NOTE: I am not a therapist, but I have experience with therapy. I have edited this post numerous times. If possible I will continue to do so, because my journey on solving depression, what is important and what works, constantly changes. I try to keep a comprehensive list of possible undertakings here in this post. These are subject to changes in wording and emphasis over time. This is by no means a protocol to cure our symptoms, but may help you improve your quality of life regardless.
I wanted to share a message of positivity. I see a lot of people here hopeless and without perspective.
Our conditions vary greatly but they are all terrible, daunting and destructive to our lives in their own way. Are we going to allow it to reduce our quality of life any further than that? No.
I recently saw a post saying there is no way to escape from depression. Not true.
I came out of a very deep depression a while ago. Still working on the rough edges as always, though. I suffered from suicidal ideation for a long time. I self-harmed in more ways than one and I’ve had my experiences staring down mesmerized into the metaphorical abyss. I’m not saying this trying to sound cool or badass because there is absolutely no glory in depression, just saying I’ve been there. But not anymore, because I got external help and I made changes in my life.
Having to deal with PFS on top of depression is horrid but I am glad I’ve had some cracks of the whip before this pharmaceutical curveball got handed to me. I will share some tips for those who are in need.
Take from this what you will. There is no golden formula. Do what works for you. Just don’t try to do it all at once. It’s impossible. Beating ourselves up over things is part of depression. It is a form of self-harm. Most importantly: Don’t expect to cure yourself from depression in a week or two. It can take months, sometimes years, for your mind to re-learn the good things and unlearn the bad things. Progress over perfection (credit goes to user MerckdHeart for this nice little phrase). So go easy on yourself and take it real slow, because that’s okay. The past is in the past, and the future does not have to be perfect. You’ll get there.
Below are various topics I would like to discuss regarding depression and ways to get back in control.
A) Therapy
Therapy will do wonders for you. It sure did for me. It may not solve PFS but it will help you solve most of the other mental crap you’re dealing with.
Don’t wait for therapy to come to you, because waiting lists and intake times and diagnosis periods can be long. There is always somebody with bigger problems than you, or whatever, but you are deserving of help with your problems.
Personally, I engaged in CBT (cognitive behavioral therapy) and IPT (interpersonal therapy). Both helped me a lot.
Cognitive behavioral therapy (CBT) specifically may help you rationalize your thoughts when you are in a state of panic or in a negative thoughts spiral. Often your thoughts are pitch black, but when analyzed you will realize that you often draw too big conclusions too soon.
Having a professional person outside of your circle of friends or family may also be a good conversation partner to talk about your problems (IPT). He/She may ask good critical questions that others would not dare ask and seperate the real problems from the drama. It can be very therapeutic by itself just being able to talk to such an outsider person even if it’s just once per month. It will steer you to analyze and confront your problems in a controlled, healthy and rational manner.
B) Find your little things. Grant yourself your little things
When depressed, try doing little things for yourself that you enjoy. Depression will make you uncaring, it will make you blind to the fact that you are not doing the little things for yourself anymore, it will sometimes make you unable to even come up with anything. Trust me, allow yourself a little good thing once in a while. It can be as simple as taking a moment to really take in the smell of a hot meal, or adding some nice extra herbs to it. Or lighting a candle in the evening. Smell a flower. Or buying a nice snack ahead of time or that stupid thing you saw in a shop that you maybe liked but did not want to admit to yourself. Don’t deny yourself some of these things because somebody else said it was silly or corny. They matter. Of course the little things aren’t going to cure your entire depression right away, but they are contributions to your comfort and mood on an easily approachable and realistic level. If you don’t know where to start just try something new, some new food or some crazy thing.
Please stay away from drugs or alcohol. They are likely to trigger depressive episodes. I had one or two glasses of wine while playing a video game last week to make things cozy for myself but I plummeted back into a negative thoughts spiral soon after. Not a coincidence if you ask me.
C) Do enjoyable things that require your focus or attention
Seek out things that require your focus and attention, so that you cannot obsess over problems that you cannot control. This way you comfortably force yourself to live inside the moment and not think about the past or future. Things like cooking a meal, playing a videogame, reading a book, watching a movie, will all give your mind something to bite into and help reduce your depressed state. Or if you want to push it even further pick up a music instrument, or singing classes, or acting. I took up singing classes myself, I can’t sing for shit but it certainly helps me overcome my stupid perfectionism and insecurities. It’s confrontational but funny too.
