A Miller School student’s paper describes the value of a “joy journal” in addressing depression during the pandemic
By Richard Westlund
Illustration by Andrea Ucini
Photography by Tom Salyer
riting about things that bring joy to one’s life can help counteract feelings of isolation and depression during the COVID-19 pandemic, according to a Miller School of Medicine student.
During the fall semester, Rikera Latrese Taylor, an M.D. candidate in the Class of 2021, met with an elderly hospitalized patient during her psychiatry elective rotations.
“She was feeling isolated and hopeless after an unexpected job loss,” Taylor said. “I encouraged her to start a ‘joy journal,’ listing activities that brought her happiness and enjoyment, such as traveling and collecting jewelry. This resulted in a significant improvement in her depressive symptoms and helped her focus less on negative experiences and develop hope for the future.”
Taylor was the lead author of “Joy Journal: A Behavioral Activation Technique Used in the Treatment of Late-Life Depression Associated with Hopelessness During the COVID-19 Pandemic,” published January 7 in the Primary Care Companion for CNS Disorders. Co-authors were Nikita Bodoukhin, M.D., resident in the Department of Psychiatry and Behavioral Sciences; Mousa Botros, M.D., assistant professor of clinical psychiatry and psychiatry clerkship director; and Luminita Luca, M.D., Ph.D., assistant professor of clinical psychiatry.
Giving emotional relief
“While medications and supportive therapy had relatively little impact, the joy journal provided the patient with significant emotional relief,” Taylor said. “It gave her a solution-based plan that allowed her to be safely discharged with home health and follow-up care.”
Behavioral activation techniques are methods implemented to restore motivation and interest in personal activities that bring joy to the person.
“The therapy identifies specific goals and attempts a positively reinforced cycle of gratitude,” Dr. Botros said. “During the stressful time of the COVID-19 pandemic, it is easy to overlook hobbies and interests. We examined a tailored approach to assist with the negative symptoms of depression through reinforcing activities that have been a source of joy and content.”
Taylor, who is co-chair of the Miller School’s Wellness Advisory Council and founder of its Peer Support Network, said elderly people are at increased risk for mental health disorders during the pandemic, and up to 50% of hospitalized patients do not respond to pharmacologic treatment.
“It is important for providers to recognize this risk and implement psychotherapeutic interventions,” she said.
A personal perspective
Younger patients have also reported higher levels of depression and anxiety during the pandemic, added Taylor, who noted that the pandemic also affected her personal health.
“After finding myself feeling pessimistic about the future at times, I decided to start my own joy journal in December as a 30-day log of positive experiences,” she said. “I created a list of my favorite activities, including exercising, catching up with friends, and watching Christmas movies. Engaging in these activities changed my mood and helped me feel optimistic about the future.
“I hope that providers find the joy journal to be a useful intervention for patients who are facing mental health challenges during these unprecedented times.”