How to Manage Depression and Anxiety: 9 Gentle Steps You Can Start Right Now
While much of what I've written here may be nothing new to those who have sought medical or counseling help for their mental health issues, these things bear repeating. Below, I've given some creative ideas and have shared the ones that have helped me personally. I hope these things are helpful to you as well. As I have finally implemented these things into my life, I have a better quality of life than I ever dreamed. Give them a try before balking. Be willing, be encouraged, be hopeful, and be grateful for whatever progress you make. Best wishes.
The information provided here is not intended to substitute for the advice of a medical or psychological professional. Always consult your doctor to determine appropriate treatment. Never take medications or supplements without your doctor's approval.
1. Take Responsibility for Your Recovery with a Willing Attitude
One of the greatest lessons I've learned as someone who has struggled with anxiety and depression is being a part of my own recovery. After many difficult times, I've realized and decided that if I do my part in my recovery journey, then my life will be of much higher quality. The tools and suggestions we are given by mental health professionals, family, or friends won't do any good if we aren't willing to try them. Some methods won't work right away, and it is necessary to keep trying. It's all in the attitude. If one wants to move forward, they need to take responsibility to do what they can to reach recovery and a better quality of life.
2. Practice Spiritual Disciplines if You Find Strength from God
I realize not everyone has the same beliefs as I do, and that some have no desire or interest in spiritual matters, so of course, you are free to practice whatever resonates with you personally. As for me, I cannot speak enough of the help I have received by reaching out to God through reading the Bible and praying.
I start with this because I find strength and comfort in God. It's a good way to start the day. It gives me a better perspective, keeps my awareness of God's love fresh, and often sustains me in difficult moments. I find that when I neglect this time with God, my perspective and attitude become skewed.
Having said this, there are times when I have no sense of God's presence, and concentration in prayer and devotional reading is challenging—sometimes nearly impossible. I like to read the Bible, so when it's hard to absorb an entire passage, I find one verse and meditate on that. When I say meditate, I don't mean emptying myself; I mean filling up with God. Sometimes I go to the library and find a CD or audiotape of someone reading the Bible. It's so soothing.
3. Set Small Daily Goals During Acute Stages
Severe, clinical depression can be incapacitating. It's easy to feel guilty about not being active or able to take care of basic things, such as grooming, housework, or paying bills. One thing you can do to alleviate some of this guilt is to set a feasible goal for yourself every day. This may sound silly, or overwhelming and unrealistic, but it is very helpful if you try.
On days when you can hardly get out of bed, your daily goal might be brushing your teeth, combing your hair, or changing out of your pajamas—anything small and simple. In the beginning, don't set your daily goals too high, like paying off your bills, cleaning the house, or going to baseball practice with your kids. Keep it within your current ability based on how you're feeling that day.
When you set a small goal and are successful in completing it, you'll feel a sense of accomplishment and some relief from your guilt and self-loathing. It will encourage you to try another goal the next day, or as soon as possible. You may even feel a little bit of energy.
As you improve, you may want to set two or three goals a day, but continue to keep them very simple and doable. You could make a phone call, get out of bed for 15 minutes, or look at magazine pictures (reading can be difficult since depression can cause an inability to concentrate). You could also aim to take a nice shower or bath or light a scented candle, which can have a pleasant and soothing effect.
Setting and accomplishing goals will not take your depression away on the spot, or even in a few days. However, they may give you a small sense of productivity accomplishment, a few minutes of pleasure, and make you feel good about yourself.
After receiving some professional mental health treatment such as therapy or medication (if prescribed), you can set your goals a little higher as you start to feel better. Perhaps you'll feel up to taking a short walk, doing a load of laundry, washing the breakfast dishes, or paying one bill. Still, it is best to keep it to three goals or less so you don't feel overwhelmed.
4. Exercise to Promote Mood and Health
The importance of exercise is not news to most people. It's something you'll hear from most of your mental health care providers. It seems unimaginable to think of exercising when very depressed; however, it's good advice because it does make you feel a lot better. Exercise, as you probably know, releases endorphins—a hormone that gives us a sense of energy and wellbeing.
Exercise can seem overwhelming in the beginning, but by "exercise," I don't necessarily mean going to the gym and doing an hour-long workout. You don't have to walk three miles or swim eight laps. Outdoor walking is a perfect exercise, and it doesn't cost anything. An additional treat to outdoor exercise is the invigorating pleasure of fresh air and a change of scenery. Taking your dog on these walks can double your pleasure when you see your dog enjoying the great outdoors and exercise as well.
