Overcoming Depression: Self-Help Guide

Having decided that you are depressed, or probably so, you will be interested in reading this article if looking for accessible, practical steps you can take to help yourself.
First, a few words about some societal attitudes about getting help.  I grew up under the influence of my parents’ views that “doctors really can’t do much,” and that almost everything ailing you will “probably be better in a few days.” While many were perhaps overly reluctant to seek medical assistance in the past, how times have now changed now! I defy anyone to watch 30 minutes of television and not hear the phrase “ask your doctor.” It is just one example reflecting a contemporary shift in society urging us to seek professional expert approval for an ever increasing number of life’s decisions. As a mental health professional, I’m certainly not against appropriate use of professional services, however, it seems that we are all being encouraged to be overly deferential to “authority.” We are invited to surrender independence in favour of an overly passive and dependent position in which we unquestioningly substitute the opinions of others for our own judgement.

I raise this problem to underscore the point of this article, which is that there are things you can do to help yourself minimize, even resolve depression, and I will not begin with “get thee to a doctor.” Rather, I will finish that way. If, after trying to help yourself, you are not beginning to feel better, perhaps then contact a professional.

Self-Care: Routine Maintenance

Depression frequently disrupts sleep, resulting in getting either too much or too little. The normal pattern of sleep time and wake time may also be disturbed. It is important to get adequate, restful sleep. Re-establish a normal pattern of going to bed and waking, striving for 8 hours of sleep per night. It often helps to establish a pre-bedtime routine to “wind down” – this serves as a stimulus to the system to prepare for and induce sleep. Strengthen the association between your bed (stimulus) and sleeping (response). To the extent you engage in non-sleep activities in your bed, particularly alerting activities like reading, web-browsing, and watching television, you establish associations that compete with the stimulus-response relationship between bed and sleep. When unable to fall asleep, don’t remain in bed alert and frustrated, weakening the bed-sleep association and building other bed-non-sleep associations. Get up and do some relatively non-stimulating activities until you feel tired enough to return to bed.

Appetite and eating patterns are often disrupted by depression. It is important to maintain good and sufficient nutrition. Re-establish your normal pattern of 3 regular meals per day to maintain health and physical energy. So doing also leads to a feeling of personal effectiveness that comes from doing something for your self that is meaningfully good for you.

Supplementation?

You may wish to “ask your doctor” about this (if unwilling to read about it for yourself). Certainly I have no expertise in vitamins or supplements, however, there is mounting information on the internet, including increasing reports of apparently rigorous research published in peer reviewed academic (read: “legitimate”) journals supporting assertions about some supplements having a positive impact on mood. While the “buyer [should, as always] beware . . .”, this is an option that seems increasingly difficult to ignore considering.

What’s Brewing with Alcohol?

Alcohol is classified as a “depressant,” meaning it has a slowing, inhibitory impact on our nervous system. Paradoxically, or so it seems, when first ingested, it has a mood elevating effect, and when we feel miserable, anything that elevates our mood may seem welcome. I suspect the initial mood “elevation” results from alcohol suppressing the area of mental function that makes us worry and fret, leaving us feeling relieved. This benefit comes at a cost: I have repeatedly observed, among patients and friends, that an evening of even very moderate social drinking is followed by a sustained lowering of mood the day following. Drinking, it seems, often makes us more depressed, and this is an effect that is under your control to regulate

Exercise

“I really need to do some serious exercise one of these days,” said one of my depressed patients. “No, you’re better-off doing some not-so-serious exercise everyday– starting today,” I replied. Exercise is strongly related to mood and well-being. The effect is well-established, and some research reports it is more effective than antidepressant medication. Many sources suggest the effects of exercise on mood are biological, and this may be true, at least in part. I have clinically noted many patient reports of uplifting effects beginning on the way to the gym  even before the first work-out. As with other self-care activities, I suggest that knowing you are doing something positive for yourself has a psychological impact on mood that is independent of, and additional to the biological aspects. Make exercise a routine fixture in your schedule.

