Overcoming Teenage Low Mood and Depression A Five Areas Approach This page intentionally left blank Overcoming Teenage Low Mood and Depression A Five Areas Approach Dr Nicky Dummett MBBChir BA (Hons) MRCPsych DCH MMedSc Consultant Child and Adolescent Psychiatrist, Leeds Primary Care Trust, UK Dr Chris Williams MBChB BSCMMEDSCMD FRCPSYCH Senior Lecturer and Honorary Consultant Psychiatrist, Section of Psychological Medicine, University of Glasgow Medical School, Glasgow, UK Helping you to help yourself www.livinglifetothefull.com www.fiveareas.com First published in Great Britain in 2008 by Hodder Arnold, an imprint of Hodder Education Part of Hachette Livre UK, 338 Euston Road, London NW1 3BH http://www.hoddereducation.com © 2008 Nicky Dummett and Chris Williams All rights reserved. Apart from any use permitted under UK copyright law, this publication may only be reproduced, stored or transmitted, in any form, or by any means with prior permission in writing of the publishers or in the case of reprographic production in accordance with the terms of licences issued by the Copyright Licensing Agency. In the United Kingdom such licences are issued by the Copyright Licensing Agency: Saffron House, 6–10 Kirby Street, London EC1N 8TS. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side effects recognised. For these reasons the reader is strongly urged to consult the drug companies’ printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN-13 978-0-340-94657-2 1 2 3 4 5 6 7 8 9 10 Commissioning Editor: Philip Shaw Project Editor: Clare Patterson Production Controller: Karen Tate Cover Design: Amina Dudhia Typeset in 11pt Frutiger by Pantek Arts Ltd., Maidstone, Kent. Printed and bound in Malta. What do you think about this book? Or any other Hodder Arnold title? Please visit our website: www.hoddereducation.comor send comments to [email protected] New ways of accessing the workbooks Other linked resources are available from www.fiveareas.com Buying the books in bulk: Bulk copies of the book are available at discounted rates direct from the publisher. 5–30 copies: 25% 31–50 copies: 30% 51–100 copies: 40% 100–200 copies: 45% 200+ copies: 50% To take advantage of these reduced rates please contact: Jane MacRae,Sales Development Manager,Hodder Headline,338 Euston Road, London NW1 3BH.Tel: +44 (0) 20 7873 6146; e-mail: [email protected] Details of other ways of delivering the course are available at www.livinglifetothefull.com are www.fiveareas.com This page intentionally left blank Contents Foreword by Professor Paul Stallard ix Introduction xi Part 1 Understanding why I feel as I do Understanding why I feel as I do 3 Why bother changing? 33 Part 2 Making changes Doing things that make me feel good 51 Using exercise to boost how I feel 75 Helpful things we do 89 Unhelpful things we do 107 Restarting things we’ve avoided 137 Practical problem solving 163 Noticing and changing extreme and unhelpful thinking 195 Being assertive 217 Building relationships 233 Overcoming sleep problems 247 Alcohol, drugs and me 265 Understanding and using anti-depressant medication 281 Planning for the future 291 Part 3 Support materials for relatives and friends Ideas for families and friends: how can I offer the best support? 313 This page intentionally left blank Foreword Young people often feel down,sad or unhappy for short periods of time,although for some this unfortunately becomes a way of life.Feelings of unhappiness persist,become intense and start to interfere with everyday activities.Low mood and depression take over,with school work,social life,friendships and family relationships all being affected. Many of these young people would benefit from some form of help but undoubtedly are often deterred from seeking help by the stigma associated with mental health problems.There is also poor recognition and understanding of adolescent depression within general practice and by community professionals.It is therefore not surprising that comparatively few young people are referred and seen for treatment by specialist child mental health services.This highlights the need to increase the availability of good,user-friendly,theoretically based materials which can be more directly accessed and used by young people. Overcoming Teenage Low Mood and Depression: A Five Areas Approachis a welcome and much needed self-help manual designed for young people with depression and low mood.It is based on the very successful self-help format used in Overcoming Depression and Low Moodbut has been specifically adapted and written for use with young people.The material is based on the theoretical model of cognitive behaviour therapy (CBT),which has been identified as being effective in mild and moderate depression by the National Institute of Health and Clinical Excellence (NICE 2005).1 Overcoming Teenage Low Mood and Depressionuses a ‘five areas’approach to help young people understand how they are feeling.They are helped to discover the relationship between people and the events that happen,what they think about these,how these thoughts make them feel,the physical symptoms these produce and the effect of these on their behaviour.Developing this understanding is an important first step that can help a young person to make sense of how they are feeling.This understanding can in itself be very empowering and can help the young person realise that they can make changes that will help them to feel better. Through a series of attractive workbooks Overcoming Teenage Low Mood and Depressionprovides the young person with opportunities to explore some of the important areas that contribute to the development and maintenance of low mood and to develop skills that will help them to feel better.There are workbooks to help understand the importance of activity; to identify,challenge and modify extreme and unhelpful thinking; to develop helpful problem-solving skills; and to understand how to build supportive relationships and how to manage some of the physiological symptoms associated with low mood,such as disturbed or disrupted sleep.There is also a helpful workbook for families and friends that provides useful information about depression and low mood,and many practical ideas about what they can do to help. Overcoming Teenage Low Mood and Depressionis written specifically for young people and provides a wealth of useful information,helpful self-assessment tasks,and many practical ideas and activities.This practical emphasis is very engaging and helps the 1NICE (2005) Depression in Children and Young People: Identification and Management in Primary,Community and Secondary Care.National Clinical Practice no.28.London: NICE. Overcoming Teenage Low Mood and Depression:AFive Areas Approach © Dr Nicky Dummet and Dr Chris Williams (2008)