Managing Depression

From the outside, depression looks like an attitude problem. The person sitting across from you is quick to flare, at times weepy, a beacon of gloom sent to suck all joy and energy from your day. If they'd just get over it! From the inside, depression is pain, an inexplicable nails-on-the-chalkboard feeling that follows you day in, day out, causing the happy moments to be bittersweet and the sad ones to be overwhelming. It alters your appetite, disrupts your sleep, even makes you feel stupid at times. A shock such as a job loss puts the best of us into a tailspin. If this has happened to you, and if you're already depressed, I'm going to wager that it's put you in bed. For at least a few days, if not longer. And if your case is severe . . . if your case is severe, you might find yourself hearing things. Voices, music that isn't playing anywhere. You might find yourself having thoughts of suicide or homicide, or you might find yourself having some out-of-place thoughts that nobody around you agrees with.

If this is you, there really IS help. Especially if you are having the symptoms of severe depression I mentioned, please see a doctor and call a therapist. A doctor can get you on medications and the therapist will tend to any emotional wounds that continue to bleed. But if your thoughts of suicide or homicide are to the extent that you are afraid someone could be hurt, bypass that suggestion and go straight to the emergency room. Ditto, if your unusual thoughts have reached a level where you or your children are in harm's way for any reason. You'll be assessed for hospitalization, yes, but you'll be alive. And in the long run, things will work their way through.

These are caveats that are very necessary and that do not belong in fine print at the bottom of the page. Always ensure your safety, including your psychological safety. "Mental Illness" is actually a physical illness that affects portions of the brain, altering our moods and thought patterns as well as our body's overall rhythms. If you need help, you need help - get it.

But not all depression is life-threatening. Mild to moderate depression can be managed at least in part by making some lifestyle changes. So I'm going to list and discussion these changes - the things you can do to help yourself. Look down the list here, choose one that seems easiest to do, and start there. Once that habit feels normal, try the next easiest suggestion. You can do more than one of these if you'd like, but keep the focus on learning one at a time.

Light. Some researchers have questioned if our skin has light sensors that combat depression, however I never saw additional research on this issue after I'd read a study on this. Open the blinds, let in the daylight, and try wearing shorts around the house. It sounds hokey, but it helps.

Physical health. When's the last time you had a check-up? That's right, an actual physical. If it's been over a year, get this updated. A physical health issue can look like a mental health issue, because mental health issues are worsened by stress. If you're sick, your system is stressed, regardless of how happy the rest of your life seems.

Exercise. Sorry, I don't mean to use foul language here! I promise I will not become a fitness nazi on you. BUT - 20 minutes of moderate exercise each day will do wonders for depression. I'm not talking boot camp - just a walk around the neighborhood will do. Maybe you could do calisthenics in front of the TV in the evenings or go dancing. If this is new to you, see a doctor to know what you can do, and pace yourself. Whatever routine you choose for this purpose doesn't need to be difficult.

Thought-stopping. Another thing researchers have determined is that our thoughts shape our mood. If you see a dark squiggly thing writhing in front of you, you'll take a step back. A snake! Your pupils dilate, your adrenaline flows, and your heart beats in like a tribal drum in your chest. No . . . wait. It's not a snake at all. Look - it's a stick that just now fell from the tree. You smile, breathe a sigh a relief and look around to see if anybody caught you being silly. No. That's good, because you didn't want to explain your reaction to anybody. Let's look at this more closely. You thought it was a snake. And since you thought that, everything in your body responded to keep you safe from the threat. Once you thought it was a stick, you were able to relax again. Take one thought that's negative and that isn't helping. There might be several, but especially at first, it's good to start with one. First of all, do you have a plan to address the situation? Ok, good. In that case, we keep going. The plan needs to be followed, but these thoughts are hurting you. So when you have these thoughts, think to yourself, "Stop!" Some people also snap a rubber band on their wrists to help with this. And then, purposely, switch to a different thought. This is not about avoiding problems. This is about seeing a stick for what it is.

Sleep. We need about eight hours of uninterrupted sleep each night. The first four hours heal your body and ensure physical health. The next four hours heal your brain. Serotonin, the neurotransmitter that makes us happy, doesn't start to regenerate until we've been asleep for five hours. Since light eases depression, try sleeping when it's dark outside.

Fluids. Water being another source of our bodies' energy, please get your share. Eight to ten glasses each day can make a big difference.

