Monday, 23 July 2012

Depression Part 2, Some Helpful Ideas to Cope

- By Kazza K

Last time I talked about 'Depression, Recognising It.' This time I want to talk about coping once you know you are depressed; after all, knowing you're depressed is only part of the road forward. So, once again, I wish to reiterate that this is a friendly blog spot and nothing I say here is intended to replace professional advice and help. I'm just throwing things out there as a discussion point and to make people think, be cognisant, to help themselves or someone they care about understand, and so you may have some ideas to work with.This is only a small blog and certainly doesn't cover nearly everything it could. Just some basics.

Mostly, human beings have a need to know what is wrong with them or why something is happening. So it's good to have a diagnosis, it means you are consciously aware and accepting, which should help lead you towards dealing with the steps to recovery or feeling better.

First some dont's.

Don't hide your depression - I'm not suggesting you go around telling everybody you have depression. I mean don't deny it or bury it and let it get on top of you so that it all gets too much and no-one can help. I also mean don't feel as if you are weak because you are depressed, plenty of strong people suffer depression. I have always told every single one of my clients, with depression, I have had/still have bouts of depression. That actually flys in the face of my training, a therapist is not supposed to share these kind of things with their clients. Well, I like my clients to have hope, and I like them to know that they are not alone, so I tell them, and they appreciate it. My point here? Don't be ashamed. If you look up famous people, leaders who have suffered from depression there is a long list. You're in good company. Heck, you're just like me, and I'm a strong, decent person :)

Don't medicate with acohol - Alcohol is a depressant and whilst you may feel more mellow or numb at first, the following day you will feel more down. Men have a much greater tendency to 'self medicate' with alcohol. It exacerbates anger and it exacerbates sadness. The other thing to know is that alcohol and anxyiolitics are a particularly bad combination. Alcohol and anti-depressants are not always great either. If your anti-depressant has a sedative effect then it can cause problems. Alcohol can also affect the efficacy of the medication. Please talk to your doctor about this. I'm not saying don't enjoy a few glasses, if your doctor says you can, but I'm saying be aware. Of course certain classes of AD's, such as MAOI's, don't mix with tyramine rich foods or alcohol -  beer and wine included.

Dont medicate with self destructive behaviour - I have seen more than a few people do things that they ordinarily would not do because of severe depression, mood disorders, bipolar etc. Things like gambling, with particular emphasis on poker machines. Now I know that gambling can be an addiction for anyone, you don't have to be depressed, but what I'm refering to here is the behaviour that comes about through depression and an inability to cope. Not taking medication, not seeing a therapist/doctor and doing things that endanger a family and individual's wellbeing. I won't say anymore on it, just be aware of things that can make something difficult almost unbearable and impact everyone around you. It is hard to have depression, it is hard on the loved ones of someone suffering depression.At times depressed people act out in unusual, self defeating ways. Getting professional support aids everyone, self destructive behaviour doesn't.

Alright, those heavier points are out of the way. Let's get positive. Things that I have found to be helpful include -

Keeping a journal - It can help to write down how you're feeling. When you go to your therapist/doctor you can tell them what you may have been thinking or feeling between sessions, because short term memory during depression is terrible. It's also amazing to look back and see your progress. To see that you have gotten better and you are actually moving ahead with more good days than bad. You don't have to write every day but once you get through the worst part try to keep a regular update going.

Meditation/Relaxation - Guided meditation/relaxation is wonderful to help keep calm and focused on something other than runaway thoughts. If you are severely depressed this will not work until your medication has kicked in, usually 2 weeks after starting. If you aren't able to be on medication then wait until you feel a bit more in control before starting meditation/relaxation, so that you give it a chance to help. I'm a firm believer in CD's/tapes where you are guided through the process, not just music or chanting, actual steps to follow. Start with a 10 minute CD and work your way up to 20 minutes to a half an hour. I don't want to favour someone over anyone else but I have always had a love of Sarah Edelman's CD's. Some people take to meditation/relaxation better than others. Do not get despondent if your mind is drifting when you start. I find it takes people a good 3 weeks to start to get good at it and another 3 weeks to get really into it. I can assure you I used to be the worst person to get to meditate, but now I'm good at it because I used to run groups, and I use it when I get anxious or down.

CBT - Cognitive Behaviour Therapy really does work. It helps you look at things in a more realistically positive way. It takes a lot of work, I won't kid you, but it helps immensely. Because I can't take AD's I rely heavily on CBT to help me through my depression. When I have been severely depressed I can't get into it initially, but once I'm feeling a bit better I get into full CBT swing. There are lots of books out there on CBT, seek one out that looks good for you. One where you're comfortable with the writing style and the way the author explains things. CBT is different to affirmations. Affirmations are lovely but if you don't believe the words, then that's all they are, words. I'm not against affirmations, use them in conjuction with CBT, but not just on their own. The basic premise behind CBT is to help change negative thinking into something more positive. Our thoughts are very powerful and have a major impact on how we feel, how we react and behave. For example during my bleakest depression going out of the house was difficult. It was easier to stay indoors, but that was not a good option for me long term. I certainly didn't want to develop agoraphobia. So I would say to myself "this may seem hard but you can do it, if you get a bit anxious it's to be expected, if I keep doing this by next week  I'll be better at it, if I don't try I won't progress" or "I know that I feel awful now, but I won't always feel this way." The last one I would repeat every day because I found it hard to believe at times but intrinsically, deep down, I knew it to be the truth. "I wasn't this way before, with effort and time I can be who I was again." This is very basic, there is much more to CBT but it's too much to discuss here, hopefully you get the gist.

