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Part 4 of 5 =========== **Self-care** (cont.) - How can I help myself get through depression on a day-to-day basis? **Books** - What are some books about depression? Self-care (cont.) ----------------- Q. How can I help myself get through depression on a day-to-day basis? On a day-to-day basis, separate from, or concurrently with therapy or medication, we all have our own methods for getting through the worst times as best we can. The following comments and ideas on what to do during depression were solicited from people in the alt.support.depression newsgroup. Sometimes these things work, sometimes they don't. Just keep trying them until you find some techniques that work for you. * Write. Keep a journal. Somehow writing everything down helps keep the misery from running around in circles. * Listen to your favorite "help" songs (a bunch of songs that have strong positive meaning for you) * Read (anything and everything) Go to the library and check out fiction you've wanted to read for a long time; books about depression, spirituality, morality; biographies about people who suffered from depression but still did well with their lives (Winston Churchill and Martin Luther, to name two;). * Sleep for a while * Even when busy, remember to sleep. Notice if what you do before sleeping changes how you sleep. * If you might be a danger to yourself, don't be alone. Find people. If that is not practical, call them up on the phone. If there is no one you feel you can call, suicide hotlines can be helpful, even if you're not quite that badly off yet. * Hug someone or have someone hug you. * Remember to eat. Notice if eating certain things (e.g. sugar or coffee) changes how you feel. * Make yourself a fancy dinner, maybe invite someone over. * Take a bath or a perfumed bubble bath. * Mess around on the computer. * Rent comedy videos. * Go for a long walk * Dancing. Alone in my house or out with a friend. * Eat well. Try to alternate foods you like ( Maybe junk foods) with the stuff you know you should be eating. * Spend some time playing with a child * Buy yourself a gift * Phone a friend * Read the newspaper comics page * Do something unexpectedly nice for someone * Do something unexpectedly nice for yourself. * Go outside and look at the sky. * Get some exercise while you're out, but don't take it too seriously. * Pulling weeds is nice, and so is digging in the dirt. * Sing. If you are worried about responses from critical neighbors, go for a drive and sing as loud as you want in the car. There's something about the physical act of singing old favorites that's very soothing. Maybe the rhythmic breathing that singing enforces does something for you too. Lullabies are especially good. * Pick a small easy task, like sweeping the floor, and do it. * If you can meditate, it's really helpful. But when you're really down you may not be able to meditate. Your ability to meditate will return when the depression lifts. If you are unable to meditate, find some comforting reading and read it out loud. * Feed yourself nourishing food. * Bring in some flowers and look at them. * Exercise, Sports. It is amazing how well some people can play sports even when feeling very miserable. * Pick some action that is so small and specific you know you can do it in the present. This helps you feel better because you actually accomplish something, instead of getting caught up in abstract worries and huge ideas for change. For example say "hi" to someone new if you are trying to be more sociable. Or, clean up one side of a room if you are trying to regain control over your home. * If you're anxious about something you're avoiding, try to get some support to face it. * Getting Up. Many depressions are characterized by guilt, and lots of it. Many of the things that depressed people want to do because of their depressions (staying in bed, not going out) wind up making the depression worse because they end up causing depressed people to feel like they are screwing things up more and more. So if you've had six or seven hours of sleep, try to make yourself get out of bed the moment you wake up...you may not always succeed, but when you do, it's nice to have gotten a head start on the day. * Cleaning the house. This worked for some people me in a big way. When depressions are at their worst, you may find yourself unable to do brain work, but you probably can do body things. One depressed person wrote, "So I spent