If you have severe depression like I have then it can be difficult to do anything. Depression can be further exacerbated by unrealistically high expectations and constantly shifting your focus.
The first step towards treating depression is to realize and accept that you have depression - so say it out loud, "I have depression." It isn't permanent and it isn't for life - it's just a state of mind. It's like your mind has a virus and it's making all your thoughts negative. The only way you can kill the virus is by identifying those bad thoughts, recognizing that they are only the depression talking and gradually changing the way you think by focusing on positive thoughts. The number one thing to realize when overcoming depression is that you are not your mind and that you cannot believe everything you think. I talk more about this in my blog post here where I discuss an important exercise assigned by my life coach Annelene Decaux.
But anyway, I'm getting away from the main purpose of this post. Even though we can think of ourselves as having a separate mind, body, emotions, and spirit - in truth, they are all connected. Therefore, we can't just focus on changing the way we think - we also have to take care of our physical body.
One of the worst aspects of depression is that it can be difficult to tell whether or not you're getting better. And when things are really bad - it can feel like you don't have enough energy to even get out of bed and perform basic human functions like eating, sleeping, and getting exercise. We need to be compassionate with ourselves and accept that in a state of depression we need to have reasonable expectations of ourselves - otherwise we'll feel like a failure. You need to be kind to yourself and have patience with yourself - just like you would have with a small child. In truth, showing patience and compassion to yourself is like recognizing your inner child and showing compassion to her/him.
Below, I provide a simple excel sheet that I use to track my progress in overcoming my depression. It focuses on basic human functions - healthy exercise, sleeping, and eating.
I have been focusing on these basic goals and they have helped me. I print out a new sheet every week and record my progress - then I save the sheet and when I accomplish all my goals for the day then I record that fact.
I view these goals as the main things that I have to accomplish every day to see my day as a success. When I have more energy then maybe I read, hang out with friends, write, work on projects, clean my house, or help out a friend. But at the very minimum, I strive to complete these goals every day. At first, there were many days that I could not even accomplish half the goals on this sheet, but I didn't beat myself up about it. Instead, I told myself - that's okay, you'll get there eventually. Every day is it's own opportunity. And every day that I completed all my goals - I would reward myself $1. With that dollar, I would use it towards buying an iTunes song that I enjoyed or saving it up to enjoy some other capricious desire. The point is that you should focus on rewarding yourself when you do a good job and telling yourself, "I'll do better tomorrow," when you have a rough day.
Let me elaborate a little bit more on why I chose this set of goals. After making it very clear to my behavioral psychologist that I was not comfortable taking any form of medication to treat my depression, she encouraged me to do one hour of vigorous exercise every day. My psychologist has a PhD and is very knowledgeable and well-read in the various treatments available for depression. She explained to me that an hour of vigorous exercise where you elevate your heart rate and really get your blood pumping fills your body with endorphins. These naturally created endorphins are sort of like a free form of anti-depressants without any of the negative side affects. She told me that even if I felt too awful to do anything else - that I should at least exercise for one hour a day. If you're not strong enough to exercise for one full hour - don't worry. Start with 15 or 30 minutes and gradually build up from there. In the section labeled "One hour of Exercise" record the amount of time you exercised and the activity.
The next section - stabilizing sleep patterns - I added because I noticed that my depression was causing me to sleep at all sorts of odd hours. Some days I would go to sleep at 4am and wake up at 6am. Other days I would sleep from 8pm to 11am. Some days I was awake all night and slept for the whole day. My entire sleeping schedule was destroyed. This was mainly because my "bad" episodes (where I would break down crying and my head would fill with bad memories) happened mainly at night. My lack of regular and restful sleep only intensified my feelings of paranoia, exhaustion, and weariness. Even during the worst of it - I knew that if I could just get on a better sleep cycle - things would get better for me, but it felt nearly impossible. At first, I just wanted to fix it all at once. I told myself - I would just set my alarm and get up at the same time no matter what. But this did not work, since my body craved sleep so badly that I would collapse from exhaustion eventually. I then decided to take a more reasonable approach and be more patient with myself. I realized and accepted that my body needed sleep and that the "bad" episodes needed to happen - they were a way to express and process my emotions. So I focused on getting 7-9 hours of sleep everyday. I decided that if I was aware of when I got to bed and when I got up, I could gradually move towards a more regular sleeping schedule. I also made it a point to incorporate other tenants of achieving better sleep that I had read about - no napping and no TV before bed. The point is that I didn't get angry at myself for not waking up at a certain time or falling asleep by a certain time. This took the pressure off of me. At night, I worked on activities that did not involve watching television (I usually read or wrote in my journal) and then I feel asleep when I was really sleepy. I did not set an alarm and I got up when I was rested.
