Depression is a serious and disabling condition, "real" Depression is something that you cannot just snap yourself out of. I wanted to share some thoughts I have based on my own experiences on how I made Clinical Depression easier to deal with when it was a factor in my own life.
When I suffered with Clinical Depression it was a long drawn out process. I personally suffered four major episodes over a twelve year period. I was hospitalised during my first episode and my final episode lasted over a year before it even started to feel better. I certainly know how debilitating Depression can really feel.
I never want to be in a position where I feel those feelings again and because of this I work hard on my maintenance programme to prevent it. I never falter in my own efforts to stay well, as I would not like to take that chance. That said the whole way I see things has changed now and if it ever did come back, I would accept it and work through it. I no longer live in fear of Depression, not any more.
I don't have to like the thought it may come back, but I can be aware of it as a possibility and apply everything I have learnt to prevent it happening.
You would be very foolish to presume that once recovered it could never happen to you again.
I have taken steps to manage myself and to develop long term habits such as the ones below that are now an essential part of my life and my mental well being. The fact is I have to do it to stay well and retain my quality of life.
Long term recovery from Depression is about taking care of your physical health as well as your mental health. Looking after your body helps to keep your mind well too. This is fact and should be taken seriously.
Here are my tip's for coping with and emerging through serious Clinical Depression:
1.Adapt your Diet to limit foods and drinks that over stimulate your nervous system and affect your mood.
Think about it, your nervous system is already well over stimulated and surging with adrenalin, so why would you feed yourself things that are going to stimulate it even more such as sugar based foods?
Mood and diet are strongly connected, so managing your diet will help your symptoms become more manageable.
Have a look at the diet page I have created for information on which foods to avoid.
2.Get into a habit of taking regular exercise, even if you don't feel like it.
The importance of building an exercise regime into your life and sticking to it during your acute symptoms and once symptoms are in remission cannot be underestimated.
Stress produces excess adrenalin and must be worked off to limit the effects of panic symptoms. It must be worked off while you are suffering and also once you feel that you have regained your quality of life, to keep your symptoms in remission.
Exercise not only burns off all your excess adrenalin (which needs to go somewhere), but it also releases the feel good hormones endorphins and improves your self confidence. Personally I now exercise 5-6 times a week and would never be without it as I understand how important it is to my wellbeing. It helped me to have more bearable symptoms during my own acute stages and now helps me to keep my own symptoms in remission.
The same self care would apply for physical illness, let me give an example:
Let's say that you have suffered a heart attack. On leaving hospital your doctor have discussed with you that because you have had a heart attack you could be more prone to suffering another.
He would have highlighted that there are things that you can do to minimise the chance of this happening such as, stopping smoking, reducing your salt intake, limiting your alcohol, and taking regular exercise. He is not lying, it is now your choice whether you take the advice moving forwards. You can accept this advice and understand that there is no going back now, you have to accept that whether you like it or not and that to avoid heart attack in the future you must understand your condition and look after yourself more, developing new habits that you will have in place for the rest of your life.
Try to look at Mental Health as exactly the same, you have suffered with Anxiety or Depression and the fact is there are things you can do to limit your chances of ever having to suffer again. You must first accept that you have the "condition" and also that you must manage it going forward to prevent relapse.
Let's look at me as an example. Even though I suffered with both Anxiety and Depression I spent a long time never really accepting that this was now a part of me and I would have to actually do anything to prevent its return.
When I started to feel better, I just grabbed it with both hands and tried to forget how bad it had been as I raced straight back into my old ways of thinking and life.
Four major relapses later, and lots more self searching and needless suffering I now understand that I must look at ways to limit my stresses, challenge my way of thinking and the way I look at the world and look after my body. This will then reward me by lengthening the time I stay recovered. If I don't do it I will end up back there and believe me that option is not something I want.
I now exercise regularly and could not be without it. I feel so much better and I can tell in my mood if I let it slip.
I find cycling and running work well for me, but any form of exercise will help. Being outside puts you at one with nature and brings you outside of your head and if you would rather join a class that is great too as it gets you back into socialising with others.
