Mental Health Cheatsheet Cheatsheet

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Depression vs Burnout Checklist

Know the Difference

Depression and burnout share overlapping symptoms but have different root causes and require different approaches. Misidentifying one as the other can delay proper treatment. Use this checklist to assess your symptoms.

Feature	Depression	Burnout (Occupational)
Primary Cause	Biochemical, genetic, trauma, loss; can happen without obvious trigger	Chronic workplace stress, overwork, lack of control or recognition
Duration	Persistent (weeks to years); can be lifelong without treatment	Develops gradually; improves with rest, boundary changes, job changes
Mood Pattern	Low mood persisting across ALL areas of life	Dissatisfaction primarily related to work; may enjoy hobbies/social life
Self-Worth	Pervasive feelings of worthlessness, guilt, self-loathing	Feelings of incompetence specifically at work; self-worth intact outside work
Physical Symptoms	Changes in sleep (insomnia or hypersomnia), appetite changes, unexplained aches, fatigue	Exhaustion, headaches, GI issues, insomnia; improve during weekends/vacations
Motivation	Anhedonia — loss of interest in ALL activities (sex, hobbies, socializing)	Loss of motivation for work tasks; may still enjoy personal activities
Cognitive Impact	Difficulty concentrating, indecisiveness, negative thought patterns	Cynicism, detachment, mental fogginess, irritability at work
Treatment Priority	Professional therapy (CBT, IPT) + medication (SSRIs/SNRIs) may be needed	Workplace changes, boundary setting, rest, time off; therapy if persistent
Risk if Untreated	Suicidal ideation, self-harm, substance abuse, relationship breakdown	Physical illness, chronic stress, eventual depression, career derailment
Key Differentiator	Symptoms present even during vacations, weekends, and pleasurable activities	Symptoms significantly improve during time away from work

PHQ-9 Depression Screening (Quick Self-Assessment)

0 = Not at allOver the last 2 weeks, how often have you been bothered by the following?

1 = Several days

2 = More than half the days

3 = Nearly every day

Question 1Little interest or pleasure in doing things

Question 2Feeling down, depressed, or hopeless

Question 3Trouble falling or staying asleep, or sleeping too much

Question 4Feeling tired or having little energy

Question 5Poor appetite or overeating

Question 6Feeling bad about yourself — that you are a failure or have let yourself/family down

Question 7Trouble concentrating on things like reading or watching TV

Question 8Moving or speaking so slowly that others notice, OR being fidgety/restless

Question 9Thoughts of being better off dead or hurting yourself in some way

Scoring0-4: Minimal | 5-9: Mild | 10-14: Moderate | 15-19: Moderately Severe | 20-27: Severe

ActionScore 10+ = Consult a mental health professional | Score on Q9 any 1+ = Seek help immediately

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Important: PHQ-9 is a screening tool, not a diagnosis. Only a qualified mental health professional can diagnose clinical depression. If you score 10 or above, or have any suicidal thoughts, please reach out to a professional immediately. You are not alone.

Maslach Burnout Inventory — Key Domains

Domain	Description	Signs You May Be Affected	Recovery Action
Emotional Exhaustion	Feeling emotionally drained, unable to give more of yourself	Dreading work, chronic fatigue, dread upon waking, emotional numbness	Prioritize rest, set firm boundaries, take actual vacation (no work emails)
Depersonalization	Developing cynical, detached attitudes toward work/people	Treating people as objects, irritability, calling in sick frequently	Reconnect with purpose, mindfulness, reduce workload, seek new challenges
Reduced Accomplishment	Feeling incompetent and that your work lacks meaning	Believing nothing you do matters, loss of confidence, avoiding new tasks	Celebrate small wins, seek feedback, take on meaningful projects

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Anxiety Management Techniques

Evidence-Based Strategies

Anxiety disorders affect approximately 30% of adults at some point in their lives. While some anxiety is normal and adaptive, chronic anxiety can be debilitating. These techniques are backed by clinical research and recommended by the APA and NICE guidelines.

Types of Anxiety Disorders

Disorder	Key Features	Prevalence	First-Line Treatment
Generalized Anxiety Disorder (GAD)	Excessive worry about multiple areas (health, finances, work) for 6+ months; physical symptoms (muscle tension, restlessness, fatigue)	3-5% of population	CBT, SSRIs (Sertraline, Escitalopram), SNRIs (Venlafaxine)
Panic Disorder	Recurrent unexpected panic attacks; intense fear of future attacks; avoidance behaviors	2-3% of population	CBT with interoceptive exposure, SSRIs, benzodiazepines (short-term only)
Social Anxiety Disorder	Intense fear of social situations, scrutiny, humiliation; avoidance of social interactions	7-13% lifetime	CBT with exposure therapy, SSRIs, group therapy
Specific Phobias	Intense, disproportionate fear of specific objects/situations (heights, spiders, flying, needles)	8-12% lifetime	Exposure therapy (systematic desensitization), CBT
Health Anxiety	Preoccupation with having or acquiring a serious illness; frequent body checking, medical visits	1-3% of population	CBT, SSRIs, mindfulness-based therapy
OCD	Intrusive thoughts (obsessions) + repetitive behaviors (compulsions); fear of contamination, symmetry, harm	1-2% of population	ERP (Exposure and Response Prevention), SSRIs (high dose), CBT

Immediate Anxiety Relief Techniques (5-Minute Toolkit)

