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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Sprache: Englisch
- Veröffentlichungsjahr: 2022
Tackle anxiety and depression head-on with this practical workbook If you're one of the millions of people affected by--or whose loved ones are affected by--anxiety and depression, you're probably looking for strategies to help subdue or even transcend these debilitating and painful disorders. In that case, Anxiety and Depression Workbook For Dummies is a great place to start. This book is filled with chapters that cut across diagnostic categories, incorporating treatment techniques based on Cognitive Behavioral Therapy, Acceptance and Commitment Therapy, Emotion Focused Therapy, and Interpersonal Therapy. Use the techniques explored in this book to start making real changes, which can quickly lead to you feeling better. It also includes: * Practical and hands-on descriptions of mindfulness-based practices you can implement immediately * Brand-new updates to reflect modern changes in technology, social media, and the prevalence of loneliness * Consideration of the pros and cons of medications and other biological interventions for depression and anxiety, including exploration of the placebo effect * Additional worksheets online available for download Perfect for anyone trying to work through the challenging issues presented by anxiety and depression, for those trying to help a loved one do the same thing, or for those in therapy, this book is an excellent supporting resource that can help contribute to positive changes in the lives of people affected by emotional distress.
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Anxiety & Depression WorkbookFor Dummies®, 2nd Edition
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Library of Congress Control Number: 2022902721
ISBN 978-1-119-86742-5 (pbk); ISBN 978-1-119-86743-2 (ebk); ISBN 978-1-119-86744-9 (ebk)
Anxiety & Depression WorkbookFor Dummies®
To view this book's Cheat Sheet, simply go to www.dummies.com and search for “Anxiety & Depression WorkbookFor Dummies Cheat Sheet” in the Search box.
Table of Contents
Cover
Title Page
Copyright
Introduction
About This Book
Foolish Assumptions
Icons Used in This Book
Beyond the Book
Where to Go from Here
Part 1: Dissecting Distress and Preparing a Plan
Chapter 1: Sorting Out Symptoms of Anxiety and Depression
Dwelling on Negative Thoughts
Blue and Anxious Behavior
Physical Funkiness
Emotions of Anxiety and Depression
Reflecting upon Relationships
Plotting Your Personal Problems Profile
Choosing Your Challenge
When and Where to Get More Help
Chapter 2: Discovering the Beginnings
Biological and Genetic Influences
Plotting Out a Lifeline
Surveying Current Stress
Drawing Conclusions
Chapter 3: Overcoming Obstacles to Change
Change-Blocking Beliefs
Searching for Self-Sabotage
Chapter 4: Minding Your Moods
Deciphering Body Signals
Connecting the Mind and Body
Putting Events, Feelings, and Sensations Together
Becoming a Thought Detective
Part 2: Thinking About Thinking: Thought Therapy
Chapter 5: Untangling Twisted Thinking
Introducing the Reality Scramblers
Making the Wrong Judgment
The Blame Game
Doing What You Can to Solve the Problem
Chapter 6: Indicting and Rehabilitating Thoughts
From Arraignment to Conviction: Thought Court
After the Verdict: Replacing and Rehabilitating Your Thoughts
Reflections on Chapter 6
Chapter 7: Looking at Problematic Assumptions
Examining Unhelpful Beliefs
Changing Your Assumptions
Chapter 8: Managing Mindfulness and Achieving Acceptance
Making Space for Meditation
Start by Losing Your Mind!
Arriving at Acceptance
Connecting with Now
Part 3: Actions Against Angst: Behavior Therapy
Chapter 9: Facing Feelings: Avoiding Avoidance
What’s Wrong with Avoidance?
Exposure: Jumping in Feet First
Chapter 10: Lifting Mood Through Exercise
How Much Is Enough?
The Case for Health Improvement
Fitting Exercise into Your Life
What to Do When Willpower Wilts
Chapter 11: Entertaining Enjoyment
What’s Your Pleasure?
Poisonous Pleasures
Pleasure Busters
Chapter 12: Moving and Tackling Life’s Problems
The Motivation Myth
Organizing Your Problem with S.O.C.S.
