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By Christine Holowick
Most people will experience a depressive episode at some point over the life span. Depression can be debilitating, affecting how one feels about themselves and others, their relationships, and their ability to function in their roles (at work, as a parent, as a partner). At its’ worst, it can bring up feelings of hopelessness and no longer wanting to live, putting those living with depression at a higher risk for suicide.
Depression comes in all shapes and sizes: it can be situational, seasonal, or persisting. Symptoms can range from mildly to severely distressing, and each person’s subjective experience is different. There may be an absence of feeling (numbness or emptiness), a great degree of emotional suffering, or a mix of both. Sometimes depression is invisible, occurring as the individual continues to go about their daily life. While for others, it unexpectedly knocks them off their tracks, making getting out of bed feel enormously difficult.
Depression can be connected to major life events or transitions, such as having a child or moving to a new community. It can occur after a loss (relationship loss, loss of a loved one, loss of a job), sometimes shortly after the loss, but other times it waits and comes up much later. Depression can also come about when things in life are going well, when there is finally space for wounds from the past, even from childhood, to arise. Talking to a therapist can help make sense of what’s happening.
Managing depression most often involves finding a combination of things that work for you. Finding a solution can take a bit of trial and error. Most importantly, do no suffer alone: talk to someone - be it your doctor, a therapist or a friend or family member.
Below is a short list of strategies to try. However, not all strategies are helpful for every person or situation, so be mindful as to what is helping and what is not!
Low mood can make the day ahead feel daunting and overwhelming. It can also affect our ability to initiate moving towards our goals, keeping us in a place where we feel stuck. “Behavioural activation” is about breaking that inertia, that urge to stay in place. Interrupt inertia by scaling back your expectations and focus on doing just the very next thing. Break large tasks into bite-sized pieces and focus only on the first step. If the first step feels too big, ask yourself what part of the first step feels doable? Perhaps doing the task for only 5 minutes? Once we break that inertia, it’s more likely that we will keep the momentum going.
During episodes of depression, it can feel that negative moods are pervasive and never change. However, there are usually times throughout the day when depressive feelings may feel less or more intense, even if the feelings are persistent. Getting to know how your own mood shifts, even on a small scale, can help challenge the “all or nothing” thinking that can come with depression. It can also open space to consider how you want to take care of yourself through the lowest low points, and how you might be able to build on the times when you feel less low.
To track your mood, at several points during your day, take a moment to reflect on and record:
the Intensity of the depressive feelings on a scale of 0 to 10
the Context: where you are, what you are doing
the Content: what are your thoughts saying?
Reflect on what you’ve tracked and notice when depression feels more or less intense. Try using a healthy coping strategy (ie., challenge negative thoughts, journal, walk, breathe) and rate depressive feelings again from 0 to 10. Notice if there is any shifting, and incorporate more of the things in your day that had a positive effect.
Depressive feelings create a feedback loop that keeps you isolated from others. Negative thoughts about the self feed into the urge to withdraw. The more we stay away from others, the worse we feel. However, the need for social interaction is hard-wired: humans need other humans. Counteract isolation by taking small steps to increase your interpersonal interactions on a daily basis, in a way that feels manageable. This might include messaging or calling a friend or family member just to say “hi”. Or intentionally creating ‘microinteractions’, those small friendly exchanges with other people as you go about your day. Structured settings like joining a class or a group can also help decrease isolation. If you tend to connect with others online, counterbalancing this with increasing your physical-world interactions may be important as well.
Most humans have a self-critical side to our personality. Self-critical “parts of the self” usually develop in an attempt to help us in some way: to keep us in line and motivate us to meet the expectations of others or of society, securing our place in the family or in the group. Although these parts may be trying to help us, their voice is usually harsh, biased toward negativity and blaming.
With depression, self-critical parts are often dominant over other parts of the self, creating a spiral of shame that compares you to others and judges you for the way you feel. Self-critical parts often fear that depression is going to last forever. Getting to know your internal landscape and the different sides of your self can be hugely beneficial in recovery from depression. Our recommended self-help reading on this topic is “No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model” by Richard C. Schwartz (2021).
Working with a therapist can help you increase awareness of your self-critic and develop a different relationship with them. Self-critics are often loud and mean, are we usually don’t question what they say. Learning to gently ask the self-critic to step aside, even just briefly, can create opportunity for doing something different. When doing this, offer yourself some words of self-compassion: what would you say to a friend who is struggling? For most of us, the self-critic has been around for years, so changing the way we relate to this part of ourselves takes time and practice.
Below is a list of things to try, but this is by no means an exhaustive list! When trying different strategies, notice if you feel a shifting in your mood (better or worse). Strategies that are support emotional regulation may be:
Sensory: listen to relaxing or uplifting music, surround yourself with happy colours, go outside, be in nature, wrap yourself in a cozy or weighted blanket, pet an animal.
Involve Body Movement: aim for 10 minutes of walking, exercising, dancing, yoga, or swimming.
Task-Oriented: do one thing on your to-do list, make a meal, clean for 10 minutes, tend to house plants or a garden.
Geared Toward the Future: make plans to see people, make plans to do something special or something that you will look forward to, try something new.
Many of us are aware of how taking care of our physical health supports our mental health. This is again one of those negative feedback loops: we stop taking care of ourselves physically when depressed, which affects how we feel mentally, further reinforcing patterns of self-neglect. However, humans feel the best when we are: feeding our body healthy food, moving our bodies regularly, getting enough sleep, taking care of physical ailments, and avoiding mood-altering substances. Even making small changes in any of these areas can help start to reverse this cycle.
In summary, don't suffer with depression alone! There are treatments and solutions, which often include methods beyond the scope of this article, such as medication, EMDR, talk therapy, or other life and lifestyle changes. YOU ARE WORTH IT.
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