Coping with depression: Strategies for maintaining mental health

Depression is not a feeling of sadness. Although everyone experiences it differently, there are key elements. Some might describe it as a feeling of not knowing how to be alive. Of not enjoying life – even when life on paper looks good. You may have enough money, no worries, a lovely family and great friends, but you still have a feeling of doom. This can lead to feelings of guilt, as no one understands why you cannot feel happy. You experience discomfort when you try to share how you feel.

You may feel like you don’t bring value to anything or anyone. Feeling lonely is different to being alone, so you may feel lonely even though you have people surrounding you. Or perhaps you desperately want friends but do not feel worthy of friendship. Suicidal ideation is a symptom of depression. You may wonder if it would make any difference to anybody if you disappeared. You may think it would enhance the lives of others if you were no longer here. This is depression at its worst.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, (DSM-5) is the book that mental health practitioners use to diagnose mental health disorders. To receive an official diagnosis of major depressive disorder, you must experience five or more of the following symptoms in a two-week period, and at least one of the symptoms must be either depressed mood or loss of interest or pleasure. A depressed mood is described as feeling sad, hopeless or empty most of the day. This is valid whether observed by yourself or someone else. A loss of interest or pleasure, the official name anhedonia, is disinterested in things normally enjoy.

The other symptoms you might experience are:

• A change in weight and/or appetite
•  A significant change in sleep pattern, either an inability to sleep fully or sleeping much more than usual.
• Restlessness, or the opposite slowing down – as observed by yourself AND others.
• Tiredness or low energy.
• Feeling worthless or excessively guilty.
• Difficult concentrating or making decisions.
• Suicidal ideation or suicide attempts.

If you meet the criteria for major depressive disorder, it is advisable to seek external support. Whether this is a telephone call to a crisis line, your GP or a private therapist. If you don’t meet the criteria but experience some of the symptoms, you may benefit from the following strategies to help you maintain your mental health.

Seeking professional help

Seeking professional help is a broad term that encompasses a wide range of ideas. In England, we have the NHS, which most of us feel lucky to have. In general, the NHS follows a pharmaceutical model with a narrow range of treatments.  It is important to remember, that the NHS writes protocols on a wide scale to cover the majority. It is difficult to personalise treatment, and there are limited offerings. Your GP is a good first point of contact, however, it’s important to investigate what else is available. You should find local charities that offer a free or low-cost service. Private practitioners offer modalities ranging from ancient wisdom to those that utilise modern technology. You might find the perfect source of healing for you, something you wouldn’t ever receive from the doctor, by speaking to different people and trying something new.

Building a support system

A support network is paramount. You might have friends and family that surround you and support you, but it’s not always easy to allow. Guilt can seep in, or you may feel a burden. Not to mention trying to keep the space open for fun times. A good first step is to accept help when it’s offered and ask when it’s not. Beyond this, a therapist you trust and feel safe with provides stability. Group therapy brings a community of people more likely to resonate with your struggles. The regular meet-ups will help get you out of the house and to socialise.

Some recommend you talk with the people you choose as your support system, so they can confirm whether they have the capacity for this. This helps with transparency and expectation.

Adopting healthy lifestyle habits

Before anything, ensure you have healthy sleep habits, move regularly, and have ideal nutrition. Experts recommend a sleep opportunity of at least eight hours per night, with two hours screen-free time before bed. Ideally, you’ll also avoid bright lighting. Fifteen minutes of reading before bed helps sleep. Several other habits help sleep. These are easy to learn by listening to a podcast or reading The Anatomy of Anxiety by Dr. Ellen Vora or Why We Sleep by Matthew Walker.

Nutrition helps significantly with mental health and sleep. Sugar highs and lows can cause sleep disruption, as can eating too much or too little before bed. Take time to focus on your nutrition. Dr Rangan Chattergee gives valuable information on his website, or you can try the Zoe Study podcast.  

Finally, ensure you have sufficient movement in your day. A formal exercise plan isn’t necessary unless you are sedentary for the rest of your day. Try taking a few short walks – ideally in a natural environment – each day, or using the internet to find a gentle workout at home. Yoga is particularly good for connecting your mind and body.

Practicing mindfulness and meditation

Mindfulness and meditation are separate but connected ideas. Mindfulness is a way of life and is exactly what it says on the tin – living mindfully. Being in the present moment, without judgement. Meditation is a practice that helps you live mindfully. Meditation is a way to train your brain to remain mindful. Most people attempt to clear their minds with meditation and sit in silence. However, you can use a guided meditation, that takes you through a visual story. You can use an app for this or YouTube. A hypnotherapist will help you learn self-hypnosis, which is similar to meditation.

These are just a few ideas to help you through depressive feelings. Remain patient with yourself as you navigate the different challenges. If you find it overwhelming, start with one small change. When that becomes a habit, add in something else. Recovery is a process that takes time. Be gentle with yourself and know there is a way out of the tunnel of darkness.