Strategies For Managing Depression and Anxiety
- Making Progress in Recovery
Recovery of any kind takes work on our part. No one can wave a magic wand and you are fully recovered. It all boils down to using the tools you've been given to live a quality life.
Willingness, attitude, and responsibility
One of the greatest lessons that I've learned as one who has struggled with anxiety and depression is being a part of my own recovery. After many difficult times, I realized and decided that if I do my part in my recovery journey, then my life will be of much higher quality. The tools and suggestions we are given by mental health professionals, and family and friends (sometimes) will do absolutely no good if we are not willing to try them. Some will not work right away and it is necessary to keep trying them. It's all in the attitude. If one wants to move forward, one needs to take responsibility to do what one can to find recovery - a better quality of life.
I start with this because if you are a person who finds strength and comfort from God, it's a good way to start the day. I must say that when I neglect this time with God, my perspective and attitude become skewed.
For myself, connecting with God is of great comfort, strength, and encouragement. It gives me a better perspective, keeps my awareness of God's love fresh, and sustains me sometimes in difficult moments.
Having said this, there are times when I have no sense of God's presence, and concentration in prayer and devotional reading is challenging, sometimes nearly impossible. I like to read the Bible, so when it's hard to absorb a passage, I find one verse and meditate on that. When I say meditate, I don't mean emptying myself, I mean filling up with God. Sometimes I go to the library and try to find a CD or tape of someone reading the Bible. It can be so soothing.
I realize not everyone has the same beliefs as I do, and that some have no desire or interest in spiritual matters, so of course you do what you want. But I cannot say enough of the help I have received by reaching out to God.
Setting small daily goals during acute stages
Severe, clinical depression can be incapacitating. You feel very guilty that you are not active and doing your part to take care of basic things in your life, such as grooming, housework, paying bills, etc. One thing a person can do to alleviate some of this guilt is to set a goal for yourself every day. This may sound dumb, or overwhelming and unrealistic, but it is very helpful if you try.
A goal, when you can hardly get out of bed, might be brushing your teeth. Or, you may want to set a goal to comb your hair or put some clothes on. Anything small and basic. Don't make a goal in the beginning of paying your bills, or cleaning the house, or going to baseball practice with your kids if you can't get out of bed. Keep it simple, and keep it small.
If you set a basic goal like this, and you are successful in carrying it out, it will give you a sense of accomplishment and some relief from your guilt and self-loathing. It will encourage you to try another goal the next day, or as soon as possible. You may even feel a litte bit of energy.
As time goes by you may want to make 2 or 3 goals a day, and again, make it very simple and doable. Maybe it could be to make a phone call, or get out of bed for 15 minutes and sit in a chair and look at magazine pictures. Reading can be difficult during depression, which can cause an inability to concentrate. Another goal could be to take a nice shower or bath, or to light a scented candle, which can have a pleasant and soothing effect. Setting and accomplishing goals will not take your depression away on the spot, or even in a few days; however, they may give you a small sense of accomplishment, a few minutes of pleasure, and make you feel good about yourself. It will give you in a small way a sense of productivity.
With mental health treatment of medication and therapy, you will most likely start feeling better sometime soon and your goals can be a little more higher. Taking a short walk, doing a load of laundry or washing the breakfast dishes. Perhaps you can pay one bill. Still, it is best to keep it to just 1-3 goals.
Exercise promotes mood and body health
The importance of exercise is not news to most people. It is something that you will hear from most of your mental health care providers. It seems unimaginable to think of exercising when very depressed; however, it's good advice because it does make you feel a lot better.
By exercise, I do not necessarily mean going to the gym and doing an hour long work out. You don't have to walk three miles, or swim 8 laps. Start small. A walk to the end of your street. Gradually work up to around the block, and slowly increase as you feel better. A dip in the pool and swim across the pool or one of two laps.
Exercise, as many of you know, stimulates your endorphins, a hormone that gives us a sense of well being, or energy. Exercise can seem overwhelming in the beginning. At one point I agreed to exercise two days a week. I got a membership to the YMCA and did the treadmill or bicycle for ten minutes. Once in a while, I did a few minutes of weight training. I felt like a million dollars for a few hours after even just a short time of exercising.
