Social Emotional Support

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Behavioral Activation

Depression saps a person’s energy to do just about anything—even activities they enjoy. As a result, people with depression tend to become less active, which causes the depression to worsen. However, even a little bit of activity can help stop this cycle.

1. Choose activities you are likely to complete.

Exercise	walk, go for a bike ride, weightlift, follow an exercise video, swim, practice yoga
Socialize	call or text a friend, organize a group dinner, visit family, join a club / group
Responsibilities	cleaning / housework, pay bills, professional development, homework
Hobbies	sports, gardening, drawing, playing music, hiking, playing with a pet, cooking
Personal Care	dress up, get a haircut, prepare a healthy meal, tend to spiritual needs

 

2. Practice your chosen activities. Use the following tips to improve consistency.

Start Small	If needed, break activities into smaller pieces. Some activity is better than none.
Make a Plan	Set an alarm as a reminder, or tie an activity to something you already do. For example, practice a hobby immediately after dinner every day.
Bring a Friend	Including a friend will increase your commitment and make things more fun.

 

Social Support

Social isolation is a common symptom of depression. Related issues—such as fatigue, lowered self-esteem, and anxiety—exacerbate this problem. Resisting social isolation, and instead leaning on social support, can improve resilience to stress and depression.

• Lean on your existing relationships. Make it a priority to socialize with friends or family every day. If this is proving difficult, or if no one is nearby, plan times to interact remotely. Try cooking together on a video call, playing a game together, or sharing a coffee over the phone.
• Say “yes” to socializing. Depression makes it tempting to stay home, isolated from friends and family. Make a habit of saying “yes” to social opportunities, even when you’re tempted to stay in.
• Join a support group. Support groups let you connect with others who are dealing

Three Good Things

Negative thinking is a defining feature of depression. Positive experiences are minimized, while negative experiences are magnified. Gratitude helps combat this tendency by shifting focus toward positive experiences, rather than negative ones.

1. Write about three positive experiences from your day. These experiences can be small (“The weather was perfect when I walked to work”) or big (“I got a promotion at work”).
2. Choose one of the following questions to answer about each of the three good things:
   • Why did this happen?
   • Why was this good thing meaningful?
   • How can I experience more of this good thing?
3. Repeat this exercise every day for 1 week.

Mindfulness

Mindfulness means paying attention to the present moment. It means taking a step back and noticing the world, and one’s thoughts and feelings, without judgment. The goal of mindfulness is to simply observe. Mindfulness helps reduce the rumination and worry that often accompany depression.

One way to practice mindfulness is through meditation. During mindfulness meditation, you will simply sit and focus your attention on the sensation of breathing. By focusing on your breathing, you will put yourself in the here-and-now.
Time and Place
Find a quiet, comfortable place where you can practice mindfulness for 15 to 30 minutes every day. Frequent and consistent practice leads to the best results, but some practice is better than none.
Posture
Sit in a chair or lie down in a comfortable position. Close your eyes or let your gaze soften. Let your head, shoulders, arms, and legs relax. Adjust your posture whenever you feel uncomfortable.
Awareness of Breath
Focus on your breathing. Notice the sensation of the air as it travels in through your nose and out through your mouth. Notice the gentle rise and fall of your belly.
Wandering Mind
During meditation, it’s normal for the mind to wander. When this happens, gently turn your attention back to your breathing. You may need to do this frequently throughout your practice.

 

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Deep Breathing
Deep breathing is a simple technique that’s excellent for managing emotions. Not only is deep breathing effective, it’s also discreet and easy to use at any time or place.

Sit comfortably and place one hand on your abdomen. Breathe in through your nose, deeply enough that the hand on your abdomen rises. Hold the air in your lungs, and then exhale slowly through your mouth, with your lips puckered as if you are blowing through a straw. The secret is to go slow: Time the inhalation (4s), pause (4s), and exhalation (6s). Practice for 3 to 5 minutes.

