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Specific

Measurable

Attainable

Realistic

Timely

Specific: A specific goal has a much greater chance of being accomplished than a general goal. To set a specific goal you must answer the six “W” questions:

*Who:      Who is involved?

*What:     What do I want to accomplish?

*Where:    Identify a location.

*When:     Establish a time frame.

*Which:    Identify requirements and constraints.

*Why:      Specific reasons, purpose or benefits of accomplishing the goal.

EXAMPLE:  A general goal would be, “Get in shape.” But a specific goal would say, “Join a health club and workout 3 days a week.”

Measurable – Establish concrete criteria for measuring progress toward the attainment of each goal you set.

When you measure your progress, you stay on track, reach your target dates, and experience the exhilaration of achievement that spurs you on to continued effort required to reach your goal.

To determine if your goal is measurable, ask questions such as……

How much? How many?

How will I know when it is accomplished?

Attainable – When you identify goals that are most important to you, you begin to figure out ways you can make them come true. You develop the attitudes, abilities, skills, and financial capacity to reach them. You begin seeing previously overlooked opportunities to bring yourself closer to the achievement of your goals.

You can attain most any goal you set when you plan your steps wisely and establish a time frame that allows you to carry out those steps. Goals that may have seemed far away and out of reach eventually move closer and become attainable, not because your goals shrink, but because you grow and expand to match them. When you list your goals you build your self-image. You see yourself as worthy of these goals, and develop the traits and personality that allow you to possess them.

Realistic– To be realistic, a goal must represent an objective toward which you are both willing and able to work. A goal can be both high and realistic; you are the only one who can decide just how high your goal should be. But be sure that every goal represents substantial progress.

A high goal is frequently easier to reach than a low one because a low goal exerts low motivational force. Some of the hardest jobs you ever accomplished actually seem easy simply because they were a labor of love.

Timely – A goal should be grounded within a time frame. With no time frame tied to it there’s no sense of urgency. If you want to lose 10 lbs, when do you want to lose it by? “Someday” won’t work. But if you anchor it within a timeframe, “by May 1st”, then you’ve set your unconscious mind into motion to begin working on the goal.
Your goal is probably realistic if you truly believe that it can be accomplished. Additional ways to know if your goal is realistic is to determine if you have accomplished anything similar in the past or ask yourself what conditions would have to exist to accomplish this goal.

T can also stand for Tangible – A goal is tangible when you can experience it with one of the senses, that is, taste, touch, smell, sight or hearing.

When your goal is tangible you have a better chance of making it specific and measurable and thus attainable.

Talk therapy is a powerful treatment option. Here’s what psychologists want people to know to get the most out of depression therapy.

Cognitive behavioral therapy (CBT) can help you out-think negative patterns that may be keeping you from depression recovery — and from enjoying life.

Negative thinking can slow depression recovery, and the reason is obvious: If you think negative thoughts, you’re more likely to stay depressed. But what’s less obvious is the way people with depression deal with positive emotions. Researchers have made a surprising observation: People with depression don’t lack positive emotions, they just don’t allow themselves to feel them.

This cognitive style is called “dampening,” says Chloe Carmichael, PhD, a clinical psychologist in New York. It involves suppressing positive emotions with thoughts such as, “I don’t deserve to be this happy” or “This good feeling won’t last.” For example, a new mother with postpartum depression might tell herself she doesn’t deserve to recover because she’s a bad mother for being depressed in the first place, Dr. Carmichael says.

Why do people with depression think this way? Carmichael refers to that negative voice as defensive pessimism — protection against getting high hopes dashed. “You don’t want to be the fool, so you resort to dampening positive thoughts to protect yourself from potential disappointment,” she says.

How CBT Can Help With the Negative Thoughts of Depression

Cognitive behavioral therapy (CBT) has been found to help significantly withdepression treatment. In CBT, you and your therapist work together to agree on patterns of behavior that need to be changed. The goal is to recalibrate the part of your brain that’s keeping such a tight hold on happy thoughts.

“An unexpected reaction to a major life event might be at the root of the dampening effect,” Carmichael says. “Through CBT, you and your therapist address it and work toward putting it into perspective.”

Regular CBT sessions and work you do on your own outside of therapy can help reinforce the new patterns, “To be able to recognize those negative thoughts and leave them behind can be very liberating,” Carmichael says.

5 CBT Techniques to Counteract the Negative Thinking of Depression

Carmichael has found that people with depression rarely respond well to self-study. For this reason, she recommends committing to CBT for at least six weeks. Your therapist will teach you CBT strategies that can help counteract the negative thinking associated with depression. She or he can also help you stay on track with practicing the techniques. Here are five CBT strategies you might end up working on with your therapist:

1. Locate the problem and brainstorm solutions. Journaling and talking with your therapist can help you discover the root of your depression. Once you have an idea, write down in a simple sentence exactly what’s bothering you and think of ways to improve the problem. A hallmark of depression, Carmichael says, is hopelessness — a disbelief that things can ever get better. Writing down a list of things you can do to improve a situation can help ease depressive feelings. For example, if you’re battling loneliness, action steps to try might include joining a local club based on your interests or signing up for online dating.

