If you suspect you are suffering from depression, your first port of call is the doctor. He or she is used to dealing with this and won’t judge, criticise or condemn you. He may also decide that some medication is advisable. Quite often this is of the type which “eats up” the surplus hormones, so that the body comes to recognise it doesn’t need to produce such high levels. Medication can also allow you to feel strong enough to tackle the underlying causes, as well as cope better with day-to-day living. Medication may take a week or two to kick in. Different types suit different people, so if one particular anti-depressant hasn’t worked for you, another might be much better. There are plenty of anti-depressants which are not physically addictive.
A reasonable amount of exercise helps to balance out hormone levels so you feel less depressed. Exercise uses up the stress hormone adrenaline and produces the feel-good hormone serotonin. Depending on your level of fitness you could spend twenty minutes walking three or four times a week. Or go swimming, go to the gym, learn yoga, work out at home or play some sport. Quite often this may feel like the last thing you want to do, but it can be very helpful. Again, check with your doctor if you’re not sure you’re up to this. Exercise can be one prong of your attack on depression.
Sometimes depression is linked to the use of alcohol, recreational drugs or cigarettes. Cutting down or cutting out these things can be very helpful in feeling better.
Set yourself small, achievable targets. Sometimes this might be just getting out of bed before noon one day a week, or washing your hair once a week. When you set targets, it’s helpful if they’re realistic, achievable, safe and observable. Targets need to be specific, like “I will get dressed before noon on one day this week”. Maybe next week’s targets could include getting dressed before noon on two days.
Don’t overburden yourself by setting big targets. You don’t have to do everything at once. The longest journey starts with the first step.
Reward yourself. Just recognising that you have had a problem is an achievement. Carrying out your target once is an achievement. Your reward might be having a cup of coffee, taking a nice, hot bubble bath or making a phone call to a friend. It could also be listening to some favourite music or watching something uplifting on TV.
You are allowed to ask for help.
You don’t have to be perfect. Nobody else is.
Multivitamins can be helpful, but please don’t exceed the stated dose.
Some people find St John’s Wort useful. It’s a good idea to consult your doctor or pharmacist about this before you start taking it, especially if you’re on other medication.
Don’t blame yourself. Having depression is not your fault. If you get flu or break your leg, that’s not your fault, is it? Depression is a curable illness. You are allowed to ask for help to get better. You are allowed to believe that even you in your situation can get better.
Listening to people laughing can be very helpful. Even if you don’t feel like it, watching or listening to comedy tapes or videos for ten or fifteen minutes every day for three weeks has been shown to have a positive effect even when dealing with fixed circumstances. Even if the comedies no longer give you the same pleasure they used to, it’s also helpful to make yourself join in with the laughter, as laughing has physical effects on the body and hormone levels which can help you lift your mood.
Pleasure is the best antidote. Finding even ten minutes a day to have the best time you can is a good start. Interest is what you put into an activity, not what you get out of it.
A lot of the problems associated with depression are affected by how we think. People who have depression quite often think bad things about themselves and believe this is the only possible or realistic view. This is very unlikely to be true. You are allowed to learn to think in different ways which are helpful to you. Here’s how:
Replace words like “always” and “never” with “ sometimes”. Instead of telling yourself you never get things right, remind yourself that you sometimes do things well. Look for any evidence of times, however small, that you did do something well in any area. This helps you to adopt a more positive outlook and build on good things.
Replace words like “ought to”, “have to” and “should” with “could”. Sometimes people punish themselves with negative thoughts because they think there’s something wrong with them if they don’t instantly do something they believe they “should” do. Saying “I could do the hoovering now but I choose to put my feet up for ten minutes” puts your decisions more firmly under your control.
Recognise good things as being at least as important as bad things. Although you may not be perfectly happy with the way you are right now, you have some good qualities and skills. It helps to make a list of them – though you may need someone else’s help to get you started on realising how much you’ve got going for you. For example, you’re literate and can use the internet. Perhaps you’ve done some good deeds, or been a friend when somebody needed one. That means you’re kind, friendly and likeable. You can carry your list around with you or keep it where you can look at it often. You can add to it. You’re allowed to use your good qualities and skills to make life better for yourself. You’re allowed to recognise and value good things that happen to you.
Things don’t always stay the same. Just because you feel bad now, it doesn’t mean you’ll always feel bad. Feelings aren’t fixed in stone. Nobody can predict the future. When you’re walking down the street, you don’t know what colour the next car you see will be, do you? You may have some good luck. You may meet new friends and find new and rewarding ways of spending your time, even if that time is limited. You can learn new skills, including the art of positive thinking and how to be confident.
