a few ideas for hard times
I am a therapist specialized in the treatment of depression. I am also a person that has experienced depression. I want to share some of what I know both personally and theoretically about the subject. Depression—the darkness, the heaviest empty, hopelessness with no end—is an unruly, slippery cluster of miserable experiences. It’s also, counterintuitively, a sign of good health. Depression tells us something we need to know. We might think it is telling us I’m no good, defective, worthless, but instead it is telling us something deeper. It tells us that something needs to change. When it occurs it gives us the opportunity to be curious, to reach out, to open to something vast and unknown. It also calls us to accept something about our current situation in order to have more choice.
I think therapy is one useful way to treat depression (obviously), but there are also many other things to do outside of therapy. As a therapist, I do not want to be the gatekeeper of how to feel better. I want to share ways to treat depression in a holistic, practical, and authentic way outside of traditional therapy. This is by no means an exhaustive list.
Anchor. Find a book that inspires you and read it. For me, this book is When Things Fall Apart by Pema Chödrön. Chödrön is an American Buddhist Nun. She is funny and earnest. She has a way of speaking and writing that helps the mind chatter fall away. She cuts to heart of the matter. I lean on her book in times of need or when I’m feeling stuck in how I’m approaching a difficult situation. My copy of her book literally looks leaned on—it is dog-eared, dented, and frayed. Her words are an anchor.
Mindfulness. Yes, the term “mindfulness” is overused. Yes, it’s ubiquitous in wellness culture. But if you really practice it, it will be helpful. So much of what causes and feeds depression is being on autopilot. We are using the strategies to reduce emotional pain that we’ve always used without considering if they are actually working. Our body/mind is amazing; we do a lot of incredible stuff without thinking (yay for our beating hearts!). But we also have ways of thinking that are anachronistic. They no longer fit the current situation. Consider your favorite way to learn (audio, visual, kinetic, tactile) and start with that type of mindfulness. Great writers on the subject of mindfulness are Pema Chödrön, Jon Kabat-Zinn (Mindful Way Through Depression), and Thich Nhat Hanh. But you can also take a class, use an app, or go to yoga.
Movement. Move your body in any way you can a couple times a week. The research supports it!
Supplements. Live in Seattle? Talk to your doc about upping your Vitamin D. Low D levels can be linked to depression, among other health issues. Although it’s link to depression is not confirmed, Vitamin D are small, easy to swallow pills, and relatively inexpensive.
Connect. Tell others that you trust that you aren’t feeling great. Depression often leads people to withdraw from others, but try connecting if you can. Don’t push yourself to go to a crowded concert if you aren’t leaving your house, but do ask a friend to go for a walk.
Opposite Action. One helpful concept borrowed from Dialectical Behavioral Therapy, is “opposite action.” Often what feels natural when you are depressed (sleeping, staying in your house, watching TV, drinking alcohol) leads to feeling more depressed. These are strategies to avoid emotional pain and, if done all the time, can make things worse. Opposite action is an approach to feeling better that asks you to do the (healthy) opposite of what you feel like doing. It often leads to long term benefits, but presents some short term discomfort. For example, I know that doing yoga helps me when I’m depressed. There is nothing I want to do less when I’m down than put on yoga pants and shlep myself over to a yoga class. But it is my most effective opposite action.
Reframe. Consider reframing your goal. Is it to feel happier? Might I suggest feeling more resilient, instead of just feeling happier. If we set our sights on removing all emotional pain, not having negative thoughts, and having all things work out the way we want them too, we may be headed for more hopelessness. Pain is a part of life. But we can decrease suffering by how we approach our pain, distress, and failures. Don’t fight to be a positive person; grow to be exactly who you are with a more playful approach to your thoughts- joy and lightness will come from that.
Group Therapy. I think group therapy is highly underrated. Good therapeutic groups provide social support, decrease isolation, de-individualize suffering, and tend to be less expensive than individual therapy. There are many types of groups (process, support, recovery, skill). Try out out a few or start with a recommendation from a therapist.
If you happen to be reading this and are not depressed, make a contingency plan for depression or even a temporary crisis. Assume there will be another time in your life where taking good care of yourself will be difficult and make a list of numbers (friends, therapists, doctors, crisis lines), opposite action activities, podcasts to listen to, books to read, inspiration quotes that actually inspire you. A little goes a long way in preventing or shortening a depressive episode.
I want to also state outright that you should seek the support of a therapist, doctor, psychiatrist, or a qualified professional if you are having thoughts of harming yourself or others. And if you ever feel in immediate danger of acting on those thoughts, go to your nearest ER or 866-4crisis. There is no shame in needing help!