That can be a great way to build up self esteem, to meet people and get out of the house. I hope some of this has helped. We would like to know how you are getting on, so I hope you get back to us. I'm no professional but a suggestion is maybe you should have a talk to your gp or psychiatrist about the possibility of atypical depression.
The thing with atypical depression is that it responds better to Maoi's than more modern anti depressants. I found the chromium picolinate supllement really helpful for reducing my cravings for food. I also think cbt and excersise is great for any type of depression. Unfortunately I brought it upon myself by doing the wrong thing and making bad choices. I was a very happy and successful person a year ago but due to stress and idiotic thinking I left my high paying corporate position and haven't been able to work since. I have lost my house, my car and all my friends.
I don't go anywhere anymore unless it is to buy cigarettes another bad decision I live with my earlderly parents, which both have disabilities now and I have nothing left in my life. I don't sleep and I eat all day long to pass the time. What was a full and exciting life has turned into complete nothingness. I praise you for being able to continue to push on after having depression for so long.
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This is my first real experience with this illness and I can say with certainty it is the worst thing a human being can go through. As I didn't understand before, people just cannot grasp the suffering that consumes you no matter how hard you try to beat it. Sadly, medication cannot fix the problems in our lives. Sure, it may superficially ease the physical symptoms a bit, but it can't change what is. I think you are far stronger than you realise because from my experience, if you can last 15 years with this evil illness you can last a lifetime.
For me though, it has hit me so hard I do not believe I have any hope at all. I can't fight any longer for myself but I believe you can continue to fight on. Continue to fight so depression has one less casulity. I wish I could believe in myself as much as I believe in you!! Trust me when I say this, you have been winning the battle and if you keep going you will win the war. You just handed out some invaluable advice. I really hope u can take that advice yourself bcas it sadens me that you are feeling as though u can't continue.
You too can win the war. Sometimes you need to take yourself out of your situation for a while. Please don't give up hope. Some ppl do recover. U might not see it now but u can also recover U have got this x. I think about suicide alot, but don't act upon it. And i also have a feeling of not having much time left.
I've seeked help but i haven't found anything that helps. I've tried counseling and whatnot but nothing really works for me. Sign up below for regular emails filled with information, advice and support for you or your loved ones. Home Get support Online forums. Online forums Before you can post or reply in these forums, please complete your profile Complete your profile.
Cancel The title field is required! Hello, I'm new and have never written on a forum before but thought I'd try it out. Hi Lulumax, welcome Re: Pity they didnt mind their own business and take on a quote- "if you are going to say something nice- say nothing at all" As for study or any other advance you try throughout your life that after a while seems a drag and you cant continue- again, you are unwell and unstable therefore accept that you are not like the person down the street, you are you and you tried.
Some people might respond better to renting a home in the country that costs less and is more relaxing People. Hope I've helped Tony WK. Maybe you could use this time you are still at home as a stepping stone to getting well. Can you defer your studies for a while and try to get back into them later? Cheers for now from Mrs. I'm in the similar situation as you. Actually, being a single person is rather common nowadays. I see no point in getting married as you might complicate things.
I'm also contemplating to withdraw and head back home. Since I stopped going back to campus since last week. Plus, I'm lagging way behind the coursework. My only suggestion is if you're really serious about withdrawing. The aim of this study is to explore strategies used by people recovering from depressive, anxiety, and bipolar disorders by asking 50 of them to describe their own strategies.
Strategies were classified according to dimensions of recovery: Within these themes, 60 distinct strategies were found to be used synergistically to promote personal recovery as well as symptom reduction. Findings highlight the diversity of strategies used by people, whether they have depressive, anxiety, or bipolar disorders. This study underscores the importance of supporting self-management in a way that respects individual experience.
Mood and anxiety disorders are the most common mental disorders Patten et al. The lifelong prevalence of anxiety disorders is Even though self-management strategies are known to be essential to recovery, only a few researchers have examined strategies for fostering the recovery of people with a depressive disorder Eller et al. Furthermore, despite the high comorbidity rate of these mental disorders, there has been no investigation of the commonalities among their self-management strategies, even if some authors e.
We can distinguish two types of recovery in mental health: This is the type of recovery that is most often studied in medicine and psychology. It defines recovery on the basis of five inter-related dimensions: Discerning self-management strategies, based on their impacts on the various dimensions of recovery, appear to be not only possible from a theoretical point of view but also essential for practical purposes.