Technique	How to Do It	Why It Works	Best For
4-7-8 Breathing	Inhale 4 sec, hold 7 sec, exhale 8 sec; repeat 4 cycles	Activates parasympathetic nervous system; slows heart rate	Acute anxiety, panic attacks, sleep difficulties
5-4-3-2-1 Grounding	Name 5 things you see, 4 you hear, 3 you touch, 2 you smell, 1 you taste	Redirects attention from internal worry to external reality	Panic attacks, dissociation, acute stress
Progressive Muscle Relaxation	Tense each muscle group 5 sec then release (feet to head); notice the contrast	Reduces physical tension that feeds anxiety loop	GAD, insomnia, chronic muscle tension
Box Breathing	Inhale 4 sec, hold 4 sec, exhale 4 sec, hold 4 sec; repeat 4-8 cycles	Regulates CO2 levels; used by Navy SEALs for stress control	Pre-performance anxiety, acute stress, PTSD triggers
Cold Water Immersion	Splash cold water on face or hold ice cube for 30-60 seconds	Triggers mammalian dive reflex; instantly activates vagus nerve	Panic attacks, emotional flooding, self-harm urges
Body Scan	Close eyes, slowly scan attention from toes to crown; notice sensations without judgment	Interrupts rumination cycle; builds interoceptive awareness	GAD, health anxiety, general tension, bedtime

Long-Term Anxiety Management — Daily Habits

Exercise (30 min, 5x/week)Reduces anxiety symptoms by 48% (meta-analysis, 2023); as effective as medication for mild-moderate anxiety

Limit CaffeineMax 200mg/day (1-2 cups coffee); caffeine mimics anxiety symptoms (racing heart, jitters)

Sleep Hygiene7-9 hours; sleep deprivation increases anxiety reactivity by 30-40% (fMRI studies)

Reduce Social MediaMore than 2 hours/day linked to 2x higher anxiety risk (especially comparison-based content)

Journaling15 min/day expressive writing reduces anxiety by 37% (Pennebaker studies); try worry-time scheduling

Social ConnectionRegular meaningful social interaction reduces cortisol and anxiety; even 10 min of conversation helps

Mindfulness Practice10 min/day mindfulness meditation reduces anxiety relapse by 40% (MBCT studies)

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When to Seek Professional Help: If anxiety interferes with daily functioning (work, relationships, sleep) for more than 2 weeks, or if you experience panic attacks, see a psychiatrist or psychologist. Anxiety disorders are highly treatable — 60-90% of people improve with evidence-based treatment. Do not self-medicate with alcohol or substances.

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CBT Thought Record Template

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is the gold standard for treating anxiety and depression. The core principle: our thoughts, feelings, and behaviors are interconnected. Changing distorted thinking patterns changes emotional responses. A thought record is the most powerful CBT self-help tool.

Common Cognitive Distortions (Thinking Traps)

Distortion	Definition	Example	Balanced Thought
All-or-Nothing Thinking	Viewing situations in only two categories (black/white)	"I failed one exam — I am a total failure"	"I did poorly on this exam, but I passed 4 others this semester"
Catastrophizing	Assuming the worst possible outcome will happen	"If I make a mistake at work, I will be fired"	"A mistake is disappointing but manageable; I can learn from it"
Mind Reading	Assuming you know what others are thinking	"My boss did not say hi — she must think I am incompetent"	"She might be busy or distracted; I cannot read her mind"
Emotional Reasoning	Believing feelings reflect reality	"I feel anxious, so something bad must be about to happen"	"Feelings are not facts; anxiety does not predict danger"
Should Statements	Rigid rules about how you or others must behave	"I should always be productive; relaxing is wasteful"	"Rest is essential for productivity; I deserve downtime"
Personalization	Taking blame for events outside your control	"My child is struggling at school — I am a bad parent"	"Many factors affect school performance; I am supporting them as best I can"
Overgeneralization	Drawing broad conclusions from a single event	"This relationship ended — I will always be alone"	"This relationship did not work out; many people find love after breakups"
Mental Filter	Focusing only on negative details, ignoring positives	"My presentation had one mistake — it was terrible"	"The presentation went well overall; one mistake does not define it"
Discounting Positives	Minimizing achievements or good experiences	"I only got the promotion because they needed someone"	"My skills and hard work contributed to my promotion"
Labeling	Attaching a fixed negative label to yourself or others	"I am lazy"	"I procrastinated today; I can take action tomorrow"

CBT Thought Record Template (7-Column Model)

Column	Prompt	Your Entry
1. Situation	What happened? (Facts only, no interpretation)	"My colleague did not invite me to lunch"
2. Emotions	What did you feel? Rate intensity 0-100%	"Excluded (85%), Sad (70%), Angry (60%)"
3. Automatic Thought	What went through your mind?	"They do not like me. Nobody wants me around"
4. Evidence For	What facts support this thought?	"They invited others but not me"
5. Evidence Against	What facts contradict this thought?	"They helped me yesterday; we had coffee last week; they might have had a private meeting"
6. Balanced Thought	Based on all evidence, what is a more balanced view?	"I was not invited this time, which stings, but one instance does not mean they dislike me. I can ask to join next time"
7. Outcome	How do you feel now? Rate 0-100%	"Excluded (40%), Sad (30%), Angry (20%) — more manageable"

How to Challenge Automatic Thoughts — Socratic Questions

What is the evidence?What facts support this thought? What facts contradict it?

Is there an alternative explanation?What else could explain this situation besides my first interpretation?

What would I tell a friend?If a friend told me this thought, what would I say to them?

Is this thought helpful?Does thinking this way help me feel better or solve the problem?

Am I confusing a feeling with a fact?Just because I feel something does not make it objectively true

What is the worst/best/most likely outcome?Decatastrophize: what is realistically most likely to happen?

Will this matter in 5 years?Perspective check: is this a temporary setback or a life-defining event?

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Daily Practice Tip: Complete 1-2 thought records daily for 2-3 weeks. Research shows that consistent thought record use reduces depression relapse rates by 50% and anxiety symptoms by 30-40%. Use a notebook or apps like Thought Diary, Moodnotes, or Woebot. The goal is not positive thinking but realistic, balanced thinking.

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DBT TIPP Skills

Distress Tolerance

Dialectical Behavior Therapy (DBT) was developed by Dr. Marsha Linehan for borderline personality disorder, but its distress tolerance skills are universally useful. The TIPP skills are rapid-acting biological interventions to reduce extreme emotional arousal when you are at a crisis point.

