Winning the Battle Against Depression

Introduction

Depression is not fun. It is like being in a war that we didn’t ask for. A battle we didn’t sign up to fight. Even though depression is unwanted, and many times unexpected, it happens to many of us. This blog post is about understanding depression and the ways that we can deal with it. Ultimately, it is about winning the battle against depression.

Symptoms of Depression

Depression can look like a lot of things. Sadness. Irritability. Low energy. Fatigue. Difficulty doing our job or our daily activities. Relationships that become broken or lost. It’s important to understand the many symptoms that depression can embody:

• Depressed mood
• Hopelessness
• Tearfulness
• Irritability (especially with children and teens)
• Decreased interest in activities
• Weight loss (when not dieting) or weight gain
• Decreased or increased appetite
• Insomnia (not sleeping) or hypersomnia (sleeping too much)
• Restlessness (psychomotor agitation) or a feeling of being slowed down (psychomotor retardation)
• Fatigue or loss of energy
• Feelings of worthlessness or inappropriate guilt
• Low self-esteem
• Poor concentration
• Difficulty making decisions
• Recurrent thoughts of death
• Recurrent suicidal ideation

Diagnosis: Different types of Depression

The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th edition) outlines the various forms of depression one can experience. These depression diagnoses differ from one another based on severity of symptoms, length of time symptoms are present, and general presentation of depressive symptoms. For a complete presentation regarding the criteria for any of the depressive diagnoses listed below, please refer to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition.

Three of the more common forms of depression include:

• Adjustment Disorder With depressed mood
• Persistent Depressive Disorder (formerly known as Dysthymia)
• Major Depressive Disorder

Adjustment Disorder With depressed mood

Adjustment Disorder With depressed mood occurs when someone develops emotional or behavioral symptoms in response to an identifiable stressor, within three months from the time of the onset of that stressor. In the case of Adjustment Disorder With depressed mood, these symptoms may include low mood, tearfulness, or feelings of hopelessness. The symptoms either cause marked distress that is out of proportion to the actual stressor or may cause significant impairment in social, occupational, or other important areas of functioning.

The symptoms of Adjustment Disorder With depressed mood do not represent what would be seen in someone who is experiencing grief or normal bereavement. If the symptoms of someone with Adjustment Disorder With depressed mood last longer than an additional six months beyond the end (or termination) of the stressor, then the Adjustment Disorder diagnosis no longer applies.

Persistent Depressive Disorder

Persistent Depressive Disorder was formerly known as Dysthymia. To differentiate Persistent Depressive Disorder from Major Depressive Disorder, I would often ask clients to think about the difference between someone who had a really high fever that lasted for a short while (Major Depressive Disorder) versus someone who had a low-grade fever that lasted for months and months (Persistent Depressive Disorder).

With the newest addition (5th ed.) to the DSM, Persistent Depressive Disorder represents a consolidation of Dysthymic Disorder and chronic Major Depressive Disorder. The key word here is chronic. Persistent Depressive Disorder’s main symptom is depressed mood most of the day, for more days than not, that lasts for at least two years.

In addition to depressed mood, people with Persistent Depressive Disorder must experience at least two (or more) of the following symptoms:

• Poor appetite or overeating
• Insomnia or hypersomnia
• Low energy or fatigue
• Low self-esteem
• Poor concentration or difficulty making decisions
• Feelings of hopelessness

During this two-year period of time, people diagnosed with Persistent Depressive Disorder cannot be without the symptoms for more than two months at a time. And these symptoms must cause significant impairment in social, occupational, or other important areas of functioning.

Major Depressive Disorder

The diagnosis of Major Depressive Disorder can be fairly complicated, in that it not only includes the major diagnostic criteria, but also severity, course, and symptom specifiers. In order not to confuse matters, I’ll stick to the diagnostic basics here. If you are interested in the full diagnostic criteria, I invite you to take a look at the DSM-5.

