Exposure therapy worksheet
This free downloadable depression fact sheet gives mental health therapists a brief overview of psychoeducation on depression, describing depressive episodes in easy-to-understand terms for clients and their parents or caregivers.
You’ll also find a list of therapy activities to alleviate symptoms of depression and a free downloadable “What is depression?” worksheet to save to your electronic health record (EHR).
Symptoms of depression
Psychoeducation on depression is essential for clients to understand that depression is a common mental health disorder affecting approximately 332 million people worldwide.
In the United States, approximately 21 million adults experienced at least one depressive episode in 2021.
Depression is a leading cause of disability in America, yet only a third of adults with depression typically receive mental health treatment.
Providing psychoeducation on depression and anxiety is an easy first-step intervention for individuals experiencing depression and other distressing symptoms, whether that’s in a community mental health setting, primary care, or therapy.
When providing psychoeducation on depression to clients, you might highlight prevalence, symptoms, risk factors, and diagnosis and treatment options.
Depression is different from feelings of sadness or grief due to a life event, like going through a breakup. The symptoms are more pronounced and persistent.
The key features of depression include:
Loss of interest or pleasure in once pleasurable activities (anhedonia)
Irritability
Thoughts of suicide or dying
Difficulty concentrating
Feelings of worthlessness or guilt
Hopelessness about the future
Anxiety (especially in younger children)
Depressed mood or feelings of sadness or grief
Fatigue or lack of energy
Significant changes in appetite
Difficulty sleeping or sleeping too much
Psychomotor changes (feeling like you’re moving or talking more slowly)
These symptoms can affect all aspects of life, including work, school, relationships, and home life. They must last two weeks or longer and significantly impact day-to-day functioning.
Psychoeducation on depression should also emphasize that it differs between people depending on their age and gender. For example, more women experience depression than men, and females more commonly experience symptoms like sadness, guilt, and worthlessness.
Teenagers with depression may be more irritable and moody, get into trouble at school, and also have co-existing eating disorders, substance use problems, and anxiety.
Men are more likely to show symptoms like tiredness, anger, irritability, and engage in reckless behavior or substance use. Males may also struggle to identify they are depressed and to seek help.
Older adults may be less open to discussing their feelings of sadness and the medical conditions that may be leading to depression.
Types of depression
When providing psychoeducation on depression, it's important to explain that major depressive disorder is the most common variant of the condition.
However, there are other types of depression, each with unique features, including:
Persistent depressive disorder: Involves a low sad mood (among other symptoms) for most days over two years.
Bipolar disorder (depressive episodes): While bipolar disorder is a separate mood disorder, it can involve dramatic shifts in a person's mood and energy levels from high energy to low mood.
Adjustment disorder with depressed mood: Depressive symptoms (sad mood, tearfulness, hopelessness) that develop within three months of an identifiable stressor.
Premenstrual dysphoric disorder: Severe changes in mood preceding and during a person’s menstrual cycle.
Seasonal affective disorder: Depressive symptoms that occur during changes of season, typically fall and winter months.
This information is included in our comprehensive depression fact sheet to help individuals recognize different manifestations of the condition.
Risk factors for depression
As detailed in the free depression fact sheet, there are various risk factors for depression, including:
Physical health
Harmful use of substances, physical inactivity, heart disease, diabetes, cancer, and other illnesses can lead to depression due to the challenges of managing these conditions.
Other conditions, like chronic pain, anxiety, and attention-deficit hyperactivity disorder (ADHD), are also risk factors for depression.
Trauma
Early experiences of trauma can cause changes in the brain related to fear and stress, which may lead to depression.
Genetics
Mood disorders commonly run in families.
Drug and alcohol use
People who experience substance use disorder are at a higher risk for depression.
What are depressive episodes?
A depressive episode is a timeframe during which an individual experiences depression symptoms with specific severity and frequency patterns.
Unlike mood fluctuations, episodes last most of the day, nearly every day, for at least two weeks.
Episodes of depression may be categorized as mild, moderate, or severe, depending on the severity of symptoms and the impact depression has on the individual’s day-to-day functioning.
Individuals can experience single or recurrent episodes (called recurrent depressive disorder) of depression.
Depression therapy activities
Depression typically responds well to a combination of treatments. This may involve psychotherapy, medication, movement, light therapy, alternative interventions (acupuncture, meditation, and faith-based approaches), and brain stimulation therapies.
Treatment approaches that are also detailed in the depression fact sheet involve:
Safety planning
Safety planning is when therapists assess for suicidal ideation, which may be a symptom of depression, and create a safety plan when needed.
Cognitive behavioral therapy (CBT)
CBT exercises like thought records, cognitive distortion worksheets, and cognitive restructuring are helpful strategies to change unhelpful thoughts and behaviors that could be exacerbating symptoms of depression.
Interpersonal therapy
Interpersonal therapy involves recognizing life stressors contributing to depression, problem-solving, and finding ways to support the individual.
Behavioral strategies
Activity scheduling worksheets and other coping skills for depression can help manage symptoms of depression.
Psychoeducation on depression for parents
When providing psychoeducation on depression to parents or caregivers, it may be helpful to highlight the following:
Educate yourself: Depression can affect anyone and is more than children and teens feeling sad or “moody.” It’s a complex condition encompassing emotional, behavioral, physical, and cognitive components.
Look out for signs of depression: Watch for symptoms like sadness, irritability, mood swings, difficulty concentrating, negative self-talk, social withdrawal, changes in appetite, difficulty sleeping or sleeping too much, changes in academic performance, feelings of hopelessness, self-harm, and substance use.
Know the risk factors: Changes in health, family stressors (divorce, conflicts, substance use, instability, and mental health disorders), genetics, bullying, relationship difficulties, traumas, and other stressors are all risk factors for depression.
Get help: If you recognize signs of depression, provide emotional support, communicate openly, promote healthy habits, and seek guidance from a medical or mental health professional.
Sources
Anxiety and Depression Association of America. (n.d.). What is Depression?
Donker, T., Griffiths, K. M., Cuijpers, P., & Christensen, H. (2009). Psychoeducation for depression, anxiety and psychological distress: A meta-analysis. BMC Medicine.
National Alliance on Mental Illness. (2017). Depression.
National Institute of Mental Health. Major depression.
World Health Organization. (2023). Depressive disorder (depression).
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