Part 4: Focus on Physical Feelings
Chapter 13: Sleeping Soundly for Emotional Health
Recognizing the Importance of Sleep
Tracking Your Sleep
Sleep Guidelines
Associations and Sleep
Relaxation and Sleep
Dream Demons
Thinking About Sleep
Making Sleep More Efficient
My Sleep Plan
Chapter 14: Making the Medication Decision
To Take or Not to Take
Preparing Your Prescriber
Sizing Up Side Effects
Part 5: Relationship Therapy
Chapter 15: Restoring Relationships
Revealing the Emotion-Relationship Connection
Enhancing Your Relationship
Dealing with Relationship Loss
Chapter 16: Smoothing Out Conflict
Overriding Defensiveness
Discovering the Problem Isn’t All About You
Talking About the Tough Stuff
Part 6: Looking Beyond Anxiety and Depression
Chapter 17: Reining in Relapse
Sizing Up Your Risk of Relapse
Not Letting Relapse Sneak Up on You
Having a Fire Extinguisher Ready
Keeping the Ball Rolling
Chapter 18: Promoting Positives
Focusing on Gratitude
Making the World a Bit Nicer
Letting Go
Exercising Self-Control
Discovering What’s Really Important
Finding Meaning Before Your Funeral
Part 7: The Part of Tens
Chapter 19: Ten Reasons to Seek Additional Support
You Feel Hopeless
You Feel Like Ending Your Life
You’re Getting into Trouble at Home
You’re Having Trouble at Work or School
You Want to Isolate from Others
You’re Abusing Drugs or Alcohol
You Feel Overly Agitated
You Can’t Control Your Temper
You Can’t Get Motivated to Do Anything
Family and Friends Worry About You
Chapter 20: Ten Ways to Help a Loved One with Anxiety or Depression
Listening without Judging
Learning More
Staying in Touch
Separating the Emotion from the Person
Offering a Hand with Finding Help
Providing Hope
Taking a Walk
Helping with Daily Chores
Not Blaming Yourself
Taking Care of Yourself
Index
About the Author
Connect with Dummies
End User License Agreement
Guide
Cover
Table of Contents
Title Page
Copyright
Begin Reading
Index
About the Author
Dedication
Authors' Acknowledgments
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Introduction
Do you worry too much? Are you often sad or down in the dumps? Do you have to drag yourself out of bed in the morning? Or maybe you avoid people more than you should. If so, you’re probably dealing with some type of anxiety or depression. Everyone feels sad or worried from time to time because unpleasant feelings are a normal part of life. But when depression or anxiety interferes with your work, play, or relationships, it’s time to act.
Good news! You can conquer these problems with the help of Anxiety & Depression Workbook For Dummies. Feel free to use this workbook on its own or as a supplement to counseling. In either case, studies show that self-help efforts work.
Experts estimate that almost a quarter of the people in the world will experience significant problems with anxiety at some point in their lives. And between 15 and 20 percent will succumb to the ravages of depression at one point or another. Unfortunately, many people suffer from both of these maladies. Recent events such as the pandemic have increased rates of both anxiety and depression among adults and children all over the world.
So if you struggle with anxiety, depression, or both, you’re not alone. This book joins you in your battle by giving you research-based strategies and plenty of practice opportunities to help you defeat depression and annihilate anxiety.
About This Book
The purpose of this book is to give you a range of skills and tools for managing anxiety and depression. Although there’s information here about the essential concepts of depression and anxiety, this book is action-oriented — in other words, you have the opportunity to actively apply research-based ideas to your life in meaningful ways.
There’s no doubt you used workbooks while you were in school. A math workbook helped you apply math concepts to everyday problems. Or a reading workbook improved your ability to comprehend stories. Today, you can find workbooks on almost any topic, from selling your home and succeeding on tests to preparing your taxes and improving your memory.
The purpose of any workbook is to lay out the basics of a topic and then provide numerous opportunities to apply and practice the concepts at hand. Typically, books explain issues, and workbooks help you master new skills. In other words, Anxiety & Depression Workbook For Dummies is “less talk — more action.”
Did you notice the “work” part of workbook? Don’t let that scare you. You’ll be well paid for your work in the form of increased life satisfaction and reduced emotional distress. And the work is actually rather interesting because you discover new ways to live your life and get what you want.
Unlike most workbooks, you don’t necessarily have to read and use the chapters of this book in order, beginning to end. You can pick and choose what chapters to read and which exercises to do, besides where to start and stop.
This book is meant to be written in unless, of course, you’ve borrowed it from the library, in which case you’ll need to write your answers elsewhere. Writing enhances skills and commits you to action, so I strongly encourage you to do the work required for your recovery by writing out your answers in the forms and worksheets. Don’t worry about your handwriting or spelling — nobody’s grading your work.
Throughout this book, you’ll see sections labeled My Reflections. When you come across a reflection space, take a little time to ponder what you’re feeling, what you’ve discovered, and any new insights you’ve achieved. But hey, this is your workbook — write down anything you want in My Reflections.
Foolish Assumptions
By the sheer fact that you’ve picked up this book, I assume, perhaps foolishly, that you want to do something about depression or anxiety. Maybe you suffer from some of these issues, or you think that a family member or close friend may have problems with anxiety of depression.
