by Joelle Steele
If anyone understands depression, it’s people who have been there and experienced it first hand. I’m one of those people. I was in a major automobile accident and have been suffering with widespread arthritis as a result. After the accident, I spent nine years in various states of constant depression and anxiety. I saw four different therapists who were no help to me at all. They prescribed medications and encouraged me to go to group therapy – a waste of time that I now refer to as “the big wallow.” I eventually met someone who had gone through the same thing, and she referred me to a therapist who helped her. I was reluctant, but eventually I went and saw the therapist, and she gave me a set of steps to alleviate depression and anxiety, and to avoid falling down that rabbit hole again. This doesn’t mean you will never depressed, or that you will be able to stop taking your medication, but it can help you avoid becoming severely depressed or anxious. And now I’m going to share her steps with you.
About Depression & Other Mood Disorders
Depression and anxiety are essentially two sides of the same coin. Half of all people with depression also suffer from anxiety. They are both part of the same set of mood disorders that also include persistent depressive disorder (PDD, formerly called dysthymia or non-situational depression). These mood disorders affect millions of people (mostly women, and also children) worldwide – 17.3 million in the United States alone (NIMH 2017). Yet despite these numbers, fully two-thirds of all who suffer from these disabling disorders fail to get treatment and, unfortunately, those who do get treatment don’t always get relief. This is important because depression and anxiety can lead to other serious physical diseases such as coronary artery disease. In fact, people with mood disorders make far more trips to doctors for their non-depressive physical problems which so often accompany depression or are part of the underlying cause of many mood disorders. After all, living with chronic pain can be depressing. And, if none of that is enough, children are far more likely to develop the same depression or anxiety disorders as their parents. And that is not good.
Surely a cure is the answer, and you will notice that the title of this post is “alleviating” depression, not curing it. But many people believe they are just stuck with being depressed and anxious, prone to negative thoughts, panic attacks, etc. Medications are important, but they don’t always fully alleviate your symptoms if you don’t learn to undo some of the causes and contributors to depression and anxiety.
The Roots of Depression
Your mind, your memory, is filled with life experiences, good and bad. But, when you’re young, your experiences are not always positive ones, or they are neither positive or negative, but are merely filed away incorrectly in your memory. They may even be misinterpretations that you’re hanging onto. But, whatever the case, they were not dealt with at the time, you may have rationalized or denied them, and now, here you are, all grown up, maybe even in your golden years, and you’re still dealing with life based on those undealt-with experiences. You might not even remember them at all, or remember them incorrectly. So, as an adult, you have had years to learn how to automatically do the very things that keep you in your depressed and anxious states.
One-on-one therapy can help with those past memories and experiences, but you can lift yourself out of depression by starting to change the things you do (or don’t do) that are impacting negatively on your brain chemistry, and replacing them with what impacts positively on your brain chemistry.
The Eight Steps
If you read my article on pain management you may already be familiar with some of these steps. If you are on medication, keep taking it as prescribed until you and your therapist feel you can start reducing the dosage to see how you do without it. I have listed the steps in the order that the therapist who gave them to me said they should be done, and they must be done in this order, because they are a part of a process, and each step is built on the ones prior to it. Master one step at a time and then stick to it while you move on and work the next step. All these steps ultimately work together to make you a mentally (and physically) healthier person. Some will be easier for you than others, so the amount of time each step takes is … however long it takes. Be patient and keep at it.
Step 1. Support and Enablers. You need support from family and friends to change your life and lift your depression. Resolve your relationship problems, even if the problem with a person dates back to your childhood, even if the person has been gone from your life for a decade, even if the person is long dead. Write them a letter if they live far away or you don’t want to talk to them about it in person. And, if you feel they wronged you, forgive them. But most of all, forgive yourself for anything you’ve done that was wrong. Relationships go wrong because there are two people and two sides to every argument.