By knowing the impacts of the self-management strategies they use to recover, persons with a mental disorder or their health professional could identify on which recovery dimensions they are working as well as those they have yet to work on. Furthermore, if Whitley and Drake have delineated the key dimensions of recovery, there is still a lack of knowledge on what people may do concretely to foster these dimensions. To fill gaps left by prior research, the goals of this study were a to explore the variety of self-management strategies used by people to recover from a depressive, bipolar, or anxiety disorder and b to describe the strategies fostering recovery in each of the key recovery dimensions.
The desired composition of the sample targeted comparable proportions of men and women; participants with depressive, anxiety, and bipolar disorders; participants of high and low economic status; and participants living in urban and rural environments. However, despite a sustained recruiting effort, it was not possible to obtain comparable proportions of participants for the variables of environment and socio-economic status.
The final sample consisted of 24 men and 26 women. The participants averaged A large majority of them An individual interview was conducted with each participant by one of two co-investigators. All the participants signed a consent form that was approved by the accredited ethics committees. Finally, the interviewer asked semi-structured questions inviting participants to describe their self-management strategies. The interviews lasted between 45 and 60 minutes.
Each interview was recorded on a digital audiotape and transcribed in its entirety. The semi-structured questions were developed based on the Critical Incident Technique Flanagan, As proposed initially by Flanagan , the technique focused on actual behaviors that people report using to achieve an objective specified by the researcher. This technique has been applied to identify the self-management strategies used by persons living with HIV Nicholas et al.
Each participant was asked to describe several critical incidents to elicit the maximum number of self-management strategies, so that exhaustiveness is maximized as required by the technique Kemppainen, Although we concentrated our analysis on the actions or thoughts collected with the second question, answers to the other questions were used as criteria for relevance W oolsey, The interview guide was successfully pretested with two persons who satisfied the inclusion criteria.
Data were transcribed verbatim and, as data collection continued, two coders used NVivo v. The main steps in the procedure proposed by Braun and Clarke were followed: First, the two coders inductively developed codes for characterizing the self-management strategies emerging from the data.
The initial codes were not fixed; rather, they were subject to change as the analysis progressed. Each of the recovery dimensions corresponded to one theme encompassing several sub-themes describing more specifically the nature of the included self-management strategies. We then verified which themes were reported by participants from each diagnostic group depressive, anxiety, and bipolar and whether there were important differences between these three groups.
Chi-square and Fisher tests were performed to verify whether the differences were significant. The research team took various measures to establish the validity of the study. To begin with, the first six interviews were cross-coded by the two coders. For consistency, they also cross-coded two other interviews: In addition to these inter-rater agreements, the two coders met on a regular basis throughout the data analysis period to evaluate the relevance of codes as they were created or modified.
Last, upon completing each group of approximately 15 analyzed transcripts, they shared the results of their analysis with the other members of the research team to obtain their points of view on the coding table. Team members had to reach a consensus on each new theme or sub-theme and each change made to the codes. A consensus was established so that the themes or sub-themes could be considered mutually exclusive, while maximizing their exhaustiveness.
Finally, new participants were interviewed until a point of data saturation was reached. In other words, data collection stopped when no more themes or sub-themes had to be added when analyzing the data from a new interview. This was important, as we wanted to explore the full diversity of self-management strategies rather than collect data only on the most obvious or frequent ones. Furthermore, it enhanced the trustworthiness of the data Elo et al. Table 1 provides a detailed listing of the 60 self-management strategies that emerged from the data and that, according to our participants, foster recovery.
Most of the participants mentioned strategies aimed at breaking their isolation and maintaining or developing satisfying social relationships. To this end, many sought support from family, friends, and people with a similar illness. This allowed them not only to receive support and develop new friendships but also to break their isolation. Several participants also became involved in social activities e. For example, one participant said that playing badminton helped him recover, as it gave him opportunities to socialize with friends.
Nevertheless, some participants made an effort to choose the people they socialized with, to find the kind of support they needed. Other participants ended relationships that they considered detrimental to their recovery. As one participant explained,.
