“Mental pain is less dramatic than physical pain, but it is more common and also harder to bear. The frequent attempt to conceal mental pain increases the burden: it is easier to say “My tooth is aching” than to say “My heart is broken.”
― C.S. Lewis, The Problem of Pain
I’ll preface this article by saying you won’t find anything new about depression in here. No miracle cure, no breakthrough answers, no one thing that will make that hollow empty feeling become a distant memory. I know that’s what you desperately need: an innovation in science, medicine or therapy. But I can’t give you that. What I can give you is what I believe is the truth about living with and overcoming depression. And, like most things in life, there’s no quick fix. It takes work, commitment and a willingness to change.
So, are you with me?
If you are then I have one single request for you: an open mind. This is a long article and as you skim through you will see lifestyle changes that you may have tried before or that don’t appeal to you. When you come across these and automatically want to jump to the next tool, I ask that you stop and ask yourself why you are so against this one. Have you tried it before and it didn’t work? Is it something you don’t believe in? Then, I would challenge you to look again. Is it worth another shot if it could help? Did you give it enough time before? Are you open to seeing through different eyes?
Know that I am someone who has been (and still goes to) where you are. I have suffered from depression for as long as I can remember. I was the child who cried herself to sleep for no particular reason; the mother who struggled with postpartum depression; the woman who fights every day to make choices I know will nourish my mind, body, and soul. If I slip up and make a wrong turn with those choices, it’s very easy to spiral down into a black hole. Hope can slip through my fingers like water and I find myself running from life again.
Isn’t that what it’s like to live with depression?
I’m not sure it’s something we ever truly overcome, whether we take medication or go to therapy, or both. If only it were that simple. But I do believe we can manage depression so that when it creeps up on us we are ready with the tools that help us through. I believe we can create a lifestyle that not only helps the depression, but has a positive ripple effect on every other area of our lives, from relationships, to health, to our work lives.
There are many books out there on how to “cure depression.” Believe me, I’ve read them. Some say it’s all about therapy, others say it’s in our genes, and still others say the secret is diet. Your doctor will tell you to “just take this pill” and your therapist will help reframe your thinking. A naturopath will give you supplements, perhaps try acupuncture, and examine your sleep and stress levels. All of these things can elevate mood, but if you are like I was for many years, you are probably wondering who to believe and what really helps.
Here’s your answer: all of it.
I understand that this is the point where I might lose you. I get it. No one wants to be told that they have to try ALL these things and make so many changes. But after 30 plus years of dealing with depression, I can honestly tell you that no ONE thing has ever worked. Perhaps for you it will, but I have had to find the combination of tools that work, sort of like my own perfect remedy. And I believe if you try many of the things listed here, you will find the combination that works for you too.
You’ll notice that I’ve split these tools into four different categories. Here’s my reasoning; depending on our beliefs and personality, we have a tendency to try the tools that fit into one category, e.g, physical tools such as medication and exercise, or “new age” tools such as visualization, reiki, and energy work. But in all likelihood, making changes in only one area of your life won’t cut it. We are spiritual, emotional, thought producing, and physical beings, and whilst making a change in one area will likely help another, we can’t ignore the different parts of ourselves and only do work in one area. It all matters and it’s all part of the healing journey.
The choice to take antidepressants can be a complex one, with many different schools of thought around whether they help, and the long term effects. Some people have gone so far as to say they are nothing more than a placebo, while others say they have literally saved their life. Personally, I believe they can be beneficial in the right hands, but I also think they are handed out far too easily and used as a BandAid in too many cases. For example, should a woman grieving the death of her husband be handed an antidepressant to numb the pain, or allowed to naturally grieve the death and go through the normal emotions that we all feel when faced with a loss?
Antidepressants are sometimes used to treat conditions unrelated to mood. Case in point: the first time I was prescribed anti-depressants was for irritable bowel syndrome twenty years ago, but my doctor didn’t tell me that was what he had prescribed. He later admitted he thought my digestive symptoms were caused by anxiety, but didn’t want to scare me with the word “antidepressant.” I never saw him again.
The main issue I see is that once you go down the path of taking antidepressants, it’s difficult to stop. Withdrawal can be debilitating and last for months, leading you to believe that the depressive symptoms have returned. I’ve been there, and fear that antidepressants are now a life sentence. I hope that won’t be the case.