That’s part of clearing the decks for wellness. But you must also learn to spot your enablers. No one stays depressed without help from an enabler or two … or more. Enablers are not evil people bent on making your life miserable. In fact, one way to spot them is that they are such sweet, well-meaning, concerned, and helpful friends, spouses, parents, etc., who feel sorry for you and want to help you and do things for you so that you don’t have to do them yourself. People with physical illnesses and disabilities also have enablers. So, you need to let everyone know that you want to get better and that you need them to encourage you to make changes in your life to do so. If anyone is not supportive, you should try to reduce the time you communicate or spend time with them. They will only make it harder for you to get well. And beware, people with mood disorders tend to support each other’s disability rather than try to help each other get well. This means you are both enabling each other in a relationship that neither of you may recognize as toxic.
2. Sleep. Adhering to a regular sleep schedule is one of the single most important things anyone can do that will not only help with depression and anxiety, but will also improve your overall physical health. And, if you have physical pain, a sleep schedule will actually help alleviate it. Every night, your body needs to fulfill a regenerative sleep cycle that has several sub-cycles. This cycle cannot be achieved if you don’t sleep enough hours every night and don’t stay asleep straight through the night. How many hours is enough? Depends on the person, but for optimum health, anywhere from six to eight hours. You will know if you’re not getting enough if you are frequently tired during the day and lack the physical and mental energy to get things done.
You correct/adjust your sleep cycle based on when you get up in the morning, not when you go to bed at night. Try to get up at the same time every day, including weekends. Stay awake all day – no napping – and go to bed about eight hours before the time you want to get up in the morning. Do not eat, watch TV, or use your tablet or cell phone for at least an hour before you go to sleep. It usually takes at least two weeks of doing this to get your sleep cycle in order. If there are reasons for the interruptions in your sleep, such as an animal, a mattress, a snoring spouse, too warm/cold room, or some other disruption, try to find solutions for it. Your sleep is the most important bodily function you have aside from breathing and eating. Sleep well and you will feel much better mentally and physically, and you’ll have far more energy too.
3. Organization. Some people have organized daily schedules. They get up, make the bed, take a shower, get dressed, feed the kids, go to work or do some other activity, and have things that they have to do, whether or not those things are enjoyable. These people rarely suffer from mood disorders. People with mood disorders rarely have a fixed schedule of any kind. Their days are more or less random, and some are unemployed or have no activity to pursue. Usually they will say they don’t have time to do the things they love, but it is more likely that they have the time but are just too disorganized to make anything happen. When you get organized, you will be amazed at how much free time you suddenly have. Make a “to do” list and keep a detailed calendar. Do all your errands on a single day rather than wasting time spreading them throughout the week. Spend some time organizing your things if you’re overrun with clutter. Plastic bins or shelves can really help. Don’t panic if the house, garage, or yard is a mess. Just get in the habit of cleaning up after yourself whenever you first make a mess or leave things out. As for the entire house, garage, or yard, just do one small area every day or every other day or once a week – whatever the chore dictates. And when all of those areas are done, start all over again. These areas don’t ever have to be made 100% perfect in a single day. Thinking they do is really nothing more than a recipe for failure because you’ll just feel too overwhelmed to tackle anything.
4. Exercise. Daily exercise, even at low levels, can dramatically reduce depression (and physical pain). How this occurs has long been debated by scientists. Many experts believe that the hypothalamus and pituitary gland in your brain produce endorphins, your body’s natural pain relief chemicals. But, if you also have pain, you might be happy to know that other experts now believe that exercise-related pain relief is due to a neurotransmitter called anandamide, which becomes elevated when you exercise. And still other experts believe that both depression and pain relief from exercise is due to the release of serotonin and norepinephrine. Well, whatever the chemical reaction is in the brain, exercise offers relief. Start with low-impact exercises such as yoga, tai chi, swimming, or simply walking. Work your way up to hiking, dancing, or gardening. And keep yourself hydrated no matter what kind of exercise you choose to do, as dehydration leads to fatigue and heightened physical pain. I get dehydrated when I work in the yard on a hot day, and I add Nuun to my water to keep me on my feet.
