ASW Vietnamese

CHNG TRNH T CHM SC TRM CM
CHNH L LN TH 2
HNG DN CC K NNG
KIM SOT TRM CM
(Chnh l bn dch v in ln th 2)
Bs. Dan Bilsker TS. Sandy Paterson
Bc s Dan l chuyn gia tm l Tin s Sandy l chuyn gia
lm sng ti Bnh vin a khoa tm l, gim c Phng khm
Vancouver v tham gia t vn cho Changeways v l tc gi ca
nhm nghin cu v sc khe tm cun sch S trm cm
thn ti i hc Simon Fraser. ca bn.
Chng Trnh T Chm Sc Trm Cm c xy dng da trn kinh nghim ca
cc tc gi v cc nghin cu khoa hc v cc chin lc kim sot trm cm hiu
qu nht.
Chng trnh ny dnh cho:
Ngi c triu chng trm cm
Gia nh, bn b quan tm mun gip ngi trm cm
Cun sch ny nhm cung cp nhng thng tin chnh xc v trm cm. Cun sch
khng phi iu tr y t hay liu php tm l v khng thay th cho iu tr y t. Nu
cn phi iu tr hoc cn chuyn gia h tr, nn tm kim s gip ca cc
chuyn gia.
Quyn sch ny nhn c h tr ti chnh ca B Y T Canada, Dch V Cai

Nghin v Sc Khe Tm Thn BC, i din C quan Dch v Y t tuyn Tnh,
British Columbia, Canada.
Vancouver, Canada
C th ti min ph bn ting Anh ca cun sch ny theo ng dn di y:
www.bcmhas.ca hoc www.carmha.ca/publications
Lu : Cun sch ny c xut bn nhm cung cp cc thng tin chnh xc v xc

thc. n v xut bn khng tham gia cung cp dch v tr liu tm l hoc cc dch
v chuyn mn khc. Nu cn h tr ca chuyn gia hoc cn iu tr, nn tm kim
dch v ca cc chuyn gia c chuyn mn.
c Vin Dn s, Sc khe v Pht trin dch, kim tra v c in di s ti tr

ca Qu Grand Challenge Canada
CHNH L LN TH 2
HNG DN CC K NNG
KIM SOT TRM CM
DN
HNG NG
N
CC K
T
KIM SO
M
TRM C
MC LC
Gii thiu 1
Trm cm l g? 3
Nguyn nhn gy ra trm cm? 6
Bn c th lm g khi b trm cm? 14
Thuc chng trm cm 16
Cc k nng kim sot trm cm 18

1. Thit lp li cuc sng ca bn 19
2. Suy ngh mt cch thc t 30
3. Gii quyt cc vn mt cch hiu qu 39
Con ng pha trc: Gim cc nguy c ti pht 49
Cu chuyn ca Hng 53
Cc ti liu nn c 54
Nhng thng tin hu ch v mu ghi chp 55

Ch n ung 56
Hot ng th cht 57
Gic ng 58
Caffeine 60
Ma ty v Ru 61
Biu mu 63
GII THIU
rm cm l mt trong nhng tri nghim au n v kh khn nht ca
T con ngi. N cp i nng lng, s yu thch v mong mun lm mi

vic tr nn tt p. N mang n cm gic tiu cc su sc v bn
thn, th gii v tng lai. Khi trm cm, bn thy dng nh khng c g
c th thay i, v th bn ngh bn khng bao gi c th hi phc.
Nhng tnh trng trm cm ca ngi trm cm c th Thm vo , mt s la chn v phong cch sng
thuyn gim v trm cm c th kt thc. C cc bin gim trm cm c tho lun trong phn Thng Tin
php cha tr v cc k nng t chm sc hiu qu Hu ch cui sch. Mc d cc phng php thng
kim sot trm cm. Nhn vin y t c th cung cp c tho lun ngn gn, phn ln chng ti nhn
cho bn cc bin php iu tr trm cm, nhng bn c mnh vo phng php tip cn: cc k nng kim
th hc cc k nng t chm sc v p dng chng. sot trm cm hn l thuc chng trm cm.
Hng dn ny gip bn nm c cc k nng kim
Chng ti hi vng rng cun hng dn ny s gip
sot trm cm. C lc bn c th ch cn s dng
ch cho bn. Nhng ch c th khng . pht huy
nhng k nng ny khi khng b trm cm qu nng.
tc dng, bn s phi p dng vo thc t. Chng ti
C khi bn phi s dng cc k nng ny ng thi vi
c gng miu t cc k nng mt cch r rng, theo
vic iu tr.
th t tng bc gip bn tng bc vng chc t
c mc tiu ca mnh.
Hng dn ny nhn mnh vo ba bc: thay i cch

sng, suy ngh thc t, gii quyt vn .
CHNG TRNH T CHM SC TRM CM 1 HNG DN CC K NNG KIM SOT TRM CM

GII THIU
T hi bn thn 3 cu hi. nh du cu tr li ca bn trn thang im di y. Thang im t 0 n 100:
Tm trng bun chn c nh hng tiu cc nh th no n cuc sng ca bn?

0 50 100
KHNG NH HNG NH HNG RT TIU CC
Vic cm thy kh hn quan trng nh th no vi bn?

0 50 100
KHNG QUAN TRNG CHT NO CC K QUAN TRNG
Ti c sn sng u tin lm nhng vic khin cuc sng ca ti tt ln khng?

0 50 100
KHNG U TIN CHT NO CC K U TIN
Nu s im ca bn trong hai hoc ba cu hi t hn 50 im, c th bn ang ngh n vic thay i, nhng vn

cm thy cha chc chn. Nu bn ri vo trng hp ny, hy c cun hng dn v suy ngh thm.
Nu s im ca bn trong hai hoc ba cu hi cao hn 50 im, bn sn sang thay i. Nhng g bn tri qua
l qu v bn chun b dnh thi gian mi ngy lm cho mi vic tt hn.
M sang trang k tip v bt u

TRM CM L G?
an thng xuyn cam thy khng vui hoc bun ru, o khng co nghia la
B bn b trm cm. Cm giac bun ba hoc chn nn l mt phn khng th

trnh khi trong cuc sng hang ngay. Mi khi c iu g xy ra khng
theo bn, o c th l ci v vi ngi yu, mu thun vi sp hoc m au,
th tm trng ca bn c th i xung.
Trm cm khng phai l

Hu ht nhng ln khi bn cm thy khng vui hoc Nu bn cm thy rt bun hoc kh chu v tnh
bun ru, khng c ngha l bn b trm cm. Cm trng ny, c th i km vi vic mt ng, khng
thy bun hoc chn nn l mt phn khng th trnh mun gp g bn b hoc gia nh, n qu nhiu
khi trong cuc sng hng ngy. Mi khi c iu g hoc qu t - bn c th ang tri qua cm gic bun
xy ra khng theo bn, c th ci v vi ngi yu, chn. Cm gic ny thng s mt i trong mt hoc
mu thun vi sp hoc m au, tm trng ca bn hai tun, nht l nu tnh hung gy ra tm trng ny
c th i xung. c ci thin.
Trm cm l
Nu tnh trng trn khng ci thin v ngy cng t 2. Nu bn c cc vn khc nh:
hn. C th bn b trm cm: thay i ng k v cn nng hoc s thm n;
1. Bn cm thy rt u bun, su no hoc khng khng th ng gic hoc ng qu nhiu;
c bt k hng th, nim vui g trong hu ht cc lun cm thy bn chn hoc chm chp, u oi;
ngy. Cm gic ny c th ko di hng tun; cm thy bn thn v gi tr hoc ti li;
V lun cm thy mt mi;
cm thy ngu ngc hoc trng rng;
gp nhiu kh khn v tp trung hoc ra quyt
nh;
ngh n ci cht hoc t st.

TRM CM L G?
Hai loi trm cm thng gp nht l Chng trm cm nh v Chng trm cm nng.
Mi loi u c cng nhng vn nu trn nhng Bc s, cn b y t, chuyn gia tm l hoc bc s tm
i vi trm cm nng, cc vn ny trm trng hn. thn c th chn on liu bn c b trm cm hay
Khi mt ngi b trm cm, thng l trm cm nh. khng.
PHN LOI TRM CM

xy ra
TM TRN

TRM
gic
ic
rng
G
v
TRM
IX
cm
CM
ts
N
m
ng
U
GC
v
hi
m t
NH
c tr
hy bun chn
CM
m
ho
t
ho
C
N
gi t
th
NG
th
cb
un
m h c
C
ng
gi chn k R t k h
o di. i
c
au t
b un th y m
, tuy
t vng c tip din. Cm

TRM CM L G?
Mt s quan st v trm cm
T chn on trm cm rt kh Thng c khong hn 4% ngi ln b trm cm
mt thi im nht nh v hn 15% ngi ln b
Tm trng ca chng ta nh hng n kh nng
trm cm mt thi im trong cuc i.
nh gi v bn thn. Do , vic t nh gi liu
chng ta c thc s b trm cm hay khng thng Trm cm khng phi l mt du hiu yu ui
rt kh. Thng thng, cn ngi c chuyn mn
Rt nhiu ngi thng minh, ti gii v thnh cng
chn on.
tng trm cm. B trm cm khng c ngha bn
Nu bn b trm cm, bn khng c n c nhn cch km hoc co tnh cch c thiu st.
Bn ngh rng mnh b trm cm...

Nu bn ngh mnh b trm cm, iu quan trng l Nhn vin y t c th l bc s, cn b y t, chuyn
bn cn tm kim s gip . Cc k nng trong cun gia tm l, bc s tm thn hoc chuyn gia sc khe
hng dn ny l nhm gip bn kim sot trm cm, tm thn. H c th cung cp cho bn cc liu php
nhng bn khng nn t mnh x l. Hi kin t iu tr trm cm. Cc liu php ny s c kt qu tt
ngi bn tin tng c th gip bn hiu vn ca km theo cc k nng bn hc c t cun hng
mnh hoc t h vo tnh hung ca bn. Nu bn dn ny.
tip tc cm thy trm cm, tm kim s gip ca
nhn vin y t.
Bn mun lm au bn thn
i vi nhiu ngi, trm cm lm cuc sng dng tr khng hong hot ng 24/7. Tm cun Nhng
nh v vng v khng kim sot. Phn ln ngi trm Trang Vng v m phn Cc Trung Tm Khn Cp
cm u c nhng lc cm thy nh vy. i vi mt tm s in thoi trong khu vc bn sinh sng. Bn
s ngi, cm gic v vng qu mnh n mc h bt cng c th n Phng Cp Cu ti bnh vin gn ni
u ngh khng mun sng na. Nu bn cm thy bn sinh sng.
nh vy hoc ai bn bit cm thy nh vy, l
lc cn tm s gip . Tm nhn vin y t c th gip
bn vt qua cc cm gic ny. Nu bn khng th
i n bui hen, bn c th gi cc s khn cp h Hy nh, mi vic c th tr nn tt hn.

NGUYN NHN GY TRM CM?
Con ngi c th b trm cm do rt nhiu nguyn nhn khc nhau.

