7 Types of Therapy That Can Help Depression

Finding a therapist
Depressed? Anxious? The good news is that talk therapy can really help, sometimes as much as medication. But if the only thing you know about therapy you learned from watching The Sopranos, finding the right therapist can feel overwhelming.

“There are probably more than 400 types of psychotherapy,” says Jeffrey Magnavita, PhD, a licensed psychologist and affiliate professor of clinical psychology at the University of Hartford.

The good news is that therapies fall into one (or more) “schools,” each with its own theories and techniques. Find out your options and choose the therapy that will work best for you.

Psychoanalysis
This is the mother of all talk therapies. Sigmund Freud developed psychoanalysis, which probes the patient’s psyche and brings unconscious impulses and behavior patterns to the surface, more than a century ago.

The treatment centers on the dynamic between patient and analyst, and it can be rigorous—you may attend several sessions a week for years, if not decades.

The power of psychoanalysis is that it “creates a laboratory,” says Prudence Gourguechon, MD, the president of the American Psychoanalytic Association. “If you have a person who can't make decisions, for example, [the patient] actually starts demonstrating the same behavior right there in front of you.”

Psychodynamic therapy
You might call psychodynamic therapy psychoanalysis lite. Patients rarely lie on The Couch, sessions are less frequent (usually only once a week), and the treatment is briefer (sometimes a year or less).

You may not dig as deep as in psychoanalysis, but treatment still focuses on the unconscious, personal development, and the relationship between therapist and patient.

“The psychodynamic therapies are all modifications of [psychoanalysis],” says Dr. Gourguechon. “They hold to the same basic premises, but the techniques are different and the goals are more limited.”

Cognitive therapy
Negative thought patterns can cause—or contribute—to depression and anxiety, and cognitive therapy aims to turn that thinking around.

During treatment, you'll learn how to recognize harmful or irrational thoughts and replace them with more constructive ones.

Unlike psychoanalysis, cognitive therapy is geared toward solving immediate problems. It is brief (typically 16 weeks or less) and highly structured, with a specific lesson plan for each session. It also involves “homework”: The therapist may ask you to track your moods or practice new ways of thinking, for example.

Behavior therapy
As cognitive therapy targets negative thoughts, behavior therapy can help you overcome problems by changing your behavior.

For example, one common technique to treat anxiety disorders and phobias is "desensitization," in which a patient is gradually exposed to (or asked to imagine) anxiety-inducing situations as a way to become more comfortable with them.

Behavior therapy is often paired with cognitive therapy in cognitive-behavioral therapy (CBT), an umbrella term that refers to many methods that incorporate both techniques.

Interpersonal therapy
Are interpersonal conflicts and a lack of social support causing your depression? If so, interpersonal therapy (IPT) might be right for you.

In IPT—which is brief and focused, like CBT—patients closely examine their relationships with family, friends, coworkers, and other key people, with the goal of resolving interpersonal conflict, improving communication, and building a more solid support network.

As part of the treatment, you may be asked to create an “inventory” of important relationships and role-play with the therapist.

Experiential therapy
In this type of treatment, you'll learn to distinguish healthy emotional responses from those that are misguided or harmful.

But unlike some types of therapy in which the patient-therapist relationship is strictly neutral, experiential therapy is characterized by the supportive, empathetic relationship that the therapist cultivates with the patient.

“If the person who’s being treated feels understood and feels a warmth from the therapist, these factors in and of themselves seem to be a large part of what makes people get better,” says Magnavita.

Online therapy
Don't rule it out. Like just about everything else, you can now get therapy on the Web, in real time. You can use instant messaging (IM) or set up one-to-one video services such as Skype, to interact with your therapist much as you would in person.

This may be particularly helpful if you lack transportation, live in a rural area, or are otherwise unable (or unwilling) to visit a therapist’s office.

What little research has been conducted on Internet-based therapy appears promising. In a 2009 study published in the Lancet, 38% of patients who received up to 10 sessions of CBT via IM recovered from their depression.

