How therapy and counseling can help

Talking about your thoughts and feelings with a supportive person makes you feel better. It can be very healing, in and of itself, to voice your worries or talk about something that’s weighing on your mind. And it feels good to be listened to—to know that someone else cares about you and wants to help.

It can be very helpful to talk about your problems to close friends and family members. But sometimes, we need help that the people around us aren’t able to provide. When you need extra support, an outside perspective, or some expert guidance, talking to a therapist or counselor can help. While the support of friends and family is important, therapy is different. Therapists are professionally-trained listeners who can help you get to the root of your problems, overcome emotional challenges, and make positive changes in your life.

You don’t have to be diagnosed with a mental health problem to benefit from therapy. Many people in therapy seek help for everyday concerns: relationship problems, job stress, or self-doubt, for example. Others turn to therapy during difficult times, such as a divorce.

Why therapy and not medication?

The thought of being able to solve your problems with taking a pill each day can sound appealing. If only it was that easy! Mental and emotional problems have multiple causes, and medication is not a one-stop cure.

Medication may help ease certain symptoms, but it comes with side effects. Furthermore, it cannot solve the “big picture” problems. Medication won’t fix your relationships, help you figure out what to do with your life, or give you insight into why you continue to do things you know are bad for you.

Therapy can be time consuming and challenging, as uncomfortable emotions and thoughts often arise as part of the treatment process. However, therapy provides long-lasting benefits that go beyond symptom relief. Therapy gives you the tools for transforming your life—for relating better to others, building the life you want for yourself, and coping with whatever curveballs come your way.

Finding the right therapist for you

Finding the right therapist will probably take some time and work, but it’s worth the effort. The connection you have with your therapist is essential. You need someone who you can trust—someone you feel comfortable talking to about difficult subjects and intimate secrets, someone who will be a partner in your recovery.
Therapy won’t be effective unless you have this bond, so take some time at the beginning to find the right person. It’s okay to shop around and to ask questions when interviewing potential therapists.

• Experience matters. One of the main reasons for seeing a therapist, rather than simply talking to a friend, is experience. Look for a therapist who is experienced in treating the problems that you have. Often, therapists have special areas of focus, such as depression or eating disorders. Experienced therapists have seen the problems you’re facing again and again, which broadens their view and gives them more insight. And for some problems, such as trauma or PTSD, seeing a specialist is absolutely essential.
• Learn about different treatment orientations. Many therapists do a blend of orientations. However, it’s a good idea to learn about the different treatment types, because that can affect your therapist’s way of relating and suggested length of treatment.
• Check licensing. Credentials aren’t everything, but if you’re paying for a licensed professional, make sure the therapist holds a current license and is in good standing with the state regulatory board. Regulatory boards vary by state and by profession. Also check for complaints against the therapist.
• Trust your gut. Even if your therapist looks great on paper, if the connection doesn’t feel right—if you don’t trust the person or feel like they truly care—go with another choice. A good therapist will respect this choice and should never pressure you or make you feel guilty.

Questions to ask yourself when choosing a therapist

What’s most important in a therapist or counselor is a sense of connection, safety, and support. Ask yourself the following questions:

• Does it seem like the therapist truly cares about you and your problems?
• Do you feel as if the therapist understands you?
• Does the therapist accept you for who you are?
• Would you feel comfortable revealing personal information to this individual?
• Do you feel as if you can be honest and open with this therapist? That you don’t have to hide or pretend you’re someone that you’re not?
• Is the therapist a good listener? Does he or she listen without interrupting, criticizing, or judging? Pick up on your feelings and what you’re really saying? Make you feel heard?

Types of therapy and therapists

There are so many types of therapies and therapists; it might feel a little overwhelming to get started. Just remember that no one type of therapy is best, any more than any style of car is best. It all depends on your individual preferences and needs.

It is true that certain techniques are more useful than others in dealing with specific types of problems (phobias, for example). But in general, research about the “best” type of therapy always reaches the same conclusion: the philosophy behind the therapy is much less important than the relationship between you and your therapist.

If you feel comfortable and trusting in that relationship, the model of therapy, like your car, is just the vehicle that will help you move ahead to lead a more fulfilling life, regardless of the circumstances that brought you to therapy.

Common types of therapy

Most therapists don’t limit themselves to one specific type of therapy, instead blending different types in order to best fit the situation at hand. This can offer many powerful tools for the therapist to use. However, therapists often have a general orientation that guides them.

• Individual therapy. Individual therapy explores negative thoughts and feelings, as well as the harmful or self-destructive behaviors that might accompany them. Individual therapy may delve into the underlying causes of current problems (such as unhealthy relationship patterns or a traumatic experience from your past), but the primary focus is on making positive changes in the here and now.
• Family therapy. Family therapy involves treating more than one member of the family at the same time to help the family resolve conflicts and improve interaction. It is often based on the premise that families are a system. If one role in the family changes all are affected and need to change their behaviors as well.
• Group therapy. Group therapy is facilitated by a professional therapist, and involves a group of peers working on the same problem, such as anxiety, depression or substance abuse, for example. Group therapy can be a valuable place to practice social dynamics in a safe environment and get inspiration and ideas from peers who are struggling with the same issues.
• Couples therapy (marriage counseling). Couples therapy involves the two people in a committed relationship. People go to couples therapy to learn how to work through their differences, communicate better and problem-solve challenges in the relationship.