two weeks cleaning my house, and I mean CLEANING: cupboards scrubbed, walls washed, stuff given away... throughout the two weeks, I kept on thinking "I'm not cleaning it right, this looks terrible, I don't even know how to clean properly", but at the end, I had this sparkling beautiful house!" * Volunteer work. Doing volunteer work on a regular basis seems to keep the demons at bay, somewhat... it can help take the focus off of yourself and put it on people who may have larger problems (even though it doesn't always feel that way). * In general, It is extremely important to try to understand if something you can't seem to accomplish is something you simply CAN'T do because you're depressed (write a computer program, be charming on a date), or whether its something you CAN do, but it's going to be hell (cleaning the house, going for a walk with a friend, getting out of bed). If it turns out to be something you can do, but don't want to, try to do it anyway. You will not always succeed, but try. And when you succeed, it will always amaze you to look back on it afterwards and say "I felt like such shit, but look how well I managed to...!" This last technique, by the way, usually works for body stuff only (cleaning, cooking, etc.). The brain stuff often winds up getting put off until after the depression lifts. * Do not set yourself difficult goals or take on a great deal of responsibility. * Break large tasks into many smaller ones, set some priorities, and do what you can, as you can. * Do not expect too much from yourself. Unrealistic expectations will only increase feelings of failure, as they are impossible to meet. Perfectionism leads to increased depression. * Try to be with other people, it is usually better than being alone. * Participate in activities that may make you feel better. You might try mild exercise, going to a movie, a ball game, or participating in religious or social activities. Don't overdo it or get upset if your mood does not greatly improve right away. Feeling better takes time. * Do not make any major life decisions, such as quitting your job or getting married or separated while depressed. The negative thinking that accompanies depression may lead to horribly wrong decisions. If pressured to make such a decision, explain that you will make the decision as soon as possible after the depression lifts. Remember you are not seeing yourself, the world, or the future in an objective way when you are depressed. * While people may tell you to "snap out" of your depression, that is not possible. The recovery from depression usually requires antidepressant therapy and/or psychotherapy. You cannot simple make yourself "snap out" of the depression. Asking you to "snap out" of a depression makes as much sense as asking someone to "snap out" of diabetes or an under-active thyroid gland. * Remember: Depression makes you have negative thoughts about yourself, about the world, the people in your life, and about the future. Remember that your negative thoughts are not a rational way to think of things. It is as if you are seeing yourself, the world, and the future through a fog of negativity. Do not accept your negative thinking as being true. It is part of the depression and will disappear as your depression responds to treatment. If your negative (hopeless) view of the future leads you to seriously consider suicide, be sure to tell your doctor about this and ask for help. Suicide would be an irreversible act based on your unrealistically hopeless thoughts. * Remember that the feeling that nothing can make depression better is part of the illness of depression. Things are probably not nearly as hopeless as you think they are. * If you are on medication: a. Take the medication as directed. Keep taking it as directed for as long as directed. b. Discuss with the doctor ahead of time what happens in case of unacceptable side-effects. c. Don't stop taking medication or change dosage without discussing it with your doctor, unless you discussed it ahead of time. d. Remember to check about mixing other things with medication. Ask the prescribing doctor, and/or the pharmacist and/or look it up in the Physician's Desk Reference. Redundancy is good. e. Except in emergencies, it is a good idea to check what your insurance covers before receiving treatment. * Do not rely on your doctor or therapist to know everything. Do some reading yourself. Some of what is available to read yourself may be wrong, but much of it will shed