by Charles H.Elliott,PhD and Laura L.Smith,PhD Foreword by Aaron T.Beck,MD University Professor of Psychiatry,University of Pennsylvania Anxiety & Depression Workbook FOR DUMmIES ‰ 01_597930 ffirs.qxd 9/28/05 2:18 PM Page i Anxiety & Depression Workbook For Dummies® Published by Wiley Publishing, Inc. 111 River St. Hoboken, NJ 07030-5774 www.wiley.com Copyright © 2006 by Wiley Publishing, Inc., Indianapolis, Indiana Published by Wiley Publishing, Inc., Indianapolis, Indiana Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Sections 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400, fax 978-646-8600. 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NO WARRANTY MAY BE CREATED OR EXTENDED BY ANY PROMOTIONAL STATEMENTS FOR THIS WORK. NEITHER THE PUBLISHER NOR THE AUTHOR SHALL BE LIABLE FOR ANY DAMAGES ARISING HEREFROM. For general information on our other products and services, please contact our Customer Care Department within the U.S. at 800-762-2974, outside the U.S. at 317-572-3993, or fax 317-572-4002. For technical support, please visit www.wiley.com/techsupport. Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. ISBN-13: 978-0-7645-9793-0 ISBN-10: 0-7645-9793-0 Manufactured in the United States of America 10 9 8 7 6 5 4 3 2 1 1B/RX/RQ/QV/IN 01_597930 ffirs.qxd 9/28/05 2:18 PM Page ii About the Authors Charles H. Elliott, PhD, is a clinical psychologist and a member of the faculty at Fielding Graduate University. He is a Founding Fellow in the Academy of Cognitive Therapy, an inter- national organization that certifies cognitive therapists. He has a part-time private practice in Albuquerque, New Mexico, that specializes in the treatment of anxiety and depression. In addition, he has written many articles and book chapters in the area of cognitive behavior therapies. He has made numerous presentations nationally and internationally on new devel- opments in assessment and therapy of emotional disorders. He is coauthor of Depression For Dummies (Wiley), Overcoming Anxiety For Dummies (Wiley), Why Can’t I Get What I Want? (Davies-Black, 1998; A Behavioral Science Book Club Selection), Why Can’t I Be the Parent I Want to Be? (New Harbinger Publications, 1999), and Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth, (Prima, 2001). Laura L. Smith, PhD, is a clinical psychologist at the Presbyterian Medical Group, Behavioral Medicine Outpatient Clinic in Albuquerque, New Mexico. She specializes in the assessment and treatment of both adults and children with depression, anxiety, and other emotional dis- orders. In addition, she has presented on cognitive therapy and mental health issues to both national and international audiences. Dr. Smith is coauthor of Depression For Dummies (Wiley), Overcoming Anxiety For Dummies (Wiley), Hollow Kids: Recapturing the Soul of a Generation Lost to the Self-Esteem Myth, (Prima, 2001) and Why Can’t I Be the Parent I Want to Be? (New Harbinger Publications,1999). Drs. Elliott and Smith are available for speaking engagements and workshops. You can visit their Web site at www.PsychAuthors.com. 01_597930 ffirs.qxd 9/28/05 2:18 PM Page iii 01_597930 ffirs.qxd 9/28/05 2:18 PM Page iv Dedication We dedicate this book to our kids: Alli, Brian, Grant, Nathan, Sara, and Trevor. And to our granddaughter: Lauren Melodie. And finally to our parents: Edna Louise Smith, Joe Bond Elliott, Tea Elliott, William Thomas Smith (1914-1999), and Suzanne Wieder Elliott (1923–2004). Acknowledgments We’re no longer in denial. We’re hopelessly addicted to this writing business. We no longer need to apologize to our family and friends for our neglect; they’re used to it by now! We appreciate the efforts of our agents, Ed and Elizabeth Knappman who have encouraged our pursuits. Thanks to our editors at Wiley: Mikal Belicove, Tim Gallan, and Elizabeth Rea. We would not be able to function without help from Audrey Hite. Special thanks to Scott Love at Softekllc.com, who designed our Web site and keeps our computers happy. Thanks also to Elizabeth Deardorf for making our dogs smile in our authors’ picture. Finally, we have been privileged to hear the many stories of suffering, hurt, trauma, hope, recovery, and resilience from our clients over the years. We respect and appreciate what they have taught us. This book would not be possible without their collective wisdom. 01_597930 ffirs.qxd 9/28/05 2:18 PM Page v Publisher’s Acknowledgments We’re proud of this book; please send us your comments through our Dummies online registration form located at www.dummies.com/register/. Some of the people who helped bring this book to market include the following: Acquisitions, Editorial, and Media Development Senior Project Editor: Tim Gallan Acquisitions Editors: Mikal Belicove, Mike Lewis Copy Editor: Elizabeth Rea Editorial Program Assistant: Courtney Allen Technical Editor: Linda Ames Editorial Manager: Christine Meloy Beck Editorial Assistants: Nadine Bell, David Lutton, Hanna Scott Cover Photos: © Tim Brown, Stone, Getty Images Cartoons: Rich Tennant (www.the5thwave.com) Composition Services Project Coordinator: Adrienne Martinez Layout and Graphics: Lauren Goddard, Denny Hager Proofreaders: Leeann Harney, Sandra Profant Indexer: Naomi Linzer Publishing and Editorial for Consumer Dummies Diane Graves Steele, Vice President and Publisher, Consumer Dummies Joyce Pepple, Acquisitions Director, Consumer Dummies Kristin A. Cocks, Product Development Director, Consumer Dummies Michael Spring, Vice President and Publisher, Travel Kelly Regan, Editorial Director, Travel Publishing for Technology Dummies Andy Cummings, Vice President and Publisher, Dummies Technology/General User Composition Services Gerry Fahey, Vice President of Production Services Debbie Stailey, Director of Composition Services 01_597930 ffirs.qxd 9/28/05 2:18 PM Page vi Contents at a Glance Foreword ....................................................................................xv Introduction.................................................................................1 Part I: Analyzing Angst and Preparing a Plan ................................7 Chapter 1: Sorting Out Signs of Anxiety and Depression........................................................................9 Chapter 2: Discovering the Beginnings ...................................................................................................19 Chapter 3: Overcoming Obstacles to Change.........................................................................................31 