As a clinician, I see this all the time. It's hard to appeal to a child or adolescent about the need for "commitment to treatment" because they're young and feel invincible. They roll their eyes or give me an I-know-what's-better-for-me-than-you look. Though it's easier to plead this case to adults, many want to "see how things go" or "try to work this on my own." I remind them that my door is open should they want to try again. Some do, and return wiser and more mindful of the power of depression. Others don't, which worries me because stopping treatment at the response level increases the likelihood of depression relapse by 80 percent. For those that I don't see again, I hope they've found a way to manage depressive symptoms or found another professional with whom to work--and are not without continuation of care. The second goal in treating your depression is to bring you to a full state of remission. "Remission" is clinically defined as the experience of being symptom-free from illness.2 This differs from response in that you not only report an improvement from when you started treatment but also describe the presence of well-being, optimism, self-confidence, and a return to a healthy state of functioning.3 Di-agnostically speaking, remission is achieved when fewer than three of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision (DSM-IV-TR) diagnostic criteria are noted, and your feelings of well-being continue for three consecutive weeks. The goal of getting you to a state of remission requires many things to move smoothly. For example, your commitment to treatment, the steady flow of medications month to month, your healthcare professional's monitoring of progress, tracking your triggers, knowing relapse warning signs, and maintaining a healthy lifestyle are vital to remission. One of the most disturbing issues regarding depression is the fact that most children and adults never reach full remission.4 There are many reasons for this troubling statistic. Treatment of depression can sometimes reach a partial remission--an experience of significant improvement in which mild symptoms still exist. These mild depressive symptoms, called "residual symptoms," are often overlooked in the maintenance of depression.5 Children and adults who are depressed report "feeling better" is their decisive factor for gauging remission, while practitioners look at clinical data from symptoms checklists and diagnostic criteria.6 Given this discrepancy, it is vital for you and your healthcare professional to have a clear working definition of remission. Using symptom checklists at the beginning of treatment, during treatment, and at remission stages can solidify the diagnostic and emotional features of your depression. Before you despair that a break will never truly refresh you, the secret might be to put greater weight on what happens before the vacation itself. Beyond actually going on an extended holiday, simply planning or thinking about taking a trip can boost your overall happiness. That was the finding of a team of researchers in the Netherlands who surveyed 1,530 Dutch adults about their feelings of happiness before and after taking a vacation. While they similarly found that feelings of happiness and relaxation dropped off after a trip, they discovered that the largest boost in happiness came in the planning stages of a getaway. Vacationers displayed higher levels of happiness than nonvacationers for weeks, and sometimes even months, before the holiday began.

Start planning your next trip months in advance. You'll give yourself plenty of time to imagine lying on the beach, wandering historic city streets, or whatever else your ideal escape involves (plus save money on the flight). Sometimes it may be better to have your dessert before dinner. We often think that we will enjoy a leisure activity or vacation as a reward for getting our work done, but it turns out we'll have just as much fun playing before working. Researchers at the University of Chicago Booth School of Business tapped 181 adults from a wide range of employment backgrounds to complete two activities: a set of cognitive tests (aka work) and an iPad game in which participants created and listened to music (aka play). While participants expected that having fun first would decrease their enjoyment of playing the game, in fact there turned out to be no difference between the two. The researchers got the same results with an experiment in which 259 college students had a choice to enjoy a spa treatment either before their midterms or as a destressing experience after taking their tests. Again, the enjoyment was the same whether before or after. Ed O'Brien, coauthor of the study, said the findings "suggest we may be over-worrying and over-working for future rewards that could be just as pleasurable in the present." Just as breaks during the day are found to correlate with higher levels of happiness and productivity, weekends are key to helping raise your level of happiness. Research finds a "weekend effect" among workers in every field, in which their mood improves from Friday afternoon to Sunday evening. A study tracked the moods of participants over a three-week period and consistently found that respondents reported feeling both mentally and physically better on the weekend, regardless of age, marital status, or other factors. The subjects also reported feeling more competent on the weekend than during the week, likely because they had more freedom to choose the activities they wanted to do. "Far from frivolous, the relatively unfettered time on weekends provides critical opportunities for bonding with others, exploring interests and relaxing--basic psychological needs that people should be careful not to crowd out with overwork," said Richard Ryan, a psychology professor at the University of Rochester, who authored the study. One good litmus test for whether your leisure activities will bring you happiness is to ask yourself, "Does it put me in a flow state?" Positive psychologist Mihaly Csikszentmihalyi coined the term flow to describe the kind of hyperfocus that he defines as "being completely involved in an activity for its own sake. The ego falls away. Time flies." You know what he's talking about: Maybe you were totally engrossed in a great book or rode your bike all afternoon and lost track of the day. You were "in the zone" and went on a kind of euphoric autopilot. In this flow state, you can accomplish more creative work and do so much more effectively or creatively than in your typical distracted state--all while being more relaxed and positive. Seeking help, training, and guidance doesn't make you stupid, incompetent, less valuable, or uncool. It makes you smart and educated - but it requires maturity, honesty, and security.

