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Good measurement may be the single-most underestimated intervention in mental health.

I was reminded of this recently with a patient I was treating. This patient had experienced minimal response to medication changes, and I had suspected from the beginning that life circumstances were the primary drivers of her depression. She wanted to focus on medication, but agreed to try making small behavioral changes to improve her life. At each visit, she failed to make any changes and would ask for a different medication.

I felt a little frustrated. Medications are helpful for many people, and at the same time, they aren’t a substitute for a mentally healthy lifestyle. 

I felt stuck with this patient going into our most recent visit. The medication I had prescribed had been predictably ineffective. The tiny behavioral change we had agreed upon didn’t happen. But she felt much, much better. And in discussing the change, she noted that the psychotherapist on our team had broken the stalemate by asking her to do one simple thing: keep a journal of how she felt each day.

This simple measurement made her realize that certain situations contributed to her depression. It made her realize that she had some control over her mood. And it also helped her recognize that overall, things weren’t as bad as she had thought they were. Even though she hadn’t changed a single behavior, she suddenly felt empowered and hopeful. 

Measurement doesn’t always have such profound effects. And measuring the wrong things may be misleading and even harmful. But if you are struggling to make a change in your life, a good first step may be to start measuring the problem. Build that habit first. It may help you learn what you need to change.