Types of therapists and counselors

The following types of mental health professionals have advanced training in therapy and are certified by their respective boards. Many professional organizations provide online searches for qualified professionals. You may also want to double check with your state regulatory board to make sure the therapist’s license is up to date and there are no ethical violations listed.

However, keep in mind that lay counselors—members of the clergy, life coaches, etc.—may be able to provide you with a supportive, listening ear. It’s not always the credentials that determine the quality of the therapy.

What to expect in therapy or counseling

Every therapist is different, but there are usually some similarities to how therapy is structured. Normally, sessions will last about an hour, and often be about once a week, although for more intensive therapy they maybe more often. Therapy is normally conducted in the therapist’s office, but therapists also work in hospitals and nursing homes, and in some cases will do home visits.

• Expect a good fit between you and your therapist. Don’t settle for bad fit. You may need to see one or more therapists until you experience feeling understood and accepted.
• Therapy is a partnership. Both you and your therapist contribute to the healing process. You’re not expected to do the work of recovery all by yourself, but your therapist can’t do it for you either. Therapy should feel like a collaboration.
• Therapy will not always feel pleasant. Painful memories, frustrations or feelings might surface. This is a normal part of therapy and your therapist will guide you through this process. Be sure to communicate with your therapist about how you are feeling.
• Therapy should be a safe place. While there will be times when you’ll feel challenged or when you’re facing unpleasant feelings, you should always feel safe. If you’re starting to feel overwhelmed or you’re dreading your therapy sessions, talk to your therapist.

Your first therapy sessions

The first session or two of therapy is a time for mutual connection, a time for the therapist to learn about you and your issues. The therapist may ask for a mental and physical health history.

It’s also a good idea to talk to the therapist about what you hope to achieve in therapy. Together, you can set goals and benchmarks that you can use to measure your progress along the way.

This is also an important time for you to be evaluating your connection with your therapist. Do you feel like your therapist cares about your situation, and is invested in your recovery? Do you feel comfortable asking questions and sharing sensitive information? Remember, your feelings as well as your thoughts are important, so if you are feeling uncomfortable, don’t hesitate to consider another therapist.

Making the most of therapy and counseling

To make the most of therapy, you need to put what you’re learning in your sessions into practice in your real life. 50 minutes in therapy each week isn’t going to fix you; it’s how you use what you’ve learned with the rest of your time. Here are some tips for getting the most out of your therapy:

• Make healthy lifestyle changes. There are many things you can do in your daily life to support your mood and improve your emotional health. Reach out to others for support. Get plenty of exercise andsleep. Eat well. Make time for relaxation and play. The list goes on…
• Don’t expect the therapist to tell you what to do. You and your therapists are partners in your recovery. Your therapist can help guide you and make suggestions for treatment, but only you can make the changes you need to move forward.
• Make a commitment to your treatment. Don’t skip sessions unless you absolutely have to. If your therapist gives you homework in between sessions, be sure to do it. If you find yourself skipping sessions or are reluctant to go, ask yourself why. Are you avoiding painful discussion? Did last session touch a nerve? Talk about your reluctance with your therapist.
• Share what you are feeling. You will get the most out of therapy if you are open and honest with your therapist about your feelings. If you feel embarrassed or ashamed, or something is too painful to talk about, don’t be afraid to tell your therapist. Slowly, you can work together to get at the issues.

Is therapy working?

You should be able to tell within a session or two whether you and your therapist are a good fit. But sometimes, you may like your therapist but feel like you aren’t making progress. It’s important to evaluate your progress to make sure you’re getting what you need from therapy.

A word of caution: There is no smooth, fast road to recovery. It’s a process that’s full of twists, turns, and the occasional backtrack. Sometimes, what originally seemed like a straightforward problem turns into a more complicated issue. Be patient and don’t get discouraged over temporary setbacks. It’s not easy to break old, entrenched patterns.

Remember that growth is difficult, and you won’t be a new person overnight. But you should notice positive changes in your life. Your overall mood might be improving, for example. You may feel more connected to family and friends. Or a crisis that might have overwhelmed you in the past doesn’t throw you as much this time.

Tips for evaluating your progress in therapy

• Is your life changing for the better? Look at different parts of your life: work, home, your social life.
• Are you meeting the goals you and your therapist have set?
• Is therapy challenging you? Is it stretching you beyond your comfort zone?
• Do you feel like you’re starting to understand yourself better?
• Do you feel more confident and empowered?
• Are your relationships improving?

Your therapist should work with you, reevaluating your goals and progress as necessary. However, remember that therapy isn’t a competition. You are not a failure if you don’t meet your goals in the number of sessions you originally planned. Focus instead on overall progress and what you’ve learned along the way.