TIPP Skills — Breakdown

Skill	Full Name	How to Do It	Mechanism of Action	Duration	Caution
T	Temperature	Hold ice cubes to face/neck, splash cold water on face, take a cold shower, or suck on an ice cube. Aim for below 50°F (10°C)	Activates the dive reflex — slows heart rate via vagus nerve stimulation; reduces sympathetic nervous system arousal	30 seconds - 2 minutes	Do not use if you have a heart condition. Avoid ice directly on skin for more than 2 minutes (frostbite risk)
I	Intense Exercise	20 minutes of vigorous exercise: running, jumping jacks, pushups, cycling, dancing, brisk walking uphill	Burns off stress hormones (cortisol, adrenaline); releases endorphins; redirects blood flow from emotional brain to muscles	15-20 minutes	Start slow if deconditioned. Intense exercise followed by slow stretching works best. Do not overexert to injury
P	Paced Breathing	Breathe in deeply (5 seconds), exhale slowly (7 seconds). Focus on making exhales longer than inhales. Belly breathing preferred	Longer exhales stimulate the vagus nerve; reduces heart rate and blood pressure; activates parasympathetic system	5-10 minutes	Do not hyperventilate. If dizzy, return to normal breathing. Breathing should be smooth, not forced
P	Paired Muscle Relaxation	While breathing IN slowly, tense a muscle group (fists, arms, shoulders). While breathing OUT slowly, release the tension completely	Combines breathing with progressive muscle relaxation; creates a body-mind feedback loop that signals safety to the brain	10-15 minutes	Do not tense injured or painful areas. Focus on the contrast between tension and relaxation

When to Use TIPP Skills

Emotion is at 85+ intensityYou feel emotionally out of control — overwhelmed, about to act impulsively, on the verge of a panic attack

Before making impulsive decisionsYou feel the urge to self-harm, use substances, send an angry message, or make a rash decision

When other coping is not enoughStandard grounding and breathing techniques are not reducing the emotional intensity

Physical interventions work fastestTIPP uses your biology against intense emotions — they work faster than cognitive techniques at peak arousal

Not a replacement for therapyTIPP is a crisis skill, not a cure. It helps you survive the moment so you can address the root cause in therapy

Additional DBT Distress Tolerance Skills

Skill	Technique	Example
STOP	Stop, Take a breath, Observe, Proceed mindfully	Before reacting to provocation: pause, breathe, notice your emotions, then respond deliberately
TIP (Skills Above)	Temperature, Intense Exercise, Paced Breathing, Paired Relaxation	See detailed breakdown above
Self-Soothe (5 Senses)	Vision: look at nature photos. Hearing: listen to calming music. Smell: lavender, coffee. Taste: chocolate, mint tea. Touch: soft blanket, warm bath	Create a self-soothe kit with items for each sense; use when feeling anxious or sad
IMPROVE the Moment	Imagery, Meaning, Prayer, Relaxation, One thing, Vacation (brief), Encouragement	Imagery: visualize a safe place. Meaning: find purpose. Prayer: connect with spirituality. One thing: focus on one task
Radical Acceptance	Fully accept reality as it is without fighting it; acknowledge pain without judgment	"I do not like this situation, but fighting it only adds suffering. I choose to accept it and move forward"
TURNING THE MIND	Making an inner commitment to accept reality; you may need to turn the mind 100 times	"I notice resistance. I am turning my mind toward acceptance again. It is hard but necessary"

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DBT Skills Hierarchy: Use TIPP when emotion intensity is very high (above 80/100). Use cognitive techniques (CBT thought records, problem-solving) when intensity is moderate (40-80). Use mindfulness and self-care when intensity is low (below 40). Trying to do cognitive work during peak emotion is like trying to solve a math problem while running from a tiger.

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Mindfulness Quick Practices

5-Minute to 30-Minute

Mindfulness is paying attention to the present moment with curiosity and without judgment. Over 25,000 studies on PubMed confirm its benefits for anxiety, depression, chronic pain, and stress. Jon Kabat-Zinn's MBSR (Mindfulness-Based Stress Reduction) program is the gold standard, used in 740+ hospitals worldwide.

Mindfulness Practices by Duration

Duration	Practice	Step-by-Step Instructions	Best For
1 Minute	Anchor Breathing	Close eyes. Feel 10 natural breaths. Notice where you feel the breath most (nostrils, chest, belly). When mind wanders, gently return. Count each breath.	Transitioning between tasks, before meetings, waiting in line
3 Minutes	STOP Practice	S: Stop what you are doing. T: Take 3 deep breaths. O: Observe your body, thoughts, and emotions. P: Proceed with awareness of the next action you take.	Mid-day stress reset, before difficult conversations, when feeling overwhelmed
5 Minutes	Body Scan (Mini)	Close eyes. Starting at toes, slowly bring attention to each body part moving upward. Notice sensations (warmth, tingling, tension, nothing). No judgment — just notice.	End of day wind-down, post-exercise, when feeling disconnected from body
10 Minutes	Mindful Breathing	Sit comfortably, spine straight. Focus on the sensation of breathing at the nostrils. When thoughts arise, note "thinking" and return to breath. Count exhales 1-10, restart if lost.	Daily practice, morning routine, reducing general anxiety
15 Minutes	Loving-Kindness (Metta)	Silently repeat phrases: "May I be happy. May I be healthy. May I be safe. May I live with ease." Then direct toward a loved one, a neutral person, a difficult person, all beings.	Self-criticism, anger toward someone, feeling isolated, relationship stress
20 Minutes	Open Monitoring	Sit in silence. Notice whatever arises — sounds, thoughts, sensations, emotions — without following or pushing away. Label experiences: "hearing," "thinking," "itching." Wide awareness.	Advanced practitioners, building present-moment awareness, reducing reactivity
30 Minutes	Full Body Scan	Lie down comfortably. Systematically scan entire body from toes to crown, spending 1-2 min per region. Notice temperature, pressure, pain, tingling, or absence of sensation. Breathe into tension areas.	Insomnia, chronic pain, deep relaxation, weekly self-care ritual

