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6 Common Depression Traps to Avoid

Expert advice on how to sidestep pitfalls that often accompany depression.

WebMD Feature

By Jennifer Soong

Reviewed By Louise Chang, MD

When Orion Lyonesse is getting depressed, she turns into a hermit. She doesn’t want to leave the house (not even to pick up the mail), and she cuts off contact with her friends and family.

“The more I’m alone, the deeper the depression gets,” Lyonesse, an artist and writer in Lake Stevens, Wash., tells WebMD in an email. “I don’t even want to cuddle my cats!”

Avoiding social contact is a common pattern you might notice when falling into depression. Some people skip activities they normally enjoy and isolate themselves from the world. Others turn to alcohol or junk food to mask their pain and unhappiness.

Depression traps vary from person to person, but what they have in common is that they can serve to worsen your mood, perpetuating a vicious cycle. Here are six behavioral pitfalls that often accompany depression — and how you can steer clear of them as you and your doctor or therapist work on getting back on track.

Trap #1: Social Withdrawal

Social withdrawal is the most common telltale sign of depression.

“When we’re clinically depressed, there’s a very strong urge to pull away from others and to shut down,” says Stephen Ilardi, PhD, author of books including The Depression Cure and associate professor of psychology at the University of Kansas. “It turns out to be the exact opposite of what we need.”

“In depression, social isolation typically serves to worsen the illness and how we feel,” Ilardi says. “Social withdrawal amplifies the brain’s stress response. Social contact helps put the brakes on it.”

The Fix: Gradually counteract social withdrawal by reaching out to your friends and family. Make a list of the people in your life you want to reconnect with and start by scheduling an activity.

Trap #2: Rumination

A major component of depression is rumination, which involves dwelling and brooding about themes like loss and failure that cause you to feel worse about yourself.

Rumination is a toxic process that leads to negative self-talk such as, “It’s my own fault. Who would ever want me a friend?”

“There’s a saying, ‘When you’re in your own mind, you’re in enemy territory,'” says Mark Goulston, MD, psychiatrist and author of Get Out of Your Own Way. “You leave yourself open to those thoughts and the danger is believing them.”

Rumination can also cause you to interpret neutral events in a negative fashion. For example, when you’re buying groceries, you may notice that the checkout person smiles at the person in front of you but doesn’t smile at you, so you perceive it as a slight.

“When people are clinically depressed, they will typically spend a lot of time and energy rehearsing negative thoughts, often for long stretches of time,” Ilardi says.

The Fix: Redirect your attention to a more absorbing activity, like a social engagement or reading a book.

Give children unconditional love.

Love, security, and acceptance should be at the heart of family life. Children need to know that your love does not depend on his or her accomplishments.

Mistakes and/or defeats should be expected and accepted. Confidence grows in a home that is full of unconditional love and affection.

Nurture children’s confidence and self-esteem.

􀂃 Praise Them – Your attention helps build their self-confidence and self-esteem.

􀂃 Set Realistic Goals – Young children need realistic goals that match their ambitions with their abilities. With your help, older children can choose activities that test their abilities and increase their self-confidence.

􀂃 Be Honest – Do not hide your failures from your children. It can be very re-assuring to know that adults are not perfect.

􀂃 Avoid Sarcastic Remarks

􀂃 Encourage children – To not only strive to do their best, but also to enjoy the process.

Encourage Children to Play

To children, play is just fun. However, playtime is as important to their development as food and good care. Playtime helps children be creative, learn problem-solving skills and learn self-control. Good, hardy play, which includes running and yelling, is not only fun, but helps children to be physically and mentally healthy.

Play for fun. Winning is not as important as being involved and enjoying the activity. One of the most important questions to ask children is “Did you have fun?’’ not “Did you win?”

In our goal-oriented society, we often acknowledge only success and winning. This attitude can be discouraging and frustrating to children who are learning and experimenting with new activities. It’s more important for children to participate and enjoy themselves.

Provide appropriate guidance and instructive discipline

Children need the opportunity to explore and develop new skills and independence. At the same time, children need to learn that certain behaviors are unacceptable and that they are responsible for the consequences of their actions.