Cc nghin cu xc nh mt s cc yu t gn Mi loi ng vai tr nht nh trong vic gy ra trm
lin vi vic gy ra v ko di tnh trng trm cm. cm v trm cm cng c th nh hng n tt c
S di y chia ra nm loi yu t chnh: tnh cc yu t ny. Trong phn tip theo, chng ti s
hung; suy ngh; tnh cm; tm l; v hnh ng. miu t chi tit tng loi yu t.
TNH HUNG
l Mt mt
l B c lp
l Xung t/ Mu
thun
l Stress
HNH NG
l C lp bn thn
khi x hi
SUY NGH
l Gim hot ng l Thi quen suy
l T chm sc bn ngh tiu cc
thn km l T ch trch
l Khng cng bng,
khng thc t
CM XC
SINH L l Chn nn
l Ri lon gic ng l Bun
l Thiu nng lng l Tht vng
l Thay i ni tit l Cm thy ngu ngc
trong no l Hi hp

Tnh hung
Trm cm thng khi pht t mt tnh hung rt cng Stress lin quan n sc khe. iu ny c bit
thng trong cuc sng. Nu bn c gng i ph ng trong trng hp c vn mn tnh v sc
vi tnh hung ny bng cch ci thin hoc chp nhn khe gy ra rt nhiu au n hoc kh khn trong
n nhng khng thnh cng, bn c th bt u cm vn ng v vic iu tr ch ci thin mt phn. Mt
thy qu ti v mt hi vng. Sau , nguy c xut hin s bnh tt hoc liu php iu tr c th gy ra
cn trm cm tng ln. Mt s tnh hung c th gy trm cm do tc dng trn c th. V d, nhc gip
ra trm cm bao gm: (tuyn gip tit qu t hormon tuyn gip) thng i
km vi mt mi v trm cm.
S kin quan trng trong cuc sng, nht l lin
quan n mt ngi thn. S kin nh ngi bn Nh vy khng c ngha trm cm ch xy ra khi c
yu qu cht, chuyn i, li d, ph sn hoc mt vic s vic khng nh xy ra. Mt s ngi b trm
l bin c ln trong cuc i. cm ngay c khi cuc sng ca h ang thun
bum xui gi: trm cm xut hin nh t trn tri
Thiu lin lc vi mi ngi. B c lp khi x hi l
ri xung! Cc k nng kim sot trm cm nh
yu t ri ro ng k gy trm cm.
trong cun hng dn ny cng hu ch cho nhng
Xung t trong quan h. Cc xung t mi quan h ngi ny.
c nhn trong hn nhn hoc gia nh rt cng
thng v c th gy ra trm cm.
Stress lin quan n cng vic. C th
l cng vic khng n nh (khng
bit r cng vic ca bn c tip
tc khng), xung t vi ph trch
v ng nghip hoc lm vic
qu ti (con ngi ch c th
lm vic ti a 16 gi mt
ngy, bt k trong mi
trng ngh nghip
hoc vic nh)

Suy ngh
Mi chng ta b nh hng khc nhau t cc s kin ch ng ngi, ngh rng s cm thy ti t v mi
bn ngoi, ph thuc vo cch chng ta ngh nh th ngi s nh gi, chi b mnh. Suy ngh ca mi
no v cc s kin . Tng tng c hai ngi bc ngi nh hng s kin s xy ra nh th no. Kt
vo bui tic. Mt ngi hng ngoi, t nhin, ngh qu nghin cu cho thy ngi trm cm thng c suy
rng c y s rt vui v vi bui tic v ngh mi ngi ngh lch lc v th gii v cch suy ngh sai lch ny
tham gia bui tic thn thin v ci m. Ngi kia s c th gy ra hoc lm ti t thm tnh trng trm cm.

NH Y H
H N H M N N GHT MN
C H U Y U
RA C
I MNH LUN
GY MI NG
T C PH HNG
T
I TH MI TH
G
M NH MNH
O
I SA Y? TH
T S
T M V
QU
L NGU NGU
NGC NG
C!

Cch suy ngh lch lc

Suy ngh tiu cc, khng thc t v cc tnh hung Cch suy ngh ny thng xut hin t khi cn nh.
Bn nhn nhn cc tnh hung mt cch tiu cc, Mt s ngi ln ln trong gia nh ch c nhn xt
khng thc t, nhn mnh cc yu t tiu cc hoc tiu cc v ch trch ngi khc. Trong mt s gia
e da v qun i cc yu t tch cc hoc kh quan. nh, tr khng c khuyn khch ni iu tch cc v
bn thn v c thng khi bit t kim im mnh.
Suy ngh tiu cc, khng cng bng v bn thn
Bt k cch suy ngh tiu cc l do trm cm gy ra
Bn ngh v bn thn theo cch rt ch trch, nh gi
hay l thi quen t thi th u, cch suy ngh ny c
bn thn theo cch qu khc nghit v khng cng
nh hng rt ln n tri nghim ca bn v th gii.
bng.
Nhng cch suy ngh ny lm tng ln cc nh hng
Suy ngh tiu cc, khng thc t v tng lai
tiu cc ca cc tnh hung kh khn trong cuc sng
Bn d on tng lai s tht bi v nhiu tht vng,
v dn con ngi n nhng au n v cm xc. Mt
phng i kh nng c kt qu tiu cc.
ngi b trm cm c th cm thy chn nn hoc mt
hy vng ngay c khi mi vic tr nn tt p hn.
Chng ti gi tp hp ca 3 du hiu ny l Tam
Chng Tiu Cc: suy ngh tiu cc khng cng bng
v khng thc t v tnh hung hin ti, v bn thn
v v tng lai.

Cm xc
Trm cm thng bt u vi cm gic tht vng v Nh rng, ngi trm cm nhn nhn th gii theo cch
bun chn sau khi c gng x l tnh hung kh bi quan khng thc t v nh gi bn thn mt cch
khn trong cuc sng nhng khng thnh cng. Tuy khng cng bng v qu nghim khc. Cm xc ngi
nhin, v trm cm vn tip din, cm gic khng hnh trm cm cm thy nh hng rt nhiu t cch nhn
phc gy ra cm xc au n hn v nghim trng nhn tiu cc ca h v cuc sng. Nu suy ngh v
hn. Ngi mc trm cm b nh bi bi cm gic th gii ca h khng thc t v tiu cc, cm xc ca
tuyt vng, khn kh, v vng trn ngp. Cm giac hi h cng s khng thc t v tiu cc theo suy ngh .
hp cng thng (mt mi c th, lo lng v ni bt
C th bn thy kh c th c cm xc khng thc t.
hnh ang treo l lng trn u) thng i km vi
Nhng tng tng mt ngi lun tin rng i li bng
trm cm.
my bay l cc k nguy him v my bay hay b ri khi
Mt s ngi trm cm thy t lit v cm xc, mt kh ang bay. Ngi ny s cm thy rt s bay. Tuy
nng cm thy bt c cm xc g. Nguyn nhn l ni nhin, s s hi ny l da trn nim tin khng ng
au v tm l qu cng thng n mc tm tr ca bn v an ton ca my bay, do khng thc t v
mt ht cc cm xc. khng ng vi hin thc. Tng t, ngi trm cm
thng c nim tin khng thc t v th gii v bn
thn, dn n cm xc tiu cc, khng thc t.

Sinh l
Mt triu chng r rng nht ca trm cm l ri lon Mt l thuyt v trm cm cho rng trm cm l do mt
gic ng. Thng thng, trng thi ny biu hin l cn bng ni tit trong no. c nghin cu ch ra
khng th ng gic c th di dng kh ng hoc rng vi mt s ngi trm cm, mt s ni tit nht
thc gic nhiu ln khi ang ng hoc thc dy qu nh trong no t hot ng hn. Tuy nhin, vn cha r
sm. C nhng trng hp ng qu nhiu gy ra bi liu c phi s thay i ni tit trong no ny gy ra
mong mun mun trn trnh trong gic ng hoc qu trm cm. Tt c nhng g chng ta bit l trm cm
mt mi n mc lun cm thy thiu ng. Khi ng thng lin quan vi vic thay i ni tit trong no.
khng hi phc sc khe - ngha l khi thc dy
Nhng thay i v sinh l khi b trm cm khin cho
khng cm thy c ngh ngi v khe mnh -
ngi mc cm thy kh khn hn khi i mt vi vn
con ngi s cm thy kh khn hn khi i mt vi
ca cuc sng hoc ngay c khi thc hin cc
cc tnh hung v kh khn hng ngy. Ngi trm
bc trong chng trnh qun l trm cm ging nh
cm thng cm thy thiu nng lng v kit sc v
chng trnh ny. Cc thuc chng trm cm thng
cc hot ng thng ngy.
c tc dng hi phc li gic ng v nng lng. S
dng thuc chng trm cm gip bn c th hc v
th thc hin cc k nng mi cn thit vt qua
cn trm cm.

Hnh ng
Trm cm thng c nh hng ng k ln hnh vi ngi mc. Di y l mt s nhng hnh vi thng b
nh hng.
Khng tham gia cc hot ng gii tr
Cc hot ng a thch, lam th cng, chi th thao, c sch v du lch u c th b nh hng. Ngi trm
cm thng cm thy qu mt mi hoc khng c ng lc theo ui cc hot ng ny, do vy cng t thc
hin cc hot ng ny, ngi trm cm cng cm thy t c kh nng thc hin. Hu ht ngi trm cm mt
hng th trong cuc sng, gim cm gic vui v hoc hng th vi mi th xung quanh. Ti sao ti nn i xem
phim, tham gia hot ng gii tr hoc lm vic ti tng thch nu ti khng ngh rng ti s hng th vi cc
hot ng ? Khng hot ng tr thnh thi quen. Kt qu l ngi trm cm khng cn cm thy hi lng
khi tham gia cc hot ng ny, iu ny cng lm gia tng cm gic chn nn ca ngi trm cm.
Khng chm sc bn thn
Cc hnh vi chm sc c th v v b ngoi thng khng c quan tm. Ngi trm cm thng t quan tm
n qun o hoc n mc chnh t nh bnh thng. Thm vo , hot ng th cht cng gim, k c tp th
dc nh chy b hoc n gin i b xung quanh ni . Khng hot ng th cht lm tng trm cm v loi b
hot ng mang li s khe mnh v th cht v nng cao lng t trng. Ngi trm cm cng thng thay i
thi quen n ung c th n t (qun n) do n khng thy ngon hoc n qu nhiu t cm thy thoi mi
bn thn.

Khng lm cc vic nh thng ngy
Ngi mc trm cm thng xao nhng hoc tr hon nhng vic nh thng ngy nh lm vic vt, rc, dn
nh hoc ti cy, dn vn. Khng hon thnh cc vic vt trong ngy lm tng ln cm gic khng tha mn
v khng kim sot c cuc sng ca ngi trm cm. Vic khng hon thnh cc vic nh thng ngy c
th gy ra xung t vi mi ngi v gy ra thm stress cho cc mi quan h.
Xa ri gia nh v bn b
Ngi mc trm cm thng t chi tham gia cc hot ng x hi, khng nghe in thoi v khng t tp gia
nh hoc bn b. Thu mnh khi x hi nh hng nhiu n tm trng trm cm v ly i s m p v cm
gic kt ni vi mi ngi cn thit cho tt c chng ta. Ngi trm cm thng tin rng mi ngi khng thch
giao tip vi h v h khng c cm xc g hoc rt bun chn.

BN C TH LM G KHI B TRM CM?
TRM CM NH
Ni chuyn vi gia nh v bn b tin cy v cm Ni chuyn vi bc s gia nh, chuyn gia tm l
gic ca bn l vic nn lm. H c th gip bn hoc bc s tm thn. Ngi c chuyn mn c th
tm ra gii php cho vn ca bn; bn cnh , gip bn l gii chuyn g ang xy ra v c th a
ch cn bit c ngi quan tm n bn cng ra cc gi hu ch.
gip ch cho bn.
Trong mt s trng hp, cc thuc chng trm
Vit ra giy vn m bn ang gp phi, cm cm c th gip vt qua Chng Trm Cm Nh.
gic, suy ngh ca bn v cc gii php c th thc Nhng vi a s trng hp trm cm nh, cu tr
hin. Cch ny c th gip bn hiu bn ang tri li khng nm thuc chng trm cm.
qua nhng g v bn c nhng la chn no.
Hc v luyn tp cc k nng kim sot trm cm theo nhng hng dn nay co th se

rt hu ich trong vic giup ban vt qua chng Trm Cam Nh.

BAN C TH LM G KHI B TRM CM?
TRM CM NNG
Ngoi nhng hnh ng bn c th lm c miu t php hng dn cc k nng suy ngh v hnh
trong phn Trm Cm Nh ng hiu qu hn. Hng dn ny c pht trin
da trn cc phng php CBT.
Chc chn bn nn i n gp bc s nu bn ngh
mnh b trm cm nng. Trm Cm Nng l vn Mt liu php iu tr hiu qu na l Liu php
nghim trng v nn c bc s gia nh, chuyn cng c mi quan h c nhn (IPT), liu php ni
gia tm l hoc bc s tm thn chn on. chuyn nhm hng dn cc k nng giao tip vi
ngi yu, bn b v gia nh.
Cc thuc chng trm cm c ch nh ph bin
vi Trm Cm Nng v thng c tc dng. i vi cc trng hp trm cm ko di hoc ti
pht, phng php tip cn hiu qu nht l kt
Mt cch iu tr cng c hiu qu tng ng
hp thuc chng trm cm vi mt trong cc liu
cho phn ln cc trng hp Trm Cm Nng la
php ni trn.
Liu Php Nhn Thc Hnh Vi (CBT). CBT l liu
Hc v luyn tp cc k nng kim sot trm cm trong hng dn ny c th gip

vt qua chng Trm Cm Nng. NHNG hy nh rng cc k nng trong cun sch ny
khng x l cc vn nghim trng. Nu bn b Trm Cm Nng, bn nn tm
kim s gip ca ngi c chuyn mn.