Hope Filled Recovery From Depression And Anxiety
Furthermore, certain participants implemented strategies focused on taking care of their families or friends. Some participants also said that serving others, whether informally or through volunteer work, helped their recovery. For example, one participant said that discussing her depression at conferences had helped her feeling good, as she believed that by sharing her knowledge, she can help other depressed people recover.
Many participants reported using strategies to instill hope for recovery by having a positive outlook. To this end, some participants mentioned that they were inspired by persons who had already been through the recovery process. This included well-known public personalities, family members or friends, or people met at a conference, in a support group, or at a workshop. Some participants became more optimistic after having compared themselves with people whose problems were more severe downward social comparison.
For example, one participant noticed that he felt better after having met people who appeared to be worse off than him. For some participants, it helped to compare themselves with how they felt before, seeing how things had improved. Participants used other strategies to think more positively, such as trying to perceive their illness as an opportunity for personal growth.
In this respect, one participant said that she had been able to fill two notebooks with quotes and excerpts from her readings. To develop a positive self-image, some participants tried to recognize and emphasize their strengths and achievements. To this end, some participants took the time to acknowledge everyday achievements, even small ones.
Participants mentioned remembering their talents or recording them on paper to have a more positive perception of themselves. Certain participants tried to recognize weaknesses as well as strengths. Other participants tried not to compare themselves with others or apologized for past mistakes. Many participants also talked about how it is important to accept their mental illness as a fact of life. To help themselves, some participants tried to make a distinction between their mental illness and their personality. If you take antidepressants, you just take them; it has nothing to do with being crazy.
To find meaning, some participants also changed their beliefs about recovery. Considering recovery as a long process, or as a process with ups and downs, allowed some participants not to become discouraged in their most difficult moments. Having a project, a goal, or a dream also helped some participants find meaning and remain optimistic about the future. As one of them explained,. When I was in Grade 11, I was looking forward to college because I had found a program that I really liked, and that really became my rock.
Highlighting a process of empowerment, some participants mentioned how important it was to appreciate the key role that they played in their own recovery, and the efforts they needed to make to recover. My well-being truly comes from me. Wanting to get better is very important.
Another strategy used by participants to take charge of their recovery was to be assertive about their needs and expectations. For this purpose, some had to learn to be more expressive. Adopting a routine allowed some participants to reduce their symptoms. To this end, participants chose mostly activities that required them to follow a schedule, such as work or studies.
Performing personal care tasks e. Focused on taking actions, most participants appeared to suffer less from their symptoms when they managed to relax or engage in an enjoyable activity. Many strategies were mentioned in this regard. First, engaging in a pleasant activity appeared to be an effective way to reduce symptoms. This included cultural, artistic, manual, or other activities. Some participants mentioned that they had found an activity in which they could use their skills.
Work was often mentioned in this context. Regularly setting small objectives is another strategy that allowed our participants to function well. This included serving as a volunteer or focusing on work. Similarly, for some participants, their role as a parent was the most important thing in their lives.
Some participants stated that it is also important to respect their rhythm as they take action: Another learned to pay attention to how she was feeling and adjusted her approach to work accordingly: Many of the strategies described by participants specifically concerned physical recovery. In particular, many developed or tried to maintain a healthy lifestyle. Often they spoke of engaging in a sporting activity. One participant stated that his consumption of drugs was the cause of his lingering depression. One participant with bipolar disorder found that she needed to stop consuming coffee when she was in a manic episode.
Stopping smoking was also mentioned as a strategy. In addition to general health behaviors, several participants reported strategies focused on managing their energy, such as avoiding stressful situations, performing relaxation exercises e. In terms of clinical strategies directly aiming at reducing symptoms, most participants noted the importance of seeking formal professional help. This professional assistance came from a physician, a psychologist, a social worker, a peer helper, a facilitator at a mental health workshop, or someone working at a help line.
Some participants mentioned that they sometimes needed to go to a hospital. Besides turning to traditional mental health resources, some participants also relied on alternative resources such as acupuncture, art therapy, lithotherapy, or luminotherapy to help them recover. Whether or not the participants were favorable to medication, most of them recognized this strategy as effective to reduce symptoms. Many participants also sought to better understand their mental disorder and the symptoms they were feeling.