Progressive Muscle Relaxation
By tensing and relaxing the muscles throughout your body, you can achieve a powerful feeling of relaxation. Additionally, progressive muscle relaxation will help you spot anxiety by teaching you to recognize feelings of muscle tension.

Sit back or lie down in a comfortable position. For each area of the body listed below, you will tense your muscles tightly, but not to the point of strain. Hold the tension for 10 seconds, and pay close attention to how it feels. Then, release the tension, and notice how the feeling of relaxation differs from the feeling of tension.

Feet	Curl your toes tightly into your feet, then release them.
Calves	Point or flex your feet, then let them relax.
Thighs	Squeeze your thighs together tightly, then let them relax.
Torso	Suck in your abdomen, then release the tension and let it fall.
Back	Squeeze your shoulder blades together, then release them.
Shoulders	Lift and squeeze your shoulders toward your ears, then let them drop.
Arms	Make fists and squeeze them toward your shoulders, then let them drop.
Hands	Make a fist by curling your fingers into your palm, then relax your fingers.
Face	Scrunch your facial features to the center of your face, then relax.
Full Body	Squeeze all muscles together, then release all tension.

Challenging Irrational Thoughts
Anxiety can be magnified by irrational thoughts. For example, the thoughts that “something bad will happen” or “I will make a mistake” might lack evidence, but still have an impact on how you feel. By examining the evidence and challenging these thoughts, you can reduce anxiety.

Put thoughts on trial. Choose a thought that has contributed to your anxiety. Gather evidence in support of your thought (verifiable facts only), and against your thought. Compare the evidence and determine whether your thought is accurate or not.
Use Socratic questioning. Question the thoughts that contribute to your anxiety. Ask yourself:

“Is my thought based on facts or feelings?”
“How would my best friend see this situation?”
“How likely is it that my fear will come true?”
“What’s most likely to happen?”
“If my fear comes true, will it still matter in a week? A month? A year?”

Imagery
Your thoughts have the power to change how you feel. If you think of something sad, it’s likely you’ll start to feel sad. The opposite is also true: When you think of something positive and calming, you feel relaxed. The imagery technique harnesses this power to reduce anxiety.

Think of a place that you find comforting. It could be a secluded beach, your bedroom, a quiet mountaintop, or even a loud concert. For 5 to 10 minutes, use all your senses to imagine this setting in great detail. Don’t just think fleetingly about this place--really imagine it.

• What do you see around you? What do you notice in the distance? Look all around to take in all your surroundings. Look for small details you would usually miss.
• What sounds can you hear? Are they soft or loud? Listen closely to everything around you. Keep listening to see if you notice any distant sounds.
• Are you eating or drinking something enjoyable? What is the flavor like? How does it taste? Savor all the tastes of the food or drink.
• What can you feel? What is the temperature like? Think of how the air feels on your skin, and how your clothes feel on your body. Soak in all these sensations.
• What scents are present? Are they strong or faint? What does the air smell like? Take some time to appreciate the scents.