THUC CHNG TRM CM
huc pht huy tc dng trong mt s trng hp. Rt nhiu ngi s dng
T thuc trm cm ci thin c tm trng v thuyn gim mt s triu

chng (nh mt cm gic ngon ming hoc kh tp trung).
Nhng thuc ch c tc dng ci thin tm trng: vic Thay vo , hy suy ngh thuc gip bn c nng
thay i cch suy ngh v x l cuc sng hng ngy lng v ci thin tm trng bn c th thay i
cng rt quan trng. ng s dng thuc nh mt (nh bt u tp th dc hng ngy, hc cc k nng
cch cho php bn duy tr cch sng khng lnh mnh ra quyt nh hoc lp k hoch v lm vic t
c cc mc tiu cuc sng ca bn).

THUC CHNG TRM CM
Mt s im cn ch khc v thuc:
Cc loi thuc khc nhau c tc dng khc nhau trn Vic s dng thuc trong thi gian ko di c th c li
cc c th i vi mt s ngi
C th mt thi gian tm ra loi thuc (hoc phi i vi mt s ngi, thuc chng trm cm vn c
hp cc thuc) ph hp vi mt bnh nhn m khng hiu qu khi s dng ko di. Phn ln bnh nhn ch
gy ra qu nhiu tc dng ph. Cc tc dng ph c s dng trong thi gian ngn c th c nhng thay
th l kh ng, thay i cm gic ngon ming v mt i tch cc, sau gim dn v ngng s dng thuc.
hng th tnh dc.
Bn c th mun ngng thuc ngay khi tnh trng ca

Khng bao gi ngng thuc t ngt bn c ci thin n mc mong mun
Mt s ngi gp tc dng ph khi s dng thuc Kt qu ca vic ngng thuc sm l trm cm ti pht
chng trm cm nn mun ngng thuc. Nu bn nhanh chng. V vy tt nht bn nn tip tc s dng
mun ngng thuc, hi kin bc s k n. Thng thuc cho n khi tm trng n nh. Khi tm trng
thng, bn s gim dn liu dng trc khi ngng ca bn c kim sot, bn c th gim thuc dn
thuc hon hon. dn.

CC K NNG KIM SOT TRM CM
Thit lp li
cuc sng ca bn
Gii quyt
vn
Suy ngh mt
cch thc t
rong phn ny, bn s hc ba k nng c th lm ngng tm
T trng chn nn, gim trm cm v gip ngn nga ti pht.

Cc k nng l:
Thay i Cch Sng Suy Ngh Thc T Gii Quyt Vn
Chng ti s gii thch cc k nng ny s gip bn Trm cm nh hng n tt c mi mt trong cuc

vt qua trm cm nh th no v ch cho bn tng sng ca bn: cm xc, suy ngh, hnh ng, th cht
bc lm th no s dng cc k nng ny. Tt v tnh hung cuc sng (bao gm h tr x hi, mi
nht, bn nn ngh v vic hc cc k nng ny nh quan h gia nh, ngh nghip, ti chnh v hn th
khi bn ang hc mt cng vic mi hoc b mn th na). Mi kha cnh li lin quan n nhau. Kt qu l,
thao mi: luyn tp rt quan trng. Mt s ngi thy s thay i mt kha cnh c th to ra s thay i
nn chia s cun hng dn ny vi v/chng, bn trong cc kha cnh khc. Khi mi b trm cm, s
b, ngi t vn hoc thnh vin gia nh - hoc vi thay i tiu cc trong mt kha cnh lm cc kha
ngi c th gip bn duy tr vic luyn tp c khi bn cnh khc xu i. Nhng khi bn luyn tp ci
thiu nng lng hoc ng lc thc hin. Nu bn thin tnh trng ca mnh, s ci thin trong mt kha
khng c ai nh vy, hy duy tr vic luyn tp cc k cnh s ci thin cc kha cnh khc. Mc ch ca
nng kim sot trm cm. Khi bn luyn tp c cc vic iu tr l gip cho tt c cc kha cnh trong cuc
k nng, mi vic dn dn s tr nn d dng hn v sng ca bn c ci thin, mi kha cnh c s thay
kt qu thu c s xng ng vi s n lc ca bn. i tch cc c th ci thin cc kha cnh khc.

THIT LP LI CUC SNG CA BN
Thit lp li
cuc sng ca bn
Gii quyt
vn
Suy ngh mt
cch thc t
hi b trm cm, phn ln ngi b trm
K cm khng lm nhng vic bnh thng

gip h c tm trng tch cc.
Nhng nu bn ngng chm sc bn thn hoc khng Trm cm dn n khng hot ng, nhng khng
lm nhng vic bnh thng bn thch, cuc sng ca hot ng lm cho tnh trng trm cm nng hn. iu
bn tr nn bun chn v c ch. Mc d c th bn bn tng l gii php tt i ph vi tnh trng
cm thy vic t hot ng hn lm bn thoi mi, thc trm cm li lm duy tr hoc trm trng thm tnh
t, bn ang gip trnh trng trm cm tr nn nng n trng trm cm. Gii php: ng i cho n khi bn
hn. Ni cch khc: cm thy mun hot ng hn. Ch i ch cng ngn
bn lm cho mi vic kh hn. V ng i cho n
khi bn cm thy c ng lc - khi bn cm thy kh
hn, bn s cm thy c ng lc hn. Trc ht hy
hnh ng, ng lc s xut hin sau . t cc mc
TRM CM KHNG HOT NG tiu tng mc hot ng ca bn l phng
php hiu qu kim sot trm cm.
Mc tiu l lm cho bn hot ng dn dn mc d
bn c th khng cm thy thch. Di y l cc
bc bn dn dn thay i cch sng.

Bc 1: Xc nh cc hot ng cn tng cng

C bn loi hot ng m ngi trm cm thng xc nh mt s mc tiu, hy suy ngh v tng loi
trnh. l: T tp vi gia nh v bn b; Cc hot hot ng ny. Lit k mt s hot ng trong mi loi
ng gii tr; T chm sc; v Cc vic vt. b nh hng bi tnh trng trm cm (hoc b sao
nhng k c trc khi b trm cm) v c th trm
trng hn.
Cc hot ng gii tr
V d:
c bo. i b gia thin nhin. Lm th cng hoc s thch. Ln k hoch i du lch.
Xem phim, kch hoc chi tr chi.
Tng hot ng trong loi hot ng ny s to nn s khc bit v:

1. Nhc nh cho bn v s thch, nhng iu quan trng vi bn
2 Cho bn s th gin rt cn thit khi trm cm bt u gia tng
tng ca bn:

T Chm Sc
V d:
n mc p hng ngy. Dnh thi gian tm ra v v sinh c th. Tp th dc. n sng. n thc n nhiu dinh
dng. (Cc phong cch sng lin quan n gim trm cm c tho lun trong phiu thng tin cui sch).

1. Trc tip nng cao sc khe th cht ca bn
2. Nhc nh cho bn rng bn l ngi c kh nng
tng ca bn:

Cc Vic Vt
V d:
Kim tra hm th. Tr cc ha n. V sinh nh ca. Mua dng trong nh. Lm vic lt vt trong nh.

1. Tng cm gic kim sot cuc sng ca bn
2. Gim s cng thng trong mi quan h vi ngi khc v bn bt u chia s cng vic nh
tng ca bn:

T tp vi gia nh v bn b
V d:
Mi mi ngi tham gia hot ng no . Gi lin h vi ngi bn tng sng cng. Tr li cc cuc in
thoi. Tham gia lp hc hoc nhm x hi.

1. Gip bn ly li cm gic kt ni vi mi ngi
2. Cho mi ngi c hi an i v gip bn
3. Gip bn khng b c n v trnh cc suy ngh tiu cc
tng ca bn:

Bc 2: Chn hai trong s cc hot ng

T cc hot ng c nu bc 1, la chn hai hot ng ph hp nht vi bn bt u thay i. Hai
la chn ny nn thuc hai loi hot ng khc nhau.
Hot ng 1:
Hot ng 2:

Bc 3: t cc mc tiu thc t
t mt mc tiu c th t c cho mi hot ng m Nu bn mun dn dp nh ca, mc tiu u tin ca
bn la chn trong tun ti. Ghi nh rng tnh trng bn c th l ht bi mt phng hoc lau bi gi sch.
trm cm lm bn cm thy kh khn khi thc hin k Nu bn mun giao tip li vi mi ngi, mc tiu u
hoch. Do , bn cn t mc tiu thp hn so vi bnh tin ca bn c th l ni chuyn in thoi vi mt
thng. ngi bn trong vng nm pht
V d, bn mun p xe p li, mc tiu u tin ca

bn c th lm tm xe p ca bn v kim tra xem liu
c cn sa xe khng.
thnh cng, mc tiu ca bn phi:
C th
Trm cm c th lm cho tt c mi th dng nh u tht bi. Bn cn c mt tng v mc tiu rt r rng
gip bn bit bn thnh cng.
Thc t
Bn c th t t mc tiu cho mnh da trn mc bn ngh bn c th hon thnh. ng lm nh vy. Nh rng
tnh trng trm cm s lm bn chm i v lm mi vic kh khn hn. Mc tiu ca bn nn d dng thc hin
ngay c khi nu bn cm thy rt trm cm trong tun ti. i khi, bn cm thy qu ti khi ngh v vic bt u
phi hot ng mi. Trong trng hp ny, c gng t mc tiu thu thp thng tin lin quan n hot ng: v d,
tm kim thng tin v vic loi hnh th dc no sn c trong khu vc bn sinh sng.
Ln k hoch chi tit

Bn nn c tng r rng v vic bn s thc hin mc tiu khi no v nh th no. i b trong 15 pht vo ti
th Nm tt hn l i b nhiu hn.

Bc 3: t cc mc tiu thc t, tip theo

Di y l mt v d:
Minh khi u vi hai mc tiu: tng dn mc hot ng th cht (t khng i b n i b ngn mt ln mi tun)
v tng mc tham gia hot ng x hi (t khng i ra ngoi n i ra ngoi vi v v con gi hai tun mt ln).
Mc tiu ca Minh s nh sau:
HOT NG MC THNG XUYN CHNH XC KHI NO?
i b, 15 pht Bt u mi ln/ tun Ti th nm
Ra ngoi vi v v con 2 tun mt ln Ti th By hoc Ch Nht
Anh y s dng quyn s ghi chp lch hn vit cc hot ng. Sau khi thc hin, anh y s nh du
vo s.

Bc 3: t cc mc tiu thc t, tip theo

C gng t mt s mc tiu thc tin thc hin trong tun ny. Quyt nh mc thng xuyn hoc tn sut
bn s thc hin hot ng v khi no bn s thc hin.
By gi hy vit ra cc mc tiu ca bn:

HNH NG MC THNG XUYN CHNH XC KHI NO?
1.
2.
Ngh v cc mc tiu hot ng nh cc cuc hn vi Ghi ch: ng t thng mnh v lm c nhiu

chnh bn. Tn trng cc mc tiu nh khi bn hn hn l mc tiu t ra. Nu bn lm c nhiu hn,
khm bc s. Nu bn phi hy mt trong hot ng m cng tt thi, nhng nh vy khng c ngha l bn
bn d kin, ln k hoch li ngay lp tc v ng c php b k hoch thc hin hot ng tip theo.
b l. Nu bn tnh trng ny s xy ra, mc tiu ca bn
s sm b sao nhng.
Bn nn mua quyn s ghi lch hn theo di cc mc tiu ca bn. Khi bn hon

thnh mt mc tiu, nh du vo cun s cho bn thy bn hon thnh c g -
trong giai on c gng ban u ny, chnh l phn thng cho s n lc ca bn.