On the other hand, maybe you’re a mental health professional who’s interested in finding a resource to help structure therapy with your clients. I’ve had positive feedback from both clients and professionals who have used this book in addition to psychotherapy.
Icons Used in This Book
Throughout this book, icons in the margins alert you to important types of information:
This icon marks particularly noteworthy information that you might record or write down so you can refer to it later.
This icon tells you it’s time to roll up your sleeves and get to work! It denotes a worksheet, form, or exercise for you to fill out.
This icon points to specific examples that show you the way through worksheets or exercises. Examples are fictional composites that represent accurate struggles, but they’re not real people.
This icon appears when you need to take care; you may need professional help or should be on the lookout for possible trouble.
This icon alerts you to especially useful insights and explanations.
Beyond the Book
Throughout the book, there are worksheets that you may want to complete more than once. Go to www.dummies.com/go/anxiety&depressionworkbookfd2e to download them.
In addition, there’s a cheat sheet with tips and information about anxiety and depression. To access this online cheat sheet, go to www.dummies.com and then type “Anxiety& Depression Workbook For Dummies Cheat Sheet” in the search box.
Where to Go from Here
Anxiety & Depression Workbook For Dummies can help you deal with your depression and anxiety. It’s pragmatic, concrete, and goes straight to the point. As such, this workbook doesn’t devote a lot of text to lengthy explanations or embellishments of basic concepts, so you may want to find out more about specific types of depression and anxiety, available medications, and alternative treatments elsewhere. For that purpose, consider reading one or both of the companion books: Depression For Dummies (Wiley) and Anxiety For Dummies (Wiley).
Part 1
Dissecting Distress and Preparing a Plan
IN THIS PART …
Understand the tolls of depression and anxiety
Take a look back at your history
Figure out if it’s time to change
Keep track of your moods
Chapter 1
Sorting Out Symptoms of Anxiety and Depression
IN THIS CHAPTER
Figuring out how depression and anxiety affect you
Finding your personal starting point
Knowing when to get more help
For people all over the world, these past years of unrest, divisiveness, and fear and uncertainty related to the devastating pandemic have increased stress significantly. Stress often precedes the emergence of emotional disorders, especially anxiety and depression. In the United States, recent surveys suggest that about 40 percent of the adult population suffer from notable symptoms of anxiety or depression. The rates of anxiety and depression among adolescents have also risen dramatically due to disruptions in their lives during these tumultuous times.
Everyone feels sad or worried from time to time. Such emotions are both natural and unavoidable. People worry about their children, bills, aging parents, jobs, health, and powerful social issues. And most people have shed a tear or two watching a sad movie or a news story about a poignant tragedy. It’s perfectly natural to experience significant sadness when faced with loss, frustration, or pain. That’s normal. Anxiety and depression are part of everyday life.
But when sadness fills most of your days or worries saturate your mind, that’s not so normal. You may be experiencing a real problem with depression or anxiety. Anxiety and depression can affect how you think, behave, feel, and relate to others. The discussion and quizzes in this chapter help you figure out how depression and anxiety affect your life. When you understand what’s going on with your emotions, you can start doing something to manage them more effectively.
This workbook is designed to help with troubling emotions. It isn’t meant to be a comprehensive review of emotional disorders. Many people choose to use this book along with professional counseling or therapy. Some use this book on their own. If you want more information and an in-depth discussion about anxiety or depression, take a look at the latest editions of Anxiety For Dummies or Depression For Dummies.
Don’t freak out if the quizzes in this chapter reveal that you have a few symptoms of anxiety or depression. Almost everyone has struggles; that’s human. However, you should be concerned when these symptoms significantly interfere with your life. See the later section in this chapter, “When and Where to Get More Help,” for more information.
If your symptoms are numerous and severe or your life seems out of control, you should consult your primary care provider or a mental health professional. These quizzes aren’t meant to replace trained mental health professionals — they’re the only people who can really diagnose your problem.
Dwelling on Negative Thoughts
If you were able to listen in on the thoughts that reverberate through a depressed person’s head, you might hear, “I’m a failure,” “My future looks bleak,” “Things just keep on getting worse,” or “I regret so many things in my life.”
On the other hand, the thoughts of an anxious person might sound like, “I’m going to make a fool out of myself when I give that speech,” “I never know what to say at parties,” “The freeway scares me to death,” “I know that the odds of a plane crash are small, but flying scares me,” or “I’m going to have a nervous breakdown if my editor doesn’t like what I write.”
Thoughts influence the way you feel. The very darkest thoughts usually lead to depression, whereas anxiety usually stems from thoughts about being judged or hurt. And, of course, people often have both types of thoughts.
