Doing the exercises in Mary Ellen Copeland’s The Depression Workbook is the only way to get its full value as a self-help recovery resource.
A workbook is as useful as you make it. You can skim to get the gist, dismiss it as too basic or obvious to help you, and put it down. Or you might stop at the sight of all those exercises and directions because you feel so depressed that you couldn’t possibly follow its advice.
Or you can take it on its own terms, start on page 1, and see how far you can get. The book may challenge some of your ideas about treatment since it puts you at the center of decision making. That’s what I like about it.
Healing Starts with Doing
I’ve worked my way through the book and found that it only comes to life as a helpful tool when you get active enough to answer its questions and try out its suggested practices. Sure, some of it seems too obvious, covering what you already know, but I found that if I suspended that judgment and did the work I learned more than I imagined I would.
Obvious doesn’t mean ineffective. Getting past depression and sustaining wellness depend on applying the most basic knowledge and skills every day. I doubt you can ever get too much practice of even the simplest things.
If you’re too depressed to get started, you’ll probably find that the illness is blocking you from any therapeutic practice. Getting the extreme symptoms under control, perhaps by medication or some other method, is necessary before you can do much to help yourself.
It’s like physical therapy. You need it to get mobile again, but you can’t do the work when you’re in extreme pain. You have to find a way to ease that first.
Using the book brings out the basic assumptions woven through every aspect of Copeland’s method. They’re especially compelling, partly because Copeland has based them on surveys of people with depression as well as the responses of hundreds of participants in her workshops.
Here’s a quick summary of the principles that I find most essential to the healing effect of this workbook.
If you personally take responsibility for your own wellness, you’re more likely to achieve a high level of stability, well-being and sense of control over your own life. You will respond best to any treatment or recovery strategy if you make decisions on how to work toward wellness for yourself.
You turn to your health care providers to make recommendations and provide assistance as needed. That doesn’t mean you can ignore them as you please. They are an important part of a support team, but their advice may be slanted toward one form of treatment or prove ineffective. The fact is that every treatment for depression often fails, and you need to be able to say when you’re ready to stop one therapy and move on to something else. The tradition of the passive patient who leaves every decision up to a doctor hasn’t worked for a great many people trying to recover from depression.
Starting on a path to recovery can require more structure and step by step methods than you may have ever used before. That can include things that may at first seem unnecessary or pointless, like listing symptoms and forming action plans. However, they can be crucial in helping you establish patterns of living that support recovery and break through the paralysis of depression.
Writing everything down forces you to think carefully about what you need and which specific actions you can try. Being specific is important since it’s easy to neglect or forget an overly general goal. The written plans also give you references to turn back to when depression makes it hard to remember.
Writing down symptoms and action plans also sharpens your awareness of how depression distorts your life. Greater awareness helps distance you from the illness so that you break your fusion with depressive thinking and beliefs.
Choosing a Path to Recovery and Wellness.
Like any good workbook, this one sets out an overall pathway to recovery. It’s a basic structure that you fill with your chosen strategies as you go through the book.
There are five major parts:
Getting a clear picture of what your depression is like. The approach at the outset is typical of every section of the workbook. Copeland presents the full range of symptoms reported by participants in her survey and workshops, then asks you to indicate which ones affect your life. She provides brief descriptions of possible sources of depression and asks you pick out the life experience or current conditions that you feel contribute to the illness.
Taking charge of your path to wellness by choosing strategies and committing to trying each one. Copeland guides you through a process of setting goals in a realistic manner, identifying treatments to deal with your symptoms, deciding what forms of support you want and deciding what to do when you spot early warning signs of depression.
Developing a Wellness Recovery Action Plan (WRAP) is a centerpiece of Copeland’s method. It’s another response to the needs of her workshop participants for a single written plan they could refer to in order to keep themselves on track. The WRAP consists of 9 sections in which you identify the wellness strategies and tools you want to use, along with your triggers for action.
The most important part is a detailed crisis plan that helps you, your family and support team identify the signs that you are becoming too ill to care for yourself. It sets out instructions on what you do and do not want done if you need to be hospitalized, who will make decisions for you and details about your treatment preferences. The crisis plan becomes a legal document signed in the presence of witnesses so that it cannot be ignored.
Lining up support from many sources is another critical step. Copeland describes how support groups work and offers details on how to set one up. She also reviews all the types of professional help you can seek and the importance of family support – if that is available.
Developing a wellness lifestyle is the way she describes the use of the full range of professionally guided therapies and self-help methods that you decide to use. Most books refer to these as strategies for dealing with symptoms, but a hallmark of Copeland’s approach is to keep you focused on living well. The most detailed guidance concerns reinforcing self-esteem, changing patterns of distorted thinking and reducing stress.
The final section of the book offers material on understanding and preventing suicide, based on the methods she used to control her own suicidal tendencies.
Copeland’s approach won’t appeal to everyone, but that’s to be expected. As she emphasizes, taking responsibility for your wellness means choosing the strategies that you find appropriate. This book may not be one of them.
But I recommend it primarily for its strong support of your taking charge of recovery and wellness. I know that I would never have gotten as far as I have in recovery unless I had to decided to get active. You’re the only person who can go beyond controlling symptoms to making decisions about your well-being and life as a whole.
For my purposes, The Depression Workbook is an excellent starting point for deciding what you will do to support recovery. If using workbooks makes sense as one of your strategies, I would recommend starting with this one and then following up with others devoted to more specific methods. There are innumerable workbooks on almost every aspect of depression, such as mindfulness, stress-reduction, cognitive therapy, anger, anxiety, self-esteem and many more.
Have you tried any workbooks as part of your effort to recover? It would be helpful to know which ones you have found effective and why.
Image by Rosa y Dani at Flickr.
ϒes! Finally someone writes about prɑctice
Michelle Mullins says
I am leaving the clinic tomorrow and my psychiatrist had recommended the book. I started reading and couldn’t put it down. Thank you