As members of a family, children need to learn the rules of the family unit. Offer guidance and discipline that is fair and consistent. They will take these social skills and rules of conduct to school and eventually to the workplace.

Provide a safe and secure home.

It’s okay for children to feel afraid sometimes. Everyone is afraid of something at some point in their life. Fear and anxiety grow out of experiences that we do not understand.

If your children have fears that will not go away and affect his or her behavior, the first step is to find out what is frightening them. Be loving, patient, and reassuring, not critical. Remember: the fear may be very real to the child.

When to seek help

Parents and family members are usually the first to notice if a child has problems with emotions or behavior. Your observations with those of teachers and other caregivers may lead you to seek help for your child. If you suspect a problem or have questions, consult your pediatrician or contact a mental health professional.

Warning Signs

The following signs may indicate the need for professional assistance or evaluation:

􀂃 Decline in school performance

􀂃 Poor grades despite strong efforts

􀂃 Regular worry or anxiety

􀂃 Repeated refusal to go to school or take part in normal children’s activities

􀂃 Hyperactivity or fidgeting

􀂃 Persistent nightmares

􀂃 Persistent disobedience or aggression

􀂃 Frequent temper tantrums

􀂃 Depression, sadness or irritability
　

Where to seek help

Information and referrals regarding the types of services that are available for children may be obtained from:

􀂃 Mental health organizations, hotlines and libraries

􀂃 Other professionals such as the child’s pediatrician or school counselor

􀂃 Other families in the community

􀂃 Family network organizations

􀂃 Community-based psychiatric clinic
　

For more information, contact the Mental Health Association of East Tennessee at (865) 584-9125.

How to Exercise When Depressed — Even if You Prefer Staying in Bed
By Graeme Cowan

How to Exercise When Depressed — Even if You Prefer Staying in BedWant to treat your depression quickly, safely and for free? Exercise!

It works, has no side effects (unless you really overexert yourself) and is great for your mental and physical well-being in every respect. In fact, a recent review of over 26 years of research shows that moderate physical activity each day — even something as simple as gardening — can prevent depression in all age groups, not just treat it. So exercise as part of a depression treatment strategy really is a no-brainer!

But let’s face it, you don’t really want to exercise, do you? I know that feeling. Maybe you’re reading this article as part of a desperate effort not to do any physical activity!

It’s Not Just You

Alastair Campbell In Back From The Brink, I interviewed Alastair Campbell, who served as Chief Advisor to former UK Prime Minister Tony Blair.

Alastair’s battle with depression is well-publicized and he is a vocal critic of mental health stigma.

For Alastair, keeping fit is a crucial part of his daily regime and he acknowledges the importance of exercise to his mental well-being. When he ran the 2003 London Marathon, sponsored by then-U.S. President George W. Bush, he drew a lot of media attention.

But Alastair admits that when he’s depressed, even he finds it harder to generate the enthusiasm and energy required for exercise, despite this being such an important and enjoyable part of his life.

It’s a problem that affects many of us when suffering from depression or the lows of bipolar disorder. Even thinking of exercise is tiring. Exercise involves working up a sweat, long runs, exhaustion or hours in expensive gyms, right?

Wrong!

If you realize that exercise is not synonymous with marathons or intensive workouts, the fear and aversion subsides. Starting exercise doesn’t mean starting significant exercise and it doesn’t have to be hard work.
Whisker Goals: Breaking Things into Manageable Chunks

Whisker Goals are small, no-stress goals. You set yourself a very small, easily achievable goal and then do it, without thinking about anything larger and doing nothing more than just that whisker goal.

The main purpose of whisker goals is very simple: You set and achieve small, realistic goals and prove to yourself that you are capable. Then you slowly scale up those goals.

Imagine a thoroughly messy cupboard in your house. You’ve been meaning to clean it for ages, but the thought of tackling all that disorganization puts you off. You’ll do anything but take on this mammoth task, which could take you hours or even days.

But what if you set a whisker goal of spending just five minutes a day cleaning that cupboard? Set a timer, open the door, work on what is in front of you and — bing! — as soon as the timer goes off, close the cupboard door, no matter where you’re at.

Five minutes a day. For a week. The next week, you increase that time to 10 minutes a day. The next week, 15 minutes.