For the basic diagnosis of Major Depressive Disorder to be made, a person must experience five (or more) of the symptoms listed below. At least one of these symptoms must be either depressed mood or loss of interest or pleasure. These symptoms have to be present at least for two weeks and must represent a change in the person’s normal functioning. Here’s the list:

• Depressed mood (this can present as irritability in children and teens)
• Diminished interest or pleasure in all, or almost all, activities
• Significant weight loss when not dieting or weight gain
• Insomnia or hypersomnia
• Psychomotor agitation or retardation (see initial symptom list above for definitions)
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate, or indecisiveness
• Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt, or a specific plan for committing suicide

As with the other depressive diagnoses, these symptoms must cause significant distress or impairment in social, occupational, or other important areas of functioning.

Twenty Ways to Battle Against Depression

And now on to the most important focus of this blog post – winning the battle against depression! In describing depression with my clients in the past, I have discussed with them what I believe are the three major options we have when deciding how we are going to respond to depression. I would ask them to imagine themselves in a deep hole, such as a well that has gone dry. That dry well represents their depression. Once they recognize that they are in that hole (depression), they have three basic choices to make. How are they going to respond to their depression? They can either:

1. Stay where they are (allowing their depression to remain)
2. Dig themselves even deeper (allowing their depression to get worse) or
3. Start looking for ways to climb out of that hole (battling against the depression)

In counseling, I would always encourage my clients to CHOOSE OPTION #3, start looking for ways to climb out of that hole! And how do they climb out? Through the use of a variety of treatment interventions. Not every tip or technique is going to work for every person. The key here is to find the RIGHT COMBINATION of treatment interventions that will work for YOU.

There are so many tips and techniques that are available for use. All that is needed is your willingness to try them. Below you will find TWENTY treatment interventions for depression. There are a few BONUS resources included within this list too. Winning the battle against depression starts with that first step toward climbing out of that dark hole and moving toward the light and life that awaits.

1. Rest

Rest is restorative for the mind and body. Some people have difficulty sleeping (insomnia) when they’re depressed. Sometimes people with depression experience hypersomnia (sleeping too much). Try to get a healthy amount of sleep each night. On the flip side, avoid spending too much time sleeping. Balancing rest with healthy activities helps to develop a good sleep-wake cycle. A technique to help make sure you get regular sleep is to go to bed and get up each morning at the same time each day. Avoid naps, if possible.

2. Nutrition and Hydration

Try to eat healthy, nutritious food and stay hydrated by drinking water. Good nutrition and hydration help your body function at an optimal level. Sometimes when we are depressed, we may experience either an increased or decreased appetite. Keeping our bodies fueled with healthy food and drink can improve energy and overall physical functioning.

3. Exercise

Exercising can help to produce endorphins, which are chemicals that interact with the receptors in your brain, reducing the sense of pain and increasing a general sense of well-being. “Regular exercise has been proven to 1) reduce stress, 2) ward off anxiety and feelings of depression, 3) boost self-esteem, and 4) improve sleep.” (Exercise and Depression – WebMD)

4. Time Outdoors/Nature

Communing with nature is a wonderful way to connect with the bigger picture of life and can help to alleviate depressed moods. If possible, try to spend some time each day outside, in the fresh air during daylight hours. If this is not possible, make sure to open your drapes and blinds during the day to let natural light pour into your inside environment.

5. Avoid Alcohol and Other Substances of Abuse

When depressed, some people turn to alcohol and other substances of abuse to feel better, reduce stress, and to escape from their depressed, negative thoughts and feelings. They may feel a sense of relief initially, but ultimately, their depressive symptoms will return.

“Nearly one-third of people with major depression also have an alcohol problem. Often, the depression comes first. Drinking will only make depression worse. People who are depressed and drink too much have more frequent and severe episodes of depression and are more likely to think about suicide. Heavy alcohol use also can make antidepressants less effective.” (Alcohol and Depression – WebMD)

6. Personal Hygiene and Dressing

Make an effort to care for your personal hygiene, even if you don’t feel like it. People who are depressed often lack the energy, desire, or motivation to engage in self-care activities, such as hygiene and dressing. Take that shower. Wash your hair. Get dressed each day (pajamas don’t count). You may find that when you actually begin to care for your personal hygiene and grooming, you’ll feel better. Think of self-care as one of those building blocks that can help you climb out of that hole of depression (see responding to depression OPTION #3 above).

