Change: A Clinical Definition

“There’s a difference between wanting to change because you hate yourself & wanting to change because you love yourself.” – Anonymous

According to psychology, there are 6 steps to change. These steps will help make change a less arduous process and open you up to possible new behaviors and habits that are currently holding you back. Please remember, it is normal & natural to regress, to attain one stage only to fall back to a previous stage. “No one can force a person to change their behavior, lifestyle, mentality, attitude, etc. The individual must be ready for change” – Psychology.tools

The first step is precontemplation. Here you have not yet acknowledged that there is a problem. At this point, you are in denial and will defend your current bad habit or behavior. You have no intention of changing this habit or behavior because you do not see a problem.

The second step is contemplation. Here you are acknowledging that there is a problem but you don’t know if you want or are ready to change. You are aware that a problem exists with your current behavior or habit, however you are ambivalent and have no commitment to making a change. You do spend time thinking about the problem, trying to determine if change is needed.

The third step is preparation or determination. You are getting ready to change and have an intention to take action. This is also known as the research phase because you are gathering information on how to make the needed change. This step is often skipped and leads the person to fail at their initial attempt to change because they haven’t accepted that it will be a change that will affect their lifestyle.

The four step is action. This involves the willpower to actively modify the behavior or habit. You have to have a belief in your ability to change and be actively involved by using different techniques and putting effort into the change. It is in the phase that people are at the greatest risk for relapse however they are also more open to receiving help and support from others.

The fifth step involves maintenance. Here you have to avoid temptations to return to bad habits and you have to maintain the behavior or habit change. You need to remain aware of the situation, be patient with yourself and remain on track. By sustaining the change, the new habit or behavior will replace the old.

The sixth step is relapse. This is included because it is considered normal to experience at least one relapse in the course of the change. In a relapse, you return to the old behaviors or habits and abandon your changes by falling back into old patterns of behavior. Most importantly you have to remember that you didn’t fail. Instead look at your relapse as an opportunity for learning and becoming stronger. The process can be restarted again at any of the last three phases: Preparation, action or maintenance.

Eventually you will have maintained maintenance long enough to attain transcendence. Transcendence is when the former habit or behavior has now become atypical and abnormal. You will also be able to work with your emotions, view your behaviors in a new light and understand them.

Now that you know the steps to making changes? What is it you would like to change in your life? The following is a prompt to inspire change.

“Things I Want to Change”

  • Two things I want to change about myself…
  • Two things I like about myself and don’t want to change are…
  • The most important change I’ve made since __________ is…
  • A change that I’ve made since ____________ is …
  • If I try to change, I worry that…
  • A Change that I would like to make in myself but don’t think I can is…
  • The reason it is hard for me to change is…

Psychology Tools

What Are Emotions?

Emotions are feelings that are felt during a particular situation or event.

Here are some facts you need to know about emotions:

  1. Emotions are neither good or bad, right or wrong. Emotions just are; they exist.
  2. Emotions don’t last forever.
  3. Emotions are not facts.
  4. When a strong emotion comes, you do not have to act on that emotion.
  5. You can’t get rid of emotions because they serve as important survival functions.

There are eight primary emotions.

  • Anger
  • Sorrow
  • Joy
  • Fear
  • Disgust
  • Guilt/Shame
  • Interest
  • Surprise

Secondary emotions also exist. These are an emotional reaction to a primary emotion. An example would be to feel shame when your primary emotion is anger. Secondary emotions are learned emotions from families, cultures and our environments. Secondary emotions are important, but it is more important to discover the primary emotion so you can get to the root of the problem.

Emotions have three jobs.

The first is communication. They can be communicated both verbally and nonverbally. Verbal communication of emotion occurs through words, voice tone and volume. Nonverbally, emotions can be communicated through our faces, posture and gestures. Non-verbal communication happens very rapidly and can often help us in certain situations. Even if we try to hide an emotion, it is often communicated through our nonverbal actions.

Emotions also motivate us. They tell us to ‘act now’ and to ‘stay focused’. They give us the motivation we need to change certain situations and strong emotions allow us to overcome obstacles both in our minds and in our environments. Emotions also save us time in important situations because we don’t have to think everything through.

Lastly, emotions can give us validation. Emotions can be informative about a situation. ‘Gut Instinct’ emotions can be used as signals and alarms. However, when carried to the extreme, emotions can often be treated as facts. This is where validation turns against us and this will be discussed in a future post.