Everyone feels a little melancholy when the days get shorter. But for some people, the change in the seasons brings with it something more serious than the blues: seasonal affective disorder (SAD), a form of depression that can be debilitating.

How To Treat Anxiety In 6 Steps Using Mindfulness Meditation

Mindfulness meditation, a holistic mind-body treatment based in Buddhist psychology, is a powerful tool clinically proven to treat anxiety. This technique works by stopping the cycle of negative thoughts and helping you manage your feelings. The process of mindfulness meditation can be boiled down using these six essential steps:

1. Stop yourself from obsessive thinking. Obsessing can make it difficult to let go of negative thoughts. Escaping this mental cycle is the goal of mindfulness meditation.

2. Use an anchor to still the mind. Focusing on a single point can trigger physical relaxation, which will help you through the meditation process.

3. Calm the body using the breath. A simple breathing exercise described below will help you relax and get in touch with your emotions.

4. Focus on the sensations in the body. Every emotion has a sensation signal in the body. Find one sensation signal in the present moment and focus on it.

5. Explore the qualities of the sensation signal you chose.

6. Build up your ability to meditate for longer periods of time. Like any ability, meditation is a skill that takes practice. The longer you are able to meditate, the more benefit you will get from this exercise in mental control and emotional tolerance.

Read on to learn more about the process of mindfulness meditation - by fully understanding and utilizing these six steps, you can be on your way to practicing mindfulness meditation, and achieving all the mental health benefits that accompany it.

Mindfulness meditation has become nearly as recognizable and popular in mainstream Western culture as yoga. From ancient origins in the contemplative science of India and Tibet1, to the research laboratories of Ivy League medical schools, and from the conference rooms of elite corporations like Google2 to the VA hospitals of the US military3, there seems to be no discipline or sphere of life that isn't taking an interest in mindfulness.

The healthcare community agrees that research outcomes support its efficacy - so how can you begin to utilize mindfulness meditation in your own life? You still need clear instructions and competent mentors to guide your experience. What follows are some easy steps to get a basic mindfulness practice started, with specific attention given to managing difficult or overwhelming emotions such as anxiety. While mindfulness meditation is very safe, please consult your therapist when starting any new regime and do not try the following instructions when you are having a panic attack.

1. Get out of the spin cycle of your thinking mind.
You may already be aware that the intensity and duration of negative emotions is driven or exacerbated by excessive rumination. That is - you can't seem to let go of negative thoughts and instead , to your own detriment, obsess over and indulge worst-case scenarios that only compound shame, sadness, fear or anger. Quick hint, trying to suppress negative thoughts does not solve ruminations. When you're caught in the grips of a spin cycle, use the following mindfulness technique.

2. Use an anchor to stabilize the turbulent mind.
The mind needs an anchor, or a single point of focus, to direct it away from ruminations and elicit the body's natural relaxation response. Dr. Herbert Benson, a Harvard Medical School cardiologist who specializes in mind-body medicine, coined the term "the relaxation response" to describe the physical state of deep rest that changes the body's response to stress. Many objects or anchors of attention are useful in stabilizing the mind and achieving this relaxation response. These anchors could include attending to sounds in the present moment, focusing on your breath passing in and out of the nostrils, repeating a prayer or affirmation, or any of the four foundations used in traditional Buddhist training.1

For those who struggle with anxiety, I often recommend using the second foundation, mindfulness of sensations, as the primary focus. The second foundation not only provides a solid, real-time anchor for attention, but also serves as an exposure or desensitization exercise that short-circuits habituated stimulus-response patterns.

After finding an anchor, the next mindfulness step is physically based - the following breathing exercise will help you attain the body's natural relaxation response.