7. Care for Your Home Environment

Just as it’s important to care for yourself with personal hygiene and dressing, it’s also important to care for your home environment. When we’re depressed, we don’t want to wash the dishes, do the laundry, take out the trash, pick up after ourselves, etc., etc., etc. It’s the same as number 6 above…”people who are depressed often lack the energy, desire, or motivation to…” (you can fill in the blank). I have two tips for you in this area. If you do only two things to care for your home environment each day, do these two:

• Make your bed
• Clean your kitchen sink

That’s it. That’s a great place to start. If, after you 1) make your bed and 2) clean your kitchen sink you feel motivated to do a bit more, great! But just start with the bed and the sink. Give it a try.

8. Don’t Isolate

People who are depressed often feel like they cannot connect with other people on an emotional level. They fear that showing their true feelings and sharing their real thoughts will result in relationship disaster. People who are our friends and loved ones will no longer want to be our friends or will no longer love us. THIS IS NOT TRUE. I put that in capital letters to emphasize that THIS IS NOT TRUE. If the people in your life are your real friends and your real loved ones, they will not flee when you tell them your truth. Let these people in. My suggestion here is to talk to friends and loved ones that HAVE YOUR BEST INTEREST AT HEART. You know who these people are. You do. Don’t isolate. Let the people who HAVE YOUR BEST INTEREST AT HEART in.

“There is no greater agony than bearing an untold story inside you.”

Maya Angelou

9. Find a Mentor

This find a mentor tip is a little bit like tip #8, don’t isolate. The difference here, however, is that in finding a mentor, your focus is on seeking someone who is wise. Someone who may have the experiences or background or knowledge that can be helpful to you as you work toward winning the battle against depression. As in #8 above, it is also helpful that this person has YOUR BEST INTEREST AT HEART.

Do you know someone who you would characterize as a wise person? Someone who is willing to listen and journey with you through your healing? If yes, that is wonderful. If no, then maybe you could consider more creative ways to find mentors in your life, for example, through suggestions from friends, reading information from trusted authors, or seeking professional help.

10. Therapy/Psychiatric Care

We’ve mentioned the possibility of seeking professional help in #9 above. With depression, seeking therapy and/or psychiatric care may truly be in your own best interest. This is an option that you may wish to consider, particularly if your symptoms of depression are significant, for example, if you are having recurrent thoughts of suicide.

Therapy and/or Psychiatric Care is clinically indicated in many cases for people who have Major Depressive Disorder. Some people need the extra assistance of antidepressant medications in order to resolve their symptoms of depression. In this day in age, psychiatrists typically provide psychiatric care through the use of medications, and therapists are the ones who do “talk therapy.”

If you feel you could benefit from psychiatric care, I suggest that you speak with your primary care physician to discuss your concerns and to request recommendations for psychiatrists. Your primary care physician may also be able to give you recommendations for therapists. Another option in seeking a therapist or psychiatrist is through Psychology Today’s website: Find a Therapist.

11. Fun

When we are depressed the idea of doing anything fun or pleasurable seems to fly out the window. Activities that used to bring feelings of joy or contentment may just seem too difficult to engage in. Winning the battle against depression includes fighting these thoughts and feelings. Try to have fun, even if you don’t think that participating in activities will be fun anymore. If you can’t seem to summon the motivation to engage in pleasurable activities, build in assurances that you will give fun a try. Plan fun time on your calendar (schedule something daily or at least several times a week.) Let your friends and family know that you are working on this area of your life to combat depression. Ask these people to engage in these activities with you or ask them to be your accountability buddies on this goal. So, get out that boardgame, puzzle, or deck of cards. Dust off those watercolor supplies. Open up that cookbook and stock up the pantry. Whatever it is, give fun a try. It really can help to decrease symptoms of depression.