Mindfulness for Specific Situations

Situation	Technique	Duration	Instructions
Cannot Sleep	Yoga Nidra / Body Scan	15-20 min	Lie in savasana. Listen to a guided body scan (YouTube: "Yoga Nidra for sleep"). Follow attention through body parts; remain still and awake-observer
Anger Rising	RAIN Technique	5-10 min	Recognize anger. Allow it to exist. Investigate where you feel it in body. Non-identify: "Anger is present, but I am not my anger"
Overthinking / Rumination	Thought Observation	5-10 min	Imagine thoughts as clouds passing across sky. Each thought appears, drifts, disappears. You are the sky, not the clouds. Do not engage with content
Before a Difficult Task	Centering Practice	3-5 min	Feet flat on floor. Feel gravity. 5 breaths. Set intention: "I will do my best with what I have right now." Open eyes and begin
Social Anxiety	External Sensing	2-5 min	Before entering social situation, focus on 5 sounds you hear, 4 colors you see, 3 textures you feel. This shifts attention outward from self-focus

Building a Sustainable Mindfulness Habit

Start SmallJust 5 minutes daily is enough to build the habit. Consistency matters more than duration.

Same Time, Same PlaceAnchor practice to existing habit (after brushing teeth, before bed). Context cues make habits stick.

Guided vs UnguidedBeginners: use guided apps (Headspace, Calm, Insight Timer, Waking Up). After 30 days, try unguided.

Expect Mind-WanderingMind-wandering is NOT failure. Noticing that you wandered IS the practice. The moment of noticing = 1 rep at the mental gym.

Track ProgressNote your practice in a journal: duration, how you felt before/after. Benefits compound over 8-12 weeks.

Group PracticeJoin a local meditation group or online sangha. Social accountability increases consistency by 65%.

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Science Backs Mindfulness: A 2024 meta-analysis of 226 RCTs (n=35,000+) found mindfulness reduces anxiety by 32%, depression by 28%, and chronic pain by 23%. Brain imaging shows increased gray matter in the prefrontal cortex (decision-making) and decreased amygdala reactivity (fear response) after just 8 weeks of practice.

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Crisis Support Guide

Emergency Resources

If you or someone you know is in a mental health crisis, immediate help is available. You do not need to face this alone. These resources are free, confidential, and available 24/7.

India Crisis Helplines (24/7, Free)

Resource	Number	Type	Details
iCall (TISS, Mumbai)	9152987821	Counseling helpline	Professional counselors from Tata Institute of Social Sciences; Mon-Sat 8 AM - 10 PM; email: icall@tiss.edu
Vandrevala Foundation	1860-2662-345 / 1800-2333-030	Crisis helpline	24/7 emotional support; trained counselors; available in English, Hindi, and regional languages; free from all networks
AASRA	9820466726	Suicide prevention	24/7 crisis intervention; Mumbai-based but pan-India via phone; also available on WhatsApp
NIMHANS	080-46110007	Psychiatric helpline	National Institute of Mental Health & Neurosciences, Bangalore; 24/7 psychiatric support and referrals
Fortis Stress Helpline	08376804102	Stress counseling	24/7 counseling support by Fortis Healthcare; trained psychiatrists and counselors
NATIONAL: 112	112	Emergency (India)	Pan-India emergency number for any crisis including mental health emergencies; connects to nearest emergency services
NATIONAL: Tele-MANAS	14416	Tele-mental health	Government of India initiative; 24/7 toll-free; counseling in 20+ languages; connects to district mental health teams
Sneha Foundation	044-24640050 / 044-24640060	Crisis support	Chennai-based; 24/7; emotional support for depression, suicidal ideation, relationship issues

International Crisis Resources

Country	Number	Notes
USA / Canada	988 (Suicide & Crisis Lifeline)	Call or text 988; available 24/7; also text HOME to 741741 (Crisis Text Line)
UK	111 (NHS) / 116 123 (Samaritans)	Samaritans free 24/7: 116 123; also jo@samaritans.org
Australia	13 11 14 (Lifeline)	24/7 crisis support and suicide prevention
Global	befrienders.org	Directory of crisis centers worldwide; find local resources in 30+ countries

How to Help Someone in Crisis — ALGEE Action Plan

A — ApproachApproach the person gently. Find a private space. Use a calm voice. Say: "I have noticed you seem to be going through a tough time. I am here for you."

L — ListenListen non-judgmentally. Do not interrupt, problem-solve, or offer platitudes ("cheer up," "it could be worse"). Validate their feelings: "That sounds really hard."

G — Give SupportGive reassurance and information. Say: "You are not alone. Help is available." Offer to call a helpline together or accompany them to a doctor.

E — Encourage Professional HelpEncourage seeing a mental health professional. Offer to help find a therapist, make appointments, or arrange transportation. Offer to go with them.

E — Encourage Self-HelpEncourage coping strategies: exercise, journaling, talking to trusted friends, avoiding alcohol/drugs, maintaining routine.

Warning Signs of Suicide — Take Them Seriously

Warning Sign	What to Look For	What to Do
Talking About Death	Statements like "I wish I were dead," "I will not be around much longer," "What is the point of living?"	Ask directly: "Are you thinking about suicide?" This does NOT plant the idea — it opens the door for help.
Giving Away Possessions	Giving away prized items, writing farewell notes, making a will, settling debts	Do not keep this a secret. Inform a trusted family member, friend, or professional immediately.
Withdrawing from Life	Isolating from friends and family, loss of interest in activities, neglecting appearance	Stay connected. Reach out even if they push you away. Persistent gentle contact matters.
Sudden Calmness	After severe depression, a sudden calm or peace can mean they have made a decision	This is a critical warning sign. Do not be fooled by the calm. Seek professional help immediately.
Previous Attempts	Anyone who has attempted suicide before is at significantly higher risk	They need ongoing support and professional monitoring. Help them maintain their safety plan.
Substance Abuse Increase	Sudden increase in alcohol or drug use, especially in someone previously in recovery	Substances lower inhibitions and increase impulsivity. Address the substance use as a safety concern.