light on your disorder. * Talk to your doctor if you think your medication is giving undesirable side-effects. * Do ask them if you think an alternative treatment might be more appropriate for you. * Do tell them anything you think it is important to know. * Do feel free to seek out a second opinion from a different qualified medical professional if you feel that you cannot get what you need from the one you have. * Skipping appointments, because you are "too sick to go to the doctor" is generally a bad idea.. * If you procrastinate, don't try to get everything done. Start by getting one thing done. Then get the next thing done. Handle one crisis at a time. * If you are trying to remember too many things to do, it is okay to write them down. If you make lists of tasks, work on only one task at a time. Trying to do too many things can be too much. It can be helpful to have a short list of things to do "now" and a longer list of things you have decided not to worry about just yet. When you finish writing the long list, try to forget about it for a while. * If you have a list of things to do, also keep a list of what you have accomplished too, and congratulate yourself each time you get something done. Don't take completed tasks off your to-do list. If you do, you will only have a list of uncompleted tasks. It's useful to have the crossed-off items visible so you can see what you have accomplished * In general, drinking alcohol makes depression worse. Many cold remedies contain alcohol. Read the label. Being on medication may change how alcohol affects you. * Books on the topic of "What to do during Depression": "A Reason to Live," Melody Beattie, Tyndale House Publishers, Wheaton, IL. 167 pages. This book focuses on reasons to choose life over suicide, but is still useful even if suicide isn't on your mind. In fact, it reads a lot like this portion of the FAQ. An excerpt: * Do two things each day. In times of severe crisis, when you don't want to do anything, do two things each day. Depending on your physical and emotional condition, the two things could be taking a shower and making a phone call, or writing a letter and painting a room. * Get a cat. Cats are clean and quiet, they are often permitted by landlords who won't allow dogs, they are warm and furry. Books ----- Q. What are some books about depression? This is an shorter version from a list of books compiled from the personal recommendations of the members/readers/participants of the Walkers-in-Darkness mailing list, the alt.support.depression newsgroup, and the Mood Disorders Support Network on AOL. The full list is available at the Walkers ftp site (see Internet Resources) and at the MIT *.answers site, rtfm.mit.edu; pub/usenet/alt-support-depression/books If you have any additions, updates, corrections, etc. for this list, please send email to "firstname.lastname@example.org" (Dan Ash). ~A Brilliant Madness: Living with Manic Depressive Illness.~ Patty "Anna" Duke and Gloria Hochman. Bantam Books 1992 Comments: Patty Duke's very personal account of her account of her struggle with manic-depression. ~The Broken Brain: The Biological Revolution in Psychiatry.~ Nancy Andreasen, MD, Ph.D.. Harper. Perennial. 1984 ~Care of the Soul.~ Thomas Moore. Harper. Perennial. 1992 ~The Consumers Guide to Psychotherapy.~ Jack Engler, Ph.D. and Daniel Goleman, Ph.D. Fireside-Simon & Schuster. 1992 ~Cognitive Therapy & The Emotional Disorders.~ Aaron T. Beck, MD Penguin. Meridian. 1976 ~Darkness Visible: A Memoir of Madness.~ William Styron. Vintage. 1990. ~The Depression Handbook.~ Workbook. Mary Ellen Copeland ~Depression and it's Treatment.~ John H. Greist, MD.. and James W. Jefferson, MD.. Warner Books. 1992 ~The Essential Guide to Psychiatric Drugs.~ Jack Gorman. St. Martin's Press. 1992 ~Everything You Wanted to Know About Prozac.~ Jeffrey M. Jonas, MD and Ron Schaumburg. Bantam. 1991 ~Feeling Good: The New Mood Therapy.~ David Burns, MD. Signet. 1980 Self-help cognitive therapy techniques for depression, anxiety, etc. ~The Feeling Good Handbook.~ David D. Burns, MD. Plume. 1989 ~Good Mood: The New Psychology of Overcoming Depression.~ Julian L. Simon. Open Court Press. 1993. ~The Good News About Depression.~ Mark S. Gold. Bantam. 1986 ~Listening To Prozac.~ Peter D. Kramer, M.D. Viking. 1993 A psychiatrist explores some of the implications of anti- depressants, and especially of Prozac's unusual effects on the personality. Kramer also discusses the recent research on depression, as well as several other issues which seem linked to depression. ~How to Heal Depression.