Question: I have lots of pressures from school and recently began a job as well. I find that I am increasingly stressed out and depressed, even lethargic. I continue to follow through on my responsibilities, since I have no other choice, but it becomes increasingly difficult to get motivated to do so. Are there any self-help exercises that you would recommend? Or, should I seek counseling?
Answer: You are raising a difficult and important question, and one which I can’t answer definitively without knowing more of your situation and symptoms. Feeling “stressed out” because of school and job pressures is fairly common, and – while unpleasant – not usually something requiring professional counseling or psychotherapy. Instead, trying to identify the specific stressors and reducing them as much as possible usually suffices.
For example, can you reduce your job hours at all? Can you find ways to organize your study time more efficiently?(There are many books out on this topic). If you can’t change your job or its hours, can you speak with your supervisor about the nature of the work itself? Are there aspects that could be changed to your liking? Do you have an academic or “peer” advisor who could provide guidance regarding your course load? Should you reconsider your major? etc.
Regarding “self-help” exercises, I assume you have in mind something like self-relaxation or stress reduction. Yes, you can certainly learn these. Herbert Benson’s The Relaxation Response is a good place to start. Various relaxation tapes can be purchased in most good book stores, and certainly can’t do you any harm.
On the other hand, you need to be more concerned if you are actually developing signs and symptoms of a “clinical” depression, or major depressive episode. Symptoms would include, e.g., depressed mood nearly every day for more than 2 weeks; markedly diminished interest or pleasure in most activities, nearly every day; significant weight gain or loss; insomnia or excessive sleep; severe fatigue; feelings of worthlessness or guilt, impaired concentration or inability to make decisions; or thoughts of ending your life, recurrent thoughts about death, etc. More than two or three of these features (or the presence of suicidal ideation alone) should first prompt a visit to your general or family doctor, or school clinic, for a physical exam and routine laboratory studies to rule out medical illness; e.g., low thyroid function, and other underlying physical problems.
If all this is “negative,” you should then consider getting a referral to a mental health professional (psychiatrist, psychologist, psychiatric social worker, or clinical nurse specialist) for psychotherapy and perhaps a trial of antidepressant medication. (Medication can be prescribed only by physicians or, under supervision in some states, clinical nurse specialists and physician assistants).
In the mean time, reading the book Feeling Good by David Burns may be helpful in learning ways of “thinking your way out” of depression. Good luck!