Coping with depression

The following guidelines are designed to help you cope more effectively with the symptoms of depression.

Loss of interest, slowed activity, lack of energy

When you're depressed, it's often hard to get any enjoyment or pleasure out of things. As a result, you may have stopped doing things you used to enjoy. Having nothing enjoyable in your life then helps keep the depression going. It often helps to slowly get back into your routine and also to increase the number of things that you enjoy. Your doctor, counsellor or friend can help you.


1. Identify things you used to do regularly and things which you used to enjoy. 

Write down the things you did every day (or every week) before you were depressed. Now think about the things you enjoyed doing and those that you wanted to do and write them down too. You might want to talk about these with someone else.

Before becoming depressed:

My routine activities - Grocery shopping
Pleasant activities - Going for a walk
Activities I wanted to do - Reading


2. Plan to gradually increase the routine and pleasant activities. 

Once you have identified your daily routine activities and pleasant activities, with the help of your doctor, counsellor or friend, you can slowly try to return to your routine and also try to do some of the pleasant activities you enjoy. At the beginning of each week you can choose activities from your "daily routine" list and "pleasant activity" list and build them into your day. 


3. If a task seems too difficult, try breaking it into a series of small steps

Set yourself the goal of completing one step at a time. For example, making a flower bed can be broken down into a number of smaller tasks:

• Choose some new plants
• Pull out the old plants (need gloves and spade)
• Prepare the soil (need compost and fertiliser)
• Put in the new plants.


4. Above all reward yourself for your efforts.

Ask others around you to encourage and praise you for each small step you take. Recovering from depression is a bit like learning to walk again after breaking your leg.

Remember, it is important to do these activities even when you do not feel like it. 
Getting going again can help you feel better.

Loss of appetite

Eat small portions of food that you particularly like. Take your time and do not feel under pressure to finish if you are eating with others. Drink plenty of fluids, especially fruit juices and milkshakes.

Sleep disturbance

• Get up at the same time every morning.
• Avoid sleeping during the day.
• Reduce tea and coffee intake if excessive (no more than two to three cups per day and none after about 4 pm).
• Do not lie awake for more than about 30 minutes - get up and find a relaxing activity.
• Try relaxation exercises. Ask your clinician for more information about these exercises.

Your health worker can give you more information about managing sleep difficulties.

Loss of interest in sex

Seek non-sexual activities with your partner that you still enjoy. Explain to your partner that your loss of interest and affection is a symptom of your depression, not a rejection of him or her, and that these symptoms will be temporary.

Miserable feelings, unpleasant thoughts

These negative thoughts and feelings tend to focus your attention on things you do not like about yourself or your life. These thoughts also tend to make your problems seem worse than they really are. As well as concentrating on your negative features and experiences, when you are depressed you tend to underestimate your positive characteristics and your ability to solve problems. A number of strategies may help you achieve a more balanced view of things:

• Make a list of your three best features - perhaps with the help of a friend or relative. Carry the list with you and read it to yourself whenever you find yourself focusing on negative thoughts.
• Keep a daily record of all the small pleasant things that happen and discuss these events with your friends when you see them.
• Recall pleasant occasions in the past and plan pleasant occasions for the future (this may best be done in conversation with a friend).
• Identify those areas of your life that are positive. When you are depressed it is easy to lose sight of those things that you value in your life. Think about life before depression. What did you value and what was special? Make a list of them.

e.g. Family - Children - Work - Sport - Music

Having identified those areas of your life that are positive, discuss them with your doctor and/or counsellor.

• Avoid discussions about your bad feelings. Expressing unreasonable thoughts about yourself is not helpful - solving realistic problems is helpful. Friends may politely interrupt such conversations and redirect the discussion to positive issues or useful problem solving.
• Consider alternative explanations for unpleasant events or thoughts. Although your initial explanation may be that you are at fault, rethink these conclusions and write down all other possible explanations for these events or thoughts.
• Keep yourself busy doing useful activities. Avoid sitting or lying around, doing nothing.

Your health worker can give you more information about balancing your thinking.

Dealing with worries and problems

If you find that you are worrying, endlessly turning over your different problems in your head, try putting your worry to a useful purpose. Pick out one or two problems that seem really important and make a decision to resolve them. You may like to ask a friend to help you.

Sit down with a problem solving sheet (your health worker can provide you with one) and go through the following steps:

• Say exactly what the problem (or goal) is.
• List 5 or 6 possible solutions to the problem - write down any ideas that occur to you, not merely the 'good' ideas.
• Evaluate the good and bad points of each idea in turn.
• Choose the solution that best fits your needs.
• Plan exactly the steps you will take to put the solution into action.
• Review your efforts after attempting to carry out the plan. Praise all efforts. If unsuccessful, start again.

Your health worker can give you more information about problem solving techniques.

Dealing with stresses

Depression is more common in people who have had to make major adjustments in their lives during the past year (e.g. death of a loved one, birth of a baby, loss of a job, or moving house). These adjustments may result in continued stress. Over time, this stress may make people vulnerable to depression. Thus, in order to fully resolve the depression and to prevent recurrence, it is important to resolve the stress.

The same problem-solving approach described in `dealing with worries' can be used to help you deal with stress. With the help of a friend or your health worker, try to define exactly what aspects of the major change is causing the stress. For example, the birth of a baby is a major adjustment, and the aspects causing most stress for you might be difficulty getting time alone or dealing with disturbed sleep. Then go through the steps outlined above in order to devise a detailed plan to resolve the issue. There are agencies which provide specialist advice and support with particular types of problems - for example, debt or relationship problems. Your health worker may have information about these agencies or you could ask your local Citizens Advice Bureau for their addresses. The Citizens Advice Bureau is listed in the telephone directory.

Not all stresses can be fully resolved. However, there is usually some way of helping you cope better so that the impact of the stress can be reduced. For example, some chronic illnesses cannot be cured, but doing relaxation exercises may help someone to deal with the pain and support groups may be able to provide useful tips for how to live with the condition. Some communications skills, such as assertiveness training, can help people deal better with difficult relationships or situations at work or at home. Your health worker may be able to give you information about these. Many local Colleges of Further Education or Community Schools run day and evening classes in relaxation, yoga and assertiveness skills. Support from friends and family is also very important. Now is the time to ask for and accept support. Avoid discussions about your bad feelings. Expressing unreasonable thoughts about yourself is not helpful - solving realistic problems is helpful. Friends may politely interrupt such conversations and redirect the discussion to positive issues or useful problem solving.