How To Survive Depression
I am so blur at the moment. Stressed out from lack of sleep and dealing with the new reality ushered in by coronavirus. Man, am I sick of that word.
On the other hand, it could be worse. I could still be depressed. Depression is so much worse than anything else I have ever experienced, it is difficult to describe. Roughly speaking, depression feels like a shaggy black dog has knocked you to the floor, bitten down into your amygdala and refuses to let go. I don't know how I would cope with that right now.
A lot of people are though. So I thought it would be an opportune time to share some of the strategies I used to survive depression. I've kept these handy, of course, in preparation for the inevitable return of the black dog. Be prepared, they say.
It's too easy to slip into depression without even realising it. If you can observe your behaviour objectively, you have a better chance of catching a depressive episode before it gets a chance to take hold. Some of the red flags I watch out for are:
When you're depressed you can become hypervigilant and easily triggered by the people around you. That's why I found curating a safe place can be so effective. When you feel safe, you have the time and space to rebuild yourself without having to constantly be on edge. To that end, I'd recommend you:
I never found categorising depression as a "mental illness" to be even remotely helpful. If we call depression a mental illness, I think we must also call love a mental illness. Both are resilient states where the sufferer's reality makes a departure from objective reality. Additionally, in many studies, depressed people have even been shown to be more realistic than control groups, a phenomenon called depressive realism. Maybe we should we call everybody else mentally ill?
I believe depression is an important adaptation which forces you to stop and debug your life. You should listen to the black dog rather than run from it. Something is wrong with your life and now is the time to dig it out, painful though it might be. On that note, the suffering that comes hand-in-hand with depression may exist purely for the purpose of forcing you to change. If you cannot make any changes to your life, you are in big trouble.
Getting started is always a problem, even in the best of times. But during depression, it is mission impossible. Fortunately there are a few hacks that can help here, particularly with getting out bed. First, give yourself a ridiculously easy task like opening the curtains. Then chain it to another task, say putting on sunscreen. Then to another: stretch, go outside. And so on. Making this a routine will help. Your mind and body will resist, but sometimes you just have to ignore the emptiness.
I'm naturally a night owl, but I make sure I get to bed before 4 am. This means I get at least half a day of sun, which is important. It helps to find an activity that puts you to sleep. For me it's studying flashcards or watching episode of Father Ted.
I've never taken pharmaceuticals for depression, but there are a few good natural medicines. The most obvious is exercise. I sometimes wonder if I would have survived depression if it weren't for exercise. I am extremely lucky on that count though, because physical activity is one of my basic needs. Cold showers work wonders too. The colder the better. It's a sort of shock therapy. Music with a strong beat will help, and lastly, you could try a placebo. Fish oil supplements and ibuprofen are supposed to help treat inflammation which is often a symptom of depression. I don't believe they have much real effect, but the placebo effect is just as good.
A hit of icecream, soft-drink, tom-yum soup or even pornography might sometimes be appropriate. You probably don't want to self-medicate with alcohol or marijuana though. Both are depressants, and I'd expect them to make it worse. I can't say much for other drugs, because I don't use them. Coffee is probably okay, but if you get into hard stimulants like amphetamines, cocaine or MDMA, you're probably just going to replace one problem with another. This is also why I've never used anti-depressants. The idea behind "medicate yourself" is to get some dopamine flowing, not to make you dependent on drugs.
Given that depression usually centres around social problems, I do believe social distancing is to some degree necessary. It gives you a chance to solve those problems. However, there is a difference between distancing yourself and isolation. Being around people, even if you aren't interacting with them, creates a social normative influence. This takes some of the burden off you in maintaining healthy behaviours. Isolation, on the other hand, can quickly become an echo chamber for your ruminations.
Some simple tricks to avoid isolation are working outside or in cafes, staying in shared accommodation, leaving your door open, or even just leaving your curtains open so other people can see you.
Ruminations are negative stories which you either tell yourself or experience as a narrative. I think they contain important information about your depression, but they can easily get out of hand. For that reason, I think the best way to short-circuit ruminations is to write them down. Anywhere. This identifies an issue without letting it get out of control. When you are feeling better, you can review your ruminations. By sifting through hundreds of thoughts I had captured, I found I actually only ruminated on a handful of topics, albeit in different ways or different scenarios.
Once you have identified your ruminations, you are in a position to address them. For each one, you need to find a neutral mantra that you both believe, and effectively ends the rumination. This can be quite difficult. As a fairly benign example, let's say you ruminate a lot on capitalism. Here, a mantra like "you get what you negotiate" can be useful. It's neutral, believable, and shuts down the whole capitalism is unfair thread. Obviously, it doesn't fix capitalism, but your priority has to be fixing yourself. You can take on capitalism later.