Outdoor walking is nearly a perfect exercise and it doesn't cost anything. An additional treat to outdoor exercise is the invigorating pleasure of fresh air and a change of scenery. Taking your dog on these walks can double your pleasure when you see your dog enjoying the great outdoors and exercise as well.
Learn to eat healthier
How does junk food make you feel?
You may wonder what difference a good diet can make. Many who are suffering from depression crave and turn to junk food because there is little preparation involved, and they are rich in salt and sugar which we crave. I would pose the question: How does the take-out pizza and Doritos and soda make you feel? How does it make you feel when you are sedentary and eat that stuff? You may not realize how bad you feel until you start to eat healthy and feel that energy and clear thinking improve. Eating junk food will expand your waistline and other body areas. Clothes get tighter and it only doubles a poor self image. Cooking can seem daunting. Keep it simple and ask a spouse or someone else living with you to do it with you. It's always more enjoyable to do things with another person.
Some people who suffer from depression or anxiety have little or no appetite. This is a challenge. I suggest healthy snacks and small meals. Following is list of a few of the snacks I eat.
- Rice cakes with hummus spread
- Dry roasted, low or no salt nuts. Dry roasted is less fat.
- String cheese. They now come in cheddar, colby, and pepper jack as well as mozzarella.
- Kale chips. This is the new thing. They are easy to make and highly nutritious.
- Fresh fruit or veggies
- Air popped popcorn
That old sweet tooth
The craving for sweets can get us into trouble. I have found a few that are healthier than ice cream, cake, candy, and pie.
- Dark Chocolate bar with cacao. I get the Ghiradelli or Cadbury brand. They are not that costly if you don't eat them in one sitting. They are so healthy and rich. I keep one or two in my fridge and break off a square when I get a craving for sweets.
- Yogurt. I like ice cream but it's not the best thing to eat when I'm depressed because we all know the whole carton gets eaten in those times. I discovered putting yoplait or the greek yogurts in the freezer is tastes close enough to ice cream. I don't eat as much either.
- Frozen berries. I am not a fruit eater except for bananas and berries. I buy the big bag of mixed berries at Costco. You can do so many things with them. I put them in my cereal, oatmeal or in a bowl with a dab of yogurt, or whip cream. You can get real creative and the antioxidants are phenomenally healthy.
The important thing about diet is to be sensible. You don't have to be a rocket scientist to know fresh or frozen fruits and vegetables, whole grains, fish and chicken, nuts and seeds,, whole foods in general (as opposed to processed) should be part of a healthy well balanced diet. Stay away from fatty, fried, and highly salty foods. There is the old adage that says you are what you eat. I don't know about that, but you will feel what you eat. If you are so used to processed foods and feel going straight to whole foods is too drastic all at once, just add it in little by little.
Hydration, hydration, hydration
The medical community and health researchers say most people walk around dehydrated and it really affects how you feel and the quality of your health. We really need to be drinking throughout the day. The use of psychotropic medications can create a terrible problem with dry mouth. It is very annoying being thirst all day long, and I found out from my dentist it causes tooth decay and gum disease, as evidenced by recent x-rays. I drink water all day long. There are people who hate water. That's okay, just drink something, as long as you can do it without a lot of sugars, caffeine, and especially artificial sweeteners.
Of course if you have anxiety problems, caffeinated coffee is not wise. It has been long said that coffee is a diuretic and is counter productive to hydration. Some studies are now saying not so. Moderation of course is called for.
Vitamins and supplements
There are all kinds of nutritional supplements. But the one thing psychiatrists are really pushing today is fish oil. There is no flavor or odor, and studies are showing that fish oil is very, very good for the health of your brain. It helps with memory and cognitive abilities, among other things.
Multivitamins and B vitamins are also very important. There are also many herbal concoctions out there for depression, but can be very harmful if you mixi them with antidepressants, or any other psychotropic drugs. One or the other, whichever is most effective. It's best to talk to your doctor and/or pharmacist.
Quality sleep is crucial
This is a really hard one because it is the most difficult to control. People with depression either sleep too much, or they can't sleep at all, or minimally. Quality sleep is as important than quantity of sleep. Sleep is restorative to the body and the mind.
If we are not sleeping, it compounds the symptoms of our depression. Think about a time in your life when you were mentally and emotionally healthy, but for some reason you were sorely lacking in sleep. How did you feel? Most likely, it was harder to cope with everyday stressors and activities. Your mood goes down and you get irritable. Add depression or bipolar to that and it can send you into a downward spiral.
