Surviving a depressive episode does not mean that life is suddenly beautiful. For the person who suffers from dysthymia (low-grade chronic depression), recovery from major depression can simply mean a return to the gray zone. Yet no matter the severity of your melancholy, there is much you can do to increase the likelihood that you will continue to stay and feel well. Since depression is a complex disorder with multiple causes, it makes sense to approach it on a variety of levels. A good analogy is the way we approach heart disease. If you went to a cardiologist and wanted to know how to prevent a heart attack (or to recover from one), he or she might prescribe a cholesterol-lowering medication and tell you to eat a low-fat diet, exercise three to four times a week, and cut down on the stress in your life.

What follows is also a holistic program for the prevention and management of depression. I have developed it:

• from my own experience (both during and after my depressive episode)
• from talking with others who are successfully managing their depression and anxiety
• from researching the medical and psychiatric literature

This “brain maintenance” program is meant to serve:

1. Those individuals who have experienced one or more episodes of major depression and wish to stay well. (Although there is no guarantee that this program will keep depression at bay, it can strengthen your “psychological immune system” and therefore enhance your resistance to the illness.)
2. Those individuals who suffer from dysthymia (low-grade chronic depression) and desire to elevate their mood, as well as prevent a major depression.
3. Those people who are experiencing a major depressive episode and wish to use these strategies as an adjunct to medication and/or psychotherapy.

I have organized these self-care activities into five areas–physical self-care, mental/emotional self-care, spiritual self-care, people support, and lifestyle habits. The accompanying diagram gives a visual overview of the program. As you read through the material, think of my recommendations as guidelines, not hard-and-fast prescriptions. Each person’s healing journey is unique. It is up to each individual to sift through the available options and discover what works.

As you read through my program, you will see that there is nothing new or radical in what I have suggested. The plan is a simple common sense approach to living a healthy and balanced life. But simple does not mean easy. Developing and sticking to good habits requires persistence, discipline and diligence (ask anyone who has quit smoking). But the dedication is worth it. Having spent too many days in the dark house, I do not wish to return; and I am confident that neither do you.

There is one final point that I would like to emphasize. No matter how many episodes of depression you have experienced, you are not your illness. The label “depression” does not define who you are but how you are suffering. If you start to believe that having depression makes you inherently defective, remind yourself that you are a normal person responding to an abnormal condition. Your spiritual essence transcends depression and cannot be touched by it or any illness. As the great 20th century visionary Pierre Teilhard de Chardin put it, “We are not human beings having a spiritual experience. We are spiritual beings having a human experience.”

Above all, try to be at peace with your condition. Some people have diabetes, others heart disease; you get to deal with depression. By applying the strategies described in this section, and by drawing upon other resources in this book, you can take small steps to improve the quality of your life. Remember, life is not always about fairness, but about how gracefully we learn the teachings of our unique path. Best wishes on your transformational journey.

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