Someone recently inquired about coping strategies for depression. I started to put together a quick “off the top of my mind” list of depression coping strategies. …But as the minutes ticked by and I had not yet run out of things to say, I began to realize that my mind is apparently rather tall. Or at the very least that the portion designated as “top” is rather horribly out of proportion to the rest of it. Plus, being always and forever a teacher at heart, my gut instinct rails against a “quick list” of any kind, preferring the seductive pleasures of a Full And Comprehensive Analysis. In fact, it quickly maps out how I could turn a brief handful of suggestions into four separate pages of detailed information on various sub-genres of coping. If I actually manage to post this as a single entry, you can count it as a victory (while on some level deep down, I mourn how it has not reached its potential, and make silent promises to myself that someday I will make that full vision happen. Anyone still surprised I burnt out? No? Me either.).
At any rate, I’ve been actively working to kick this for about two years now, and am naturally inclined towards collecting unnecessarily large amounts of information about things that are Important. Like health. And getting back to work. And not stabbing things into my leg. So I’ve collected a near endless supply of tips and tricks and coping skills to draw from, a small portion of which I will try to write up below. All of them I’ve put into practice myself, though some tend to get more focus at one time or another, then less once something else takes the forefront. Some of them I find tremendously effective. Some just take the edge off. But a lot of little things making little differences can add up to a big change in feeling.
I don’t presume to think that what I write here will be a revelation for anybody, but if it helps one person find one tiny moment of relief, than it would be well worth it. If you have a coping strategy that has worked for you (whether you’re dealing with “average” levels of passing sadness, or fighting Major Depressive Disorder like I am), please leave it in the comments. I would love to hear it.
A Quick and Dirty List of Tips for Managing Depression:
1) Be willing to try things that are supposed to help. Note that you do not actually have to believe that they will help you in order for them to do so. I am hoping this one won’t come off as too pretentious, but I wanted to include it because it is apparently a VERY common stumbling block. If you don’t think something will work in your situation, consider giving it a try anyway. Realistically, you’ve got very little to lose by trying, and a lot to potentially gain. Try to keep in mind that part of what depression does is create hopelessness and emotions that seem unfathomably deep, so it is very common for people to think that making a positive change “can’t really be that easy” or that certain suggestions might be find for other people but “won’t work for them,” so if you find yourself saying that to yourself, you’re not alone (I did a lot of that too. I think everyone does, and then some of us feel a little silly afterward). There is scientific reasoning and data to support many of the strategies that are out there, even if the reason they work isn’t immediately obvious to you. I know first hand that battling depression is far from easy, but that does not mean that “easy” things can’t make a meaningful difference. And seriously, this stuff is hard enough as it is; don’t we deserve every scrap of positive difference we can get? It can be very difficult to face this at first, though, because if any part of our experience can be changed with things that aren’t impossibly difficult we feel like we should already have been able to do it, or because we feel like if it can be healed even just a little that minimizes how truly dark and horrible it is. Work toward being as open as you can, and try not to judge a technique until you’ve given it a sincere try and time to help. If after that you think it’s still not for you (and some things probably won’t be), that’s fine. You haven’t lost much. Doubt it, do it anyway, decide it didn’t work, continue to do it anyway, and then after a few weeks see how you feel.
2) Get up at a specific time each day, creating a routine for yourself for the morning (I get up with my husband and we started having breakfast every morning). Forces you to be up and moving, and takes away the option to just stay in bed. Staying out of bed is much easier than getting out in the first place.
3) Eat regular meals (scheduled if necessary), and keep an eye on legitimate signs of hunger. Try to feed yourself healthy food when possible, and don’t let yourself get so hungry that you start craving. Blood sugar fluctuations make everything much, MUCH worse. The stereotype of a depressed person involves overeating, but sometimes that is just because we go so long without feeding ourselves, or are drawn to foods that spike our sugar and leave us hungry later. Try to go to the effort of feeding yourself at regular times, even if you do not yet feel hungry. If you know that you’ve been having trouble facing the effort of doing that, prepare for it as much as you can by having easy foods on hand that don’t require much preparation.
4) If possible, get dressed in “real” clothes every morning, even if you know you won’t be leaving the house and nobody is going to see you (something that makes you feel good, or like a functioning member of society, whatever that may be). Likewise, if you are up to it, fix your hair, or brush your teeth, or take a quick shower if you can. Save pajamas for special occasions when you can feel good about indulging by wearing them.
5) Learn (slowly) to ask for help from other people.