For people with Bipolar, lack of sleep can send you into an intense, rapid mood swing. Often times a symptom of mania or hypomania is the inablitly to sleep, and you feel no need to sleep. But eventually this wears off and you slide rapidly into depression. It gets to be a vicious cycle that can be hard to break. Your doctor may be able to work with you on some medical, herbal, or other nutrional supplement to help with sleep. Sleep hygeine is very important.
- Going to bed and getting up at the same time every day.
- If you can't sleep, get out of bed and do something relaxing. Laying in bed makes you miserable and anxious and your brain gets trained not to sleep when you are in bed.
- Don't eat just before bed. A full stomach can cause discomfort if you have acid reflux and may intensify your wakefulness. Sometimes, it can cause nightmares. There is a certain pizza I eat that never fails to give me nightmares.
- Make a pre-sleep routine. Read a book, do relaxation techniques, brush teeth, go to the bathroom, brush your hair.
- Keep your room real dark.
- If you sleep better with fresh air, make the effort to open your window.
Again, exercise and a healthier diet may help tremendously to encourage sleep. A word to those suffering from PTSD nightmares: There is a medication that helps prevent these nightmares. The medication is called Minipress, or Prasosin. It is very effective. Suffering nightmares on a regular basis can make you fearful of sleep and will interfere with your sense of feeling rested.
For those who can't stop sleeping, sleep hygeine is just as important for you, but honestly, it can be very difficult. This is where all the above suggestions come in. A goal to get out of bed for a certain amount of time, fresh air, and even the mildest of exercise. Work with your doctor for possible solutions. For more tips on getting to sleep, see the the Youtube presentation at the end of this hub.
Anxiety is a huge issue for Americans today. A therapist shared with our anxiety class about making a self-soothing first aid kit. Here is what it entails: Find a box or basket and put some soothing things in it for every sense. Here is what I chose to put in my first aid kit:
- For touch - I put in some smooth polished stones, and a powder puff. You can use anything you want. A blanket, stuffed animal, the sky is the limit. Sometimes I just pet my dog. It doesn't have to go in the basket.
- Taste- a favorite snack or herbal tea. Often it was sleepy time or chamomile tea.
- Hearing - I used an instrumental CD of hymns or nature sounds.
- Sight - I had a photo album of my grandchildren. Also, a small book on roses, my favorite flower, and looked at all the different varieties, allowing myself to dream which ones I want to plant next.
- Smell, a scented candle
Use your imagination for these. It's fun.
As I said, using these when you are in full crisis won't be nearly as effective. The idea is to get into a routine of keeping your body and mind relaxed enough to ward off escalating, crisis-mode anxiety symptoms. I had the following routine at one time:
- A.M. Rise at 8:30, no matter what, OJ, light breakfast, meds, and coffee.
- Read bible or inspirational material followed by prayer.
- Relaxation, breathing excercises.
- A one or two household chores, depending on how well I was doing.
- Played a stretching DVD and did a 15 minute routine. If I felt pretty good, I would do one of the longer routines. If I couldn't get through the whole segment, I gave myself credit for doing what I could.
- A brief walk, building up over the weeks and months to lengthier walks.
- Another small household chore, or make some phone calls to check in with close friends.
- Free time in afternoon, again, use your imagination and make sure whatever you do it is healthy and soothing or pleasurable.
- Reading, or doing the other sight tools from my first aid kit.
- While doing so, I lit a scented candle
- A half hour prior to bedtime, I made my tea, put on the music, and said my evening prayers and went over my day. I allowed myself to be fully in the moment (mindfulness) and didn't allow myself to worry about tomorrow.
- Breathing, relaxation tecniques
- I would brush my teeth and take my meds and be in bed by 9:30 without fail.
I found this routine of relaxation very helpful.
Give it the old college try
Much of what I've written here is nothing new to those who have sought medical or counseling help for their mental health issues. But these things bear repeating. I've tried to give some creative ideas, and share the ones that have helped me. I hope these things are helpful to you. As I have finally implemented these things into my life, I have a better quality of life than I ever dreamed. Give them a try before balking. Be willing, be encouraged, be hopeful, and be grateful for whatever progess you make. Best wishes.
© 2011 Lori Colbo