5. Keep Busy. Find a reason to get out of bed every day. Not your children, not your spouse, not a person, but rather some thing or things that you do that are just for you. It should be for your own enjoyment or your own income, etc., like a hobby, a job, a class, or a volunteer activity. Having purpose in life will take you away from what bothers you, what you can’t do, what you wish you could have done, and lead you to feeling fulfillment and satisfaction in your life. Keeping busy is also a way to promote a regular “distraction” that forces you to focus on the here and now, the present, rather than the past or what’s bothering you at the moment. You simply have to find a way to get through your day in a way that does not involve laying around doing nothing because you don’t feel like doing anything. You’re more likely to feel better mentally and physically if you are pursuing your work or favorite hobby or volunteering to help people who are probably far worse off than you are.
Make your life a joyous experience. Take a walk in a park and revel in all of nature’s glory. Play games with other people, not just games on your cell phone. Listen to positive, upbeat music. Read books – novels or non-fiction. Learn how to do something new and different by reading or taking a class or two. In fact, consider going back to school if you didn’t finish. Avoid TV as much as possible, particularly news channels that dwell on the disaster of the day. You don’t need to allow yourself to be depressed by news stations that broadcast negative news in order to make more money from their advertisers, many of which are pharmaceutical manufacturers. How depressing is that?
6. Meditate. This is basically the power of positive thinking and relaxation. Do it three times a day for about 5 minutes each time. It really makes a difference. I always start the day with a short meditation, do it again mid-afternoon, and again a couple hours before I go to bed. Sit upright in a chair in a quiet room or outside on a nice day. Fold your hands in your lap, tilt your head down slightly, and focus on your breathing. Breathe in and out slowly, counting to ten with each inhalation and exhalation. Do this for about a minute or so, and then you can start to send yourself positive messages and feelings of being happy, fulfilled, pain-free or whatever it is that you want to bring into your life. You can think the words or speak them softly. Always keep them positive. Don’t say, “I’m never depressed,” or “I’m not in pain.” Leave out the words no, not, and never. Say instead, “I feel great,” “I’m happy with my life,” or “My body feels so relaxed,” or “I have so much energy.” You get the picture. You might want to reflect on a time when you were happy and/or pain-free, and try to remember how that felt. Also, illness or pain levels are more affected by your psychological outlook than by the physical ailment itself because you tend to focus more on the pain. Meditation helps break down that psychological mechanism so that you can release at least some of your pain and despair.
And now, the steps that most people find the hardest to follow, but can have a huge impact on how you feel mentally and physically:
7. Nutrition. This is often the hardest step for people with mood disorders. Depressed people are notorious for their bad eating habits, mostly their love of junk food, their love of comfort food. You don’t have to give up all your junk food, but if you are hooked on sweets or mac and cheese, you could be headed for trouble. Food cannot fix what ails you when you’re depressed, and it won’t relieve physical pain either. It only confirms that something is wrong and that you have gotten into the (bad) habit of eating to relieve your stress, anxiety, depressive state, and/or physical pain.
The best foods are fresh foods rather than processed. Processed foods come in boxes, bags, jars, and cans. They contain large amounts of salt and sugar, and they are waaaaaay more expensive than fresh foods. Many processed foods have misleading labels saying “natural,” which doesn’t mean anything. You don’t have to give up processed foods entirely, but they should not be the mainstay of your daily diet. The same is true of fast food, which is generally made with processed foods.
