-related sleep problems.
06:04
How can you get a good night's sleep? In this lecture we review basic strategies to help you bring your sleep cycle into an effective 24-hour rhythm. Research indicates that behavioral management strategies are as or more effective than sleeping medication - and with only positive side effects.
04:23
Just as Pavlov's dogs salivated when they heard the bell, we want you to associate bedtime with sleep. To this end we talk about before-bed activities, limiting the functions of the bedroom, and other tips involving the creation of a good sleep environment.
04:58

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.

Section 9: Premium Fuel - Dietary Recommendations for Depression
9 pages
Mood affects diet; diet affects mood. And even if you don't feel hungry, your body still needs fuel. Here is the workbook section for the upcoming lectures on diet.
04:57
So what is an antidepressant diet, and how do you get yourself to follow it? In this section we provide strategies to improve your eating without having to revolutionize your behavior. The good news is that your diet doesn't have to be perfect, and that simply following a basic food guide will generally help immensely.
05:03

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.

03:56
What about supplements? We constantly read in the news and (especially) in advertising about the latest magic depression cure. Most of the research on depression from the nutritional literature isn't great, frankly, but there are a few promising avenues. No magic bullets here, but we do review some recommendations on the four most promising areas.
Section 10: Having Fun is Serious Business - Cultivating Enjoyment During Depression
4 pages
Anhedonia - the inability to enjoy things you used to like - is a standard symptom of depression. Naturally, it results in people doing less of what used to make their lives sustainable. Here we provide the Workbook material for the lectures on enjoyment to come.
03:19
In this lecture we talk about a central snowball effect. Depression reduces our ability to enjoy the things we used to like, so we become less inclined to do them, so life becomes a little more dull, and we become even more depressed. Recognizing this cycle is crucial to interrupting it!
08:34
So if we're stuck in the anhedonia trap, how do we get out of it? Answer: By not waiting for the anhedonia to lift. We need to do a survey of the activities that have lifted us in the past and do them without desire or the expectation of enjoyment - at least at first. We will feel foolish doing this the first time, and the second, and often the third - but eventually the anhedonia will begin to lift. Here's how.
Section 11: Find the Tribe - Social Life Enhancement Drives Mood Enhancement
13 pages
No human is an island, but depressed people often lose their appetite for social interaction. We need to reconnect with our lives and with the people around us - even though we don't really want to. Here is the Workbook content for the lectures to follow.
03:00
Depression reduces our desire for social contact - and challenging social interactions are often among the causes of our depression in the first place. Let's examine how the negative snowball happens, and why making the push against it a priority is so important.
05:55

Time to look at your own life. We introduce the bulls-eye diagram of your social network, then invite you to complete your own Social Census. Who are your Close Friends, your Other Friends, your Acquaintances? Then we make some observations about your results.

06:26
People drift out of our lives, and the drift often happens a little faster during depression. Here are the reasons why, and how to work against each of them.
09:52

Want to build up your network? There are two main pitfalls waiting for you, and here we'll review them both. First: The people you really want aren't the people you need to look for. Second: So long as you're focussed on the goal of meeting people, you will fail. Here's why, and the simple strategies for working around these barriers. Following this material, the workbook includes a BONUS section on building up your social life.

Section 12: The Meaning of Life - Creating the Life Worth Living
6 pages

In this section we consider the question of the main purposes that we want our lives to be about. What is the good life? What are the important questions to ask? How can we use our past as a guide to meaningful action in the future? Here you will find the Workbook content for the lectures to follow.

03:04

Overcoming depression is all about getting your life back. But what then? What do you want to use it for? In this lecture we consider the role of meaning in a person's life, and the relationship between meaning and depression. The sense of pointlessness may just be a symptom - like the loss of appetite or low energy. But it may also be one of the original causes of the depression - in which case, addressing it will be an important part of recovery.

04:53

Time once again to get practical. In The Meaning Inventory you are invited to explore the future of meaning by examining your own past. What has proved meaningful for you at some point in your life - even if only for a moment?

05:30

The quest for meaning, like most aspects of depression recovery, can be stirred into your goal setting. In this lecture we discuss strategy - and the all-important element of emotional acceptance as you try new things out.

Section 13: Wrapping it To Go - An End and a Beginning
12 pages

We are almost at the end of our course. But first, we need to consider what happens when the depression lifts. What should you do then? And how can you increase the likelihood of remaining depression-free?

06:40

When people recover from a painful depression, the temptation is simply to move on and forget that it ever happened. There are good reasons not to do this! The skills in this course aren't just anti-depressant strategies, they are techniques for creating a better life no matter what your mood is like. And they can be easier to use (or KEEP using) when you aren't depressed.

06:22

Let's face it: Stress is coming for all of us. Some of the things that stress us out are unpredictable and hard to plan for. Others are VERY predictable. Rather than relying on hope, we can make a plan for them to go well. In this lecture I invite you to consider the stressful events coming your way and brainstorm how to handle them.

04:34

Most people experiencing depression just want to be their old self again. But most also recognize that the "old self" may have inadvertently contributed to the problem - perhaps by not pursuing their goals, perhaps by isolating, perhaps by being inactive. They want to be MOSTLY their old self, but perhaps with a revision or two. What would be a sign that you were sliding into a depression-inducing pattern? What's the plan - if and when you notice that happening?

04:42

We want to prevent future episodes - oh, but what if it comes back? The thought of a recurrence is one of the biggest stressors that people who have been depressed report. We want a clear plan to intervene sooner and make changes quicker so that you don't need to go through an episode of the same intensity or duration. If it happens, you can put the plan into action. And maybe having a plan will reduce the worry enough that a plan isn't necessary.

08:45

Want more? In this lecture we consider some of the other resources out there for working on depression and low mood. I'll give you a link to the Antidepressant Skills Workbook, a free online resource on which I am coauthor. I'll discuss some of the best books on depression and recovery. I'll point you to a series of other online depression resources. And I'll shamelessly promote my new book, How to be Miserable: Forty Strategies You Already Use.

05:49

This lecture provides a final summary and sendoff, with an exhortation to keep up your efforts and build on the successes you have had. Thank you for coming on this journey.

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Instructor Biography

Randy Paterson, Psychologist and author (Your Depression Map & others)

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.

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