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1. Exercise (running, walking, etc.)
2. Put on fake tattoos
3. Write (poetry, stories, journal)
4. Scribble/doodle on paper
5. Be with other people
6. Watch a favorite TV show
7. Post on web boards and answer others’ posts
8. Go see a movie
9. Do a word-search or crossword
10. Do schoolwork
11. Play a musical instrument
12. Paint your nails, do your make-up or hair
13. Sing
14. Study the sky
15. Punch a punching bag
16. Cover yourself with Band-Aids where you want to cut
17. Let yourself cry
18. Take a nap (only if you are tired)
19. Take a hot shower or relaxing bath
20. Play with a pet
21. Go shopping
22. Clean something
23. Knit or sew
24. Read a good book
25. Listen to music
26. Try some aromatherapy (candle, lotion, room spray)
27. Meditate
28. Go somewhere very public
29. Bake cookies
30. Alphabetize your CDs/DVDs/Books
31. Paint or draw
32. Rip paper into itty bitty pieces
33. Shoot hoops, kick a ball
34. Write a letter or send an email
35. Plan your dream room (colors/furniture)
36. Hug a pillow or stuffed animal
37. Hyper-focus on something like a rock, hand, etc.
38. Dance
39. Make hot chocolate, a milkshake or a smoothie
40. Play with modeling clay or Play-Doh
41. Build a pillow fort
42. Go for a nice long drive
43. Complete something you’ve been putting off
44. Draw on yourself with a marker
45. Take up a new hobby
46. Look up recipes, cook a meal
47. Look at pretty things like flowers or art
48. Create or build something
49. Pray
50. Make a list of blessings in your life
51. Read the Bible
52. Go to a friend’s house
53. Jump on a trampoline
54. Watch an old happy movie
55. Contact a hotline/your therapist - If you want, you can call us 1-800-448-3000
56. Talk to someone close to you
57. Ride a bicycle
58. Feed the ducks, birds or squirrels
59. Color
60. Memorize a poem, play or song
61. Stretch
62. Search for ridiculous things on the internet
63. “Shop” on-line (without buying anything)
64. Color-coordinate your wardrobe
65. Watch fish
66. Make a CD/play-list of your favorite songs
67. Play the “15 Minute Game” (Avoid something for 15 minutes, when time is up start again)
68. Plan your wedding/prom/other event
69. Plant some seeds
70. Hunt for your perfect home or car on-line
71. Try to make as many words out of your full name as possible
72. Sort through/edit your pictures
73. Play with a balloon
74. Give yourself a facial
75. Play with a favorite childhood toy
76. Start collecting something
77. Play a video/computer game
78. Clean up trash at your local park
79. Look at yourlifeyourvoice.org
80. Text or call an old friend
81. Write yourself an “I love you because...” letter
82. Look up new words and use them
83. Rearrange furniture
84. Write a letter to someone that you may never send
85. Smile at five people
86. Play with your little brother/sister/niece/nephew
87. Go for a walk (with or without a friend)
88. Put a puzzle together
89. Clean your room/closet
90. Try to do handstands, cartwheels or backbends
91. Yoga
92. Teach your pet a new trick
93. Learn a new language
94. Move EVERYTHING in your room to a new spot
95. Get together with friends to play frisbee, soccer or basketball
96. Hug a friend or family member
97. Search on-line for new songs/artists
98. Make a list of goals for the week/month/year/5 years
99. Perform a random act of kindness

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Depression, poor self-esteem, and anxiety are often the result of irrational negative thoughts. Someone who regularly receives positive feedback at work might feel that they are horrible at their job because of one criticism. Their irrational thought about job performance will dictate how they feel about themselves. Challenging irrational thoughts can help us change them.

Answer the following questions to assess your thought:

Is there substantial evidence for my thought?

Is there evidence contrary to my thought?

Am I attempting to interpret this situation without all the evidence?

What would a friend think about this situation?

If I look at the situation positively, how is it different?

Will this matter a year from now? How about five years from now?

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Welcome to the body scan relaxation exercise.

Over the next several minutes, you will focus on the physical sensations throughout your body. These sensations might be the feeling of clothes on your skin, tension within your muscles, the temperature of the air, or anything else you can feel. Sometimes, you might not notice any sensation at all.

Your job is to simply observe these sensations. You do not need change how your body feels or do anything else.

5 second pause

To begin, sit back or lie down in a comfortable position. Close your eyes if you’re comfortable doing so, or let your gaze soften. Take a few deep breaths.

10-20 second pause

Notice the feelings all throughout your feet, including your sole, heel, toes, and top of the foot. Notice the sensation of the ground, your shoes, and anything else you can detect.

10-20 second pause

Travel up your body, noticing the sensations in your ankles, shins, and calves. Notice sensations both deep in the muscles, and on the surface of your skin.

10-20 second pause

Continue noticing the feelings in your legs as you move up to your knees and thighs. Notice how your clothing feels against your skin.