Breathing. Somehow, we all learned to breathe wrong. Try taking a deep, easy breath. Pull the air all the way down to your diaphragm (by your waist), and hold this for a few seconds. Now exhale s-l-o-w-l-y-y-y. This boosts our energy, reduces our anxiety, and it can be done in public.

Connect with your packs. Humans are pack animals . . . or 'social beings' if we want to dress the term up a bit. Regardless of the semantics we choose, we need our people. Our friends, family, co-workers, church-goers, club members, online friends . . . our people. Reach out to them. An emotional injury suffered privately, festers. If you're invested in a job-hunt, chances are good that they'll want to help you. And even if they can't offer you a lead you can use, you will still be a part of something.

Plan pleasant experiences. Let's try an exercise for a moment. Take a sheet of paper and write all the five senses on it. Now, beside each sense, make a quick list of things pertaining to that sense that you like. They need to be free and easy to encounter. My list would go something like this: Sight - fall leaves, kittens, candles; Sound - wind in the trees, jazz, my cat purring; Touch - warm shower, hugs, a kitten's fur; Smell - lilacs, burning leaves, vanilla; Taste - herbal tea, water with lemon, chicken salad sandwiches. Looking at this list, if I light a scented candle and play with a cat, I've just made four of my five senses happy. Either of these can be done at any moment I choose.

Nutrition. Blood sugar fluctuations will also mimic depression. To manage mood, try eating three to six balanced healthy meals each day. This is true even if you don't feel like eating. You can't expect to feel energetic if you deprive your body of energy.

For emotional overeaters - please look into finding other sources of energy. Focus on getting your sleep, breathing, exercise, and fluid intake in appropriate amounts. Then train yourself to be aware of your appetite levels. If you're a little hungry, eat something that's healthy. Once you're a little full, stop. Overeaters Anonymous can be an excellent resource for support.

Affirmations. Ok, so the SNL skit was really funny! But they forgot to mention how well these can help. You can either Google 'affirmation' and find some that have already been written, or you can write your own, but either way, make sure they apply to you and your life. Have several - say, maybe six - written down. And say them to yourself out loud in front of the mirror at least five times a day. If you're not working, this isn't difficult - you could put them in your bathroom and say them in the mirror each time you use the little room. If you are working, you may not be able to do them as many as five times, but three times a day should be feasible.

Housework. Ouch. First I mention exercise, and now it's housework! But believe it or not, there is research that claims that a living in a messy house will exacerbate depression. Which is a raw rub. I mean, if you weren't depressed, your house would be clean in the first place! Break this chore down. You eat a meal one bite at a time. Clean your house one room at a time. Or maybe just one chair at a time. Different people conquer this project in different ways. My favorite approach to housework is to set a timer for one hour. For that hour, I work on a specific room. Once the hour's up, I go do something else.

Journaling. Make that journal your own. Keep it in a place where nobody will find it - this is here for you. For your thoughts. It's personal, and it's meant to be for those thoughts that nobody else needs to know. You'll be surprised at how good a listener a piece of paper can be.

Friends. Connect with them, but try not to burn them out. We all need to talk to someone at times in our lives. Part of giving back is that at some point, you'll be the person listening.

Watch what you watch! Your television, the news, the movies or videogames. What are you watching? Will it put you in a good mood or will it simply raise your hackles and stress you out even more? You have enough going on in your life without having stressful entertainment.

Learn something new. This doesn't need to be linked to finding a job. Think of something you've always wished you knew more about. And then see if there's a free way to learn it. Many classes are offered for free online (you won't get course credit) and sometimes you can even get the instruction face-to-face. I found a free class on home maintenance, and I look forward to it every week! Our brains like a reasonable challenge. This is healthy for us.

Find a sense of purpose. Many people lose their purpose when the lose their jobs. Think back to the last time you tried to make conversation with someone you'd just met. "What do you do?" is often one of the first questions asked, with "I'm a . . . " being the answer. It's the bridge between small talk and showing interest in that person, specifically. And yet, people who don't hold jobs can still take pride in their lives. "I'm a stay-at-home mom," answer some. Me, I'm unemployed as a therapist, but I do odd jobs for my folks, I write a blog, and I tend to the feral cats who populate my yard. (They're ridiculously cute!)