As a society we are also too early on in our relationship with antidepressants to know the long-term effects. After all, how many people do you know who have been on them a lifetime? Widespread use didn’t really begin
So, my advice? Arm yourself with knowledge. Know the consequences and side effects before you begin. If you are taking them already and they are working for you, great. Just don’t assume they are your only option for the rest of your life.
I have struggled with digestive issues since I was 16. It was only when I read the books “The Mind-Gut Connection” by Emeran Mayer and “A Mind of Your Own” by Dr Kelly Brogan, that I learned of the strong link between digestive health and mood. It’s true that when my diet is poor and my sugar intake high, I notice a decline in my mood. Slowly I have begun to make changes in my diet that promote healing in my gut, which in turn has a positive effect on my mood, as well as some bonus side effects like improved skin, a clear mind, and increased energy. Diet really does play a huge role, so if you deal with gut issues, or even if you don’t, take a look at the above books and see what you think. The benefits are huge.
I’m sure the last thing you want is a lecture on exercise, but time and again the research has shown that exercise is the single most beneficial on medicinal thing you can do to help depression. So whilst you’ve heard it before, it does bear repeating: exercise works. When we work up a sweat over a sustained period of time (at least 20 mins) the body releases endorphins and serotonin, our natural feel good hormones.
Even if all you can manage is a walk in the fresh air on your lunch break, it’s better than nothing. And if the idea of joining a gym leaves you clinging to the couch, consider taking up a new hobby—rowing, basketball at your local community centre, tennis, or joining a cycling club. It’s so hard to force yourself to get out there and do something active, but I can almost guarantee you will feel better for it.
If you’ve ever suffered from insomnia, or parented an infant, you’ll know that a lack of sleep is a major inhibitor of a good mood. If you are suffering from depression and also not sleeping well (the two often go hand-in-hand) getting on top of your sleep is a must.
The problem with insomnia is that the more you focus on it, the more debilitating it becomes. It’s as though your mind just simply won’t let you sleep, no matter how exhausted you are. This is why the more you can do to escape the mind, the better. Try reading or a guided meditation. My favourite tool for sleep time meditation is an app called Insight Timer. You can also add natural aids such as melatonin, essential oils, and valerian root. If those don’t work, talk to your doctor about taking something stronger. Unfortunately sleep is not optional.
There are several supplements that doctors and naturopaths recommend to support mood. I am neither a doctor nor a naturopath so make sure you do your research and visit someone trained this area before adding a concoction of vitamins and minerals to your diet. But I’ll let you know what helps me: First I take vitamin B6. Many people also swear by B12 so figure out what works best for you. I also take Omega 3s, vitamin D, a probiotic, and curcumin, all said to have mood enhancing effects. I don’t expect that the supplements would do much if I ate a diet high in processed foods and sugars, but as a support to an already healthy diet I think they play an important role.
6. Alternate therapies
Alternate physical therapies include massage, reflexology, acupuncture, and I would stretch to include yoga in this section. Again, their effects may be limited alone, but this is all about finding those little things you can add to your lifestyle that will enhance your wellbeing and mood as a supplement to other tools. Yoga is great for both body and mind and very effective in managing stress. If you can add a weekly session to your schedule, along with an occasional massage, these small additions will help.
Mental & Emotional Change
As a counsellor I would be remiss if I didn’t talk about the benefits of talk therapy for depression. Connection with another human being who is trained to guide, support, and challenge in a way that no other can do in your life, is a vital part of living with depression. However, two points about this. Number one; we can’t all afford therapy. If this is the case, talk to your doctor about getting a referral to community mental health. Quite often there are therapy groups and free counselling sessions available through your local health authority. If not, you can also access free, or subsidized, counselling through a nearby church (membership may be required though.)
Number two: therapy alone is usually not enough. The effects of therapy will also depend on the reasons for your depression. If you have lived with lifelong depression and experienced trauma in your past, or, if you struggle with self-judgement, low self-esteem and perfectionism, therapy is usually very effective.
If, however, your depression is connected more to neurochemistry, poor diet, medication, gut issues, or chronic pain, talk therapy may be less effective. I do strongly believe though, that to someone about why you feel depressed is a great first step. Your counsellor can talk to you about options for therapy and ways to support your mental health.
8. Mindfulness & meditation
I mentioned my favourite tool for guided meditation earlier: Insight Timer. The thing I love about this free app is that you can filter meditations by topic. So if I’m feeling down, I’ll listen to a meditation for depression, or self-compassion, or grief. Or I may do a breathing meditation, or simply listen to music. The options are endless and much of the content is very uplifting. Again, a great addition to other tools you may be using to manage your depression.
