My first encounter with Mrs. Martin (not her real name) was the day before my birthday in August 2010. She came to my office complaining of fatigue. She was 49 years old and working as a secretary. I noticed during our initial conversation that she made poor eye contact.
In further questioning, she revealed that she had no children, had never been married and had unhappily worked the same job for the last 15 years. During the interview, I noticed that she had a flat affect, or an unemotional response, and she responded negatively to all my questions. This led me to ask her additional, specific questions to help determine if she was depressed.
Early into the questioning, she started to cry. Mrs. Martin reported general sadness, decreased energy and concentration, increased appetite, and thoughts of not waking up. When I asked if she wanted to hurt herself or someone else, she answered no.
"I simply feel worthless," she said.
Significantly, the physical exam found that she was overweight and had borderline diabetes, significant hypertension and elevated cholesterol. Mrs. Martin told me that she had been prescribed blood-pressure medication in the past, but stopped taking it after a couple of weeks. She said she saw no point because she had no symptoms.
I asked Mrs. Martin if she wanted to make a change, and she told me she did.
"It's time to live," I told her.
I told Mrs. Martin that we first had to gain control of her medical conditions, including the elevated blood pressure. I asked her to imagine two trucks hired by the same company to transport goods from Jackson to New Orleans and back every day. One truck carried bricks, and the other transported paper cups. I explained that both trucks would do fine for the first few years, but the truck carrying the bricks would start to break down sooner.
I asked her to imagine that her heart pumping blood against her elevated blood pressure was like the truck transporting heavy bricks. I told her that she must take her blood-pressure medication for now to keep it down and protect her heart. The effect would be like taking the heavy load of bricks off the truck. I told her that with lifestyle modifications—including diet, exercise and significant weight loss—and with proper medical monitoring and management, we might be able to get her off the medication in the future.
Eighteen months later—and 80 pounds lighter—Mrs. Martin no longer needs to take blood-pressure medication. She is no longer a borderline diabetic, and her cholesterol level is better than mine. This transformation took more than a year, a total lifestyle change, persistent medical management and plain, old-style coaching.
One of the most important components of her success was that I didn't just put her on anti-depression medication. Unfortunately, for many people seeking medical assistance, that is what happens in cases similar to Mrs. Martin's. Instead, I referred her to a local psychologist for a trial of cognitive behavioral psychotherapy.
The 'All-Natural' Anti-Depressant
Have you ever experienced these common "mental" symptoms—stress, anxiety, worry, sadness or unexplained fatigue? Have you tried alternatives such as medication, exercise and meditation, but it just did not seem to improve your overall mood? If so, consider using cognitive behavioral therapy, a form of therapy that is proven to help these problems rapidly and without the side effects of medication. It is, by far, one of the best all-natural "medications" for the issues many of us face.
Cognitive behavioral therapy, also known as CBT, is an evidenced-based psychotherapy often used to treat depression and anxiety, according to the American Psychological Association. CBT can also be helpful in treating a variety of other clinical presentations, including dealing with stressful life events, such as the loss of a loved one, divorce or unemployment.
CBT is a type of talk therapy that focuses on helping individuals change their behaviors and thoughts so that it can positively affect their mental health, thus improving their overall mood. CBT is not like traditional therapies, which tend to be free flowing, leading to endless talking and no action. Rather, in CBT, the therapist and client work together to identify and change negative thinking and behavior patterns that may contribute to emotional and physical psychopathology (depression, for example).
The aim in CBT is to change these thoughts, or self-talks, which express one's beliefs and perceptions. Cognitive therapy exercises work to replace one's thoughts, beliefs or self-talk with others. For example, in Mrs. Martin's case, she could transform her belief of being "worthless" into "I have a purpose in life."
CBT is focused, structured and goal-oriented and requires a person to put forth effort, all in a supportive environment. It requires one to think positively, focus on the future and not constantly look back at the past. This form of therapy uses homework, teaching and practicing life skills, and measuring and monitoring symptoms. Some of the benefits of CBT include feeling empowered and supported, according to the American Psychological Association, providing an overall better outlook on life by focusing on the positives rather than the negatives.
In the case of Mrs. Martin, two years after her first visit, she came back for a follow-up. In addition to having a better outlook on life, Mrs. Martin had lost another 40 pounds, and her vibrant smile lit up the room. Moreover, she had great news: She was engaged to be married and would soon be a bride.
Get the Help You Need
Not every therapy works for everyone. If you need help, here are a few CBT resources to explore.
• "Change Your Life with CBT: How Cognitive Behavioural Therapy Can Transform Your Life" by Corinne Sweet (Prentice Hall, 2010, $19.99)
• "Thoughts and Feelings: Taking Control of Your Moods and Your Life" by Matthew McKay, Patrick Fanning, Martha Davis (New Harbinger Publications, Fourth Edition 2011, $24.95)
• "An Introductory Self-Help Course in Cognitive Behaviour Therapy" by Carol Vivyan, download at http://www.getselfhelp.co.uk
• National Association of Cognitive-Behavioral Therapists, NACBT Online Headquarters http://www.nacbt.org
• "What Is Cognitive Behavior Therapy?" http://psychology.about.com
• "What is Cognitive Behavior Therapy (CBT)?" The Association for Behavioral and Cognitive Therapies, http://www.abct.org
• American Psychological Association, http://www.apa.org
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