Dealing with depression

How to deal with mild depression

There is much you can do yourself to deal with the symptoms of depression, once you have been pointed in the right direction. This is sometimes referred to as guided self-help. There's a lot of advice out there - on the internet, in a leaflet such as this, in magazines and books and from professionals such as GPs, practice nurses and counsellors.

Don't bottle it up

Don't try to 'soldier on' with your depression. You may try to hide your feelings in the hope that your depression will go away. You may fear that revealing that you have depression is a sign of weakness. This may be aggravated by unkind remarks from acquaintances that you should 'pull your socks up'.

Trying to suppress your depression is never a good idea and will only make you worse. This leaflet shows you how to understand your symptoms, that depression is an illness and that it is very common. Spending time being open and honest with your family and friends will help them understand and they can be a good source of support for you.

Keep yourself occupied

If you are depressed, your natural reaction may be to withdraw from the world. However this can often worsen depression.. You need to increase your activity, (not reduce it) to improve your mood. Getting out from under that duvet and engaging with life may be very hard to start with, but it is the first step on your road to recovery.

• Make a list of activities you enjoy.

• Engage with people.

• Participate in activities.

• Do some exercise.

Making a list

You will need to get motivated; otherwise you may spend the entire day staring out of the window. Make a daily plan of the things you need to do. Add in a few 'treat' activities that you normally enjoy (and maybe don't usually have enough time for).

Keep it simple and choose activities that don't need a lot of organising, such as a walk in the park or listening to music. Activities which bring you into contact with friends, family or pets are useful,

Exercise has been found to be beneficial. In some groups of people where taking medication may be problematic, the effects of exercise may be similar to antidepressant treatment. Additionally it is unlikely to cause unpleasant side-effects and is regarded as an essential part of a healthy lifestyle.

Keeping a diary

Tick off each activity once it is done. At the end of the day, look back and see what you have achieved and what you have enjoyed. Don't be surprised if you don't enjoy some of the activities you list to start with. Give it time; the enjoyment will come back. Just think of it as therapy in the first instance. Rate your enjoyment from 1 to 10. You can see which activities you most enjoy and how you are progressing over time.

Avoiding what is unhelpful

You may list activities which you think are going to make you feel better but actually make you feel worse. Drinking alcohol, watching TV all day, unhealthy sleeping patterns or staying in bed are typical examples. By keeping a daily diary you should be able to identify these unhelpful activities. Reduce the amount of time you spend on them and increase those that have brought you pleasure or a sense of achievement, to compensate.

Solving problems

Problems that you used to solve in your stride may seem insurmountable when you are depressed. Fear not - help is at hand.

• Write the problem down, including as much detail as possible:

  • Write down possible solutions using the following approach:

    • Did you solve a similar problem in the past and if so how did you tackle it?

    • What would a friend do?

    • What are the possible solutions? (Be creative, write the silliest or most impractical solutions first.)

• Break your solution down into steps and tick them off as you achieve each step.

The vicious cycle

Depression can make you lack motivation, energy levels and feel physically unwell. It may be easier to avoid activities than to tackle them. You may then feel guilty and start to get angry with yourself. This in turn can cause lack of self-esteem and make you feel even more depressed. Understanding how depression affects your thinking can help you break this vicious cycle.

Make a list of any thoughts that have fallen into any of the categories below in the last couple of weeks:

Gloomy thoughts

When you are depressed, your image of yourself may suffer. You may feel you are worthless, lazy or unattractive. You may feel more sensitive about what other people think of you and imagine that you have become less popular among your friends.

Catastrophising

This means jumping to the worst conclusion. If a family member is late, you immediately picture them being rushed to hospital in an ambulance. Or if you haven't heard from a friend for a few days, you assume you've said something to upset them.

Over-generalising

This means drawing wide conclusions from one small detail. If someone spoke sharply to you at work, you may think: 'All my colleagues hate me.' Or if you run out of milk, you may think: 'I'm a total disaster and useless at organising my life.'

Focusing on the negatives

This means over-exaggerating setbacks whilst ignoring all the good things in your life. For example, you may focus on a negative comment someone has made at work, whilst taking no notice of the praise other colleagues have given you. Or you may criticise yourself for not achieving everything on your list of tasks but ignore all the things you did manage to do.

Taking the blame unnecessarily

This means blaming yourself for no good reason. For example, if a co-worker is off-hand with you, you immediately wonder what you have done wrong. It may be that the other person has just had a bad day or is preoccupied.

Guessing another's thoughts or predicting the future

A neighbour who normally stops in the street for a chat passes by with just a wave. You immediately think: 'I must have upset her last time we spoke.' In reality, she may just be late for an appointment. You may be convinced that things are not going to go well at an interview and think: 'I know they won't offer me the job, so I won't bother going.'

Breaking the cycle

Don't beat yourself up if any of the thinking patterns above look familiar to you. Celebrate the fact that you are beginning to recognise them in yourself. You will now be in a position to stop them from affecting your mood.

Whatever it is that has upset you, sort it out into three parts:

• What happened?

• What did I think?

• What did I feel?

For example:

• Your best friend ignored you all evening and chatted to someone else.

• You thought: 'She finds the other person better company than me.'

• You felt unwanted and inferior.

Various techniques can be used to break the cycle.

Balancing

This means cancelling out the negative thought with a positive thought.

Using the above example:

"She finds the other person better company than me.' This could be balanced with: 'She bought me a great present for my birthday.'

It may be worth keeping a diary of events, with columns for feelings, negative thoughts and balancing thoughts.

It's known that people who are depressed are not very good at recording details, so keeping a diary will help. Diaries are useful - not only to help with the balancing technique but also to record positive experiences such as praise from a colleague or a compliment from a partner.

Challenge long-held views

You may be your own worst critic and you may have developed long-held negative opinions about yourself. For example, you may think you are lazy, not well liked or not particularly bright. These criticisms are often imagined and have no basis in reality. Imagine that you were trying to cheer up a friend who had these thoughts. Look for evidence that supports the opposite view. Writing things down may help.

Mindfulness

This is a technique which has become increasingly popular as a way of getting 'in tune' with your thoughts and bodily feelings. It can be used to help manage anxiety and boost your mood. In a nutshell it involves focusing on what is happening in the present and not being distracted by the past or the future.

One exercise involves concentrating on your breathing whilst observing in an objective way whatever else is happening to your mind and body. If thoughts come into your mind, acknowledge them but bring your attention back to your breathing. You may notice physical feelings, emotions and sounds: notice them but let them drift away, and come back to your breathing. If you do become distracted, recognise that this has happened but just bring your focus back on to your breathing,

The more you practise this technique, the easier it will be to deal with the negative thoughts that come into your mind during a bout of depression.

You can find out more about mindfulness from our leaflet.