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If someone is in immediate danger: Do not leave them alone. Remove access to means (medications, sharp objects, ropes, firearms). Call 112 or take them to the nearest emergency room. Stay with them until help arrives. Your presence matters more than you know.

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Therapy Types Compared

Choosing the Right Approach

Not all therapy is the same. Different approaches work better for different conditions, personalities, and goals. This comparison helps you understand the options and make an informed decision with your therapist.

Therapy Type	Best For	How It Works	Duration	Cost in India (per session)	Evidence Level
CBT (Cognitive Behavioral Therapy)	Depression, anxiety, OCD, phobias, eating disorders, insomnia	Identifies and challenges negative thought patterns; behavioral experiments; homework between sessions	12-20 sessions (3-6 months)	₹800-3,000	Strongest evidence base; 2000+ RCTs; NICE first-line recommendation
DBT (Dialectical Behavior Therapy)	BPD, self-harm, emotional dysregulation, eating disorders, substance use	Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness; individual + group sessions	6-12 months minimum	₹1,000-4,000	Strong evidence for BPD and self-harm; effective for emotion regulation
Psychodynamic / Psychoanalytic	Depression, anxiety, relationship patterns, personality issues, trauma	Explores unconscious patterns from childhood; free association; explores transference in therapeutic relationship	1-5 years (long-term)	₹1,000-3,500	Moderate evidence; effective for complex, deep-rooted issues
ACT (Acceptance & Commitment)	Chronic pain, anxiety, depression, OCD, work stress	Accepts difficult thoughts/feelings rather than fighting them; committed action toward values-based goals; mindfulness	8-16 sessions	₹800-2,500	Strong growing evidence; WHO-endorsed for chronic pain
EMDR (Eye Movement Desensitization)	PTSD, trauma, phobias, grief, anxiety	Bilateral stimulation (eye movements, taps, tones) while recalling traumatic memory; reprocesses memory to reduce emotional charge	6-12 sessions	₹1,500-5,000	Strong evidence for PTSD (NICE, WHO recommended); emerging for other conditions
IPT (Interpersonal Therapy)	Depression, grief/bereavement, relationship disputes, life transitions	Focuses on interpersonal relationships and social functioning; improves communication skills; attachment patterns	12-16 sessions	₹800-2,500	Strong evidence for depression; as effective as CBT for mild-moderate depression
SFBT (Solution-Focused Brief)	Specific life problems, behavioral issues, relationship conflicts, goal-setting	Focuses on solutions rather than problems; identifies strengths and resources; miracle question technique	3-10 sessions	₹500-2,000	Moderate evidence; very effective for goal-oriented individuals
MBCT (Mindfulness-Based CBT)	Depression relapse prevention, anxiety, chronic stress	Combines CBT with mindfulness meditation; teaches awareness of thoughts as mental events, not facts	8 weekly group sessions	₹500-1,500 per group	Strong evidence for preventing depression relapse (50% reduction)
Couple Therapy (Gottman/EFT)	Relationship distress, communication issues, infidelity, intimacy concerns	Gottman: conflict management, friendship building. EFT: attachment-based emotional responsiveness	10-25 sessions	₹1,500-5,000 per couple	Strong evidence; 70-75% of couples show improvement
Family Therapy	Family conflict, child/adolescent behavioral issues, eating disorders, addiction	Treats the family as a system; examines communication patterns, roles, boundaries; structural and strategic approaches	10-20 sessions	₹1,500-4,000	Strong evidence for child/adolescent issues and eating disorders

How to Choose a Therapist

CredentialsLook for: M.Phil in Clinical Psychology, PhD in Psychology, or MD Psychiatry. RCI (Rehabilitation Council of India) registration for psychologists.

Approach MatchCBT for specific symptom reduction. Psychodynamic for self-understanding. DBT for emotional regulation. EMDR for trauma. Match the therapy to the problem.

Comfort LevelTherapeutic alliance is the #1 predictor of outcome (40% of improvement). If you do not feel safe and heard, switch therapists. No shame in that.

Online vs In-PersonOnline therapy (Practo, BetterHelp, Lybrate) is equally effective for most conditions. In-person is preferred for severe PTSD, eating disorders, and personality disorders.

Platforms in IndiaPracto, Lybrate, Manastha, YourDOST (student-focused), TTK Healthcare, Fortis, NIMHANS OPD (low cost). Tele-MANAS is free.

Red FlagsTherapist who guarantees a cure, crosses boundaries, dismisses your concerns, only listens without providing tools, or pressures you into decisions.

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Therapy Works: 75-80% of people who enter therapy show significant improvement. The average person in therapy is better off than 79% of those who do not receive treatment. It is not a sign of weakness — it is a sign of courage and self-investment.

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Loading cheatsheet...

Feature

Depression

Burnout (Occupational)

Primary Cause

Biochemical, genetic, trauma, loss; can happen without obvious trigger

Chronic workplace stress, overwork, lack of control or recognition

Duration

Persistent (weeks to years); can be lifelong without treatment

Develops gradually; improves with rest, boundary changes, job changes

Mood Pattern

Low mood persisting across ALL areas of life

Dissatisfaction primarily related to work; may enjoy hobbies/social life

Self-Worth

Pervasive feelings of worthlessness, guilt, self-loathing

Feelings of incompetence specifically at work; self-worth intact outside work

Physical Symptoms

Changes in sleep (insomnia or hypersomnia), appetite changes, unexplained aches, fatigue

Exhaustion, headaches, GI issues, insomnia; improve during weekends/vacations

Motivation

Anhedonia — loss of interest in ALL activities (sex, hobbies, socializing)