Bc 4: Thc hin mc tiu

Mt iu quan trng bn cn nhn ra rng bn c th Chng c ngha, nht l trong tnh trng trm cm.
s khng cm thy thch thc hin cc mc tiu hot Nu bn thy mnh coi nh thnh tch ca bn thn
ng ca bn. Khi b trm cm, ng lc lm mi (nhng vic ch l vic qu nh), hy nh hon
vic ca bn u thp hn bnh thng. Nu bn i thnh mc tiu nh khi b trm cm ging nh i b
cho n khi bn thch lm, gn nh chc chn l vic mt qung ngn vi ba l rt nng trn lng. t mc
s khng xy ra. Hy hnh ng v bn t mc tiu khi b trm cm l mt vic thch thc v xng
tiu cho bn thn v v vic s gip bn kh hn. ng chc mng.
Sau bn thc hin v nh du mc tiu bn
Nu bn khng thnh cng, iu g ngn tr bn? Bn
thc hin, bn s thy mnh hon thnh c g.
c th lm g t mc tiu d dng hn? C th mc
Trong giai on u hi phc ca trm cm, bn c tiu ca bn qu cao. C gng h thp mc tiu trong
th khng cm thy vui thch vi cc hot ng mnh tun ti hoc thay th bng mc tiu khc. Ngi trm
lm, nhng khi bn bt u tng mc hot ng v cm thng t mc tiu qu cao, khng th t c
tp trung vo vic hi phc, bn s dn dn ly li mc tiu v tr nn chn nn. Vn l ngi trm
c kh nng vui thch vi hot ng ca mnh. Thm cm thng li bing, nhng h qu nn nng ci
ch bn s c ly li c kh nng to ng lc cho thin tnh hnh!
bn thn!
t mc tiu m bn chc chn bn c th lm c,
Nu bn hon thnh mt mc tiu, bn c t chc thm ch nu tun ny bn khng cm thy kh hn
mng khng? Nu khng, hy t chc mng bn thn tun trc. Ra mt ci bt, gi mt cuc in thoi,
ngay by gi. Trm cm lm cho bn tp trung vo tr mt ha n, i b xung quanh khu nh hoc dnh
vic bn khng lm c v l i hoc coi nh nhng nm pht cho s thch ca bn: u l cc mc tiu
vic bn lm. c im ny lm cho tnh trng trm hp l. Khi nng lng ca bn tr li, bn s c
cm tip din, v bn tip tc cm thy mnh tht bi. th lm nhiu hn. Nhng by gi, hy cho php mnh
Nhc nh bn thn v thnh tch ca bn bt k l bt u mt cch chm ri.
thnh tch nh b nh th no. n ri, mnh ln
k hoch i b xung quanh khu nh v mnh thc
hin. Tt. ng qun nhng chin thng nh b hoc
ngh rng chng khng c ngha g.

Bc 5: Xem li cc mc tiu ca bn
Sau hai tun thc hin cc mc tiu, xem xt li tnh trng ca bn
Bn c mun tng mc tiu ln mt cht khng hoc gi nguyn mc nh vy cho n khi bn cm thy thoi
mi? l la chn ca bn.
y l thi im tt thm mt mc tiu mi. La chn mt mc tiu t mt loi hot ng khc. V d, nu
bn c mc tiu Chm sc bn thn v Cc hot ng gii tr, la chn mc tiu T tp vi gia inh v bn
b hoc mc tiu Cc vic vt.
Hnh ng mi:
HNH NG MC THNG XUYN CHNH XC KHI NO?
Vit mc tiu mi vo lch ca bn cng vi hai mc tiu c. Hy nh nh du mc tiu bn thc hin v t

chc mng bn thn khi hon thnh n.
Sau hai tun thc hin cc mc tiu ny, xem xt li t cho bn 3 mc tiu.
tnh trng ca bn. C mc tiu no cha c thc Vit vo lch ca bn.
hin khng? iu g ngn tr bn? Bn c cn gim nh du mc tiu bn thc hin.
hoc thay i mc tiu khng? T chc mng bn thn mi khi thc hin c mt
mc tiu.
Xem xt li cc mc tiu hai tun mt ln quyt
Thc hin k hoch ca mnh! Tip tc t ra cc mc nh liu bn c cn sa i hay khng v liu bn
tiu v xem xt b sung thm mc tiu nu nng lng c cn t mc tiu mi hay khng.
ca bn cho php. Nu bn hon thnh mt nhim v
(v d nu bn hon thnh thu thp thng tin v cc Cui cng, bn s thc hin 3-4 mc tiu hoc nhiu
hot ng gii tr trong khu vc bn sng), hy chuyn hn cng mt lc. ng qun rng t ra qu nhiu
sang mt mc tiu mi. Duy tr qui trnh sau: mc tiu c th lm bn qu ti.

SUY NGH MT CCH THC T
Thit lp li
cuc sng ca bn
Gii quyt
vn
Suy ngh mt
cch thc t
ch suy ngh tiu cc lch lc lm trm
C trng thm tnh trng trm cm. Chng

ti gi l suy ngh trm cm
Suy ngh trm cm l khng thc t v khng cng bng: C phi chng ta mun t nh la bn thn rng
Suy ngh tiu cc, khng thc t v tnh hung ca khng c vic g xu s xy ra khng? Khng. Vt
bn; qua suy ngh trm cm khng c ngha l thay th n
Suy ngh tiu cc, khng thc t, khng cng bng bng suy ngh tch cc lch lc (ai cng yu qu ti,
v bn thn; khng c g xu c th xy ra, ti s lun t c iu
Suy ngh tiu cc, khng thc t v tng lai ca ti mun). Mu cht l suy ngh mt cch khng thc
bn. t d l tch cc hoc tiu cc u lm chng ta cm
Mc ch ca chng ta l thay th suy ngh trm thy v c x mt cch khng ph hp. Mc tiu ca
cm bng suy ngh thc t. chng ta l nh gi cuc sng v bn thn mt cch
thc t. Mc tiu l suy ngh cng bng v thc t.
Suy ngh thc t l:
Suy ngh ng vi tnh hung, nhn mi th r rng iu c ngha l cng bng v thc t v bn thn
nh bn cht ca chng (ch vo kh nng v th mnh cng nh im yu),
Cng bng vi bn thn, nhn cc kha cnh tiu v tnh hung hin ti (cn nhc kha cnh tch cc v
cc v tch cc trong cuc sng ca bn mt cch tiu cc ca cuc sng mt cch chnh xc) v v
cn bng tng lai ca bn (khng phng i kh nng c kt
Suy ngh ng v tng lai ca bn, khng phng qu tiu cc). Nh vy, lm th no bn thay i
i tin on tiu cc suy ngh trm cm?
Mc tiu ca vic i ph vi suy ngh trm cm l g?
Mc tiu c phi l lun lun suy ngh tch cc khng?
Lm theo cc bc sau

Bc 1: Hc cch xc nh cc suy ngh trm cm

Cc suy ngh trm cm khng cng bng v khng thc t. Chng lch lc bi v chng phn nh khng chnh xc
v th gii hoc v bn. Bng di y (v tip tc trang tip theo) m t mt s dng thng gp ca cc suy
ngh lch lc trong trm cm1:
Chn lc
Trong suy ngh trm cm, bn ch nhn thy iu xu, khng bao gi nhn thy iu tt. V bn ch nhn thy phn
tiu cc, cuc sng ca bn c v ch c tiu cc. Nhng suy ngh thc t cn nhc cn bng gia kha cnh tch
cc v tiu cc ca cuc sng ca bn.
Qu khi qut ha
Trong suy ngh trm cm, mt s kin tiu cc dng nh l khi u khng bao gi kt thc cho nhng s kin
tiu cc khc. Nu mt ngi bn ra i, tt c ngi khc cng s ra i. Nu bn tht bi ln u, bn s lun lun
tht bi. Nhng suy ngh thc t nhn nhn ra rng tnh hung ng tht vng va xy ra khng quyt nh cc tnh
hung khc s nh th no.
Suy ngh tt c hoc khng g c

Bn nhn th gii mt cch cc oan. Bn ch c th bo hoc gy, thng minh hoc ngu ngc, sch s hoc ba
bi, trm cm hoc vui v, v tng t. Khng c g nm gia hai thi cc. Ci thin dn dn khng bao gi l
v ch c s thay i hon ton mi c th c tc dng. Ai qun tm n vic ti lm c mt na cng vic?
Cng vic vn cha xong m! Nhng suy ngh thc t nhn nhn con ngi v s kin gia hai thi cc, u
mc trung lp.
Bi kch ha
L mt cuc hn nh c nhn nhn nh mt thm ha. V d, bn hon thnh mt d n nh hi mun, th l coi
nh c thng ca bn hng; bn phn ng vi bi kch tng tng (thng ti t) hn l vi s kin nh (d n b
mun). Nhng suy ngh thc t nhn nhn s kin theo ng tm quan trng ca n, khng phng i cc s kin
tiu cc.
T nh gi bn thn
Bn t nh gi bn thn mt cch nghim khc, t gi mnh l ngu ngc, k tht bi hoc bt k t g xc phm
bn nht. Bn ni vi mnh theo cch m bn s khng bao gi ni vi ngi khc. Nhng suy ngh thc t khng
s dng cch xc phm bi v cch khng cng bng, bn s khng ni vi mi ngi cch v cch gy
tht vng mt cch khng cn thit.
1 Cc kiu suy ngh lch lc ny c m t trong mt cun sch rt hay, Cm thy sung sng - Feeling Good ca David Burns (Avon, 1992).

Bc 1: Hc cch xc nh cc suy ngh trm cm (tip)

c suy ngh
Bn cm thy nh bn bit ngi khc ngh g v mnh v bn ngh l ngi khc lun ngh mt cch tiu cc. Do
bn c x nh cch bn tng tng ngi khc ngh v mnh m khng cn hi. Nhng suy ngh thc t nhn
ra rng vic phng on suy ngh ca ngi khc rt c th khng chnh xc, nht l khi bn b trm cm.
D on tng lai
Bn cm thy nh th bn bit tng lai s nh th no v tng lai ca bn rt tiu cc. Khng c g tt p c,
vy ti sao li phi c gng? Nhng suy ngh thc t nhn ra rng bn khng bit mi vic din ra nh th no: bng
cch ci m vi kh nng tch cc c th xy ra, bn c th c nhiu hi vng hn v c th lm mi vic tt p hn.
Qu cu ton
Ch c hon ho mi tt. V bn khng th lm mi th mt cch hon ho, bn him khi hi lng v t ho v bt
c iu g. Nhng suy ngh thc t cho php bn hi lng khi t mt thnh tch no , ngay c khi kt qu khng
c hon ho. Ch c mt s t ngi c th hon thnh hon ho cng vic mnh lm, nhng nhng g chng ta
t c l ng c hi lng.
Nn
Bn ngh rng bit th gii ny nn th no v thc t khng nh vy. Bn bit bn nn nh th no v bn khng
c nh vy. Kt qu: Bn lin tc tht vng v gin vi bn thn v vi mi ngi xung quanh. Nhng suy ngh
thc t hiu gii hn ca th gii v bn thn - c gng ci thin nhng cng chp nhn thc t.
C nhiu loi suy ngh trm cm khc nhau, nhng c mt s loi ph bin nht. Khi bn thy mnh suy ngh trm
cm, bn nn c danh sch ny xem mnh c suy ngh nh vy khng.