When to stop therapy or counseling

When to stop therapy depends on you and your individual situation. Ideally, you will stop therapy when you and your therapist have decided that you have met your goals. However, you may feel at some point that you have got what you need out of therapy, even if your therapist feels differently.

Leaving therapy can be difficult. Remember that the therapeutic relationship is a strong bond, and ending this relationship is a loss – even if treatment has been successful. Talk about this with your therapist. These feelings are normal. It’s not uncommon for people to go back briefly to a therapist from time to time as needs arise.

As long as you continue to progress in therapy, it’s an option

Some people continue to go to therapy on an ongoing basis. That’s okay, especially if you don’t have other people to turn to for support in your life. Ideally, your therapist will be able to help you develop outside sources of support, but that’s not always possible. If therapy meets an important need in your life and the expense is not an issue, continuing indefinitely is a legitimate choice.

Paying for therapy and counseling

In the U.S., for example, many insurance companies provide limited coverage for psychotherapy—often as few as 6-12 sessions. Read through your plan carefully to see what benefits you have. Some types of mental health professionals might not be covered. You may need a referral through your primary care physician.

Also keep in mind that some therapists do not accept insurance, only payment directly from the patient. Sometimes these therapists will accept sliding scale payments, where you pay what you can afford for each session. Don’t be afraid to ask what arrangements can be made if you feel the therapist could be a good fit for you.

In other countries, insurance and eligibility requirements vary. See Resources & References below for links on finding therapy in your country.

Affordable therapy and counseling options

Take a look around your community for service agencies or organizations that may offer psychotherapy at discounted rates. Senior centers, family service agencies, and mental health clinics are good places to start. Many offer affordable options, including sliding payment scales.

Agencies that involve interns in training also can be an option for quality therapy. An intern may be a good choice for you if the intern is enthusiastic, empathetic, and has quality supervisory training. However, an intern’s time at the agency is limited, so when the training is finished, you either need to stop the therapy or find another therapist.

Another possible way to obtain affordable therapy is to try bartering with a therapist or mental health clinic. A few clinics and health centers across the U.S. already encourage bartering services, swapping health care for carpentry, plumbing, or hairdressing services, for example. If you have a useful skill or are willing to volunteer your time, it may be worth trying to strike a deal.

Understanding depression in men

Depression affects millions of men of all ages and backgrounds, as well as those who care about them—spouses, partners, friends, and family. More than just a dip in mood in response to life’s setbacks and disappointments, depression changes how you think, feel, and function in your daily life. It can interfere with your productivity at work or school and impact your relationships, sleep, diet, and overall enjoyment of life. Severe depression can be intense and unrelenting.

• Depression in men can often be overlooked. Many men find it difficult to talk about their feelings so they tend to focus on the physical symptoms that often accompany depression. This can result in the underlying depression going untreated.
• Men suffering from depression are four times more likely to commit suicide than women.It’s important for any man to seek help with depression before feelings of despair become feelings of suicide. Talk honestly with a friend, loved one, or doctor about what’s going on in your mind.
• There is plenty men can do to overcome depression. The important thing is to recognize the symptoms.

Am I depressed?

If you identify with several of the following, you may be suffering from depression.

• you feel hopeless and helpless
• you’ve lost interest in friends, activities, and things you used to enjoy
• you’re much more irritable, short-tempered, or aggressive than usual
• you’re consuming more alcohol, engaging in reckless behavior, or using TV, sports, and sex to self-medicate
• you feel restless and agitated
• your sleep and appetite has changed
• you can’t concentrate or your productivity at work has declined
• you can’t control your negative thoughts

Signs and symptoms of depression in men

Men are far less adept at recognizing symptoms of depression than women. A man is more likely to deny his feelings, hide them from himself and others, or try to mask them with other behaviors. The three most common signs of depression in men are:

• Physical pain. Sometimes depression in men shows up as physical symptoms—such as backache, frequent headaches, sleep problems, sexual dysfunction, or digestive disorders—that don’t respond to normal treatment.
• Anger. This could range from irritability, sensitivity to criticism, or a loss of your sense of humor to road rage, a short temper, or even violence. Some men become abusive or controlling.
• Reckless behavior. A man suffering from depression may exhibit escapist or risky behavior such as pursuing dangerous sports, driving recklessly, or engaging in unsafe sex. You might drink too much, abuse drugs, or gamble compulsively.

Triggers for depression in men

Biological, psychological, and social factors all play a part in depression in men, as do lifestyle choices, relationships, and coping skills. Stressful life events or anything that makes you feel helpless, profoundly sad, or overwhelmed by stress can also trigger depression in men, including:

• Overwhelming stress at work, school, or home
• Marital or relationship problems
• Not reaching important goals
• Losing or changing a job; embarking on military service
• Constant money problems
• Health problems such as chronic illness, injury, disability
• Recently quitting smoking
• Death of a loved one
• Family responsibilities such as caring for children, spouse, or aging parents
• Retirement; loss of independence

Help for depression in men tip 1: Seek social support to reduce stress and feel happier

Work commitments can often make it difficult for men to find time to maintain friendships, but close relationships are vital to helping you get through this tough time.

