Here are some ideas. If you like to speak more than you like to write, you can record the TRAP with your phone. If you're walking and talking in public, to the people around you, you're simply having a phone conversation. If you record your monitoring, I encourage you to transcribe the content later that day, as it is easier to observe your patterns visually. What matters most is that you are tracking with fidelity. Each week, you can take out all your forms, contemplate them, and learn about yourself--especially through the patterns you detect. Once you get better at catching these crucial moments, and you become consistent at tracking and reviewing, you'll find that it becomes easier to cope a bit differently. How can you do this? How do you hit pause and do something different? From the awareness you gain through monitoring, you enhance behavioral flexibility--the ability to choose more deliberately before you act. In the next two sections, I offer tips on hitting pause when faced with low-intensity and high-intensity triggers because they may require somewhat different approaches. I'll also give you ideas for coping with sadness, anger, fear, guilt, or other tough emotions that are tailored to your emotional response style. Remember, if you're still experiencing depressive symptoms, you have not reached a full remission. Partial remission with residual symptoms signals the need to continue with your antidepressant treatment. Depression has a trajectory that is unique. If you're in psychotherapy and/or taking medication longer than most people, remind yourself that "one size fits all" doesn't apply for depression. If you're feeling better and want to "see how things go," resist the urge to leave treatment early. Another obstacle to full remission is disruption of healthcare. Some examples of interruption of treatment are skipped sessions, insurance delays for session approval, denials for specialist visits, missed doses, or delays in prescription refills. These gaps in treatment interfere with response, and without response remission cannot occur.

Sometimes you can control gaps in treatment, like making sure you get to sessions and being diligent about filling your prescriptions and/or having them on hand. Other times, gaps in treatment are more difficult to monitor. If you're dealing with managed care, keep a calendar of when sessions are approved, and remind your practitioner to ready the paperwork to extend care. If approvals for treatment are lost or delayed in a clerical maze, inquire if your practitioner can continue working with you or if medication can be advanced while the matter is arbitrated. From time to time, pharmacists have given me a week's supply of medication so my pharmacotherapy didn't get interrupted during clerical delays. Professionally, I make sure that children and adults I work with don't experience gaps in treatment by continuing to see them while insurance issues get ironed out. If you're someone who has no health insurance, don't let that prevent you from getting treatment or make you think you will not experience continuity of care. There are clinics, hospitals, and research programs you can access to get the care you need. Treatment-resistant depression (TRD) poses another hurdle in attaining full remission. Treatment-resistant depression is NOT classified if a child or adult is refusing treatment, if treatment is discontinued prematurely, or if comorbid mental or physical diagnoses are operating but are currently undetected. Generally speaking, TRD is defined as an inability to achieve a response with four or more trials of different antidepressant medications, including augmentation--which is the use of an additional medicinal agent to boost the effect of a currently prescribed antidepressant. There appear to be a variety of factors that cause 25 percent of depressed individuals to experience treatment-resistant depression. For most, a genetic metabolizing factor, or overactivity in Brodmann Area 25, prevents current treatments from reducing depressive symptoms. For those who have these issues, it's helpful not to blame yourself for these genetic traits. Instead, realize that medical science has not yet caught up with technological advances and genetic findings and therefore cannot utilize these resources to create suitable treatments that provide full remission. Another cause for TRD is linked to chronicity, or the length and intensity of a depressive episode. A lengthy and severe unipolar episode increases the likelihood for TRD. Many of the alternative therapies (ECT, vagus nerve stimulation, transcranial magnetic therapy, deep brain stimulation) address TRD factors. So don't let being a nonresponder weaken your already fragile state or make you believe that feeling better is beyond reach. Alternative therapies can result in a response or partial remission with residual symptoms.