Start small with a walk to the end of your street. Gradually work up to going around the block, and slowly increase pace or distance as you feel better. You could also take a leisurely dip in the pool and gently swim from one side to the other.
At one point, I agreed to exercise two days a week. I got a membership to the YMCA and used the treadmill or bicycle machine for 10 minutes. Once in a while, I would do a few minutes of weight training. Even after just a short time of exercising, I felt like a million dollars.
5. Learn to Eat Healthier
You may wonder what difference a good diet can make. Many who are suffering from depression turn to junk food because there is little preparation involved, and they crave salt and sugar.
I recommend asking yourself, how does junk food make you feel? How does eating pizza and soda and being sedentary make you feel? You may not realize how bad you feel until you start to eat healthily and feel an improvement in energy and clarity. Eating junk food negatively affects your body and can worsen a poor sense of self- image.
The important thing about the diet is to be sensible. You don't have to be a rocket scientist to know a healthy, well-balanced diet includes whole, unprocessed foods like fresh or frozen fruits and vegetables, whole grains, fish, chicken, nuts, and seeds. Stay away from fatty, fried, and highly salty foods. There is the adage that says you are what you eat. I don't know about that, but you will feel like what you eat. If you are so used to processed foods that you can't quit all at once, try adding healthy ingredients to your meals little by little.
Cooking healthy meals can seem daunting, so keep it simple and ask a spouse, friend, or family member to do it with you. It's always more enjoyable to share a meal with someone you love.
Nutritious Snack Ideas if You Don't Have an Appetite:
Some people who suffer from depression or anxiety have little to no appetite. This makes healthy eating even more of a challenge. I suggest taking bites of healthy snacks and small meals. Here are some of the snacks I eat when I don't feel hungry:
- Rice cakes with hummus.
- Dry-roasted nuts. Dry-roasted means less fat, and I choose the ones with low or no added salt.
- String cheese. These come in more varieties than just mozzarella—try cheddar, Colby, or pepper jack to switch it up.
- Kale chips. This is the new thing! They are easy to make and highly nutritious.
- Fresh fruit or veggies.
- Air-popped popcorn.
Healthy Snack Alternatives That Satisfy Sugar Cravings:
The craving for sweets can get us into trouble. I have found a few that are healthier than ice cream, cake, candy, and pie:
- Dark-chocolate bar with cacao. I get the Ghiradelli or Cadbury brand. They aren't too costly if you don't eat them all in one sitting. They are so healthy and rich. I keep one or two in my fridge and break off a square when I get a craving for sweets.
- Yogurt. I like ice cream, but it's not the best thing to eat when I'm depressed because we all know the whole carton disappears in those times. I discovered that putting Yoplait or another Greek yogurt in the freezer tastes close enough to ice cream. I don't eat as much of it either.
- Frozen berries. I'm not much of a fruit-eater except for bananas and berries. I buy big bags of mixed berries at Costco. You can do so many things with them. I put them in my cereal, oatmeal, or in a bowl with a dab of yogurt or whipped cream. You can get creative with berries, and their antioxidants are phenomenally healthy.
6. Stay Hydrated
The medical community says dehydration really affects how you feel and the quality of your health. We always need to be drinking throughout the day. The use of psychotropic medications can also create a terrible problem with dry mouth. It's very annoying to feel thirsty all day long, and I found out from my dentist that it causes tooth decay and gum disease, as shown by recent x-rays. I make sure to drink water all day long.
If you don't like the taste of water, make sure you're at least drinking something throughout the day without a lot of caffeine, sugar, or artificial sweetener.
Of course, if you have anxiety, consuming caffeine isn't wise. It's also been long said that coffee is a diuretic and is counterproductive to hydration. Some recent studies prove otherwise, but moderation is always the best practice.
7. Take Vitamins and Supplements
There are all kinds of nutritional supplements, but the one thing psychiatrists are really pushing today is fish oil. There is no flavor or odor, and studies are showing that fish oil is very, very good for the health of your brain. It helps with memory and cognitive abilities, among other things.
Multivitamins and B-vitamins are also very important. There are also many herbal supplements that may help with depression, but they can be very harmful if you mix them with antidepressants or any other psychotropic drugs. Always talk to your doctor and/or pharmacist before adding supplements to your regimen.