2. Write self-statements to counteract negative thoughts. After locating the root problems of your depression, think of the negative thoughts you use to dampen positive ones. Write a self-statement to counteract each negative thought. Remember your self-statements and repeat them back to yourself when you notice the little voice in your head creeping in to snuff out a positive thought. In time, you’ll create new associations, replacing the negative thoughts with positive ones.

Carmichael says that the self-statement shouldn’t be too far from the negative thought, or the mind might not accept it. For example, if the negative thought is, “I’m so depressed right now,” rather than saying, “I’m feeling really happy now,” a better statement might be, “Every life has ups and downs, and mine does, too.” The message tells you that it’s okay to bump up the degree of happiness you experience. At the same time, your mind applauds itself for keeping joy in check to protect from disappointment. “It’s okay to recognize that part of you that’s trying to do something healthy,” she says.

Sometimes self-statements become too routine and need to be refreshed, Carmichael says. She recommends to translate your self-statements into other languages that you might speak, or rephrase them, possibly even bumping up their joyful feelings a bit. “For example, the self-statement “It’s okay to explore my ups” might become “It’s okay to have a super ‘up’ day.”

3. Find new opportunities to think positive thoughts. People who enter a room and immediately think, “I hate that wall color,” might instead train themselves to locate five things in the room that they feel positively about as quickly as possible. Set your phone to remind you three times a day to reframe your thoughts into something positive. Carmichael recommends “buddying up” with someone else working on the same technique. That way, you and your buddy can get excited over having positive thoughts and experiences to share with each other throughout the day.

4. Finish each day by visualizing its best parts. At the end of each day, write down or type into an online journal the things in your life you’re most thankful for. Recording positive thoughts, and even sharing those thoughts online, can help you form new associations in your mind or create new pathways, Carmichael says. Someone who’s created a new pathway of thinking might go from waking up in the morning thinking, “Ugh, another workday” to “What a beautiful day it is.”

5. Learn to accept disappointment as a normal part of life. Disappointing situations are a part of life, and your response can affect how quickly you can move forward. Someone going through a breakup might blame him or herself or even gain weight, thinking, “What’s the point in looking good? I’ll never meet anyone else.” A better approach might be to allow yourself to feel disappointed and remember that some things are out of your control. Work on what is within your control: Write down what happened, what you learned from the experience, and what you can do differently next time, watching out for overly negative thoughts. This can help you move on and feel better about your future.

Depression is an ongoing battle for many people. Knowing what can trigger a depressive episode can help you minimize or avoid a relapse.

Sanjay Gupta, MD, Everyday Health: What is bipolar illness, how do you define it?

Katherine Burdick, PhD, Associate Professor, Psychiatry, The Icahn School of Medicine at Mount Sinai: Bipolar disorder is largely distinguished from major depression because it has what they refer to as both poles, both the depression as well as the acute mania. You see fluctuations between patients experiencing euphoria or heightened irritability and very increased levels of energy, lack of need for sleeping, the side of what we think about is mania, in contrast to the exact opposite pole, which is the depression. It’s an episodic illness, so what we see are patients who have acute periods followed by what tends to be at least some periods of recovery.

Dr. Gupta: Is there some sort of existing pattern of cycling?

Dr. Burdick: We tend to see, if untreated, episodes of depression that last I think on average about nine months. With adequate treatment, it can be much shorter than that. Manias in contrast tend to last slightly shorter, but they also tend to be more disruptive in patients’ lives. We do know that if mania is your first episode that the course of your illness tends to be predominated by mania. You’ll have more manic episodes than you’ll have depressed episodes, and the opposite is true.

Dr. Gupta: Who is the typical patient, and when do they first start to have symptoms?

Dr. Burdick: The short answer is there is no typical patient. What we tend to see is an onset somewhere around the mid-20s. Many patients do very, very well in school all the way through high school. Problems start to occur sometime either in late college or even in the beginnings of the first job that they may have after college

Dr. Gupta: Bipolar 1 and bipolar 2. What are the differences?

Dr. Burdick: So the differences tend to be the severity of the mania, whether or not a patient ever experiences what we think of as full-blown mania. Patients with bipolar 2 never develop that full mania.

Dr. Gupta: Someone’s diagnosed and it’s a clear diagnosis. Do they have to be on medications?

Dr. Burdick: Most doctors would argue that a patient once diagnosed with bipolar will start medication and will take medication for the rest of their lives. There are patients who do well off of medications. They’re not your typical patient with bipolar disorder.

Dr. Gupta: If someone’s very diligent about their taking their medications, what can you tell them in terms of, you know, the life they’re going to have?

Dr. Gupta: When patients respond early to medications, and many patients do, that is a good predictor of good outcome.

Talk therapy is a powerful treatment option. Here’s what psychologists want people to know to get the most out of depression therapy.

