Living with depression - Tips for self care

 When you have depression or are suffering a depressive episode, it's sometimes very difficult to remember to take care of yourself. You might feel like you aren't deserving of feeling good and find it hard to motivate yourself to do anything, even things you used to enjoy. Here I've compiled a few points containing tried and tested ideas that might make living your life with depression, or perhaps another mental illness, a tiny bit easier. 

1.) Do not be afraid to ask for help - repeatedly.
Maybe you're the only person that knows about how difficult you're finding it to keep going. Chances are, you've been feeling the way you are now for a long while. Feeling down may seem normal to you; you've forgotten what it's like to enjoy life. Even if on the outside you appear to be keeping it together, as soon as you're alone you might feel isolated and afraid. It will be very difficult to convince yourself to do this, but honestly, telling someone about how you're feeling will likely be the best thing you've ever done. It could be a close friend, a family member, a work colleague, or anybody else who you might feel comfortable talking to. If you can't say it, write it down, send a text or a letter - any form of communicating your struggles is perfectly acceptable if it means that you don't have to keep everything bottled up in your mind. 

Perhaps, on the other hand, you've suffered and treated an episode of depression before and have found yourself in relapse. Remember how much easier it was last time after you were able to confess your concerns about your mental health to someone else? I'm sure you also remember how difficult it was and how much courage it required - but right now you need to focus on how much talking about your struggles has helped you in the past. 

If you don't know how the person will react when you confess your worries, you could perhaps give them some ideas on how they could help support you through it all. If you're not sure on how they could help, maybe send them a link to one of my previous blog posts on "How to help a loved one who is struggling with mental illness" - this can be found here: http://ignoranceisyourchoice.blogspot.co.uk/2014/10/rachaels-top-10-tips-how-to-help-loved.html

If you've already reached out and asked for help, don't be afraid to ask again. If you're feeling down, let someone know. It's always better to talk to someone about it.

2.) Visit your GP - repeatedly.
There are a number of ways in which your GP can help you with depression, and it is important to understand that the help they can offer isn't just in the form of medication. If you feel like some help from a medical professional could be beneficial, book an appointment. They can offer advice, give you information and even assist with disclosing your struggles with your workplace or educational institution to make your daily life easier.

If you do think that some sort of medication might be helpful for you, you can discuss this too. You will not be placed on a psychiatric medication such as an antidepressant if it is not what you want to do in terms of your treatment - it is your choice. But you should never feel like you are "not unwell enough" for medication or as though medication is only "masking the problem." Medication has been proven to be very effective in the treatment of depression and other mental health conditions; in fact, the most successful treatments usually consist of a combination of medication and some form of talk therapy / counselling.

If you've already been to see your GP, and have changed your mind about your treatment since that point, don't hesitate to book another appointment. If your current medication isn't working (after the initial 6-8 weeks) don't be afraid to ask about changing to something different or altering the dosage. You can work with your GP to find a treatment that suits you best - but be a "patient patient", because not everyone reacts in the same way to certain treatments and it could take a few different attempts to find the right medication for you.

(It took 18 months, 5 different antidepressants each at a variety of doses and also a course of Cognitive Behavioural Therapy before I started feeling a little bit more in control. But holding on and persisting has been worth it. I remind myself of this every day.)

3.) Look after yourself - Remember to do little things that may help.
It can be so difficult to want to look after yourself when you're feeling low, but it's important to try and do the little things that help ease the symptoms of depression. Here's a few ideas:

• Immerse yourself in a hobby like drawing, craft, learning a language or playing a musical instrument - this will pass some time and help you to feel productive. 
• Turn on the lights or open the window. 
• Get dressed and go outside if you can, even just for a 5 minute walk or for a relaxing few minutes in your garden, because getting a bit of fresh air will probably do you some good. 
• Stretch or learn a little bit of Yoga to help your body feel well if you are physically able to.
• If you are able to, try to exercise regularly. Even just going for a walk a few times a week can really help increase your energy levels.
• Learn some techniques for relaxation such as deep breathing and meditation. This can help to make you feel calm and can also be used to combat stress or in distressing situations.
• Have a quick shower to refresh you or a nice long bath to relax you. 
• Listen to music, read a book, watch a film or find a comedy series to watch on TV. If nothing else, it passes some time and keeps you nicely distracted.
• Perhaps invite a friend round so you can spend some time together, or go out for an afternoon coffee with someone. Even if you don't think you want to, spending time with people will often make you feel better. 