12. Activity Basket

Along the same idea as having fun (number 11 above) is building an activity basket to have on hand when needed. A basket (or box or container of some sort), filled with enjoyable activities, is a good idea when you find yourself home and unmotivated toward activity of any kind. If you feel like you are stuck in a rut and don’t know what to do next, look to your activity basket for ideas. If you are suddenly at home due to inclement weather or illness, an activity basket can be one of your saving graces. Fill your basket with things you enjoy doing, e.g. reading a book, writing in a journal, watching a favorite DVD, flipping through magazines, etc. It is also helpful if you consider adding other pleasurable objects, such as a favorite blanket/throw, a pleasing scented candle, or a little snack.

13. Laughter/Humor

Have you heard the old saying, “Laughter is the Best Medicine?” Well, research has proven that laughter is a simple and effective way towards winning the battle against depression. “It’s true: laughter is strong medicine. It draws people together in ways that trigger healthy physical and emotional changes in the body. Laughter strengthens your immune system, boosts mood, diminishes pain, and protects you from the damaging effects of stress. Nothing works faster or more dependably to bring your mind and body back into balance than a good laugh. Humor lightens your burdens, inspires hope, connects you to others, and keeps you grounded, focused, and alert. It also helps you release anger and forgive sooner.” (Laughter is the Best Medicine – HelpGuide)

If you have trouble finding the laughter in your life, try watching funny movies, TV shows, and YouTube videos. Read the funny pages. Share a good joke. Play with a pet (puppies and kittens can be hilarious). Your emotional and physical health will thank you!

14. Distractions

When we become depressed it’s almost like we experience tunnel vision. We focus on our sadness, our misery, our negative thoughts. That focus can become all we think about or all that we see. So, a helpful tactic to battle against depression is to distract ourselves away from the negativity of depression.

Distractions include many of the resources we have already mentioned, e.g. puzzles, movies, games, reading, conversations with others, etc. The important aspect of this intervention is your intentional desire and action to change your focus from negative to positive.

15. Combat Cognitive Distortions

In the substance abuse treatment world, cognitive distortions are frequently referred to as “stink’in think’in.” When we are depressed, our depressed mood is fueled by negative thoughts, or cognitive distortions.

Cognitive Behavioral Therapy is a specific therapeutic approach which focuses on changing our negative thoughts and behaviors into more positive and realistic thoughts and behaviors. “CBT focuses on challenging and changing cognitive distortions (e.g. thoughts, beliefs, and attitudes) and behaviors, improving emotional regulation and the development of personal coping strategies that target solving current problems” (Wikipedia).

BONUS: I’ve designed a Cognitive Behavioral Chart that describes the connection between our thoughts, feelings, and behaviors. In general, negative thoughts lead to negative feelings. Negative feelings lead to negative behaviors. Those negative behaviors trigger yet more negative thoughts, etc. etc. It’s like a downward spiral of negativity. In this chart you are given tips on circumventing the negativity and developing more positive responses as a result. To access this PDF information (download, print, share, save), just click on this link:

COGNITIVE BEHAVIORAL CHART

16. Crying as a Release

Did you know that crying can be an actual healing mechanism when we are depressed? Belleruth Naparstek, who is a famous Guided Imagery practitioner and author talks of crying as a way of “rinsing” our emotions.

We cry three different types of tears: 1) reflex, 2) continuous, and 3) emotional. Reflex tears help to clear out the dust and dirt and general debris that come into our eyes on a daily basis. Continuous tears help to keep our eyes moist and help to prevent infections in our eyes. Emotional tears flush stress hormones and other toxins from your body. Because emotional tears release stress hormones from our bodies, they can result in improving your mood as well as strengthening your immune system. When you cry emotional tears, you are activating your parasympathetic nervous system (PNS). The PNS helps with digestion, and it also helps you rest better. Crying helps to lessen pain. Crying also helps you to move through the grieving process (10 Benefits of Crying for Mental Health – NorthStar Transitions).