3. Come into your body where your emotions reside.
Find a comfortable and relaxed position, whether seated or lying down. Try to keep your spine straight and stay physically relaxed as much as you can. Begin by taking ten natural, gentle breaths, focusing your mental attention on your nostrils as you inhale, pause, and then exhale. At the tail end of your exhale, count a number aloud or to yourself, designating the completion of a cycle. Then, repeat that number during the next inhalation until you've completed ten full breath cycles.

If you get distracted by external sounds, passing thoughts, or physical discomfort, that's totally normal. Don't give up, get frustrated, or treat the breathing exercise like a race. Simply recognize your distraction as part of the exercise and calmly choose to return your focus to the breath, beginning again at the number one. After ten continuous breaths, expand your awareness to include your entire body.

Drop down into the body and feel the sensations arising, fully devoting your attention in the same manner that you were attending to the breath passing in and out of your nostrils. Yes, this body is where you always live, and yet, perhaps, you hardly notice it. If your entire body is too broad or vast a terrain to attend to, break it up into parts or regions in your mind, and go through a complete body scan, segment by segment, from the crown of your head to the tips of your toes and back again.

Do not judge what you notice about your body, desire something different, secretly hope for something to change, or expect a continuous, pleasant ride. Meet every physical sensation with utter acceptance. The goal of this practice is to ground yourself in the present moment of lived experience, here and now, rather than dwelling on the mental abstractions of past and future. This practice also helps you reconnect with the body, close to where the emotions truly reside, rather than occupying yourself with the stories or perceptions of emotions. Once you've completed a body scan, continue on the next step...

4. Befriend one emotion to undercut the reactivity circuit.
Imagining your body is a terrain and your awareness like a radar scanner, tracking the most intense or pervasive signal. Gravitate towards that signal, wherever it is, and make it the new object or anchor of attention. Every emotion has two parts: the sensation signal in the body, and the story fabricated in the mind. You are only interested in the first. Perhaps your sadness is like a hollow sensation in the gut. Your anxiety might be a constriction in the chest. Your anger may present as a burning sensation in the jaw. As you experience pain, tension, tightness, gripping, bluntness or dullness in any particular region, let those physical sensations become your signal and resist the urge to push them away.

Explore the signal like a child exploring a new territory, or a scientist using a microscope. You are observing energy patterns at play in the present moment. Meanwhile, avoid indulging the story line about what the signal seems to mean - allow those thoughts to pass on their own in the background of your awareness. If, at the time of your practice, your signal is pleasant, relaxing, and enjoyable, follow the same instructions of attending moment by moment with acceptance and without attaching to the story. If there is no pervasive sensation or signal, keep your attention openly scanning the body from head to toe and back, resist the urge to become disinterested, and stay attuned until something prominent emerges. Once you're locked into a pervasive emotional signal, continue to the next phase of the exercise.

5. Go deeper by inquiring into the qualities of the sensation.
During this phase of the meditation practice, I often encourage my clients to inquire about the specific nuances of their signal by prompting them with the following questions: Where is the signal located in the body? What is its shape? What is its texture? Does it have a color? Is it dense or dispersed? Static or moving? This inquiry helps bring one's attention closer to the signal, thereby deconditioning the habituated stimulus-avoidance-response circuit. When focusing on the sensation without the story line, my clients are often amazed to find that they are able to sit with and accept their distressing emotions for longer periods of time. However, one session of mindfulness meditation is not enough to escape the cycle of negative thoughts and emotional reactivity. You'll need to continue to practice accordingly as follows.

6. Work your edge, systematically staying present for longer periods of time.
Just like physical strength, endurance and flexibility, emotional tolerance and resilience are skills that can by systematically developed. Treat meditation like a mental workout - you wouldn't expect physical results in one session, but you would expect slight to moderate discomfort as you stretch and tone new muscles. Befriending distressing emotions through mindfulness requires a systematic increase in the intensity and duration of exposure to the signal. When you lift weights, run on the treadmill or do yoga postures, you are often asked to "work your edge" in a safe, responsible and consistent manner. You go right up to the threshold of your perceived capacity, breathe, and stay a little longer than you think you can. If you back off and avoid the edge of your comfort zone, you won't grow new neural pathways and your emotional flexibility atrophies.

