Depression is currently one of the most prevalent mental illnesses in the world. According to Anxiety & Depression Association of America, Major Depression Disorder affects 16.1 million Americans and Persistent Depressive Disorder affects 3.3 million Americans. Whether you have some form of depression, have been formally diagnosed, or worry that you have one of these conditions, you may be interested in learning some essential skills to help you through these dark times.
Before getting into this, I want to stress the importance of working with your counselor or psychiatrist in order to receive a diagnosis and treatment. These are skills that your counselor might suggest, but there are literally dozens of other skills that might better fit your unique situation. Depression might only be part of the puzzle, as you might really be facing bipolar disorder, schizoaffective disorder, or several other conditions.
With that in mind, let’s get to the 7 Essential Skills for Depression.
1: Behavioral Activation
This is a very common CBT skill for depression, and it’s also a very effective one. I am only going to go through the basics here, but check out our article Behavioral Activation: Kick Depression on Its Butt for more info.
This skill involves finding a target behavior and “activating” it, or simply engaging with it. In terms of depression, a physically taxing behavior such as exercising, walking, gardening, or cooking would be effective.
While mentally taxing behaviors can be effective as well, such as reading or watching a movie, I don’t believe they will benefit you as much. Depression already makes you want to stay in bed. Doing a behavior that furthers that may not be as effective, but the decision is ultimately yours.
In the CBT triangle there are three components that influence each other: Thoughts (what you are thinking, usually in sentence form), Feelings (your emotions, typically one word like Sad or Happy), and Behaviors (what you are doing).
Activating any of these can influence the other two. Most people believe they need to have motivating thoughts or good feelings to engage their behaviors, but that’s not entirely true. Engaging your behaviors can improve your thoughts and feelings.
While depression might tell you that you can’t do this, behavioral activation is actually pretty easy. Pick one behavior (or two if you feel ambitious) and pick a time and place where you will do it. If it’s a behavior that you know you won’t engage in much, then choose a duration as well.
For example, let’s say that you want to walk. Your plan can be: “Every weekday at 3pm I will walk around my neighborhood for 30 minutes.”
See, isn’t that easy? You can do it, just believe in yourself and get out there.
2: Meditation and Mindfulness
Depression has a funny way of making your world go dark and body feel numb. Your body is hard to move and you can barely see in front of you. Everything feels distant and it’s hard to make sense of anything.
Meditation and mindfulness might be able to help you make sense of what you are thinking and feeling. I am lumping the two together here because both help you become more aware of your body, the world around you, and what you are thinking and feeling.
The two are very similar, but how they are done varies significantly. While there is such a thing as walking meditation, this normally refers to sitting or lying down with your eyes closed and focusing on your breath. Many also repeat a mantra over and over to stay centered.
Mindfulness refers to staying in the present and paying attention to your thoughts and your physical body. Our brains naturally tune out what it deems unnecessary information, but this has the consequence of us losing sight of our bodies and our thoughts becoming jumbled. You will simply pay attention to your thoughts like wandering balloons or clouds. They are present, but they do not control you. You will also notice how your body feels and what it’s trying to tell you.
I made a list on 20 Mindfulness Practices for Stress Relief. Start by deciding if you would rather try mindfulness or meditation. They are similar, so you can’t go wrong with either or both. There are many guided meditations on YouTube that are free and very beneficial. For mindfulness, you would start by visualizing your thoughts as separate from you and not in control of you, and then do a body scan by paying attention to each part of your body and seeing what it feels like, what it’s saying to you.
It’s easy to start, way easier than you think. Give it a try and see what happens.
3: Analyze Thinking Errors
Nearly every form of mental illness, mental health concern, or stress involves thinking errors. These are automatic thoughts that typically put you in a bad mood and aren’t accurate of what is truly going on. The thinking errors themselves are typically dependent on your concern.
Since we are talking about depression, then the thinking errors normally involve seeing a bleak future, seeing the world as awful, and seeing yourself as bad. You also likely blame yourself for any problems that occur and give yourself 100% of the blame whether you were directly involved or not. There are also thinking errors in terms of benefits. Any change to your schedule that could be for the better (doing more activity, going out with friends, trying a hobby) seems like they aren’t worth the energy or effort. Yet, these activities are exactly what would help you with depression.
Journaling can help here because you can see what your thoughts are, but I decided to separate journaling as another helpful skill for depression. If you’re not journaling, then take a moment to hear your thoughts and what you’re telling yourself. Mindfulness can help with this too as you can separate the thoughts from yourself.