Reduce Stress

“Stress” is on everyone’s mind: life is stressful, we all know this. Technically, stress can be understood as the intersection between and external event (the “stressor”) and one’s subjectively distressing response to that “stressor.” With this in mind, we can begin to see how the simple goal of “reducing stress” may have several components. First, it is often possible to reduce stress by reducing the stressors in your environment. Some stressors are amenable to being eliminated, reduced, or transferred to others. Other stressors cannot be moved, and these call for a different approach. Instead of changing the environment here, we must change our attitude toward it in order to better accommodate to unchangeable realities. Understanding the stressor differently, or “reframing” its meaning can do this. One client was offended and outraged when a colleague publicly ridiculed the “stupidity of anyone . . .” subscribing to a particular major world view which my client happened to hold dear. He was consumed with aggravation, unable to excuse the pompous and presumptuous devaluation of anyone who might think differently – that was until he understood that his colleague had significant mental health issues of his own that caused significant challenges maintaining coherent and rational thought as well as difficulties maintaining personal relationships. Anger and upset faded, and were replaced with compassion and tolerance in addition to personal relief.

Practicing relaxation is another way to reduce the impact of stress. Research indicates that practicing relaxation techniques reduces both the subjective perception of stress as well as physiological indicators of high stress. Other research also confirms the positive impact of relaxation in reducing depression. When practiced at bedtime, relaxation techniques often facilitate falling off to sleep. Consider obtaining recordings that take you through guided imagery relaxation techniques. There are also many books and sources on the internet that will teach a variety of approaches to relaxation. Choose one that appeals to you.

Musical Appreciation

Listening to relaxing music also has the effect of reducing physiological indications and emotional perceptions of stress. Sigmund Freud reportedly hated music, believing it “lulled the Ego.” Perhaps it also lulls the Super Ego, silencing its unreasonable indictments and harsh criticisms so characteristic of depressed individuals, thereby granting a welcome reprieve that permits relaxation. However formulating its effects, music is an easily available resource you can use to your benefit. Its effects can be readily combined with relaxation and with exercise with little effort for additive benefits.

In addition to passively listening to recorded music, I also encourage patients and others to avail themselves of the somewhat different benefits of live music events on a regular basis. Live music tends to be less passively relaxing, and instead actively engaging, stirring emotional if not physical responsiveness. While doing so, it distracts you from dwelling on inner misery, taking you outside of yourself, fostering attention to and connection with the world outside the confining boundary between self and other.

Not the Nine O’Clock News

You probably learned from Social Studies class or your parents, that every socially responsible citizen has an obligation to be up-to-date on current events. To be otherwise is surely the definition of ignorance! While the old adage “ignorance is bliss” is intended ironically as a condemnation, not a recommendation, social psychology research long ago established that those who consume more news media are more depressed, feel more vulnerable, and more pessimistic about the future. Take a moratorium on reading or listening to the news–you already know its depressing conclusions. When asked “have you heard the latest?” don’t fear the shame of appearing ignorant–turn it into a sardonic joke: “Don’t tell me, everybody dies!”

Good Things Come in Twos, or Threes

When depressed, withdrawing from social activities and personal relationships becomes almost a reflex. Defy the reflex! It is important to maintain our connections; the benefits of so doing are tangible and significant, even if we our participation is “completely fake.” Confiding in, and even just spending time in the presence of others has beneficial effects, while isolation only exacerbates depression. If nothing else, phone one or two friends or relations each day, even just to talk for a few minutes about nothing much–just so long as it is not bad news, current events or politics.

Ye Though I Walk Through the Valley . . .

Matters of religion and faith are among the more divisive and contentious topics of discussion, and with the exception of those offering faith-based services, most professionals shy away from this loaded topic. While the separation of church and state may be a good idea, health professionals might be too hasty in saying “me too,” abdicating their responsibility to discuss a subject that is often meaningful to their patients and relevant to their health.

Health care professionals do not hesitate to recommend the benefits of not smoking, even when they themselves are smokers. This being so, why should there not be a sober discussion of religious faith, since research has established there is a stronger relationship between faith and depression than the relationship between cigarette smoking and lung cancer?

It would be irresponsible to attempt to induce a change of faith, when this really is an important matter of personal responsibility and choice. That said, the majority of the population does hold some religious faith, and where that is the case, it would also seem irresponsible to avoid addressing it as a means of recovery. Increased participation in the aspects of faith relevant to one’s tradition (e.g., prayer, worship, devotional reading, dialog) have strong, positive effects on depression and well-being. To be fair to those who do not have a religious faith tradition, I recommend you do not practice these activities; they are unlikely to help, and only annoy you.

Hopefully this article helps you overcome or at least identify areas that you can start working on. Of course, contacting a qualified professional is always encouraged and recommended.