Patient Handout Diagnosis: Depression Deep Breathing-an exercise that can be utilized to help to reduce stress in your life. 1. Although this exercise can be practiced in a variety of poses, the following is recommended: Lie down on a blanket or rug on the floor. Bend your knees and move your feet about eight inches apart, with your toes turned slightly outward. Make sure that your spine is straight. 2. Scan your body for tension. 3. Place one hand on your abdomen and one hand on your chest. 4. Inhale slowly and deeply through your nose into your abdomen to push up your hand as much as feels comfortable. Your chest should move only a little and only with your abdomen. 5. When you feel at ease with step 4, smile slightly and inhale through your nose and exhale through your mouth, making a quiet, relaxing, whooshing sound like the wind as you blow gently out. Your mouth, tongue, and jaw will be relaxed. Take long, slow, deep breaths that raise and lower your abdomen. Focus on the sound and feeling of breathing as you become more and more relaxed. 6. Continue deep breathing for about five or ten minutes at a time, once or twice a day. Then, if you like, gradually extend this period to twenty minutes. 7. At the end of each deep-breathing session, take a little time to once more scan your body for tension. Compare the tension you feel at the conclusion of the exercise with that which you experienced when you began. Use the Record of General Tension (see below) to monitor your progress. 8. When you become at ease with breathing into your abdomen, practice it any time during the day when you feel like it and you are sitting down or standing still. Concentrate on your abdomen moving up and down, the air moving in and out of your lungs, and the feeling of relaxation that deep breathing gives you. 9. When you have learned to relax yourself using deep breathing, practice it when- ever you feel yourself getting tense. Record of General Tension-rate yourself on this 10-point scale before and after deep breathing relaxation exercise to rate its effectiveness. 1-totally relaxed (no tension) 6-Slightly tense 2-Very relaxed 7-Fairly tense 3-Moderately relaxed 8-Moderately tense 4-Fairly relaxed 9-Very tense 5-Slightly relaxed 10-Extremely tense (most tension) Day of Week Monday Tuesday Wednesday Thursday Friday Saturday Sunday Before Session After Session Comments Organizing Your Time Organizing your time effectively reduces stress in your life, which may ultimately reduce depressive symptoms that may arise due to stress. Here are twelve suggestions to structure your time and focus your attention on creating the life of your choice. 1. Purchase an organizer. Find one that includes a daily, weekly, and monthly calendar and use it. 2. Post copies of your written values, goals, action plans, and self-contracts in places where you will often be reminded of them. Use brightly colored paper and ink to catch your eye. Keep a copy in your organizer, on a wall calendar, on your bathroom mirror or any other place that you look at frequently. 3. Make sure that your list of daily goals and your calendar reflect your long-term, medium-term, and short-term goals. If you want to be physically fit and relaxed, schedule time each day for exercise and for practicing relaxation techniques. If spending quality time with a loved one is a high priority, block off regular time on your calendar to do this and include that time on your daily to-do list. If you arrange your schedule of activities on a weekly or even monthly basis, you will find that you have time to work on all of your important goals. 4. Plan for efficiency. Combine activities that can be done at the same time, such as watching your favorite TV show while exercising, ironing, or washing dishes. Sequence activities to save time. Match tasks to your varying energy levels. Although you can usually predict your energy level at different points during the day and plan accordingly, occasionally you will run out of steam earlier than anticipated. If so, you may want to reschedule activities that require energy and alertness to a time when you can perform them with maximum efficiency. 5. Minimize time wasters. Cut back on TV, telephone interruptions, drop-in visitors, unproductive meetings, ineffective delegation of responsibilities, crises, activities that lack direction, and overly ambitious goals. Plan ways to avoid as many predictable time wasters as possible, but be realistic enough to schedule some time for unexpected interruptions. 6. Learn to say no. Set limits on how much you are willing to do for others. 7. Make a list of things to do when you're waiting. Good candidates include doing a relaxation exercise, planning tomorrow's list of goals, reviewing your priorities and goals, reading a book, or filing your nails. 8. Set aside several short periods each day for quiet time. Use this time to practice your deep relaxation techniques. This will help you stay in touch with what is most important to you, rather than rushing faster and faster in response to others' demands. 9. When you are performing a high-priority activity, focus your full attention on it. Make a list of your usual distractions and plan how you can block each one of them. For instance, if you often find yourself daydreaming when you should be working, schedule in a visualization session or some other way of using your imagination during one of your quiet times. 10. Arrange your environment to support your values and goals. If your priorities require focus and concentration, make sure that you have a quiet room or comer available for reading, writing, practicing deep relaxation, or just thinking through your plans. 11. Don't waste time on decisions that involve equally attractive or inconsequential alternatives. If you find yourself in a quandary over choices like this, just flip a coin and go with the winning call. 12. Reward yourself for improving your time management. One of the greatest rewards of effective time management comes from not having to rush to accomplish the important things in your life. By prioritizing and planning your activities, you can choose to move through your day at a more leisurely pace. Sample Time Log Activity Waking until lunch After lunch until dinner After dinner until sleep Time Adapted from: Davis, M., Eselman, E. R., & McKay, M. (2000). The Relaxation & Stress Reduction Workbook, 5th (ed.). Oakland, CA: New Harbinger Publications, Inc.
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