Conversely, if you go through the process of exposure in meditation too deeply, too quickly, or too recklessly, you risk getting overwhelmed or experiencing re-traumatization, the mental equivalent of physical injury, and can actually strengthen the negative avoidance response. Finding the right balance is key, and I often use a rating scale to help orient clients to the optimal ranges for new learning: the numbers 1-4 mean you're not in the ball game, while 8-10 mean you're risking injury. A number within the range of 5-7 is considered the sweet spot for change.

By mindfully attending to emotions with care, patience, and diligence, and by following these instructions over time, you'll find that it is possible to turn an enemy into an ally, befriend anxiety, and reclaim your life. Though it can be very beneficial to find a mentor, therapist, or group that can help you understand and practice mindfulness meditation, by following these steps you can begin to experience the benefits of mindfulness through day-to-day efforts.

How to Help Someone Who's Depressed

What to do
When someone you know and love is clinically depressed, you want to be there for that person. Still, keep in mind that your friend or loved one has a medical condition, so giving support may mean more than just offering a shoulder to cry on.

“There are many things you can do to make them feel better,” says Jackie Gollan, PhD, assistant professor in the department of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine in Chicago, but medical care may be what they really need to recover.

Here are nine helpful things you can do for someone with depression.

Realize treatment is key
Depression is a medical condition requiring medical care. As a family member or friend, you can listen to the person and give your support, but that might not be enough.

If you keep this in mind, it can prevent you from losing patience or getting frustrated with them because your best efforts don't "cure" their depression.

"People that are depressed can't sleep it off; they can't avoid it," says Gollan. "You can give care and support, but it's not going to solve the problem."

Get active in their care
The best thing you can do for someone with depression is support his or her treatment. Tell your friend or loved one that depression is a medical problem and ignoring it will not make it go away.

"If someone breaks their leg, they are taken to a doctor or hospital," says Gollan. "If someone has depression, they need medical care and psychosocial support."

Talk about it
Let them know that you and others care about them and are available for support. Offer to drive them to treatment or, if they want to talk to you about how they're feeling, know what to listen for.

"This can reduce risk of suicide," says Gollan. "Listen carefully for signs of hopelessness and pessimism, and don't be afraid to call a treatment provider for help or even take them to the ER if their safety is in question."

Stay in contact
Call or visit the person and invite her or him to join you in daily activities. People who are depressed may become isolated because they don't want to "bother" other people.

You may need to work extra hard to support and engage someone who's depressed.

"Activities that promote a sense of accomplishment, reward, or pleasure are directly helpful in improving depression," says Gollan. "Choose something that the person finds interesting." Still, keep in mind that they may not feel interested in the activity right away.

Routines that promote exercise, nutrition, and a healthy amount of sleep are helpful.

Focus on small goals
A depressed person may ask, "Why bother? Why should I get out of bed today?" You can help answer these questions and offer positive reinforcement.

"Depressive avoidance and passivity can be reduced through activation [to help the person regain a sense of reward] and small goals of accomplishment," says Gollan.

Document and praise small, daily achievements—even something as simple as getting out of bed.

Find local services
Use support services in your community or online resources such as National Alliance on Mental Illness to help you find the right specialists to consult on depression treatment. A primary-care physician or an ob/gyn can also provide referrals for a psychiatrist.

Some people with depression may not recognize that they're depressed. Explain to them that the condition can get progressively worse, even become chronic, if not treated early. Hence, it's worth investigating supportive services and specialists.

Encourage doctor visits
Encourage the person to visit a physician or psychologist; take medications as prescribed; and participate in cognitive behavioral therapy for depression.

Gollan suggests checking the Association for Behavioral and Cognitive Therapies or the American Psychological Association to locate psychologists and medical centers' psychiatry departments.