In general, crying can be helpful when we are dealing with symptoms of depression. There is a caution with this, however. “If you find yourself crying emotional tears consistently over an extended period, it could allude to a deeper issue at hand. This could mean it is time to seek help from a professional to help your overall mental health and wellbeing. There is no shame in needing extra help sometimes, and crying can alert you that it is time to seek it out” (10 Benefits of Crying for Mental Health – NorthStar Transitions). 

17. Music Therapy Playlist

Music Therapy is a wonderful way to work through feelings of depression. The Iso Principle originated within the field of Music Therapy and is a way utilizing music for mood management. It is based on the idea that music is used to match a person’s mood and then move that person’s mood to a more positive state through the use of a curated Music Therapy Playlist.

For example, if you are feeling sad or depressed and want to feel happy or content, you start by listening to music that matches your sad/depressed mood and then gradually listen to music that evokes a feeling of happiness/contentment.

BONUS: I’ve developed a Music Therapy Playlist that you can listen to when you are feeling sad/depressed and want to feel better. To listen to the full audio tracks, please have your Spotify app or website opened up on your listening device. You can download the Spotify app or website for free! To access this Music Therapy Playlist to improve your mood, click on the link below:

MUSIC TO IMPROVE YOUR MOOD (PLAYLIST)

18. Journaling

Sometimes we have difficulty sharing our emotions verbally. We can’t seem to find the right words when we are speaking to someone else. Expressing our emotions on paper can be a wonderful way to communicate who you are and how you feel. When journaling we can take the time to ponder what we want to say. We can write very little or write volumes. Since journaling can be such a personalized experience, you also have the right to express yourself and then choose whether or not you want to share these thoughts and feelings with others. Journaling can also be a cathartic experience, a release of pent-up emotions that, once written, can begin to be emotionally processed.

19. Guided Imagery

Guided Imagery is one of my favorite ways to deal with any difficult emotions I may be dealing with. Using the creativity of our right brains, we can harness the power of our imaginations and our wise minds to process the feelings or emotions we are struggling with. To learn more about Guided Imagery in general, check out my audio recording, What is Guided Imagery?

A good resource for Guided Imagery for depression can be found at Health Journeys. Once you are on the website or app you can look up Guided Imagery for Depression. One suggested resource in particular would be A Guided Meditation to Help You Relieve Depression by Belleruth Naparstek.

20. Prayer/Faith-based Activities

For many people Inspirational or faith-based activities are very helpful when feeling depressed. Praying, Bible reading, Bible journaling, devotional reading, and reading inspirational books/poetry/quotes have helped to provide support to people who are depressed. If you are feeling depressed and feel supported by your faith, perhaps you may desire to dig deeper into God’s word for you. Reach out to others who you can share your struggles with, in a faith-based environment.

Conclusion

I hope that this post has been helpful in providing you with information about depression and 20 techniques to defeat this foe. We can all join together in winning the battle against depression!

Resources

Books, Blog Posts, and Articles

• 10 Benefits of Crying for Mental Health (NorthStar Transitions)
• Alcohol and Depression (WebMD)
• American Psychiatric Association: Desk Reference to the Diagnostic Criteria From DSM-5. Arlington, VA, American Psychiatric Association, 2013
• Cognitive Behavioral Therapy (Wikipedia)
• Exercise and Depression (WebMD)
• Laughter is the Best Medicine (HelpGuide)
• What is Guided Imagery? (The Heart’s Way, Imagery and Insights)

Guided Imagery

• A Guided Meditation to Help You Relieve Depression (Belleruth Naparstek)

Music Therapy Playlists

• Music to Improve Your Mood

Printables

• Cognitive Behavioral Chart

Websites

• Find a Therapist (Psychology Today)
• Health Journeys

This post contains Amazon affiliate links AND nonaffiliate links to additional resources (highlighted in blue above.) “As an Amazon Associate, I earn from qualifying purchases.”