Some mentioned that they tried to find resources, attend conferences or workshops, or collect information on mental illness written material or from health professionals. For example, one participant mentioned that the various documents he had read on mental illness had helped him better recognize his symptoms. For some participants, thinking about the causes of their mental illness helped them reduce their symptoms. One participant spoke of the moment that she became aware that her illness was due in part to a difficult childhood: All of a sudden, this new awareness made everything feel easy.
Nothing stressed me anymore. Various strategies were also used to manage daily symptoms. One of the most often reported was analyzing and changing dysfunctional ways of thinking or behaving. By examining their fears, the participants found that they could gradually gain a different perspective and find solutions to reduce the impact on their emotions and behaviors. As one participant recounted, not confronting what makes you uncomfortable will, over the long term, generate more stress than facing up to them.
Not avoiding conflictual situations was also an important strategy for some participants. Other strategies used by participants to gain some perspective over difficult situations included drafting a list of pros and cons, taking some time to reflect, not worrying about certain irritants, dedramatizing situations, and working to solve problems.
For preventing relapse, many participants recognized the importance of paying attention to their moods and perceiving the early signs of a relapse. Some participants kept a mood journal, in which they regularly took notes on mood changes.
This allowed them to prevent relapses or avoid having their condition deteriorate by implementing an appropriate strategy as soon as they became aware that their symptoms were becoming more intense. For example, one participant explained that when she felt that she was entering a depressive episode, she made an effort to sleep only 7 or 8 hours per night and take a nap during the day, to avoid sleeping 12 hours at a time.
Each overarching theme of self-management strategies was mentioned by a large proportion of participants from each diagnostic group. Only two significant differences emerged. A last finding concerns the synergistic use of the above-mentioned self-management strategies.
The results revealed that the participants simultaneously implement strategies tied to the clinical dimension from Whitley and Drake as well as to the other more personal dimensions of the model. This observation also applies to the use of various strategies within the dimensions. In sum, self-management strategies seem to work synergistically to foster recovery. I can say that my medication is very important. It really takes a dose of all these things.
This study identifies many, varied self-management strategies used to foster recovery as described by individuals with anxiety, depressive, or bipolar disorders. We identified a total of 60 distinct self-management strategies delineated in several themes and sub-themes. The large number of distinct strategies—given the number of participants—shows the individualized nature of mental health self-management. Although the themes or sub-themes identified here converge with dimensions from the literature, they do not constitute a finished list of strategies that apply or should be prescribed to everyone.
The strategies are those experienced as useful by the participants in this specific study, and recovery is a very personal process. Nevertheless, achievement of data saturation suggests that the list is relatively exhaustive. In line with previous research, self-management strategies fostering social recovery highlight the importance of peer relationships and social activities Mezzina et al. This is consistent with the theory of social comparison Festinger, , which suggests that downward comparison is one means for feeling better about oneself.
Participants also implemented a variety of strategies to foster greater control over the recovery process, such as believing in oneself or setting small objectives. With respect to strategies fostering functional recovery, one of our most striking findings is the perceived contribution made by concrete activities that allow an individual to play a role in society e. In other words, the individual is able to maintain or regain a sense of functioning through actions that are meaningful to that person and others.
Regarding strategies fostering physical recovery, the study findings call attention to health behaviors e. Clinical recovery encompasses a large variety of strategies. This includes well-known strategies, such as medication, illness education, cognitive restructuring, and professional support. The participants also used alternative medicines e. First, compared with prior studies, they offer a broader range of self-management strategies used by persons with depressive or bipolar disorders Chapman, ; Eller et al.
Second, the results fill a gap in the literature by exploring the self-management strategies used by persons with anxiety disorders. All the broad self-management themes were evoked by a similar proportion of participants from each diagnostic group, with two exceptions. Including cognitive behavioral techniques recommended for anxiety e. Nonetheless, the overall similarity in strategies used by the three groups suggests that the recovery experience may serve as a rallying point for people with different disorders. In describing their diverse self-management strategies, the participants demonstrated an ability to control and take charge of their own recovery, and they were aware of the importance of this involvement.
In other words, they knew that the outcome would depend on the efforts that they were prepared to make. Health professionals should be sure to support the empowerment of persons in recovery, as suggested by recent studies e. This implies the need to regularly inquire about the recovery strategies used by patients Deegan, while encouraging efforts to develop new strategies Veseth et al.
