9 Steps to Managing Depression


Manage your illness; adopt and maintain a positive belief system; allow time for love, wonderment and serenity; don't do it alone; and forgive yourself for past mistakes. Steps 2 through 9 which follow provide the basis for Managing Your Illness. Put as many of these positive steps as possible to work for you each day. New Directions' four+ meetings per month will help to focus on the skills that you require to take charge of your life.

Develop a Positive Mental Attitude (PMA) and use it to attain success. Believe strongly in your ability to achieve and sustain a functional, productive, and happy life and use the resources and experience of New Directions and other support group members to aid you in this objective.

Don't fight the enemy -- depression or mania -- alone. It is cunning, recurrent and exhausting.Provide time each day for fun, relaxation, mindfulness and love. Remember that depression thrives on your stress, aloneness and despair. Expect miracles each day and allow time to wonder at the world's beauty and diversity.

Find the very best psychiatrist you can to work with you. Don't settle for anyone less. Your choice of psychiatrist is one of the most important decisions you will make in the management of your illness.Choose someone you intuitively like and feel comfortable with, someone who treats you with respect and is comfortable answering your questions.Your psychiatrist should be an expert in prescribing medication. He or she should be up to date on the latest medications and latest medical developments. In addition, he should schedule you for necessary blood work if you're on medications such as Lithium or Tegretol.

Today it's quite common for some psychiatrists to specialize in medication only, while others do both traditional "talk therapy" plus medication. Many people see two kinds of mental health professionals: a psychiatrist who dispenses medication and a psychotherapist for "talk therapy. " (More about talk therapy in Step No. 6).It's important to have that good psychiatrist NOW, while you're well, instead of waiting until you're in the midst of a crisis. Check with group members or your family doctor for a referral. Referrals are preferable to picking out someone at random from the phone book.

Once you've found a doctor to put your trust in, the two of you can work on getting just the right medication(s) -- if necessary -- to keep you healthy. Sometimes it takes patience and diligent trial and error effort to hit upon the right combination of drugs for you. Remember that the medical arsenal has greatly expanded over the years and chances are extremely good that you can be helped.Take an active part in learning about your medication. Ask questions: What exactly is the medication supposed to do? What category does it fall under? Antidepressant? Antianxiety? Antipsychotic? How soon will it work? What side effects might you expect? How long should you stay on a medication before you and your doctor conclude it doesn't help you? Are there other meds you can try instead?While the doctor is the undisputed expert, it's in your very best interests to be an informed consumer. (See New Directions "Guide to the Most Commonly Used Psychiatric Drugs.")

Most illnesses have a frightening ring to them. Shed light on the facts about depression and manic depression. Don't rely on hearsay reports, much of which contain half truths or distorted myths. Find out the truth. The more you know about your illness, the less intimidated and the more in charge you will feel.Knowledge is power. Many feelings of helplessness are reduced as people take bold steps to gain knowledge and learn the "good news" -- that highly effective treatments are available, that medical progress has been made in the past years and continues to be made, and the fact that so many people share your illness and you are not alone.

Information on mood disorders is available from numerous sources: the public library, bookstores, group members, your psychiatrist, psychotherapist, videos, lectures at local hospitals and New Direction's library. New Directions has established a psychoeducation program providing professionals to speak to our members on topics pertinent to diagnosis and treatment of the illness.

Both depression and mania can often be caught in their earliest stages and, with appropriate treatment, brought under early control.Learn what your early warning signals are. Then take action to combat them. Call your doctor when your earliest symptoms appear. You and he can then plan a strategy which hopefully can nip the illness in the bud. This can range from using medication ... to having therapy sessions ... to making changes in your personal life that may cause you distress.The ability to take action when we feel an episode coming on puts us in a powerful position to prevent a full-blown episode. (See "Catching a Manic Episode Before it Gets Started/How to Stop a Hypomanic Episode.")

6. GET "TALK THERAPY" IF NEEDED. In addition to medication, many people benefit greatly from one-on-one therapy.While medication is invaluable in alleviating symptoms of depression or mania or in stabilizing the mood, some people are still left with a residue of unresolved personal issues that may interfere with living well. These issues may include relationships with others, job success, personal growth and fulfillment, negative thinking, etc.One especially common problem is the lack of self-esteem people feel after having been diagnosed with a mood disorder -- or after suffering a major episode of the illness.In this and other cases, therapy with a skilled psychotherapist can prove of tremendous value. In therapy, we gain an understanding into our inner selves: our strengths, our conflicts, our patterns of behavior. Through this understanding comes the ability to change and to grow.

Staying healthy begins with having something meaningful to do each day. People who work at jobs they enjoy feel productive, needed and important. They feel a sense of belonging, a part of society. The pride they feel in their jobs is reflected in their self-esteem and self-confidence.

Work comes in many varieties. Some people find satisfaction in a relatively low-stress job, while others enjoy the challenge of having lots of responsibility. What matters is that your job fits your emotional needs -- which may change from time to time -- and that your job bring you that vital sense of satisfaction.Not everyone is able to work. Fortunately there are several options to keep people stimulated and to take them out of their homes. Volunteer work offers a cornucopia of opportunities in almost every field imaginable. Volunteer work can be a prelude to entering the work force or it can be a valuable end in itself.Another option is the "Day Program", also called "Partial Hospitalization program". Like volunteer work, it may be temporary or on a more permanent basis. Day programs offer structured days of activities, therapy groups and fellowship with others.But no matter what you choose to do each day, staying healthy means leaving home, getting out into the world and making a contribution.

Support groups are unique. They offer an all-important sense of validation, a feeling that, "Hey, I'm not the only person with this condition, I'm in good company."Groups offer role modeling, practical information on how to cope, education on the illness and medication, doctor referrals, friendship and camaraderie, and a safe place to unburden yourself about things you may not be able to share anywhere else.

9. REACH OUT. There is a magic in being able to help someone else. Put your unique experiences to work. You are in a privileged position to help out others who share your same illness ... to lend an understanding ear or to offer a message of hope.No one can understand like someone who's been through it. Your experiences can make a difference in someone else's life.