If depression has you feeling like you just can’t get going, an action plan can help get you moving again. Here’s how to create a motivating plan — and stick to it.

Everyone feels down at some point in their lives. But if you have major depression(also called major depressive disorder), you likely feel depressed every day for most of the day, especially in the morning. You might wake up and have no energy to get out of bed. And even when you do get up, deciding what to do first can feel like a mountainous task.

At those times of inertia, it’s easy to get discouraged. But giving up the idea of getting anything done can make you feel powerless and perpetuate feeling depressed. Instead, fight back with an action plan that propels you ahead, even when you’d rather lag behind.

Creating a Depression Action Plan

A depression action plan can help take the guesswork out of where to get started each morning. It can also empower you to see just how much you can do, which is important because people with depression tend to compare their current levels of activity to past ones.

“For an action plan to be effective, you first have to understand that major depression is an illness, not a weakness,” says Stephen J. Ferrando, MD, a professor of clinical psychiatry and clinical public health in the department of psychiatry at the New York-Presbyterian/Weill Cornell Medical Center in New York City. Stop comparing yourself to the past. “It’s not your fault you have depression,” he says.

To get started creating an action plan, it’s best to work with your doctor or therapist. “When you’re depressed, it can be difficult to determine where to begin,” says Randy Auerbach, PhD, ABPP, a researcher, an assistant professor in the department of psychiatry at Harvard School of Medicine, and the director of the Child and Adolescent Mood Disorders Laboratory at McLean Hospital in Belmont, Mass. Your doctor or therapist can help you identify both short-term and long-term goals to work toward.

Consider these steps you might want to include in your daily action plan:

• Tasks you need to do. Make a list of four or five things you need to get done today, such as work and chores. To avoid getting overwhelmed, break down each goal into small parts. For example, instead of making cleaning the entire house your goal, decide to clean just one room today, says Brian Iacoviello, PhD, an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai Hospital in New York City.
• Activities you enjoy. If depression has taken the enjoyment out of all activities for you, write down what you once found pleasurable. Working toward doing the things you once enjoyed can help you slowly regain momentum. You can also try adding new activities, such as soothing stress-coping experiences (e.g., meditation, yoga, and tai chi).
• Time with your support network. Research shows that a support network is critical for depression recovery. Make plans with friends and family and show up even when you don’t feel like it. It helps to have a friend who will hold you accountable. “Social support can be an enormous ally when you’re in dealing with depression,” Dr. Auerbach says. A local or online depression support group can also be a good resource.
• Exercise. In a review published in in 2013 in the American Journal of Preventive Medicine, researchers reported that even low levels of physical activity, such as walking or gardening for 20 to 30 minutes a day, can help ward off depression. If you’ve stopped exercising, set reasonable goals to allow yourself to slowly get to the level of physical activity you want to reach. You might even combine exercise with socializing by picking a workout activity to do with a friend.
• Healthy meals. Eating a balanced diet may help alleviate depression symptoms. Include steps in your depression action plan to create healthy meals each day. To maximize benefits, aim for three meals that include whole grains, fresh fruits and vegetables, beans, lentils, nuts, seeds, lean meat, fish, eggs, and low-fat or fat-free diary. Never skip breakfast. Be sure to drink plenty of water because even mild dehydration can affect mood. Limit your alcohol intake.
• Medication. If you’re taking medication, include specific times to take it in your depression action plan. Sticking to your prescribed treatment plan is the best way to speed recovery.
• Journaling. Your entries can provide insight for you and your doctor or therapist to review together to determine patterns of behavior that may be holding you back from doing everything you want to do. Record behaviors such as what you’re doing, how successful you’re being at doing those things, and what you think about when you’re doing them. Once you’ve identified any negative patterns, you can work with your doctor or therapist on how to let them go.
• Rewards. Implement a system of rewards to give yourself when you’ve accomplished a goal in your depression action plan. Self-care activities — such as a massage, a new haircut, a movie, or any other activity that makes you feel good and follows your plan for recovery — make good rewards.

How to Stick to Your Depression Action Plan

When the temptation to do nothing crops up each morning, realize that you’ll have to push yourself to take the first step to get started. Once you do that, know that your level of motivation will likely increase. To stay on track, be sure to schedule activities at specific times so you don’t get overwhelmed about what to do next or how much you have to get done. Post your depression action plan in a visible place, and set up reminders by programming alerts on your phone.

Also, remember that your depression action plan may not follow a straight path. There may be setbacks, and that’s okay — just do your best to keep going. Then at your regular doctor appointments or therapy sessions, you can discuss your progress and work together with your doctor or therapist to identify what may still be getting in your way and figure out what to do to change it.

At the end of each day, focus on what you’ve accomplished instead of what you haven’t. “The greatest challenge for a person with depression is to overcome pessimistic thinking, helplessness, and hopelessness,” Auerbach says. “But with proper treatment and a good action plan, depression can be conquered.”