• The simple act of talking to someone face to face about how you feel can be an enormous help.
• The person you talk to doesn’t have to be able to fix you; they just need to be a good listener, someone who’ll listen attentively without being distracted or judging you.
• If you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and improve your support network.

Finding social support to beat male depression

• Reach out to family and friends. Accepting help and support is not a sign of weakness and it won’t mean you’re a burden to others. In fact, most friends will be flattered that you trust them enough to confide in them.
• Participate in social activities, even if you don’t feel like it.When you’re depressed, it feels more comfortable to retreat into your shell. But being around other people will boost your mood.
• Join a support group for depression. Being with others facing the same problems can help reduce your sense of isolation and remove any stigma you may feel.
• Volunteer. Being helpful to others delivers immense pleasure and is also a great way to expand your social network.
• Meet new people with common interests by taking a class or joining a club.
• Walk a dog. It’s good exercise for you and a great way to meet people.
• Invite someone to a ballgame, movie, or concert. There are plenty of other people who feel just as awkward about reaching out and making new friends as you do. Be the one to break the ice.
• Call or email an old buddy. Even if you’ve retreated from relationships that were once important to you, make the effort to reconnect.

Help for depression in men tip 2: Exercise for greater mental and physical health

When you’re depressed, just getting out of bed can seem like a daunting task, let alone exercising. But regular exercise can be as effective as antidepressant medication in countering the symptoms of depression in men. It’s also something you can do right now to boost your mood.

• Aim to exercise for 30 minutes or more per day—or break that up into short, 10-minute bursts of activity. A 10-minute walk can improve your mood for two hours.
• The most benefits for male depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.
• Adding a mindfulness element is particularly effective. Focus on how your body feels as you move—the sensation of your feet hitting the ground, for example, or the wind on your skin.
• Joining a class or exercising in a group can help keep you motivated and make exercise a social activity. Or find a workout buddy, and afterwards have a drink or watch a game together.

Help for depression in men tip 3: Eat a healthy diet to improve how you feel

What you eat has a direct impact on the way you feel.

• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy.
• Reduce your intake of foods that can adversely affect your mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones.
• Eat more Omega-3 fatty acids to give your mood a boost. The best sources are fatty fish (salmon, herring, mackerel, anchovies, sardines), seaweed, flaxseed, and walnuts. 
• Try foods rich in mood-enhancing nutrients, such as bananas (magnesium to decrease anxiety, vitamin B6 to promote alertness, tryptophan to boost feel-good serotonin levels) and spinach (magnesium, folate to reduce agitation and improve sleep).
• Avoid deficiencies in B vitamins which can trigger depression. Eat more citrus fruit, leafy greens, beans, chicken, and eggs.

Help for depression in men tip 4: Make healthy lifestyle changes to lift your mood

Positive lifestyle changes can help lift depression and keep it from coming back.

• Get enough sleep. When you don’t get enough sleep, your depression symptoms can be worse. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night.
• Reduce stress. Too much stress exacerbates depression but there are healthy ways to cope. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Professional treatment for depression in men

If support from family and friends and positive lifestyle changes aren’t enough, seek help from a mental health professional. Be open about how you’re feeling as well as your physical symptoms. Treatments for depression in men include:

• Therapy. You may feel that talking to a stranger about your problems is ‘unmanly,’ or that therapy carries with it a victim status. However, if therapy is available to you, it can often bring a swift sense of relief, even to the most skeptical male.
• Medication. Antidepressant medication may help relieve some symptoms of depression, but doesn’t cure the underlying problem, and is rarely a long-term solution. Medication also comes with side effects. Don’t rely on a doctor who is not trained in mental health for guidance on medication, and always pursue self-help steps as well.

Helping a man with depression

It often takes a wife, partner, or other family member to recognize a man’s symptoms of depression.

Talking to a man about depression

Many men don’t exhibit typical depressive symptoms—but rather anger and reckless behavior—so you may want to avoid using the word “depression” and try describing his behavior as “stressed” or “overly tired.” It could help him to open up.

• Point out how his behavior has changed, without being critical. For example, “You always seem get stomach pains before work,” or “You haven’t played racquetball for months.”
• Suggest a general check-up with a physician. He may be less resistant to seeing a family doctor than a mental health specialist at first. The doctor can rule out medical causes of depression and then make a referral.
• Offer to accompany him on the first visit with a mental health specialist. Some men are resistant to talking about their feelings, so try to remove roadblocks to him seeking help.
• Encourage him to make a list of symptoms to discuss. Help him focus on his feelings as well as physical ailments, and to be honest about his use of alcohol and drugs.

The road to depression recovery begins with a single step

It’s the Catch-22 of depression: recovering from depression requires action, but taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better, like going for a walk or spending time with friends, can feel overwhelming. That’s why it’s important to start small and slowly build from there.

Start small and stay focused

Draw upon whatever resources you have. You may not have much energy, but you probably have enough to take a short walk around the block or pick up the phone to call a loved one.

Be patient with yourself and celebrate each accomplishment. The steps may seem small, but they’ll quickly add up. If you continue to take positive steps day by day, you’ll soon find yourself feeling better.