Loss of motivation for work tasks; may still enjoy personal activities

Cognitive Impact

Difficulty concentrating, indecisiveness, negative thought patterns

Cynicism, detachment, mental fogginess, irritability at work

Treatment Priority

Professional therapy (CBT, IPT) + medication (SSRIs/SNRIs) may be needed

Workplace changes, boundary setting, rest, time off; therapy if persistent

Risk if Untreated

Suicidal ideation, self-harm, substance abuse, relationship breakdown

Physical illness, chronic stress, eventual depression, career derailment

Key Differentiator

Symptoms present even during vacations, weekends, and pleasurable activities

Symptoms significantly improve during time away from work

Domain

Description

Signs You May Be Affected

Recovery Action

Emotional Exhaustion

Feeling emotionally drained, unable to give more of yourself

Dreading work, chronic fatigue, dread upon waking, emotional numbness

Prioritize rest, set firm boundaries, take actual vacation (no work emails)

Depersonalization

Developing cynical, detached attitudes toward work/people

Treating people as objects, irritability, calling in sick frequently

Reconnect with purpose, mindfulness, reduce workload, seek new challenges

Reduced Accomplishment

Feeling incompetent and that your work lacks meaning

Believing nothing you do matters, loss of confidence, avoiding new tasks

Celebrate small wins, seek feedback, take on meaningful projects

Disorder

Key Features

Prevalence

First-Line Treatment

Generalized Anxiety Disorder (GAD)

Excessive worry about multiple areas (health, finances, work) for 6+ months; physical symptoms (muscle tension, restlessness, fatigue)

3-5% of population

CBT, SSRIs (Sertraline, Escitalopram), SNRIs (Venlafaxine)

Panic Disorder

Recurrent unexpected panic attacks; intense fear of future attacks; avoidance behaviors

2-3% of population

CBT with interoceptive exposure, SSRIs, benzodiazepines (short-term only)

Social Anxiety Disorder

Intense fear of social situations, scrutiny, humiliation; avoidance of social interactions

7-13% lifetime

CBT with exposure therapy, SSRIs, group therapy

Specific Phobias

Intense, disproportionate fear of specific objects/situations (heights, spiders, flying, needles)

8-12% lifetime

Exposure therapy (systematic desensitization), CBT

Health Anxiety

Preoccupation with having or acquiring a serious illness; frequent body checking, medical visits

1-3% of population

CBT, SSRIs, mindfulness-based therapy

OCD

Intrusive thoughts (obsessions) + repetitive behaviors (compulsions); fear of contamination, symmetry, harm

1-2% of population

ERP (Exposure and Response Prevention), SSRIs (high dose), CBT

Technique

How to Do It

Why It Works

Best For

4-7-8 Breathing

Inhale 4 sec, hold 7 sec, exhale 8 sec; repeat 4 cycles

Activates parasympathetic nervous system; slows heart rate

Acute anxiety, panic attacks, sleep difficulties

5-4-3-2-1 Grounding

Name 5 things you see, 4 you hear, 3 you touch, 2 you smell, 1 you taste

Redirects attention from internal worry to external reality

Panic attacks, dissociation, acute stress

Progressive Muscle Relaxation

Tense each muscle group 5 sec then release (feet to head); notice the contrast

Reduces physical tension that feeds anxiety loop

GAD, insomnia, chronic muscle tension

Box Breathing

Inhale 4 sec, hold 4 sec, exhale 4 sec, hold 4 sec; repeat 4-8 cycles

Regulates CO2 levels; used by Navy SEALs for stress control

Pre-performance anxiety, acute stress, PTSD triggers

Cold Water Immersion

Splash cold water on face or hold ice cube for 30-60 seconds

Triggers mammalian dive reflex; instantly activates vagus nerve

Panic attacks, emotional flooding, self-harm urges

Body Scan

Close eyes, slowly scan attention from toes to crown; notice sensations without judgment

Interrupts rumination cycle; builds interoceptive awareness

GAD, health anxiety, general tension, bedtime

Distortion

Definition

Example

Balanced Thought

All-or-Nothing Thinking

Viewing situations in only two categories (black/white)

"I failed one exam — I am a total failure"

"I did poorly on this exam, but I passed 4 others this semester"

Catastrophizing

Assuming the worst possible outcome will happen

"If I make a mistake at work, I will be fired"

"A mistake is disappointing but manageable; I can learn from it"

Mind Reading

Assuming you know what others are thinking

"My boss did not say hi — she must think I am incompetent"

"She might be busy or distracted; I cannot read her mind"

Emotional Reasoning

Believing feelings reflect reality

"I feel anxious, so something bad must be about to happen"

"Feelings are not facts; anxiety does not predict danger"

Should Statements

Rigid rules about how you or others must behave

"I should always be productive; relaxing is wasteful"

"Rest is essential for productivity; I deserve downtime"

Personalization

Taking blame for events outside your control

"My child is struggling at school — I am a bad parent"

"Many factors affect school performance; I am supporting them as best I can"

Overgeneralization

Drawing broad conclusions from a single event

"This relationship ended — I will always be alone"

"This relationship did not work out; many people find love after breakups"

Mental Filter

Focusing only on negative details, ignoring positives

"My presentation had one mistake — it was terrible"

"The presentation went well overall; one mistake does not define it"

Discounting Positives

Minimizing achievements or good experiences

"I only got the promotion because they needed someone"

"My skills and hard work contributed to my promotion"

Labeling

Attaching a fixed negative label to yourself or others

"I am lazy"

"I procrastinated today; I can take action tomorrow"

Column

Prompt

Your Entry

1. Situation

What happened? (Facts only, no interpretation)

"My colleague did not invite me to lunch"

2. Emotions

What did you feel? Rate intensity 0-100%

"Excluded (85%), Sad (70%), Angry (60%)"

3. Automatic Thought

What went through your mind?

"They do not like me. Nobody wants me around"

4. Evidence For

What facts support this thought?

"They invited others but not me"

5. Evidence Against

What facts contradict this thought?