Some common thoughts that might come up are:
- I’m not good enough
- The world is awful
- It’s not worth doing (activity)
- Everything is my fault
- There’s nothing good in the future
This is just a small sample. As you can see, they paint a very bleak picture of the world and of yourself. Instead, use more gentle and nuanced language when describing yourself.
Here are modifications to the above thoughts:
- Maybe I’m not as good as I want right now, but I’m good enough and I can get better
- I’m seeing the world as awful, but there are good things that I love
- I may not feel like I have enough energy for (activity), but let me try it and see if it helps
- Some things might be my fault, but that doesn’t mean everything is
- The future may not look bright now, but I can work to make it better
These new thoughts acknowledge how you feel while also being more realistic. Writing the thoughts makes this a little easier, but you can do it in the moment in your head.
Grounding is similar to mindfulness in that it wakes up your body and mind while keeping you in the present moment. This is most commonly down with trauma disorders. Trauma disorders in the simplest terms involve distressing memories, your internal danger sense being overly sensitive, and being trapped in those memories. For example, veterans are instantly brought back to the battlefield and abuse victims are brought back to moments they were abused.
Grounding is useful here because it reminds you of where you are. Instead of seeing yourself in a different place and in the past, your body and mind wake up and place you back in the present moment.
I would argue that this is useful for depression as well. Depression dulls the body and mind while making you relive depressing moments or ruminate on depressing thoughts. As such, you can try grounding techniques to see if this pulls you out from the depression.
There are many techniques you can try. These all involve your bodily senses and placing you firmly in the present. Some grounding techniques for depression include:
- 5-4-3-2-1: Say out loud 5 things you can see, 4 things you can hear, 3 things you can feel with your body, 2 things you can smell, and 1 thing you can taste (if there’s nothing you can taste, then pay attention to the inside of your mouth). Some people also prefer 4 things you can feel and 3 things you hear.
- Water Grounding: go to a sink and turn the water to warm. Place your hands under the faucet and feel as the water changes temperature. Feel the water work its way around your fingers, palms, and all the angles in your hands. You can also place water in your mouth and feel as it changes temperature.
- Tapping: firmly tap your body. Start with your shoulders and then work your way down your arms, then your chest and stomach, then your back, and then stomp your feet slightly (not enough to be loud, but enough to feel your feet against the ground). This forces your body to recognize where your body is in space.
These are just a few grounding techniques. There are dozens if not hundreds of ways of doing this. As you can see, it’s all about activating your body’s sensations so you aren’t trapped in your mind.
If you’re like a lot of people (including me at first, so I’m right there with you!) journaling seems lame and useless. I know who I am and what I think, so why do I need to write it down? Plus, it takes so much time.
This couldn’t be further from the truth.
In reality, you probably aren’t paying attention to your doubt labels or what mean things you’re saying to yourself. There are also probably many simple things that you’ve forgotten because they didn’t seem important enough to remember. Journaling chronicles what you’re going through and (more importantly for this exercise) how you’re seeing the world.
Try journaling for a week. Simply fill one notebook page a day with what you experienced during the day. Most people do this at night before going to bed. Go back and read your entries. If you are suffering with depression, then you might notice that you describe everything in a bleak way. You can then work to modify these thoughts or at least understand patterns that are emerging.
For example, do you feel better or worse at certain times of the day, after certain activities, or around certain people? Journaling helps with this, plus it forces you to pay more attention during the day because you’ll have to write about it later.
While there are many fancy journals with mood trackers, hour trackers, prompts, and so on, you don’t need them. They’re useful, but they’re best for people who are already sold on how well journaling works. If you’re starting out, then a simple notebook is perfectly fine.
6: Distress Tolerance
Also known as frustration tolerance, this refers to your ability to cope with bad feelings. In terms of depression, this might be bad feelings you encounter around other people, when thinking of your past, when things don’t go your way, or when your mind feels fuzzy. People with depression tend to have a lower distress tolerance and it’s common to isolate during these times. The world seems too tough to deal with and you need time to recharge.
Distress tolerance skills will help you cope with the situation at hand without depleting your batteries. Not only that, but this will help you see that you can deal with the world better than you thought, which is essential to reducing your depression to a point where you can still engage with the world.