Do your thoughts dwell on the dark, dismal, or the scary aspects of life? Take the quiz in Worksheet 1-1 to determine if your thoughts reflect a problem with anxiety or depression. Put a check mark next to an item if you feel the statement applies to you.
Although these thoughts can occur to someone who’s depressed or anxious (or both), the odd-numbered items are most indicative of depression, and the even-numbered items reflect anxious thinking. There’s no pass or fail mark on this quiz. However, the more items you endorse, the more you have cause for concern; specifically, if you check more than eight or ten items, you should think seriously about addressing your condition. At the same time, if you very strongly believe in or you frequently have any of these thoughts, you may have too much anxiety or depression. For example, if you worry all the time (item number 2) with no relief, you could benefit from working on that issue.
Worksheet 1-1 The Negative Thinking Quiz
1. Things are getting worse and worse for me.
2. I worry all the time.
3. I think I’m worthless.
4. I never know what to say.
5. No one would miss me if I were dead.
6. I’m afraid that I’ll get sick.
7. I think I’m a failure.
8. My thoughts race, and I obsess about things.
9. I don’t look forward to much of anything.
10. I get really nervous around people I don’t know.
11. The world would be better off without me.
12. Thoughts about past traumas keep rolling through my mind.
13. I find it impossible to make decisions.
14. I can’t stand it when I’m the center of attention.
15. My life is full of regrets.
16. I can’t stand making mistakes.
17. I don’t see things getting any better in the future.
18. I worry about my health all the time.
19. I’m deeply ashamed of myself.
20. I over-prepare for everything.
Take a moment to write down your results on Worksheet 1-2, and then reflect on whether or not you believe you have difficulties with anxiety, depression, or both.
Worksheet 1-2 My Reflections
If you have any thoughts of suicide or utter hopelessness, consult your primary care provider or a mental health professional immediately.
If you have symptoms of both anxiety and depression, don’t be surprised. Anxiety and depression often occur together.
Blue and Anxious Behavior
If you were to follow a depressed or anxious person around, you might see some behavioral signs of their emotional turmoil. That’s because depression and anxiety on the inside affect what people do on the outside. For example, a depressed person may look tired, move slowly, or withdraw from friends and family; an anxious person may avoid socializing or have a trembling voice.
Take the quiz in Worksheet 1-3 to see if your behavior indicates a problem with anxiety or depression. Check off each statement that applies to you.
Worksheet 1-3 The Distraught Behavior Quiz
1. I’ve been crying for no clear reason.
2. I pace around when I’m worried.
3. Sometimes I can’t make myself get out of bed.
4. I avoid going into crowded areas.
5. I can’t seem to make myself exercise.
6. I avoid risks because I’m afraid of failure.
7. I don’t do things for fun lately.
8. I always stay away from activities that could be dangerous.
9. I’ve been missing work lately because I just don’t have the motivation.
10. I’m really fidgety.
11. I feel like I am walking in quicksand; I can’t get moving.
12. I avoid people or places because I feel anxious.
13. I don’t care what I look like anymore.
14. I spend too much time making sure I look okay.
15. I don’t laugh anymore.
16. My hands shake when I’m nervous.
17. I’ve been letting things go that I need to attend to.
18. I feel compelled to repeat actions to keep myself safe.
Again, there’s no pass or fail on this quiz. The more items you check, the greater the problem. Once again, even-numbered items are most consistent with anxiety, and odd-numbered items largely indicate depression. And, of course, like many people, you may have symptoms of both types of problems.
Again, add up your answers and reflect on your results in Worksheet 1-4.
Worksheet 1-4 My Reflections
Physical Funkiness
Depression and anxiety inevitably produce physical symptoms. In fact, some people primarily suffer from changes in appetite, sleep, energy, or pain while reporting few problematic thoughts or behaviors. These symptoms directly affect your body, but they’re not as easily observed by other people as the behavioral signs covered in the preceding section.
Take The Sad, Stressed Sensations Quiz in Worksheet 1-5 to see if your body is trying to tell you something about your emotional state.
Worksheet 1-5 The Sad, Stressed Sensations Quiz
1. I have no appetite.
2. My palms sweat all the time.
3. I wake up too early each morning and can’t go back to sleep.
4. I’ve been experiencing a lot of nausea and diarrhea.
5. I’ve been sleeping a lot more than usual.
6. I feel shaky all over.
7. I’ve been having lots of aches and pains for no good reason.
8. When I’m nervous, my chest feels tight.
9. I have no energy lately.
10. My heart races when I’m tense.
11. I’ve been constipated a lot more often than usual.
12. I feel like I can’t catch my breath.
13. I’m eating all the time lately.
14. My hands are often cold and clammy.
15. I’ve lost my sex drive.
16. Sometimes I hyperventilate.
17. Every move I make takes more effort lately.
18. I get dizzy easily.
The symptoms in this quiz can also result from various physical illnesses, drugs in your medicine cabinet, or even your three-cup coffee fix in the morning. Be sure to consult your primary care provider if you’re experiencing any of the symptoms in The Sad, Stressed Sensations Quiz. It’s always a good idea to have a checkup once a year, or more frequently if you experience noticeable changes in your body.