Depression self-help tip 1: Stay connected

When you’re depressed, the tendency is to withdraw and isolate. Even reaching out to close family members and friends can be tough. Compound that with the feelings of shame and the guilt you may feel at neglecting your relationships.

But social support is absolutely essential to depression recovery. Staying connected to other people and the outside world will make a world of difference in your mood and outlook. And if you don’t feel that you have anyone to turn to, it’s never too late to build new friendships and improve your support network.

• Reaching out is not a sign of weakness and it won’t mean you’re a burden to others. The truth is that most people are flattered if you trust them enough to confide in them. Your loved ones care about you and want to help.
• Look for support from people who make you feel safe and cared for. The person you talk to doesn’t have to be able to fix you; he or she just needs to be a good listener—someone who’ll listen attentively and compassionately without being distracted or judging you.
• Make face-time a priority. Phone calls, social media, and texting are great ways to stay in touch, but they don’t replace good old-fashioned in-person quality time.  The simple act of talking to someone face to face about how you feel can play a big role in lifting the fog of depression and keeping it away.
• Try to keep up with social activities even if you don’t feel like it. Often when you’re depressed, it feels more comfortable to retreat into your shell, but being around other people will make you feel less depressed.
• Find ways to support others. It’s nice to receive support, but research shows you get an even bigger mood boost from providing support yourself. So find ways—both big and small—to help others:volunteer, be a listening ear for a friend, do something nice for somebody.
• Care for a pet. While nothing can replace the human connection, pets can bring joy and companionship into your life and help you feel less isolated. Caring for a pet can also get you outside of yourself and give you a sense of being needed—both powerful antidotes to depression.

Depression self-help tip 2: Get moving

When you’re depressed, just getting out of bed can seem like a daunting task, let alone working out! Butexercise is a powerful depression fighter—and one of the most important tools in your recovery arsenal. Research shows that regular exercise can be as effective as medication for relieving depression symptoms. It also helps prevent relapse once you’re well.

To get the most benefit, aim for at least 30 minutes of exercise per day. This doesn’t have to be all at once—and it’s okay to start small. A 10-minute walk can improve your mood for two hours.

Exercise is something you can do right now to boost your mood

• Your fatigue will improve if you stick with it. Starting to exercise can be difficult when you’re depressed and exhausted. But research shows that your energy levels will improve if you keep with it. You will be less fatigued, not more, once it’s part of your routine.
• Find exercises that are continuous and rhythmic. The most benefits for depression come from rhythmic exercise—such as walking, weight training, swimming, martial arts, or dancing—where you move both your arms and legs.
• Add a mindfulness element, especially if your depression is rooted in unresolved trauma or fed by obsessive, negative thoughts. Focus on how your body feels as you move—such as the sensation of your feet hitting the ground, or the feeling of the wind on your skin, or the rhythm of your breathing.

Depression self-help tip 3: Do things that make you feel good

In order to overcome depression, you have to do things that relax and energize you. This includes following a healthy lifestyle, learning how to better manage stress, setting limits on what you’re able to do, and scheduling fun activities into your day.

Do things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel more upbeat and energetic as you make time for fun activities.

• Pick up a former hobby or a sport you used to like.
• Express yourself creatively through music, art, or writing.
• Go out with friends.
• Take a day trip to a museum, the mountains, or the ballpark.

Support your health

• Aim for eight hours of sleep. Depression typically involves sleep problems; whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
• Expose yourself to a little sunlight every day. Lack of sunlight can make depression worse. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day to boost your mood. If you live somewhere with little winter sunshine, try using a light therapy box.
• Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Depression self-help tip 4: Eat a healthy, mood-boosting diet

What you eat has a direct impact on the way you feel. Reduce your intake of foods that can adversely affect your brain and mood, such as caffeine, alcohol, trans fats, and foods with high levels of chemical preservatives or hormones (such as certain meats).

• Don’t skip meals. Going too long between meals can make you feel irritable and tired, so aim to eat something at least every three to four hours.
• Minimize sugar and refined carbs. You may crave sugary snacks, baked goods, or comfort foods such as pasta or French fries, but these “feel-good” foods quickly lead to a crash in mood and energy. Aim to cut out as much of these foods as possible.
• Boost your B vitamins. Deficiencies in B vitamins such as folic acid and B-12 can trigger depression. To get more, take a B-complex vitamin supplement or eat more citrus fruit, leafy greens, beans, chicken, and eggs.

Depression self-help tip 5: Challenge negative thinking

Do you feel like you’re powerless or weak? That bad things happen and there’s not much you can do about it? That your situation is hopeless? Depression puts a negative spin on everything, including the way you see yourself and your expectations for the future.

When these types of thoughts overwhelm you, it’s important to remind yourself that this is the depression talking. These irrational, pessimistic attitudes—known as cognitive distortions—aren’t realistic. When you really examine them they don’t hold up. But even so, they can be tough to give up. Just telling yourself to “think positive” won’t cut it. Often, they’re part of a lifelong pattern of thinking that’s become so automatic you’re not even completely aware of it.