~ Harold H. Bloomfield, MD and Peter McWilliams. Prelude Press. 1994 ~Manic-Depressive Illness.~ Fredrick K. Goodwin, MD, & Kay Redfield Jamison, Ph.D.. Oxford. 1990 ~Munchausen's Pigtail.~ Psychotherapy and 'Reality': Essays & Lectures. Paul Walzlawick, Ph.D.. Norton ~On The Edge Of Darkness.~ Kathy Cronkite. Doubleday. 1994 ~Overcoming Depression.~ Demitri F. and Janice Papolos. Harper. Perennial. 1992. Good basic text on the various aspects of depression and manic depression. Considered by some to be a "classic" in the field. ~A Primer of Drug Action: A Concise, Non technical Guide to the" "Actions,Uses and Side Effects of Psychoactive Drugs.~ Robert M. Julien. W.H. Freeman. 1992. 6 ed. ~Prozac: Questions and Answers for Patients, Families and Physicians.~ Dr. Robert Fieve, MD... Avon. 1993 ~Questions and Answers about Depression and its Treatment.~ Dr. Ivan Goldberg. The Charles Press in Philadelphia. 1993. A 112-page FAQ on depression that has appeared in book form. Dr. Goldberg has also contributed to the FAQ for a.s.d. and frequently posts to Walkers-in-darkness. ~A Reason to Live.~ Melody Beattie (General Editor).. Tyndale House Publishers, Inc.. 1992. This is a book that explores reasons to live and reasons not to commit suicide. It also contains suggestions for life-affirming actions people can take to help themselves get through those times when they're struggling to find a reason to live. ~From Sad to Glad.~ Nathan S. Kline, MD. Ballantine Books.. 1991 20th printing. Out of date pharmacologically "but excellent otherwise." Kline says: "Psychiatry has labored too long under the delusion that every emotional malfunction requires an endless talking out of everything the patient ever experienced." ~Season of the Mind.~ Norman Rosenthal, MD.. This book explores Seasonal Affective Disorder. ~Talking Back to Prozac.~ Peter Breggin. St. Martins Press. 1994 ~Touched with Fire: Manic-depressive Illness and the Artistic~ ~Temperament.~ Kay Jamison. A look at a number of 19th century poets, writers, and composers who were Bipolar. This book in quoted liberally in this FAQ under "Who are some famous people with depression?" ~Toxic Psychiatry: Why Therapy, Empathy, and Love Must Replace Drugs,~ ~Electroshock, and the Biochemical Theories of the 'New Psychiatry'.~ Peter Breggin. St. Martin's Press. 1991 ~We Heard the Angels of Madness: One Family's Struggle with Manic~ ~Depression.~ Diane and Lisa Berger This book was written by a mother who had a son stricken by manic-depression at 19 and documents the rough road they walked to get him the help he needed. Very heartfelt and well written. ~Understanding Depression.~ Donald Klein, MD, and Paul Wender, MD (founders of the National Assn. for Depressive Illness). Oxford, 1993 Melvin Sabshin, MD, Medical Director, American Psychiatric Assn. writes: "A very good source of information that will be extraordinarily useful to patients and their families." ~The Way Up From Down.~ Priscilla Slagle, M.D. This book stresses a nutritional approach heavy on the amino acid tyrosine, and a complete vitamin supplement program. ~What You Need to Know About Psychiatric Drugs.~ Stuart C. Yudofsky, MD; Robert E. Hales, MD; and Tom Ferguson, MD. Ballantine. 1991 ~When am I Going to Be Happy?~ Penelope Russianoff, Ph.D.. Bantam. 1989 ~When the Blues Won't Go Away.~ Robert Hirschfeld, MD... 1991 Concerns new approaches to Dysthymic Disorder and other forms of chronic low-grade depression. ~Winter Blues: Seasonal Affective Disorder and How to Overcome It.~ Norman Rosenthal, MD... The Guilfold Press. 1993 ~You Are Not Alone.~ Julia Thorne with Larry Rothstein. Harper Collins. 1993 Comments: The writings of depressives, for both depressives and those who need to understand them. Shervert Frazier, MD, former director of the National Institutes of Mental Health says: "A ground breaking book that...reveals the impact of depression on the lives of everyday people. This little book is must reading for sufferers, those associated with depression, and mental health professionals" ~You Mean I Don't Have To Feel This Way?~ Collette Dowling. Bantam. 1993 Comments: Jeffrey M. Jonas, MD writes: "An important book that is filled with information helpful to sufferers of mood and eating disorders and other illnesses. It should be read not only by lay people but also by professionals who deal with these illnesses." ..