Pretty soon, without even realizing it, that mammoth task of cleaning the cupboard was completed and was nowhere near as painful as you thought it’d be. Because instead of doing it all at once, you used whisker goals to break the project into small, manageable chunks.
Walk To The Mailbox & Back

The same strategy applies to exercise — start off with tiny whisker goals and slowly work your way up from there.

After reading this article, put on your running shoes and walk to the mailbox, then back to your house. That’s your exercise for the day (and maybe the next day) done!

After that, maybe walk to the end of your block. The day after, to a shop a block or two away – make sure to reward yourself with a treat or your favorite snack!

By doing this, you build up your level of exercise and prove to yourself that you can set and achieve small and manageable goals. That can do wonders for your self-belief. As you slowly ratchet up the distance or intensity of a particular exercise, you’ll quickly feel the self-reinforcing benefits that regular exercise brings to the mind and body.

Whisker goals make exercising easy and manageable when you have depression or bipolar disorder. But you have to act on those goals, not just set them. Otherwise, the only exercise you’ll be doing is in procrastination.

Boost your school performance by taking care of you

It can be hard to maintain a healthy lifestyle in college. If you are running to classes, studying, commuting to school and working or taking care of your family, time can seem to evaporate. If you are just starting college, the changes can feel overwhelming-and you may neglect your health.
Taking good care of your body and mind can make a difference in how well you do in school and how well you manage change. Exercising, eating right, getting enough rest and relaxing will help you do better, enjoy school more and improve how you deal with life’s challenges. Caring for yourself may take a little extra time, but you will feel better and be more successful. Here’s what you need and why it helps:

Regular exercise:
•Elevates mood, reduces stress, increases energy level, improves appearance, and stimulates the release of endorphins and serotonin, which makes you happier.
•Increases alertness and creativity.
•Improves your overall mental and physical well-being. Even taking a 15-minute walk, 3 times a week, can help.
•Like playing intramural sports, keeps you active and also creates more opportunities to meet new friends!
•Decreases stress. On days when you are feeling overwhelmed, hit the gym.

A healthy diet:
•Improves your ability to learn.
•Means eating a nutritious breakfast everyday. Skipping meals leads to a lack of energy.
•Includes eating something nutritious every time you are in the cafeteria. Try vegetables from the salad bar or an apple from the fruit stands.
•Means limiting your alcohol intake.
•Avoids excessive amounts of caffeine. Caffeine dehydrates you. Drink at least 8 glasses of water a day to prevent dehydration.

Plenty of rest:
•Means getting at least 7-9 hours of sleep. This is essential and will make you more attentive and active. Inadequate sleep can lead to mood changes and lowered resistance to illness.
•Means you have more physical and psychological resources to cope with everyday life. Without it you have to work harder to get school assignments done and you have less energy.
•Is half the battle, the other half is cutting back on your alcohol consumption because it can disturb your sleep. Though you might fall asleep faster, you’re body will not be as rested.

Relaxation:
•Means taking short study breaks, especially when you feel stuck.
•Means taking time each day to unwind, especially before sleeping. Listen to music, read or do whatever you enjoy. Alcohol or drugs are not the way to go.
•Offers a distraction from problems, a sense of competence and many other benefits.
•Means getting a good laugh. Laughing decreases pain, may help your heart and lungs, promotes muscle relaxation and can reduce anxiety.
Take care of your mind as well as your body. If you find that you are struggling emotionally or you are unable to cope, reach out to others for help. Seeking help is a sign of strength. Talk with someone you trust, and go to your college counseling service or doctor. Your local Mental Health America (MHA) affiliate can refer you to services as well.
To find the nearest MHA affiliate, call 800-969-6642 or go to Find an Affiliate.

In crisis? If you or someone you know is in crisis now, seek help immediately. Call 1-800-273-TALK (8255) to reach a 24-hour crisis center or dial 911 for immediate assistance.

There are many different conditions that are recognized as mental illnesses. The more common types include:
Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or nervousness, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the person’s response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias.
Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, mania, and bipolar disorder.
Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations — the experience of images or sounds that are not real, such as hearing voices — and delusions, which are false beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder.
Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders.
Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships.
Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the person’s patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the person’s normal functioning. Examples include antisocial personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder.

