Safety Check: Don’t Rule Out Antidepressants
If you’re reading this article because you, or someone you know is living with depression, and you’re against medication, please consider the following – as one of my favorite clinical psychologists once said, “You can’t help somebody when they’re dead.” If you or a loved one are having thoughts of suicide it is important to seek help immediately. Do not be so quick to dismiss the many benefits that antidepressants can have on keeping a person alive. What most of us are aiming at is to make things a little better. Also important to note here, if you’ve suffered through catastrophe, antidepressants might help lift you up enough to keep fighting, but they will not remove the things in your life that are contributing to your depression. This article outlines specifically the things that you can begin to do to reduce depressive symptoms if you are not suicidal, and you are not interested in taking medication.
Set Your Frame Properly to be Most Impactful
Sometimes, when a person is going through terrible times, they will not have the motivation to think of solutions, or the hope that solutions will even do anything to make things better. This is where “setting the right frame” really matters. Your future looks abysmal and you don’t have any idea of how to deal with it, and who would? Let’s take a page out of the AA literature to “live one day at a time.” Now, for some people this is too daunting, and so you’d need to shrink your time horizon even smaller, “live one hour at a time.” Concentrate on the moment. You need a plan. Make your plan something that is acceptable to you, something that you could do, that you would do. Let’s start with one or more of these 6 things that you could do.
6 Lifestyle Changes to Effectively Reduce Depressive Symptoms
1. Set the first goal: Create and follow a routine. The brain likes predictability. Humans are at ease when things go as they expect. Amidst the chaos of the world, there are things that you can control. If you could and if you would, write out your day. Write out the things that must happen – these are the things that if you don’t do them, things will be worse tomorrow than they were yesterday – and put it on your schedule when to do these things. Create the kind of schedule that you will be able to follow. Things will not get better by creating a schedule in which you will “let yourself down.” Be realistic. Start small.
2. Regulate your sleep. Remember that predictability claim? It’s true here as well. Your nervous system did not evolve to incorporate the cultural construct that is the weekend (or night shift work). Some of you have night shift jobs, and it may be one of the reasons that your brain is out of rhythm with the natural diurnal circadian cycle, leading to depressive symptoms. You should read Avoiding Shift Work Sleep Disorder (SWD) On the Night Shift: Tips for Better Sleep. Some of you may get terrible sleep because you don’t have a job anymore and there isn’t a reason to get up in the morning. Regardless of your employment status, set a time for lights out and a time to wake. For an in-depth look at how to efficiently regulate your wake and sleep systems check out Retraining Your Brain for Improved Sleep: Part 1 – Understanding the Wake-Sleep System.
3. Get regular exercise. Hopefully that routine you are creating will have a block of time dedicated to cardiovascular exercise. A recent study done by the Harvard T.H. Chan School of Public Health found that running for 15 minutes a day or walking for an hour reduces the risk of major depression by 26%. Many people know that exercise is good for them. Knowing something and actually doing it are two different things. If you’ve tried medication and haven’t seen a change (treatment resistant depression), you may want to strongly consider the benefits to your brain and body of getting regular exercise.
4. Feed your body differently. “There is overwhelming evidence supporting the benefits of a healthy diet and lifestyle for, oh, just about everything: preventing cardiovascular disease, cancer, dementia, and mental health disorders, including depression,” says Monique Tello, MD, MPH, a contributing editor for the Harvard Health Blog. While there is no proven diet to specifically relieve depression, per se, there are some lifestyle medicine best practices to reduce depressive symptoms.
5. Take on responsibilities. There is a “sweet spot” that one must find, because taking on too much responsibility can lead to burnout, defeat, and a sense of hopelessness. Having too little responsibility can lead to a lack of structure (which can hinder a healthy sleep cycle), a lack of direction in pursuing meaningful goals, and potentially foster a nihilistic attitude towards life. When you adopt the “optimal level of responsibility”, you are creating enough room to properly care for yourself, and enough room to act towards making things better in a meaningful way.
6. Ask yourself, “What is a thought?” Neuroscientist, best-selling author and creator of the Waking Up Course, Sam Harris breaks it down, “Almost everything you experience is the product of thinking. You may feel that you are the thinker, using thoughts. But the self is a construct of thought. The feeling of ‘self’ is what it feels like to be thinking in each moment, without recognizing the arising of the next thought. Getting rid of thought is not an option. If you are suffering, you are lost in thought. Once you understand how to meditate, then you have a choice. When you are suffering, just notice the present thought. Where is it? What is it? What happens to it when you pay attention? And how is it that your suffering can continue in the next moment, when the present thought has disappeared?”
Of course there are more habits you could form to make things better as well. The scope of this article is to first focus on any one of the aforementioned 6 action items.
What Else Could I Do to Make Things a Little Better? 6 More Strategies to Consider
- Try to engage in something new that you think would be fun.
- Check with your doctor about potential deficiencies in your diet that supplements could help balance out.
- Spend more time in nature, away from pollution.
- Look at your social support network. Where are there people in the world who have your back, who care about you? Reach out to them and connect.
- Visit a place where you can pet friendly animals – again, nature heals.
- Reduce nicotine, caffeine, and alcohol consumption.
Disclaimer: This article is for general information purposes only and does not constitute the practice of medicine, psychotherapy, or other professional healthcare services, including the giving of medical advice. Note: No therapist patient relationship is formed. The use of this information is at the reader’s own risk. The content of this article is not intended to be a substitute for professional medical advice, diagnoses, or treatment. Readers should not disregard or delay in obtaining medical advice for any medical condition they have and should seek the assistance of their healthcare professionals for any such conditions.
Robin S. Smith, MS, LCMFT is a Licensed Marriage and Family Therapist in clinical practice in Bethesda MD, and specializes in relationship issues for couples, families, and individuals, for improved quality of life. His clinical specialties include: transition to parenthood for new and expecting parents, infidelity, sex and intimacy issues, premarital counseling, and trauma. Robin has given talks to various groups including hospital administrators, graduate students, therapists, and child birth educators. He is the primary contributor to The Couple and Family Clinic Blog.