Recovering from Depression

Making a depression recovery plan

Recovering from depression requires action. But taking action when you’re depressed is hard. In fact, just thinking about the things you should do to feel better can be exhausting: Exercise… Eat right... Sleep right... Get out into the world… Be more social... Stop thinking negatively... Do things that you enjoy…

You probably already know that these things will help you overcome depression. But that doesn’t make them any easier. After all, when it’s tough to get out of bed in the morning, taking on anything more than the bare minimum for daily survival is overwhelming. This is the Catch-22 of depression recovery. The symptoms of depression (such as fatigue, hopelessness, clouded thinking, and self-loathing) make it difficult to take the necessary steps to wellness. There is a difference, however, between difficult and impossible.

If you understand what it takes to cope with and overcome depression, neither underestimating the illness nor your own capacity to heal, you can make a workable plan for recovery. A realistic recovery plan involves taking responsibility for the choices and changes you do have control over, while avoiding self-blame and guilt over the mistakes you’ve made or the things you can’t control.

Taking baby steps

The key to depression recovery is to draw upon whatever energy and resources you do have. Start with small goals. You may not have much energy, but you probably have enough to take a short walk around the block or pick up the phone to call a loved one.

If you’re severely depressed, focus on adding more activity into your life. You don’t need to start training for a marathon to get a benefit. Activities can be as small as going out into the sunshine for ten minutes when you’d rather stay inside on the couch, taking a shower and getting dressed, or grabbing coffee with a friend.

Take your recovery day by day, be patient, and reward yourself for each accomplishment. Baby steps are fine. Put enough of them together and you’ll find yourself well on the way to getting out from under depression’s shadow.

Developing a “wellness toolbox”

The idea of a wellness toolbox can be helpful as you plan for recovery. For your wellness toolbox, come up with a list of things that you can do, or have done in the past, to relieve your depression. Include any strategies, activities, or skills you can use for a mood boost. The more “tools” for coping with depression, the better. Try and implement a few of these ideas each day, even when you’re feeling good.

Doing things you enjoy (or used to)

While you can’t force yourself to have fun or experience pleasure, you can choose to do things that you used to enjoy. Pick up a former hobby or a sport you used to like. Express yourself creatively through music, art, or writing. Go out to dinner or a movie with friends. Take a day trip to a museum, the mountains, or the ballpark.

Push yourself to do things, even when you don’t feel like it. You might be surprised at how much better you feel once you’re out in the world. Even if your depression doesn’t lift immediately, you’ll gradually feel less sluggish and blue as you make time for fun activities. 

Depression Self-Help Tip #1: Changing negative thinking

Depression puts a negative spin on everything, including the way you see yourself, the situations you encounter, and your expectations for the future. But while depression causes negative thinking, negative thinking also triggers and fuels depression, causing a vicious cycle that’s tough to escape. Making it even tougher is the fact that our negative thoughts can be so automatic that we’re not even aware of them or that we can choose to control them.   

The pessimistic thinking of depression is based on cognitive distortions that transform neutral, impersonal, or even positive events or situations into negative ones.

Top Ten Cognitive Distortions that Lead to Depression
All-or-nothing thinking	There’s no middle ground. You’re either a hero or a loser. The situation is either ideal or a disaster. If you make any mistakes at all, you look at yourself as a failure.
Overgeneralization	Generalizing from a single negative experience, expecting it to happen over and over again in all situations. If you got turned down for one job, no company will ever hire you.
The mental filter	Dwelling on the negatives while filtering out all the positives. For example, you got an A on a term paper, but all you can think about is the one small criticism your professor made.
Diminishing the positive	Coming up with reasons why positive events don’t count. If you were praised at work for a great presentation, you tell yourself that you just got lucky or it was an easy job that anyone could have aced.
Jumping to conclusions	Despite any proof to back it up, you go straight to a negative interpretation of events. You act as either a mind reader (assuming that someone is reacting negatively to you) or a fortune teller (you “know” that things will turn out badly).
Magnification or minimization	Also known as the binocular trick. You either magnify problems, blowing them way out of proportion, or you minimize your own achievements and positive qualities until they seem insignificant.
Emotional reasoning	You buy into the idea that the way you feel reflects reality. If you feel like you’re worthless, that means it’s true.
'Should' and 'must' statements	You constantly beat yourself over the head with the things you should or shouldn’t do. This rigid to-do list of “shoulds” and “musts” leads to guilt, shame, and stress.
Labeling and mislabeling	You label yourself according to what you do or don’t do. If you make a mistake, you slap on a negative label (failure, idiot, loser). These labels stick, long after the negative event is forgotten.
Personalization	You assume guilt and responsibility for things that are outside your control. Whenever something goes wrong, you blame yourself.