Chapter 4: Minding Your Moods...............................................................................................................43 Part II: Thinking About Thinking: Thought Therapy.......................55 Chapter 5: Untangling Twisted Thinking.................................................................................................57 Chapter 6: Indicting and Rehabilitating Thoughts.................................................................................77 Chapter 7: Correcting Your Life-Lenses: A New Vision..........................................................................99 Chapter 8: Managing Mindfulness and Achieving Acceptance...........................................................117 Part III: Actions Against Angst: Behavior Therapy......................129 Chapter 9: Facing Feelings: Avoiding Avoidance..................................................................................131 Chapter 10: Lifting Mood Through Exercise .........................................................................................149 Chapter 11: Entertaining Enjoyment......................................................................................................159 Chapter 12: Getting Moving and Tackling Life’s Problems..................................................................169 Part IV: Phocus on Physical Pheelings .......................................181 Chapter 13: Relaxing the Heart and Soul...............................................................................................183 Chapter 14: Making the Medication Decision.......................................................................................197 Part V: Relationship Therapy.....................................................205 Chapter 15: Restoring Relationships .....................................................................................................207 Chapter 16: Smoothing Out Conflict ......................................................................................................219 Part VI: Looking Beyond Anxiety and Depression........................231 Chapter 17: Reining In Relapse...............................................................................................................233 Chapter 18: Promoting Positives............................................................................................................247 Part VII: The Part of Tens..........................................................261 Chapter 19: Ten Resources for Help ......................................................................................................263 Chapter 20: Ten Quick Ways Out of Upset ............................................................................................267 Index.......................................................................................271 02_597930 ftoc.qxd 9/28/05 2:18 PM Page vii 02_597930 ftoc.qxd 9/28/05 2:18 PM Page viii Table of Contents Foreword .....................................................................................xv Introduction .................................................................................1 About This Book.........................................................................................................................1 A Note to Our Depressed and Anxious Readers ....................................................................2 How to Use This Book ...............................................................................................................2 What Not to Read.......................................................................................................................2 What We Assume About You ....................................................................................................2 How This Book Is Organized.....................................................................................................3 Part I: Analyzing Angst and Preparing a Plan ...............................................................3 Part II: Thinking About Thinking: Thought Therapy ...................................................3 Part III: Actions Against Angst: Behavior Therapy.......................................................3 Part IV: Phocus on Physical Pheelings ..........................................................................3 Part V: Relationship Therapy..........................................................................................4 Part VI: Looking Beyond Anxiety and Depression .......................................................4 Part VII: The Part of Tens ................................................................................................4 Characters in This Book............................................................................................................4 Icons Used in This Book............................................................................................................4 Where to Go from Here..............................................................................................................5 Part I: Analyzing Angst and Preparing a Plan.................................7 Chapter 1: Sorting Out Signs of Anxiety and Depression................................................9 Dwelling on Dismal and Worried Thoughts............................................................................9 Walking in Quicksand: Apprehensive and Blue Behavior...................................................11 Feeling Funky............................................................................................................................11 Reflecting upon Relationships................................................................................................12 Plotting Your Personal Problems Profile...............................................................................13 Choosing Your Challenge ........................................................................................................15 Knowing When to Get More Help...........................................................................................17 Chapter 2: Discovering the Beginnings............................................................................19 Building the Body Connection................................................................................................19 Laying Out a