Since “coming out” as a person with depression, a lot of people have confided in me that they or someone they love is depressed. Often the question is, “what do I do?” My answer is perhaps very different from what I’ve seen on the Internet. I don’t recommend starting with self-help, I tell them to start with professional help.
Before I hospitalized myself in 2014, I was on a slow path downward for many years. I wanted to shake my depression myself. I hated the thought of taking medication. I told my general practitioner I didn’t want to be a guinea pig for the pharmaceutical company, so I worked with her to reduce the amount of Remeron I was taking. (I had been on 15 mg of Remeron for a decade, which is a low dose as it was.) Eventually I was down to cutting 7.5 mg tablets in half. I exercised like crazy, diligently took my vitamins and supplements, ate my fruits and veggies. I forced myself to stay social, going out with friends every Friday and Saturday night. I read dozens of self-help books and performed therapy on myself. I worked hard to keep my depression at bay, but all my efforts stopped working.
I don’t know if it was the lowering of Remeron, or the hormones of peri-menopause, or my mother dying, but I stopped being well despite all my self-help efforts. I was forced to turn to medical professionals. It’s not what I wanted, but I was desperate and out of options.
As I think about this journey, I see now that professionals got me better in less than two years. Where did self-help get me? I spent over a decade of my life in unnecessary pain as I frantically tried to cure myself. I lost those years to depression and anxiety.
When I’m asked, this is what I recommend to deal with depression. Now is not the time to cheap out and cut corners. I recommend doing at least one of the following, or better yet, all four!
Get a good psychiatrist.
I know that many people are leery of psychiatrists. We want to muscle through depression on our own, without medication. What you may not realize is that a psychiatrist can help with more than medications. They are licensed medical doctors (MDs) who understand the interactions between mind and body. A good psychiatrist will want to run bloodwork to check for biological reasons for depression such as vitamin levels, thyroid function, and hormones. Plus, if you do decide to take medications, psychiatrists are far more educated than a family doctor and know how drugs work together, good and bad. A family doctor is much more inclined to play it safe and only prescribe SSRIs at low doses which are basically placebos. You want someone who can accurately diagnose your condition and prescribe the lifestyle and medication changes you need.
Get a good therapist.
Whether you have a psychiatrist or not, a therapist will be your sounding board, your champion. Distorted thinking fuels depression. A therapist will help you re-learn normal thinking skills.
Find a support group or two or three.
Typically you’ll see a therapist once a week, which really isn’t often enough. It’s too easy to fall right back into bad habits the other six days. That’s where a support group comes in. As you attend a group regularly, you make friends who will hold you accountable, help you stay on track. Check out the Depression Bipolar Support Alliance (dbsalliance.org) for groups near you. Mental health facilities and hospitals often hold support groups as well. Go to as many groups each week as you need to keep yourself occupied and supported by like-minded people. They’re usually free.
Be willing to go to a hospital.
Sometimes depression reaches a crisis point. Don’t expect a therapist or psychiatrist to know when that time has come. They are human, and they can’t always tell. If you know in your heart that you need more, tell them. If you decide you need outpatient or inpatient therapy, I have some very specific lessons learned from my own experience:
- Doctors and therapists don’t necessarily know much about the programs and facilities in your area. Sounds crazy, but they tend to know only about the few hospitals and programs where they have worked, or where their colleagues and friends work. I had assumed they would make site visits to all the facilities in the area, but that’s not the case. Often those facilities won’t even allow them to visit if they’re not on staff. My psychiatrist checked me into a hospital because she liked the head psychiatrist, but had no idea the place was like One Flew Over the Cuckoo’s Nest. I checked myself out the next day after a young schizophrenic man in the throes of serious delusion walked into my room while I was changing my clothes. It was scary.
- Don’t wait until your illness is so bad someone calls the cops. You don’t want to be forcibly committed. You will be treated as a criminal and placed in a total lockdown unit. These units house people who are dangerous to themselves or others, so the units are stripped of absolutely anything that can be a weapon or suicide tool. Chances are the patients don’t want to be there, so they’re angry and disruptive. It’s not a healing environment; it’s a holding cell. Alternatively, when you voluntarily commit yourself, you maintain some control over the situation and get to choose where to go.
- Support groups know best! Think about it. Who can tell you about the best hospital or outpatient program than people who have been a patient there? Ask your support group for their recommendations. When I checked out of the psycho ward my doctor put me in, I went to my DBSA support group that night and asked for their help. Questions I asked them:
- Are the forcibly committed patients separate from the voluntary patients? Some facilities simply don’t have the space to house forcibly committed and voluntary patients separately, so everyone gets treated at the lowest common denominator. After my psycho ward experience, I wanted to be separate from the forcibly committed patients. I’m so glad I did. The voluntary patients enjoyed a lot more freedom.
- Are the men and women housed together? Again, after my experience with a man entering my room, I wanted to be with women only. Some patients have impulse control issues, and the flirting can ramp up to annoying levels. I believe you and the people you’re around need to be 100% focused on getting well.
- Are patients allowed to go outside? I wanted to be able to get fresh air and sunshine every day.
- Do they have physical exercise programs? Some facilities don’t accommodate exercise, which I feel is very important for recovery.
- What are their group therapy programs like? Some facilities really don’t have much in the way of therapy and stick their patients in front of the TV. Boring as all get out.
- Do they have outpatient programs? It’s critical to have a good outpatient program when you’re discharged from the hospital. You need to ease back into your day-to-day life after all the work you’ll do at the hospital, and outpatient is a great place to do that. You may also decide to try outpatient first before going inpatient.
This advice isn’t meant to imply that self-help isn’t useful. I absolutely love yoga and mindfulness techniques and recommend them highly. Self-help and holistic therapies are a great augmentation to professional help. However, I feel professional help is the foundation. Talk to your therapist about ways to supplement your treatment.
I hope this article is helpful to you or your loved one. I am always available to answer questions or offer online support. Please comment on this article and I’ll respond!
Keep an eye out for my new book coming soon, 100 Days of Mindfulness: Presence, on Amazon and Barnes and Noble! Stay tuned…