Using A Depression Chart
Developed in the 1970s by the American psychologist Marsha Linehan, dialectical behavior therapy (DBT) builds on several concepts associated with cognitive behavioral therapy (CBT), one of the most common types of talk therapy today. However, DBT was designed for individuals who experience emotions especially intensely and is often used to treat those living with a personality disorder––specifically borderline personality disorder (BPD). In some cases, this treatment may also help address symptoms of depression, as its emphasis on skills training and managing painful emotions may help reduce the prolonged low moods of depressive disorders. If you are looking at therapeutic modalities for depression, it may be beneficial to look into DBT.
What are depression and major depressive disorders (MDD)?
Depression is a general term that refers to all depressive disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) but it is often used to refer specifically to major depressive disorder (MDD), the most common type. This mental health condition is characterized by a sense of persistent sadness or hopelessness lasting over two weeks, along with other symptoms.
Depression is more complex than “feeling down.” Instead, it's marked by various, persistent physical and emotional symptoms that can significantly impact a person’s ability to function. Below are some of the common physical and behavioral symptoms of this condition:
- Exhaustion and general lethargy, including slower speech and movements
- Isolation from others and increased time spent alone
- Substance misuse
- Dramatic changes in one’s sleep schedule, including insomnia or hypersomnia
- Significant shifts in eating habits
- Agitation and restlessness
- Worsened personal hygiene
- Pain or achiness with no clear physical or medical cause
- Withdrawal from work, school, or other responsibilities
- Difficulty concentrating, remembering events, or making decisions
- Self-harm or self-destructive behaviors
Emotional symptoms of depression according to a depression chart
The following are common emotional symptoms of depression that individuals may experience,
often reflected in patterns observed in a depression chart.
- Persistent feelings of sadness
- Hopelessness
- Apathy or a feeling of being “empty”
- Irritability, including outbursts of disproportionate anger
- Decreased self-esteem, including a heightened sense of self-blame
- Sensitivity to criticism
- A loss of interest in previously enjoyed activities
- Deteriorating relationships with friends, family members, or partners
- Feeling guilty or worthless
- A bleak outlook toward the future
- Frequent thoughts of death or suicide
What is dialectical behavior therapy?
Dialectical behavior therapy (DBT) has some of the goals and treatment methods included in cognitive behavioral therapy but focuses more on developing new coping skills for intense emotions. DBT can involve training in four key modules that can significantly impact overall well-being: mindfulness, emotional regulation, interpersonal effectiveness, and distress tolerance.
Mindfulness
The mindfulness module of dialectical behavior therapy (DBT) discusses mindfulness, the practice of grounding yourself in the present moment, not dwelling on the future or the past, and recognizing what is currently occurring within your body and in your environment. Mindfulness skills can be developed through techniques like breathing exercises, meditation, and journaling. Mindfulness is not about changing one’s reality but understanding it for what it is without judgment.
Emotional regulation
Developing a mindfulness mindset can enhance one’s ability to learn the second dialectical behavior therapy (DBT) skill: emotion regulation. Emotion regulation involves recognizing and understanding your emotions, including sources of intense or distressing feelings.
Some emotions are primary emotions, which result from your initial reaction to a thought or situation, and some are secondary emotions, which are a reaction to your initial reaction. A common example of this relationship between primary and secondary emotions is feeling angry, followed by a sense of guilt for feeling angry.
Practicing emotion regulation can mean acknowledging that your emotions exist and are valid while understanding they don’t necessarily need to control your thoughts or impact your behaviors. Emotional regulation skills through DBT teach that you can have agency over yourself, regardless of your emotional experiences. The act of understanding two opposing realities at once (dialectics) is what makes dialectical behavior therapy unique compared to other modalities.
Interpersonal effectiveness
Interpersonal effectiveness continues to build on the dialectical behavior therapy (DBT) skills of mindfulness and emotion regulation. Interpersonal effectiveness focuses less on knowledge and awareness and more on behaviors in interactions and relationships. Interpersonal effectiveness involves healthy communication skills, including understanding your own needs and the needs of other people and knowing when you need to say no. This kind of assertive communication and boundary-setting can help an individual develop healthy self-respect.
Distress tolerance
The final component of DBT, distress tolerance, involves skills training for coping with distress. When faced with an intense or stressful situation, a natural reaction is a fear response, often resulting in avoidance or minimization. Such techniques may not address the source of distress. Hence, distress tolerance teaches a person how to exist in a stressful situation and recognize aspects of the situation they can change as well as those that may be beyond their control. New skills to learn in this category may include changing your environment and learning to accept situations outside of your control.
What are the potential benefits of DBT for depressed mood?