You must do it though, it's an essential part of Anxiety and Depression management.
3.Accept that the early days are going to be difficult.
When you first begin to suffer Anxiety and Panic symptoms, it can be a frightening experience. You cannot imagine ever feeling better, time seems to stand still with every minute seeming like an day in length. It feels a struggle to hang in there and make sense of what you are feeling. There is no getting away from this and it doesn't feel great, but as a veteran of feeling this way I can promise you that this won't last. Over time you will be more and more able to stand back from these thoughts and feelings. . Then the hard bit is accepting that you need to change the habits you have to stay well. One of the best things I did for myself during four relapses was to accept that when these feelings were most acute, that it would pass and to keep my hope.
Low mood is a terrible thing and living with that feeling of impending doom day after day is really hard, but it can be done, it really can.
Depression tends to begin with all bad days, but eventually you will notice that the odd good day happens. Then more good days, until you have more good than bad and then the bad seem to just melt away as the episode finishes. Grab your good days with both hands and work through your bad days.
4.Accept that there are stages of the illness that you need to go through.
When I first suffered with Depression as an adult, I spent a little time sat with a Psychiatrist who explained to me that there were stages of the illness that I would have to "take on the chin" and go through before I could come out of the other side. It was really good advice and helped to normalise what I was going to go through. Stages such as a period of obsessive black thoughts, that would otherwise have scared the hell out of me, but thanks to him, I was able to stand back a little and see them for what they are. It was still hard to cope at its worst, but it really helped me to understand this is a process, an episode even that needs to run its course.
I found it was useless trying to resist the process, it was much easier to learn about it and accept it whether I liked it or not.
I had to accept it as a process that I must allow to happen in order to come out of the other side.
Mindfulness in short is the art of being in control of your own mind and thoughts. Having the ability to live in the moment not in the past or the future. It's about allowing in your thoughts whatever they are, in to your mind, observe them without judging them to be good or bad and allow them to float away.
It is a very powerful tool in learning to cope with an unsettled mind.
You don't have to like your thoughts, but you can learn to accept that they are there and choose whether to let them bother you or not. This is really worth practising as the art of learning to quiet your own mind is essential in long term Anxiety and Depression management.
6.Try to give your mind something else to focus on.
Every moment that you can spend engrossed in something other than churning over your fears and coping with your low mood, is a moment that you do not have to suffer and will give you some relief from your symptoms.
Both Depression and Anxiety take up a lot of time, they need a 100% focus from you to stay so strong. I got to the point where I stopped wanting to dedicate my life to a cause that only served to make me feel so bad.
I find that something that really engages your mind such as playing cards (solitaire in my case), or maybe knitting or writing in a journal or cleaning the house (cleaning out cupboards or scrubbing floors). Anything that will re direct your thoughts and cause you to concentrate on something else. The more time you spend away from Anxiety provoking and Depressive thoughts the closer you are to beginning to recover.
Over time you will find you naturally step back, but in the beginning when I was completely caught up in the thoughts, feelings and sensations I found this tip really helped me to cope, learn to centre your mind to concentrate on the job in hand, it really does help as you are unable to panic in the present moment, only when you are thinking of the past or worrying about the future.
7.Set yourself some simple tasks.
The key here is to set yourself tasks which due to your Depression you are no longer doing. Remember it does not matter if the tasks are as simple as posting a letter, changing the bed sheets or cooking some dinner. The fact that you are finding them difficult just means that you are finding them difficult at the moment because of your Depression (rather like someone with a broken leg may find it difficult to walk without crutches or run a mile), it does not mean that you will find them this difficult forever.
It's really important to understand that because of your Depression you may not find these activities enjoyable at all and they may even seem pointless due to your low mood, but don't be fooled, by re- engaging in things you are taking a very important step to overcoming your Depression as you are beginning to once again take part in things you gave up because of it.
Do it even if you find it really hard or don't enjoy it, that is the key.
8.Keep a Journal or Diary of your activities.
Keeping a journal is a very useful exercise. It can help you to realise suppressed feelings, see your progress and make sense of what you are feeling.