Not asking questions because you "know everything" communicates you're immature, dishonest, and insecure. Not a place you want to find yourself in. Let's be clear - graduating high school and going to college doesn't make you "educated". It doesn't mean you never have to ask for help. It doesn't mean you know more than everyone around you. It doesn't make you better. Lose the "I'm educated and better" mindset. A real "education" is asking questions, collecting useful information, and regularly applying it towards reaching goals and improving your life. A real "education" is gaining specific knowledge to better yourself and others, creating something bigger than yourself, and then contributing to the world using what you're learning. A real "education" is acquiring valuable knowledge that, when passed on to others, will change their thoughts, emotions, behaviors, habits, and lives. Jim Rohn said, "Formal education will make you a living; self-education will make you a fortune." Here's what he actually meant - "Formal education (school and college, the stopping point for most people because they think they know everything and they've actually achieved something in life) will make you a living (you will learn just enough and be just smart enough to get a job working for someone you hate and at a job you hate. A job that will tell you when to wake up, when to take a break, when to eat, when to go home, when you can see your family, when you can spend extra time with them, how much money they think you're worth, and how little of a raise they'll give you over the course of a year or two); self-education (being smart enough to ask questions, not thinking you know it all, and seeking to always get better) will make you a fortune (you will see, learn, and understand a different way of doing things. A way that only 1% see, learn and understand. A way that will give you the life you want, the job you want, the money you want, and everything else. A way that will make you free, happy, and fulfilled)." So far, 100% of the credit for anything I've done, goals I've reached, and the person I've become goes to asking questions, seeking help, and not being too proud to say, "I don't know what I'm doing and I can use some guidance, training, and help." I KNOW I will never come close to knowing everything and I ask more questions than a 4-year-old because there's so much to learn and such a short period of time to learn it. Knowledge and asking for help helps maintains accuracy in your thinking, emotions, behavior, and habits. It helps keep everything in focus. It helps you stay grounded, updated, and in touch with reality. Asking for help is now easier than ever before because, before the internet, you'd have to ask around to see if someone knew of a person who was familiar with a certain topic or you'd have to go to the library and read the available books to try and find an answer. Now, you simply search it.

I Google EVERYTHING and it doesn't matter how small or stupid the question is - if I am curious or need to know something specific, I'm 99% sure some other person has, since the invention of the internet, asked the question before, a somewhat intelligent and common-sensed, person gave a useful reply, and there's a searchable record of the information exchange sitting somewhere on the internet. One of the most common and oldest forms of groups is the book club. A book club is essentially when a group of 5-15 people, or sometimes more, reads the same book over the course of a month or two and then gets together to discuss it. Think college English but without any grades and with books you actually want to read. Book clubs are not for everyone, but if you like to read and want the challenge of speaking up in a group of people, you'll have plenty of opportunities to do both in a book club. is loaded with book clubs if you want to join one cold and meet up with people. Alternately, you can find groups at many independent book stores or on websites like where they are organized by readers in every conceivable genre. And before you think that most book clubs only read the latest Oprah selection or something from 9th grade literature, know that there are all types of book clubs. I have been part of science fiction, children's lit, post-apocalyptic fiction, poetry, and translated book clubs and they were all full of interesting people and very interesting books. Starting your own group takes a good amount of ambition, organizing power, and the ability to get people to follow your lead in as many ways as possible. In short, you'll need to have mastered quite a few of the tips in this book and already be putting them to good use in all aspects of your social life. But, starting your own group gives you quite a few things. First, it ensures you meet a lot of people. If you join a group that meets with 20 people every two weeks, the odds are that you won't get to know all of those people very well. As the leader of the group, it's your job to introduce yourself, maintain order, and be on good terms with every member of the group. If leadership is something you gravitate towards, and your new likability is in need of a test, take a leap and try starting your own group in this fashion. It's not easy, but it can be very rewarding. In an ideal world, you would fill out the TRAP monitoring form in real time, as events unfold. And the ability to do so might develop over time. When you have only just begun monitoring, maybe it's not until 11 a.m.

the next day that you realize watching a second episode of Mad Men had been a TRAP because you feel exhausted. As soon as you realize your TRAP, get your form and record it. As you continue tracking, you may even start to notice a TRAP as it's unfolding. You could be twenty minutes into the second episode when you realize you were just trapped. Good for you--it can be a great feeling to catch yourself in autopilot and gain the opportunity to view your behavior from this refined perspective. To foster this growing ability, I encourage you to pause whatever you're doing and fill out the form as soon as you recognize you got trapped. You don't have to rush to change the behavior if you're not ready. In the example, you could pause the episode for two minutes to write down the TRAP and then resume watching it. Even taking a few minutes to record will help you start to catch yourself earlier and earlier in the sequence. If you find yourself totally forgetting to monitor, then schedule a regular time for a check-in. You could dedicate a period of time in the early evening when you can reflect back on your day. To get in the spirit of checking in more regularly than that, you might set times to routinely check in right after meals or bathroom breaks at work, which can be great cues to establish a monitoring habit. You'll likely find that you want to adapt your level of interaction with TRAP monitoring as the weeks go on, based on your observations. Are there vulnerable times of day when you need to monitor more frequently than others? Are there certain days of the week when you get trapped all over the place, whereas other days they have less pull? I encourage you to experiment to make monitoring as useful for your needs as it can be. There are a lot of methods for monitoring. I use old-school pen and paper with my patients, giving them the same form provided on the website and encouraging them to have one copy for every day of the week. You can absolutely incorporate technology if that feels easier or more natural. What is most accessible to you and appropriately private?