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What Should You Do If You Are Depressed or Anxious?
Psychotherapy (talk therapy) may be used in combination with mood medications, or it can begin before or after medications are started. It should be continued for a time after you stop taking medications, as a means of insuring that your improved emotional well-being continues. Talk therapy can occur between you and a therapist, or it can be done in groups, with several individuals meeting together with one or two therapists.
Therapy is a place in which you share your fears and worries, mourn the losses you have experienced as part of injury, talk about the new you, deal with the reactions of others, plan for a new future, and learn healthy strategies for coping with life's challenges. Therapy should focus primarily on here-and-now issues related to your adjustment to injury. Psychotherapy should encourage your attempts to better understand your situation, help you build flexible ways of thinking, encourage you to use compensatory strategies (such as memory aids), and address the behaviors that you and others find unacceptable. A major focus of therapy is to review recent activities to determine what went wrong in specific situations. This paves the way for anticipating problems in similar future situations and helps you plan strategies for preventing further failures.
Who is a good therapist? One who engages in the kind of talk therapy described above. This is a person who you feel really listens to you and does not judge you or your actions. This person can be a trained mental health professional or can be a religious leader, a person in a community agency or members of a self-help group. The essential element in his or her training is being highly knowledgeable about TBI and how it can affect day-to-day life.
What Else Can You Do to Help Overcome Emotional Distress?
Many people find aerobic exercise to be useful in overcoming or reducing depression. With sustained, fast-paced exercise such as running, walking, swimming, or biking, they find themselves less tense and fatigued, and with increased energy and improved self-esteem. As we reported in TBI Consumer Report (Issue No. 2) exercisers with TBI who we interviewed experienced less depression and fewer cognitive problems.
Some people find that depression and anxiety are reduced simply by adding structured activities into their daily lives. This may mean they return to school or volunteer their time at a community agency. They might join a self-help group or church activities. They may even increase the number of daily household activities in which they engage. This structure increases the individual's self-esteem and enhances his/her contribution to the family's welfare.
Other people opt for therapeutic approaches such as biofeedback, eye movement therapy, hypnosis, relaxation therapy and desensitization techniques. Other alternative treatments include acupuncture, massage, yoga, Tai Chi, and other forms of meditation, as well as over-the-counter herbal medications for mood. These approaches help some individuals but not others.
A final point: The most important thing you can do is to stay actively engaged in seeking means to improve your mood. This means that you must own your emotional state and define your well-being as your responsibility. Thus, if one path you take to feel better doesn't work, it is up to you to try another approach. Both depression and anxiety after TBI can be helped, especially when you reach out to others in your community to help you find the right path. Your task is to find the way that works best for you.
TBI Consumer Report is a publication of the Research and Training Center on Community Integration of Individuals with Traumatic Brain Injury, supported between 1993 and 2004 by Grant Nos. H133B30038 and H133B980013, to the Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York City, from the National Institute on Disability and Rehabilitation Research, United States Department of Education.
From Mount Sinai Medical Center. www.mssm.edu .
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