Although physical sensations overlap in anxiety and depression, even-numbered items in the quiz above are most consistent with anxiety, and the odd-numbered items usually plague those with depression. There’s no cutoff point for indicating a problem. The more statements you check off, though, the worse your issue.
Add up your answers and reflect on your results in Worksheet 1-6. Think about other physical problems you may have that don’t appear on the list that may be related to your emotions and jot those down as well.
Worksheet 1-6 My Reflections
Emotions of Anxiety and Depression
Emotions erupt in response to what happens in the present, what happened in the past, and what might happen in the future. Emotional reactions involve physiological, cognitive, and behavioral responses. People across the world express six primary emotions:
Happiness
Sadness
Anger
Fear
Disgust
Surprise
From those basic emotions, more subtle expressions emerge. For example, from happiness springs joy, contentment, cheerfulness, or pleasure. From sadness, depression, gloom, despair, despondency, low self-esteem, or shame occur. Fear may bring anxiety, terror, worry, embarrassment, or panic. Disgust usually leads to distaste or feelings of grossness. Surprise is a brief emotion. What follows surprise varies depending on what brought forth the initial response. Surprise may turn into curiosity, amusement, disgust, relief, or fear.
Emotions guide behavior. Fear increases alertness and avoidance, anger produces aggression, and sadness involves withdrawal. Although most people have a variety of emotional experiences, those with anxiety or depression are likely to experience more sadness and fear, or possibly anger and disgust.
Which primary emotions do you experience the most frequently? Think about a typical day and reflect on what you’re feeling. Think about what happened just before your feeling. Were you thinking about the past or the future? Record your experience in Worksheet 1-7.
Worksheet 1-7 My Reflections
Reflecting upon Relationships
When you’re feeling down or distressed for any length of time, odds are that your relationships with those around you will take a hit. Although you may think that your depression or anxiety affects only you, it affects your friends, family, lovers, coworkers, and acquaintances. Even the strangers you interact with, such as waiters, flight attendants, clerks, and bank tellers, can suffer from your emotional state.
Take the quiz in Worksheet 1-8 to see if your emotions are causing trouble with your relationships. Check off any statements that apply to you.
Worksheet 1-8 The Conflicted Connections Quiz
1. I don’t feel like being with anybody.
2. I get very nervous when I meet new people.
3. I don’t feel like talking to anyone.
4. I’m overly sensitive when anyone criticizes me in the slightest way.
5. I’m more irritable with others than usual.
6. I worry about saying the wrong thing.
7. I don’t feel connected to anyone.
8. I worry about people leaving me.
9. I don’t feel like going out with anyone anymore.
10. I’m plagued by visions of people I care about getting hurt.
11. I’ve withdrawn from everyone.
12. I feel uptight in crowds, so I stay at home.
13. I feel numb around people.
14. I always feel uncomfortable in the spotlight.
15. I feel unworthy of friendship and love.
16. Compliments make me feel uneasy.
You guessed it; there’s no cutoff score here to tell you definitively whether or not you’re anxious or depressed. But the more items you check off, the more your relationships likely suffer from your anxiety, depression, or both. Odd-numbered items usually indicate problems with depression, and even-numbered items particularly accompany anxious feelings.
Many people are a little shy or introverted. You may feel anxious meeting new people and may be uncomfortable in the spotlight — these feelings aren’t necessarily anything to be concerned about. However, such issues become problematic when you find yourself avoiding social activities or meeting new people because of your shyness.
Reflect on your results and write about which relationships are most affected by your emotions in Worksheet 1-9.
Worksheet 1-9 My Reflections
Plotting Your Personal Problems Profile
The Personal Problems Profile provides you with an overview of your problematic symptoms. (If you skipped the quizzes in the previous sections of this chapter, go back and take the time to complete them; your answers to those quizzes come into play in this exercise.) The profile exercise in this section helps you identify the ways in which anxiety and depression affect you. One good thing about this profile is that you can track how these symptoms change as you progress through the rest of this book.
Tyler, a middle-aged chemical engineer, doesn’t consider himself depressed or plagued with any emotional problems. But when he sees his primary care doctor, Tyler complains of fatigue, recent weight gain, and a noticeable loss in his sex drive. These feelings predated the pandemic but became more noticeable while he was quarantined. After ruling out physical causes, the doctor suggests that he may be depressed. He reluctantly agrees to meet with a social worker.