10-20 second pause

Continue moving up your body, taking note of the feelings in your hips and backside. Simply notice the feelings, without any need to change them.

10-20 second pause

Pay attention to the feelings in your lower back and abdomen. Notice how your body feels against the surface on which you are [sitting / lying down].

10-20 second pause

For a few moments, pay attention to your breathing. Notice how your abdomen rises when you breathe in deeply, and falls when you exhale.

20-30 second pause

Experience the sensations in your upper back and chest. Notice the feeling of clothing on your body.

10-20 second pause

Now, notice the feelings in your hands, fingers, and wrists.

10-20 second pause

Notice the sensations in your forearms, upper arms, and shoulders.

10-20 second pause

Pay attention to the feelings in your neck and throat.

10-20 second pause

Notice the feelings in your face and head. Attend to every feature in your face, one by one.

20-30 second pause

Finally, slowly scan your entire body, noticing all the sensations from your toes to the top of your head.

10-20 second pause

The body scan exercise is coming to a close. At your own pace, allow your eyes to open.

5 second pause

This concludes the body scan exercise.

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Deep Breathing: A relaxation technique performed by purposefully taking slow, deep breaths. When practiced regularly, deep breathing provides both immediate and long-term relief from stress and anxiety.

How Deep Breathing Works

During periods of anxiety, the body triggers a set of symptoms called the stress response. Breathing becomes shallow and rapid, heart rate increases, and muscles become tense. In opposition to the stress response is the relaxation response. Breathing becomes deeper and slower, and the symptoms of anxiety fade fade away. Deep breathing triggers this response.

Instructions

Sit back or lie down in a comfortable position. Close your eyes, if you would like to do so. When you're learning, try placing a hand on your stomach. If you breathe deeply enough, you should notice it rising and falling with each inhalation and exhalation.

1. Inhale. Breathe in slowly through your nose for 4 seconds.
2. Pause. Hold the air in your lungs for 4 seconds.
3. Exhale. Breathe out slowly through your mouth for 6 seconds. Tip: Pucker your lips, as if you are blowing through a straw, to slow your exhalation.
4. Repeat. Practice for at least 2 minutes, but preferably 5 to 10 minutes.

Tips

• If it isn't working, slow down! The most common mistake is breathing too fast. Time each step in your head, counting slowly as you do so.
• Counting out your breaths serves a second purpose. It takes your mind off the source of your anxiety. Whenever you catch your mind wandering, simply return your focus to counting.
• The times we use for each step are suggestions, and can be lengthened or decreased. Lengthen the time if it feels natural to do so, or decrease the time if you feel discomfort.

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Mindfulness is a state of nonjudgmental awareness of what’s happening in the present moment, including awareness of one’s own thoughts, feelings, and senses. RAIN is a mindfulness practice that will help you focus on the present and cope with uncomfortable thoughts and emotions.

Prepare

Sit or lie down in a comfortable position. Close your eyes or let your gaze soften. Take three slow, deep breaths. Follow the steps below, lingering for a couple minutes on each step.

R Recognize	Let yourself feel at ease in the present moment. Slowly take in your surroundings. Recognize your thoughts, feelings, and physical sensations. Name your feelings out loud or silently to yourself.
A Allow	Observe your experience as if watching a movie. Let your thoughts, feelings, and sensations come and go as they are. Let go of any judgment—it is okay to feel however you are feeling. You may tell yourself, “This is how it is right now.”
I Investigate	What words are going through your mind? What emotions are you feeling, and where are they coming from? How are these feelings experienced in your body? Sense the most vulnerable part of yourself and reflect on what it needs, such as acceptance, forgiveness, love, or belonging.
N Nature	Be kind toward your experience. Give yourself a comforting message, such as “I love you,” “you are okay,” or anything else you need. Think of a friend, family member, pet, or spiritual figure, and imagine their love flowing to you. Let in healing and compassion until you feel calm and centered.

 

Conclude

Take three slow, deep breaths. Continue to be mindful and kind to yourself throughout your day.

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