Substances? Alcohol is a depressant. That's right - it actually causes depression. Although it's true that alcohol's a muscle relaxant, it does nothing to change the levels of stress hormones in a person's blood system. (Meditation, however, is good for that.) And people think that marijuana makes a person more mellow? Nix to that idea. Ok, if it were used extremely occasionally in small amounts, it might. But we've all hear that for every action, there's an equal and opposite reaction? If someone uses marijuana regularly, they become much more high-strung than they ever were in the first place. It also increases the risk of becoming permanently psychotic. That's the rebound effect for a drug that remains in our fat cells for at least a month after one use. (The brain has a high percentage of fat, did you know that?) Additionally, if marijuana is used during pregnancy, the pot crosses the placenta into the baby's system and stays there. Other drugs, while possibly more harmful, at least have a limited time frame of exposure. Caffeine raises the level of stress hormones in our blood, which is the last thing we need if we're already stressed out. It also prevents us from sleeping well, and it reduces the effectiveness of antidepressants. And we all know that cigarettes will make a person wheezy, there's no need to even cover that one.

Hygiene. Yes, you must. Really. I don't care if you want to take a shower or not. One issue with depression is that people stop washing themselves. It's not an issue of time or money - it's one of energy. It's easier just to stay in bed, and without a job, who's going to see you anyway? That's not the point. The point is that depression is a slowly shifting wall, and the more breathing space you give it, the more impending it becomes. So - get up. Get into the shower, do a quick shampoo, soap up the stinky spots, and rinse. I think it goes easier if you've laid out your clothing the night before. You may or may not feel better once it's done, but over time you'll feel a lot worse if you don't.

How about St. John's Wort? The jury is out. Myself, I encourage people to go with prescription medications for a few reasons . . . starting with, just because something is 'all natural' does NOT mean it's safe. Hemlock is all-natural, and it was used to execute Socrates. Because the USDA doesn't regulate herbs, we don't know the side effects or drug interactions that St. John's Wort would have with various other medications you need. We also don't know what amounts are helpful as opposed to what constitutes an overdose for your body weight. We don't know how it impacts men vs. women or children vs. adults. And lastly, we don't know if the specific pill you're taking even has the herb inside.

If the cost is what prevents you from taking prescription medications, find a pharmacy that has a reduced-cost plan, such as a four-dollar plan, and then ask if the pharmacist will allow people to fill 90 days' worth at a time. In some places, a 90-day refill costs ten dollars. Ask your doctor for samples; sometimes they have those on hand. And if not, see if the pharmaceutical company that creates the medication has a program to lower the cost. Some doctors will allow some of their patients to fill a prescription for twice the dosage per pill, fill that prescription, and then use a pill-cutter to halve the pills. The patient gets the correct dosage at half the cost.

Eye Movements. I'm going to offer an exercise here, but before doing so, I need to ask you for two favors. The first is that you don't do this exercise unless you have mastered every other suggestion here. The second is that if doing this exercise rips open any past traumas, you need to be willing to see a therapist. If you can't make both of those two promises, that's ok. Skip this and do something else.

You'll need to read through all of this before doing any of it. For this exercise, set a timer for thirty seconds. Sit/stand up straight. Directly in front of you, extend both your arms with the index fingers pointed upward. Focus your vision on something directly above your fingers, and slowly move both arms out to your sides. The second you no longer can see your index fingers in your peripheral vision, stop and hold them there. Now, that old, painful wound that continues to bleed? Let's think about it. That's right, we're taking a break from the thought-stopping just for now. As the clock ticks, think about that situation as clearly as possible - but we're going to do something differently. As you remember this, your eyes will remain open and they will move back and forth from one finger to the other. Start with the situation itself, and move to what has made you safer since that point? How are you powerful? When your timer goes off, continue moving your eyes for another few seconds and say out loud the things that give you strength and safety. Find a sheet of paper and write these down.

How's your family? Families function differently under stress than they do in happy times. The people change, the roles change. It's ok to have a sit-down meeting with your family and to tell them what's going on. It's also ok to let your kids know that you're afraid. But the last thing you want is for the kids to feel as though they need to take charge, even if you'd love to hand over the reins. For one thing, they're going to do a bad job at it, because they don't have the maturity and experience they'd need to succeed. For another thing, they're not going to want to relinquish the power they have. Instead, assure them that everything is going to be ok, and that you're still in charge, but that you might sometimes ask them for help. Financial hardship can be a learning tool for children. How would you want them to handle this if it came up in their lives down the road? The older kids can see a budget in all stages of implementation. The younger children might enjoy cutting out and organizing coupons. Just keep them away from the toy store fliers.

This information should be enough to get most people started on a path of better self-care. Some of these suggestions may require further discussion, but if they do, that's a different post.

Signing off for tonight,

The 'Cent ;-)