Depression can involve distressing symptoms, and people with the condition may sometimes be tempted to avoid acknowledging or addressing their emotional state. The four key skills of DBT may be an effective treatment for helping people with depression better understand what is occurring with their feelings and behaviors, cultivate a mindset of acceptance and grace, and learn to shift maladaptive behavior patterns that may be worsening symptoms in order to improve quality of life.
Developing emotion regulation and coping skills through DBT
Emotion regulation skills could expand this recognition by helping individuals develop skills to process unwanted emotions like sadness and hopelessness instead of allowing these emotions to worsen over time. Interpersonal effectiveness may address relationship concerns that could contribute to one’s depression or connections that may have been impacted by depression. Distress tolerance may also be valuable, helping people learn healthy coping skills and behaviors to address unhappiness and other intense emotions. A licensed therapist can be a key support system in developing these DBT skills.
An alternative to in-person therapy for depressed mood and other mental health conditions
Depression can feel overwhelming, and those experiencing the condition may find it difficult to seek treatment. If you are experiencing low energy levels, physical pain, or other depression symptoms that make it hard to leave the house, online therapy sessions may be a more convenient way to receive support. Through an online therapy service like BetterHelp, you can match and meet with a licensed therapist from home or anywhere you have an internet connection.
Effectiveness of online therapy
Individual therapy using DBT can be an effective treatment method when provided in-person or through an online platform. For example, one scoping review of 11 studies examined the effectiveness of online DBT for a range of concerns, including depression. Its findings suggest that outcomes for clients enrolled in online DBT were comparable to those of individuals receiving traditional face-to-face DBT. If symptoms of mental health conditions like depression make it complicated to attend in-person therapy or if you have a busy schedule and prefer to engage in therapy from home, online therapy may be helpful.
Takeaway
If you are experiencing symptoms of depression, borderline personality disorder, or another mental illness, know that you are not alone and that treatment options are available. Dialectical behavior therapy is a type of therapy that can be used to reduce symptoms of mental health conditions like depression, treatment-resistant depression, bipolar disorder, and borderline personality disorder through the practices of mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. Consider contacting a DBT treatment provider online or in your area for further guidance in this modality.
Frequently asked questions about depression chart and related depressive disorders
Read more below for answers to questions commonly asked about depressive disorders and other mental health conditions.
Do coping mechanisms work for depression?
Several coping mechanisms can reduce the impact of depression symptoms. However, basic coping strategies alone may not be enough to resolve depression completely. Depression can also significantly reduce motivation, which may make it harder to apply coping strategies appropriately. It also raises the risk of using unhealthy coping strategies, like substance abuse.
One of the best ways to start managing depression is by reaching out to a qualified mental health professional. Not only can counseling teach you coping mechanisms that are known to be effective, but it can also help address the complex facets of depression that are difficult to manage alone. While it is true that depression can be managed with coping strategies, it is likely much more effective to apply those coping strategies under the guidance of a trained professional.
What are some coping strategies to help people who suffer from depression?
While many coping strategies can help alleviate depression’s adverse effects, those strategies will likely be significantly more effective if applied with the help of a qualified mental health professional. A therapist or other professional can help uncover the root cause of depression and help their client avoid pitfalls associated with depression recovery. They can also use evidence-based clinical techniques to help make the recovery process more manageable.
While recovering from depression is likely best done with the help of a therapist, there are non-clinical coping strategies known to be effective that can be done by most adults independently. One common strategy involves leveraging the beneficial effects of nature; evidence suggests that spending time in natural environments can significantly boost happiness and well-being.
Regular physical activity is also associated with a substantial reduction in depression symptoms. It may be worthwhile to combine exercise and nature by taking a walk down a wooded trail or through a local park. You can further enhance the beneficial effects of nature and exercise by including others in your activity. Positive social contact is associated with reduced depression and increased well-being, and a nature walk with friends might be one of the best coping strategies for depression.
What are the two best coping mechanisms to mitigate depression?
Everyone will find coping mechanisms that work best for them, but there are a few techniques that tend to work well for most people. Two of those techniques, exercise and practicing gratitude, have substantial evidence supporting their effectiveness.
Regular physical activity is associated with a significant reduction in depression symptoms. In some cases, regular exercise can have a greater positive effect than antidepressant medication. The exercise doesn’t need to be intense or strenuous; as little as 90 minutes of moderate physical activity (like a brisk walk) is enough to show benefit.
While exercise is a physical intervention that supports whole-body wellness, practicing gratitude is a cognitive activity that only requires intentional thought. Evidence indicates that taking time to recognize positive things consciously can reduce depression symptoms and improve overall well-being. It may be helpful to start a gratitude journal, a place where a person can write down positive things they are grateful for or happy about. When negativity becomes overwhelming, it is often helpful to be able to look at past positive events to bolster optimism.
