healfrmdepress

Often time clients ask me to list the most important things they should do if they become depressed. Here are my top five recommendations.

The first is what I call set the intention to heal. This means making the decision that you want to get well, even if you don’t know how. Setting the intention to heal does two things. First, by setting the intention to heal you will stimulate and support your body’s “healing system”—its innate capacity to control disease and bring itself back into balance.”To take full advantage of the healing power of intention, I suggest that people write what I call a vision statement wellness. The vision statement answers the question, “What would my life be like if I were free of the symptoms and depression and anxiety?” I will be posting a blog that outlines exactly how to create an effective vision statement of wellness.

The second thing that a person with depression needs to do is to reach out for support. There are two reasons to do this. First the power of intention is magnified when it is shared with another person. When we state our vision of wellness in the presence of one or more supportive people, that vision becomes strengthened and exponentially magnified. Second, human beings are biologically hard wired for connection; this is why Dean Ornish writes in his book Love and Survival, Anything that promotes a sense of  love and intimacy, connection and community, is healing.”

My third recommendation is to take care of your physical body as best you can. Part of this involves making sure that you are getting enough sleep, eating well, and exercising your physical body. Of course all three of these things are problematic to a depressed person. Sleep disruptions are common andmany people who are depressed lose their interest in food and their motivation to exercise. Yet these tendencies can be overcome with counseling, support and medication.

The fourth thing to do if you are depressed is to create structure and routine that allows you to engage with the world. To heal from depression, we need a reason to get out of bed. We need somewhere to go and something to do. Going to an outpatient mental health treatment program is one way to do this. Otherwise, you concrete your own structure by:

Taking a walk with a friend
Going to a movie
Doing some kind of volunteer work
Taking a class in a subject that interests you
Attending a book club
Going to the gym
Going out to eat with a friend.
Going to the library

The final and probably most important thing to do when you are depressed is to Tell  yourself, “This too shall pass.”  As many of you may know, when we depressives have an episode, our dysregulated brain tells us that us that the episode will never end, that we are condemned to a kind of eternal hell. If this occurs, we must respond to this untruth with statements such as: “This too, shall pass,” “Nothing lasts forever,” “The only constant in the universe is change,” and I can get through this.”

In summary, the five top things to do when you are depressed is to set the intention to heal, reach out for support, do your best to care for your physical body, create structures that engage you with the world, and tell  yourself, “This too shall pass.” Now there are many other thoughts and behaviors that can change your brain chemistry and lead you to wellness. I have a diagram of them which you can find by clicking on this link.

https://healingfromdepression.com/treating-depression-holistically.htm

Good luck, and I wish you the best in your mental health recovery.

In this blog, I want to talk about an important principle of depression recovery–forgive yourself for your mistakes. We who suffer from depression can be overly hard on ourselves. With our self-esteem in the pits, we can be overly self-critical and self-judgmental. And when we make a mistake or misstep, our inner critic can go wild.

So I want to respond to this by saying that we must learn to forgive ourselves when we make mistakes. There are at least three reasons for this.

First, as I said being mistakes is part of being human. That is why Alexander Pope famously said, “To err is human, to forgive divine.”

Second, we can learn from our mistakes. There is a saying that through our experience we gain wisdom. But what is experience? The accumulation of our mistakes we have made. So mistakes can help you to grow and become wise.

 I would like to illustrate the principle of self-forgiveness with a story from my own life.

Last week I decided to get new rain jacket for my partner, as she walks nearly every day in the Oregon rain. Even though I knew that the size Joan’s current jacket is a small, I went to the outdoor store and purchased a medium, figuring that the larger size was needed to accommodate layers of clothes underneath. However, when I got home and Joan tried the medium on, it was too large for her. Thus, I would have to go back to the store and do an exchange. Unfortunately, I had lost the receipt, something that was typical of my absent minded nature.