The bottom line here is that if you're someone with treatment-resistant depression, you'll likely have more than one round of alternative treatment to manage your symptoms. Finding a specialist who understands treatment-resistant depression can help you design an appropriate course of action. I've worked with several individuals with TRD. With the help of specialists, alternative therapies, such as electroconvulsive therapy and transcranial magnetic therapy, were administered with successful results. Though not in full remission, the symptom reduction of depression offered all of them a newfound quality of life. Csikszentmihalyi laid out the factors that contribute to a sense of flow, including intense focus and concentration, a feeling of personal control over what you are working on, a distorted experience of time (i.e., time flies), and a loss of the sense of self-consciousness. To enter the flow state, the key is engaging in a task that balances with your skills. Something too simple leads to boredom; something too challenging leads to anxiety. While the flow state can happen in any area of life, sports and outdoor activities are often where it can be seen at its clearest. Aim to reach flow state when having fun: Seek out activities that challenge your skills but won't overwhelm you, and cut out distractions while you're having fun. Getting into flow is not something that has to be done solo. A research team from St. Bonaventure University in upstate New York asked subjects to participate in a paddleball activity, both by themselves and with a team, meant to trigger a sense of flow individually and as part of a group. It turned out that students got greater satisfaction from "social flow" than from "solitary flow." Turn your hobbies into group activities: If you like playing guitar, start a band; if you love jogging, run races. Adventure outings have been found to be particularly effective at creating this sense of flow--even when generating feelings of anxiety at the same time. One study surveyed fifty-two white-water kayakers, analyzing their experiences with kayaking and subsequent feelings. It found that even when subjects expressed feeling anxious due to the difficulty of the river, these emotions were counterbalanced by subjective experiences of flow, "suggesting that white-water kayakers may have positive experiences even when their abilities are exceeded by the difficulty of the river," as the researchers put it. They also found that those who experienced a flow state continued to feel its effects even after the more difficult parts of the rapids had passed, making it seem that "benefits from the flow experience may be taken away from the river into everyday life." Challenge yourself with an adventurous outing. The butterflies you feel can create long-term mood improvement. But you don't have to put yourself in harm's way to improve your sense of happiness.

It turns out that knitting is an effective way to boost your mood. A survey of 3,545 knitters found a notable connection between how frequently someone knitted and their feelings of calm and happiness. Those who knitted more frequently also reported sharper concentration and memory. Part of that might be yarn itself: Some respondents reported that the color they used while knitting influenced their mood. About half of respondents said the texture--what some referred to as "tactile pleasures in fibers" and "touchable feelable result"--impacted their mood. Similar findings came from a survey of quilters. Those taking part in a survey about quilting and well-being reported higher levels of concentration and emotional benefits, thanks to the strong social network generated from interacting with others in a quilting circle. Visit a craft store and start a new hobby--with friends, if possible. The only thing that makes you an idiot is not asking questions. Never assume to know it all. More knowledge is available on the internet than ever before and it's growing, multiplying, and compounding day in and day out. No matter how small it is, seek guidance. See what others have to say and compare it to your own experience and judgment. Tai Lopez says, "The average millionaire has made 10,000 good decisions. That's called `meticulous'. The rest of us are f*cking sloppy." He's right. Having your act together requires absolute meticulousness. Meticulous - "showing great attention to detail; very careful and precise." Another definition is "taking or showing extreme care about minute details; precise; thorough." Being meticulous is "paying attention", to "detail". Not just any attention, but "great" and "extreme" attention. You "care" and you give a damn about what you're doing.

You operate with "precision". It's harder to be sloppy when you're "meticulous-minded". Not having your act together is the sum of sloppy decisions - the decision to be not go to bed on time, to get up late, to avoid folding clothes and washing dishes, to not be on a schedule to get done what needs to be done and when it needs to be done, to thoughtlessly spend money, and everything else we do that's extremely sloppy. When we don't have our act together, we're careless, sloppy, and lacking attention to detail - we're not meticulous. If you're sloppy and lacking attention to detail in the little areas of your thoughts, emotions, actions, behavior, habits, decisions, and your life, there's a 99% chance you're the same way when it comes to the big things that matter the most. Choose RIGHT NOW to start being meticulous in every area of your life. Choose to pay better attention to detail, to give a damn, and to start being precise in your thinking, behavior, and habits. Choose precision. Choose to pay attention to the things most are overlooking. Most of us refuse to look inwards and admit we don't have our act together. We refuse to say, "I don't have my act together, I can make improvements, it's my fault I'm having these problems, and my choices have led me to this point in my life." It's so easy to do - but our emotions, ego, and our inner-child won't let us. It's not in your ego's best interest. We like to think "Everyone around me needs improvement, but I'm not going to admit I've made a lot of bad choices because that would embarrass me and make me look stupid. That would make me look less smart. I have a reputation to live up to." Speaking of the Internet, there is always the opportunity to meet new people online. Despite the long standing stigma over online meetings and interactions, more and more people are finding it easier to be themselves in a digital setting, prior to meeting up with a potential friend or romantic interest in person. How you handle online meetings really isn't that much different than the offline variety, but I do have one important tip for you. Remember, unless you are using a webcam so you and the other person can see each other, there are a lot of unspoken inflections and body language quirks that go into a conversation. As a result, if you word something awkwardly in an email or chat message, it's very easy for someone to take it completely the wrong way. Gaming - In recent years, online gaming has become an extremely popular way to meet new people, generate relationships and stay social when all else fails.