Other, less common types of mental illnesses include:

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Adjustment disorder: Adjustment disorder occurs when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Adjustment disorder usually begins within three months of the event or situation and ends within six months after the stressor stops or is eliminated.
Dissociative disorders: People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or “split personality,” and depersonalization disorder are examples of dissociative disorders.
Factitious disorders: Factitious disorders are conditions in which physical and/or emotional symptoms are created in order to place the individual in the role of a patient or a person in need of help.
Sexual and gender disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders.
Somatoform disorders: A person with a somatoform disorder, formerly known as psychosomatic disorder, experiences physical symptoms of an illness, even though a doctor can find no medical cause for the symptoms.
Tic disorders: People with tic disorders make sounds or display body movements that are repeated, quick, sudden, and/or uncontrollable. (Sounds that are made involuntarily are called vocal tics.) Tourette’s syndrome is an example of a tic disorder.

Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimer’s disease, are sometimes classified as mental illnesses, because they involve the brain.

What is postpartum depression?

Postpartum depression is a serious illness that can occur in the first few months after childbirth. It also can happen after miscarriage and stillbirth.

Postpartum depression can make you feel very sad, hopeless, and worthless. You may have trouble caring for and bonding with your baby.

Postpartum depression is not the “baby blues,” which many women have in the first couple of weeks after childbirth. With the blues, you may have trouble sleeping and feel moody, teary, and overwhelmed. You may have these feelings along with being happy about your baby. But the “baby blues” usually go away within a couple of weeks. The symptoms of postpartum depression can last for months.

In rare cases, a woman may have a severe form of depression called postpartum psychosis. She may act strangely, see or hear things that aren’t there, and be a danger to herself and her baby. This is an emergency, because it can quickly get worse and put her or others in danger.

It’s very important to get treatment for depression. The sooner you get treated, the sooner you’ll feel better and enjoy your baby.

What causes postpartum depression?

Postpartum depression seems to be brought on by the changes in hormone levels that occur after pregnancy. Any woman can get postpartum depression in the months after childbirth, miscarriage, or stillbirth.

You have a greater chance of getting postpartum depression if:
You’ve had depression or postpartum depression before.
You have poor support from your partner, friends, or family.
You have a sick or colicky baby.
You have a lot of other stress in your life.

You are more likely to get postpartum psychosis if you or someone in your family has bipolar disorder (also known as manic-depression).

What are the symptoms?

A woman who has postpartum depression may:
Feel very sad, hopeless, and empty. Some women also may feel anxious.
Lose pleasure in everyday things.
Not feel hungry and may lose weight. (But some women feel more hungry and gain weight).
Have trouble sleeping.
Not be able to concentrate.

These symptoms can occur in the first day or two after the birth. Or they can follow the symptoms of the baby blues after a couple of weeks.

If you think you may have postpartum depression, take a short quiz to check your symptoms:

A woman who has postpartum psychosis may feel cut off from her baby. She may see and hear things that aren’t there. Any woman who has postpartum depression can have fleeting thoughts of suicide or of harming her baby. But a woman with postpartum psychosis may feel like she has to act on these thoughts.

If you think you can’t keep from hurting yourself, your baby, or someone else, see your doctor right away or call 911 for emergency medical care. For other resources, call:
The national suicide hotline at 1-800-273-TALK (1-800-273-8255).
The National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453).

How is postpartum depression diagnosed?

Your doctor will do a physical exam and ask about your symptoms.

Be sure to tell your doctor about any feelings of baby blues at your first checkup after the baby is born. Your doctor will want to follow up with you to see how you are feeling.

How is it treated?

Postpartum depression is treated with counseling and antidepressant medicines. Women with milder depression may be able to get better with counseling alone. But many women need counseling and medicine. Some antidepressants are thought to be safe for women who breast-feed.

To help yourself get better, make sure you eat well, get some exercise every day, and get as much sleep as possible. Seek support from family and friends if you can.

Try not to feel bad about yourself for having this illness. It doesn’t mean you’re a bad mother. Many women have postpartum depression. It may take time, but you can get better with treatment.