Do a reality check. Have you been magnifying bad things and discounting good things? Talking to other people can help you put things in perspective. This is one of the ways that counselling can help. If other people have overcome a situation or made the best of it, you can learn to do that too.
Label the action, not the person. Lots of people make their own lives worse by saying, “I’m stupid” or “I’m a loser”. It’s much more helpful to say, “I’ve done something stupid but I won’t do it again”. You are more than just one action! It’s also important to label the action and not the person when dealing with children.
Separate out feeling and thinking. Just because you feel silly, it doesn’t mean you are. Nor does it mean that other people think you’re silly. Most people are far more concerned with themselves than with others, so don’t believe your self-criticism is the way the world views you!
Separate out your responsibility from other people’s. You are not responsible for another adult’s thoughts, feelings or actions. They are. You are only responsible for your own feelings, thoughts and actions (unless you have pre-adult children).
Give yourself permission to accept compliments and know you deserve them. Even if you don’t think the compliment was sincere, at least the person values you enough to say something nice about you! And what if the compliment is sincere? Aren’t you at least willing to acknowledge that, like every human being, you have some good points?
Don’t accept other people’s criticism blindly. If you believe you’ve done something wrong, say sorry and do your best to make amends. If you haven’t done anything wrong, why believe you’re to blame? By the way, nobody can make another person abuse them. The abuser is responsible for how he or she responds and what he or she does.
Other people don’t necessarily know how you’re feeling or what you want. They’re not mind-readers and neither are you! It’s more helpful to negotiate for what you – and they – want. Be clear and specific: if you want sympathy, what ways do you want it shown? In words, touch, action? Phone calls at a specific time? Being clear about what you want and asking for it openly cut down lack of communication and bad feelings all round.
You’re allowed to recognise your own good qualities and skills. It’s not big-headed. It’s not boastful. Telling other people all the time how wonderful you are is boastful, but being quietly pleased with what you’ve accomplished or what you are is good. It’s self-supportive and intelligent to know what you’re good at. Making a list of your good qualities and skills – and looking at it often – is helpful. If you’ve ever been cheerful, even for one second, you can put “cheerful”. If you’ve ever helped someone, you can put “helpful”. You can start your list of skills with “internet literate”!
If you want a hug, ask for one! Hugs and kisses you ask for count double because the person values your wishes enough to go along with them!
You’re allowed to ask for compliments. “Do I look OK in this?” is a useful question – especially if you’re talking to someone who’s nice to you.
There is enough positive attention to go round. It’s not useful to depend on those closest to you to lift your mood. They are responsible for their own lives just as you are responsible for making the most of yours. You can also ask others for what you want, and begin to make new friends as soon as you are ready. That way you’ll have a wider support network – as well as more fun! The section on Loneliness may be very helpful to you.
I’m 43 now and I’m happy. At one time I thought I never would be. I had depression for three and a half years after having the twins, but I did get over it. I had two more episodes, one for three months and one for three weeks, but that was 15 years ago. In fact, I don’t think I’ll ever have depression again but even if I do, this time I’ll know what to do to get out of it.
The birth of my twins was quite traumatic. The hospital was very busy, and the birth was long and difficult. I reacted badly to the painkillers the nurse gave me, so that I was hallucinating. For a long time I didn’t realise that the screams I heard were my own. My husband couldn’t take it and the midwife sent him out. When I finally saw the twins I was angry and resentful with them for hurting me so much. I felt guilty for feeling that way. I thought I’d love them straight off and I didn’t, so that made things worse. I felt weird and abnormal, not a proper mother with all the feelings I thought I was supposed to have. When my husband had gone and the twins were taken to the creche, I was left on my own until a nurse came to stitch me up three hours later. She was horrified with what she saw and exclaimed, “What a mess! It looks like tramlines!” After she’d sewn me up - without anaesthetic - I had a cup of tea and a biscuit and they left me alone. Between the thirst and the drugs still in me I had nightmares that left me sweating and terrified, and in the morning when they took me to the ward the children wouldn’t stop grizzling. I couldn’t produce enough milk for them, and I didn’t know babies need water too. Nobody told me and I didn’t know to ask. I felt so lost and helpless and trapped, it was awful.
Though I continued to have weeping fits for years, I covered up how bad I felt because I thought they’d label me an unfit mother and take the twins into care. I felt inadequate. The slightest thing was too much effort, everything at home was a mess and I was lonely and frustrated stuck at home. We’d only just moved in so I didn’t know anybody, and my mother, who lived 50 miles away, was no help at all. My husband would get impatient and shout, “Pull yourself together!” which made me feel worse. I looked really ill and I put on two stone. Even when the babies slept through, which wasn’t very often, I couldn’t sleep. I’d lie in bed crying silently so my husband wouldn’t hear, thinking over and over again how pathetic and useless I was. Colours seemed muted as though everything was only shades of grey, and I’d hear babies crying where there couldn’t possibly be any. I thought I was going mad and I couldn’t imagine ever feeling happy again.
