Depression can impact more than your mood. It can impact every area of your life and lead to a sense of despair and hopelessness. It affects not only your mood but also your thoughts, behaviors, and physical health. Relationships can suffer because you tend to withdraw from social interactions. Depression can effect your health. It can contribute to fatigue, pains, and increase the risk of some medical conditions. Evidence shows that rates of depression for both men and women are on the rise. We are fortunate that there are many treatments for depression, including online DBT. In this fifth and final edition of our DBT blog series, we will delve into how online DBT can help treat depression.

Recognizing Symptoms of Depression

Depression is more than being “sad.” All humans feel sad once in a while. As the movie Inside Out taught us, sadness can help us identify what matters to us. It can motivate us to seek support from friends and family. This can make us stronger and more resilient. Sadness is not a negative emotion. Fun fact: We don’t have negative emotions. As a depression therapist, I like to describe emotions as pleasant and unpleasant. Emotions are not negative or positive, or bad or good! Even though depression can be an unpleasant emotional experience, it can teach us a lot. Depression symptoms differ from person to person in how intense they are and how long they last.

• Persistent Sadness: Ongoing feelings of sadness, emptiness, or a sense of hopelessness that lasts most of the day. Instead of sadness, you may feel irritable, which is common in teens.

• Loss of Interest or Pleasure: A decrease or lack of interest in activities or things that you once liked. This might be spending time with friends or family or playing sports.

• Changes in Appetite or Weight: Experiencing a significant increase or decrease in appetite and/or weight.

• Sleep Disturbances: Problems falling asleep, staying asleep, or experiencing excessive sleepiness.

• Fatigue and Low Energy: Even after a full night’s sleep, you feel tired and lack energy.

• Difficulty Concentrating: You experience problems with concentration, decision making or memory

• Feelings of Worthlessness or Guilt: Feeling worthless, blaming yourself or feeling excessive guilt

• Suicidal Thoughts: You may have thoughts of death, self-harm, or suicide. If you experience these thoughts, call 911, 988 or go to your local emergency room.

• Change in Physical Activity: Experiencing a significant decrease in physical activity (psychomotor retardation). Or an increase in restlessness and agitation (psychomotor agitation).

How Do I Know If I Have a Depressive Disorder?

Depressive disorders are a group of mood problems where you might feel sad, lose hope, and not want to do the things you used to enjoy. To have a diagnosis, you must meet specific criteria in the Diagnostic Statistical Manual 5 (DSM-5). Each disorder varies in their causes, symptoms, and severity.

Below are some common types of depressive disorders:

• Major Depressive Disorder (MDD): Major Depressive Disorder is often referred to as “depression.” To have a diagnosis of MDD, you have to have two of the following symptoms for at least two weeks. These symptoms include feeling sad, loss of interest in activities, changes in appetite, sleep problems, fatigue, feeling worthless, difficulty concentrating and recurrent thoughts of death or suicide.

• Persistent Depressive Disorder (PDD): PDD is also known as Dysthymia. With PDD, depressive symptoms last for at least two years (or one year in children and adolescents). These symptoms are less severe than MDD but can still interfere with your life..

• Seasonal Affective Disorder (SAD): SAD occurs seasonally, typically during the fall and winter months when there is less natural sunlight. Symptoms include fatigue, oversleeping, weight gain, and social withdrawal.

• Perinatal Depression: Perinatal depression occurs during pregnancy (prenatal depression). Postpartum depression occurs in the postpartum period after pregnancy. The symptoms are like those of MDD.

• Premenstrual Dysphoric Disorder (PMDD): PMDD is a severe form of premenstrual syndrome (PMS). In the weeks leading up to menstruation, you experience mood changes. These include depression, irritability, and tension.

• Situational Depression or Adjustment Disorder with Depressed Mood: Your mood changes because of a life stressor such as losing a pet. These symptoms are less than 6 months and related to the event.

What is DBT?

Dialectical Behavior Therapy (DBT) is an evidenced based treatment for mood disorders. Dr. Marsha Linehan created DBT in the late 1980's. It can be effective if you are experiencing depression. There are many benefits to DBT such as learning skills and strategies to manage your depression symptoms. There are four modules of DBT - mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. DBT provides useful ways to control your feelings and lower stress. You're relationship with yourself and others will also improve.

Mindfulness Skills for Depression

Mindfulness skills can be valuable tools for managing depression. Using Dialectical Behavior Therapy (DBT) mindfulness skills helps you stay in the moment. They allow you to know yourself better and deal with feelings of sadness and the negative thoughts associated with it.

Examples of DBT Mindfulness Skills:

• Participating: Do your best to engage in activities. This can be hard when your symptoms of depression make it hard! Practice participating in the moment everyday. Break down tasks into smaller manageable steps to make them feel less overwhelming. This will help you stay in the present moment.

• Non-Judgmentally: When you experience depression, it is common to criticize or judge yourself. Try to avoid self-criticism or judgements about your depression. Treat yourself with the same compassion you would offer a friend going through a hard time. Depression is not a reflection of your character, it is a feeling.

• One-Mindfully: Focus on one thing at a time and bring your full attention to the present moment. It can get easy to get caught up in ruminating about the past or worrying about the future. Practice being “one mindful” while doing everyday activities. Try doing this while eating dinner, walking or doing the dishes.

Emotion Regulation Skill for Depression

When you experience depression, it can feel very intense and like it will last forever. Emotion regulation skills assist you in managing your depression symptoms. They reduce your suffering and allow you to feel more in control of your feelings.

