20 Strategies for Dealing with a Crippling Depressive Episode

September 26, 2009 at 6:00 am | Posted in Uncategorized | 2 Comments

My darling Julia, who has seen me through many a rough patch.

My darling Julia, who has seen me through many a rough patch.

Reading If You’re Going Through Hell Keep Going reminded me — as if I needed reminding — that sometimes depression is so terrible that you’re lucky to brush your teeth, let alone go hiking. For those occasions, I offer the following list of coping strategies:

1. If you’re thinking seriously of suicide (for instance, planning it or being tortured by compulsive thoughts about death), go straight to the hospital. Same goes if you’re hurting yourself in any way. If you aren’t safe to drive, have a friend or family member pick you up. If, in your judgment, you might hurt yourself, don’t worry about insurance or anything else — just go. Being in the hospital sucks, but you may meet a shrink who can change up your meds in a beneficial way.

2. Call your psychiatrist, if you have one. Don’t permit yourself any excuses (“She doesn’t understand,” “He’s always too busy to return my call”). Just call.

3. Call a local crisis line (your doctor should have one on her answering machine), or call 1-800-273-TALK. Again, no excuses about how things aren’t bad enough or you’ll be better soon (I get surprisingly optimistic about my health at the very thought of getting help) — just call.

4. Go on any of the following websites and post to the discussion groups: Depression and Bipolar Support Alliance, The Icarus Project, or Find the Light. Let people know that you’re terribly depressed and need love. It will come pouring out over you. The Icarus Project crisis discussion group is particularly supportive and caring.

5. Call a friend and sob shamelessly. Again, no excuses. Read the post on phone phobia if you need help talking back to your negative thoughts. You may have to call people — even a single person — daily until you feel better. Do it.

6. Read books you love or watch a movie that pleases you. Patrick O’Brien’s 20-volume Aubrey-Maturin series has seen me through more than one low point.

7. See to your physical comfort and hygene. If it’s miserably hot, make sure you turn on a fan or air conditioning, if you have it. If it’s cold, take a hot bath or crank up the heat. Don’t suffer any more than you have to. Also, try very, very hard to bathe, brush your teeth, and wash your hair. These simple steps will improve your mood, even though they seem like too much trouble.

8. Open the blinds. Get that vitamin D, and get some natural light on your retinas. This will help you to sleep properly, and will energize you a bit.

9. Have a friend come over and clean, or, if you can afford it, hire someone to come in. It’s embarrassing to let anyone see how far you’ve let the dishes go, but professional cleaners, in particular, have seen it all and really don’t care. A a filthy house will drag your mood down; a clean one will lift it. I actually have to keep my house clean at all times. If I don’t, my mood will begin to spiral downward.

10. Accept help when it’s offered, and ask for help if you need it. I always get into a weird, prideful place when I’m depressed, and I find it hard to let people help me. I also think too slowly to spell out what I need. This should be a part of your crisis plan. If it’s not, ask your friends what they think you need, and then ask them to do it. If you can’t do any of the things on this list, have a friend come over and help you.

11. Get out into nature, even if that just means finding a single plant. Study that plant. Pretend you are that plant. Turn yourself over to the plant completely for as long as you can. List its parts, touch it lightly, notice whether it has new growth.

12. Give love to your pet. Stroke it, groom it, feed and water it, give it a treat or scraps if you’re into that. Caring for another living creature can be easier than caring for yourself, and giving love can help you to receive it. If you don’t have a pet, get a rescue the next time you’re vaguely functional. They need you, are highly therapeutic, and will connect you to life when everything else seems meaningless. Cats are soft and sweet, dogs give unconditional love, and fish are lovely. Snakes have nice skin and feel very muscular. Do it. Get a pet.

13. Get fresh flowers, or have someone bring them to you. Trader Joe’s is an excellent, cheap source of bouquets. Once you have them, let yourself become absorbed in arranging them, smelling them, and admiring them.

14. String a necklace. I’m serious. Nothing is more absorbing and zen than fiddling with tiny, brightly colored beads. Making aesthetic choices may dislodge your mood a little.

15. Breathe deeply and recite a mantra. Pick one while you’re healthy, post it prominently, and recite it at least five times when bad thoughts attack.

16. Put together a crisis plan when you’re well, and use it when you’re sick. Post it, hand it out to friends and family, and for heaven’s sake, follow it. (I tend to lose them, or put them in inaccessible places like unbookmarked web sites.)

17. Comment on this blog, and I will send you love. Lots of it, with all my power.

18. If you attend church, have lay ministers come to give you the sacrament of healing, and ask to be added to any lists for intercessory prayer. The power of prayer is well-documented by a variety of rigorous scientific studies. For whatever reason, if people are praying for you, you will tend to get better.

19. If you think you might find this list helpful, print it out and post it prominently. Heck, I’m going to.

20. Do what you love. Set an alarm for 10 minutes, or even five minutes, and write, paint, or sing. No matter how dried-up your brain feels, it will benefit you. So, yes, do it.

It’s funny. When I first started writing this post, I thought I wouldn’t be able to come up with a single meaningful strategy beyond, “Call your shrink.” It turns out that there’s a lot you can do — it’s just hard to remember all of it.

Love to all.

I mean that when I say it, you know.



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  1. Copying and saving this – thank you R&R, this is a great list of coping measures!

    • I’m so you like it! I really hesitated to write this post — it’s always difficult to give advice to people who are really suffering without it sounding like “snap out of it.” Let me know if you use some of the strategies and they work for you.

      By the way, I love the “Namaste, Bitches” bumper sticker on your blog!

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