It’s likely that most people, at some point over the course of their lifetime, will experience a period of depression. Every individual’s experience will be unique in the way it affects them and the particular context and circumstance of its arrival, but common features exist. For some it comes as a response to a devastating loss or unpredictable life change, precipitating a loss of meaning in life and a mental and physical withdrawal from the world. For others, it is a state of being which feels chronic and comes and goes like the weather over a span of many years, seemingly without clear cause or trigger. These times are characterised by feelings of isolation, intense negativity and self-criticism, low energy, a feeling of pointlessness, social anxiety, and at worst a pull towards the ending of life itself.
But as painful and suffocating as these experiences can be, at some point most depressions will lift (albeit for some only to return again at some further point down the road). The points below are designed for those times when we find ourselves in the midst of it, struggling to see a way out. I hope they provide some help in finding ways to manage these times in such a way as to alleviate some of the suffering and take care of ourselves when at our lowest ebb.
1. Getting enough strokes
‘Strokes’ are a term used in TA to describe any form of recognition or contact with another person. This could be a simple nod and a smile, a verbal interaction, or physical contact. The psychological effect is to confirm to us that we exist, and that no matter how fleetingly, someone else is aware of our existence. When we don’t receive enough strokes, we begin to feel anxious, insecure, and disconnected from the rest of the world.
The pull to isolation and withdrawal that comes with depression can rob us of the strokes we need to fulfil our basic sense of existence and safety in our connectedness with others. Maintaining social contact and relationships with others can become extremely difficult, so it can be helpful to find other ways that we can get a minimum number of strokes to at least get us through the day. This might include going to a nearby shop or cafe to buy something so as to have a small interaction with the person behind the counter. It could mean speaking to a friend or family member, of if needs to be phoning a helpline such as the Samaritans. Anything that provides even a small feeling of recognition from another can help soothe the frightening distress of isolation depression can cause.
2. Reduce your time-frame
The cloud of negativity that comes over us when depressed makes it very difficult to think towards the future in any medium to long-term way. Our minds capacity for complex, abstract thought is also greatly reduced, and so any attempts at future planning will likely be met with persistantly negative and pessimistic responses, from ‘what’s the point?’ to ‘well it’s all doomed to failure anyway’.
With this in mind, it can be helpful to reduce the time-frame in regard to how far ahead into the future you allow your thoughts to go. So you might say to yourself, ‘I’m just going to think about how to get to the end of the day’, or when feeling particularly bad, you might take things hour by hour. This reduces the amount of complex thinking you’re asking your brain to do at a time when its resources are at their lowest point. If done with self-compassion it can play an important role in practising self-care until you reach a point where you start to feel better.
3. Aim for the simplest task you can realistically manage
Due to low motivation and energy, negative self-talk and pessimistic thinking it can be very hard when depressed to complete even the simplest of tasks. Unfortunately this also robs us of the simple positive emotion that comes with setting a goal and making steps towards achieving it. We are engaged in this process all of the time without even realising it, from seemingly small and trivial things that we do on a day-to-day basis to setting long-term life goals. Every time we make a step towards a goal, no matter how large or small, we receive a small hit of positive emotion.
When depressed, our capacity for goal-oriented action is greatly diminished, and so is our experience of positive emotion. One way we can try and rediscover some of this positive emotion is to think of the smallest goal we think we can achieve for the day, and set our intention to that. This will be different for every individual. For one person having a shower and cleaning their teeth might be all they can manage in any given day, but at least setting the intention to do those things and completing them will release a small amount of positive emotion. When you start to feel better, you can slowly add more things, but making sure you’re not setting yourself traps by setting unrealistic goals that just provide more fuel for your self-criticism when you’re not able to achieve them.
4. Find a way to tell someone
Talking to someone when you feel depressed can feel like the last thing in the world you want to do. You can feel like a poisonous toxin that will spread to others if you try and communicate with them, or you might convince yourself that nobody cares, that no-one will really understand, or that people will think that you’re weak and pathetic. All of these thoughts create a dark web around you that prevents you from reaching out to others, keeping you isolated and denying you the basic human contact that we all need to maintain our well-being.