Lifeline................................................................................................................20 Surveying Stress.......................................................................................................................28 Drawing Conclusions...............................................................................................................30 Chapter 3: Overcoming Obstacles to Change..................................................................31 Discovering and Challenging Change-Blocking Beliefs .......................................................31 Detecting beliefs standing in your way .......................................................................31 Blasting through beliefs blocking your path...............................................................34 Looking Out for Self-Sabotage ................................................................................................38 Stopping self-sabotage...................................................................................................39 Rewriting your self-sabotaging scripts........................................................................41 02_597930 ftoc.qxd 9/28/05 2:18 PM Page ix Chapter 4: Minding Your Moods ........................................................................................43 Deciphering Body Signals .......................................................................................................43 Connecting the Mind and Body..............................................................................................46 Putting Events, Feelings, and Sensations Together .............................................................47 Becoming a Thought Detective..............................................................................................50 Part II: Thinking About Thinking: Thought Therapy........................55 Chapter 5: Untangling Twisted Thinking..........................................................................57 The Information Reality Scramblers......................................................................................57 Recording Information Reality Scramblers on Thought Trackers...........................60 The Self-Judging Reality Scramblers......................................................................................64 Shoulding on yourself....................................................................................................64 Making critical comparisons.........................................................................................66 Tagging yourself with loathsome labels......................................................................68 The Self-Blame Reality Scrambler..........................................................................................72 Doing What You Can to Solve the Problem...........................................................................74 Chapter 6: Indicting and Rehabilitating Thoughts..........................................................77 From Arraignment to Conviction: Thought Court ...............................................................77 Examining a sample case in Thought Court ...............................................................78 Putting your thoughts on trial......................................................................................81 Reviewing more Thought Court cases.........................................................................84 After the Verdict: Replacing and Rehabilitating Your Thoughts........................................87 Getting a little help from a friend .................................................................................88 Traveling to the future...................................................................................................89 Recalculating risks .........................................................................................................92 Imagining the worst .......................................................................................................94 Reflections on Chapter 6.........................................................................................................97 Chapter 7: Correcting Your Life-Lenses: A New Vision.................................................99 Examining Life-Lenses .............................................................................................................99 How life-lenses work ....................................................................................................102 The origins of life-lenses..............................................................................................105 Changing the Prescription of Your Life-Lenses ..................................................................107 Distinguishing the past from the present..................................................................107 Tallying up costs and benefits of current life-lenses ...............................................110 Taking direct action against problematic life-lenses ...............................................113 Chapter 8: Managing Mindfulness and Achieving Acceptance................................117 Start by Losing Your Mind! ...................................................................................................117 Distinguishing between observing and evaluating ..................................................117 Tuning in and tuning out mind chatter......................................................................120 Playing with your mind chatter..................................................................................121 Arriving at Acceptance..........................................................................................................123 Connecting with Now ............................................................................................................126 Part III: Actions Against Angst: Behavior Therapy.......................129 Chapter 9: Facing Feelings: Avoiding Avoidance.........................................................131 What, Me Worry?....................................................................................................................131 Building a Staircase of Fear...................................................................................................134 x Anxiety & Depression Workbook For Dummies 02_597930 ftoc.qxd 9/28/05 2:18 PM Page x