Create the Perfect Treatment Plan for Your Depression in 3 Steps: Part 2

Rachel Doboga avatar

by Rachel Doboga |

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The Mighty Mind Rachel

Part two of a series. Read part one here.

To help you get started with creating your perfect treatment plan for depression, I will share my experience with two types of therapy that have been especially helpful as I learn to cope with living with ALS. I hope this will inspire you to research different types of therapy to add to your wish list. There truly is something for everyone.

Acceptance and commitment therapy (ACT)

This is the type of therapy I turned to after my ALS diagnosis. According to Psychology Today, ACT focuses on facilitating acceptance of hardship and the resulting emotions, many of which may be deeply painful because burying these feelings can lead to even more distress. After acceptance, you will learn and commit to using new thought patterns and behaviors that will allow you to live according to your values and goals.

ACT helped me come to terms with my diagnosis and the resulting uncertainty about my life expectancy and how my progression would unfold. Ultimately, I became more optimistic. I also achieved a major improvement in my quality of life when we explored my values, priorities, and lifestyle before ALS through conversations, some homework, and light journaling. We then worked to design a new daily routine that I agreed to commit to in order to regain purpose and joy instead of, say, watching “Pretty Little Liars” all day, every day. Hypothetically, of course. I hope everyone who has ALS or loves someone who has ALS considers giving ACT a try. My therapist, who wishes to remain anonymous, said that ACT could also benefit people who are grieving.

Cognitive behavioral therapy (CBT)

What I find most impressive about CBT is that it is immediately empowering. According to Psychology Today, this solution-based approach to stopping distorted thought and behavior patterns is effective across a wide variety of mental illnesses. Whatever you’re facing, CBT can help you identify the dysfunctional patterns that are impeding your happiness.

My best experience with CBT actually saved my life. After I was assaulted, I struggled with fantasies about suicide. I was particularly fixated on a desire to cut myself. Every single mildly sharp object around me triggered the urge. My then-boyfriend, now-husband hid all our knives, razors, and scissors — but that wouldn’t have kept me safe forever. The therapist I was seeing at the time made me instantly safer by suggesting that when I see a sharp object, I cut off my fixation by reminding myself of its original purpose and thinking of good memories associated with the correct use of the object. For example, if a pair of scissors triggered me, I would take a moment to meditate on what scissors are actually for, and on positive times I had used them, like when sewing or scrapbooking. I was able to brush off the self-destructive ideas and continue with my day. Then we spent time figuring out how to address the compulsion in a more comprehensive way that would eventually prevent the urges altogether.

Because of what I learned in CBT, I knew exactly what to do when self-destructive thoughts surfaced after my ALS diagnosis. To get the most out of CBT, read “Cognitive Behavioral Therapy: 7 Effective Tips.

I have also benefited greatly from art therapy, Gestalt therapy, and somatic experiencing when dealing with post-traumatic stress disorder (PTSD) and the nasty way it interacts with ALS. That, however, is a subject that deserves its own column.

Step 3: Find your dream therapist

Once you decide who you would like to include in your treatment plan and which types of therapy you want to try, I recommend visiting The website allows you to search for a practitioner using every criterion imaginable. You will begin by entering your zip code.

The list of matches is likely to be so extensive that it’s overwhelming. However, you can immediately slash your list by clicking the option to only show practitioners who are accepting new patients. Then, further narrow the list by inputting your personal criteria, from basics like gender, languages spoken, and insurance accepted, to more nuanced qualifications like topics of expertise and average patient ratings. In my column about the importance of emotional intelligence in doctors, I cite patient reviews as a necessary resource for learning about the practitioner, so be sure to check out at least a few. Each practitioner’s profile includes a personal statement, information about the person’s education and years practicing, and lists of specialties and types of therapy they can use. Profiles usually include a link to email the practitioner directly, so if you have questions, don’t be shy. Get in touch!

You may also want to ask around at your clinic and local chapter of the ALS Association to see if anyone can recommend a therapist who has experience working with members of the ALS community.

Good luck!


Note: ALS News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of ALS News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to ALS.


Charlie avatar


This author has clearly faced some difficult psychological issues in the past, and it's good she has mastered them.
Most ALS patients have not had to face those challenges but are simply 'normal' human adult beings who have been told there are no effective treatments, no cures, and a profound robbery of one's dignity, proceeding to total immobility. They have also been informed that the simplest and most beautifully gratifying pleasures of life, such as picking up one's young grandchild for a cuddle, will be impossible.

Rather than worrying about self-harm through sharp objects, they face the theft of life's basic enjoyments.
It is that aspect which precludes the regaining of 'optimism.'

Theft never results in optimism.

Melissa R avatar

Melissa R

The author is writing based on her own experiences with ALS and those same struggles you mention, and was open enough to share other experiences for the benefit of even more readers.

Charlie avatar


I sense you may be chiding me.
I strongly suggest you re-read my note for a better understanding of what I said.

Celeste Lamosse avatar

Celeste Lamosse

Charlie was right. The article suggests the author was dealing with some other psychological problems as well. Its great she shared it, but hers isn't a "typical" experience. Thats all.

Mary Nix avatar

Mary Nix

I would dare say we all carry around some life experiences that are not shared by every other human being. Examples of how the author dealt with differing mental health challenges is not suggesting or should not suggest, she is more or less capable of dealing with ALS. She simply wanted to share that she has used several types of therapy to overcome her personal challenges. There is not a typical ALS patient or human being, for that matter. We're all a bunch of onions with multiple layers of ugliness, beauty, suffering and strength mixed together. She gave me some great jumping off points. Counseling ALS patients is a challenge and very difficult. The loss is multiplied as time goes by. It builds. There is no relief from it at all. Helping the patient to somehow handle their own experience is not easy to do. Good luck everyone.


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