"They helped me yesterday; we had coffee last week; they might have had a private meeting"

6. Balanced Thought

Based on all evidence, what is a more balanced view?

"I was not invited this time, which stings, but one instance does not mean they dislike me. I can ask to join next time"

7. Outcome

How do you feel now? Rate 0-100%

"Excluded (40%), Sad (30%), Angry (20%) — more manageable"

Skill

Full Name

How to Do It

Mechanism of Action

Duration

Caution

Temperature

Hold ice cubes to face/neck, splash cold water on face, take a cold shower, or suck on an ice cube. Aim for below 50°F (10°C)

Activates the dive reflex — slows heart rate via vagus nerve stimulation; reduces sympathetic nervous system arousal

30 seconds - 2 minutes

Do not use if you have a heart condition. Avoid ice directly on skin for more than 2 minutes (frostbite risk)

Intense Exercise

20 minutes of vigorous exercise: running, jumping jacks, pushups, cycling, dancing, brisk walking uphill

Burns off stress hormones (cortisol, adrenaline); releases endorphins; redirects blood flow from emotional brain to muscles

15-20 minutes

Start slow if deconditioned. Intense exercise followed by slow stretching works best. Do not overexert to injury

Paced Breathing

Breathe in deeply (5 seconds), exhale slowly (7 seconds). Focus on making exhales longer than inhales. Belly breathing preferred

Longer exhales stimulate the vagus nerve; reduces heart rate and blood pressure; activates parasympathetic system

5-10 minutes

Do not hyperventilate. If dizzy, return to normal breathing. Breathing should be smooth, not forced

Paired Muscle Relaxation

While breathing IN slowly, tense a muscle group (fists, arms, shoulders). While breathing OUT slowly, release the tension completely

Combines breathing with progressive muscle relaxation; creates a body-mind feedback loop that signals safety to the brain

10-15 minutes

Do not tense injured or painful areas. Focus on the contrast between tension and relaxation

Skill

Technique

Example

STOP

Stop, Take a breath, Observe, Proceed mindfully

Before reacting to provocation: pause, breathe, notice your emotions, then respond deliberately

TIP (Skills Above)

Temperature, Intense Exercise, Paced Breathing, Paired Relaxation

See detailed breakdown above

Self-Soothe (5 Senses)

Vision: look at nature photos. Hearing: listen to calming music. Smell: lavender, coffee. Taste: chocolate, mint tea. Touch: soft blanket, warm bath

Create a self-soothe kit with items for each sense; use when feeling anxious or sad

IMPROVE the Moment

Imagery, Meaning, Prayer, Relaxation, One thing, Vacation (brief), Encouragement

Imagery: visualize a safe place. Meaning: find purpose. Prayer: connect with spirituality. One thing: focus on one task

Radical Acceptance

Fully accept reality as it is without fighting it; acknowledge pain without judgment

"I do not like this situation, but fighting it only adds suffering. I choose to accept it and move forward"

TURNING THE MIND

Making an inner commitment to accept reality; you may need to turn the mind 100 times

"I notice resistance. I am turning my mind toward acceptance again. It is hard but necessary"

Duration

Practice

Step-by-Step Instructions

Best For

1 Minute

Anchor Breathing

Close eyes. Feel 10 natural breaths. Notice where you feel the breath most (nostrils, chest, belly). When mind wanders, gently return. Count each breath.

Transitioning between tasks, before meetings, waiting in line

3 Minutes

STOP Practice

S: Stop what you are doing. T: Take 3 deep breaths. O: Observe your body, thoughts, and emotions. P: Proceed with awareness of the next action you take.

Mid-day stress reset, before difficult conversations, when feeling overwhelmed

5 Minutes

Body Scan (Mini)

Close eyes. Starting at toes, slowly bring attention to each body part moving upward. Notice sensations (warmth, tingling, tension, nothing). No judgment — just notice.

End of day wind-down, post-exercise, when feeling disconnected from body

10 Minutes

Mindful Breathing

Sit comfortably, spine straight. Focus on the sensation of breathing at the nostrils. When thoughts arise, note "thinking" and return to breath. Count exhales 1-10, restart if lost.

Daily practice, morning routine, reducing general anxiety

15 Minutes

Loving-Kindness (Metta)

Silently repeat phrases: "May I be happy. May I be healthy. May I be safe. May I live with ease." Then direct toward a loved one, a neutral person, a difficult person, all beings.

Self-criticism, anger toward someone, feeling isolated, relationship stress

20 Minutes

Open Monitoring

Sit in silence. Notice whatever arises — sounds, thoughts, sensations, emotions — without following or pushing away. Label experiences: "hearing," "thinking," "itching." Wide awareness.

Advanced practitioners, building present-moment awareness, reducing reactivity

30 Minutes

Full Body Scan

Lie down comfortably. Systematically scan entire body from toes to crown, spending 1-2 min per region. Notice temperature, pressure, pain, tingling, or absence of sensation. Breathe into tension areas.

Insomnia, chronic pain, deep relaxation, weekly self-care ritual

Situation

Technique

Duration

Instructions

Cannot Sleep

Yoga Nidra / Body Scan

15-20 min

Lie in savasana. Listen to a guided body scan (YouTube: "Yoga Nidra for sleep"). Follow attention through body parts; remain still and awake-observer

Anger Rising

RAIN Technique

5-10 min

Recognize anger. Allow it to exist. Investigate where you feel it in body. Non-identify: "Anger is present, but I am not my anger"

Overthinking / Rumination

Thought Observation

5-10 min

Imagine thoughts as clouds passing across sky. Each thought appears, drifts, disappears. You are the sky, not the clouds. Do not engage with content

Before a Difficult Task

Centering Practice

3-5 min

Feet flat on floor. Feel gravity. 5 breaths. Set intention: "I will do my best with what I have right now." Open eyes and begin

Social Anxiety

External Sensing

2-5 min

Before entering social situation, focus on 5 sounds you hear, 4 colors you see, 3 textures you feel. This shifts attention outward from self-focus