Examples of DBT Emotion Regulation Skills:

• Self-Soothing: In DBT, you will learn different self-soothing techniques. These include relaxation exercises and self-compassion practices. Examples include participating in calming activities like reading or listening to soothing music.

• Acceptance of Emotions: Depression is a medical condition. It is not a personal flaw or failure. By accepting your emotions in a compassionate way, the intensity of your symptoms will decrease. This will also promote self-acceptance and curiosity.

• Creating Emotional Boundaries: It’s important to set boundaries with others. Setting boundaries can help you regulate your emotions and feel less overwhelmed.

Interpersonal Effectiveness Skills for Depression

Depression can affect how you feel about yourself and interact with others. This can result in social withdrawal or strained relationships. After learning DBT Interpersonal Effectiveness skills, you will get along better with others. You will also get the help you need and make your relationships better.

• DEAR MAN: This acronym stands for: Describe, Express, Assert, Reinforce, (Stay) Mindful, Appear Confident, Negotiate. It’s a tool used in situations where you need to negotiate, set boundaries, or express your wants or needs.

  • Describe: Start by describing the current situation and only state the facts!

    • “You told me you would call me last night but you didn’t.”

  • Express your feelings and opinions: Don’t assume the other person can read your mind. Use “I statements” rather than “you” statements. “

    • “When you didn’t call, I felt abandoned and forgotten about.”

  • Assert: Ask for what you want or say no clearly.

    • “In the future, if you say you are going to call please call me.”

  • Reinforce: Reward the person by telling them how it will benefit them to do what you’ve asked. If necessary, identify the consequences if they don’t do what you need.

    • “I would be so relieved and feel much closer to you if you called.”

  • (Stay) Mindful: Stay focused on your goals and don’t get off topic. Ignore any distractions or attacks. Keep making your point.

    • “I would still like a call.”

  • Appear (Confident): Use a confident tone and make eye contact.

    • Avoid saying things like, “I’m not sure” and don’t look at the ground or whisper!

  • Negotiate: If necessary, be willing to negotiate but don’t give in completely. Be willing to give a little to get your needs met.

    • “How about if you text me instead of calling me?”

Distress Tolerance Skills for Depression

Distress Tolerance skills are useful to cope with intense emotions. They can also help with distressing thoughts that often go with this depression. These skills allow you to better tolerate emotional pain and prevent impulsive behaviors such as self-harm.

• IMPROVE the Moment: IMPROVE stands for Imagery, Meaning, Prayer, Relaxation, One thing, Vacation and Encouragement. This technique can help when there isn’t always a quick solution to your problem or emotion. Sometimes we have to sit with uncomfortable emotions and wait for them to pass.

  • Imagery: Use imagery to distract yourself. For example, you could imagine a peaceful place far from your worries. You could also use your imagination to think back to the best vacation you’ve ever had. What are the sights, sounds, and smells you notice? Another way you can use imagery is to imagine the best resolution of your current challenge.

  • Meaning: Is it possible to find or create any meaning from the situation you are in? Can you reflect on ways you might be able to use your experience to help others? Identify ways you can grow from your experience.

  • Prayer: Prayer does not have to be spiritual or religious. You can repeat a mantra, list things you’re grateful for or meditate.

  • Relaxation: There are many ways to relax. Do your best to find a quiet place where you feel safe and comfortable. Experiment with a different relaxation techniques. Examples include deep breathing, progressive muscle relaxation, stretching or yoga.

  • One thing in the moment: Commit yourself to doing a simple task that requires your full attention. You could organize your closet, read a book, do the ABC’s backwards or play sudoku.

  • Vacation: A vacation does not have to be getting out of chilly Detroit and spending time in Sunny Hawaii (that would be nice though!) A vacation can be taking a short break from your worries by doing something fun. You could call a friend, go on a bike ride, watch your favorite movie or treat yourself to a new outfit.

  • Encouragement: Practice motivating yourself. Be your own cheerleader! Saying phrases to yourself like, “I can do this” or “This too shall pass” can help get you through tough times. The key is to only use phrases that feel true and motivating to you.

Begin DBT for Depression in Detroit Today

Are you ready to heal from your depression? Do you want to live a life free from sadness, hopelessness and despair? Are you looking for concrete skills to help you get there? Discover how Dialectical Behavioral Therapy for Depression can help you reach your goals. Our DBT depression therapists offer practical ways to cope with sadness, improve your relationships and tolerate mood changes. To learn more about the four DBT skills like mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness and how they can heal your depression, follow these steps!

1. Reach out for a free consultation.

2. Start your healing at Embodied Wellness, PLLC with DBT for Depression today.

3. Welcome the idea that a better future is possible.

Additional Online Therapy Services in Ann Arbor, Detroit & Michigan

At Embodied Wellness, PLLC we also specialize in therapy for trauma and PTSD, anxiety, and OCD. We utilize different approaches such as EMDR, IFS and somatic therapy. We also have counseling for empaths. We provide online therapy in Michigan to teenagers 12+ and adults. También ofrecemos terapia en español en Michigan.

About the Author: 

Sarah Rollins, LMSW, SEP is the founder of Embodied Wellness, PLLC, a group therapy practice providing online therapy in Michigan. She is passionate about expanding awareness of somatic therapy as way to treat and heal trauma. She incorporates other holistic treatments into her practice including EMDR and IFS.