Put your thoughts on the witness stand

Once you identify the destructive thoughts patterns that you default to, you can start to challenge them with questions such as:

• “What’s the evidence that this thought is true? Not true?”
• “What would I tell a friend who had this thought?”
• “Is there another way of looking at the situation or an alternate explanation?”
• “How might I look at this situation if I didn’t have depression?”

As you cross-examine your negative thoughts, you may be surprised at how quickly they crumble. In the process, you’ll develop a more balanced perspective.

When to get professional help

If you’ve taken self-help steps and made positive lifestyle changes and still find your depression getting worse, seek professional help. Needing additional help doesn’t mean you’re weak. Sometimes the negative thinking in depression can make you feel like you’re a lost cause, but depression can be treated and you can feel better!

Don’t forget about these self-help tips, though. Even if you’re receiving professional help, these tips can be part of your treatment plan, speeding your recovery and preventing depression from returning.

Depression self-help checklist

Use this checklist to track your progress using these self-help tips to deal with depression. Feeling better can take time, but try comparing how you feel on days when you make lots of ticks on the checklist to those when you make few or none.

Click here for a printer-friendly weekly checklist.

If stress or poor relationships are contributing to depression,FEELING LOVED can help.

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Related HelpGuide articles

• Depression Treatment: Therapy, Medication, and Lifestyle Changes That Can Help Depression
• Helping a Depressed Person: How to Reach Out and Help Someone While Taking Care of Yourself
• Antidepressant Medication: What You Need to Know About Medications for Depression

Resources and references

Depression self-help tips and tools

Back from the Bluez – Self-help modules for coping with and recovering from depression. (The Government of Western Australia Department of Health)

A Case of Catch 22 – Learn how to get around the Catch-22 of depression, in which the things a person needs to do to get well are the very things the illness makes it difficult to do. (Psychology Today)

Wellness Tracker – Find free online tools designed to help you track your moods, monitor depression symptoms, and create a personalized wellness plan. (Depression and Bipolar Support Alliance)

Depression Doing the Thinking – Learn about common cognitive distortions and how to change them. (Psychology Today)

Healthy lifestyle habits and depression

Exercise and Depression – Learn about research that shows that regular exercise can improve the symptoms of mild to moderate depression. (Harvard Health Publications)

Depression and Nutrition – Explore nutritional imbalances that can contribute to depression, and how diet can help improve symptoms. (Food for the Brain)

Fighting Depression and Improving Cognition with Omega-3 Fatty Acids – Explore the link between Omega-3s and depression, and the implications for treatment. (LE Magazine)

Bedfellows: Insomnia and Depression – Discover the connection between sleep and mood, including how lack of sleep can trigger depression. (Psychology Today)

Support groups for depression

Find Support – To locate a depression support group in your area. (Depression and Bipolar Support Alliance)

What other readers are saying

“Thank you so much for your advice and expertise. I am in the midst of going off antidepressant and anti-anxiety meds as I felt I was getting worse, not better. Your website is the beginning of doing something good for myself . . .” ~ Indiana

“I suffered with major clinical depression, and unfortunately had limited support from friends and family, but this website really helped me understand the illness . . . It gave me coping tips, and has been paramount in my fight against it . . . and it has allowed me to help and understand some of my friends who suffer with mental health issues.” ~ United Kingdom

“I was going through the state of depression for some months. I am really thankful for the refreshing thoughts and tips suggested. After reading these, I’m relieved a great deal, realizing I’m not the only one facing these negative thoughts.” ~ India

“Thank you for providing these materials. I’m on antidepressants and don’t want to increase them. I feel a huge relief that there’s something I can do for myself.” ~ California

Authors: Melinda Smith, M.A., Robert Segal, M.A., and Jeanne Segal, Ph.D. Last updated: July 2016.

Understanding depression in women

Depression is a serious condition that can impact every area of your life. It can affect your social life, relationships, career, and sense of self-worth and purpose. And for women in particular, depression is common. In fact, according to the National Mental Health Association, about one in every eight women will develop depression at some point during her lifetime.

If you’re feeling sad, guilty, tired, and just generally “down in the dumps,” you may be suffering from major depression. But the good news is that depression is treatable, and the more you understand about depression’s particular implications for and impact on women, the more equipped you will be to tackle the condition head on.

Signs and symptoms of depression in women

The symptoms of depression in women are the same as those for major depression. Common complaints include:

Differences between male and female depression

Although some of the signs and symptoms of depression are the same for both men and women, women tend to experience certain symptoms more often than men. For example, seasonal affective disorder—depression in the winter months due to lower levels of sunlight—is more common in women. Also, women are more likely to experience the symptoms of atypical depression.

In atypical depression, rather than sleeping less, eating less, and losing weight, the opposite is seen: sleeping excessively, eating more (especially carbohydrates), and gaining weight. Feelings of guilt associated with depression are also more prevalent and pronounced in women. Women also have a higher incidence of thyroid problems. Since hypothyroidism can cause depression, this medical problem should always be ruled out by a physician in women who are depressed.