If only I’d known sooner how to overcome depression! But I’m so glad I found out. It’s really made my life better, in all sorts of ways I’d never dreamed of. Learning how to overcome depression is such a gift – and if I can do it, you can!
My recovery started when I broke down completely at the Health Visitor’s Clinic. The twins were two and a half, a real handful. When the health Visitor asked me how I was, I just burst into tears. Far from being critical, she was really sympathetic and helpful. She found them a place in a nursery at a reduced fee. It was just afternoons and it meant walking 20 miles a week but it was such a relief to have two hours a day when I could finally sleep. She also told me to go the doctor for some antidepressants, and though the first type didn’t suit me, the second lot did. She also recommended seeing a counsellor.
At that time I didn’t go, but when I next felt bad I did. That was after we’d moved because of my husband’s job, and I felt uprooted and isolated. Because it had been so helpful before, I had no hesitation this time in seeing the doctor, and I was lucky enough to be referred to an excellent counsellor. She helped me see things in a new perspective that was much healthier. Here’s what I learned:
I’m not alone, or weird. It’s normal to be stressed in a stressful situation. It’s all right to feel depressed – not that it’s comfortable, but it’s not my fault. Lots of people feel this way, and it’s OK to ask for help. I don’t have to be perfect. Good enough is good enough. I’m allowed to trust my feelings and know when things aren’t right. Best of all, I don’t have to beat myself up if I do something I’m not satisfied with. Very few things are beyond redemption. Not being able to do everything perfectly doesn’t make me a failure. Anyway, I’m allowed to know that I do some things well, and I can learn what I need to do other things better. I don’t have to set myself up for failure by demanding unattainable targets of myself. Small steps are really valuable, and I can celebrate them. I’m also allowed time off, and though my husband wasn’t very happy at first when I started going to night school, he got used to it. It was great to be doing something just for me and to talk about something other than housework and babies. And later, it was helpful in finding a good job. I’ve now got friends, and I know that hiding my feelings keeps others at a distance! Now that I value my feelings, other people are much more likely to respect them. I enjoy life, I’m getting on fine with my husband, and the twins have grown up well and happy. Best of all, I know that depression does go away.
What is depression?
Depression is not a temporary low mood. It’s when the low mood seems deeper and more prolonged than might be expected from the cause. It’s sometimes called the illness of loss. That loss could be a bereavement or redundancy, although it might be loss of a lifestyle such as when you have a baby or move house. Work related stress can also lead to depression. Whatever triggers it, if it continues to the point where it interferes with your life for more than a few weeks, it’s a good idea to talk to your doctor about it.
Depression may involve several of these symptoms:
You feel very low most of the time more days than not, and this goes on for more than a couple of weeks.
You feel tired and lacking in energy.
You find it difficult to concentrate or make decisions.
You aren’t sleeping well, or you’re sleeping far more than you normally do.
You find it difficult to begin or complete tasks.
You feel hopeless, as though it’s always going to be like this and you’re helpless to do anything about it.
You have low self esteem or strong feelings of failure.
You may believe that you’re the only one who feels this way.
You may experience weight loss or weight gain.
You are not the only one. Statistics vary but they all show it’s quite common. Some medical textbooks say that it affects three out of ten men and four out of ten women at some stage in their lives. Because it’s so common, there are lots of effective treatments, and doctors are used to dealing with it. Because people (not just you) feel bad, quite often they don’t talk about it for fear of being judged. You probably know other people who have depression.
Depression goes away. It is treatable. People get over it, and when they do, they feel stronger because they have overcome it. This means that if they should ever feel the beginnings of it again, they can recognise it and deal with it much more quickly.
What causes depression?
Depression is not the same as grief. This page is not about bereavement (I recommend www.griefnet.org for people who have lost someone close to them) but many of the techniques here will help you deal with your feelings so that daily life is less difficult. This is also true for depression arising from other causes.
The mind, body and emotions are closely linked. Whatever may have been the trigger, the body responds by producing hormones which affect our mood. These are in turn affected by how we feel and what we think. In other words, the mood-hormone cycle goes into a spiral. This can be aggravated by the changing hormones of having a baby, especially a miscarriage or stillbirth. When depression sets in, the body may come to recognise these higher levels of unhelpful hormones as the new “norm” and continue to produce these high levels until it receives instructions to go back to lower, more helpful levels. Studies have shown that the pleasure receptors in the brain also shrink when we’re depressed so they can’t take in and use our ordinary mood-lifting hormones to the same extent. In other words we can stay “stuck” in depression until we do something about it.