Bc 2: Nhn ra suy ngh trm cm ca bn thn v cch m nhng

suy ngh ny gy ra tm trng chn nn
Hu ht cc suy ngh rt nhanh v t ng nn chng Mnh ang suy ngh v ci g? Bn ang c x nh th
ta khng nhn ra chng ta suy ngh nh vy. Chng no? Hy vit cu tr li ra giy. V d, khi bn ln xe
ta phi hc cch t thc khi mnh xut hin suy ngh but vo bui sang, bng nhin bn cm thy rt bun
trm cm. Mt chin lc rt hiu qu l mang theo ru. Bn ang suy ngh iu g? C th bn rng
bt v giy trong vng mt tun l. tt c mi ngi trn xe but ang nhn bn, v bn c
suy ngh rng h ang nh gi bn tiu cc. Tt! Hy
vit ra giy.
Mc d suy ngh trm cm ging nh m my en
Lu li suy ngh ca bn cho n khi bn nhn ra mt
bao ph bn, thc t n cng thay i trong ngy. Khi
loi suy ngh trm cm c lp i lp li. Bn c th thy
tm trng bn i xung, t hi bn thn cu hi quan
mnh nh du bn cnh mt s suy ngh m bn
trng sau:
vit i, li ngh th ri y. Khi iu xy ra, bn c
th xc nh mt s loi suy ngh trm cm thng gp
Trong u mnh va c suy ngh g? nht ca bn.
Hy vit mt s suy ngh trm cm ca bn:
Sau th lm g? Mt s suy ngh trm cm r rng C th bn s thy cc suy ngh trm cm t nghim
l lch lc. i , l do tt c mi ngi nhn mnh trng hn khi bn bit chng n t u. Khi chng ta
trn xe but l do mnh ng ng trc, ch khng thc v cc suy ngh trm cm, chng ta c th cm
phi v h mun nh gi mnh! i khi ch cn bit thy mun tn cng bn thn. Lm th no m mnh c
rng vi tnh hung no, suy ngh trm cm xut hin th suy ngh ngc ngch nh vy nh? Trm cm lm
cng l . C gng thc khi suy ngh trm cm cho bn t ch trch v nhn ra rng suy ngh trm cm
xut hin v nhc bn suy ngh n t u. Ti suy c th nh bi chnh bn. ng lm nh vy. Thay vo
ngh nh th bi v tm trng ti ang bun chn v , nhc bn thn rng suy ngh trm cm l kt qu
bi ti l a tr bit thc sm - ch khng phi ca tm trng bun chn v ca qu kh ca bn. Bn
bi v tt c mi ngi ang nh gi ti. khng ngu ngc v suy ngh nh vy. Nhng suy ngh
nh vy l bnh thng khi b trm cm.

Bc 3: Hc cch thch thc cc suy ngh trm cm v thay th

chng bng cc suy ngh cng bng v thc t
Thch thc cc suy ngh trm cm bng cch suy ngh Ly mt t giy v chia thnh cc ct nh v d di
thn trng li tnh hung lm bn bun. lm iu y. cui sch cng c mt biu mu ny. Bn c
ny, bn c th s dng chin lc Thch Thc Suy th sao ra nu bn mun.
Ngh Trm Cm.
Thch Thc Suy Ngh Trm Cm
Tnh hung: Bn cua ban hy bui hn n tra.
SUY NGH TRM CM SUY NGH THC T
C y khng thch mnh. Mnh khng bit ti sao c y li hy cuc hn; c th c

(c suy ngh) vic gp. ch l ba tra thi m.
Khng ai thch mnh. Mnh chn cht. Mt s ngi c v khng thch mnh, mnh s phi c lm
(Qu khi qut ha) mi ngi thch mnh hn.
Cuc sng ny tht c n, t nht v ai cng Mt ba tra khng c lin quan n c th gii. Mnh
chi b mnh. (Bi kch ha) c mi ngi chp nhn trc y.
Mnh s lun c n. Mnh khng th bit trc c tng lai. Mt ba tra

(D on tng lai) khng c ngha l khng c ai thch mnh.
u tin, vit ngn gn v tnh hung ca bn. V d: Ni chuyn vi con gi, i b n ch lm, Ln k hoch
nu ba ti. Sau , vit ra cc suy ngh tiu cc c v lin quan n cm gic ca bn. Nu thch, bn c th th
lit k mt s suy ngh tiu cc (nh trn).
Cui cng, suy ngh v tnh hung v c gng nh gi tnh hung mt cch cng bng v thc t hn. Gi : Suy
ngh trm cm thng l nhng suy ngh vt qu thc t. Thng thng suy ngh thc t v cng bng ch nhc bn
thn bn rng bn khng c thng tin bit chc iu g ang xy ra. Ti khng bit ti sao c y hy bui hn
n tra; c th c hng trm l do cho chuyn .

Bc 3: Hc cch thch thc cc suy ngh trm cm v thay th bng

cc suy ngh thc t v cng bng, tip tc
T gi mnh l ngu ngc s lm bn cm thy tht Khi bn bun hoc trm cm, khng d dng suy
vng hn; kt qu l bn t b. Nhng t khuyn khch ngh cng bng v thc t. Di y l mt s cu hi
mnh v nh gi cng bng s gip bn n lc hn v s gip bn suy ngh tch cc hn.
tng kh nng thnh cng.
Suy Ngh Trm Cm:
Ti c th tm thm bng chng chng hn nh hi kin ai v tnh hung ca mnh?
Hu ht mi ngi c ng h suy ngh ny khng? Nu khng, suy ngh thc t hn l g?
Chng ti thng suy ngh thc t hn v ngi khc hn l v bn thn. Nu bn ti gp tnh hung tng t,
ti s ni g vi bn o?
iu g s xy ra nu ti tip tc suy ngh nh vy?
Cch suy ngh no c tnh ng vin bn thn hoc hu ch hn?

Bc 3: Hc cch thch thc cc suy ngh trm cm v thay th bng

cc suy ngh thc t v cng bng, (tip)
By gi, hy s dng cc cu hi trn suy ngh thc t hn v tnh hung lm bn bun. Lu rng suy ngh thc
t s lm bn cm thy tt hn l suy ngh trm cm.
Tnh hung:

Bc 4: Luyn tp suy ngh thc t.

Ch mt ln suy ngh cng bng v thc t l khng . tun tp luyn cc k nng kim sot trm cm.
Suy ngh trm cm thng lp li v ko di, c khi
Mt s tnh hung nht nh c th gy ra cc suy ngh
hng nm cho n khi cch suy ngh ny tr thnh t
trm cm. Cc tnh hung thng gy ra suy ngh trm
ng. Cch suy ngh cn bng hn s gip bn cm
cm bao gm gp sp, gp mt vi nhiu ngi bn
thy tt hn, nhng cch suy ngh ny khng t ng
khng bit r hoc tranh ci vi mt thnh vin ca gia
n - t nht khi bn mi tp thay i. iu tt l thay i
nh. co li nht cho ban t cch tip cn nay, bn
cch suy ngh trm cm khng mt thi gian n hng
cn t nhn ra cc tnh hung thng gy ra cc suy
nm: trong thc t, ngi trm cm thng bt u
ngh trm cm cho bn.
nhn thy s thay i v mt cm xc ch sau mt vi
Th ngh n mt vi tnh hung thng lm bn suy ngh trm cm.

Hy vit ra:
1.
2.
3.

Bc 4: Luyn tp suy ngh thc t, (tip)

Khi bn gp phi mt trong cc tnh hung trn, thn C th khi mi th cc suy ngh thc t, bn c th
trng nhc li cch suy ngh thc t v cng bng. thy cch suy ngh ny khng ng vi bn. V d: bn
ng ngh rng cch suy ngh tch cc ny t n. yu cu cng vic ca bn phi hon ho v ni
Bn phi t ni vi mnh v cch bn s nhn nhn vi bn thn rng ti phi hon thnh cng vic 100%
tnh hung nh th no ging nh khi bn ang cho hoc nu khng th khng c gi tr g c nhng bn
bn li khuyn hoc khuyn khch mt ngi bn. Ni c qu t thi gian hon thnh cng vic, nn bn
ngc li suy ngh trm cm. ng cho php suy ngh thng cm thy mnh tht bi. Bn nhn ra rng cch
trm cm n m khng phn ng li. Mi khi bn ni suy ngh ny khng thc t v chuyn sang cch suy
ngc li suy ngh trm cm, bn lm suy ngh trm ngh cng bng v thc t rng hon thnh 80% cng
cm yu i v suy ngh thc t mnh ln. Nhng cn vic ny trong thi gian ngn nh vy l chp nhn
c thi gian trc khi cc suy ngh thc t c nh c ri; l mc ti a nhng g nhng ngi khc
hng vi bn nhiu hn l cc suy ngh trm cm. c th lm c. u tin, cch suy ngh thc t ny
c v nh khng ng, ging nh bn ang la di
bn thn. Theo thi gian v lp li cch suy ngh thc
t - s tht - bn s cng cm thy cch suy ngh thc
t s ng vi bn. Cui cng, bn s i ti chp nhn
cc suy ngh thc t.
TI C HT SC. C TRCH C MNH L

KHNG CNG BNG. TI C BN B, V TI LM
VIC TT. Y L MT CNG VIN P.

GIAI QUYT CAC VN MT CACH HIU QUA
Thit lp li
cuc sng ca bn
Gii quyt
vn
Suy ngh mt
cch thc t
rm cam thng l kt qu ca vn qu ti trong cuc sng
T Cc chin lc gii quyt cc vn ny thng khng hiu qu

hoc thm ch lm trm trng thm vn .
Ti sao mi ngi li b trm cm, c phi l kh nng V tt c cc l do trn, khng c g ngc nhin khi cc
gii quyt vn ca h gim i khng? C mt s l vn khng c gii quyt m thay vo chng
do nh sau: cht thm. Vy bn phi lm g? u tin, nhn ra
Gii quyt vn lm tiu tn nng lng. Khi tnh rng kh nng gii quyt vn ca bn khng tt
trng trm cm tng ln, mc nng lng gim i. nh trc kia. ng t nh bi mnh v l do .
l triu chng bnh thng ca trm cm v tnh trng
Cc vn hng ngy gy ra vn ln hn - trm
ca bn c th tt hn. By gi, hy ngi li v lm
cm. V quan tm nhiu hn n vn tm trng,
theo cc bc tip theo
cc vn khc khng c x l v trm trng
hn.
Trm cm lm mt tp trung, gim tr nh, gim
kh nng ra quyt nh v sng to. Phn ln bn
cn cc k nng ni trn gii quyt vn .

Bc 1: La chn mt vn
Bc u tin trong gii quyt vn chnh l la chn trc khi tm trng bn thay i? Nhng chuyn bin
vn . Nhng ngi b trm cm i khi gp phi trong tm trng ca bn c th l mt ch dn hu ch
nhng kh khn trong vic xc nh cc vn c th gip bn xc nh ngun gc ca vn .
trong cuc sng ca h. H cm thy gp kh khn
Mt s vn ca bn c th l nhng vn ln (v
trong mi vic. Vic xc nh mt s vn c th cn
d: Tun ti ti s b tch thu ti sn), hoc c th l
u tin x l l hu ch i vi h. Vic ny s gip h
nhng vn nh (Ti s cn c rt nu ti mun lm
tm ra cc cu tr li mang tnh thc tin.
salad ti nay). Cc vn khc c th nm u
Mt cch xc nh vn l ch n s thay i gia hai mc ny (C mt tp th trn bn ca ti
ca tm trng bn thn trong sut tun. Lu iu g m ti khng th c can m nhn vo n trong
ang xy ra khi tm trng bn i xung: bn ang ngh sut tun qua).
ci g; bn ang u; v chuyn g xy ra ngay
Chn la mt trong nhng vn nh ang din ra. ch ra c vn y l g. Bn thn nht ca ti

Sau ny, bn c th la chn vn ln hn. C gng khng gi in cho ti c thng ri: l c th hn
din t vn mt cch tht c th. V d: Cc mi v ch ra r chuyn g khng bnh thng ang xy ra
quan h ca ti rt phc tp: l cha c th v cha v bn mun thay i ci g.
Vn bn chn l:

Bc 2: Suy ngh nhng hnh ng gip gii quyt vn

Vit ra ba iu bn c th lm gii quyt vn . gng nhng khng c kt qu - tnh hung khng thay
Cn nhc n nhng vic bn c th lm m khng b i. V ng lo lng liu nhng hnh ng ny c gii
ph thuc vo mt ai khc. ng c gng quyt nh quyt c hon ton vn hay khng - Mc tiu ca
u l vic tt nht: ch nu ra nhng hnh ng khc bn by gi l lm vic g mt cch c ch, ch
nhau bn c th thc hin. ng lo lng nu bn c khng phi l gii quyt ton b vn .
y l mt v d:
Do Trang, th k ring ca mt gim c cng ty ln, vit lai.
Vn :
Cng vic ca ti ang b qu ti. Cc ti liu ang cht ng trn bn lm vic. D ti x l cng vic trong
nhiu gi m ti vn cn qu nhiu vic. Ti ni chuyn vi ngi qun l rng khi lng cng vic tng ln
qu nhanh, nhng c y vn khng lm g c. Tnh trng ny dng nh khng th kim sot v ti bt u cm
thy b trm cm.
Nhng vic c th thc hin:

1. Tip tc nh vy. C th ngi qun l s nhn ra cng vic ca ti ang qu ti nh th no v s tuyn
thm ngi gii quyt mt phn cng vic ca ti.
2. n phng lm vic ca ngi qun l v c y bit rng qu ri. Yu cu c y dng vic a ra cc
yu cu bt hp l.
3. Vit ra tt c cng vic. Sau , ghi ch nhng vic cp bch cn phi c thc hin trong ngy hm nay,
nhng vic cn phi c hon thnh trong tun ny, thng ny v thm ch l th k ny. Theo cch ny, ti
s tp trung nng lng vo nhng mc tiu u tin nht v c th lp k hoch hiu qu hn.