Some last notes about emotions. To discover an issue, it can often help to discover where you ‘feel’ this emotion. For an example anger is often felt in the stomach, with a tensioning of the muscles.Urges to do something are natural, but not necessarily healthy. Everyone’s emotions are different so everyone will react differently to different emotions. Finally, unhealthy thoughts occur when we attach judgements to our emotions. You need to be willing to radically accept your emotions as they occur (Radical Acceptance).

Emotions are not bad. In fact, they often can be helpful depending on the situation. It’s how we react to our emotions that can cause us problems.

Emotions
Dealing with Negative Emotions

Disclaimer

When you are first diagnosed with depression, it can seem overwhelming. There are so many different types of medications and therapies that can treat depression.

In the next couple of posts, I will be describing the various types of medications, therapies, lifestyle changes and alternative medicines that can help treat depression. I am not a doctor and I will not claim anything other than a basic understanding of medicine. I am just trying to set down a basic understanding for everyone.

If you have questions about any of these medications or treatments, please talk your doctor.

Being Diagnosed

If you think you have depression, the first step you need to take is to make an appointment with your primary care physician.

Before your appointment, you should get an in-depth family history. You should also include any symptoms and behaviors, whether they seem related or not, as well as personal information including stress, life changes and lifestyle habits (exercise, diet, sleep, alcohol & drug use). The doctor will also ask for all medications, vitamins and supplements, both prescribed and over-the-counter, that you are taking. It is usually best to sit down and write out this information before your appointment, to insure that you remember everything.

During your appointment, your doctor will ask a lot of questions. Many of these questions may seem extremely personal, but you need to answer them as honestly as possible. The doctors won’t judge you, they want to make sure you get the help you need. The doctor may do a physical exam to rule out a physical health problem. They may also do lab test including a blood test to check your thyroid. An overactive or underactive thyroid will also present the same symptoms as depression. You might also have to have a psychological evaluation. Don’t hesitate to ask questions anytime you don’t understand anything.

To be diagnosed with depression, you must meet the symptom criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. As previously discussed, major depression is characterized as having more than 5 of the symptoms discussed in a previous post, for over a 2 week period.

If you see your primary care physician, get referrals for a psychiatrist and/or a psychologist. I will go into more detail on the differences between the two in another post.

If you are diagnosed with depression, seek the help that you need. Be your own advocate & realize you are not alone.

Depression: A Clinical Definition

To have a better understanding of depression, you need to understand the medical definition as well as how it relates to a depressed person.

Depression, as defined by Mayo Clinic, “is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depression, major depression disorder or clinical depression, it affects how you feel, think and believe and can lead to a variety of emotional and physical problems.”₁

While this is the definition Mayo Clinic, NAMI₂ and various other institutions use to describe depression; the easiest and most forthright definition is that depression is a disease.

Let me repeat that.

Depression is a disease.

And like many diseases, depression can be fatal. Of course, it doesn’t have to be. With proper treatment, depression can be managed. Many depressives may only experience one episode or can even go into remission.

The best way to recognize depression in a person, or in yourself, is to know the symptoms.

Depression signs and symptoms vary from person to person, but they can include:

  • Angry outbursts, irritability or frustration, even over small matters
  • Loss of interest or pleasure in normal activities, such as sex
  • Sleep disturbances, including insomnia or sleeping too much
  • Tiredness and lack of energy, so that even small tasks take extra effort
  • Changes in appetite — often reduced appetite and weight loss, but increased cravings for food and weight gain in some people
  • Anxiety, agitation or restlessness — for example, excessive worrying, pacing, hand-wringing or an inability to sit still
  • Slowed thinking, speaking or body movements
  • Feelings of worthlessness or guilt, fixating on past failures or blaming yourself for things that are not your responsibility
  • Trouble thinking, concentrating, making decisions and remembering things
  • Frequent thoughts of death, suicidal thoughts, suicide attempts or suicide
  • Unexplained physical problems, such as back pain or headaches
  • Feelings of sadness, emptiness or unhappiness
  • Abusing alcohol or drugs

The thing to remember, is that everyone is different and each person experiences depression in their own way. My next post, will be about my beginnings with depression. It is important to differentiate between the clinical definition of depressive and the life a depressive person, lives. Although the definition explains the symptoms, depression is a complicated disease that is caused by genetic, biological, environmental and psychological factors.

I’m hoping this clinical definition will give you a better understanding of depression as I take you through my life as a mentally ill, depressed person.

For more information view this video on The Science of Depression.

  1. Mayo Clinic
  2. NAMI – National Alliance on Mental Health