For the next 24 hours, I was very upset with myself for having chosen the wrong size and losing the receipt. I beat myself up saying, “How could you have lost the receipt you fool.” Finally after witnessing enough of my self-flagellation, Joan said, “Why don’t you forgive yourself. You can’t get it right all the time.”

After Joan’s comment, I thought to myself, no one gets it right. Or as Billy Joel says in his song, Second Wind, “You’re only human, you’re supposed to make mistakes.” So I decided to let go of my self-blame. Eventually, I was able to exchange the medium jacket for a small one.

The moral of the story is: forgive yourself for your mistakes. Since mistakes are part of being human, they can and will happen. When this occurs, it is important to replace self-criticism with self-compassion. As we do this, the symptoms of depression will lessen and your mood will improve.

The title of today’s blog is, “Does Exercise Really Heal Depression. In my experience the answer is a definite “yes.” Over the past fifteen years of facilitating depression support groups, I have had dozens and dozens clients tell me over and over that physical activity raises their mood, whether it is taking a walk in the neighborhood or going for a three mile run. They say that after they exercise, the brain fog of depression lifts from their mind. They feel more alert, energized, and thus in a better mood.

The New York Times reported that recent study concluded that moderate exercise, if it was moderately strenuous such as brisk walking, jogging, hiking or going for a bike ride had quote “A large and significant effect” unquote against depression. At the conclusion of the article, the head researcher said, “The main message from all of these studies is that to maintain their mental health, people should be as active as possible.

Of course, when a person is depressed, this is easier said than done. The biggest complaint I hear from my clients is that they can’t find the motivation to do exercise. I have found two ways to overcome this. The first is to pick an exercise that you like to do, the one that you enjoy. Think of the e in exercise as standing for enjoy. This enjoyable activity could be walking, running, cycling, swimming, doing the martial arts, resistance training, etc.

My second strategy is to work out with another person. It is so much easier to go to the gym if you have some company. I have two stories that illustrate this. (Tell stories of walking girls and David, John and Ed, three retired men who were members of my support group). Eventually he began to look forward to their weekly routine and when they arrived at his house at 9am, he was waiting for them with a fresh pot of coffee.

In conclusion, dozens of more studies have shown that exercise can treat mild to moderate depression as well as antidepressants. This is why the head of the APA recently suggested that every psychiatrist should write on his prescription pad, in addition to medication, 30 minutes of exercise every day. Exercise lifts the mood as well as drugs, it is quicker acting, and the only side effects are a healthy heart and greater vitality.

One of the questions I am most often asked by my group members and clients is, “Douglas, is there a time to stop taking my medications? I have felt better since being on medication(s). Now can I stop them?”

A related question is, “I have been taking this medication and have been exercising, eating right, and getting good social support. I am feeling better. How do I know what is causing this improvement? If it is the lifestyle changes that are helping, can I stop the medication?

This is a tough question. In many instances, it is extremely difficult to tell what a medication is or is not doing. This is significant because with 18 million Americans suffering from depression, millions of people are taking psychiatric medications. They are no doubt asking themselves, “Can I ever stop taking these drugs? If so, when is the best time to stop them?”

I brought this question to my nurse practitioner. He said, “It really is impossible to answer this question. The only way to know if the medications are helping is to stop taking them.”

“So should I stop,” I asked? “I wouldn’t try that,” he responded. “Not now. Because if the medications are helping you to stay afloat and you stop them, you will probably have a relapse.”

I responded, “Of course, if we go by that philosophy, I will have to be on these medications the rest of my life. Why should I do that when before this breakdown I had nineteen years of stability without taking any medication?” Jim thought for a moment and then said, “Let’s give it another three months. If you are still feeling well, you will have had six months of stability. Then we can try to wean you off the medications.”

