Writing Your Way Out of Depression

Last Editorial Review: 1/30/2005

Dear Diary

WebMD Feature

Reviewed By Charlotte Grayson

Before Laurie Nadel, PhD, became a psychotherapist, she was a journalist covering some of the world's political hot spots. Nadel eased the anxiety of finding herself in volatile surroundings by writing -- not just for publication, but also for herself. "I thought that if I could write everything down, I could stay safe," she says now.

Later, through illnesses, divorce, and a series of events that made her life look like a "bad country-western song," Nadel once again wrote down her thoughts and fears. Five years after this bad patch ended, she found one of those journals. "I realized when reading it that I had moved through every one of my fears," says Nadel. "The journal showed me where I had started from -- and just how much I had accomplished."

Nadel, author of Zen and the Art of Windsurfing (not surprisingly, written in the form of a journal), regularly suggests to her clients that they keep a journal themselves. For people who are depressed, in a crisis, or feel "stuck," journal- keeping is a way to gain insight into their thoughts and feelings, says Nadel.

"Journaling allows you to dialogue with parts of your psyche that are frozen in time," she says. "It allows you to tap into deeper reserves of creativity and problem-solving. By keeping a journal, you can get a flash of knowing and awareness that you haven't seen before."

According to Kathleen Adams, founder and director of The Center for Journal Therapy in Lakewood, Colo., the difference between keeping a traditional diary and keeping a journal is that in the former, you record daily events and happenings, while in the latter, you focus on your reactions and perceptions to those events.

"Journaling forces people to do something," says Michael Rank, PhD, associate professor and co-director of the International Traumatology Institute at the University of South Florida in Tampa.

"Keeping a journal is a good way to start coping with depression," agrees Jessie Gruman, PhD, executive director of the Center for the Advancement of Health (www.cfah.org) in Washington. "It's not aggressive, it's something you can do by yourself, and it gives you the chance to see your feelings in black and white and then make plans to do something about them."

Though keeping a journal is a simple thing to do, most people resist it, says Rank. "For many people, writing is hard work, especially if they're depressed," he says. "It's painful to write about bad feelings."

That said, Rank finds journaling the "most effective and cheapest" form of self-help. "If you do it in earnest, and you work through your resistance, you will improve," he says. If you really don't like to write, Rank suggests recording your thoughts on a mini-cassette recorder.

What journaling provides is a way of turning subjective thoughts to objective words on paper that can be analyzed, changed, even destroyed, says Rank. "Once your thoughts are externalized ... once they're out of your head and onto paper, there's no longer a mystique attached to them," he says.

Keeping a journal forces you to be honest, Rank continues. Write for yourself only, he advises. At some point, though, you will want to share the journal with someone -- a therapist, a friend, or a family member whom you trust implicitly. "That's when the real healing begins," Rank says. "By sharing your thoughts, you're accepting the idea that none of us can do things alone. To get through depression or trauma, we need feedback."

Writing about important personal experiences is not only good for your mental health, but your physical health as well, says James Pennebaker, PhD, professor of psychology at the University of Texas in Austin. Pennebaker, author of Opening Up: The Healing Power of Expressing Emotions, has been hailed as the "guru" of "confession research," and in numerous studies has found that writing about upsetting personal experiences for just 20 minutes at a time, over three or four days, can result in a significant drop in blood pressure and a healthier immune system.

Catherine Carlo, MSW, an oncology social worker at Exeter Hospital in Exeter, N.H., says that journaling gives her patients the opportunity to nurture themselves. Though they write as a group, they don't have to share their writing, Carlo says. "Just having that unspoken support and encouragement gives them courage to write about their feelings."

Among the topics Carlo suggests the group write about are the people who have touched them most in their life, and the peaks and valleys they have experienced throughout their life. The objective, she says, is to give the patients a better sense of where they've been, where they are, and where they're going.

One difference between traditional journaling and Carlo's program is that she has the participants envision that they're in a medieval castle. This transports them to another time and place, allowing them to distance themselves from their life. "It takes them out of the context of everyday chaos," says Carlo.

You don't need a therapist or a group to keep a journal. If you'd like to try it on your own, Gruman suggests one or both of these strategies:

Sit in a comfortable chair, take a deep breath, and start writing. Keep it up for 20 minutes without stopping. See what comes out. "If you are having trouble putting your finger on what's bothering you," says Gruman, "this may help you narrow the field."

Another journaling tip, Gruman says, is to focus a 20-minute writing session on a problem or concern that keeps coming back to your mind over and over. Write down, in detail, what it is about this problem that worries or angers you. Predict three different scenarios for what might happen next. Which one do you like best and why? What role might you play in making each scenario come to pass?

Just remember, says Carlo, that how you write is not important. You're not going to be graded. Jot down phrases, skip the punctuation if you feel like it. "This doesn't have to be perfect," she says. To make the process more pleasing, Carlo suggests buying a journal that you will really enjoy using -- perhaps one with pictures, or one with colored pages -- and using pens or colored pencils that are fun and appealing.

"Just start to write," says Carlo. "Don't expect your writing to be monumental. It's the process that's important."

Reviewed by Charlotte E. Grayson, MD, April 8, 2002

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