There is no such thing as a bad fruit or vegetable. And, while many experts say you should only buy fruits and vegetables that are in season, many markets carry fruits and vegetables grown in all parts of the world, and there are no reputable studies that indicate they are not good for you. There are a few caveats to eating some things. For example, when you eat a green salad, avoid head lettuce and romaine and stick with the far more nutritious mixed small greens instead. If you can tolerate them, eat plenty of bell peppers, onions, and garlic, especially the latter, which is known to lower cholesterol. With potatoes, any potato is fine, but sweet potatoes are the healthiest. Just take it easy on the butter and sour cream!
Meat, poultry, and fish, like any other foods, are best purchased fresh rather than frozen. Meat is okay, but try not to overdo it. Once a week should be the most. Poultry can be eaten more frequently. Fish is really the best. Stick with salmon, steelhead (which is grown-up rainbow trout), mackerel, sardines, red snapper, and herring. With salmon, especially, try to get freshwater farmed in the United States. Shellfish can be high in cholesterol – but less so than meat – so take it easy on shrimp, lobster, and crab. Clams, mussels, oysters, and other mollusks are better shellfish choices.
The big no-no’s in food and drink are caffeine, sugar, and alcohol. They affect everyone differently, but in general, you should give them up or at least drastically cut down in consumption.
Caffeine: This addictive substance is mainly found in soft drinks, coffee, tea, and chocolate, but is also a hidden ingredient in some chocolate yogurts or ice creams. Coffee has the highest concentration with tea coming in second. Caffeine stimulates your nervous system making you feel more alert and energetic, but if you drink it heavily (throughout the day) it can also create withdrawal symptoms as you cycle through daily highs and lows. These symptoms include headaches, nausea, diarrhea, acid reflux, irritability, confusion, sleepiness, and increased blood pressure.
Sugar: Sugars can cause or contribute to fatigue, sleep problems, irritability, and mood swings, as well as physical ailments such as diabetes, arthritis, certain cancers, and osteoporosis. Simple carbohydrates that convert to sugars – such as potatoes, white rice, or pasta – can increase the body’s insulin levels, triggering the body’s inflammatory immune response. Processed sugars are the worst and are found in places you would not expect to find them, like potato chips, peanut butters, crackers, breads, etc. Aspartame is not a good substitute because it is an excitotoxin that activates neurons that increase your pain sensitivity, and if your depression is a reaction to pain, this will not help you at all.
Alcohol. This is an addictive substance that is also a depressant, whether you drink beer, wine, or hard liquor. Yet many people who suffer from depression or pain often turn to alcohol to relieve their symptoms. But, while you might feel relaxed and happy when you drink, you are only worsening your symptoms in the long run, especially if you are on medications or are using alcohol as a daily medication. Alcohol can make you fall asleep more quickly, but the quality of your sleep will not be optimum because alcohol disrupts the natural sleep cycle, which can lead to sleep deprivation, and that leads to fatigue and irritability, and more depression.
8. Other Addictions. You can be addicted to many things other than drugs, cigarettes, alcohol, or any other substance. You can also be addicted to your phone, TV, computer, porn, news, video games, etc. It is not unusual to find depressed people suffering from a combination of addictions. None of them are healthy for you, and one thing they all have in common is the inactivity that goes with them. Addicted people waste an enormous amount of time on their chosen addictions, leaving them physically inactive and often unable to pursue productive activities such as work or hobbies, or to be fully engaged in their relationships. Get rid of your addictions and start living a healthier and more fulfilling life. This is not easy to do. Quitting something cold turkey is best, but like everything else, it can also be done gradually. It’s just that doing it a little at a time often results in a lot of relapses along the way. But the important thing is to end the addiction. Get help from professionals if you can’t do it by yourself.
Summary
You can alleviate depression and many other mood disorders. In some cases you may be able to end them entirely, or at least manage them better and improve your life dramatically by making the changes listed above to reduce your levels of depression, anxiety, or physical pain. I have given this information to many people over the years, and only one was unable to make these changes, so I am confident that anyone can do it. You owe it to yourself to find true happiness and satisfaction in your life. Dealing effectively with depression is a goal worth pursuing starting today!