Keeping Score on Depression, Anxiety, and Stress

I’ve taken two courses, The Science of Happiness and The Science of Well-Being where I was asked to answer a “happiness” survey each week and keep track of my scores to determine how the weekly material impacted my happiness.

When it comes to depression, anxiety, and stress, we’re usually aware when we’re suffering. But how do we bring awareness to times when we’re not? How do we gain insights into what helps us feel okay so we can do more of it? How do we recognize when we’re starting to slide so that we can apply some antidotes?

I was elated when Alex Korb’s Upward Spiral newsletter introduced me to the DASS 21 Depression Anxiety Stress Scale.

It’s a great way to improve awareness of areas you’d like to target, try an exercise to work on it for a week, and test again to notice progress or regress.

“The DASS 21 is a self report evaluation scale aimed at revealing the severity of symptoms that the patient suffers from and which can be associated with depression or anxiety or are consistent with stress manifestations.

“The scale can be used for screening, however, for diagnosis, the patient should be referred for specialist consultation.”

Give it a try.

Making Good Habits Stick

I used to kick myself for lack of willpower when I fell back on bad habits or failed to keep good ones. But, according to behavioral scientist BJ Fogg, “I change best by feeling good, not by feeling bad.”

Celebrate Good Habits
An Old Dog Learns New Tricks

On Monday I read about a new way to convert dog years into human years. According to the old calculation I’m an 8-year-old dog. According to the new formula, I am 6 years and 7 months.

Either way, I am an old dog.

Yet, aside from learning the new dog age conversion trick, which I can’t remember how to do without referring to the instructions. I’ve successfully learned two new tricks, and turned them into habits.

Trick #1: After I get out of bed, I say the phrase, “It’s gonna be a great day.” (Don’t stop reading yet. I haven’t turned into a motivational speaker!)

Trick #2: After I comb my hair, I drink a 16 oz. glass of water.

Not Rocket Science

The ideas behind BJ Fogg’s Tiny Habits: The Small Changes That Change Everything aren’t rocket science. If you’re reading these words, you know that the journey from depression to well-being begins with a single small change.

What’s so damned frustrating is that we can’t seem to convince ourselves to make even the smallest change consistently!

There’s a simple reason for this.

Fear of Failure

It’s really not our fault that it feels much better to succeed than to fail. For thousands of years, the difference between success and failure was a matter of life or death, and since we’re descended from an unbroken lineage of people who survived long enough to have children, our brains naturally reward success.

Almost none of our failures are a matter of life or death. But, when we fail, we believe that others will think less of us. Or, if we fail in private, we’ll think less of ourselves. 

My friend Samantha Hess had a sentiment on one of the walls of her old studio: “What would you do if it was impossible to fail?”

BJ Fogg’s Tiny Habits doesn’t make it impossible to fail. But, it makes it extremely easy to succeed, and it takes all the the sting out of failure.    

Take Your Aspirations and Break them Down into Tiny Behaviors

I’ve known since I was in grammar or high school that I was supposed to drink 8 glasses of water a day. And I did it for a while when a health-conscious co-worker got me to join her in draining 32 oz. bottles that we filled once in the morning and once in the afternoon.

But that was decades ago, and I stopped paying attention to water altogether until I heard a neuroscientist/nutritionist explain that the 8 glasses a day prevented brain dehydration, which can lead to fatigue or migraine headaches. I don’t get migraines, but it would be nice to experience less fatigue.

I already have a habit of keeping a 16 oz. glass by my desk while I work. Filling it with water and drinking it seems a tiny enough behavior to accomplish on the way to my 64 oz. aspiration. And it’s also a tiny enough that I won’t beat myself up if I forget.   

Find Where a Behavior Fits Naturally into Your Life

Everyone I’ve told about the habit of putting my feet on the floor, saying “It’s gonna be a great day,” and celebrating, thinks it’s silly. But, silly or not, each time I execute it, it reminds me both that I am capable of forming a new habit (even one that I don’t fully believe in) and carrying out the steps required to remember it.

After I put my feet on the floor is a natural time to say “It’s gonna be a great day.”

A natural opportunity for drinking 16 oz. of water occurs after I’ve dressed, peed, and combed my hair. There’s a sink beneath the mirror and the glass is in my office next door. 

So, after I…comb my hair.

I will…fill my 16 oz. glass with water and drink it. 

Nurture its Growth Through Celebration

I celebrate drinking the water by raising my hands in the air like a victorious Olympic athlete and saying “Woo-hoo!”

How we choose to celebrate is up to individual preference. I chose the same form of celebration that Olympic athletes use (plus the “Woo-hoo!”) because I remember hearing that it’s a form of celebration that exists in all cultures.