What is a good coping mechanism for mental and emotional health?
One of the best ways to support good mental and emotional health is to establish healthy self-care routines. There are many ways to engage in self-care that support overall well-being, but at a bare minimum, self-care comes down to getting enough sleep, eating a healthy diet, and getting adequate physical activity.
Diet, sleep, and exercise form a foundation that helps a person develop more advanced self-care skills. High-level self-care skills include things like learning relaxation strategies like progressive muscle relaxation, practicing gratitude, and engaging in mindfulness to recognize negative or unhealthy thoughts as they occur. There are many ways to approach self-care, and everyone has a strategy that works for them. However, every comprehensive self-care plan should start with the basics: diet, sleep, and exercise.
Why are coping mechanisms important for your mental and physical health?
Coping mechanisms are important because they allow individuals to adjust to new circumstances and manage uncertainties. It is not possible to predict the outcome of every situation in life. Coping mechanisms allow humans to be flexible and recover from adverse outcomes. Another way to think of “coping” might be to think of it as synonymous with “adjustment.” Coping is a change process that takes time to complete, and coping mechanisms facilitate the adjustment process.
What is a good strategy for managing stress and coping with anxiety?
It is often helpful to have the opportunity to learn quick, effective strategies for reducing stress when trying to manage long-term anxiety. One relaxation technique, progressive muscle relaxation (PMR), is widely used and has been shown to be highly effective. PMR relies on tensing and relaxing different muscle groups in succession, which signals the body to begin calming down. As physical sensations of anxiety reduce, the cognitive load also reduces, making anxiety easier to manage.
PMR requires a quiet space and a few minutes to complete the PMR cycles. An even simpler relaxation technique, diaphragmatic breathing, is arguably the most straightforward relaxation technique available. Diaphragmatic breathing, or “belly breathing,” simply requires taking long, deep breaths and focusing on moving air with the diaphragm. It is highly effective at reducing stress, especially feelings that come on suddenly or in environments where a person cannot exit the situation quickly.
What coping mechanisms help reduce stress?
One of the best ways to reduce overall stress is to establish healthy self-care routines. Evidence suggests that stress and feelings of anxiety can increase substantially when self-care is neglected. A lack of self-care also likely lowers resiliency, making it harder to deal with change and handle adverse circumstances. Although there are many approaches to self-care, evidence indicates that three areas are especially important:
- Physical Activity. Regular exercise is strongly correlated with improved overall well-being. Getting at least 90 minutes of moderate-intensity physical activity each week is likely one of the most effective stress-reduction strategies.
- Adequate Sleep. Too little sleep or a constantly shifting sleep routine can make stress much harder to manage. Try to get 7 - 8 hours each night, and try to go to bed at the same time each night if possible.
- Healthy Diet. Eating healthy foods like fruits, veggies, and protein-rich foods is associated with improved mental and physical health. Limiting alcohol consumption and abstaining from other drugs is also advised.
What is the defense mechanism most commonly used in depression?
One of the most commonly used defense mechanisms by depressed people is denial. Denial is a defensive mechanism wherein a person does not acknowledge certain aspects of their circumstances.
Denial and justification in depressed individuals
They may deny that they are depressed, that others do not feel the same way, or that they need help. They may also cherry-pick details to justify their beliefs, and they may struggle to acknowledge that they are struggling with feelings of sadness, hopelessness, or helplessness. For example, parents may struggle to acknowledge the impact their feelings have on their children.
How can emotional stress cause depression?
Stress is linked to both anxiety and depression, but depression seems to be mediated more significantly by inescapable stress. Inescapable stress refers to stressful feelings or external stressors that cannot be changed or avoided. Researchers theorize that memories associated with inescapable stress carry significant emotional weight. The disproportionate negativity of the stress leads to automatic negative appraisals and may be a factor that contributes to the hopelessness and helplessness common among those with depression.
How can you improve coping with changes in a relationship?
In any situation, coping with changes often comes down to finding acceptance. One of the best ways to improve mental health and overall well-being is to focus on accepting things that cannot be changed. It is impossible to control everything in life, and everyone must eventually deal with adverse circumstances beyond their control. Healthy self-care routines, like getting enough exercise, eating a healthy diet, and getting adequate sleep, can significantly improve a person’s ability to cope with change. If coping with change proves to be excessively difficult, seeing a therapist for a course of acceptance and commitment therapy might prove to be a viable solution.
What are the levels of depressive disorders?
What mental disorders are associated with depression?
What coping mechanisms help reduce stress according to a depression chart?
- Previous Article
- Next Article