ELC: Primary, Secondary and Tertiary prevention of Depression

Attitude and motivation are really key in maintenance. The NWCR has found the two reasons people relapse are depression and disinhibited eating. I used to be chronically depressed and then after some recovery work for codependency and anxiety I found I was no longer depressed for no good reason. I still had feelings, but they were appropriate to the situation and if I didn’t have good feelings, I could usually find ways to cultivate some better feelings.

In human development class we’ve been talking about safety in the primary, secondary and tertiary prevention levels. Primary means systemic prevention, like the guidelines on playgrounds, which may seem annoying (and mean there are no playgrounds sometimes) but evidently they reduce injury to children. Secondary means targeted preventive intervention for folks with higher risks. Tertiary is having resources in place for when something does go wrong. This may not seem like a level of prevention, unless you consider that the alternative is assuming nothing wrong will ever happen.

Applying this to motivation and attitude, I think some of my primary strategies are limiting the amount of news media and TV commercials I consume. I used to be a compulsive news watcher, and it just increased my stress. TV commercials manipulate us to feel like we need certain products (usually food) to enjoy life. Secondary strategies are things like knowing when I am likely to have PMS or going to a party, and working out ideas for preventing a blowout. Tertiary strategies involve resliency, which I think is so important. You step on the scale and it’s up 2 or 3 pounds, I never take it personal. I figure out why. Maybe it’s salt. Maybe it’s glycogen. I recently learned that PMS hormones directly affect what your body does with sodium, and chocolate can soften the hormone withdrawal, but also keeps it from resolving. It’s crazy. But my point is, when something goes wrong, I figure it out. If I can’t figure it out, I try and be easy on myself. And if I still feel bad, I might try a non fattening “reward” like playing a videogame, just get my mind off things.

Folks talk about running out of motivation and wondering where they can pick some up, but it’s not a commodity, it’s a process.

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