6) Try not to measure yourself against the same standards you would use if you were in perfect health. If you were in a terrible accident and ended up in a full body cast, you would (hopefully!) not be berating yourself for not being able to get the dishes done that week. Just because you can’t see your health problems visually doesn’t mean you’re not functioning in a altered capacity. It’s okay to motivate yourself to do the things that you are able to do, but those may not objectively be the same things as you feel you “should” be able to do. Pushing yourself to do things that leave you feeling unsuccessful or bad about yourself doesn’t actually help anything. Neither does pushing to do things you feel you “should” be able to do, but can’t ever actually get done. Learn to accept that there are limitations you need to work within right now while you are in the process of getting your usual strength back, and find goals that stretch you a little without feeling overwhelming, or too frightening, or setting you up for failure. It is important to have goals, but the particulars of what they are will change depending on how you are doing at that moment. You’re not stuck with the same limitations forever; try to think of it like physiotherapy to slowly rebuild a damaged muscle. Sometimes for me, just changing the cat’s food and water was a big ordeal. Other times, that is a negligible task (though not beating myself up about it when it was difficult was really hard). If you can accomplish a task, and feel better after doing it, it’s probably a good idea. If just thinking about doing it throws you into a ball of sadness or anxiety, that is probably a sign to let that one go for now and choose a smaller goal to start with. You will get there eventually.
7) Avoid things that tend to make you more sad. Do as much as you can of things that tend to let you feel less sad (This sounds pretty common sense, but it’s honestly not as easy as one might think!). This requires you to be honest with yourself about your feelings after doing various activities. Pay close attention to them – they may not be what you predict them to be beforehand. Some of the things you feel like you really want to do may consistently leave you sadder, and things that your instincts tell you will be unpleasant may end up feeling really good. Making changes around those realizations can be very, very difficult. But worthwhile.
8 ) Try to do something to offset the symptoms when you’re feeling down, if only to give you more of a sense of control over what’s happening. This could be a getting outside, exercise, yoga, aromatherapy (any pleasant, natural smell actually lights up parts of your brain), putting on some music, pushing pressure points on the top of your head, eating foods that are supposed to be helpful (e.g. ripe bananas are good for communication between parts of your brain and for dopamine production), meditation, reading a self-help book, calling up pleasant memories, or a number of other things. What you do isn’t nearly as important as the act of doing it. One of the worst feelings that comes with deep depression is a sense of helplessness, so being proactive with your treatment can do a lot.
9) Don’t put too much pressure on what exactly you choose to do with your time. Try experimenting with just doing something without worrying so much about whether it is the absolute best choice. Better still, aim to do something small that you haven’t done in a while. It doesn’t have to be anything “productive” either. Just something random.
10) If you’re feeling especially low, keep expectations small. E.g. step outside for a minute rather than expecting yourself to take a 45 minute walk. But DO step outside for a minute.
11) Expose yourself to light, particularly natural light. If you’re having a really low day, just find a place to sit where some sun can shine on you while you’re curled up. If it’s cloudy outside, at least turn on whatever artificial lights you can. Light is critical to people who’s depression is seasonal, but often helpful for the rest of us too. If you’re in a place that is frequently cloudy, you may want to consider light bulbs that are supposed to mimic natural light (they have them now where “normal” bulbs are sold), or a light box specially designed to help people with seasonal affective disorder (though beware – not every light box is created equal, and some of them don’t have any backing to their claims).
12) Write down three things that you are grateful for at the end of each day (this isn’t an empty, power of positive thinking kind of suggestion – there is actual evidence behind doing this). Thinking about them is good too, but actually writing them down is significantly better (it actually makes a difference).
13) Try making a habit of vividly bringing to mind (or writing down) three things each day (or two, or one if that’s all you can find) that brought you any feelings of happiness (even tiny or fleeting ones), and try as best you can to call up that feeling again and remember what it felt like. With prolonged depression, your brain actually experiences physical changes that make it less good at feeling happy. That is not a skill you want to lose, so it’s worthwhile to practice it any chance you get. Don’t worry if you can’t come up with anything “good enough” to use as an example. Depending on how strong your depression is at that time, little glimmers of positive feeling may be the best you can do, but those will work just fine. Over time, you will get better at noticing and being able to recall those glimmers. It is worth it to practice looking for them.
14) Expose yourself to new sights and experiences when possible (it helps to get your dopamine going, and dopamine receptors can actually atrophy over time in depressed people – not good).
15) Do something that makes your brain work (puzzles, brain teasers, crosswords, trivia, etc.). It may be really difficult, but it will help to slowly get back your concentration, memory, etc. (which depression attacks) or to help prevent further loss. Mental challenges can also promote the release of dopamine, and make it next to impossible to focus on sadness.
16) If you find that you are caught in a bad moment, focus on something neutral (the feel of the floor under your feet, or mental math calculations (the harder the better), or anything else that takes your focus entirely). The brain can’t truly focus on more than one thing at once, and if you’re feeling sad, this seems simple but can actually help you feel better.
17) Try to take things only one moment at a time as much as possible. If you are feeling overwhelmed in a particular moment, try to remember that it is only that moment. It doesn’t necessarily mean anything about the rest of your day/week/month/etc. It does not mean that you are permanently like that now, or that the whole day is ruined because it contained that sadness. Ups and downs are a natural cycle, and it helps to expect that both of them will naturally make an appearance sometimes. A bad moment is just a bad moment. The next one may or may not be another bad moment. But it might be a good one too. You can start the day fresh at any second. Practice trying to meet each individual part of your day with fresh eyes.
18) Experiment with being kind to yourself.