When Tyler fills out his Personal Problems Profile (see Worksheet 1-10), he lists the following top ten symptoms and notes whether they indicate anxiety or depression (A or D).
As you can see, Tyler suffers primarily from symptoms of depression. And most of these symptoms are physical in nature. Filling out his Personal Problems Profile helps Tyler see that he has a depression he wasn’t even consciously aware of. He reflects on his discovery (see Worksheet 1-11).
This is the Anxiety & Depression Workbook For Dummies. You can’t feel better without doing a little work. Don’t worry; the work isn’t that difficult. Of course, you can skip a few exercises, but the more of them you complete, the sooner you’ll start feeling better. Odd as it may seem, writing things down does a world of good. Writing helps you remember, clarifies your thinking, and increases focus and reflection.
Worksheet 1-10 Tyler’s Personal Problems Profile
1. I have no energy lately. (D)
2. Every move I make takes more effort lately. (D)
3. I’ve lost my sex drive. (D)
4. I’ve been eating all the time lately. (D)
5. I don’t feel like being with anyone. (D)
6. I don’t look forward to much of anything. (D)
7. I find it impossible to make decisions. (D)
8. I worry about my health all the time. (A)
9. I feel shaky all over. (A)
10. Sometimes I can’t make myself get out of bed. (D)
Worksheet 1-11 Tyler’s Reflections
I can see that I do have signs of depression. I didn’t realize that before. And I see that depression particularly shows up in my body. It’s affecting my energy, sex drive, and appetite. It’s also making me withdraw from my girlfriend, which I can see from my loss of sex drive and lack of desire to be with her. Apparently, I also have a few symptoms of anxiety, and I think I always have. It’s time to do something about this.
Complete your own Personal Problems Profile in Worksheet 1-12. Look back at the quizzes earlier in this chapter and underline the most problematic thoughts, feelings, behaviors, and relationship issues you have. Then choose up to ten of the most significant items you’ve underlined and write them in the My Personal Problems Profile space that’s provided.
In addition, put an A by the symptoms that are most indicative of anxiety (even-numbered items in the preceding quizzes) and a D by symptoms that are most consistent with depression (odd-numbered items).
Do your symptoms mostly involve anxiety, depression, or a mix of the two? And do they seem to mostly affect your thoughts, feelings, behaviors, or relationships? Take some time to reflect on your profile. What conclusions can you draw? Record them in Worksheet 1-13.
Worksheet 1-12 My Personal Problems Profile
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Worksheet 1-13 My Reflections
Choosing Your Challenge
The next four parts of this workbook cover the areas of thoughts, feelings, behaviors, and relationships. One obvious way of deciding which area to begin with is to choose the one that causes you the most problems. Or you can work through them in order. Sometimes it makes sense to start with a relatively minor problem and achieve quick success. Wherever you choose to start, you should know that all these areas interact with each other. For example, if you have anxious thoughts about being judged, you’re likely to avoid (behavior) the spotlight. And you could very well experience butterflies (feelings). Furthermore, you may be overly sensitive to criticism from others (relationships).
Nevertheless, we find that many people like to start out by tackling the problem area that best fits their personal styles. In other words, some folks are doers and others are thinkers; still others are feelers, and some are relaters. Use the Personal Style Questionnaire in ,Worksheet 1-14 to pinpoint and understand your preferred style.
Are you predominately a thinker, doer, feeler, or relater? If you checked considerably more items in one area than the others, you may want to start your work in the part of this workbook that corresponds to that style:
Thinker:
Part II, “Thinking About Thinking: Thought Therapy”
Doer:
Part III, “Actions Against Angst: Behavior Therapy”
Feeler:
Part IV, “Focus on Physical Feelings”
Relater:
Part V, “Relationship Therapy”
Worksheet 1-14 Personal Style Questionnaire
Thinkers
I like facts and numbers.
I tend to be a very logical person.
I’m a planner.
I like to think through problems.
I carefully weigh costs and benefits before I act.
Doers
I can’t stand sitting around and thinking.
I like to act on problems.
I like accomplishing things each day.
I like plowing through obstacles.
I act first and think later.
Feelers
I’m a very sensuous person.
I pay a lot of attention to how I feel.
I love massages and hot baths.
Music and art are very important to me.
I’m very in touch with my feelings.
Relaters
I’m a people person.
I’d rather be with people than anything else.
I care deeply about other people’s feelings.
I’m very empathetic.
Relationships are more important to me than accomplishments.