Bc 2: Suy ngh nhng hnh ng gip gii quyt vn
Vit ra 3 iu m bn c th lm gii quyt vn xc nh.
Vn :
My workload is overwhelming files are piling up in my tray and even though I work long hours I keep
getting further behind. Ive told my boss that the workload has been growing quickly, but she doesnt do
anything about it. The whole situation seems out of control and Im starting to feel pretty depressed.
Nhng hnh ng nn lam:

1.
2.
3.

Bc 3: So snh cc hnh ng
Cn nhc hnh ng no c nhiu kh nng gii quyt vn nht. Hy ngh n u im v nhc im ca tng
hnh ng.
y l nhng iu m Trang vit:
HOT NG U IM NHC IM
1. Tip tc lm l iu m ti thng lm Vn c th tip tc tr nn t hn

Ti s khng b vng vo xung t Nu ti khng hon thnh cng vic,
ti c th gp vn ln hn
Ti se tr nn b trm cm nng hn
2. ngi qun l bit Ti s ni ra suy ngh ca mnh Ti khng thch i u vi mi ngi

rng ti khng th Ngi qun l c th x l vn Sp ca ti c th tc gin v ti qu
chu ng c na thng thn v iu ny c th tr
ri thnh mt vn khc cho ti
3. Sp xp cng vic theo Ti c th x l c nhng cng Ti s vn phi chu ng vn qu

th t u tin vic cp bch ti cng vic theo mt cch no
Ti s gim bt c mt s p lc,
v th ti c th tm kim cc gii
php khc
Ti s cm thy mi vic c kim
sot hn, iu ny s gip ch cho
tm trng ca ti

Bc 3: So snh cc hnh ng, tip

By gi, n lt bn:
HOT NG U IM NHC IM
1.
2.
3.

Bc 4: Chn ra hnh ng tt nht

Hy xem xt li cc u im v nhc im ca mi Trang chn hnh ng th 3 - Sp xp cng vic
hnh ng v quyt nh u l hnh ng tt nht theo th t u tin. V vy, c y c th tp trung gii
(hoc i khi l t gy ra tc ng tiu cc nht). Khng quyt nhng cng vic cp bch trc.
c quy tc no cho vic la chn hnh ng tt nht
cho bn: quy tc duy nht l phi c mt gii php c
U TIN:
chn bn c th bt u thc hin. Hy xem xt li
kh nng thc hin, ngh v nhng mt tt cng nh
mt xu ca mi hnh ng, sau hy chn mt hnh Vic phi lm tun ny: ,,,,,,,,,,,,,,,,,
ng trong s . Gii php c chn t nht cng a ,,,,,,,,,,,,,,,,,
bn hng ti mt cch gii quyt vn . Hy t gii Thng ny: ,,,,,,,,,,,,,,,,,
hn cho chnh mnh mt khong thi gian a ra ,,,,,,,,,,,,,,,,,
quyt nh m khng c bt k tr ngi no. Hy nh Th k ny: ,,,,,,,,,,,,,,,,,
rng, nu bn bt u thc hin nh hng dn trn ,,,,,,,,,,,,,,,,,
nhng thy khng hiu qu, bn c th th gii php
khc.
u l hot ng m bn chn?

Bc 5: Lp k hoch thc hin:

Bn s khng th gii quyt hon ton nhiu vn ch Tuy nhin, nu ch thu thp li cc giy t c lin quan
bng mt hnh ng. Nhng c th c nhiu hnh ng s khng gii quyt c vn , nhng n s gip bn
gip bn gii quyt mt phn vn . V d: nu bn tin gn hn n cch gii quyt vn m bn ang
gp phi vn v ti chnh, vic u tin m bn nn gp phi thay v ch ngi mt ch v khng lm g c.
lm l thu thp cc giy t v xem xt li chng. iu quan trng l phi bt u vi mt gii php.
K hoch ca bn nn da trn bn quy tc c th c vit tt l M.A.S.T.
C th:
Qun l c (Manageable) Nu tun ny bn khng cm thy tt hn tun trc (thm ch bn cn cm thy n
t hn mt cht), bn vn c th tip tc thc hin k hoch. Hon thnh mt mc tiu d l rt nh cn hn l khng
hon thnh mt mc tiu tham vng. y mt v d khng nn cho ln u tin i ra ngoi: Tham gia mt cuc chy
maratng. V d tt hn l: Mc tiu l i b quanh khu nh
C tnh nh hng hot ng (Action-oriented) Lp mt k hoch v nhng vic bn s lm ch khng phi l bn
ngh hay cm nhn th no khi bn thc hin vic . Thc t cho thy, bn chc chn kim sot c ci bn lm
nhng li kh c th kim sot c cm xc cng nh suy ngh ca mnh. V d khng nn l : Dnh mt gi vui
v cho nhng a con ca ti. V d tt hn l: Dnh mt gi cho nhng a con ca ti.
C Th (Specific) Vic bn cn lm nn c th. V d khng nn: Ly li vc dng trc y. V d tt hn l: Gi
in n trung tm cng ng tm hiu xem h c lp dy yoga khng.
Thi hn thc hin (Time-limited) K hoch ca bn ch nn c thc hin trong khong thi gian ngn. ng lp
k hoch thay i bn mi mi. V d khng nn: Luyn tp th dc thng xuyn cho n cui i. V d tt
hn l: i b 20 pht mt ln, 3 ln mi tun, nh gi vic thc hin sau hai thng.
K hoch chnh xc l g?

Bc 6: nh gi
Bt u nh gi sau khi thc hin k hoch mt tun hoc khi bn t c mc tiu ca mnh.
Kt qu l g? Ci g i ng hng? Ci g khng i ng hng?
Tm trng c ch s khin bn ch tm vo nhng tht Nu bn t c mc tiu ca mnh, hy suy ngh

bai va nhng iu bn khng th lm thay v khuyn mt cch k lng v s thnh cng (mc d vn
khch bn thn v bt k thnh cng no m bn t vn cha c gii quyt).
c.

Bc 7: Tin ln
S dng kinh nghim ny lp k hoch cho cc bc tip theo.
Bn c 3 s la chn:
Tip tc. V d: Thm 20 pht tm kim cc giy t
Sa li mc tiu v c gng mt ln na. V d: Lm sch nha kho/bp trong mt gi l qu kh khn, thay vo
l lm v sinh nha kho hoc bp trong 10 pht.
S dng cch tip cn mi. i khi, bn hc c mt ci g hu ch x l vn t c gng u tin ca
mnh. V d: Ni chuyn trc tip vi d Sarah khng mang li kt qu g. Thay vo , bn s vit mt l th
cho d y.
Da vo kinh nghim ca bn, bc tip theo s l g?
Tip tc lm vic vi vn ny tng bc mt. Ghi li nhng c gng ca bn v lun nhc nh bn thn v nhng
tin b m bn lm c.

CON NG PHA TRC:
GIM CC NGUY C TI PHT
c cn trm cm nng kt thc. Bn khng cm thy rng bn c
C th ti pht, nhng thc t bn c kh nng b ti pht. Khng may

l nhiu ngi li b ti pht sau nhiu thng, nm hoc c thp k.
C cch no gim nguy c ti pht khng? Cu tr li rng bn nn u tin vn sc khe tm thn ca

l C. Bn c th/khng th c kh nng loi tr cc mnh. Khi bn cm thy kh hn, bn c th mun qun
cn trm cm. Nhng bn c th lm gim kh nng i vic chm sc bn thn. Nu bn cm thy tt
xy ra, gim mc trm trng v thng xuyn ca ri, bn c th mun dng ngay vic tng cng hot
cc cn trm cm. ng, suy ngh thc t v gii quyt vn .
Ngh n nhng chin lc bn v ang s dng
Tip tc c gng
kim sot trm cm. C chin lc no bn nn tip
Khi bn cm thy mi th tr nn tht khng khip, r tc duy tr k c khi bn cm thy tt hn?
Cc chin lc no ti cn tip tc thc hin?

Lp k hoch kim sot stress Mt s s kin gy stress c th on trc c. C

th bn bit vo ngy no bn s quay tr li lm vic.
Chng ta u c nhng khong thi gian kh khn
C th nm mi/tt lun l thi im stress cho bn v
trong cuc sng - mt vi ngi c th gp nhiu kh
thng 12 ng n dn. C th ngy t tp gia nh
khn hn nhng ngi khc. Nhng ngi va hi
sp n. C th bn ang c bu, bn s phi lm rt
phc sau khi b trm cm, stress c kh nng ti pht
nhiu vic khi em b ra i. Bn c th ln k hoch
cao hn. Gii php khng phi l trnh tt c vic gy
trc cho nhng s kin ny v lm cho chng
stress (khng mt ai trong chng ta c th lm c),
cng thng hn.
nhng chng ta s c nhng k hoch c vch ra
trc kim sot stress mt cch hiu qu.
Di y l mt s cch:
Lm quen dn dn vi stress nu c th. V d: Nu bn sp tr li vi cng vic th trc tin bn nn th lm vic
bn thi gian trc.
Gim nh trch nhim. V d: Nu bn ang tham gia mt kha hc bui ti, hy cho php bn thn n ngoi nhiu
hn hoc chp nhn vic nh ca s ba bn hn.
Duy tr vic chm sc bn thn. Lm th no gip bn thn bn lun c cn bng? ng t b nhng th khi
bn cn chng nht. Nu mt ba tra mi tun vi ngi bn thn l quan trng vi bn, hy duy tr n. Nu cc bi
tp th dc gip ch nhiu cho bn, hy lm tt c mi th bn c th tip tc vic tp luyn trong sut thi gian
bn b stress.

Lp K Hoch Hnh ng Khi Tm Trng Trong Tnh hoc kh hi phc. Bng cach lp k hoach trc v
Trng Khn Cp nhng gii php mang li hiu qu, bn c th khng
phi lo lng v gim c kh nng ti pht.
Nu bn lp k hoch trc trong trng hp b ti
pht, bn c th c c s gip nhanh hn. Nh Nu bn b trm cm tr li, bn c th lm nhng g
, cn trm cm khng nng thm, khng ko di gip mnh v hi phc nhanh nht c th?
y l mt s ch bn nn ngh n:
Tng cc hot ng th gin. S dng cc bc trong phn Thay i cch sng
Gim i trch nhim ca mnh. Bn c th ln k hoch nh th no gim trch nhim ca bn khi bn thiu nng
lng nu b trm cm ti pht. V d: Bn c th tha thun trc v yu cu gim s gi lm vic hoc tm thnh
vin trong gia nh gip bn chm sc con ci
Tm s gip ngi c chuyn mn. Cn nhc vic cho php mt vi ngi bn hay thnh vin trong gia nh, hay
i khi l bc s ca bn nhc nh bn khi h nhn thy c v tm trng ca bn ang i xung.
Nhn s h tr. Ai c th gip bn v loi gip no m bn cn? i khi bn cn mt ngi no ni

chuyn, hoc c th bn s thch s gip mang tnh cht thit thc - nh l s gip vic i ch hng ngy.
Qun l cch sng ca bn. Tm trng i xung khng c ngha l bn khng tp luyn th dc, khng ra khi nh,
khng duy tr n ung y cng nh c nhng gic ng ngon. Cch sng no gip ch cho tm trng ca bn
nht?
Hy suy ngh v vic lm th no bn c th quay li vi cng vic sm trong giai on b trm cm ngn chn
chng tr nn t hn. iu g s gip ch trong thi gian ny? S dng danh sch trn nh mt im khi u v
t lp mt k hoch r rng v c th.