The reason for celebrating even tiny successes is that the good feeling cues the hippocampus to store the preceding event as a keeper.

To keep the water metaphor going, if we were wandering a desert dying of thirst, it would feel mighty good to find a water hole. And remembering where that water hole was located might be crucial to the survival of our tribe!  

Embrace Mistakes as Discoveries and Use Them to Move Forward

I have some pills that I’m supposed to take with a full glass of water later in the morning. So, that’s a second natural prompt in my day. But, I’ve had to experiment with prompts for the remaining 32 ounces.

Some complicating factors include schedule variability, the availability of bathroom facilities after the consumption of water, etc.

I don’t take any of my failed attempts personally. 

The aspiration to replenish needed water to ease mental fatigue seems worthwhile to me. If it didn’t, it wouldn’t be an aspiration, and I could choose another habit. 

If I had trouble with drinking 16 oz. of water, I could make the task tinier by trying an 8 oz. or even a 4 oz. glass.

If I couldn’t even manage to stick the “It’s gonna be a great day!” habit, I could experiment with different forms of celebration. 

The idea is to look at the process as a scientist would. Every failure suggests a new experiment.   

Ten Minute Exercise

Another concept BJ Fogg introduces is called a Swarm of Bs. Here’s a ten minute version based on the aspiration for this website. 

1. Set a timer for 10 minutes. 

2. Take out a sheet of paper and something to write with. 

3. In the center of the piece of paper, draw a cloud and write down an aspiration. 

Example: Move from depression to well-being. 

4. Outside of the circle, make a list of behaviors that will work toward that aspiration. 

Examples: 

Soak up some sun

Move your body

Improve sleep habits

Breathe

Spend time with others 

Practice gratitude

5. Put a star by behaviors that you think you might actually do.

6. Of the star behaviors, which ones can you make tiny enough to do in thirty seconds or less?

Example: 

I will stand in the sunshine for ten seconds…

7. Match that habit to an existing habit in your day. For the sunshine habit, you’ll want to choose a time when you’re already outside. 

Examples: 

After I leave for work…

After I have lunch…

8. Test the habit.

Example:

After I leave for work.

I will stand in the sunshine for ten seconds.

Then I will celebrate by (doing a fist pump, saying YES!!!, raising my arms in a V like an Olympic athlete.)

Extra Credit

The book Tiny Habits goes into greater depth about why we behave the way we do, how to grow good habits, how to untangle bad habits, and how to use the process within organizations.

Here’s a brief explanation by BJ Fogg of why Baby Steps work. (2 minutes, 11 seconds.)

Photo by Andrea Piacquadio from Pexels

Movies That Get Depression Right

“In thinking about depressing movies, many people don’t realize that all bad movies are depressing, and no good movies are.”–Roger Ebert

Movies in a Minor Key

In the year 2000 I experienced the blahs when it came to the movies. I couldn’t put my finger on what was missing. Were the comedies not funny enough? The action films not active enough? Then I saw The House of Mirth, a period piece about Lily Bart, an attractive New York socialite who starts drawing the wrong kind of attention. Her social standing takes a downward spiral as a result.

I came away from that movie feeling refreshed. It wasn’t that I disliked the character and felt that she got what she deserved. It was that I’d seen a film acknowledge that sometimes despite our best efforts things just don’t go our way. Instead of envying the protagonist’s triumph against all odds or wishing my life could be like hers, I felt compassion for Lily’s misfortune and gratitude that my day-to-day problems seemed more manageable by comparison.     

Movies That Get Depression Right

While escapist action and comedies can lift our mood when we’re having a bad day, when those days start to string together and there’s no end in sight, it’s surprisingly reassuring to spend time with others who have been there. At the very least, we feel less alone.

My favorite episodes of John Moe’s The Hilarious World of Depression feature listener recommendations of songs, books, and now movies that get depression right. The 45-minute episode brought back a flood of fond movie memories for me, and you can listen to it here. But, if you only have ten minutes to choose your evening’s entertainment. Here goes. 

Holy Wedlock! 

The pitch-black comedy-drama Melancholia starts with Earth getting obliterated by a slow-motion collision with the title planet, then flashes back to the fairy tale wedding reception and sibling squabbles that preceded our collective demise. “Even though the planet is about to be completely destroyed, Justine’s sister Claire is still telling her that she has to eat, and she has to take a bath, and things like that, and that’s ridiculous.”

In the ensemble comedy Bridesmaids, Annie’s life is falling apart. But when she finds out her lifetime best friend Lillian has gotten engaged, she’s determined to do whatever it takes to be the perfect maid of honor. “Annie has lost her bakery, her income, and her self esteem. Seeing the success of her best friend’s wedding and her new friend, the replacement friend, shows her another way she’s losing at life.”

