Coping with Common Problems

Insomnia or difficulty sleeping; procrastination or putting things off and irritability are common problems of depression

Depression can disturb the body's "clock" and sleeping schedule. When the clock is disrupted, the body cannot tell when it is time for sleep.

Some common complaints include:

• Having trouble falling asleep
   
• Sleeping restlessly, waking often
   
• Waking early in the morning
   
• Sleeping too much at night and/or during the day

Problems with sleep can result in feeling sluggish and fatigued. A regular sleep schedule is an important way to resolve abnormal sleep patterns.

Gain more control over sleep by using the following tips:

• Sleep between 6 and 8 hours each night. As people age they actually need less sleep. Adults usually need 6-7 hours nightly.
   
• Establish a routine; go to bed about the same time each night and get up about the same time, each morning.
   
• Avoid napping more than one hour at a time during the day.
   
• Avoid reading, watching TV, and activities other than sleeping in bed. This may seem difficult, but getting in bed should signal the body that it is "time for sleep".
   
• Try to limit caffeine use (coffee or colas).
   
• Try to limit your use of alcohol. You may fall asleep more quickly after drinking alcohol, but it often causes restless sleep.
   
• Get some exercise during the day. Exercise helps to improve sleep and sleep patterns.
   
• Relax before bedtime. Keep activities quiet and relaxing an hour or more before bedtime.
   
• Create a good environment for sleep. Make changes to reduce disruptions such as noise, light, an uncomfortable bed, or a stuffy room.

Putting things off

Do you have trouble getting motivated to do something? Do you think and worry about the things you know you should be doing, but then cannot get yourself to do anything about it? Putting things off can be a problem for people who are depressed.

Here are a few questions you can ask yourself to see if you tend to put things off:

• Do you put things off because you do not feel like doing them or because you tell yourself you will be in the mood later?
   
• Do you put things off because you are a perfectionist and you are afraid that you will not do a perfect job? Does this prevent you from doing tasks because you feel that you may not live up to your own standards?
   
• Do you feel guilty when you put off tasks?
   
• Do you feel like you have a whole list of tasks to do, but none of them are things you want to do?
   
• Do you feel you have to do tasks because someone else is expecting you to or 'forcing' you to? Do you have a hard time saying no to people and get talked into doing something you do not want to do?
   
• Do you think that people are hounding you to get things done?
   
• Do you tend to be able to start tasks but then give up as soon as they become more tricky than you thought they would be?
   
• Do you put things off when you feel upset at situations or with other people?

Sometimes people who put things off say they are waiting to be motivated. They say: "I will just wait until I feel really motivated, then I am sure I will do it.

When the time is right, I will do it." It seems like this might be a reasonable suggestion. However, often we have to act before the motivation sets in. As this illustration demonstrates, many times the action has to come first.

ACTION --> MOTIVATION --> MORE ACTION

As you realize that you are actually accomplishing something instead of just fretting about the fact that you are not doing anything, you will begin to feel relief! Before you know it, you will feel some motivation and think: "I am doing this! I cannot believe it. If I keep going, I will be done sooner than I ever expected. I think I will keep going." Every time you act you may not feel this way, but the times you do will encourage you to try again when you are not motivated.

Keep in mind that people who put things off are not lazy. Often, they are too hard on themselves - they are perfectionists - and it is difficult for themselves to start something that they feel they may not be able to do perfectly. Perhaps they could do the job very well, but the fear of failure prevents them from doing so.

Irritability

Do you find that you have been feeling irritable lately? When someone asks you a simple question do you fly off the handle? Do you find yourself feeling very upset about situations that would not have bothered you in the past?

If you find yourself feeling often irritable, there is probably something happening in your life that you are not addressing. Often irritability expresses itself in situations that have nothing to do with the real reason you are upset.

After a situation where you were feeling irritable, try to analyze the circumstances and discover what really was bothering you. What else has been going on in your life? You could use the Frame of Mind chart (PDF format, 7k) to reframe your thoughts to understand the true reason for your upset.

Exercise can help depression

Exercise can be beneficial to everyone, regardless of his or her physical condition. Exercise, even taking a short walk or doing a few stretches, improves mood. Exercise also increases blood levels of the body's natural painkillers called endorphins and affects the same chemicals in the brain as antidepressant medications. Before exercising, check with your doctor/nurse about what kinds of exercise are appropriate and safe for you.

• Exercise may seem difficult at first, so be sure to start slow and allow a couple of weeks to adjust.
   
• Pick activities that are enjoyable and appropriate for your physical condition. Even walking 1O minutes a day can make a difference.
   
• Monitor progress in a small notebook or on a calendar.
   
• Be sure to give yourself credit, even for a small success; walking to the corner and back is much better than doing nothing at all.

Summary

• Depression is a common medical illness that affects men and women of all ages.
   
• Depression is caused by a combination of factors including chemical changes in the brain, heredity, and stressful events.
   
• Depression has multiple symptoms which affect a person's body (for example, trouble sleeping, aches, and pains), behavior (less active, more irritable), and thinking (hopelessness, trouble concentrating). Each person has a different combination and severity of symptoms.
   
• Depression is treatable. Two common and effective treatments for depression are antidepressant medications and cognitive behavioral therapy (either group or individual). These treatments help to break the cycle of depression and the negative downward spiral.
   
• Recovery from depression takes time, anywhere from a few weeks to a few months.
   
• Persons suffering from depression can make important contributions to their recovery by following their doctor/nurse's instructions and improving sleep and exercise habits.
   
• Depression and anxiety are related and can often be treated at the same time or with the same medications.

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