Xin Chc Mng! By gi bn kt thc phn hng dn kim sot trm cm.
Tt nhin, ch c hng dn ny thi l cha . thu c nhiu li ch nht t
cc k nng c nghin cu chi tit v hiu qu ny, bn cn phi bin chng
thnh nhng hnh ng c th trong cuc sng ca bn.
N ng bn n lc. Bn xng ng vi s n lc .
CU CHUYN CA HNG
y l kinh nghim ca mt ngi s Khi c y c phn Suy ngh thc t, c y

dng hiu qu nhng phng php ny. nhn ra mt s trng thi: c y c
mt suy ngh t ph phn bn thn; c y
Hng l mt gio vin c gia nh v
mong i mnh hon ho v b qua li
khong 30 tui, c y ti gp bc s
khen t ngi khc. C dng cc cu
vi nhng triu chng ca trm cm.
hi trong hng dn t chm sc bn thn
C y chuyn n mt ngi trng cn bng v thc t hn trong cch suy
trong ni thnh, c nhiu kh khn trong ngh ca mnh: Bn c bng chng no?
cng vic. Nhng c y nhn ra rng mnh C y nhn c nhng nh gi tch
khng th thc hin c nhng cng vic cc v ng nghip ni rng c y lm
bnh thng mc d c lm vic nhiu vic tt nht c th trong trng hp ny.
gi. C y bt u mt ng v lun thy lo
Bn s ni g vi bn b mnh trong tnh
lng. C ch trch mnh v khng th
hung tng t? C y vit ra nhng cu
hon thnh cng vic nh mong i. Tm
ni cng bng v nhng li ng vin m
trng ca c tr ln ti t khin c cm
c y s ni vi bn b v luyn tp t ni
thy rt kh s. iu ny lm c y kh
vi bn thn cch ni ny.
khn trong vic hon thnh cng vic v
tr nn chn nn. Th no l cch nhn t cc oan hn
trong tnh hung ny?
Thuc chng trm cm c k bi bc s
ca c y. S dng thuc gip c ng C y vit ra nhng suy ngh thc t hn
c, c thm nng lng v gim ng v cng vic, sau t nhc nh bn thn
k tm trng chn nn ca c y. khi nhn ra mnh ang c nhng suy ngh
khng thc t, tiu cc.
Khi c y c c thng tin v Thay i
cch sng, c nhn ra rng mnh S kt hp ca thuc chng trm cm v
hn ch mi quan h bn b k t khi cch bin php t chm sc bn thn s
nhn cng vic ny v c bit l t khi ci thin dn dn mc trm cm, to
cm thy chn nn. C y t mc tiu trng thi cn bng v d chp nhn thc
l gp g bn b mi tun 1 ln. Sau , t v hng th cuc sng hn.
c tham gia thm vo cc hot ng x
hi. Sau mt thng, c thm vo mc tiu
l tp cc bi tp th dc nh nhng.

TI LIU NN C
V TRM CM V CC CH LIN QUAN
Cac cun sach di y c xut bn tai nc ngoai va cha co sach dch tai Vit Nam.
Chung ti hy vong se sm dch va a vao phat hanh tai Vit Nam.
Burns, David D. Feeling Good (1992, Avon Books) or The Feeling Good Handbook (1999,
Plume Books). Extremely successful self-help books on depression and anxiety. The
emphasis is on specific exercises to carry out.
Catalano, Ellen Mohr (1990). Getting to Sleep. Oakland: New Harbinger Publications. A
useful book that describes a variety of sleep problems and offers concrete suggestions for
dealing with them.
Paterson, Randy (2002). Your Depression Map: Find the Source of Your Depression and
Chart Your Own Recovery, New Harbinger Publications, Inc. A guide to developing indi-
vidualized strategies for recovering from depression.
Greenberger, Dennis and Padesky, Christine (1995). Mind Over Mood. Guilford Publica-
tions, Inc. A hands-on workbook for therapy clients suffering from depression, panic at-
tacks, anxiety, eating disorders, substance abuse, and relationship problems.
Cronkite, Kathy (1994). On the Edge of Darkness. New York: Delta. First-person accounts
from well-known people who have been through serious depression. Seligman, Martin E.
P. (1992). Learned optimism. New York: Simon and Schuster. How to overcome a sense
of helplessness in your life.

NHNG THNG TIN HU CH

V MU GHI CHP
CH N UNG
Hng dn ch n ca Thc n l ngun cung cp nng lng cho c th. Khi chng ta
Canada b trm cm, ch n thng b thay i. Mt s ngi n nhiu
hn. Nhng ph bin hn c l n khng ngon ming. Nu iu
Hng dn l ch n hng ny xy ra, mt iu quan trng phi nh l mc d bn khng
ngy cho ngi trng thnh. thy i nhng c th bn cn nng lng. Sau y l mt s mo
Lng thc t ca thc n ph gi ch n thch hp trong giai on kh khn ny.
thuc vo tui, kch c c th
v mc hot ng. Hng Cc ba n u n. y l cch d nht n (v kim sot
dn khuyn ngh la chn ch nhng g bn n) nu bn gi theo thi quen. C gng c 3 ba
phm t cht bo nu c th. n mi ngy. V m bo rng bn c thc n cho 3 ba .
n theo gi ch khng i khi i. Nu bn cm thy chn n,

Cc sn phm ng cc:
hy c gng bng mi cch n ng ba. Nu bn cm thy mun
5-12 phn. V d cho 1 phn n nhiu hn, hy c gng ch n ng ba.
n: 1 lt bnh m, 30g ng cc
lnh, cc ng cc nng, 1 Lm cho vic n ung d dng hn. iu quan trng l n ch
na bnh m vng, cc m khng phi l nu. Mua nhng thc n d ch bin (nhng vn
hoc go. phi cht dinh dng).
Cc loi rau v hoa qu:
Nu nhiu hn. Bn c th gim thi gian chun b bng cch mi
5-10 phn. Mt phn trung ln nu n s nu nhiu hn, bo qun nhng n ny trong t
bnh rau hoc mt ming hoa lnh v s hm nng li sau.
qu, mt cc salad, mt na
cc nc hoa qu. Nu thc n c gia tr dinh dng. D tr thc n dinh dng v
Sn phm t sa: cc n nh theo hng dn ca Hng Dn Ch n ca
Canada (xem trong hp thng tin).
2-4 phn (nhiu hn cho ph
n mang thai v ang cho con
Xem lng ng n vo. Trnh n qu nhiu ng tinh luyn.
b). Mt cc sa, cc sa
u tin chn cacrohydrate phc hp (thng c trong ng cc,
chua, 50g pho mt.
go lc v khoai ty).
Tht v thc n khc:
2-3 phn. 50-100g tht, gia cm Trnh n king. Trnh cc ch n king, thm ch c khi bn
hoc c, 1-2 qu trng, 2/3 cc ang mun gim cn. iu ny tt hn cho vic to mt thi quen
u, 1/3 cc u ph, 2 tha b n ung c li cho sc khe (hn l hn ch) v tng cc hot
lc. ng th cht. Hi kin bc s ca bn trc khi c gng gim
cn.

HOT NG TH CHT
Hot ng th cht u n gip tng sc khe tm thn v sc khe th cht. Mt s

nghin cu gn y ch ra rng nhng ngi c sc khe tt t c nguy c trm cm hn
v nhng bi tp th dc u n gim ng k triu chng ca trm cm nhiu ngi.
Cc bi tp tc ng n tm trng theo 4 cch. Th nht, n c th to ra cm gic hng

phn do chy b sau khi tp th dc mt s ngi (khi b trm cm, tc ng ny c th
khng xy ra). Th hai, sau mt vi tun tp th dc u n (3-4 ln/tun, t nht 20 pht
mi ln), nhng ci thin v tm trng bt u xut hin. Th ba, tng cc hot ng th
cht lin quan ti tng nng lng cho c th, iu ny c th gip bn lm vic c nhiu
hn. Cui cng, tp th dc l mt cch tt x stress khi bn cm thy cng thng.
Sau y l mt s mo xy dng mt ch tp th dc:

Kim tra sc khe. Trc khi bt u, hi bc s ca bn v tnh trng sc khe v gii hn
hot ng ca bn thn.
La chn ng nhng hot ng. Thch thc ln nht l duy tr n. Chn nhng hot ng
m bn thc s hng th. C bi tp th dc vn ng nhiu (cho tim mch) (trong nhp
tim ca bn tng ln n mc tiu trong 20 pht hoc nhiu hn) v bi tp th dc nh
nhng (nh nng t hoc yoga) u c nh hng tch cc n tm trng. La chn loi
ph hp nht vi bn. S a dng cng c ch: chn nhiu hn mt hot ng v xen k
chng.
Khi ng. Hc cch khi ng trc khi tp v m bo rng thc hin ng trc khi tp.
iu ny c th gip gim nguy c b thng hay au khi tp.
Thng xuyn quan trng hn l tp lu. Thng xuyn tp th dc trong mt thi gian
ngn (3-4 ln/tun) tt hn l tp lin tc trong mt thi gian di.
Ch trng vo s thch. Ngi m tp th dc theo s thch v kt qu cho thy ci thin

ng k v mt cm xc hn l nhng ngi tp th dc ch trng hnh thc p hn.
C gng ch trng vo vic bn s cm thy th no hn l bn trng th no.
Theo di nu c lng cc. Tc ng ca tp th dc ln vn lng cc cm xc (chng

ri lon lng cc) t r rng hn nhng dng trm cm khc. Tch cc tp th dc trong
giai on cm xc b kch ng c th lm tnh hnh trm trng thm trong mt s trng
hp. Bi tp nh nhng thch hp hn trong trng hp ny.
Khng c g thay i ch sau 1 m: t mc tiu r rng khi ln k hoch tp th dc ph

hp, v chc chn l chn mt s mc tiu c th t c. V d, bi mi ln trong 5 pht
hn l cam kt vi bn thn s bi 70 vng mi ngy.

GIC NG
Stress, lo u v trm cm thng nh hng ti gic ng v ngc li mt ng c th lm

cho chng lo u v trm cm trm trng hn. Ni cch khc, chng kh ng l nguyn
nhn v hu qu n cc vn cm xc. Khng cn bit kh ng hay vn cm xc xut
hin trc, cn c gng ly li nhng gic ng ngon.
y l mt s mo nh:
Trnh nhng thuc ng khng cn k n. Mc d iu ny c th gip bn d ng nhng

cch m bn ng c s khng hu ch nh cch ng thng thng. Thay vo , ung
thuc ng ch khi c ch nh ca bc s. Nu bn ung thuc ng, hy nh rng du hiu
ca s thnh cng l cm xc ca bn trong ngy ch khng phi l bn ng c hay
khng. Thng bo li kt qu ny cho bc s ca bn.
Qui nh thi gian i ng v thc dy. C th bn hot ng trong chu k sinh hc 24h, chu
k ny c th b ri lon nu thi gian i ng v ng dy thay i lin tc. iu ny l nguyn
nhn ca s mt mi do chnh lch mi gi: trong trng hp ny khng phi do di chuyn
qua cc mi gi khc nhau m do thay i thi gian ng. u n i ng v thc dy vo
mt thi im c th gip thit lp ng h sinh hc cho bn.
Khng i ng qu sm. Nu bn cha bao gi i ng trc 1h sng, ng i ng trc 12h.

Nu bn mun ng sm hn? Hy bt u t gi i ng sm hn 30 pht n 1 ting so
vi gi i ng bnh thng. Sau bt u i ng sm hn (mi tun ng sm hn khong
na gi).
Gi phng ng ch ng. Trnh dng phng ng chung vi cc hot ng khc nh n,

ci v, tp th dc, nghe in thoi, xem tivi. Mc d vy, quan h tnh dc th khng sao.

