In response to a discussion of the treatment of depression on alt.callahans, and in the spirit of "Free Advice Is Worth What You Pay For It," I hereby offer the following:
Top priority is to stay functional; it may not be sufficient, but it sure as hell is necessary. But speaking from (what I now realize to be long-term) experience with cyclic depression, (sometimes to the point of feeling suicidal), I've actually come up with a recipe that seems to work that doesn't require outside intervention. To that end, my philosopy is: use whatever works.
First, the preventives. These support the basic, physical aspects of strength and stamina, and will directly and conspicuously affect my perceived ability to cope. When I'm feeling "weak," even a trivial task can look insurmountable. Given an adequate physical foundation, the same task is hardly worth notice.
So those are the staples I use to support my mood management. I've finally learned that, when things start feeling Really Bad, I should go through the above check-list before I decide that I really can't cope with something. I can usually short-circuit a bad patch by being dilligent about the these disciplines. For what it's worth, if things have really fallen apart and I'm faced with doing a complete re-build, I find that it's most effective to tackle them in the order listed. (I'm learning to budget a month after traveling, for example, to re-equillibriate.)
- Eat right! In my experience, ample leafy greens are the king-pin to a sanity-supporting diet. The basic FDA food-pyramid seems to be a good foundation to start with. Watch carefully for specific mood effects of different foods. This can be difficult to do, but fascinating when you get the knack of it. (Sidebar: watch out for food allergies and such. These can skew your results and produce the very effects you're trying to fix.)
Junk-out carefully: anything that forcibly horks around your bio-, blood-, or brain-chemistry will make mood management all the more difficult, like trying to stop a moving pendulum by pushing on it, rather than just letting it damp out. The results are usually a chaotic tumble, which is much harder to sort out. The list includes all the obvious mood-modifiers: recreational drugs, alcohol, caffeine, sugar, tobacco. Plus the less obvious ones: sleep-deprivation, work-(or any activity-)oholism, sleeping too much, compensation-eating, etc. (It amazes me that anything can be a drug....)
- Get enough sleep! There's been a lot of press lately about this one: most people try to run on two thirds to half as much sleep as they really need, with the mistaken idea that the extra time buys them more "productivity." In fact, they're actually impairing their effectiveness by being chronically depleted. Personal experience: I can get two to three times as much quality work done in a 8-hour work day after a full night's sleep than I can if I'm sleep-depped. The ratio gets worse the longer my sleep deficit lasts.
How to tell if you're sleeping enough:
If the answer to either is "yes," then you need more sleep. If you have insomnia, handy home remedies include:
- Do you have trouble waking up on time without an alarm?
- Do you konk right out when you go to bed?
- Go to sleep and get up on a consistent, regular schedule.
- Limit caffeine and alcohol intake. Don't drink caffeine for at least 6 hours before bed. Drinking alcohol may make you sleepy, but will erode the quality of your sleep.
- Get plenty of (especially aerobic) excercise.
- Excercise! Select a good variety of aerobic, weight-bearing, and stretching excercise. Start out gently if you're a beginner: if you injure yourself, not only do you delay your good effects, but you also induce frustration that can undo your whole effort. (I finally realized, after being a dedicated couch potato for 35 years, that I'm actually a frustrated excercise junkie. My basal level of fitness is so low that I have to be very careful about what I take on. But I've found that if I do a lot of very light excercise, I can satisfy the craving and get lots of accomplishment-gratification while at the same time protecting my health.
Shop around, find excercise that you like, and pay particular attention to collateral factors, such as:
These can have as much effect on your enjoyment (and consequently your all-important motivation and maintainance) as the kind of excercise itself. For example, I've found several kinds of strength-and-flexibility excercises that I like a lot, but I don't keep up with them between classes. I finally figured out that about a third of what I'm after is the company of my class-mates, and another third is getting out of the house to go to class.
- Do you prefer to excercise alone or do you want company?
- Do you want quiet contemplative excercise or raucous energy?
- Do you want to be indoors or outdoors?
