Relapse on Depression 3

How to Prevent Relapse on Depression 3

– Hi I’m Dr. David Purves.

In this video I’m talking about active self-help CBT. Now this is the approach that I have developed over many years but it’s a new approach to tackling the problems of depression and anxiety. And we’ve been seeing in the previous videos that there’s a thing called the scar hypothesis, which hypothesizes that the dysfunctional beliefs that you’ve had about yourself have been reactivated through a life event, through stress, or some other kind of circumstance and so any benefits that you would have had from CBT, such as challenging these negative beliefs, has somewhat been overwhelmed by the power of the emotion in the pre-established dysfunctional beliefs.

Now, if you remember the picture that I showed you in the first instance, let me see if I can just bring it up on the board here. This is the acute phase which would be a first episode of depression and then we have remission, we’re gonna call that a recovery in a sense.

This is the phase that’s important because in this continuation phase, in this phase here you have the option of doing something different to mean that you have a different outcome rather than travel through or travel on the path to a recurring depression episode.

Depression is a recurring problem

And now recall that depression is a recurring problem and if you don’t do something about it you have about a 60% chance of having a second episode if you’ve had a first one. Now, antidepressants give you some benefit, some protection as long as you stay on them but you might not want to stay on antidepressants for the rest of your life. So the active self-help CBT approach is perfect for you if you’ve had an episode of depression and you don’t want to have another one.

And my general motto is this 10 minutes a day or less is sufficient for you to exercise, eat healthily, read good books or do something educational, practice a hobby, practice a musical instrument. I mean if you did piano 10 minutes a day, my goodness me you’d be fantastic! So I’m suggesting that if you want to make sure that you don’t relapse into depression again, if you could devote 10 minutes a day or less to your wellbeing, I think you’d be swimming.

You’d be doing great and you’d be very unlikely then to have a depressive episode again and that would mean that you would have saved a huge amount of time and effort, misery, resources, pain and discomfort that you would have from having another depressive episode and over a period of time, the likelihood of having another episode diminishes so the longer you stay well, the likelihood of another episode diminishes.

Active Self-Help CBT

So active self-help CBT is my approach to giving you the tools and resources you need to prevent relapse into depression. Now there are some really good, well reasonably good programs that prevent relapse. One is mindfulness-based CBT and this is basically a strategy whereby you learn a mindfulness approach. Now I’ve incorporated that into one of the Dr. Purves online active self-help CBT programs and that’s called The Mindfulness Journey.

Now I use an active mindfulness approach and that means that it enables you to separate yourself from your experience to some degree so that you’re able to say actually, hang on, I feel a bit self-critical but you know what, actually I did a pretty good job. I don’t need to be self-critical. I’m just a human being and I have faults and failings and I have foibles like everybody else but you know what, it doesn’t actually mean that I’m a bad person.

That little bit of distance between you and your experience is absolutely critical. It’s commonly the case and like literature and scientific literature supports this, that if you’re a little bit prone to depression, you’re using a lot of what’s called faulty thinking tools and tactics and this means that using cognitive shortcuts and thinking errors, things like perfectionism and loss of control and all or nothing thinking, black and white that kind of thing. So we challenge that in active self-help using a faulty thinking tools because faulty thinking tools enable you to see the processes that you’re doing and you go actually hang on a minute, that’s black and white, that’s all or nothing, I don’t need to be doing that. And that then empowers you to change it.

So just to bring this video to a kind of a conclusion, what we’ve said is that if you could devote a little bit of time and effort, and I’m gonna say 10 minutes a day or less ’cause that’s typically how long the homeworks I provide in CBT are, 10 minutes a day or less and use my active self-help CBT programs, I see no reason why you need to have another depressive episode.

And you persist in using the programs for a little bit of time and the longer you stay well, the better the chance that you’ll remain well. Now, if you want to kind of explore some of these things more, have a look on the Facebook group, have a look on my Dr. Purves online page, see my blog posts. You’ll see all sorts of opportunities to interact with active self-help and to kind of see it for yourself.

Blues Be Gone

Just as a final one, when I was running with my Blues Be Gone program, people went through the active self-help CBT Blues Be Gone program and I interviewed them 18 months after they’d finished the program and they hadn’t just maintained their gains, they’d actually got better and better, so they actually had less depression and less anxiety having used the program and the program remained with them and so they had as much continuation use of it as they wanted to.

And some people said that they’d used it, they’d stepped into it when they felt they needed to or they used a little bit every now and again. But certainly it’s the case that the ability to dip into something and use a little bit now and again is a brilliant protective mechanism.

And finally, if you had some form of vitamin deficiency, you’d take a pill. A vitamin pill. If you had um, lack of sunshine you know, lived up in the Arctic Circle, you’d probably take a Vitamin D pill, to give you that sort of sunshine thing. If you wanted to get fitter, you’d exercise. If you wanted to manage your diet so that you’re healthy and fit and well, you’d manage your diet so you’re healthy and fit and well.

All I’m suggesting, is that you manage your mental health so that you remain fit and well. Now, you don’t have to do that of course. Don’t manage your mental health and let circumstances control you and see what happens. So we’ve always got choice.

But really, only an informed choice is an actual choice. Doing nothing is not really a choice. It’s just seeing what happens. Bit like Brexit. Anyway, thanks for taking the time to watch and listen and I hope you’ve found these videos interesting. If you have any questions, please feel free to contact me.

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