A Personalized Approach
to Depression
Exercise is not depression’s holy grail
Depression ain’t what it used to be. And that is a good thing. The turn of the 21st century gave depression a better identity. Gone 
are the days when people with depression hid in the back bedroom, were shunned or worst of all, confined to an institution with barbaric practices like those seen in the movies and media.
Just the word depression was negative with its connotation of crazy or emotionally weak individuals. There are those who believe that the solution to depression is to simply go to the gym and release some endorphins. Now, in this new era of appreciating mental health challenges, we know that each individual’s experience of depression is unique and similarly, treatment should also be unique to that individual. It certainly isn’t just about exercise and it definitely shouldn’t include doing something an individual hates doing or is afraid to try.
Unfortunately, there are a lot of people dealing with the condition. Statistics don’t lie – 1 in 5 Canadians will experience a mental health problem or illness according to the Canadian Mental Health Association and the Mood Disorders Society of Canada notes that 8% of Canadians will experience a major depression in their lifetime.
Although there can still be a stigma, awareness of this proliferation of depression has led to a more open acceptance of mental health in the workplace. Depression is now moving towards being viewed as a common and possible result for everyday people who have life stresses and challenges.
Regardless of the shift in perceptions, the symptoms of depression have remained the same over time. These can include markers felt everyday or nearly every day such as:
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Depressed mood most of the day
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Markedly diminished interest or pleasure in all, or almost all, activities
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Significant weight loss when or weight gain without a correlating dietary change, or decrease or increase in appetite
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A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down)
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Fatigue or loss of energy
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Feelings of worthlessness or excessive or inappropriate guilt
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Diminished ability to think or concentrate, or indecisiveness
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Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
As a certified Canadian counsellor, I see these symptoms often. The American Psychiatry Association Diagnostic and Statistical Manual 5 notes when an individual experiences five or more of these symptoms, with at least one being either a depressed mood or a loss of interest or pleasure, for at least two weeks, a diagnosis of depression is most likely.
Once there is a diagnosis, the next step is to understand the severity (mild, moderate or severe) and how to approach treatment. Sometimes, knowing what thoughts or incidents (if any) trigger or link to the depression can help. Depression can be present because of an unexpected and sudden trauma, a loss, or a longer-term build-up of smaller life stressors which, over time, can chip away at a person’s ability to cope or maintain good mental health.
When working with clients with depression, one question I ask is:
At what point did you start to feel stuck?
This question helps in two ways:
1. Stuck has a nicer connotation than depressed, especially if there is a lingering negativity associated with the term depression
2. People can put together a timeline
Understanding the timeline can help define when the depression began and whether it was incident based, a product of long-held beliefs or built on a situation like a new job. This provides clarity on how to approach the “stuck” sensation.
There are endless articles, research and theories defining “the best way” to tackle depression. But before following the literature or someone’s opinion (like going to the gym will “fix” everything), it is important to define your own goals.
Most people, in the midst of depression, just want to feel better. Defining goals helps an individual decide what they want their life to include beyond feeling better. These are the ultimate outcomes that can lead to feeling motivated about the future when things in the moment feel absolutely awful. These goals may include:
– manage depression by recognizing mood indicators and stressors
– identify contributing factors and make changes to get better at staying in “management”
– improve confidence at work (staying at work or returning to work)
– learn about depression
– educate others and share experiences
– advocate about depression
Once your goals are set, some basics elements that often contribute to “feeling better” can begin to be implemented. These include:
Self-care – don’t put others first all of the time. Add yourself to the list and put you near the top. Self care can be whatever feels good to you. It isn’t just exercise or bubble baths or trips to the spa. Learn to listen to your inner voice and determine what self care looks like for you. Get back to activities you used to do to maintain good health or define new self-care strategies.
Mind work/attitude – don’t opt out of the necessary work to get you unstuck. Be open to learning and practicing mental and emotional strategies to gain some understanding and better manage the contributors that lead to your depression.
Sleep – don’t add sleep deprivation to your list of struggles. Find ways to get 7 – 8 hours a night or start with at least one more hour than what you are getting right now.
Diet – don’t let emotional eating become another challenge. Create a nutrition plan that is regular and predictable.
Routine – don’t be busy for the sake of being busy. Identify what is not working in your daily routine and develop routines and schedules that re-balance time with what needs to be done, work, fun and self-care.
Exercise – don’t let lack of motivation win out even while depression may be sabotaging your enthusiasm and energy. At the same time, don’t force yourself to do something you hate or that’s completely new and intimidating like running 5k or going to the gym. No matter what someone else might say is, “good for you,” added stress and guilt is not needed. Instead, find some form of exercise that will be moderately enjoyed (rather than despised or hated) and make a commitment to do it even when you don’t feel like it:
– walk 20 minutes
– do yoga or Pilates or tai chi
– use soup cans or rubber fitness bands to create an at-home strength routine
– implement a stretching routine
– go bowling or swimming, play badminton or walk dogs at the local SPCA
Explore medication – consider your beliefs around prescription medication. Talk to a doctor, pharmacist or therapist about medication, how it works and possible benefits/side effects to make an informed decision. Keep an open mind and don’t fall prey to the stigma of medication (which can easily cause resistance while experiencing the mental health challenge). Many people dealing with mental health challenges avoid medication, but it can quite literally be life-saving in some situations.
It is unfortunate and concerning that many professionals and people with depression believe getting ahead of it must always be deep, chemical-based and expensive. Certainly, for some, treatment may include prescriptions and psychological treatment/therapy and formalized programs. For others, the preference may include herbs and vitamins, self-guided work and good supporters. Yet others may use a combination of these elements or will use different things at different times. Sometimes, one tool, like anti-depressants, help to improve emotional health and management enough to make it possible to gain benefits from other techniques.
Regardless of what is available, the bottom line is to do what fits your beliefs and start with the basics.
This means figuring out:
– Beliefs about different types of therapy and medications
– Therapist fit in terms of the kind of personality and approach best for you
– Other health options like diet, supplements, meditation, alternative treatments, etc.
– Definitions of self-care and what helps you feel better
Be open to the options available and listen to the stories of what worked for others, but don’t take someone’s opinion to go to the gym to get better as an absolute. It might have worked for that person but you are not obligated to go to the gym.
Instead, look at what you used to do to feel good before the depression. Consider what that picture looked like in times before you felt stuck. There will be habits and activities you “used” to do and at some point, slowed them or stopped them. This can be hard during depression, so look at things factually in terms of what you know you used to enjoy.
Depression is far from easy, it can dis-colour memories, thoughts and feelings. It can rob you of great portions of your life. Do some assessment and figure out how you feel most comfortable tackling your depression and who can best support you. Most importantly, talk kindly to yourself and know that you aren’t weak or alone in having this condition.
If you are experiencing depression and are having thoughts of self-harm or suicide contact your doctor, call 911 or go to an emergency room immediately.
If you are feeling pressured to accept everyone else’s opinions on what you should do to get unstuck or surface from depression, now is the time to create your own strategy. We can help review options and guide you to decisions that are right for you. Contact us at 604-349-8660 or pam@pampaquet.com. Take the time to start the process or working to get past depression.