Most of the participants in this study underscored the important role played by physicians and medication in a successful recovery. Some people may prefer having their professionals make certain decisions, such as medication decisions Bird et al. Of particular relevance is the fact that symptom self-management strategies clinical dimension were not broadly reported more frequently than strategies targeting other dimensions of recovery.
Professionals should thus support the self-management of symptoms while also paying attention to other personal issues involved in recovery. Our research team is highly involved with mental health users and professionals in developing research and practice tools based on the self-management strategies reported by participants in the present study.
We developed a research instrument measuring self-management see Coulombe et al. We also are designing an empowerment-based self-management intervention aiming to help people with depressive, anxiety, and bipolar disorders prepare and implement a personalized self-management plan. The efficacy of this new intervention will be assessed in a randomized control trial.
The study has broader implications for future research. It could be interesting to examine the interrelationships between different self-management strategies used along the recovery journey. In this regard, the experiential changes of recovery are sometimes grouped in distinct phases, with movement from one phase to another indicating progress e. The participants in this study considered themselves recovered or on a path to recovery and used both clinical self-management strategies and strategies targeting personal dimensions of recovery.
One can infer that for our participants, clinical self-management was no longer as important because these strategies had allowed them to encapsulate the illness and move on to other key aspects of their recovery. This raises the possibility that specific categories of strategies predominate during certain recovery phases. Among the methodological limitations of this study, we note the bias associated with recruiting participants. Only persons who considered themselves recovered or on a path to recovery were interviewed. Consequently, the strategies identified in this study must be seen as winning strategies, used by persons who had experienced some success in their recovery process.
Also, most participants were living above the poverty line and in urban settings; hence, they may have benefited from an environment favorable to the development and use of certain self-management strategies. Furthermore, given our limited sample size and the small number of participants in recovery from an anxiety disorder, our comparison between diagnostic groups needs to be interpreted with caution.
The use of a predefined theoretical model served to orient the process by which we categorized strategies. In analyzing the transcripts, the researchers may have unconsciously taken steps to validate this model. Persons living with mood and anxiety disorders used many diverse self-management strategies in their recovery process. Many of these strategies were aimed at personal aspects of recovery such as existential or social , in contrast with other strategy inventories that are almost exclusively focused on self-management of the clinical symptoms or their impact on the functioning level.
This comprehensive view of self-management allowed us to establish similarities among the strategies used by persons with different psychiatric diagnostics—depressive, anxiety, and bipolar disorders—hence fostering the interest in a demedicalized approach centered on the experiences of persons in recovery. We wish to thank Catherine Purenne, the research coordinator, as well as the research assistants who transcripted the interviews: We also want to thank the members of our advisory committee: The following organizations collaborated in the recruitment of participants: Declaration of Conflicting Interests: National Center for Biotechnology Information , U.
Glob Qual Nurs Res. Published online Sep Provencher , 2 and Janie Houle 1. This article is distributed under the terms of the Creative Commons Attribution 3. Abstract Mood and anxiety disorders are the most prevalent mental disorders. Introduction Mood and anxiety disorders are the most common mental disorders Patten et al. Objectives To fill gaps left by prior research, the goals of this study were a to explore the variety of self-management strategies used by people to recover from a depressive, bipolar, or anxiety disorder and b to describe the strategies fostering recovery in each of the key recovery dimensions.
Data Collection An individual interview was conducted with each participant by one of two co-investigators. Data Analysis Data were transcribed verbatim and, as data collection continued, two coders used NVivo v. Validity The research team took various measures to establish the validity of the study. Results Table 1 provides a detailed listing of the 60 self-management strategies that emerged from the data and that, according to our participants, foster recovery. Recovery Self-Management Strategies 1.
Maintaining a healthy lifestyle cont. Open in a separate window. Strategies Fostering Social Recovery Most of the participants mentioned strategies aimed at breaking their isolation and maintaining or developing satisfying social relationships. Strategies Fostering Existential Recovery Many participants reported using strategies to instill hope for recovery by having a positive outlook. As one of them explained, When I was in Grade 11, I was looking forward to college because I had found a program that I really liked, and that really became my rock.
Strategies Fostering Functional Recovery Adopting a routine allowed some participants to reduce their symptoms. Strategies Fostering Physical Recovery Many of the strategies described by participants specifically concerned physical recovery.