I started writing this post on 4/9/12, and at the time it was three years since the last time I’ve used antidepressants. (I was on them for five years, though my first major depressive episode was when I was fifteen and I didn’t start medication until three years later.) I feel fine most of the time, but every now and then I find myself sliding into a prodromal period where it is likely that I will relapse if I don’t do anything to stay afloat. (I can tell that I’m getting there when I find myself feeling sad a lot, feeling tired but staying up late doing nothing, and having thoughts of destructive nature.)
I’ve accepted that depression is something I’m pretty much stuck with. However, if I’m careful, most of the time I can work my way around it, so that I can avoid relapsing (up to a certain point).
I’ve heard other people with depressive disorders say it, and I agree that I can manage as long as I keep my lifestyle a certain way.
The following are some things (in no particular order) that I have found to help. Everyone’s case is different, so what works for me may not work for you, but I believe in trying different alternatives until I find one that works, and sticking to it until I find something more effective.
- Physical activity has been shown to improve mood. For me, running “resets” my mood, whether I’m feeling sad or angry before I run. Afterward, I’m feeling pretty good and have no interest in negative thoughts. I know I need to run almost every day, to keep my mood up, but it’s something that I look forward to doing.
- Getting adequate sleep. Sleep is always important, especially when you’re depressed. Having a regular sleep cycle is a way to make sure you get enough sleep, though I’ll admit it’s a challenge to maintain. When I’m tired I tend to stay up later but not accomplish much (because my brain is slower). I end up feeling sad more, because of the sleep deprivation, and it doesn’t help that I also feel angry at and disappointed in myself. (It’s harder to regulate emotions when sleep deprived.)
- In order to do this, designate a time by which you want to go to bed and start getting ready before that time, depending on how long it takes. For me it takes much longer than I think it will, so I tell myself to get ready even before I think I need to. Be able to say no to anything that is not urgent, since that will only keep you up longer.
- I haven’t actually tried the sleep deprivation treatment, though from the publications that I’ve read on it, the effects are short term and what matters is the sleep stage that is disrupted. (See this and this for more information.)
- Learn how to manage stress. I don’t handle stress well. In fact, I find many situations stressful, including ones that most people don’t think much about. [Edit: Scientists have found that certain individuals are more susceptible to stress and depression, depending on the activity of β-catenin in their brain.] The best solution I’ve come up with is trying to minimize stress in my life. Unfortunately, some things have to be done, but there are ways to make them seem less stressful. Making clear plans, breaking tasks down into smaller parts, starting earlier (or leaving earlier when commuting), and studying/working on assignments regularly are ways to reduce last minute stress.
- Having positive social interactions. This really makes a difference for me, because I can go for days with almost no interaction with people outside of my family. If you’re isolated like I am, small superficial interactions count. I once felt apprehensive about calling a pharmacy about my prescription, but the guy was friendly and my question was answered, so I felt good after the call, even though I knew that he was just doing his job. It’s even better to have a friend to confide in.
- A friend once told me that when he was depressed, his therapist told him to make it his goal to have at least one positive social interaction with other people every day. This is especially important since depression makes us want to withdraw from others.
- Avoid stimuli with negative thoughts and emotions. This includes depressing music, films, poetry, prose, artwork, etc., and depressed people who like to dwell on their depression or see beauty in their pain. (Some of you may already know my attitude toward people who seem to enjoy their depression.) I’ve realized that it’s best for me to stay away from the mental health field because exposure to emotionally unhealthy people affects me too much. It’s not that I no longer care, but that I know my limitations.
- Identify and counter cognitive distortions. This may be the most effective of all of these strategies, since our own inaccurate beliefs and perceptions are in large part responsible for our negative thoughts and feelings. I strongly recommend reading Feeling Good: The New Mood Therapy by David Burns, MD for thorough explanations of the most common cognitive distortions and how you can identify them and come up with counter examples in your own life.
- Even if you “don’t feel like it,” do it anyway. Unless you’re sleeping all day, when you are awake, make the effort to get up, get dressed, shower and go out (even if just for a walk) or do something. If you’re waiting for the moment when you “feel like it,” you’ll be waiting for a long time. I’ve heard many people, myself included, who think, “I can’t do it, I’m sick,” and continue to do so even after recovery. However, more often than not, after I push myself to get up and go out, I realize that I was able to, and most importantly, I felt better afterward.
- Be thankful. I’m NOT trying to shove the whole “you’re actually very fortunate and there are so many people much worse off than you, so you have no right to be depressed” spiel at anyone, because 1) the people who say that don’t understand how you’re feeling and 2) saying that never helps. However, gratitude has been shown to raise mood. I find it helpful to think of three things that I am thankful for, whenever I catch myself feeling sad for no obvious reason. It can be as simple as having acceptably clean air to breathe, toilet paper, something you like about yourself (or that something you don’t like about yourself isn’t worse). If after I’ve enumerated three things but I’m still feeling sad, I’ll continue until I feel better. There have been times when I went up to sixteen.
I hope you have found these helpful. Feel free to share this list with anyone whom you think can benefit from it. If you have experience with clinical depression and know of other techniques that help, please share them in the comments.