Causes of depression in women

Women are about twice as likely as men to suffer from depression. This two-to-one difference persists across racial, ethnic, and economic divides. In fact, this gender difference in rates of depression is found in most countries around the world. There are a number of theories that attempt to explain the higher incidence of depression in women. Many factors have been implicated, including biological, psychological, and social factors.

Biological and hormonal causes of depression in women

• Premenstrual problems – Hormonal fluctuations during the menstrual cycle can cause the familiar symptoms of premenstrual syndrome (PMS), such as bloating, irritability, fatigue, and emotional reactivity. For many women, PMS is mild. But for some women, symptoms are severe enough to disrupt their lives and a diagnosis of premenstrual dysphoric disorder (PMDD) is made.
• Pregnancy and infertility – The many hormonal changes that occur during pregnancy can contribute to depression, particularly in women already at high risk. Other issues relating to pregnancy such as miscarriage, unwanted pregnancy, and infertility can also play a role in depression.
• Postpartum depression – Many new mothers experience the “baby blues.” This is a normal reaction that tends to subside within a few weeks. However, some women experience severe, lasting depression. This condition is known as postpartum depression. Postpartum depression is believed to be influenced, at least in part, by hormonal fluctuations.
• Perimenopause and menopause – Women may be at increased risk for depression during perimenopause, the stage leading to menopause when reproductive hormones rapidly fluctuate. Women with past histories of depression are at an increased risk of depression during menopause as well.
• Health problems – Chronic illness, injury, or disability can lead to depression in women, as can crash dieting or quitting smoking.

Psychological causes of depression in women

• Focusing on and rehashing negative feelings – Women are more likely to ruminate when they are depressed. This includes crying to relieve emotional tension, trying to figure out why you’re depressed, and talking to your friends about your depression. However, rumination has been found to maintain depression and even make it worse. Men, on the other hand, tend to distract themselves when they are depressed. Unlike rumination, distraction can reduce depression.
• Overwhelming stress at work, school, or home – Some studies show that women are more likely than men to develop depression from stress. Furthermore, the female physiological response to stress is different. Women produce more stress hormones than men do, and the female sex hormone progesterone prevents the stress hormone system from turning itself off as it does in men.
• Body image issues – The gender difference in depression begins in adolescence. The emergence of sex differences during puberty likely plays a role. Some researchers point to body dissatisfaction, which increases in girls during the sexual development of puberty.

Social causes of depression in women

As with men, social factors can also play a part in causing depression in women, along with lifestyle choices, relationships, and coping skills. These may include:

• Marital or relationship problems; balancing the pressures of career and home life
• Family responsibilities such as caring for children, spouse, or aging parents
• Experiencing discrimination at work or not reaching important goals, losing or changing a job, retirement, or embarking on military service
• Persistent money problems
• Death of a loved one or other stressful life event that leaves you feeling useless, helpless, alone, or profoundly sad

Treating depression in women

For the most part, women suffering from depression receive the same types of treatment as everyone else. The main treatment approaches are psychotherapy and antidepressant therapy. However, there are some special treatment considerations for depression in women.

Depression, hormones, and the reproductive cycle

Hormone fluctuations related to the reproductive cycle can have a profound influence on a woman’s mood. In light of this possibility, you and your doctor should always look for connections between your depressive symptoms and the female reproductive cycle.

• Is your depression connected to your menstrual period and a possible effect of PMS?
• Are you pregnant and struggling with complications and concerns related to the vast changes you and your body are undergoing?
• Are you struggling with the baby blues after recently giving birth?
• Or are you approaching menopause and dealing with hormonal and emotional fluctuations?

All of these milestones in the reproductive cycle can influence or trigger depression. It’s also important to consider mood-related side effects from birth control medication or hormone replacement therapy.

How depression treatment is different for women

Specific aspects of treatment must often be modified for women. Because of female biological differences, women should generally be started on lower doses of antidepressants than men. Women are also more likely to experience side effects, so any medication use should be closely monitored.

Finally, women are more likely than men to require simultaneous treatment for other conditions such as anxiety disorders and eating disorders.

Self-help for depression in women

You can make a huge dent in your depression with simple lifestyle changes: exercising every day, avoiding the urge to isolate, eating healthy food instead of the junk you crave, and carving out time for rest and relaxation.

Feeling better takes time, but you can get there if you make positive choices for yourself each day and draw on the support of others.

Expose yourself to a little sunlight every day. Sunlight can help boost your mood. Take a short walk outdoors, have your coffee outside, enjoy an al fresco meal, people-watch on a park bench, or sit out in the garden. Aim for at least 15 minutes of sunlight a day. If you live somewhere with little winter sunshine, try using a light therapy box.

