Depression Survival Guide – Larry Godwin, Ph.D.

Although I am not a healthcare professional, I’ve seen depression from the inside.

My expertise is rooted in the trials and errors of personal experience. Each person is different, so not all these suggestions will work for you, just as they haven’t all worked for me. My hope is that through this guide, you’ll gain insight into at least one new strategy that helps assuage your depression. The following list is not exhaustive – therapies I didn’t mention might help you and if they do, by all means, stick to them.

1. Recognize that depression is not a sign of weakness. Unfortunately, many people don’t understand this. A stigma can discourage us from getting help but know you are not alone. Millions, including celebrities as well as everyday people, have talked about their struggles with depression, received help, and are in recovery.
2. Get help from a professional. Don’t figure you’ll recover on your own. Make an appointment with a healthcare provider, whether it’s your family physician, a licensed mental health professional, or a psychiatrist. Choose the one you feel comfortable with. If you can’t afford the cost of a private visit, call your local county health services department or mental health centre for assistance. Or check out the SAMHSA Behavioural Health Treatment Locator.
   
3. Don’t struggle in silence. Call up a peer-run listening line staffed by people in recovery themselves. Or call a hotline to speak confidentially and anonymously with a trained support staff member or volunteer.
4. Get personal support. Confide in those you trust, whether it’s your spouse or partner, a relative, or a close friend, as well as your healthcare providers. You can also join a support group, either a face-to-face one in your community or online. At the same time, be selective in how much you disclose about your illness when a casual friend or acquaintance asks how you are.
5. Change doctors or therapists from time to time. Each healthcare provider possesses his or her own area of expertise and personal experience to draw from and brings a unique slant to your symptoms. If one doesn’t seem to be the best fit for you, try another.
6. If you’re taking medications but haven’t found relief, NEVER GIVE UP. You’ll find dozens of antidepressants on the market, including SSRIs, SNRIs, tricyclics, and MAO inhibitors. Even within each family, every drug behaves a bit differently in its effect on the brain’s neurotransmitters. Also, the FDA approves new antidepressants every year. If your doctor suggests a drug that’s still on patent, ask if an older, cheaper generic might do instead. Fortunately, pharmaceutical companies offer patient-assistance programs that lower the cost of patented drugs for low-income people. Don’t forget to ask your doctor for samples.
7. Be patient. Although some treatments, including a few antidepressants, can yield results within a few days, may take weeks to make a difference. Follow your physician’s directions – don’t exceed what he or she recommends. Look for gradual improvement rather than significant changes overnight.
8. Don’t despair if your body is struggling with a medication’s side effects. Your doctor may be able to prescribe a different suitable one with fewer undesirable results. If not, keep in mind you may not have to take the drug long-term – a short trial may suffice. And in the meantime, a more body-friendly drug may come on the market.
9. If you decide to go off an antidepressant, withdraw slowly in consultation with your physician. Allow your brain to adjust to the change so you reduce the risk of a rebound and other distressing effects.
10. Try supplements. A multi-vitamin, multi-mineral, or amino acid blend might provide relief. Consider taking probiotics, SAMe, Omega-3 fatty acids, acetaminophen (Tylenol), 5-HTP, St. John’s wort, GABA, or melatonin. If you’re taking antidepressants, keep in mind some supplements might interact negatively with them, so check with your doctor and pharmacist.
11. Try acupuncture or acupressure.
12. Let your healthcare provider know immediately if an antidepressant, a supplement, or acupuncture seems to make you feel more depressed. Some therapies may increase detrimental neurotransmitters or dampen helpful ones.
13. Experiment with only one new drug, supplement, or procedure at a time, to isolate your observations and arrive at accurate conclusions. With each, strike a balance between optimism and realistic expectations. Selecting the best therapy is not an exact science and the process often involves trial and error. Have patience. If the current trial doesn’t pan out, go on to the next, in consultation with your physician.
14. Keep a log. Write down your experience with each drug or supplement, both to share with your healthcare provider and to track results for future reference. He or she may want you to try it again later, at a different dose or in concert with another product. Some medications have a therapeutic window, that is, the dose must be fairly precise. Keep notes on dates, dosage amounts, times of the day you take it, side effects, and results.
15. If you feel more depressed after taking a steroid, painkiller, or other medication for a condition other than depression, make a note of it and try to avoid it in the future.
16. Eat healthy foods. 
17. If you crave chocolate, eat more, in moderation. Aim for a product with a high cocoa content (80-99%) and low sugar. Chocolate contains tyrosine, tryptophan, and phenylethylamine, all of which can boost moods.
18. Watch your alcohol consumption. Alcohol can contribute to depression and might cause negative interactions with your antidepressants.
19. Try yoga.
20. Practice meditation. In a quiet place, focus on your breathing and try to let thoughts that come up drift away.
21. Practice mindfulness. Become aware of your surroundings, your body, and your actions, without judgment, to ground you and connect you to the present moment.
22. Seek sunlight. When weather permits, walk in the sun or sit indoors beside a sunny window. On cloudy days, full-spectrum light bulbs might help but they could make you feel worse.
23. Explore your thoughts and feelings in a private place, on paper or disk. Just writing them down and reviewing or revising them can bring validation and relief. Let out any anger and frustrations instead of bottling them up. Reread past entries to remind yourself you survived previous hard times.
24. Create a rainy-day fund for times when you hit a rough patch. Depression can come in cycles, so prepare yourself. Keep a list of activities that make you smile and laugh. These might include calling a friend, looking through photos from a fun vacation, listening to a playlist of your favourite songs, watching a funny cat video, or rereading inspirational quotes.
25. Stay busy. Fill your agenda every day. Consider volunteering to help others, which will likely give you a positive feeling from contributing to make the world a better place. Take up a new hobby or enroll in an interesting class. Keep idle time, when you’re apt to dwell on negative thoughts, to a minimum.
26. Pursue activities you find fun or relaxing. Paint, garden, read, watch movies, attend concerts or sporting events – spend time doing whatever it is that makes you feel at peace.
27. Stick to your daily routines. They provide structure and stability, furnishing mileposts to carry you through until bedtime.
28. Occasionally break with routine and take a vacation or staycation.
29. Take long walks, jog, play tennis, or lift weights. Join a fitness club. Aerobic exercise burns calories and releases endorphins, which can reduce stress and lift your mood. If you haven’t exercised in a while or have never really gotten into it, set a small goal to start with: just 10-15 minutes several times a week. Once you create an exercise routine, sticking to it will become easy.
30. Talk to yourself, either silently at any time or aloud in private. Keep your inner dialogue positive. Tell yourself you are going to get better. Tell yourself this condition is temporary and you will overcome it.
31. Distance yourself from negative people and situations as much as you can. Negativity breeds more negativity, making it hard to stop the cycle. Surround yourself with positive people, ones who make you happy.
32. Pray.
33. Pet your cat or dog. If you don’t have one, befriend a neighbour’s or visit an animal shelter.
34. Listen to uplifting music, such as the first movement of Schubert’s Symphony No. 9.
35. Be compassionate with yourself. Forgive yourself for your blunders and for angry remarks you may have made. Realize you’re doing the best you can. But don’t get complacent – resolve to do better in the future.

Our Peer Support program services can be accessed over the phone at 403-297-1402 or through email at peer@cmha.calgary.ab.ca.