Ideally try out something that pushes you outside of your comfort zone. Nothing demands focus or attention like learning something new, or being immersed in a different world. Old dogs can still learn new tricks. Just don’t push yourself too hard or beat yourself up over failing. Sucking at something is the first step at getting good at something. Taking the first step is only hard in your mind. Don’t think too far ahead. One foot forward, then the next.
D) Get in touch with friends/family/others
It’s okay to take your distance and some alone time is important too, but don’t go too far in this. You may feel ashamed about some things or have trouble forgetting about them but it is better to keep in touch with friends and family. You may fear that you drag others down but this is not necessarily true. They can help you focus attention on other things away from your problems. Allow their positivity to reach you.
Don’t be too hard on yourself or others. They cannot fix your problems, but they do care about you, even if they don’t always say it out loud.
Don’t just let them come to you, seek them out too. Tell them what you like about them or what they’re doing. Being nice to others will make you feel nice too. Positivity is infectious, just like negativity can be. So allow positivity to infect others so they may infect you back. If that makes sense.
Avoid bitter, mean and negative people, especially abusive people, even if they are relatives or people you consider close ones. Maybe they don’t have the worst of intentions, but you need to make a decision about what gets to you in a bad way and protect yourself despite whatever justification they may or may not have, or whatever reason you have that makes you forgive them time and time again. It can be a tough pill to swallow to break off a connection to someone you see often, but if they truly get to you in a bad way, it will be worth it for your own sake. I personally had to break off contact with my father because he is an abusive person and it was not easy to do.
E) Treat your body right
Start caring about your body again, despite whatever shortcomings you consider your own body to have. One way or another it is the source and conveyor of all your happiness. Damaged or not, treat it like a sacred temple.
Brush your teeth. Take showers.
Despite losing your appetite, eat enough meals per day (at least 2), and try to eat varied. There’s a lot of mystery what constitutes a good and healthy diet, especially in PFS context. Eat your veggies, eat your protein, eat your complex carbs, avoid any high-sugar intakes as much as you can.
I don’t believe in all that bullshit dogma around paleo and keto diets. Carbs aren’t bad for you. Quit high-sugary drinks and snacks and you’re already on a good track if you ask me. Just make sure you get all the necessary nutrients and quantities and you should be good from a general health perspective.
Stop drinking. Stop smoking. Stop using recreational drugs. If you really can’t do it, admit it to yourself and go into rehab if that’s what it takes. Even relatively innocent stuff like weed can make you feel paranoid and worsen your depressive state. Go clean.
F) Treat your environment right.
For me when I’m feeling terrible, I tend to lose the motivation to take care of my house and clean things. Being aware of this is the first step. If it goes on for a long time your place will become a dump. This is generally not good for your mental health (or your physical health). If the dump has become too big for you to clean yourself, try to find external help from friends or family or someone to help you get your environment back to a state where you are in control again.
This can be very confrontational. I wasn’t able to hold back my tears because of the shame I felt when my coach came by and went outside of her contract to help me clean my place up. But after the hard part was over I am learning to take care of my house again, which is just another part of caring for myself. It is important that your environment is comfortable, so make it happen that your environment becomes comfortable.
G) Physical activity
I know that some people on this forum are against the idea of exercise because they experienced worsening of their symptoms, do what works for you obviously and don’t hurt yourself.
In my experience physical activity is helpful, at least mentally. I used to think this was some urban myth or a marketing tactic of fitness companies, but it does wonders for your mood. The prospect of sport or exercising is daunting and intimidating to many people especially when you’re demotivated and depressed or have some physical disability. But it is easier to pick up than you allow yourself to think. You don’t need any equipment either. Just start doing something easy, like lunges, squats, belly crunches, maybe running outside. Pushups usually come up as a classical first idea but they can be a pretty tough one to start out with, depending on the state of your body. Anyway, I promise you: You will feel better after an exercise, no matter how small. And it really doesn’t have to be a full-steam-ahead bodybuilding regimen, don’t even think about that stuff if you start from scratch.
H) Don’t obsess over your problems too much
You should consider visiting this website only one or two times per week. Obsessing over your condition will not make it go away. There is advice but also much panic and helplessness to be found here. This creates a one-sided perspective and can be infectious or send you on an obsessive runaway thought-train. It is sometimes best to take a break and focus on other important things.
You can influence more things than you are capable of seeing and take control in more ways than you know. The past is in the past. Always remember to grant yourself the little things. Just be aware that re-learning good habits can only be done one small step at a time and it takes time. Allow yourself that time. So take it nice and easy.
Good luck.