Mindfulness—that is, being present in the moment to what you are doing and how you are feeling, using all of your senses—is helpful not only for depression but also stress reduction and just generally living a more joyful life.
I am a huge proponent of journaling (or expressive writing) as a tool to help manage depression. Studies show the effects of this form of writing on the brain, with great results. Expressing your thoughts and feelings on the page allows you to connect with your right brain and the parasympathetic nervous system, which promotes relaxation and allows for the release of uncomfortable feelings. I have many journaling prompts and tools to manage depression through expressive writing on my website thegiftofwriting.com.
10. Self compassion
People who struggle with perfectionism and self-judgement are more prone to depression. This is because their self-attacking thoughts and the high standards they set for themselves lead them to believe they aren’t enough. A good therapist will work with you on addressing these thoughts and provide tools to bring more self-compassion into your life. But rest assured, negative self-talk alone is enough to induce depression. One book I would highly recommend to help with your thoughts is “The Untethered Soul” by Michael Singer. Singer has a straightforward no nonsense style and his book has been recommend for people with depression and anxiety for years. I also recommend the work of Tara Brach, who talks a lot about self compassion and emotional healing.
11. Cultivate community
It probably doesn’t come as any surprise that despite the many technological tools at our fingertips for connection, we are more disconnected and lonely in Western culture than ever before. The book “Tribe” by Sebastian Junger is one of my favourites in explaining why this disconnection is so prevalent nowadays. Junger discusses our innate need for community and why, in times of war and disaster, mental health problems are less (rather than more) prevalent. He uses examples such as 9-11 to explain how the unification of a community helps to navigate us through the most painful of times.
Loneliness is a huge contributor to depression in Western society. We are an individualist society, which means that in general we don’t raise our kids in community or know our neighbours well, or mourn in community when a loved one dies. Rates of depression are lower in collectivist communities where people live in close community with their families and friends, and they know the people who live around them well.
So what does this mean for the individual suffering from depression in Western society? It means we have to create community. And yes, it may be the last thing you feel like doing when you are depressed and getting out of bed is an effort in itself, but close authentic connection is healing and a huge factor in helping depression.
If the idea of interacting with others when you feel at your lowest produces feelings of anxiety, consider beginning with a therapy group for depression. In such a group you will find meaningful connection and won’t feel like you have to hide your depression. It’s a great place to start.
Another thing that has been proven to help depression is to spend some time focusing on the needs of others. Depression is isolating and it naturally follows that we focus more on self than others. To shift focus to others, if only for a few hours can be helpful. Try to find something where you must show up weekly (or whatever works for you) so that for that day you are compelled to shower, eat, get dressed, and interact with others. If there is a segment of society you feel empathy for (the elderly, the marginalized, homeless, etc) that’s the place to begin your search.
Having faith in something bigger than ourselves helps to shift our perspective in a state of depression. I am not saying you need to believe in God, or Buddha, or any one spiritual path, but finding a path that makes sense to you can be very beneficial in helping to manage depression. With depression comes feelings of unworthiness and hopelessness; having faith that no matter what you have connection to something greater helps to alleviate those feelings. Spirituality also helps people to find a sense of purpose and connects them to others.
Perhaps you are an atheist and have already decided this is one tool you’ll give a miss. All I am saying is that perhaps now, at a time when everything seems hopeless, exploration into the meaning of life and what more there may possibly be out there, could be the perfect time.
Why this is hard
If you are suffering from depression that is bad enough you can’t even imagine taking a shower or cooking a meal, many of these lifestyle changes will seem impossible. Even for the non-depressed person, change is difficult (we are, after all, creatures of habit) so I accept that trying to make changes when you feel like you live in a black hole is extremely challenging.
This is where I encourage you to fight. Fight for your life and fight for your loved ones. You are worth it. You don’t have to make drastic changes, but you do need to take the first step. Pick something on this list that is do-able for you in increments. Take baby steps and work your way through. When you don’t feel like doing anything, the only thing you can do is something that is a small step towards getting better.
You can overcome depression—it is not a life sentence and you do not have to submit to a lifetime on medication or believing you will never feel joy again. If you would like to talk more about the suggestions I have provided, or about your depression in general, email me at firstname.lastname@example.org.