I have based the following information on my clinical experience and the parts of therapy that have helped my clients the most. The information should be considered as guidelines only and not taken as medical advice.
Practical Guidelines for those facing depression
One of the most important things in dealing with depression is to not think too much. The worst thing to do when you feel 'really down' is to think about why you feel so down. This will no doubt lead you into a worse emotional state. It is far better to use some of the techniques outlined below.
Quick tricks to try if you feel really down
Get moving
If you can do something, anything, it can help to change how you feel. If you can move your body you will feel better. Doing something with your body gets the 'feel good' physiology into action, so even a short walk can help.
Set yourself a small task
This can be anything, ideally something you usually don't mind doing - taking the dog for a walk, sorting out a drawer or cleaning something - something to get you focused outwards. It is essentially a distraction technique, and completing the task will make you feel good.
Call someone
If you have a person you feel you can talk to, call them and have a chat, and not necessarily about feeling down. Just a brief chat about anything can distract you from your own thoughts.
Have a shower
There are different reasons why this works, but if you can take a shower and change your clothes this may help.
Play uplifting music
Listen to the music you would choose if you felt really good. This will feel uncomfortable psychologically as there will be a mismatch between your mood and the music, but if you can leave it playing your brain physiology and mood will lift to match the music.
Watch a comedy video
This is in line with the way music changes your emotional state, although it can be more powerful as you have the visual imagery as well as the sound.
Take a nap
Having a quick sleep (between 20 and 40 minutes) can be a good way to change your mood state.
Learn which 'trick' works best for you and try and remember to do this in those moments you feel down. Make sure you have your favorite uplifting CD or DVD readily available..
Other considerations
Avoid alcohol and illegal drugs
It may be tempting to try and 'dull the pain', but unfortunately this will only make you feel worse.
Medication?
There is mixed research regarding the effectiveness of anti-depressant medication. From my clinical experience, I believe a short course of anti-depressants may help if you are so depressed your life is at risk. This should be discussed with your Doctor. I believe everything else should be examined first and all other avenues exhausted prior to medication being prescribed. It is not recommended that children and teenagers are given anti-depressant medication.
Your diet needs to be examined first to make sure your mood is not being affected by something else, such as a lack of Vitamin B, Zinc or Essential Fatty Acids (Omega 3 etc), before a chemical is added.
Remember: Things will always change
When researchers talk to people who have made suicide attempts, there is a consistent finding: people explain they did not want themselves as a person 'to die'. They were usually glad their attempts were unsuccessful and that all they really wanted was the life they were living and the way they felt to change. This is very different from not wanting to live. So it needs to be remembered that ALL emotional states and situations change.
Acceptance: All emotions pass
Even as you have not always felt the way you do today, you will feel differently again later. It is important to remind yourself that your emotional state will pass. It may also help to notice that you are experiencing the emotion, rather than that you are the emotion.
Acceptance: All situations change
If you are reading this it is likely that you have gone through some major life changes recently; this may involve relationship, employment, or family changes or perhaps all these things. It is important to remember that as things may have changed 'for the worse', they can change just as quickly 'for the better'. Take one day at a time and allow yourself to be open to the possibility that you could be in a totally different situation in months, weeks and even days ahead.
It's okay to feel sad
Remind yourself its okay to feel sad for a short time. If something sad has happened, it's okay to feel this. Let yourself cry if that is the emotion that is building inside you. If you find yourself crying for hours check your thoughts. If you identify a repeating negative or self-blaming thought, please challenge this and use some of the strategies written here to change this.
Check your Biological State
Always check your biological state first, if you start thinking you feel 'down'. A very common error I see is that people have something affecting them physically and they will quickly assume they are depressed/ sad etc. Examples of this can include tiredness, physical pain or illness, hormonal factors, alcohol withdrawal, vitamin B deficiency, dehydration or hunger.
The truth is the physical aspect needs to be treated first. You need to do a quick 'body-check' if you feel 'down' and ask yourself if you are tired, hungry, etc. If you are, then get some sleep, take a multivitamin if you are hormonal, pain relief if you are in pain etc. If you have had alcohol, even one or two drinks, you will feel slightly 'flat' for the next day or two. This is one reason why people are not recommended to drink alcohol every day.
If you need to 'keep going' although you may be tired or unwell, for example you have work commitments, be aware of your physical state. The key here is to look after yourself during these times while acknowledging you are not likely to feel your best emotionally. Rather than thinking about how you feel emotionally at these times, listen to uplifting music, watch a comedy DVD etc. Do this until the physical is addressed.
There are other things which have also been linked to anxiety and depression, mainly Aspartame (artificial sweetener) which you will find in most 'diet' or sugar-free foods and drinks. Always check the label and avoid this chemical.
Emergency Safety Tips:
If you need something as an emergency safety trick for yourself, there are a couple of other things which I see help clients 'stay':
1. Give yourself a time-line: make a deal with yourself that you will stay around until a certain date, e.g. three months, even one week and then you will review how you feel. Continue extending these dates and it can keep you here long enough for things to change.
2. Convince yourself to sleep instead, this will give you time off from being 'conscious' without it being permanent.
3. Remember it is normal for the brain to try and search out 'solutions' to problems, which in this case is feeling really down. The brain is like a computer and will run different possibilities to try and find an answer. So just recognizing "well I could do that, but I'm choosing not to" can actually take the pressure off you mentally and help you feel better.
4. Protect yourself by making sure you have nothing around you that you could hurt yourself with, e.g. medications. Give these to a trusted person to administer to you as and when required. Or if you are putting yourself at risk driving, you may have to not drive for a few days etc.
If you try everything written here and continue to feel very unhappy and unsafe you may need to call an Emergency Services Helpline.
Contact information is listed on my website: http://www.newpsychology.com.au
Charity C- L Parrish is a Clinical Psychologist registered with the Psychological Board of Australia (PBA). She has been practicing as a psychologist since 2005 and has worked in many different areas including conducting assessments for the Family and Youth Court and clinical therapy work.
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