I've deliberately chosen a benign example, because I understand how severe people's ruminations can be, and I don't want to trivialise that. How would you make peace with ruminations of sexual abuse in your childhood, or genocide at the hands of your own government? You might not have met people in these extreme situations, but you can certainly read about them.
For ruminations that present as narratives, it is often sufficient just to acknowledge that the chances of these stories becoming reality are, effectively, zero. The mantra here is "not going to happen". You can be sure of this because, as your ruminations typically involve you, you can prevent them occuring through your own actions. If the situation never arises, it can never happen.
When mantras don't work, and you feel like you can't escape your ruminations there is a risk you will resort to maladaptive strategies like self-harm, shutting off your brain, or making a suicide attempt. Before you do, at least try the cold shower trick. If it doesn't work, there is another...
The harder you fight thoughts of suicide, the stronger they become. One of the best tricks I discovered is to capitulate--albeit conditionally. "Okay, okay. I will commit suicide... later." Substitute "later" with whatever condition or time period you like. Even "in a minute" will work. When the minute is up, try for five minutes, then fifteen, then an hour.
One of the problems I faced with suicide was that it is so damn difficult. When you're depressed it's not so much about wanting to die as it is not wanting to live. The problem is life does not come with an off button, and suicide by any means involves pain, risk of failure, and logistical difficulties. I think if there is anything worse than committing suicide it would be surviving a suicide attempt. But to cut a long story short, postponing suicide indefinitely led me to an important realisation: there is no point in killing yourself when you are going to die anyway. Nature will eventually do the job one way or another.
The problem then shifts from how to kill yourself, which you have outsourced to nature, to how to live with as little suffering as possible until you die. I am not saying this is a simple problem, but I do think it is something you can chip away at.
Okay, if you're not going to kill yourself, you're going to have to do something else with your time. My experience is that doing something constructive is the best option, even if it is only cleaning, going shopping, or sorting photos. Spending your time making social comparisons on Instagram is probably not going to help. You'll have to experiment to see what works for you. I strongly suspect the universal criterium here is anything that decreases the entropy of the universe. Jigsaw puzzle?
After some time, your standard set of distractions can stop working for you. In this case, try doing something different. You might just need a break from your regular activities for a while.
Even if you are depressed you cannot deny the existence of beauty in the Universe. It could be an image, a taste, an experience, an ideal, or whatever. I mean, how good are strawberries? How about mangoes, yoghurt, surfing, or that chord in Mozart's fifth violin concerto... Whatever it is, you have to admit there are some things worth living for. They tend to be fleeting, so you have to savour them. You must learn to appreciate the moment, regardless of good or bad it is. There is always something to be grateful for; it is up to you to find it.
I am not trying to pretend that the Universe is all Mary Poppins. I don't think it is. But I don't think is inherently a bad place either. It just is. All you can do is accept the Universe the way it is and learn to navigate your way within it. A part of that involves learning about yourself and how to fulfill your basic needs.
You do not have a monopoly on suffering. Do you remember Malala, that school girl who got shot in the head point blank by the Taliban on her school bus? I mean, shit. People are suffering everywhere, all the time. Giving other people some of your headspace helps to put your problems in perspective and might also bring you some answers. There are lots of ways to do this, such as:
We're nearly there folks. If you want a shot at lasting peace you'll need to understand and focus on your needs. Humans have a pernicious habit of projecting their own needs onto others, as though their way is the only way. The late psychologist, Steven Reiss, author of Who am I? calls it everyday tyranny. The result is we don't understand each other, and this is why there is so much bad advice out there. It is essential that you figure out what your needs are and find ways to fulfill them. You cannot a adopt a set of needs that society, your parents, or your friends wish to impose on you. You cannot even adopt a set of needs you wish to impose on yourself. Your needs are something you were born with whether you like it or not.
Determining your needs is not necessarily difficult. According to the aforementioned book, there are only sixteen. All you need to do is put them in order. If we were all superheroes from a Hollywood action movie, our needs would be something like this.
I don't know about you, but this particular ordering doesn't even come close to describing me. However, it is not too difficult to reorder into something that does match your personality. From there you can't start making decisions that actually make sense to you, not to someone else.
You're going to relapse. Sorry about that. Life just has a habit of slapping us when we are least prepared. When that happens, just come back here, read through this blog again, and keep going.How To Survive Depression
Roger Keays is an artist, an engineer, and a student of life. He has no fixed address and has left footprints on 40-something different countries around the world. Roger is addicted to surfing. His other interests are music, psychology, languages, the proper use of semicolons, and finding good food.