The next part to the excel sheet "Eating Healthy" is a simple way to improve your diet, create good energy with which to exercise, and minimize stimulants that may keep you up at night. The "No Caffeine (Tea, Coffee, Soft Drinks, Energy Drinks, Energy Bars, etc), No Chocolate, Low Sugar" goals - are all designed to remove stimulants that are keeping you from sleeping and making you jittery, nervous, or tense. Completely removing caffeine and eating less sugar helped the most for me. I found it difficult to completely eliminate chocolate, but it helped to eat less of it and only eat it in the morning. Avoiding processed foods (junk food, canned foot, packaged foods, energy bars, health bars, heavily processed cereals, etc.) was very important as well. These foods don't provide good energy and they often have additional chemicals and excessive sodium, sugar, or caffeine that shock your system. I focused on eating regularly spaced meals and made sure to include a vegetable, fruit, and a bit of protein with every meal. This is very simple - it can be a carrot, an apple, and a peanut butter and jelly sandwich. Or maybe a banana, bit of salad, and a handful of nuts. Or a pear, some red pepper slices, and some eggs. Since I was so depressed - I didn't have much energy, so at first I focused on making simple, quick meals. Gradually, as I felt better, I created tastier and more complicated meals. One relatively easy meal that can last you several days is lentil soup with vegetables. I use french green lentils and add carrots, broccoli, potatoes, onions, garlic, red peppers, etc. I put everything in a crock pot with a timer and let it cook for 6-8 hours. The timer is key, since the crock pot will just turn off when it's done and you won't accidentally burn your food by forgetting about it, since you're so depressed. Once I felt better, I also tried to incorporate more variety into my meals by never having the same thing for breakfast, lunch, or dinner two days in a row. I find that this has really helped.
The next step is tracking "bad" or unpleasant episodes. The idea here is not eliminate these episodes entirely because in many ways they are a necessary way to process your emotions. Rather, the idea is to recognize patterns - like how many bad episodes are you having; when do they happen most frequently; is there anything in particular that triggers them; how do you try to deal with them when they do happen; what works and what doesn't work when you experience an onslaught of emotions, etc. You don't need to be angry with yourself when you have a "bad" episode by experiencing a flashback or breaking down crying or just feeling completely awful and enraged for a while. These are all part of the healing process. The idea is to become more aware of ourselves - of our body and our emotions. When you have a bad episode - you want to be able to stop, accept that you are feeling bad, acknowledge that you are feeling bad, and then honor that emotion in a health way - by crying, writing, talking, screaming, singing, punching a pillow, etc. You will gradually find that by quickly accepting and embracing your "bad" episodes that they will pass by more quickly. As my life coach Annelene Decaux explained to me, depression is just a form of stuck energy inside of you - stuck emotions that need to be recognized, expressed, released, and learned from.
The next section, "One hour of Mindfulness," is to make you more aware of your spiritual practice. One of the mistakes that people who suffer from depression regularly make is that they forget and stop doing what helped them get through their depression in the first place. All the things that we learn to do to help ourselves through depression like yoga, journal writing, meditation, self-acknowledgment exercises, etc, are things that we need to continue doing and integrate into our daily lives. We will need to do them less or less frequently than when we were super depressed, but we still need to do them. They will help us be the best person that we can be and will prevent us from developing extreme depression again.
Finally, the "notes" section is a good place to record observations, random thoughts, or whatever you want. Sometimes I just put a big smiley face in this section and other times I make an insightful comment on something I learned that day about myself.
So print out this excel sheet, modify it to make your own, or whatever! You may find it especially useful to compile your week-by-week results in an excel file to keep track of your progress. You can also share your progress with your therapist, spiritual healer, mentor, or a trusted friend. Okay, here is a big virtual hug and good luck! We will overcome our depression - remember, depression is just a state of mind and it can be overcome!