The Writing Life

World’s Greatest Dad, Lance Clayton, dreamed of being a rich and famous writer but has only managed to make it as a high school poetry teacher. His only son Kyle is an insufferable jackass whose death in a freak accident offers him the greatest opportunity of his life. “He is not valued by anyone in his life around him, from his students to the girlfriend who seems to be drifting away, to his son. And then he finally gets recognition, and it’s even lonelier, even more isolating than it was before.” A dark comedy with a truly twisted premise.

The very funny odd couple road picture Sideways tags along with two old friends on a pre-wedding tour of wine country. Jack is a has-been actor and groom to be. His best man Miles is a never-was writer. “Miles suffers from nagging doubts and circular thoughts that keep him from really being present in the moment, anger with himself, and disgust mixed with envy toward Jack. He feels that maybe things would be so much easier if he could live a life like Jack where he just doesn’t care.”

The Hours tells the story of three women from different times and places linked by their yearnings, fears, and  search for more potent, meaningful lives. “It’s an extraordinarily accurate portrayal of being in such acute all-encompassing pain that the only thing you think can end that pain is death.”

Girls, Interrupted

Horse Girl is Sarah, a socially isolated arts and crafts store employee whose strangely surreal dreams challenge her ability to distinguish her visions from reality. “Alison Brie nails the secretive disorientation of psychotic depression perfectly.”

Girl, Interrupted is Susanna Kaysen’s account of her 18-month stay at a mental hospital in the 1960s. “The girls often feel like no one gets them, and even though they’re fighting with each other, they know that the only real people who understand what they’re going through are their fellow patients.”

The title character in Where’d You Go, Bernadette is a loving mom compelled to reconnect with her creative passions after years of sacrificing herself for her family. “It’s really hard to find movies that show people with depression who still have to get through each day like everything is fine. It isn’t all crying in a corner and fifteen minutes later everything is fixed.”

Wherever You Go, There You Are

Sam Bell is living on the far side of the Moon completing a three-year contract with Lunar Industries to mine Earth’s primary source of energy, Helium-3. It is a lonely job, and though his time on the moon is almost over, his physical and mental health are deteriorating. “At one point he drives away from the moon base and you see and hear him from a distance just break down and weep at his total alienation from the world and the apparent impossibility of escape from that prison of his deceptive mind.”

Aniara, one of the many spaceships transporting Earth’s fleeing population to their new home–planet Mars–collides with space junk and is thrown off her course. “One of the most fascinating and insightful explorations of hopelessness and despair that I’ve ever seen.”

Lost in Translation in Tokyo, and suffering from insomnia, Bob, a middle-aged American actor cashing in on his fame by making TV commercials for the Japanese market, and Charlotte, a neglected young American wife, cross paths one night in a luxury hotel bar and form an unusual friendship. “The main characters are functional depressives who arrive at similar emotional states from different directions and find common ground.”

Animated Alienation

Anomalisa is the stop-motion animation tale of Michael Stone, an author of customer service books, to whom everyone looks and sounds the same. One night, while on a routine business trip, he meets Lisa, a stranger with a unique voice. “It’s such a good representation of someone feeling numb to the world while also being a jerk.”

Inside Out is how adolescent Riley feels her life has been turned when her father takes a job in San Francisco and she’s uprooted from her Midwestern world. Pixar animation brings to life the emotions Joy, Fear, Anger, Disgust, and Sadness, who live in the control center of Riley’s mind. It’s “The movie that depicts depression the best because the character sadness fits it.”

Do-Overs

Eternal Sunshine of the Spotless Mind‘s Joel is stunned to discover that his girlfriend Clementine has had her memories of their tumultuous relationship erased and seeks to do the same. “It spoke to the part of me that just doesn’t want to feel anymore, the desire to erase what’s in my brain and replace it with something that allows me to just be a normal happy person.”

Groundhog Day never ends for TV weatherman Phil Connors who is sent to Punxsutawney, Pennsylvania, to cover the annual Groundhog Day festivities, gets caught in a giant blizzard that he failed to predict, and finds himself reliving the same day over and over again. “It is another day like many before and many after that you wake up into and feel the same daunting inadequacies.”

Fantasy Figures

Lord of the Rings – Return of the King reveals the ultimate fate of Middle Earth in the final film of Tolkien’s fantasy trilogy. “The ring has such a powerful hold on Frodo, as did my depression, that he struggles with parting from it. But its release, of course, is the only way to save Frodo’s world.”