19) Learn to attach less significance to feelings of depression. Until your physical health sorts itself out, they will be there sometimes. That is part of the disease, not any kind of failing on your part. Try not to blame yourself for them any more than you would beat yourself up for feeling some pain after a root canal. They do not mean anything about your future, or potential, or willpower, or worth as a person. They are just feelings, and not even ones that are necessarily the ones you would be feeling without the interference going on in your body. And they WILL be there sometimes. But they are not all of what you are. Aim to notice them with a degree of neutrality and acceptance, without feeling like they are “bad” or are something you should have been able to avoid. Or treat them with compassion, like a bedraggled emotion puppy lost in the rain. Let them come in for a while, and be as kind to them as you can while they’re there, and then let them move on when they’re ready.
20) Practice saying/thinking “I am noticing feelings of sadness (or loneliness, or frustration, or what have you)” to yourself instead of “I am feeling sad.” With repeated effort, this change gets easier and more natural over time. As you do it more often, the small difference in wording can actually make a big difference in how much of a physical reaction you have in response to the thought. It makes the emotion just a part of what you are experiencing rather than the whole of what you are in that moment.
21) Try to keep some social contact, even if you really don’t feel like it. Depression comes very much ingrained with the instinct to withdraw from people, but social contact is good for stimulating your brain, and combating loneliness/worthlessness (which, again, typically come as a part of that lovely depression package), and can even trigger the release of pleasant chemicals, like oxytocin. If you don’t feel like you can manage a wild night out, go for coffee instead. If you can’t manage coffee, make a phone call. If the phone call is too hard, send an e-mail. But don’t allow yourself to cut off completely. Sometimes a schedule can be helpful with this (e.g. decide that every Monday, you need to contact one person, or set up one get-together, no matter how you are feeling about it). If you’re unsure whether somebody will want to hang out with you, just leave it at a quick phone call to start (depression often skews our perception of how other people see us, so you may get a more positive reaction reaching out than you expect). If you really can’t think of anyone to call, look up support groups in your area and make their meetings part of your social time.
22) If you find yourself feeling consistently worse after being around certain people, aim to limit your interaction with those people as much as you reasonably can. You need to use whatever resources you can getting yourself healthy. This can particularly be a problem when interacting with other people who are going through difficult times themselves, such as with support groups for depression. Some can be extremely helpful and motivating. Some groups of people can suck your own hope right out of you. If you’re finding you’re in the second situation, move on.
23) Try to stay away from indulging in “quick fix” things that you know aren’t good for you in the long run. For example, things like suicidal fantasies, cutting, deliberately depriving yourself of food, bulimic vomiting, and unhealthy alcohol overindulgence (I’m not opposed to getting drunk sometimes, but not if it’s for the purpose of blocking things out or running away, or because you need to rather than want to) sincerely help some people feel better in the moment (that’s why people do them), but can quickly turn into something dangerous. If you immediately distract yourself when you’re feeling the urge and do something (anything) else that will take up your attention, they may be easier to resist. The more times you let yourself indulge in them, the more that behaviour gets reinforced, and the harder it will get to stop it. That’s how compulsions start – you feel anxiety, you engage in the behaviour and it relieves it a bit, and then eventually you stop having a choice in the matter. No matter how desperate you’re feeling, starting down these paths is likely to just leave you with TWO big health problems to deal with rather than one. …Which is really no help at all.
24) As much as you can, make sure your body is getting what it needs from your diet. Producing and regulating your neurotransmitters (like serotonin and dopamine, which are both feel-good chemicals) is a process that requires a number of different pieces, and if any piece is missing, it won’t happen as optimally. Even with the perfect supply of building blocks, your body may not be able to keep you feeling good, but without them it certainly won’t. Even a few small changes may help a little. Many protein-rich foods (meat, cheese, etc.) give you the building blocks to make dopamine. So do bananas (especially very ripe ones). Healthy carbs can help trigger your body to release serotonin (though spiking your blood sugar too high may drop them again). And omega 3′s from salmon, flaxseeds, or walnuts can be a big help too. As my doctor has reported, in recent research omega 3′s were found to be the second most effective thing to add to a course of prescription antidepressants to improve recovery. Better than Wellbutrin. Better than almost all of the other standard prescription answers. Of course, every individual is different, but it does illustrate well that they have a very legitimate roll in emotional health.
25) Laugh and smile as much as possible. Watch comedies. Watch stand-up routines. Read funny books if you’re up to that. Laughter has some really powerful effects on the body, and just the process of smiling can help release chemicals to make you feel better. If you’re not feeling up to really enjoying yourself, expose yourself to these things anyway. If nothing seems pleasant or enjoyable anymore, keep doing the things that you think “should” be enjoyable for you again someday, or that you know you used to like. Don’t expect to have fun yet… Just expect to be practicing doing things that are good for you. Over time this can help gain you back some sincere enjoyment from them. And heaven knows, in that state you need every scrap of happiness you can get.
In addition to the usual comments and feedback, please feel free to leave your own strategies below. The more we all pool our resources to tackle this thing, the better.
Tags: dealing with depression without medication, depression coping skills, depression coping strategies, depression coping tips, healing depression naturally, managing depression through behaviour, things that can help with depression