Author’s Note: I started this in January 2015. It’s a little long and is written in my “professional voice,” but it has some good information. I hope you enjoy it!
THOUGHTS ON LIVING LIFE AS A DEPRESSIVE PERSON
We depressed people lead lives different from other folks. We smile less, and think of death more than other people. We laugh less and cry more. Some days we barely have the energy to draw another breath, much less attend to chores or even bathe.
Depression sucks. No doubt about it. It saps your energy, your motivation, even your will to live. It robs you of your ability to enjoy yourself, dashes your self-esteem, and fills you with doubts. For many of us (like me), it’s a persistent problem, always there to some extent. For others, it comes and goes. For a lucky few, it’s one depressive episode and they’re done, never to plumb the depths of depression’s dark despair again.
As a life-long sufferer of depression and a mental health nurse, I know what it’s like. Some people believe that when you are depressed, you just have to “snap out of it” or “pull yourself up by your bootstraps.” If only it were that easy! You can no more wish yourself out of depression than you can wish yourself out of diabetes or cancer. It is a medical condition of the brain. Depression is caused by an interaction between the brain and the environment. Some people are more prone to depression than others, and when the right environmental conditions occur (family dysfunction, work stress, etc.) their brain chemistry gets out of balance and they become depressed. The type and amount of stress needed to trigger the onset of depression will vary from person to person. But just because you can’t wish yourself out of it doesn’t mean that you are helpless. There are things you can do to help you cope with depression better.
When we’re depressed, we get overwhelmed easily. The thought of doing the simplest task seems exhausting. One way to make it more manageable is to break the task into smaller tasks, bite-sized pieces that don’t seem so overwhelming.
Let’s look at getting out of bed. That can be one of the hardest things to do (the bed is warm, soft, safe, and sleep is so alluring), but you can make yourself do it. What’s your routine when you get up? Make the bed, shower, brush your teeth, and get dressed? Break it into small steps. Get out of bed. Even if you don’t make the bed, even if you don’t shower, even if you don’t brush your teeth or get dressed, get up. When you have to go to the bathroom in the morning, just don’t get back in bed. Even if you plan to sleep for the rest of the day, get out of bed. At least get up, even if it’s to move to the sofa to sleep. Why? Because in the depths of depression, getting out of bed is often the biggest challenge of the day. So even to get up in order to move to the sofa is an accomplishment. This helps rebuild your sense of control and your self-esteem. If nothing else, at least you can say to yourself, “I got out of bed today.”
And once you’re out of bed, you may decide you can manage to brush your teeth. Maybe making the bed, showering, and dressing are too much for now, but brushing your teeth seems doable. If so, great! Another accomplishment. Acknowledge it in your mind as an accomplishment. It may not seem like much to anyone else, but you know how hard it was to drag yourself out of bed and brush your teeth. So give yourself credit for it. Again, this helps rebuild your self-esteem and helps you to take back control of your life.
Small accomplishments build on one other. You may find that if you do one small thing, the next small thing doesn’t seem so bad. If you need to dust, for instance, you can dust just one bookshelf. Once you’ve done that, you may feel more motivated to do the next one, and so on. I don’t recall where I read this, but it’s true: In depression, motivation follows action. You do something, and your motivation starts to return.
So get out of bed. To do this and other things, break them into small steps. Give yourself credit for every accomplishment, large or small.
One thing that helps me when I’m feeling depressed is to mentally list my accomplishments for the day. My list often includes things like, “I got up today,” “I took my medicine,” “I cleaned out the cat’s litter box,” and “I got fresh water for the cat.” I list any accomplishment, no matter how small. After I’ve listed them, you know what? I usually have done more than I thought and I usually feel better.
Another thing that I’ve found helpful, and that may help you, is to mentally list all the good things that happened today, no matter how small. I list all the things I accomplished, because these are good things, and I list things that happened that made me feel good (or at least that made me feel less bad). My list might include, “A nice man held the door open for me at the store,” “My boyfriend and I went grocery shopping together, and I enjoyed that,” “Tomato soup was on sale,” “The cat didn’t puke today, so I didn’t have to clean up cat vomit” (remember, I said list good things no matter how small, and those of us with hyper-emetic cats appreciate a day off from puke-cleaning duty from time to time). Anyway, you get the idea. We depressives tend to notice negatives much more than positives. But there are usually a lot of positives in my day; I just have to notice and acknowledge them. It lifts my mood, and I bet it will lift yours, too.
Noticing positives and paying less attention to negatives helps we depressives get a more realistic view of our lives. We see the world through gray glasses; paying more attention to the positive things can lighten those lenses. Feeling Good: The New Mood Therapy, by Dr. David Burns, is a book that I’ve found tremendously helpful. I read it probably 20 years ago. It is still in print and available in a new edition. It provides exercises to help us challenge our negative outlook and attain a more positive, less depressive view. I can’t recommend it enough. If you struggle with depression, you owe it to yourself to get this book.
For some people, learning new ways of thinking and counseling may be enough. After many years of therapy, I finally had to admit that it wasn’t enough for me. I’m on an antidepressant medication and have been for many years. I’m one of the fortunate ones; the first antidepressant (Prozac) the psychiatrist prescribed worked for me. We didn’t have to try several to find one that worked. As a mental health nurse, I can tell you that that isn’t always the case. Sometimes it takes a long time to find a drug that works well for a client. I’m on a different medication now (Paxil) as I developed a tolerance to Prozac after I’d been on it for years. Both drugs are SSRIs (Selective Serotonin Reuptake Inhibitors), a commonly used category of antidepressants that was revolutionary in treating depression when they first came out.
For those of you on antidepressants, I advise you to take them as prescribed and to let the doctor know if you experience any side effects or if you notice they aren’t working as well as they used to. The doctor can adjust the dose or switch you to another medication. If you’ve had success with a particular antidepressant in the past, let the doctor know as he or she may want to try this same drug with you again or try a drug in the same category (another SSRI, for example).
For those of you thinking about trying antidepressants, I advise you to discuss it with a doctor to see if he or she thinks it will help your symptoms. Unfortunately, medication doesn’t cure depression, but it can lessen the symptoms or even make them go away entirely. I was very reluctant to try antidepressants initially because I know they affect brain chemistry and I was afraid I wouldn’t be “me” anymore. My therapist explained I’d still be me, just me without depression. As I’ve learned since then, a lot of things affect brain chemistry—medications, alcohol, experiences. Did you know that your brain chemistry changes when you are under stress or when you do something you enjoy? You’re still “you,” even with these changes in brain chemistry. So you’ll still be “you” with antidepressants, too.
If you do go on antidepressants, be prepared to wait awhile to feel better. It takes them between 4-6 weeks to fully take effect, though you may notice a lessening of your symptoms before then. Remember, it sometimes takes a few tries to find the right drug. Be sure to let your doctor know how you’re feeling. Your symptoms may not go away, but they should get better. If not, it may be time for a dose adjustment or for a different medication.
For many people, a combination of therapy and antidepressants works best. Depression can be a daunting disease, but you don’t have to let it beat you. There are a lot of things to help you get depression under control. And remember, you are not alone. There are many of us with this illness, and with help we can cope and live fulfilling lives.