Process - Physician - Fraser Health Authority

THE STORY OF MARGARETHere is the experience of one person whoused these methods effectively.Margaret is a married teacher in her mid-30s who came to her family physician withsymptoms of depression. She had recentlytransferred to an inner city school, attractedto the challenge of the work. But she foundshe could not accomplish what had beennormal for her, although she worked longhours. She began to sleep poorly and toworry almost all the time. She criticizedherself in a harsh manner for not doing aswell as she expected. Her mood began todrop until she felt miserable. This madeit more difficult to perform her job andshe became even more self-criticaland depressed.Antidepressant medication was prescribedby her family physician. This helped hersleep, raised her energy level and greatlyreduced her emotional suffering.When she read through the section onReactivating Your Life, she realized thatshe had been avoiding her friends sinceshe took the job and especially since shebecame depressed. She set the goal of meetinga friend once a week for tea. Later onshe increased this to includeother social activities. After the first month,she added moderate exercise as a goal.When she read through the section onThinking Realistically, she recognized severalcognitive distortions: she had a very selfcriticalway of thinking; she expectedherself to perform perfectly; and sheignored praise from others. She usedquestions from the self-care guide to comeup with more fair and realistic ways ofthinking: What evidence do you have? Shehad received positive evaluations and acolleague told her she was doing as wellas possible in the situation. What wouldyou say to a friend in the same situation?She wrote out the fair and supportive wordsshe would say to a friend, then practicedsaying them to herself. What is a lessextreme way of looking at the situation?She wrote down some more realisticthoughts about the job situation, thenreminded herself of these whenever shenoticed the unrealistic, negative thoughts.The combination of antidepressant medicationand self-care methods led to a gradualimprovement in her depression, a more fairand accepting attitude towards herself,more realistic self-expectations, and moreenjoyment of her life.SELF-CARE DEPRESSION PROGRAM53 ANTIDEPRESSANT SKILLS WORKBOOK