• Talk about your feelings to someone you trust, face-to-face. Share what you’re going through with the people you love and trust. Ask for the help and support you need. You may have retreated from your most treasured relationships, but they can get you through this tough time. If you don’t feel that you have anyone to confide in, look to build new friendships. Start by joining a support group for depression.
• Try to keep up with social activities even if you don’t feel like it. When you’re depressed, it feels more comfortable to retreat into your shell. But being around other people will make you feel less depressed.
• Get up and moving. Studies show that regular exercise can be as effective as antidepressant medication at increasing energy levels and decreasing feelings of fatigue. You don’t have to hit the gym. A 30-minute walk each day will give you a much-needed boost.
• Aim for 8 hours of sleep. Depression typically involves sleep problems. Whether you’re sleeping too little or too much, your mood suffers. Get on a better sleep schedule by learning healthy sleep habits.
• Practice relaxation techniques. A daily relaxation practice can help relieve symptoms of depression, reduce stress, and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Premenstrual dysphoric disorder

Most women are all too familiar with premenstrual syndrome (PMS). Unwelcome symptoms of PMS such as bloating, moodiness, and fatigue appear and reappear each month at the same time in the menstrual cycle. For most women, these premenstrual symptoms are uncomfortable but not disabling. But for up to one out of ten women, symptoms are so distressing and disabling that they warrant a diagnosis of premenstrual dysphoric disorder (PMDD). PMDD is characterized by severe depression, irritability, and other mood disturbances. Symptoms begin about 10 to 14 days before your period and improve within a few days of its start.

Self-help for PMDD

There are many steps you can take to improve PMDD symptoms. Many involve simple lifestyle adjustments.

• Exercise – Regular aerobic exercise can reduce the symptoms of PMDD.
• Dietary modifications – Changes to your diet may help reduce symptoms. Cutting back on salt, fatty foods, caffeine, and alcohol is recommended. Eating plenty of complex carbohydrates is also recommended.
• Nutritional supplements – Vitamin B-6, calcium, magnesium, Vitamin E, and tryptophan have all been shown to benefit women suffering from PMDD.
• Herbal remedies – Evening primrose oil and chaste tree berry are herbal supplements that have both been studied and found to be effective in the treatment of PMDD.
• Stress reduction – Relaxation techniques and other strategies to reduce stress may help with PMDD symptoms. Yoga and meditation are particularly effective.

If stress or poor relationships are contributing to depression,FEELING LOVED can help.

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Related HelpGuide articles

• Depression Symptoms and Warning Signs: How to Recognize Depression Symptoms and Get Effective Help
• Postpartum Depression: Tips to Help You Be a Happy Mother and Give Your Baby the Best Start in Life
• Helping a Depressed Person: How to Reach Out and Help Someone While Taking Care of Yourself

Resources and references

General information about depression in women

Depression in women: Understanding the gender gap – Explore the unique biological, psychosocial, and cultural factors that may increase a woman’s risk for depression. (Mayo Clinic)

Mood Disorders and the Reproductive Cycle – Review how changing levels of female reproductive hormones over the life cycle can impact depression. Includes information about estrogen, thyroid impairment, and the effect of oral contraceptives. (HealthyPlace)

More Women Suffer Depression – Article looks into some of the reasons why women around the world are more susceptible to depression than men. (Psychology Today)

Premenstrual dysphoric disorder and perimenopausal depression

PMS & PMDD – Learn about premenstrual mood changes, including the symptoms and treatment of  premenstrual dysphoric disorder. (Massachusetts General Hospital, Center for Women’s Health)

Menstrually Related Mood Disorders – A guide to the mood disorders and depression-related symptoms associated with the menstrual cycle. (UNC School of Medicine, Center for Women’s Mood Disorders)

Depression During the Transition to Menopause: A Guide for Patients and Families (PDF) – Explore the symptoms and treatment of perimenopausal depression.

Diagnosis and Treatment of Premenstrual Dysphoric Disorder – Comprehensive article geared towards medical professionals. Learn about treatment options including therapy, medications, lifestyle changes, herbal treatments, and nutritional supplements. (American Academy of Family Physicians)

Pregnancy and depression

Antidepressants: Safe during pregnancy? – Uncover the risks of taking antidepressants during pregnancy. Learn which antidepressants are safer than other and what can happen if you stop taking your medication during pregnancy. (Mayo Clinic)

Psychiatric Disorders During Pregnancy – Covers the risks associated with taking antidepressants and other psychiatric medications during pregnancy. (Massachusetts General Hospital, Center for Women’s Health)

Depression During Pregnancy: Treatment Recommendations – Explore the current treatment recommendations for depression during pregnancy. (American Congress of Obstetricians and Gynecologists)

Depression in adolescent and teenage girls

Mood Disorders and Teenage Girls– Discusses why girls are more vulnerable to mood disorders and what signs and symptoms you should look for in adolescent girls. (Child Mind Institute)

What other readers are saying

“I have been having moderate depressive and anxiety episodes . . . and I have used the many wonderful, insightful, and well-researched articles on this site in order to get through this tough time and lessen the severity of the episodes as they occur. . . Truly, I think this site has saved my life . . . and I cannot thank you all enough.” ~ Pennsylvania

“Your encouragement has really helped me change. I thought I was a lost cause. Am really grateful.” ~ Kenya

Authors: Melinda Smith, M.A., and Jaelline Jaffe, Ph.D. Last updated: May 2016.