GIC NG
To ra mt mi trng tt cho gic ng. Nhit phng ng tt nht cho mi ngi l 18O
n 21OC (65OF - 70OF). Nu nh phng ng b ting n, mt s la chn nh eo tai nghe,
lm cch m trong phng (treo vai xung quanh c th ci thin mt cht) v cc thit b pht
ra ting ng th gin (nh qut hay my pht ting chuyn bit). Loi b ting n t ng
h hoc ting chung ca ng h. Nu ngi ng cng l vn , xem xt vic c mt
chic ging ln hn, m m hn hoc thm ch ng ring ging trong mt thi gian.
Trnh nhng gic ng ngn trong ngy. Tr khi bn lun thch ng gic ng ngn 20 pht
mi ln ng. Gic ng vo ban ngy di hn c th kh ng vo bui ti.
Chun b cho gic ng. Trnh hot ng nhiu, tp th dc, n nhiu v n sng t nht 1
gi trc khi i ng.
Tp ht th hoc p dng cac cch gim tp trung trc khi i ng. Tp trung vo nhng lo
lng hoc bn cn nhng g c c gic ng s ch lm cho bn tnh to. Thc hnh
bt k bi tp tinh thn gip u c bn trnh nhng ch ny.

CAFFEINE
Caffeine kch thch h thn kinh giao cm, ni chi phi cc p ng chng li stress. Nu tnh
trng trm cm ca bn km theo nhiu lo lng, iu cui cng m bn cn l thuc kch hot
h thng p ng chng li stress. Caffein c th lm trm trng thm vn nh gy ra nhc
u, hi chng co tht rut kt, cc cn au mn tnh v cc vn vn ng khc.
Caffein l mt loi thuc gy nghin. Ngi dng nhiu c th tr nn ph thuc vo n,

tng dung np (ngha l ngi dng cn s dng nhiu caffein hn c nhng tc
dng tng t nh trc kia) v tri qua cc triu chng cai nghin nu thiu n. Triu
chng cai nghin do thiu caffein bao gm au u, u oi, d cu knh v kh tp trung.
Nhiu ngi pht hin ra rng h ph thuc vo caffeine khi h khng dng caf trong 1-2
ngy v bt u cm thy au u nng.
Dng bao nhiu caffein th s b ph thuc? c tnh l khc nhau mi ngi, nhng
khong trung bnh 450g mi ngy. Mt s ngi nhy cm hn th liu ph thuc thp hn.
Dng bng di y tnh mc dng mi ngy ca bn. Ch y dng n v tnh
l cc phn nh. Cc caf ca bn c th gp 3 hoc 4 ln.
Nu bn quyt nh gim lng caffein, hy gim dn trnh cc triu chng cai nghin.
Gim lng caffein khong mt na trong 4-6 ngy, sau , gim mt na na cho ti khi
bn ung di 2 cc mi ngy.
Loi Lng (mg) S ln mi ngy Tng
Coffee
Caf pha phin (5 oz.) 130 x _______________ = ___________
Caf pha sn (5 oz.) 70 x _______________ = ___________

Loi caffeine (5 oz.) 3 x _______________ = ___________
Caf sa (1 shot) 90 x _______________ = ___________
Tr
5 pht ngm nc (5 oz.) 60 x _______________ = ___________
3 pht ngm nc (5 oz.) 35 x _______________ = ___________
Khc
Cacao nng (5 oz.) 10 x _______________ = ___________
Cola (12 oz.) 45 x _______________ = ___________
Nc ung c ga khc (12 oz.) 0 x _______________ = ___________
Thanh socola nh 25 x _______________ = ___________
Tng x _______________ = ___________

MA TY V RU
Mt trong nhng nguyn nhn nhng ngi trm cm s dng thuc v ung ru l nhng
th ny gip h cm thy thoi mi hn trong mt thi gian ngn. Nhng trong thi gian di,
chng lm cho trng thi trm cm nng hn:
Vn ny b lng trnh hn l c gii quyt.

Biu hin trong cng vic, nh v hot ng x hi gim st.
C th pht trin nhng ph thuc v mt tm l v th cht.
Sc khe th cht gim st.
Trong qua trnh trm cm, ru v cht gy nghin rt hp dn bn. Nhng, trong thi gian
ny, s dng nhng cht ny l hon ton khng nn. Sc chu ng ca bn i vi tc
ng ca chng v kh nng kim sot vic s dng cc cht ny rt c th km hn bnh
thng. Trng hp ny i hi hnh ng c th, c k hoch hn l trn trnh vo cc
cht gy nghin. Cht gy nghin v ru tng tc vi nhiu loi thuc trm cm, bao
gm hu ht thuc k n trong trng hp lo lng, trm cm. Ni chung, tt nht l theo
hng dn sau duy tr li sng cn bng.
Trnh dng ru v cc cht kch thch trong giai on trm cm hoc stress nng.
Trnh dng ru v cc cht kch thch nu bn hay gia nh c tin s lm dng thuc.
Thm ch nu bn thy tt v khng c tin s lm dng thuc, p dng quy nh cho
bn thn ch s dng nhng cht ny c chng mc.
Vic loi b ru v cc cht gy nghin ra khi cuc sng ca bn c th l mt vic kh

khn. Hy nh rng vic khng dng bt k loi no l tt nht cho mt s ngi, mt s
trng hp ch cn gim lng dng cn tt hn l c t b, ri khng chu ng ni v
t b. S dng cc nguyn tc khi thit lp mc tiu gip bn tm hiu vn v khc
phc n.
Nu bn s dng ru v cc cht gy nghin cng nhau v cng ngoi tm kim sot, bn

khng phi duy nht: nhiu ngi c vn ny. Mt s t chc c th gip bn ly li s
kim sot. Hi bc s c thm thng tin.

THAY I SUY NGH TRM CM
Tnh Hung:

THAY TH VI SUY NGH THC T
Suy ngh trm cm:
Ti c th c nhiu bng chng hn khng, ging nh hi kin ai v tnh hung ny?
Nhiu ngi s ng vi suy ngh ny? Nu khng, suy ngh no thc t hn?
Chng ta thng thc t hn v ngi khc hn l v bn thn mnh.

Ti s ni g vi bn nu bn ti trong tnh hung tng t?
Cch ngh no t cc oan hn trong trng hp ny?
iu g xy ra nu ti tip tc ngh theo cch ny?
C cch ngh no khc m hu ch hn khng?

GII QUYT VN
HNH NG THUN LI KH KHN

1.
2.
3.
MC TIU T RA
HOT NG MC THNG XUYN CHNH XC KHI NO?

Illustration
Minh ha Design
Thit K&&Production
Sn Xut
Christy Hill Hill
Christy (CHILL)
(CHILL) Karen
Karen Cowl
Cowl
Illustrator
Illustrator Designer
Designer
Chill Factor
Chill Communications
Factor Communications Stripe Graphics
Stripe Ltd. Ltd.
Graphics
Vancouver, BC Vancouver, BC
Vancouver, BC Vancouver, BC
QXB s: 54/Q-GTVT cp ngy 10/9/2014 theo KKHXB s: 282-2014/CXB/110-13/GTVT.

In 1.000 cun ti cng ty TNHH in 268 - Tel: 04.3993.9692. In xong v np lu chiu thng 9 nm 2014.
ti min ph bn ting Anh ca ti liu, truy cp:
www.bcmhas.ca hoc www.carmha.ca/publications

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CHNG TRNH T CHM SC TRM CM

Chng trnh ny dnh cho:

Ngi c triu chng trm cm

Gia nh, bn b quan tm mun gip ngi trm cm

Quyn sch ny nhn c h tr ti chnh ca B Y T Canada, Dch V Cai

C th ti min ph bn ting Anh ca cun sch ny theo ng dn di y:

www.bcmhas.ca hoc www.carmha.ca/publications

Lu : Cun sch ny c xut bn nhm cung cp cc thng tin chnh xc v xc

c Vin Dn s, Sc khe v Pht trin dch, kim tra v c in di s ti tr

Nguyn nhn gy ra trm cm? 6

Bn c th lm g khi b trm cm? 14

Thuc chng trm cm 16

Cc k nng kim sot trm cm 18

Con ng pha trc: Gim cc nguy c ti pht 49

Nhng thng tin hu ch v mu ghi chp 55

rm cm l mt trong nhng tri nghim au n v kh khn nht ca

T con ngi. N cp i nng lng, s yu thch v mong mun lm mi

Hng dn ny nhn mnh vo ba bc: thay i cch

CHNG TRNH T CHM SC TRM CM 1 HNG DN CC K NNG KIM SOT TRM CM

T hi bn thn 3 cu hi. nh du cu tr li ca bn trn thang im di y. Thang im t 0 n 100:

Tm trng bun chn c nh hng tiu cc nh th no n cuc sng ca bn?

KHNG NH HNG NH HNG RT TIU CC

Vic cm thy kh hn quan trng nh th no vi bn?

KHNG QUAN TRNG CHT NO CC K QUAN TRNG

Ti c sn sng u tin lm nhng vic khin cuc sng ca ti tt ln khng?

KHNG U TIN CHT NO CC K U TIN

Nu s im ca bn trong hai hoc ba cu hi t hn 50 im, c th bn ang ngh n vic thay i, nhng vn

M sang trang k tip v bt u

CHNG TRNH T CHM SC TRM CM 2 HNG DN CC K NNG KIM SOT TRM CM

B bn b trm cm. Cm giac bun ba hoc chn nn l mt phn khng th

Trm cm khng phai l

CHNG TRNH T CHM SC TRM CM 3 HNG DN CC K NNG KIM SOT TRM CM

PHN LOI TRM CM

CHNG TRNH T CHM SC TRM CM 4 HNG DN CC K NNG KIM SOT TRM CM

Bn ngh rng mnh b trm cm...

CHNG TRNH T CHM SC TRM CM 5 HNG DN CC K NNG KIM SOT TRM CM

Con ngi c th b trm cm do rt nhiu nguyn nhn khc nhau.

CHNG TRNH T CHM SC TRM CM 6 HNG DN CC K NNG KIM SOT TRM CM

CHNG TRNH T CHM SC TRM CM 7 HNG DN CC K NNG KIM SOT TRM CM

CHNG TRNH T CHM SC TRM CM 8 HNG DN CC K NNG KIM SOT TRM CM

Cch suy ngh lch lc

CHNG TRNH T CHM SC TRM CM 9 HNG DN CC K NNG KIM SOT TRM CM

CHNG TRNH T CHM SC TRM CM 10 HNG DN CC K NNG KIM SOT TRM CM

CHNG TRNH T CHM SC TRM CM 11 HNG DN CC K NNG KIM SOT TRM CM

Khng tham gia cc hot ng gii tr

Khng chm sc bn thn

CHNG TRNH T CHM SC TRM CM 12 HNG DN CC K NNG KIM SOT TRM CM

Khng lm cc vic nh thng ngy

CHNG TRNH T CHM SC TRM CM 13 HNG DN CC K NNG KIM SOT TRM CM

Hc v luyn tp cc k nng kim sot trm cm theo nhng hng dn nay co th se

CHNG TRNH T CHM SC TRM CM 14 HNG DN CC K NNG KIM SOT TRM CM

Hc v luyn tp cc k nng kim sot trm cm trong hng dn ny c th gip

CHNG TRNH T CHM SC TRM CM 15 HNG DN CC K NNG KIM SOT TRM CM

T thuc trm cm ci thin c tm trng v thuyn gim mt s triu

CHNG TRNH T CHM SC TRM CM 16 HNG DN CC K NNG KIM SOT TRM CM

Bn c th mun ngng thuc ngay khi tnh trng ca

CHNG TRNH T CHM SC TRM CM 17 HNG DN CC K NNG KIM SOT TRM CM

rong phn ny, bn s hc ba k nng c th lm ngng tm

T trng chn nn, gim trm cm v gip ngn nga ti pht.

Chng ti s gii thch cc k nng ny s gip bn Trm cm nh hng n tt c mi mt trong cuc

CHNG TRNH T CHM SC TRM CM 18 HNG DN CC K NNG KIM SOT TRM CM

hi b trm cm, phn ln ngi b trm

K cm khng lm nhng vic bnh thng

CHNG TRNH T CHM SC TRM CM 19 HNG DN CC K NNG KIM SOT TRM CM