Depression Recovery: Keeping a Mood Journal

For many of us, learning how to understand and handle our feelings is a lifelong task. For depressed people, however, recognizing and experiencing emotions is essential to recovery. According to psychotherapist Richard O'Connor, PhD, this is the very starting point for overcoming and preventing depression.

Some people are afraid of emotions because they fear they will be overwhelmed, even consumed by them, says O'Connor, who himself has suffered from deep depression. But rather than saving you from emotional pain, repressing your emotions can make it more likely you'll become depressed. "The emotional self has largely been lost to the depressive," O'Connor writes in his book Undoing Depression (Little, Brown, and Co., 1997). "Reestablishing contact with it may take time, but it's worth the effort."

Since depression is a serious illness, you should always seek professional help in treating it. However, for those on the road to recovery who want to better understand their emotions and perhaps avoid another bout of depression, O'Connor and other experts suggest exercises that you can do on your own.

But first, some background

Of course, some depressions are "situational" -- that is, they may stem from trauma or an overwhelming loss, such as the death of a loved one. If you have suffered such loss, you are probably very aware of the grief and anguish you feel. But if you suffer bout after bout of depression that doesn't seem to be linked to any particular event, you may want to examine your feelings more closely to try to uncover what's behind your depression. In such cases, depression can be linked to unrecognized or repressed feelings, according to O'Conner. Many people who are struggling with depression, he says, may have learned ineffective or self-defeating ways of coping with feelings. More specifically, they are out of touch with their emotions because they fear feeling them. But the fear is misplaced, say therapists. To regain mental health, people need to understand that suffering is sometimes caused not by the feelings themselves, but by the fear of experiencing them and the habits that spring up to control or avoid that fear.

The danger of tuning out your feelings, therapists say, is that if you lose your ability to feel painful feelings, you can also lose your ability to feel joy and vitality. The result: an emotional grayness or numbness can take over your life.

This emotional numbing may cause you to withdraw from people and become isolated. Acting out inappropriately or self-destructively is also common, and the behavior -- including quarreling, road rage, or developing addictions to keep anxiety and painful feelings at bay -- is often repeated over and over. Other consequences may include a loss of interest in work, family or friends as well as divorce, fatigue (it takes a lot of energy to repress emotions), insomnia, increased stress, and even physical illness.

"One of the main consequences of depression is you avoid life," says Patricia Lee Padgett, a marriage and family therapist in private practice in Walnut Creek, California. "You avoid the things that could be nurturing or beneficial to you, including taking risks and making different choices."

Treat your own feelings with compassion

Many of us treat other people's feelings gently but are rigid and judgmental with our own. When trying to change old patterns, treat yourself with sensitivity, Padgett says. "It's important to be compassionate toward your feelings. Ask yourself, 'Why am I so sad?' Be compassionate, interested, curious to learn more. It's far better than being angry or disgusted with yourself. Go in with the intent to learn rather than judge." Paying attention to changes in your body is one way to clue in to how you're feeling at any given time. "Ask yourself, 'What am I really feeling in my body? And what is this in response to?' " says Marion Pastor. You may discover that you're feeling fear, anger or sadness, for example, by noticing physical signs such as a clenched fist or jaw, a tightened stomach, or dizziness from holding your breath.

Create a Mood Journal

To further help people recovering from depression get in touch with their feelings, O'Conner proposes a Mood Journal. This is an especially powerful tool, he says, since depressed people are usually more aware of their shifting moods than the feelings that caused the moods. One minute you're feeling fine, then suddenly you're feeling hurt, or anxious, or angry, without knowing why. Mood changes like these may be caused by an unfelt feeling, he says, which can be traced to an external event.

The Mood Journal is designed to help you trace and monitor your feelings -- and if you stick to it and use it correctly, you can begin to get around your own defenses. This may not feel good at first, O'Connor says, but the benefit is that after a few weeks you become more aware of your feelings and the things that upset you -- one of the first steps in overcoming depression.

When you notice a shift in your mood, write down the change (such as neutral to sad), external circumstances (what you were doing, where, with whom), and the internal circumstances (what you were thinking about, daydreaming or remembering). Then, based on those external and internal circumstances, describe how you think a well-adjusted person with a full range of emotion might feel (such as happy, sad, proud, discouraged). Then rate how much your mood agrees with those feelings (1= no agreement, 10 = complete agreement).

To create an easy-to-use weekly mood journal, here are O'Conner's instructions:

Make a log with six categories, perhaps using the Excel program on your computer (or a ruler and paper if you don't have access to a computer). In that log, make a calendar with room for:

1. The date and time (usually a date for every day of the month, divided into hourly categories).

2. Your mood change.

3. Externals (who was there, what was going on, where the mood change took place, and other unusual circumstances).

4. Internal thoughts (what your thoughts, fantasies, and memories were at the time).

5. What you think a well-adjusted person would feel in the same circumstances.

6. Mood/feeling agreement (assign a rating of 1-10, describing how well your mood corresponded to feelings you picture a well-adjusted person having under the circumstances).

It may sound like a lot of trouble to go to just to record your feelings, but O'Conner reports that the depressed people he treats have had some tremendous successes in doing so. Review the Mood Journal each day, and see what patterns you begin to notice. If the exercise helps you locate your feelings and listen to them with an open heart, you've already made great strides in recovering from depression.

References

American Medical Association: Essential Guide to Depression. Simon and Schuster.

Undoing Depression: What Theory Doesn't Teach You and Medication Can't Give You. Richard O'Connor, Ph.D.

Interviews with psychotherapists Marion Pastor and Patricia Lee Padgett