Resource

Number

Type

Details

iCall (TISS, Mumbai)

9152987821

Counseling helpline

Professional counselors from Tata Institute of Social Sciences; Mon-Sat 8 AM - 10 PM; email: icall@tiss.edu

Vandrevala Foundation

1860-2662-345 / 1800-2333-030

Crisis helpline

24/7 emotional support; trained counselors; available in English, Hindi, and regional languages; free from all networks

AASRA

9820466726

Suicide prevention

24/7 crisis intervention; Mumbai-based but pan-India via phone; also available on WhatsApp

NIMHANS

080-46110007

Psychiatric helpline

National Institute of Mental Health & Neurosciences, Bangalore; 24/7 psychiatric support and referrals

Fortis Stress Helpline

08376804102

Stress counseling

24/7 counseling support by Fortis Healthcare; trained psychiatrists and counselors

NATIONAL: 112

112

Emergency (India)

Pan-India emergency number for any crisis including mental health emergencies; connects to nearest emergency services

NATIONAL: Tele-MANAS

14416

Tele-mental health

Government of India initiative; 24/7 toll-free; counseling in 20+ languages; connects to district mental health teams

Sneha Foundation

044-24640050 / 044-24640060

Crisis support

Chennai-based; 24/7; emotional support for depression, suicidal ideation, relationship issues

Country

Number

Notes

USA / Canada

988 (Suicide & Crisis Lifeline)

Call or text 988; available 24/7; also text HOME to 741741 (Crisis Text Line)

111 (NHS) / 116 123 (Samaritans)

Samaritans free 24/7: 116 123; also jo@samaritans.org

Australia

13 11 14 (Lifeline)

24/7 crisis support and suicide prevention

Global

befrienders.org

Directory of crisis centers worldwide; find local resources in 30+ countries

Warning Sign

What to Look For

What to Do

Talking About Death

Statements like "I wish I were dead," "I will not be around much longer," "What is the point of living?"

Ask directly: "Are you thinking about suicide?" This does NOT plant the idea — it opens the door for help.

Giving Away Possessions

Giving away prized items, writing farewell notes, making a will, settling debts

Do not keep this a secret. Inform a trusted family member, friend, or professional immediately.

Withdrawing from Life

Isolating from friends and family, loss of interest in activities, neglecting appearance

Stay connected. Reach out even if they push you away. Persistent gentle contact matters.

Sudden Calmness

After severe depression, a sudden calm or peace can mean they have made a decision

This is a critical warning sign. Do not be fooled by the calm. Seek professional help immediately.

Previous Attempts

Anyone who has attempted suicide before is at significantly higher risk

They need ongoing support and professional monitoring. Help them maintain their safety plan.

Substance Abuse Increase

Sudden increase in alcohol or drug use, especially in someone previously in recovery

Substances lower inhibitions and increase impulsivity. Address the substance use as a safety concern.

Therapy Type

Best For

How It Works

Duration

Cost in India (per session)

Evidence Level

CBT (Cognitive Behavioral Therapy)

Depression, anxiety, OCD, phobias, eating disorders, insomnia

Identifies and challenges negative thought patterns; behavioral experiments; homework between sessions

12-20 sessions (3-6 months)

₹800-3,000

Strongest evidence base; 2000+ RCTs; NICE first-line recommendation

DBT (Dialectical Behavior Therapy)

BPD, self-harm, emotional dysregulation, eating disorders, substance use

Mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness; individual + group sessions

6-12 months minimum

₹1,000-4,000

Strong evidence for BPD and self-harm; effective for emotion regulation

Psychodynamic / Psychoanalytic

Depression, anxiety, relationship patterns, personality issues, trauma

Explores unconscious patterns from childhood; free association; explores transference in therapeutic relationship

1-5 years (long-term)

₹1,000-3,500

Moderate evidence; effective for complex, deep-rooted issues

ACT (Acceptance & Commitment)

Chronic pain, anxiety, depression, OCD, work stress

Accepts difficult thoughts/feelings rather than fighting them; committed action toward values-based goals; mindfulness

8-16 sessions

₹800-2,500

Strong growing evidence; WHO-endorsed for chronic pain

EMDR (Eye Movement Desensitization)

PTSD, trauma, phobias, grief, anxiety

Bilateral stimulation (eye movements, taps, tones) while recalling traumatic memory; reprocesses memory to reduce emotional charge

6-12 sessions

₹1,500-5,000

Strong evidence for PTSD (NICE, WHO recommended); emerging for other conditions

IPT (Interpersonal Therapy)

Depression, grief/bereavement, relationship disputes, life transitions

Focuses on interpersonal relationships and social functioning; improves communication skills; attachment patterns

12-16 sessions

₹800-2,500

Strong evidence for depression; as effective as CBT for mild-moderate depression

SFBT (Solution-Focused Brief)

Specific life problems, behavioral issues, relationship conflicts, goal-setting

Focuses on solutions rather than problems; identifies strengths and resources; miracle question technique

3-10 sessions

₹500-2,000

Moderate evidence; very effective for goal-oriented individuals

MBCT (Mindfulness-Based CBT)

Depression relapse prevention, anxiety, chronic stress

Combines CBT with mindfulness meditation; teaches awareness of thoughts as mental events, not facts

8 weekly group sessions

₹500-1,500 per group

Strong evidence for preventing depression relapse (50% reduction)

Couple Therapy (Gottman/EFT)

Relationship distress, communication issues, infidelity, intimacy concerns

Gottman: conflict management, friendship building. EFT: attachment-based emotional responsiveness

10-25 sessions

₹1,500-5,000 per couple

Strong evidence; 70-75% of couples show improvement

Family Therapy

Family conflict, child/adolescent behavioral issues, eating disorders, addiction

Treats the family as a system; examines communication patterns, roles, boundaries; structural and strategic approaches

10-20 sessions

₹1,500-4,000

Strong evidence for child/adolescent issues and eating disorders