Many psychological interventions can help promote improved mental well-being with or without antidepressants.
Symptoms of Depression
A major depressive episode is defined as experiencing five or more of the following symptoms every day (or most days) for two weeks or more:
- Depressed or irritable mood
- Sleep problems (i.e., sleeping too much or too little; sleeping mainly during the day)
- Change in interests (i.e., not being interested in what you used to enjoy) or low motivation
- Excessive guilt or unrealistically low self-image
- Significantly low energy and/or change in self-care (i.e., not showering anymore)
- Significantly worse concentration (i.e., sharp decline in grades or performance)
- Changes in appetite (i.e., eating too much or too little)
- Agitation or severe anxiety/panic attacks
- Suicidal thoughts, plans or behaviors — including self-harm (i.e., intentionally cutting or burning yourself)
It’s important to remember that not everyone who is depressed is suicidal. You can still seek help even if you haven’t demonstrated any specific suicidal or self-harm behaviors, or even if your symptoms aren’t as severe or persistent as the symptoms noted above.
OK, I’m feeling depressed… so now what?
Now that you know the symptoms of depression, some positive coping skills can be useful. All of the following techniques are supported by scientific research and medication prescribers — like psychiatrists — and these skills are frequently recommended as important parts of treatment even for patients who continue to take antidepressant medications.
WARNING: Do not suddenly go off your prescribed antidepressant medications without first talking to your medical provider. Discuss any questions or concerns about the side effects of your medications with your provider.
Practice These Coping Skills Every Day
I recommend doing many — if not all — of the following coping skills and techniques once a day when experiencing depression. It’s important to know you probably won’t be motivated to do any of them at first because depression frequently saps motivation. In other words, know that it’s normal to feel unmotivated until you’re halfway done.
The patients I work with who frequently practice these coping skills get better.The seven techniques can be memorized with the acronym MY PEERS.
1. Meaning: Find small ways to be of service to others.
Find personal meaning by serving something larger than yourself. Remember service doesn’t have to be big to count. Consider this, “Success, like happiness, cannot be pursued; it must ensue… as the unintended side effect of one’s personal dedication to a course greater than oneself.” – Viktor E. Frankl, Man’s Search for Meaning
2. Your goals: Find workable goals that give you a sense of accomplishment.
Most people feel guilty when talking about goals because they set unreasonable or unworkable goals. A goal is workable if it’s:
- Something you can control (i.e., it doesn’t depend on others)
- Manageable (i.e., not overwhelming)
- Realistic for you (not for someone else)
- Measurable (i.e., you know whether or not it is done or getting done)
If something goes wrong with your goal, adopt a “what can I learn from this?” attitude (versus a judgmental, “this is why I’m horrible” attitude). Also, be careful when comparing your progress with others. We usually compare our biggest weakness with another person’s biggest strength. This is unfair (and usually not accurate anyhow).
3. Pleasant Events: Schedule pleasant activities or events.
Don’t wait for yourself to be “in the mood.” For example, give yourself permission for a 30-minute “vacation” or schedule a healthy hobby every day. Just remember to do these activities with the right attitude (see Engagement). Also, practice gratitude — take time to notice what went well today, not just what went wrong. Consider keeping a gratitude journal. Know that being grateful for your blessings doesn’t mean you have to discount your problems.
4. Engagement: Stay in the present.
This practice is sometimes called mindfulness. As best you can, during activities try not to be in your head with self-judgment. You may not be able to turn off the self-judgment, but you can notice it and bring yourself gently back to the present. Research shows that people with higher self-compassion also have higher self-worth or self-confidence.
For those who have difficulty with self-compassion or healthy engagement, you can find self-compassion exercises on Kristin D. Neff’s website here. Mindfulness Based Stress reduction courses are also available throughout Utah.
5. Exercise: And, eat right too.
Doing moderate exercise about five times a week (30 minutes a pop) can dramatically help your mood. Moderate exercise is a level of activity where it is difficult to sing from your diaphragm while doing it. Also pay attention to how the type of food or drink you’re eating influences your mood. You don’t have to do fad diets, but anyone will be depressed if they frequently binge on carbs, junk food, and energy drinks. Remember the virtue of moderation.
6. Relationships: Focus on people who lift you up.
Interact frequently with others that bring you up (not people that bring you down). While it’s OK to have some alone time, find a balance and don’t isolate yourself or the depression will linger.
7. Sleep Regularly: Try to keep a regular sleep schedule.
Keep a balance with not too little and not too much sleep. Staying up late one night and then sleeping in excessively the next day is a sure-fire way to feed depression. Also, don’t try to solve problems late at night when your brain is half-asleep.
As you practice these coping skills, know that you’re on the path to overcoming depression
In contrast, depression tends to linger when patients make up a reason why they can’t do these things. No matter what medication you’re taking, doing several of these activities every day — especially when you don’t feel like it — is vital to the treatment of depression. These positive coping skills may take time and practice, but if we don’t take the time to be well now, the periods of “unwellness” may be forced upon us later.