Exercise - I can't begin to tell you how important exercise is during depression. Taking a 20 minute walk during the day is good for the soul in so many ways. Walking helps boost 'feel good' chemicals such as endorphins and serotonin, it makes you feel better afterwards. I'm not saying power walk, just walk at a medium pace and stop occasionally to look at the architecture, the blue sky, the birds, smell the flowers too, if you can. If the scenery isn't that great, no matter, you're doing something to help the chemistry in your body in a natural and enjoyable way. If you prefer to go to the gym, then go. Cycling, swimming, all great. Walking and swimming will always remain my favourite ways to feel better.

Food - I am a great believer in food helping an individual feel better. There is a good book  called Natrual Prozac by Joel C Robertson regarding food and lifestyle. I'm not endorsing all the sentiments in the book. I don't believe that food, excercise, music etc is the cure all for all types of depression, particularly if it is severe, or you're bipolar. I believe they're an adjunct. If your depression is milder then go for it. Never come off your medication without consulting your doctor. So, having said that, look into foods that can help you. For me, grapes always helped boost my mood, potatoes too and, my personal favourite, Milo in hot milk. I drink low fat milk with Milo every day, without fail. Milo contains B group vitamins, B group vitamins help in lots of ways and vitamin B6 helps with the central nervous system. However, just taking a B vitamin on its own doesn't work as it pasees through your sytem without aiding you. Take a mutli vitamin with B6 in it or a better still a multi B group vitamin. I am a big believer in Milo and milk, nothing anyone can say will sway my beliefs on Milo and hot milk. Serotonin is a derivative of tryptophan, an amino acid present in different foods including milk. Look up the benefits of different foods, try them and see what helps you best.

Have a support network - Some friends and family are amazing, they're so supportive, and that's what you need. It may be difficult to get out and see people, it may be hard to talk to people, but please don't shut yourself down. If people are willing to support you, let them. You need them. One day you will get to return the favour, because I guarantee you will be needed due to some illness, sadness, hurt or grief in their lives. One thing about depression is it sorts people out in your life. You suddenly discover who genuinely cares about you, and you just may be surprised. Any naysayers or people who tell you to "snap out of it" are not needed in your life during this time, stick to the positive and understanding ones.

Find a good therapist and doctor - OK, this may sound a bit harsh, but there are some people who never cease to amaze me with how terrible they are in their chosen profession.This goes within healthcare as well. Most working in healthcare are terrific, choose well. Have a friend or family member help if you feel you need it. Word of mouth is always wonderful as a reference. When you're depressed it can be hard to deal with people and some receptionists or practitioners aren't as empathetic as they could be, and it can put you off the process. Why did I start this section the way I did? In the throes of my darkest depression I had a professional tell me that I would "either die or get though it, either or." That was just awful, it made me so, so upset. Please don't be disheartened. Find somone who knows depression, they don't have to have been through it to help you, by the way. They just have to be good at what they do. There is no substitute for an experienced, genuine practitioner and they are out there. It's like everything else, some people may be good at what they do but you still don't gel. Find a person you're comfortable with, that helps you feel at ease. Someone who will help you with medication, if you need it, not everyone will need medication, and, most importantly, help you with coping strategies. It's nice to have someone who listens to you, but also gives you advice and information on how to best deal with your depression.

Be kind to yourself - You certainly didn't choose depression, it singled you out for any one of a multitude of reasons. Don't beat up on yourself. Work on finding things that you like about you. I know that it is easier said than done. We are so programmed to be humble or modest. No room for modesty here, start to find things that are fabulous about you. It's time to love you. Start a postivity notebook. Each day look for something that you did that was good. Look for the little things and then for the bigger things. If you're struggling ask a friend or family member, they should be able to help you until you get the hang of it.

Try to laugh - Laughter really is the best medicine. If you are moderately to severely depressed this won't happen for a little while, but it will happen. Ordinarily I have the craziest, most wicked sense of humour. When I'm at my darkest it disappears, but it always comes back. I have to look for it though. So, as you come on back down the road to feeling better start to look for your humour, let it back in.

Depression has many causes, I won't bore you here with that. Just know that you will get better. It takes time and effort, but you will make it. Love yourself. Find the silver lining around anything you can. My depression made me a much more caring, understanding human being. Yes, it was awful and still causes me problems here and there, but I'm a better person because of it. My children have learned to be better people because of it, because I let them in on what I've been through, and sometimes still do. They admire how I fight it and always win out. My son has had his own battles, partially outlined in another blog, My Son the Aspie, so he really gets it. He's on anti-depressants for life and accepts that, is happy how he feels, but he's had to do work too. You just can't take a pill and not learn how to recognise pressures, stressors and how to deal with them. You need to learn what your triggers are and how to head them off at the pass if you can, sometimes you can't.

You have much to offer life and life has much to offer you. Fight for it, fight through your depression. Let people help you, both friends, family and professionals. Learn why you have it and how to minimise it. Learn to love life and all that it throws at you. And remember this about depression - you start off having more bad days than good (sometimes all bad days), then it's bad days and good days, then it's more good days than bad days until life gets better.

If you have depression I'm thinking of you. All the best and, even though I'm not much of a hugger, I'm sending my best ones your way.


  1. Brilliant article, Karen, and so very useful - thank you!


    1. Thanks Anne, You're always most kind with your words. It's a small part of a big picture, but if it guides just one or two to people in a better direction I'll be happy.