When and Where to Get More Help
Self-help tools benefit almost everyone who puts in the effort. Many people find they can overcome minor to moderate emotional problems by working with books like this one. Nevertheless, some difficulties require professional help, perhaps because your anxiety or depression is especially serious or because your problems are simply too complex to be addressed by self-help methods.
Work through The Serious Symptom Checklist in Worksheet 1-15 to find out if you should seriously consider seeking treatment from a mental health professional.
Worksheet 1-15 The Serious Symptom Checklist
I have thoughts about killing myself.
I feel hopeless.
My sleep has been seriously disturbed for more than two weeks (including sleeping too little or too much).
I have unbearable pain.
I’m a horrible burden to my family.
My partner left me for another, and I can’t take the humiliation anymore.
I feel out-of-control anger toward someone and want to seek violent revenge.
My life is worthless, and I have no reason to live.
I’ve gained or lost more than a few pounds without trying to do so.
I’m ignoring major responsibilities in my life, such as going to work or paying bills.
I’m hearing voices.
I’m seeing things that aren’t there.
My drug use or drinking are interfering with my life.
My thoughts race, and I can’t slow them down.
Someone I trust and care about has said I need help.
I’ve been getting into numerous fights or arguments.
I’ve been making really poor decisions lately (such as making outlandish purchases or getting involved in questionable business schemes).
Lately I’ve felt that people are out to get me.
I haven’t been able to get myself to leave the house except for absolute essentials.
I’m taking risks that I never did before.
Suddenly I feel like I’m a special person who’s capable of extraordinary things.
I’m spending considerably more time every day than I should repeating actions such as hand washing, arranging things, and checking and rechecking things (appliances, locks, and so on).
I have highly disturbing flashbacks or nightmares about past trauma that I can’t seem to forget about.
Checking off any one item from the list means that you should strongly consider a professional consultation. Furthermore, please realize that no such list can be all-inclusive. If you’re really not sure if you need help, see a mental health professional for an assessment.
If you feel like ending your life, the suicide hotline is a quick and anonymous way to get immediate help. In the United States, the number is 800-273-8255 or 800-273-TALK. Trained counselors will talk to you 24/7. You can call the number even if you feel helpless or hopeless or not suicidal. Staff will offer support and local information. If you prefer, text 741741 and text hello or help. You will get an immediate response. Launching in July 2022, the suicide hotline can be reached by dialing 988.
If you checked one or more of the statements above and you’re not suicidal but are beginning to think that perhaps you need help, where should you go? Many people start with their primary care provider, which is a pretty good idea because your provider can also determine if your problems have a physical cause. If physical problems have been ruled out or treated and you still need help, you can:
Ask your primary care provider for a recommendation.
Check with your state’s psychology, counseling, social work, or psychiatric association.
Call your insurance company for recommendations.
Ask trusted friends or family for recommendations.
Contact your local university department of psychology, social work, counseling, or psychiatry for a referral.
Either before or during your first session, talk to the mental health professional and ask if you’ll receive a scientifically validated treatment for anxiety or depression, such as Cognitive Behavioral Therapy, Acceptance and Commitment Therapy (ACT), Emotion Focused Therapy, or Interpersonal Therapy. Unfortunately, some practitioners lack necessary training in therapies that have shown effectiveness in scientific studies. Also, make sure whoever you see is a licensed mental health practitioner.
Understanding and accepting that you need more help is a sign of strength, not weakness. It takes bravery to admit that you might have a problem with your emotions, and it takes courage to seek a resolution.
At this point, you should pat yourself on the back. Whether this is the first chapter you’ve read or not, you’ve made a good start. Every minute you spend with this workbook is likely to improve your mood. Just give it a little time.
Chapter 2
Discovering the Beginnings
IN THIS CHAPTER
Burrowing through biology
Studying your history
Reviewing what’s happening now
Finding fault (or not)
If you’re reading this book, you probably feel a little anxious or depressed, but you may not know where those feelings come from. It’s valuable to understand the origins of your feelings, whether it’s biology, genetics, personal history, or stress. This chapter helps you gain insight into the source of your problem and connect the dots. Knowing the origins of your emotions allows you to discard the baggage of guilt and self-blame, and what’s not to like about that?
This chapter reviews the major causes of depression and anxiety: biological, genetic, personal history, and stress. Many therapy clients believe that they’re to blame for having succumbed to emotional distress. They think that personal weakness is responsible for troubling emotions. However, when they discover the factors that have contributed to the origins of their problems, they usually feel less guilty. Getting rid of that guilt frees up energy that can be used for making important changes.
Figuring out why you have anxiety or depression may help you stop blaming yourself. However, dwelling in the past doesn’t move you forward. Once you understand your history, it’s time to look to the future. Gently close the door on your grievances and look to the future to find solutions so you’re not stuck in remaining a victim of your past.