This seemed fair to me. So I will have to wait more three months to answer the question, “When is it Time to Stop Taking My Medications?” Meanwhile, many of you who are reading this blog are no doubt taking medications too. Have you ever asked yourself the question, “When is it Time for Me to Stop Taking My Medications?” If you have found an answer to that question, please write it the comments section or email me at douglasbloch@gmail.com My guess is that the answer to this question will vary, depending on the individual. Some folks may be able to stop after six months. Others may have to stay on medications for many years. Finally, while most individuals can eventually get off their medications, a small number of people will need to take their medications for the rest of their lives, or until new therapies can be developed.

My suggestion is that you work with your prescriber, trust your intuition and take it one step at a time.

In January of 2016, I spent twenty five days as an inpatient in a locked psychiatric ward of local mental hospital. The cause of my hospitalization was that my psyche and my life were disintegrating, and my partner wanted to get me into a safe place. The hospitalization served a twofold purpose–to place me in a safe container and to provide a way for me to do ECT (electroconvulsive therapy). The purpose of this post is to provide an account of what it means to be hospitalized in a psychiatric ward. If some viewers are considering hospitalization for themselves or a loved one, I hope that what I say can give you an objective account of the mental hospital experience.

What was a typical day inside a psychiatric ward like? The day began at 7:45 am, when a voice on the PA system announced, “It’s time for breakfast.” Not being a morning person, I would stumble into the day room to join the other patients. For me, breakfast consisted of yogurt, oatmeal or cream of wheat, and scrambled eggs. I don’t understand how, but the hospital made scrambled eggs taste like mud. The eggs didn’t even look real. Unfortunately, a simple hard boiled egg was not on the menu and thus could not be ordered. Lunch and dinner were no different, with overcooked vegetables and overdone chicken or salmon. This was true hospital food, in every sense of the word. After breakfast the day began. The day consisted of a series of groups that went from 9 am to 9pm, with titles such as mindfulness, coping skills,distress tolerance, emotional regulation, self-empowerment, recovery tips (for alcoholics and addicts), and my favorite by far–art therapy. While I found most of the groups boring, with art therapy I could work with my hands and produce something tangible.

Aside from the poor food, another limitation of being in the psych ward was the lack of exercise. There was no gym—only a decrepit stationary bike that I could only ride for fifteen minutes. Neither could I go outside and exercise. Being that this was a locked ward, one had to stay inside. If you were put on a special list, one of the staff could take you outside to a confined space with a rock garden, but only for ten to fifteen minutes. This is more confining than jail, as many prisoners spend far more than ten minutes exercising in the yard. There was one important difference however—anytime I wanted, I could sign out, since I had entered the hospital on a voluntary basis.

Another thing that drove me crazy about being in the unit was the overhead lighting. Evidently there was a ban on regular lamps because the staff thought that patients might use the chords to strangle themselves. This “no strangle zone” extended itself to cell phone charger cords. Thus whenever my phone battery was low, I had to bring it to the nurses station where one of the staff would take it to a special room and plug it into an iPhone charging cord.

On the other had, there were some positive things about being in the mental hospital. The other patients, who suffered from the same maladies as myself, were generally approachable and kind. I made two friends on the ward. In addition, the staff were gentle, compassionate and helped to create a feeling of safety. They were the complete opposite of big nurse from the movie One Flew Over the Cuckoo’s Nest. Whenever I needed special attention, they were there to support me.

Finally, a blessing I received from my hospitalization was all the people who came to visit me. I had a total of twenty-six visitors, and many came multiple times. This reminded of the film “It’s a wonderful life” when Jimmy Stewart’s friends showed up at his house and donated money to help him repay an 8,000 debt. My visitors made me appreciate that I was very much loved, an antidote to the thoughts of suicide that continually flooded my mind. If I hurt myself, I would bring pain to these and many other people.

After being discharged from the hospital on January 30, I noticed that I began to feel better. My overall anxiety and depression had decreased. I felt calm. Friends told me that my voice was stronger and clearer, and that my affect was less flat and more vibrant. In short, I had gotten some relief from my symptoms. So while the hospitalization and ECT have not created a total cure of my depression and anxiety, it has reduced the symptoms enough that I can work on them using other tools.