An article by Kim Rosenthal, MD
Depression hurts. It robs you of hope and motivation and makes it hard to get out of bed in the morning, never mind cope with the pervasive agony that comes along with it. At times it seems hopeless. There’s no “pulling your socks up.” It isn’t that easy. If it were, you would have done that a long time ago.
Despite this, you have more control over depression than you think. Improvement takes time, but you can get there. The trick is not giving up. Here are some hints for coping with depression.
Reach out for support. Depression makes us shut out the world, but maintaining relationships is key to survival. No matter how bad you feel, keep in contact with your family and friends (those who are supportive!) If you can’t tolerate company, email or text. If you’ve lost contact with those who care about you, reach out from time to time. Contact with others can also come in the form of church, individual or group therapy, online communities, and support groups. Alternatively, join a local group without a psychiatric focus (like a book, knitting, writers’, or hikers’ club), volunteer helping others, or go back to work or school (if you haven’t already). If you have a problem with drugs or alcohol, consider attending a twelve step program.
Take care of a pet. While little can replace human connection, adopting a pet can bring joy to your life. Consider something cuddly like a cat or dog. You could also collect colorful fish, adopt and teach a parrot how to speak, or buy a couple of lovebirds and have them multiply into a dozen.
Prepare ahead of time. During your better moments, set up crutches to help you navigate depression should it happen again in the future. Here are some ideas you can do in advance.
- Written routines
- Templates for work/school to make sure you don’t forget things
- A list of what you need before you leave the house each day
- Frozen meals or gift cards to restaurants
- An MP-3 or i-pod set up with your favorite music and guided meditation
- A box at the bedside filled with puzzles, comics, beautiful artwork, and other stuff to cheer you up
- Clothes prepared ahead of time
You can even write yourself a letter with recommendations, including favorite photographs, reasons to stay alive, and a list of positive statements to counter the typical problem thoughts that arise when you’re depressed.
Sleep on, sleep off. Sometime regular sleep can help stabilize depression. Go to sleep and wake up the same time every day. If you’re having problems sleeping, ask your provider about sleep hygiene or medication. For info, check out insomnia and getting sleep without medications.
Keep a gratitude List. Focus on what you’re thankful for. Write down everything you’re happy about, everything you appreciate, all the beauty you see around you, and add to the list everyday. Next time you find your mind spiraling out of control with pessimism, pull out the list and read it!
Rewrite those problem thoughts. Watch how you talk to yourself. Take note of the negative ticker-tape that comes along with depression and work at rewriting those problem thoughts with more positive, supportive words. When you have a negative thought, ask yourself, “what is the evidence this isn’t true?” For example, if the thought is, “I’m never going to get over this depression,” look at the data. Maybe you’ve been depressed before and gotten over it. Maybe you’re improving already. Research shows that, even without treatment, the average episode is time-limited; depression never lasts forever. Additionally, there are new treatments arising for mood disorders every year. Your next step is to rewrite the negative thought. In this case, a more realistic thought about getting over depression might be, “It may feel like it’ll last forever, but I’ve gotten over depression in the past, and it already seems to be improving. This won’t last forever. Also, there are more treatments I can try if this one doesn’t work.” Look into cognitive therapy for more info. Remember, if you don’t like your perspective, change it!
Remember those affirmations. Affirmations are consciously chosen words meant to make you feel good, affirming something you need or would like to believe. They spell out the desired future. Examples include:
- Oh, what a beautiful morning!
- I’m a prolific, talented artist.
- I’m healthy and strong and live life to the fullest.
- I’m fit and slim.
- I’m content and at peace. I’m meant to do something special.
The premise is simple: if we want to change our lives, we have to hold positive thoughts in our minds. If we want to be happy with life, we have to think about ourselves as happy with life. Affirmations are typically in (1) present tense (“I am,” not “I will be”), (2) positive (“I am thin,” not “I am not fat”), and (3) repeated or written down multiple times every day, whether we believe them or not. If kept up, the subconscious mind slowly embraces the affirmation, creating a transformation in self-esteem and sense of identity.
Do more healthy stuff. Severe depression often means withdrawing from life. People sleep to escape the misery. Sometimes they use drugs or alcohol, stop exercising, and eat a poor diet. Studies show that depression can be overcome by replacing not-so-good activities with healthy ones. This is called behavioral activation therapy. Healthy activities include (1) “fun” activities and (2) “achievement” activities.
Fun activities are behaviors that make you feel good. If you find it impossible to feel joy, which is common in depression, consider doing stuff you used to enjoy. Often “going through the motions” is enough to help the endorphins kick in. Fun activities can include:
- Going for a walk or drive
- Playing an instrument
- Doing arts and crafts
- Visiting a museum
- Visiting an art, book, pet, clothing, or sports store
- Remembering good memories
- Check out this article about fun stuff to do.
Achievement activities are behaviors that might not be enjoyable but lend a sense of pride or fulfillment; they range from paying bills, finishing homework, exercising, and mopping the floor to volunteering and finishing a project at work. So keep a list of fun things you used to enjoy doing or would like to do, and chores that would make you feel proud upon completion, and do at least one from each list every day.
Manage that stress. Stress prolongs and worsens depression. It can also trigger it. It’s important to figure out what’s stressing you — is it poor health, work difficulties, financial problems, or unhealthy relationships? — and find ways to regain control. This can be extremely hard, since the disorder often messes with your thinking. Talk to friends or family to gain new perspectives. Problem solve on paper. Consider relaxation techniques. These techniques can help relieve stress, yes, but also boost feelings of well-being. Also, don’t forget coping skills and other ways to handle worry.
Get professional help. If you find your mood is overwhelming no matter what you do, reach out to a psychotherapist or psychiatrist. A psychotherapist (usually a social worker or psychologist) can offer extra support and perspective, help rewrite problem thoughts and behaviors, explore your childhood and its effect on the present, and/or assist with learning new coping skills. If the depression is moderate to severe or you prefer to avoid talk-therapy, make an appointment with a psychiatrist. They may choose to start you on an antidepressant. If drugs or alcohol are also a problem, share that information with your provider, join a twelve-step program, or check online to learn more about your local substance abuse treatment resources.
Be hopeful. Depression can be devastating. It robs us of the most important gift we need when dealing with heartache: hope. Don’t let it take that away from you. If you do just one thing, make sure to hang onto your future.
“Listen to people who love you. Believe they are worth living for even when you don’t believe it. Seek out the memories depression takes away and project them into the future. Be brave. Be strong. Take your pills. Exercise because it’s good for you… Eat when food itself disgusts you. Reason with yourself when you have lost your reason.” — Andrew Solomon (The Noonday Demon)
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