Changeways aims to lift dark thoughts

The eldest daughter of Indian immigrants, Nina Kullar was brought up to believe that the key to life is hard work. She became a chartered accountant, which she says “formed my identity, my sense of value and purpose”. When she was diagnosed with leukemia at the age of 36, however, the self-described workaholic was forced to reevaluate.

Kullar dutifully went through the treat ­ment program for her cancer. She appeared to have beaten the disease. But aside from going out to her follow-up appointments, she literally couldn’t get out of bed. She was eventually diagnosed with reactive depression. Her doctor recommended a treatment program called Changeways. She went on the waiting list in April 2006 (you must be referred by a medical professional) and attended her first session in September.

Changeways (vch.ca/psychiatry/changeways.htm) was developed at UBC as an outpatient program for people with various forms of depression. A free program of Vancouver Coastal Health, it focuses on teaching practical solutions for coping with the disease. Small groups spend two hours a week, for eight sessions, learning about the causes of their depression and how they can live in spite of it.

Changeways’ core philosophy is that thoughts, emotions, and behaviour are powerfully connected: if depressed individuals can change the way they think, they can change their moods and their actions too. Each element influences the other two, and if one can be improved, the others will follow. As simplistic (and, to a severely depressed person, unrealistic) as that sounds, many graduates of the program say it works.

Participants start with small, easily attainable goals, such as eating more than once a day. (Depression often affects appetite.) For someone so depressed she hasn’t left her house in a week, even the prospect of buying groceries is daunting. Depressed people have a tendency to isolate themselves, so participating is crucial to recovery. Accomplishing goals builds confidence, which prepares people for bigger challenges and, ultimately, a normal life as most of us know it.

Kullar spent her eight weeks tackling goals and checking her thoughts (“I didn’t realize how much automatic negative thinking I had”), but for her the biggest benefits were the support of other participants and the perspective of the workshop facilitators, two registered nurses who left hospital work to teach Changeways. Joan Harding and Sarojni Rajakumar had worked with mental-health in-patients and wanted to help those not in need of hospitalization. Kullar remembers Harding saying “You don’t have to be doing anything to be worthy of being here.”

“That was my ”˜Aha!’ moment,” Kullar recalls. “My life was my work.” She now has a “strong feeling” that if she hadn’t ended up in Changeways, she would be back to her old workaholic ways. Working part-time and cancer-free, she still struggles to reconcile her old self-image with her new reality. Despite thoughts of “What’s the point?” she now knows that her thoughts don’t have to control or define her.

“Changeways,” she says, “changes the way you look at things.”