6 steps for helping yourself through a depressive episode
Feeling depressed is horrible. Depression saps motivation, energy, sociability, optimism, and peace of mind. And what does it replace these things with? Despair, anxiety, regret, 'restless sleep', loss of confidence, hopelessness, and exhaustion; all of which combine to make depression feel literally painful.
On top of this, depression makes you think differently. Stuff that wouldn't usually worry you takes on huge and scary significance, what might normally be seen as minor setbacks come to be viewed as 'disasters', and a sense of foreboding may swamp your mind, making the future seem scary or bleak. Eventually, the build-up of stress tips into exhausted 'flatness' and what seems to others like indifference.
But there is something else here.
Whose life is it anyway?
We have all been trained to believe that depression is a 'disease' that happens to us. If we get depressed, all we can do is passively seek the guidance of an expert or someone who can dish out side-effect-inducing meds in the hope of 'correcting' our faulty brains. We have built ourselves a culture of disempowerment in which people have been led to believe that they have less influence over their own emotionality than they really do.
We talk about people being the 'victim' of depression as if depression stalks the land randomly striking those who are 'genetically predisposed'. People write about depression as if depression can be externally quantified like Anthrax disease carried in spore-forming bacteria. But depression is a response that arises from within; it is not an infectious 'biological disease', although we talk as if it were. It is, however, contagious - in the sense that all human emotion, from fear to laughter, is contagious.
Depression and the 'illness' metaphor
The fact is, no gene for depression has ever been found and there is no physical test you can take to see if you are depressed (1). We have been brainwashed to feel that if we're clinically depressed, we are helpless and there is little we can do for ourselves but help profit big pharmaceutical companies by passively swallowing 'happy pills' and wait for the depression to lift. As if the idea of us consciously helping to lift our own depression is taboo or just plain crazy talk.
I propose that this cultural idea is in danger of damaging generations to come. Yes, depressed people need help, because depression is a communication that life as it is at the moment isn't working; but depressed people can also learn to help themselves both prevent and lift depression.
Am I suggesting that depressed people should blame themselves for getting depressed? No way.
Why do some people depress and others not?
No one is to blame for their depression. We know that depression isn't primarily an events-driven response to life. It's not so much what happens to us as how we respond to what happens to us that makes the difference. So why are some people more vulnerable to depression?
Sometimes life throws so many stressors our way that we do become exhausted with it all; overwhelmed for a while. It's not just physical activity that exhausts us; what our minds do also affects energy levels in the body.
Worry, negative introspection, regret, guilt, and dread cause an overload of stress hormone (2) that exhausts us, robbing us of motivation and energy. In years gone by, people who got depressed were said to be suffering 'nervous exhaustion'. I actually think this is a more accurate and descriptive term, as it is exactly what happens when people tire themselves through an overload of stress and worry. It's like a car trying to run on empty - worry burns the 'fuel' that powers motivation and hope. One of the first signs that you are lifting your depression is renewed energy and hope.
Depression as a learned phenomenon
But some people get depressed even when their lives don't seem that stressful. This is because some folk learn to view life through a depressive lens. We all learn attitudes and life perspectives as we grow up (and throughout life) and now, as a result of this learning, when adversity strikes (sometimes any setback), the 'default' setting is to feel depressed (3). People learn to be depressed - and what we learn we can unlearn.
No one is to blame for any of this and it's true that it's not always easy to 'pull yourself out of' feeling wretched. The idea that depression is a disease rather than a feeling and behaviour may help some depressed people feel less guilty about feeling the way they do (and of course there is no just cause to feel guilty anyway), but for many others, the current medicalized depression zeitgeist is actually very disempowering. If depression is nothing to do with what they do, then how can they do anything to help themselves? Other than take pills?
To be fair, many 'experts' do often recommend a combination of pills and psychotherapy; but when psychotherapy works, it's because the psychotherapist has encouraged the depressed person to do stuff to help themselves. All effective psychotherapists, however it appears, help clients help themselves. If I cure your phobia, it may seem like me curing you - but, of course, I've just helped you cure yourself.
If you feel depressed at the moment, there are things you can do to help yourself. Don't buy into behaving helplessly; that is merely the depression and the medical model talking - don't believe it.
So what can you do to start feeling better? Follow these six steps to help yourself help yourself for a change.
Step 1: Admit to yourself that you are down
There's no shame in it. You are not a machine; and even if you were, you'd still need to stop for maintenance once in a while. There is no shame in admitting to yourself that you feel tired, pessimistic, and low. This is a natural part of being human and not indicative of 'disease'.
Paradoxically, the positive thinking propaganda that we must always 'feel awesome' can worsen the feeling of shame around feeling depressed. Forget "I shouldn't feel like this!" and accept that, at the moment, you are a bit lower than usual. But remember the phrase, 'at the moment'.
This doesn't mean you have 'got depression'. It simply means you have recognized that life as it is right now is not giving you what you need; whether that's enough interesting activity, enough of a feeling that life is meaningful, enough quality attention from other people, enough feeling of security, enough fun, enough status, or whatever. If a flower doesn't get what it needs in the way of 'nutrition' (sun and water), it will inevitably suffer.
Depressed people become depressed when something is lacking. Furthermore, they may learn to respond to life as if something is lacking when, in fact, it may not be; which brings me to the next step.
Step 2: Don't just focus on the bad
The trouble with the state of mind and body we call 'depression' is that when you're in it, you view life in specific ways. Adversity (bad stuff) seems permanent, widespread, and possibly originating from you (depressed people tend to blame themselves for stuff).