If you’re depressed, cognitive distortions are probably part of your lifelong pattern of thinking. But you can’t break this bad habit by “just thinking positive.” Happy thoughts or wishful thinking won’t cut it. Rather, the trick is to replace negative thinking with realistic thinking. You can do this by identifying the cognitive distortions you tend to use, and systematically challenging them with the facts. This is a key component of cognitive behavior therapy, one of the most successful treatments for depression.

Ways to change negative thinking for the better:

• Think outside yourself. Ask yourself if you’d say what you’re thinking about yourself to someone else. If not, stop being so hard on yourself. Think about less harsh statements that offer more realistic descriptions.
• Keep a “negative thought log”. Whenever you experience a negative thought, jot down the thought and what triggered it in a notebook. Review your log when you’re in a good mood. Consider if the negativity was truly warranted. For a second opinion, you can also ask a friend or therapist to go over your log with you.
• Replace negatives with positives. Review your negative thought log. Then, for each negative thought, write down something positive. For instance, “My boss hates me. She gave me this difficult report to complete” could be replaced with, “My boss must have a lot of faith in me to give me so much responsibility.”
• Socialize with positive people. Notice how people who always look on the bright side deal with challenges, even minor ones, like not being able to find a parking space. Then consider how you would react in the same situation. Even if you have to pretend, try to adopt their optimism and persistence in the face of difficulty.

Depression Self-Help Tip #2: Cultivating supportive relationships

As human beings, we have a biological need to feel connected to others. Depressed human beings need the support of other people even more. On your own, it’s difficult to maintain perspective and sustain the effort required to succeed in treatment. But when you’re depressed, retreating into your shell is more appealing than socializing. The problem is that social isolation fuels depression and makes it even worse. When they’re alone, depressed people tend to revert to negative, unrealistic thinking, which only exacerbates feelings of worthlessness, shame, and alienation.

Maintaining relationships and incorporating social activities into your life is therefore one of the most important coping strategy for depression.

To get the social connection and support you need:

• Turn to trusted friends and family members. In your depressed state, you’ve probably retreated from your most treasured relationships. However, it is these relationships that can get you through this tough time. Communicate your needs to the people you love and trust. Ask for help when you need it.
• Join a support group. Find a group you can of other people working toward depression recovery. Being with others in the same boat can go a long way in reducing your sense of aloneness. You can also encourage each other, give and receive advice on how to cope, and share your experiences.
• See a therapist. Therapy can help keep you on track with depression recovery. A supportive, thoughtful therapist can help you work through issues the depression has caused, change negative ways of thinking, and explore the root of your depression.

Depression Self-Help Tip #3: Healthy lifestyle habits

There is an undeniable link between physical and mental health. Depression can cause physical symptoms such as aches and pains, frequent illness, weight loss or gain, and insomnia. But on the flip side, making healthy lifestyle choices can dramatically improve your mood.

• Regular exercise.
• Healthy sleep habits.
• Daily sunlight.
• A nutritious diet.
• Avoiding alcohol and drugs.

Regular exercise can alter your brain chemistry by increasing serotonin levels and lead to feelings of wellbeing. According to Better Health Channel other factors that may help explain the benefits of exercise include:

• Taking an active role in your own recovery boosts your self-esteem
• Some forms of exercise, like team sports, are also social events.
• Physical activity burns up stress chemicals, like adrenaline, which promotes a more relaxed state of mind.
• Enjoying exercise may be distracting enough to break the vicious cycle of pessimistic thinking.

Exercise as an Antidepressant
Source: Adapted from  Johns Hopkins Health Alerts
The following six exercise tips offer a powerful prescription for boosting mood: Exercise now…and again.  A 10-minute walk can improve your mood for two hours.  The key to sustaining mood benefits is to exercise regularly. Choose activities that are moderately intense. Aerobic exercise undoubtedly has mental health benefits, but you don't need to sweat strenuously to see results. Find exercises that are continuous and rhythmic (rather than intermittent). Walking, swimming, dancing, stationery biking, and yoga are good choices. Be wary of competitive sports. Exercise that pits people head-to-head with opponents may be too stressful, leading to a bad mood in the face of defeat. Add a mind-body element. Activities such as yoga and tai chi rest your mind and pump up your energy.  You can also add a meditative element to walking or swimming by repeating a mantra (a word or phrase) as you move. Start slowly, and don't overdo it. More isn't better. Athletes who over train find their moods drop rather than lift.