The following skills are heavily based on DBT, or Dialectical Behavioral Therapy. This therapy modality is used more frequently with bipolar disorder, personality disorders, impulsive disorders, and suicidality. It helps to teach you new ways of thinking and coping.
Some distress tolerance skills include:
Distance yourself from the stressful situation. Healthy distraction involves removing yourself from the problem temporarily until you can deal with it again. For example, you might choose to take a walk for an hour before dealing with the situation. Choose an activity that will help you relax and give yourself a time limit to return to the situation. The key here is that the problem will still be dealt with, but at a later time and when you’re in a better mood.
Pros and Cons List
Write a pros and cons list about whether it is better to stay and face the situation, or to isolate and remove yourself. You can use this to see if the problem is really worth dealing with, or if it’s a battle that would only harm your mental health. Be sure to weigh both honestly as most situations are better dealt with now or soon rather than not at all.
This is very useful for bipolar clients, but it’s also useful with depression. This involves doing things that are opposite to how you’re feeling. In a situation where you feel sad, then do something to put a smile on your face. Be a little more active. Nearly everyone has a saying, song, or movie that motivates them and makes them feel better. Now is a great time to use that. This not only makes you feel better, but it shows you that you have control over your mood.
This can be a tough one depending on the situation. Radical acceptance means accepting the situation as it is right now and accepting your part in it. Normally we wish that situations would be better (I wish he would listen to me more, I don’t want things to be this way, etc). This technique involves just accepting reality as it is without our labels or preconceived notions. We must also remember that our engagement or lack of engagement also plays a role in how life is going.
As a side note, please don’t confuse acceptance with approval. If you’re in an abusive relationship, then radical acceptance doesn’t mean you approve of the situation. It means that you accept that it is happening (because denying it won’t help you) and find a way to break up with the other party.
7: Emotional Regulation
This is another major component of DBT as it helps you not only understand your emotions, but also to regulate them better. Depression is known for dulling the emotions, making it difficult to work towards improvement, and you may be quick to anger, sadness, or numbing.
Much like with the other areas, there are numerous skills that can help with this, but the ABC PLEASE method is one of the best known. This used to be known as PLEASE MASTER in the past, and I think the new name is much better. I’ll break down both parts of this so that you understand it better.
- A – Accumulate Positive Experiences: If you’re depressed, then chances are that you have negative experiences and negative thoughts hanging over your head. Intentionally accumulating and recording positive experiences (seeing friends, playing a fun game, experiencing a new place), will help you counter the negative experiences and thoughts.
- B – Build Mastery: This involves mastering a skill or hobby. It doesn’t have to be any specific skill, nor does it have to be one that involves prestige or money. It just has to be something that you’re interested in. Building mastery reminds you that you can get better, and you can fall back to how much you’ve progressed in this skill whenever you’re feeling low.
- C – Cope Ahead: We are normally aware of situations that make us feel low (tests, speaking with new people, a situation where we might fail), so it’s best to cope ahead of time. Do whatever you can to improve your success rate and review your coping skills before heading into the situation.
- PL – Treat Physical Illnesses: The PL is used for Physical here. This refers to taking care of your biological needs and any health concerns that you have. Take your medications, keep up on appointments, and make sure your health is a top priority. We feel bad if we have an illness hanging over our head.
- E – Balanced Eating: Eat a balanced diet that provides you enough nutrition. You don’t want to eat too much or too little. Just eat enough for your body to ensure you are functioning optimally.
- A – Avoid Mood Altering Substances (Except Prescribed): Mood altering substances like drugs and alcohol can cloud your mind and leave you feeling worse after the effects are done. However, some medications will alter your mood (like antidepressants) and you should keep using those as prescribed.
- S – Balanced Sleep: Keep a consistent sleep schedule and sleep enough for your body. Those with depression often sleep too much or too little. Make sure you get around 7-9 hours (or whatever is healthy for you) and try to go to sleep and wake at the same time every day. Work on improving your sleep hygiene.
- E – Exercise: Get about 20 minutes of exercise a day. This can be cardio, strength training, or even taking a walk. If you can’t do 20 minutes, then do what you can for now and work your way up. Exercise boosts your mood and improves your physical health.
These are 7 skills for depression that can help pull you out of your low mood. I also recommend connecting with a licensed counselor or psychiatrist in order to manage your specific situation. Are there other skills that you learned, or any skills that you tried? Be sure to let us know and I might add them to the list.
Be well and be your best self.