AS@W Antidepressant Skills at Work: Dealing with Mood Problems in the Workplace

Putting antidepressant skills to work: an example

Melissa criticized herself in a harsh manner.

Checklist Notebook

SituationMelissa was a teacher in her mid-30s who had recently transferred to an inner city school, attracted to the challenge of the work. Very quickly, she found she could not accomplish at work what she had usually been able to, despite working long hours. She began to sleep poorly and worried much of the time. She criticized herself in a harsh manner for not doing as well as she expected. Her mood began to drop until she was feeling quite miserable. This made it more difficult to perform her job, and she became even more self-critical and depressed.

ActionMelissa visited her family physician, who advised her that she had a major depression. She told her doctor that she was reluctant to take antidepressant medications, so her physician referred her to a psychologist specializing in Cognitive Behavioural Therapy. Her physician also gave her a copy of Antidepressant Skills at Work. Melissa saw the psychologist for 6 sessions.

ResultBy working with the psychologist and using the antidepressant skills, she was able to make important changes in her life. She realized that she had been avoiding her friends since she took her new job, and especially since she became depressed. She used the Reactivating Your Life skill and set the goal of meeting a friend once a week for tea. Later, she increased this to include other social activities. After the first month, she added exercising for a half hour, 3 times a week as a goal. She also recognized patterns of depressive thinking: she had a very self-critical way of thinking, she expected herself to perform perfectly, and she ignored praise from others.

Between therapy sessions, she used questions from the Antidepressant Skills manual to come up with more fair and realistic ways of thinking:

What evidence do you have? Her vice-principal had spoken with her on a couple of occasions and indicated being happy with her work. Another teacher told her this was one of the toughest schools in the city, and that she was handling the transfer to an inner-city school really well.

What would you say to a friend in the same situation? She wrote out the fair and supportive words she would say to a friend, and then practiced saying them to herself.

What is a less extreme way of looking at the situation? She wrote down some realistic thoughts about the job situation, and then reminded herself of these whenever she noticed the unrealistic negative thoughts. The use of self-care methods led to a gradual improvement in her depression, a more fair and accepting attitude towards herself, more realistic self-expectations, and more enjoyment of her life.

However, Melissa realized that she still tended to fall into unfair self criticism, especially when she was under more stress than usual. Even after she was feeling back to normal, she paid attention to the way she was thinking and what kind of messages she was giving herself. If she noticed that she was putting herself down unfairly, she would use the Challenging Depressive Thoughts strategy to come up with more realistic and fair ways of thinking about herself. Or, if she noticed that her mood seemed to be really down for a couple of days, she would write down the depressive thoughts that went along with her low mood. Then, she would challenge these thoughts and come up with more realistic ones to practice. If she knew that a particularly stressful situation was coming up (like end-of-semester grading), she would ask her husband to do more of the household chores while she was preparing grades and would make sure to set aside some time for social activity. She also wrote in a notebook the things that were most helpful to her in getting out of depression. She kept the notebook in a convenient place, so she could review it if her mood began to slip.

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