- Do you want to be at home or out and about?
- And so on.
- Grow! I've often found that depression is a sign that something in my life isn't working, and will lift when I get to work on the problem. Work on it. Consequently, I've made a hobby of cultivating health, on every front: physical, emotional, psychological, spiritual.
Next, palliatives (in no particular order). These are sort of like psychic aspirin -- to be taken as needed to relieve pain and discomfort:
So there you have it. Simple and simplistic, yes, but handy as a sort of emotional First-Aid kit, to keep in the mental kitchen, as it were. I'm sure there are other things that should be on this list. Let's hear 'em!
- Don't just sit there: do something! Depression=inertia, in my observation, and taking nearly any action will often unstick the system. This feels like voo-doo to me, but it works reliably.
Often I find that there's usually a "presenting problem" at the root of my depression. Going in after it with tongs (however ineffectively for the moment) often results in relieving the mood somewhat, and evoking the next step, or maybe just clarifying the issue. Nevermind: when, er, palliating, the object is less to solve the problem itself than to move into that psychic space where solutions seem impossible.
- Call a friend and complain.
- Write about "it" -- how should things be going?
- Wash the dishes.
- Kick the wall.
- Call a counselor.
- Look at the help-wanteds.
If the only thing to do that comes to mind seems too big or overwhelming, chop it down into small pieces. Say I want to call a friend, but can't quite muster the energy. So, I just look up their number and lay it out by the phone. Often even that tiny bit of momentum will jostle me loose, and I'll find myself picking up the receiver without realizing I'm doing it. An hour later I've vented, my spleen is rinsed, maybe a couple of ideas for solutions have surfaced, and I can finally face the rest of my day.
- Gratitudes! This one is really sappy, but I swear to Ghod it came close to saving my life last year. (If you want the full story....)
Even at the darkest hour, there are things that are going right. Even if it's just that I have enough raw horse-sense to be dissatisfied with my situation (emotional, psychological, physical) that is causing me illness. So I sit down and start writing down the things that I have to be grateful for.
Be honest, though; denial is no improvement over wallowing. Pay particular attention to how specific "gratitudes" make you feel. After a few, you may notice that some kinds work better than others: look for more of those.
- Get pissed! A lot of times I find that my depression is actually dis-allowed anger. Sometimes I have to really, seriously get myself into the trouble before the depression clicks over into anger. But when I finally reach the point of "Ghod damnit to hell! Why am I putting up with !$#!$!??" that's usually when I move from being a victim of my situation to its author. (We're not necessarily talking practical reality here. This is about altering the perception of a situation. The objective is to reach the psychological state of feeling able to act.) I find that the earlier I can nip depression in the bud and ignite the anger, the easier it is to manage (take control of) my response to a situation.
Often this step is a prerequiste for Palliative #1, above, although sometimes it can go the other way, too. I particualarly recommend Barbara Sher's "Bitching and Moaning, the Power of Negative Thinking" for this step. It can be found in several of her books, most notabely I Could Do Anything.
- Pray! This is another one I have trouble saying with a straight face, having only come to it very recently myself. But, strangely enough, it works! Far as I can tell, it almost doesn't matter who you pray to. It's been my observation that (the) [Gg](h)od(ess)(s), will answer you in any form you care to listen. If your patron saint is Elvis, pull out that ol' Graceland poster!
But be patient -- and observant. Sometimes the answer is immediate. (Took practice, in my case. At first, I had trouble crediting that that the response I was hearing in my head was actually that, and not just monkey-mind.) But sometimes it's not, and sometimes it's not obvious that what you get is what you asked for. That colitis flare-up I mentioned above? Well, I'd been praying for help in loosing weight.... Be careful, etc.
But (and here's the really tricky part) pray for what you truly want. If you pray for what you think you ought to want, you'll probably get it, but again in my experience, grudgingly, and it doesn't work well when it comes. But give yourself time. Especially if you're depressed, you've probably given up wanting things, so it can take time, practice, and work to get back to what's real for you.
--18 August 1998