Pay attention
If someone you love has been depressed in the past, pay attention if the person is experiencing some of the riskier life phases (in terms of depression), such as adolescence or a recent childbirth.

Also, if the going is rough for him or her emotionally due to marital separation, divorce, job loss, a death in the family, or other serious stress, be ready to step in to help.

What do you say to someone who’s depressed? All too often, it’s the wrong thing. Here is a list of helpful things to tell someone battling depression, and even more importantly, what not to say.

9 Ways to Control Bipolar Disorder

Healthy habits for bipolar disorder
Bipolar disorder is a serious mental health condition in which episodes of mania—an abnormally elevated mood often accompanied by feelings of euphoria—are interspersed with bouts of depression.

People with bipolar disorder generally need to be treated with mood stabilizers and other medications. But maintaining a healthy lifestyle is also important. Eating right, sticking to a regular sleep schedule, and other healthy habits can help people with bipolar disorder manage their condition.

Take your meds
Take your medication every day as prescribed by your doctor. In all, 1 in 3 people will remain completely free of symptoms of bipolar disorder by taking mood-stabilizing medicine, such as carbamazepine or lithium, for life.

Exercise daily
Moderate physical activity for 30 minutes a day can help control mood swings.

Eat a balanced diet
Make sure you are getting all the nutrients you need. Eating meals at regular times will help establish a stress-reducing daily routine.

Avoid traveling into other time zones
If you are planning to travel extensively, you may want to call your doctor before you leave. Traveling into other time zones can disrupt your medication schedule and trigger a manic episode.

Get the same number of hours of sleep every night
Changes in your sleep patterns can sometimes trigger a manic or depressive episode. Try your best to keep the same bedtime and rise time, varying them by no more than an hour.

Avoid alcohol and illegal drugs
Even one drink can disrupt your sleep, change your mood, or interfere with your medicines, which can make symptoms worse or even trigger an episode.

Reduce stress at work and at home
Try to keep regular hours at work so stress won’t trigger a manic or depressive episode. If stress at work or at home is a problem, counseling may help. It is important to schedule some recreation in your day, even if it is just for a short period. This should generally include social time.

Limit caffeine and nicotine during manic episodes
Caffeine and nicotine can both act as stimulants, which can make symptoms worse. Plus, too much caffeine can change your sleeping habits.

Seek treatment immediately
Getting treatment immediately will help you to proactively manage symptoms of a depressive or manic episode and avoid disruptions to your life. Often you don't notice early signs or symptoms, so take the time to educate whoever is closest to you what signs and symptoms to look for. They can alert you when they see a change that suggests the beginning of a mood episode.  Show them you welcome such feedback, and be sure to take it seriously if you get it.

How to Spots Signs of Mental Illness

Mental illness can have devastating effects on the victim who suffers and her loved ones. This is why it's so important to be able to spot the signs of mental illness early to receive treatment and have the best chance of recovery. Even though specific symptoms characterize individual illnesses, you can still spot the general signs of mental illness.

Tips

1. Notice an inability to cope with life's daily activities and challenges. If you find yourself or a loved one becomes increasingly overwhelmed and stressed by normal activities, you should speak to your physician.

2. Watch for a noticeable personality change. You can spot signs of mental illness like extreme anger or sadness not usually seen in a person's character.

3. Spot signs of mental illness by paying attention to whether a loved one acts in a strange or grandiose manner. You can easily spot signs of mental illness if you notice a loved one hears voices or becomes delusional with feelings of inflated self-importance. Contact his doctor or a psychiatrist immediately.

4. Be on the lookout for drug and alcohol abuse, also signs of mental illness. Many victims of mental illness self-medicate with various drugs or alcohol to cope with overwhelming feelings or a fear of losing control.

5. Determine if a prolonged depression exists. Everyone gets depressed once and a while, but it you find that a loved one has difficulty functioning each day due to depression or apathy over an extended period of time, encourage them to seek help right away.