Whereas when good things happen, the depressed person may see them as fragile and temporary ('too good to last'), as specific ("Yeah, that's good, but everything else is crap."), and as originating outside of the self ("The talk I gave went well because people were generous about it!" rather than "I gave a good speech!"). This is known as the 'depressive bias'. Good stuff is downplayed or even creatively reframed as negative and negative stuff is over-amplified.
Begin to undermine the way depression works by starting to look for subtle positives. The benefits of keeping a 'gratitude log' extend beyond lifting depressive feelings to physical health, wellbeing, and alertness levels (4). Make a point of sitting down twice a week and listing all the stuff for which you can possibly be grateful. Really 'small' stuff as well as major things:
- "I am grateful that the morning sunshine on Wednesday made the garden look especially beautiful."
- "I am grateful that Karen invited me to her meal."
- "I am grateful that my family express concern for me and care about me."
Find anything, because depression stops us noticing what there is to be grateful for. Worry and negative rumination feed depression - gratitude counteracts this and is a great way of switching off excess worry. Famous Nazi concentration camp survivor Viktor Frankl wrote that the grimness of life in a death camp was always alleviated by inwardly expressing gratitude for that extra sliver of meat at meal time or a glimpse of a beautiful sunset in the evening. Train yourself to notice.
Step 3: Move your body
When we feel depressed, we naturally want to stop being active - to curl up and hide away. But this plays into depression's hands. Depression puts us into defensive mode; we feel too tired to move our bodies (although sometimes we can feel so agitated we feel we can't stop fidgeting and relax). But walking briskly outside for twenty minutes (especially in nature) has been found to lift depression more effectively than antidepressants (5). The quicker you move, the more 'feel good chemicals' your body produces and the more real (as opposed to nervous) energy you generate.
Bear in mind that you have been down and don't beat yourself up that you are not doing your usual massive workout. You don't need to. A bit of brisk movement every day (even dancing) will help you conquer depression because it is the opposite of how people generally behave when they are down. And don't wait to feel like moving before you do. This does require an effort of will, but you can do it.
Step 4: Connect and do stuff you used to enjoy
Research into social connection (6) has found that the more sad people we know, the more likely we are to be sad (who we hang out with is important - the same research found that if your friends are obese, you are more likely to be, also). Interestingly, all kinds of patterns and behaviours - from divorce to depression and obesity - exist in social clusters.
When you're feeling down, it might feel more relevant to hang out with other depressed and down people, but make a point of being around people who show the kind of resilience and 'up-beatness' that you want back. At least once a week, hang out with people who have made you feel good in the past. This may feel like hard work at first, because such ebullient people can seem like they are on another planet to you whilst you are that down, but just remember that attitudes are infectious and sometimes it's good to be 'infected' by a dose of positivity.
Depression saps the pleasure from the things we normally find enjoyable, but don't use this as a reason to stop doing stuff you normally like doing. Fake it and you really will make it, eventually kick-starting those 'feel good' feelings through activity.
Step 5: De-stress
A depressed brain is a stressed brain. We could almost say that it's the build-up of stress that causes the exhaustion. Depression isn't a result of thinking negatively; it is the result of a prolonged stress build-up that is partly caused by and partly causes pessimism and all-or-nothing negative thoughts. So dealing with the physiology of the stress itself is a vital step (and perhaps should have been my number one step). This is one reason why regular massage therapy has been so effective in combating depression (7), as have regular tai chi sessions. Both lower physical and therefore psychological stress levels.
When you relax, your whole perspective can change because the part of your brain able to plan and think clearly (the prefrontal cortex) is able to shake off the grip of the 'emotional brain', freeing you to begin to do the things that make you feel sustainably better. At first, you'll find that your mind seems to prevent you 'going with the flow' when listening to a relaxation CD or doing deep breathing or having a massage; but even five seconds of comparative relaxation here and ten seconds of feeling relieved of stress there will pay important dividends to you.
Listen to the free audio below and maybe not the first time, maybe not the second time, but at some point when you listen to it, you'll have glimpses of genuine rest and relaxation and those moments will begin to increase.
Most importantly, the previous five steps will only help you help yourself to the extent that you heed the final step.
Step 6: Don't let these steps 'skim off your mind'
When you're down, it's easy to fall into the classic depressive thinking trap: "How is exercise going to solve all my problems?" or "What's the point of this or that 'tip'!" This is way too black-or-white.
There is no one way to lift depression instantly; rather, there are many different small things you can do that together help lift depression. And what can seem insignificant may make all the difference alongside other small changes. Imagine someone saying: "How is vitamin C by itself going to help me?" It doesn't...by itself. But it helps you absorb other minerals and also works to keep you healthy even when you are not aware that it is working.
Depression can make us overly dismissive and close-minded if we are not careful. There is so much advice, so many tips and ideas. It's too easy just to read something and perhaps agree with its sentiment, but not let the idea actually work within you. An idea that could dramatically benefit you may be expressed briefly in a sentence or two, but you need to explore the depth of an idea, try it out, and give it and yourself a chance. Don't let it just 'skim off the mind'.
Remember: depression isn't something that happens to us so much as something we 'do'. This doesn't mean people choose to feel depressed; rather, that it arises from within and needs you to think and behave in certain ways in order to maintain the depressed state. The steps here are designed to counter the thoughts, feelings, and behaviours that maintain the depressed state of mind and body.
These are just some of the things you can do, but don't see them as small things. Remember that research has shown repeatedly that regular exercise is more powerful than medication in lifting depression, and receiving quality psychotherapy means you have much less chance of relapsing into depression in future (8). Both of these approaches are basically about learning to help yourself. For an explanation of why you may have got depressed in the first place, see 'Why am I Depressed?'
As the saying has it: "Do not wait for your ship to come in - swim out to it yourself."