Depression Self-Help Tip #4: Reducing stress

Stressful life events are hard for everyone, but stress poses a particular risk for who are depressed or prone to be. Not only can stress prolong or worsen depression, but it can also trigger it. In fact, stress is a major factor in depression relapse following recovery. In order to get over depression and stay well, it’s essential to learn how to minimize and cope with stress.

Coping with the Stress that Triggers Depression
Identify your stressors	Figure out all the things in your life that are stressing you out. Examples  include: work overload, unsupportive relationships, substance abuse, taking on too much, or health problems. Once you’ve identified your stressors, you can make a plan to avoid them or minimize their impact.
Go easy on yourself	Many depressed people are perfectionists, holding themselves to impossibly high standards and then beating themselves up when they fail to meet them. You can battle this source of self-imposed stress by challenging your negative ways of thinking.
Plan ahead	If you know your stress triggers and limits, you will be able to identify and avoid many landmines. If you sense trouble ahead, protect yourself by dipping into your wellness toolbox and saying “no” to added responsibility.
Learn how to relax	Since some stress is inevitable, knowing how to deal with it is important. There are many relaxation techniques that can help, including yoga, deep breathing, and meditation. Mindfulness meditation is particularly effective for relieving depression and stress.

Related links for depression self-help and recovery

Coping with depression

Coping with Depression – Psychologist Jon G. Allen reviews the key concepts of depression self-help and recovery, such as minimizing stress, thinking more flexibly, and maintaining supportive relationships. (The Menninger Clinic)

Getting Motivated When You're Down – Tips for coping with depression and getting motivated, including how to jump start the recovery process. (Blue Cross and Blue Shield of Massachusetts)

What Recovery Means to Us – Covers essential facets of a depression recovery plan, including some of the most common coping strategies and recovery tools. (Mary Ellen Copeland)

A Case of Catch 22 – Learn how to get around the Catch-22 of depression, in which the things a person needs to do to get well are the very things the illness makes it difficult to do. (Psychology Today)

Depression: A Social Problem with a Relationship Solution – Describes how past and present dysfunctional relationships cause depression and what to do about it. (Association for Humanistic Psychology)

Depression self-help tools

Back from the Bluez – Self-help modules for coping with and recovering from depression. Features advice on increasing activity levels, thinking more positively, and maintaining treatment progress. (The Government of Western Australia Department of Health)

Action Planning for Prevention and Recovery: A Self-Help Guide - Booklet of ideas and strategies for relieving and preventing depression and other troubling feelings. Includes tips for jumpstarting recovery and maintaining wellness. (U.S. Department of Health and Human Services)

Working toward Wellness – Printable workbook will help you put together a wellness plan and track your progress. (Depression and Bipolar Support Alliance)

Depression Self-Care – The Mental Health Evaluation and Community Consultation Unit at the University of British Columbia’s comprehensive patient guide to depression self-care. (National Electronic Library for Health)

Wellness Toolbox – A selection of tools for depression recovery, including a therapy worksheet, symptom checklist, trigger tracker, and a personal wellness checklist. (Depression and Bipolar Support Alliance)

Negative thinking and depression

Go Ahead....Smile! – Covers how to adjust your attitude in a positive direction, exchanging pessimism for optimism. (Prevention.com)

Overcoming Negative Thinking – The “10 Negative Grand Illusions” of negative thinking, and how to replace them with realistic thinking. (Blue Cross/Blue Shied of Massachusetts)

Positive Thinking, Rational Thinking, and Thought Awareness – Our experience of stress can be caused by irrational, negative thinking. This article outlines simple tools to help cease the cycle of stress. (Mind Tools.com)

Depression recovery lifestyle

Depression and Exercise – Recent studies imply that physical activity can be as effective as medication in treating depression. (Better Health Channel/Australian Government)

Bedfellows: Insomnia and Depression – Discover the connection between sleep and mood, including how lack of sleep can trigger depression. (Psychology Today)

Healthy eating and depression (PDF) – Learn how to change your diet to improve your mood and relieve symptoms of depression. (Mental Health Foundation)

Melinda Smith, M.A., Suzanne Barston, Robert Segal, M.A., and Jeanne Segal, Ph.D., contributed to this article. Last modified on August 19, 2007.