The Babadook is the sinister titular figure of a disturbing pop-up storybook that shows up on Amelia’s doorstep six years after the violent death of her husband. Her efforts to get rid of the nasty book prove every bit as challenging as the out of control behavior of her six-year-old son. “It’s a very creepy movie, but it is equally creepy about the possible supernatural explanations and maybe the psychological ones.”

Finding Strength in Numbers

Stand by Me, based on the Stephen King novella “The Body,” is the semi-autobiographical story of an overnight hike by four adolescent Oregon boys who seek the body of a boy who had been struck by a train. “The kids in that movie were all processing some kind of trauma in ways that any middle school kid would immediately recognize.”

The Station Agent is a film about three people with nothing in common, except their shared solitude, until chance brings their lives together. “I just love how it speaks to the reality, without exaggerating it or making it larger than life, that we can be in pain with other people but still not be on the same page of pain.”

How to HEAL

Healing connection

The brain is like Velcro for negative experiences, but Teflon for positive ones. That shades “implicit memory” – your underlying expectations, beliefs, action strategies, and mood – in an increasingly negative direction.

And that’s just not fair since probably most of the facts in your life are positive or neutral.Rick Hanson, Ph.D.

What Went Wrong

Last night when I was doing a somatic listening cuddle session with my partner, the main feeling that came up for me was sadness.

I had invited a friend to meet at a safe physical distance in a local park. She replied with a long, tortured, self-contradictory email about why she didn’t feel safe doing it, even though we’d met in the same park a few weeks ago.

It wasn’t her “no” that made me sad, it was feeling cut off from the opportunity to comfort her about what was making her feel unsafe. I started ruminating about other things I felt cut off from:  

• Writing a post about the negative mental health effects of news consumption.

• Keeping up with my reading schedule on Tiny Habits.

• Getting my second meditation session in yesterday.

• Posting to Instagram.

• Creating a successful Patreon page.

• Learning only one new thing from the first few weeks of Yale’s The Science of Well-Being course.

When seen through the lens of a single rejected invitation, I was processing my entire day as a failure.

What Went Right

On the other hand…

• I fell behind on my news consumption post because I was writing about my meditation group’s experience with Rick Hanson’s H.E.A.L. exercise.

• I set up a Zoom meeting to talk with a life coach about her business model.

• I called my father’s second wife for a catch-up chat.

• I got an email from a neighbor I knew when we were teenagers.  

• I got 10,143 steps in by visiting two lovely parks. 

• I got to hang out in a virtual game night over Zoom with the same friend who had declined my park invitation.

Oh, and now I get a chance to apply the one new thing I learned from The Science of Well-Being.

The GI Joe Fallacy

Laurie Santos, who created the well-being course, talked about a lie foisted upon children of the 1980s by the GI Joe cartoon show. At the end of each episode, GI Joe would share a public service announcement with an animated child. The child would thank him, and he would say, “Knowing is half the battle.”

G.I. Joe Lied To Us—Knowing Is Not Half The Battle | Hacker Noon

As I demonstrated above, knowing about the brain’s negativity bias doesn’t stop me from getting caught up in it.

If Rick Hanson had a cartoon show in the ’80s, he might have concluded his PSAs with “Habituating positive neuroplasticity is half the battle.”

Here’s how Hanson’s framework helps us H.E.A.L.

Ten Minute (or Ten Second) Exercise

H.E.A.L. is an acronym for: 

Have an experience of safety, satisfaction, or connection.

Enrich the experience.

Absorb the experience. 

Link the experience to a minor worry.

1. Have the experience.

Looking at yesterday, I could choose to notice something that happened (like receiving the email from my old neighbor) or something that I initiated (a phone call to my dad’s second wife). Either one contributes to the positive mental and emotional state of feeling connected. The key is to practice noticing when I’m having positive experiences.

2. Enrich the experience by taking it in for at least ten seconds. The corny phrase stop and smell the roses comes to mind. Notice what’s new and fresh about the moment. What makes it unique? Where in your body are you feeling the pleasant sensations? Notice what a moment of safety, satisfaction, or connection feels like.

3. Absorb the memory of this experience with the kind of intention that precedes taking a photograph. Practice nurturing that feeling. Focus on what’s rewarding about it.

4. Link the experience to a minor worry. I can heal the wound of the rejected park invitation by balancing it with the catch-up phone call, the neighbor’s email, or any of the other things that went right.

The other half of the battle is always going to be the things that don’t go our way, but practicing learning to H.E.A.L. can add to our sense of psychological safety.

And, although I haven’t read it yet, I’ll bet Rick Hanson’s new book NeuroDharma will offer many more tools as well. Stay tuned.

Extra Credit

Check out Rick Hanson’s take on H.E.A.L. from Sounds True’s Loving, Knowing, Growing.  

Photo by Christina Morillo from Pexels