Once you do finally find the energy to tell someone, it can be really difficult to find the right words. How do you describe something that feels so diffuse and all-encompassing? One way to start is to find someone close to you who you feel you can trust, and tell them in as broad a terms as feels comfortable that you’re struggling with your mental health. Then, find a suitable shorthand or metaphor you can use with this person to explain how you’re feeling on a day-to-day basis. Common metaphors people have used for depression include ‘the black cloud’, ‘the fog’, or ‘the black dog’. Pick something that resonates with you, and start trying it out when this person asks you how you’re doing. Others find it helpful to develop a number scale to be able to easily communicate what their mood is like at any given moment.
5. Focus on meeting basic needs
Depression often comes hand-in-hand with high levels of anxiety. In this state we can feel weak, powerless, and extremely insecure, and the parts of our brains that are focused on survival can become very activated. How will we defend ourselves if threatened? How will we get enough to eat and drink? Who will help us if we’re in danger when we’re so isolated from everyone?
A way to calm these parts of ourselves is to focus what little energy we might have on making sure we have enough to eat and drink, that wherever we are is warm enough, and that where we’re resting is secure from unwanted intruders. If we’re lucky enough to have friends and family around who want to help but don’t know how, focusing on these basic needs can provide simple and practical ways that people can help. Maybe someone would be willing to go to the shops for you, prepare a meal or bring you water or cups of tea.
6. Practice observing your thoughts and feelings
In the midst of depression negative thoughts can feel all-consuming. They feel impossible to control and seem to have a mind of their own. Attempts to ignore them or push them away seem to only make them stronger. Our natural instinct may be to move away from things that are distressing and painful, but if we don’t listen to our negative thoughts and feelings they’ll often just start shouting louder to get our attention.
With this in mind, it can be of great benefit to cultivate an ability to turn towards the thoughts and feelings rather than turn away, and try to observe them without getting too caught up in them. Try and find out what they’re attempting to tell you. Imagine them coming from a scared and frightened child who is desperately seeking help and reassurance from a nurturing, comforting adult, and try to develop that nurturing stance towards yourself.
7. Write down your thoughts
Expressing our internal world through writing can help make more specific what can often feel like vast, shapeless swathes of thought and feeling that are difficult to make sense of. It can help to express thoughts and feelings that have no other outlet, bringing them out into the world rather than keeping them swirling round inside you. The key here is to try not to censor yourself, and not to worry about making sense or judging your thoughts and feelings in any way, but just to write down as freely as you can any thoughts, words, or phrases that come into your head. The goal isn’t to change or control anything, but just to see what’s there. Once we get going, we might find that there’s all sorts of thoughts and feelings happening underneath the surface that we weren’t even aware of.
8. Wait it out
The one silver-lining with depression is that it always eventually lifts. For those who suffer chronic depression it may come quickly back again, but there are at least those periods of brief reprieve between recurrent episodes. There may be times when we just feel too exhausted, too defeated and too lost to do anything that requires any amount of energy and motivation. Sometimes we just have to wait it out. Finding something that can keep our mind distracted enough to get us through the day whilst we wait to feel better can be just as helpful as the more pro-active points mentioned above. Whether it’s listening to the radio, podcasts, TV shows, films, youtube, whatever your distraction of choice, remember that you’re still engaged in a healing process and not to feel too hard on yourself for not being ‘productive’.
Finally, it’s important to remember that you’re not at fault for having depression. Depression is an unfortunate feature of the human condition which many people will experience at one point or another. You’re not wired wrongly or failing at being a person. You’re just a human being, like all the rest of us, struggling with the stress and complexity of life in the best way you know how. Depression is an unfortunate feature of the human condition which many people will experience at one point or another.
#counselling #psychotherapy #mentalhealth #psychology #depression #selfcare