It also helps you to focus on how you are spending your time.
When you are experiencing feelings of Depression your mood is low and it becomes very easy to dwell on negative aspects thoughts and feelings.
When keeping a journal, just write down your feelings as you have them, there is no wrong or right and no one has to see it but you. What is important is that you get those suppressed feelings out.
Over time when you look back you will be able to see your progress there in black and white. j
It's quite common to be shocked at what you have written and be amazed that it is even you that was in that dark place.
It is also helpful to keep an activity diary so that you can monitor how you are spending your time, staying Depressed takes up total dedication to your depressive thoughts and feelings and so any time that you can spend away from your Depression is a step towards moving away from it, even if the activity that you are doing does not make you feel good.
When keeping an activity diary there are some basic guidelines to follow:
1.Use the diary to find out how you are spending your time. Do this by dividing your day into hours and for a week fill in everything you do hour by hour. This is a powerful way of counteracting your Depressive thinking which will be intent on making you think you have no progress or no hope, but this is often distorted and not correct.
2. Rate your activities for mastery and pleasure. (1 being low 10 being high) So first go over your daily activities and rate each one on a scale of 1-10 of how difficult you found each task as you did it. Do this even if you dragged yourself around doing it as the fact that you did it deserves a credit!. You can start to see how you are overcoming the depression to complete each task.
3. Next use the same scale and rate each task for pleasure it gave you whilst doing it. Maybe you get more pleasure the more engaged you are in the task?
4. Next trouble shoot your results and look at how you can work to increase the level of mastery or pleasure to your day.
5. Plan. So use the list of daily activities to help you to plan ahead. You now have the FACTS in front of you and so can no longer be mislead by your Depressed thinking.
6.Finally schedule more events, try to do more even if you do not feel good about things. Each time you spend a while engaged in a task is a little less time you spend churning over Depressed and Hopeless thoughts.
Remember the main thing here is to have books of proof that your Depressive thinking is actually distorted and not correct. It also shows you when you have felt pleasure and that you are completing tasks, difficult or not. Overtime you will see them improvement and that will prove to you that you have made progress towards your recovery.
9.However long this continues never lose your hope or your will to continue as it will go away.
Yes it can seem relentless as minutes turn into hours and days sometime turn into months, but this will go away. Someone once told me " never ever fall into it" and that to me was great advice. When this first happened to me it seemed to hit like a sledge hammer and was very frightening. I did fall into it, it was easy to get swept away in a blur of intense thoughts and feelings.
I recovered from each of four breakdowns and I have been well for years. This does go away, so always keep your hope.
10.Rest and allow your body time to heal.
This is really important as the body and mind both have a huge capacity to heal themselves if they are just given the chance.
Nothing is more important than your health as without your health you have nothing. Accept this is an illness just as you would a common cold or a broken leg, and give yourself time out to heal.
Take time off work if you need to. Do not feel guilty about cancelling your engagements, you have to listen to your body and it's needs this is about you and your healing.
11.Spend as much time as you can with nature.
This really helps me and I know it helps others. Spend as much time outside as you can. Stand looking at a lovely view, feel the wind in your hair or sit on the grass and just be.
Nothing lifts a mood or brings you out of your head more than spending time with nature.
12.Do not be afraid to seek help if you need it.
There is a lot of stigma and shame attached to mental illness. This is not right or ok but it happens.
Essentially, it is just ignorance and lack of acceptance but It's because of this so many people are too scared to seek help even when they desperately need it.
If you can no longer cope, you must seek help. There is so much help available that can assist you in coping with your symptoms and feeling, there is really no need to suffer needlessly. One of the best things I did was see the Psychiatrist in those early days, these people are not going to drag you away in a straight jacket, they see this all the time and can help you.
The Psychiatrist I went to see was lovely, I found my visit informative and reassuring. He did not judge me and his presence did not make me feel unsure or unsafe in anyway. His knowledge really helped me to cope with the symptoms that I was having already and any surprises that were to come. He helped to rationalise things and remove a considerable amount of fear.