Biological and Genetic Influences
The debate over nature versus nurture is complicated. Are you who you are primarily because of the genetic code you’ve inherited? Or did you emerge from the many interactions with people and places over the course of your life? Of course, the answer is both. Genes interact with experiences to produce the person you are today.
Nevertheless, genetic makeup does influence certain tendencies. Does your Uncle Paul seem down in the dumps? Was Cousin Jack a neat freak? Was your grandmother a recluse? What was your great-grandmother like? Why are these questions important? Because depression and anxiety tend to run in families. And genes could be responsible for a portion of your emotional distress.
If you have access to family members, ask if they’d be willing to talk with you about your family’s history. Ask them if any relatives, from either side of the family, suffered from symptoms of anxiety or depression. You may want to review the symptoms covered in Chapter 1 first. There’s no exact number of relatives required for determining if genetics are responsible for your symptoms. However, the more family members sharing similar problems, the more likely you’ve inherited a tendency for symptoms of depression or anxiety. Fill in the in blanks with notes about what you learn (Worksheet 2-1).
Worksheet 2-1 Possible Family Origins
Members of my family with anxiety or depression (brothers, sisters, cousins, parents, uncles, aunts, and grandparents):
Before you go blaming your grandmother for your anxiety, consider the possibility that anxiety was learned and passed on from generation to generation. For example, imagine your great-grandmother grew up in the Great Depression. She always worried about money and food. Her worries were real: She didn’t have enough money or food. She repeatedly told your grandmother that the world was unsafe. Your grandmother passed that tendency down to your mother, who also worried all the time. Now you, too, are a worrier. Is that trait genetic or learned? Probably both.
In addition to genetics, depression and anxiety can have biological underpinnings in the drugs you take (legal or illegal) or as the result of physical illness or injury. Drugs, whether over-the-counter, prescription, or illegal, have many side effects. Sometimes solving your problem is as simple as checking your medicine cabinet for possible culprits.
Almost any medication you’re taking can influence your emotions negatively. Check with your pharmacist or primary care physician to see if your medication may be causing part of your problem. Just don’t stop taking the medication without medical consultation.
In addition, alcohol is widely known to contribute to depression or anxiety when it’s abused. Some people find that even moderate amounts of alcohol exacerbate their problems with mood. Alcohol also interacts with a variety of prescribed and over-the-counter drugs to produce harmful and even deadly results.
Finally, illegal drugs such as cocaine, heroin, methamphetamine, ecstasy, and so on are sometimes taken to alter moods. In the short run, they accomplish that goal; but in the long run, they almost inevitably worsen mood problems.
Marijuana, legal in many states, has strong psychoactive qualities. Some people use marijuana to alleviate emotional distress and anecdotally report success. A few early studies suggest that for depressed and anxious people, cannabis may improve moods and decrease anxiety. However, empirical research studies have not been widely conducted to verify its usefulness for this purpose.
Physical illnesses or injuries (especially head trauma) can also produce symptoms of anxiety or depression. Not only can the illness itself cause mood problems, but worry and grief about illness or injury can contribute to your distress. If you’ve been diagnosed with a medical condition, check with your doctor to see if your depression or anxiety is related to that condition. Jot down any possible physical reasons for your anxiety or depression in Worksheet 2-2.
Worksheet 2-2 Physical Possibilities
Plotting Out a Lifeline
The sadness and angst you feel today may have sprouted from seeds planted in your past. Therefore, exploring your personal history provides clues about the possible origins of your problems. The exercise in this section, called the Emotional Origins form, takes a little time.
The Emotional Origins exercise makes you revisit your childhood by asking questions about your parents or other caregivers and your childhood experiences. Some of the memories involved may evoke powerful emotions; if you start to feel overwhelmed, you may want to stop the exercise and consult a mental health professional for guidance and support.
Filling out this form is a lot easier after you look over an example. Here’s an example of how Tyler filled out his Emotional Origins form.
Tyler suffers from many physical signs of depression, such as lack of energy and increased appetite. He has little insight as to the origins of his depression. His physician refers him to a social worker, who suggests he fill out an Emotional Origins form (see Worksheet 2-3) to examine his childhood experiences.
Worksheet 2-3 Tyler’s Emotional Origins
Questions About Your Caregivers
1. Who were the primary caregivers in my childhood, and what were they like? Describe their personalities.
My mother was self-centered and rarely thought much about what my sister and I needed. When things didn’t go her way, she exploded. She was domineering and incredibly uptight. She was a perfectionist who talked about the “right way” or the “wrong way” to do things. I also remember that she always acted like a martyr.