All of these little things will hopefully make you feel slightly better within yourself.

4.) Keep track of your appetite.
It may be the case that you're barely eating anything or you might be overeating - if any of these apply to you, make sure you try and stay in control.

If you have little to no appetite, just try and eat small things that you think you can manage. If you're not really in the mood for anything, try having soup or making fruit smoothies to drink; it will at least give you a little bit of energy and nourish your body. Depression can already contribute to low energy levels so not eating can make this worse. It's always best to try and eat several small nutritious meals instead of one very large meal - but if occasionally the only thing you can face is a huge, greasy takeaway then go ahead and treat yourself!

If, on the other hand, you're struggling with having "too much" of an appetite, try to eat slightly smaller portions so that you're not increasing your food intake too significantly. Slow down when you eat, so that you take time between each bite and notice yourself getting full.

Whether your appetite is affected by your mood or not, make sure you always try to eat well and drink plenty of cold water. Staying nourished and hydrated is very important for maintaining your energy levels and in turn your overall health.

5.) "Sleep Hygiene" - get into good habits.
With depression often comes insomnia (lack of sleep), hypersomnia (sleeping too much), or excessive daytime sleepiness. You know how much sleep you need to function normally, and you know when you're not sleeping well. "Sleep Hygiene" consists of a variety of practices that may be necessary for you to get a normal sleep that leaves you feeling refreshed. Here are a few ideas:

• Try not to nap during the day as it may help you to sleep better at night time
• Avoid caffeine - especially after 3:00PM. Remember that it isn't just coffee that contains caffeine - tea, coca cola, chocolate and some ice creams contain it too.
• Try to go to sleep and wake up at roughly the same time every day so that you establish a routine
• Make sure your bed is associated with sleep - it's preferable to not watch TV, do work, read books or listen to music in your bed because your brain may subconsciously associate your bed with these things instead of being asleep
• Try not to eat large meals just before you go to bed
• Take a (non-caffeinated) warm drink to bed, like hot chocolate or chamomile tea.
• Go outside during the day so that you have had some exposure to natural light. This will help your body and it's natural clock.
• Try to do a small amount of light exercise each day if you are capable, such as Yoga, Pilates, or walking.
• Try to resolve any current worries or anxieties before getting into bed so that you don't need to think about them whilst you're trying to go to sleep. You could do this by talking about them, writing them down and putting them away, or by a number of other methods. There is plenty of information available on various websites about this. 

Hopefully these tips can help you establish good sleep habits. If your sleep habits are disrupting your daily life it's important to speak to your GP about it in case there are any underlying health issues causing your problems.

6.) Keep some little things that make you feel good in an easily accessible place.
It might be that certain books, films, or music albums make you feel happy or distract you when you're feeling down. Maybe you have a favourite snack or drink that you can treat yourself to in order to cheer yourself up. Keep nice cards and notes from friends all together and read through them to remind yourself that you are loved. You could even put your favourite photographs into a photo album to remind you of happy memories. You could compile all of these "positive" items in a box or a bag that you can try to remember to look through when you're feeling low. The idea of a "Happy Box" was given to me by my good friend Sophie, who, when I was feeling very low with depression, filled a box full of happy things for me as a gift. (Sophie is awesome and everyone needs a Sophie in their life! Unfortunately though, my Sophie is mine, so you can't share her.)

Another idea could be to form a list of people who you can speak to if you're feeling low. If you have a few specific friends or family members who know about your difficulties and may be able to help cheer you up, have their names and contact details on a list or in a notebook so that you can always remember that you have people there for you. Call them, or send them a text or an email. They will likely be pleased that you thought of going to them for help; they won't think you're a burden or a nuisance.

7.) Challenge your negative thoughts
I've taken the following ideas for challenging your negative thoughts from http://www.helpguide.org/articles/depression/dealing-with-depression.htm because I feel that they've summed it up more effectively than I can! 

Ways to challenge negative thinking:

• 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.

• Allow yourself to be less than perfect. Many depressed people are perfectionists, holding themselves to impossibly high standards and then beating themselves up when they fail to meet them. Battle this source of self-imposed stress by challenging your negative ways of thinking

• 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.

• 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 and ask yourself if there’s another way to view the situation instead.

Hopefully this post has shed some light on how to help yourself fight through your depression - or maybe it's given you an idea of what you can suggest to a friend who is suffering with their mental health. Self-care is very important for everyone and it can be very difficult to remember this when you're feeling depressed.

Remember to look after yourself! - Rachael x