8. Improve Your Quality of Sleep
This is a really hard one because it is the most difficult to control. People with depression either sleep too much or they can't sleep at all. The quality of your sleep is just as important as your quantity of sleep. Sleep is restorative to the body and the mind.
If we are not sleeping, it compounds the symptoms of our depression. Think about a time in your life when you were mentally and emotionally healthy, but for some reason, you were sorely lacking in sleep. How did you feel? Most likely, it was harder to cope with everyday stressors and activities. Your mood goes down and you get irritable. Add depression or bipolar to that and it can send you into a downward spiral.
For people with bipolar, lack of sleep can send you into an intense, rapid mood swing. Often times, a symptom of mania or hypomania is feeling no need to sleep. But eventually, this wears off and you slide rapidly into depression. It gets to be a vicious cycle that can be hard to break. Your doctor may be able to help you with some prescription, herbal, or nutritional supplements to help with sleep.
Tips for Improving Your Sleep:
- Going to bed and getting up at the same time every day.
- If you can't sleep, get out of bed and do something relaxing. Laying in bed restless can make you miserable and anxious, and your brain gets tricked into thinking of your bed not as a place to rest.
- Don't eat just before bed. A full stomach can cause discomfort if you have acid reflux and may intensify your wakefulness. Sometimes, food can cause nightmares. There is a certain type of pizza that never fails to give me nightmares.
- Make a pre-sleep routine. Read a book, do relaxation techniques, brush your teeth, go to the bathroom, brush your hair, and go to bed.
- Keep your room really dark to make it easier to fall asleep.
- If you sleep better with fresh air, open your window.
- Exercise and a healthier diet help tremendously to encourage sleep.
For those who can't stop sleeping, sleep hygiene is just as important for you, but honestly, it can be very difficult. This is where all the above suggestions come in. Make a goal to get out of bed for a certain amount of time, get some fresh air, and do even the mildest of exercise. Work with your doctor about possible solutions.
For those suffering from PTSD nightmares, there is a medication that can be very effective in preventing these nightmares called Minipress, or Prazosin. However, always consult your doctor before trying any medication.
9. Manage Anxiety Symptoms with Self-Soothing and Relaxation
When I was taking a class on anxiety, a therapist once shared a method of building a self-soothing first-aid kit. Simply find a box or basket and put some items in it to soothe each of your five senses. Use your imagination for these; it's fun!
Here is what I chose to put in my first-aid kit:
- Touch: I added some smooth, polished stones and a powder puff. You can use anything you want like a small blanket or stuffed animal—the sky is the limit. Your item doesn't even have to fit in the basket. Sometimes, I just pet my dog.
- Taste: My favorite snack or herbal tea. Often, it was sleepy-time or chamomile tea.
- Hearing: I used an instrumental CD of hymns or nature sounds.
- Sight: I included a photo album of my grandchildren and a small book on roses (my favorite flower), so I could look at all the different varieties, allowing myself to dream of which ones I want to plant next.
- Smell: A scented candle
Include Relaxation Practices in Your Daily Routine
While using relaxation techniques won't be as effective if you're already in full crisis, the idea is to get into a routine of keeping your body and mind regularly relaxed enough to ward off escalating, crisis-mode anxiety symptoms.
I kept the following routine:
- Wake up at 8:30 am, no matter what.
- Eat a light breakfast with orange juice, my prescribed medication, and coffee.
- Read the bible or inspirational material, followed by prayer.
- Relaxation and breathing exercises.
- One or two household chores, depending on how well I was doing.
- Play a fitness DVD and do a 15-minute stretching routine. If I felt pretty good, I would do one of the longer routines. If I couldn't get through the whole segment, I still gave myself credit for doing what I could.
- Eat lunch
- Take a brief walk, gradually building up over the weeks to lengthier walks.
- Another small household chore, or make some phone calls to check in with close friends.
- Free time in the afternoon—use your imagination and make sure whatever you do it is healthy, soothing, and pleasurable.
- Eat Dinner
- Read or look at the sight tools in my self-soothing first-aid kit.
- Light a scented candle
- A half-hour before bedtime, drink some tea, put on music, say my evening prayers, and reflect on my day. I allow myself to be fully in the moment (a mindfulness practice) and don't let myself worry about tomorrow.
- More breathing and relaxation techniques
- Brush my teeth, take my prescribed medication, and be in bed by 9:30 without fail.
I found this routine of relaxation very helpful.
Questions & Answers
© 2011 Lori Colbo