In my 12 years as a practicing mental health clinician, hundreds of patients have walked through my door suffering from depression. This is not surprising given that the National Network of Depression Centers has found that one in five Americans will be impacted by depression during their lifetimes. Indeed, depression is the leading cause of disability among those between ages 15-44 according to the Center for Disease Control.
While Major Depression Disorder (MDD)—often biochemically based and with genetic roots—can be extremely difficult to navigate and often requires psych meds, here is an encouraging statistic: studies show that within four to six weeks of starting treatment more than half of depression sufferers show improvement.
Try These Five Tips For Decreasing Depression
There isn’t a quick fix as in “Boom, you’re cured and will never again be beset by the blues.” But, there are techniques that can help lift the emotional paralysis and ruminating that often accompany depression. Both of which make it much more difficult to focus on the behavioral changes that are necessary to prevent a relapse. Luckily, there are ways to punch holes in the curtain of unrelenting darkness.
Take A Different View
With depression often comes a psychological myopia: the sufferer robotically repeats to him or herself soul-sucking negative thoughts: “Nothing I try ever works out” “How could I have been so stupid?” “I am not worthy of being loved”. A patient deep in the throes of that kind of thinking can, if unchecked, spend an entire session staring at one spot—often the floor. At those moments I prod, “You are so stuck on only seeing things one way that you miss any other possible view. Literally. If you force yourself to look up, there are a variety of objects in the room to observe and ponder—a bookcase; lamps: paintings; a window with sunlight streaming in… It’s not that my office is so fascinating, but there is so much you miss when you refuse to look.” The patient then sheepishly lifts his or her eyes to take in the entirety of the room (“Oh, I never noticed that funny placard!”) as I hammer home the point: “There are a plethora of ways to view anything. Instead of continually convincing yourself everything is hopeless consider all the other options. There is always a Plan B.”
Visualize A Happy Memory
When a patient continually revisits a painful memory (say, of a romantic rejection or failed business enterprise), it can tip him or her into near emotional catatonia. I say, “Wait, before you ‘go down the rabbit hole’ and all the dark feelings overwhelm you, close your eyes and go to a happy memory.” *Paul remembered, “When I graduated from college, looked out at the audience and saw my family looking so proud, I felt amazing and powerful.” I said, “Great, go there. Let’s relive that wonderful experience.” As he described details from that lovely day (his mother’s periwinkle blue dress; standing on the stage holding his diploma…) his posture went from slumped over to peacock proud. He actually smiled. I suggested, “The moment you feel yourself sliding back to an awful memory that takes you under, take a breath and instantly conjure up graduation day. Counter the gloom with an immediate dose of positivity!”
Tell Me Something Good
A depressed person has earned a PhD in The Art and Science of Self-Hatred. When I ask, “How do you see yourself?” I get answers like: “I’m boring.” “I’m a coward.” “I’m ugly.” “I’m not smart.” To the speaker, these sentiments are absolute truths; his or her sense of identity, a soul-less place to live that is familiar, thus offering a ‘comfortable discomfort’, with no exit door. As long as these annihilating beliefs rule your self-image, nothing good can break through. When I ask, “Tell me good qualities about yourself,” I am initially greeted by silence. Then I hear a halting, “I’m kind” or “I’m caring.” If the patient gets stuck, I help out: “You’re a loving mother.” “You are a survivor.” “You are a nurturer” “You are super considerate.” “You are reliable”… As we construct a list, I ask the patient to write down the wonderful attributes and keep repeating them when the ‘toxic wheel of self-hating talk’ begins. I suggest asking friends and family members to email a list of positive qualities they value in my patient. The next step will be “to compile, print out the list and carry it in your wallet like a talisman.” For extra inoculation against the constant negativity, I suggest the patient write positive qualities on post-its and sprinkle them around the house: stick “I have gorgeous eyes” on the bathroom vanity, place “I’m reliable” on the refrigerator and so on…You are what you ‘feed’ yourself spiritually speaking. Exchange the “everything I hate about myself” mantra to “all the qualities that make me a special, unique, lovable person.”
When a person is depressed the only place he or she wants to be is in bed, preferably under the covers with the shades drawn. Lifting up the phone to hear a friendly voice, much less having plans outside the bare minimum (work, school, grocery store) feels way too difficult. The Internet has made it dangerously seductive to keep to oneself. Studies show that limiting social media to approximately 30 minutes a day decreases depression. I tell patients, “It’s a catch-22 that when you are depressed the last thing you feel like doing is getting out of the house. But it’s essential to make the effort to take a shower, get dressed, take a walk, go to the gym, and socialize.” For months I would ask *Gina near the end of our Saturday afternoon session: “What are you doing after you leave here?” Gina, who lived alone invariably mumbled, “I’m going home to do laundry.” I started ordering her to have something specific planned post-session. She began joining meet-ups (“Wow, ballroom dancing is kind of fun!”), visiting the botanical garden, baking cookies with her sister… The more she ventured outside her four walls, the more her mood lifted.
Find Something to Look Forward To
This is a technique I routinely use as an anti-blues vaccination. (I’ve shared that I suffer from High Functioning Depression.) When I’m down I search for something to put on the calendar that makes me happy and excited. Indeed, this 2007 study showed that people get an emotional lift when they contemplate a future fun event, versus looking back on a fabulous activity from the past. Book a trip, buy concert tickets, plan a party—whatever brings a flush to your cheeks and rumble of joy to your belly. My biggest mood-turnarounds arise when I begin a project that can potentially create some good in the world and lead to fulfilling connections. For example, I’ve volunteered as a mentor to underserved young women who want to write, sought publishing contracts to write a book, taught workshops, submitted a video to do a TedX talk (haven’t heard back on that one yet!). The point is: stop continually telling yourself nothing good will ever again happen—you’ve been there, seen that, done that.
The Upshot: Depression is a diagnosable and treatable condition. There’s no reason to suffer in silence, or to guess whether or not what you’re feeling qualifies as depression. Your primary care physician can help direct you to someone who specializes in mental health. In the meantime, here’s a guide to the signs and symptoms and a quick assessment quiz. You can also download one of these mental health apps for more information.
If you are experiencing a mental health crisis, or someone you love is in danger, we strongly suggest that you reach out to to a qualified mental health professional. To aid in your search please consider our directory of emergency mental health resources.
*Names of patients are changed