Managing Depression

Everyone feels sad from time to time. It’s a normal reaction to life’s setbacks and disappointments, and it usually passes after a few hours or days. Depression is different though, as it’s much more debilitating. People going through depression find it hard to experience pleasure, interact with others and actively par-ticipate in life. Unlike sadness it can last for months or sometimes years.

There are a broad range of symptoms associated with depression, which can be divided them into 4 cate-gories:

1. Emotions: feeling miserable, guilty, irritable, numb or hopeless

2. Thinking: problems with memory and concentration, self-blame and poor self-esteem, thinking about suicide, losing interest in the outside world

3. Behaviour: crying, withdrawing from others, drug use, not eating or eating too much

4. Physiology: low energy levels, sleep problems, disturbed appetite, feeling physically ill, decreased libido

Depression is rarely caused by a single factor. Like many other things in life it’s the result of a combination:

• A person’s biological make-up (including for example certain physical illnesses)

• Personality traits

• Difficulties when growing up, resulting in painful memories and unresolved problems

• More recent stressful events

• Current life circumstances

• Unhelpful thinking patterns

Some experts believe that certain types of depression are caused by abnormalities in the way the brain works. It’s believed that some people are prone to depression because they have a deficiency in certain chemical messengers (called ‘neurotransmitters’). These neurotransmitters transfer messages from one brain cell to another. Medications used to treat depression work directly on these neurotransmitters to restore the brain’s chemical balance. Whether medication is the best treatment depends on a range of issues (e.g. how severe the symptoms are), and can be discussed with your GP, psychologist or psychiatrist. Medications used to treat depression come with risks as well as benefits, and should only be taken under a doctor’s supervision.

The more depressed you become, the more negative thoughts you will have and the more likely you will believe them. When you feel depressed these thoughts (which we call ‘negative self-talk’) become stronger and drown out the more sensible thoughts.

A feature of negative self-talk is what we call ‘thinking errors’.

Thinking Errors and Depression

When we feel depressed, we’re drawn to the most negative interpretations of what’s happened.

We assume too much responsibility for things that go wrong, directing blame at ourselves. This happens even when things were beyond our control.

We ruminate – thinking negatively about what’s happened over and over again, which prevents us from doing other things.

As a result, we carry a deep-seated sense of hopelessness and helplessness, and our self-esteem is dam-aged.

Typical Thoughts associated with depression

“Life isn’t worth living”

“Nobody cares”

“It’s impossible to solve my problems”

“Everything is hopeless”

“I’m a burden to everyone”

“I have nothing”

Strategies for managing depression

As we’ve already said, depression comes from a combination of factors, such as stressful life events, a lack of social support, unhelpful ways of thinking and coping strategies that could cause more harm than good (e.g. alcohol and drug use).

While it may seem really hard, there are things you can do to recover. We have broken these down into 2 main categories:

1. Changing your thinking – challenging your negative self-talk (e.g. asking yourself “is this really true? What evidence I have for this?”)

2. Changing your behaviour – doing things to lift your mood (e.g. re-setting your sleep patterns, regular exercise and talking to people who are supportive)

Changing your behaviour

Whilst depression can be debilitating, there are a number of ways we can try to minimise the effects of it:

Tips for getting a good night’s sleep

Depression can also affect your sleep pattern, and the more sleep-deprived you are, the worse you’re likely to feel.

You can help yourself by:

• Getting up the same time every morning and getting up as soon after waking as you can

• Trying to be more active and not sleeping during the day

• Steering away from drinks that contain caffeine (e.g. coffee). Don’t have these after 4pm

• Avoid drinking, using or smoking before going to bed. Alcohol and other drugs makes it harder to get into a deep sleep and smoking will increase you anxiety

• Only using your bed for sleeping, or sex

• Getting into a routine before going to bed (e.g. having a shower, putting on your pyjamas and brushing your teeth)

• Not watching TV or looking at your phone or tablet in the bedroom

• Giving yourself 15 – 20 minutes to fall asleep. If you haven’t fallen asleep in that time, get up and do something quiet and relaxing for a while before trying again

Increasing Pleasant activities

People who feel depressed often don’t want to be involved in any activities.

Developing an activities schedule and following through with the activities is one way to help overcome depression.

Here are some things that have been found to be helpful:

• Develop a schedule that is flexible

• Plan for quantity, not quality – when you’re depressed, anything worth doing is worth doing poorly – better to try than not do it at all.

• Schedule activities in 1-hour and half-hour blocks – this will make it easier to complete them

• Be task-oriented – focus on doing the task and being more active. The depression will take care of itself

• At the end of the day keep a log of how you went – focus on what you did well and where you can improve

Activities you could do:

Below is a list of activities that will help you find something to do:

• Chores andww useful tasks (e.g. cleaning, cooking, dishwashing, ironing, sewing)

• Exercise (e.g. jogging, walking, aerobic dancing, stretching or aerobic exercises, shadow boxing, skipping rope, yoga, weightlifting)

• Food activities (e.g. baking, cooking, barbecuing, choosing recipes, preparing gourmet meals, food shopping)

• Games (e.g. bridge, checkers, chess, jigsaw puzzles, monopoly, poker, scrabble, crosswords, pictionary)

• Graphic arts (e.g. cartooning, drawing, lettering, mechanical drawing, painting, photography, silk-screening, photography)

• Handicraft activities (e.g. basket-making, bookbinding, crocheting, embroidering, knitting, leatherworking, dressmaking, decoupage, needlepoint)

• Humorous activities (e.g. improvisation games, charades, joke-making)

• Martial arts (e.g. akido, jujitsu, judo, karate, fencing, wrestling)

• Outdoor activities and sports (e.g. bird-watching, gardening, crabbing, fishing, canoeing, sailing, walking, ice-skating, skiing, rowing, hiking)

• Performing arts (e.g. dancing, ballet, mime, acting, improvisation, modern dance, tap dance, singing)

• Personal growth (e.g. self-help books, workshops, lectures, meditation, skills-learning, podcasts)

• Reading (e.g. fiction, novels, plays, poems, non-fiction)

• Socialising activities (e.g. call a friend, meet up with a friend, group activities, attending rap sessions, help someone out – give a lift, help with kids etc.)

• Sports (e.g. cricket, basketball, golf, gym, football, hockey, tennis, running, skating, volleyball)

• Studying (e.g. art history, languages, music, science, history)