Introduction

Depression is a very common psychological problem that many people endure at some point in their lives. The symptoms of depression can be very distressing and impact important areas of our lives. For example, work, school, family, social connections, and our interests and hobbies.

Symptoms of depression include:

  • Low or depressed mood
  • Loss of interest in previously enjoyed activities
  • Increased or decreased appetite/weight
  • Sleeping too much/too little
  • Feeling agitated or slowed
  • Feeling worthless or guilty
  • Difficulty concentrating
  • Fatigue
  • Thoughts about death or suicide

Importantly, depression is different from normal sadness and loss. The symptoms in depression tend to last longer, are much more impairing, and are ‘above and beyond’ our usual response to loss. For example, feeling extremely worthless and depressed for months or years after the end of a romantic relationship.

To treat depression symptoms, some folks go the medication route. Others prefer a therapy-based approach.

This post helps you learn more about what might be some possible treatment goals that you can work on with your therapist.

What do we lose when we are depressed?

Before we discuss treatment goals, we need to learn what we lose when we are depressed.

People with depression usually present with very low mood and ‘anhedonia’ – a term that means we are less interested or get less pleasure from previously enjoyed activities. For example, we may stop painting, spending with friends, or playing video games. Along with a lack of motivation, we lose a lot of the ‘livelihood’ in our lives.

The loss of motivation can also start affecting our performance in school or work-related tasks, and we may lose social connectedness because we are isolating ourselves and staying away from friends.

As a result, we lose the many things in life that gave us that ‘spark’ – activities that provide us feelings of joy, mastery, connectedness, and personal meaning.

Figuring your specific treatment goals  

Many times, folks come into therapy just wanting to ‘be happier’ or ‘feel better.’

This is a very reasonable goal. However, the problem is that the goal is a little vague because what happiness looks like in one person does not look the same in another person.

Therefore, we need to get a little more specific for treatment to be actionable. The use of SMART goals can be helpful because SMART goals turn something vague into something that is more specific and measurable. We can then know what the goal looks like and recognize when it is accomplished.  

The use of the ‘magic wand’ technique can be particularly helpful to set up SMART goals. The magic wand technique asks the question: “if this treatment were successful and your life was exactly the way you want it, what would that look like?”

Out of this answer comes many possible goals. Perhaps you are looking to connect with friends again, increase productivity and reduce absences at work, or start doing the things that make you happy again.

Reintegrating important past activities into your life

When we are depressed, we feel crappy and not motivated to do the things that use to give us good feelings. As a result, this creates a vicious cycle because we don’t have as many things in our lives that support us – which makes us even more depressed.

This cycle is very important and is actually the basis of a very common treatment for depression – behavioural activation. Behavioural activation is a very effective therapy that helps us bring back things that give us 1) pleasure 2) mastery 3) social connections and 4) meaning.

To set treatment goals, it can be helpful to make a list for each of these components. Here are some examples for each area:

Pleasure

  • Making a cup of tea
  • Taking a hot shower
  • Watching a TV show
  • Taking a walk
  • Listening to music

Mastery

  • Cleaning room
  • Cooking a hot meal
  • Learning a song on an instrument
  • Studying for a test
  • Learning a new language

Social Connections

  • Having lunch with a friend
  • Calling your parents or loved ones
  • Joining a new club and meeting new people
  • Volunteering at a shelter
  • Mentoring a student

Meaning

  • This is a very personal area. Some examples include working on your craft, religion, being in nature, supporting others in their goals. However, I encourage you to think about what gives you meaning and significance in your life.

Some activities can be a good fit for multiple domains. For example, playing piano can be something that provides a lot of joy while also adding mastery to your life.

Slowly adding these types of activities back in our lives can be a great way to make goals that resonate with your own unique preferences.

Treatment goals to challenge negative thoughts

People with depression often have thinking errors that maintain depression. For example, they may be likely to personalize bad things that happen as their fault, discount positives things that happen in their life, or predict bad things will keep happening.

Therefore, it is important to tackle these ways of thinking through cognitive strategies to come up with more balanced thoughts. For example, the thought record helps us evaluate the evidence for and against a thought (like “I’m a bad person”) to come up with something that is more grounded in reality.

The best-friend technique can also be helpful to increase compassion for ourselves. We are often much more critical to ourselves than to other people. The best-friend technique uses this understanding by asking us “What would you say if this was a best friend or a loved one in the same situation?”

These cognitive strategies help us to increase flexibility in the way we think and our self-compassion as treatment goals. By working on how we think as a treatment goal, we can reduce our depressive symptoms.

Further goals to deal with depressive symptoms

There are some symptoms of depression that could be directly targeted that might help with improving overall mood.

For example, helping with sleep symptoms through CBT for insomnia strategies or improving concentration through mindfulness can be helpful to support overall mood. These can also be goals to discuss with your therapist.

Conclusion

Ultimately, your goals should depend on what you would like to get out of therapy you’re your overall values. Hopefully this post helped generate some possible ideas for treatment goals that your therapist will likely work with you on.

Best wishes,

P

Photo by Priscilla Du Preez 🇨🇦 on Unsplash