Help me beat Depression without meds

January 18, 2010 7:40 PM

How can I treat my depression without medication?

I have a history of sort of a low-grade depression that basically gets in the way of life and what I want to do - I am what could be called high-functioning. I have never missed work because of it, but it does impact my social life and interests outside of what MUST be done, and at its worst, like when I encounter super stressful situations, it can develop into major depression.

Me: Married, female, late 30's, no kids, IT professional, advanced degree, healthy (other than carrying extra weight), financially secure, great job, supportive family, pretty okay life and grateful for what I have. I have hobbies that I could pursue if I had the energy to and didn't feel so overwhelmed by just getting through each day.

Sample of my day: I get up, go to work, come home, sit on the bed and watch tv or write, go to bed. Weekend - wash, rinse, repeat, with the inclusion of a trip to the market or maybe a movie.

Not exactly a back-breaking schedule, but I try to simplify my days when I get overwhelmed. At this point, I can't cut out much more out!

I have taken almost every kind of medication out there and while some work, some end up not working eventually, or the side effects are so intolerable that I would rather deal with the depression that take the meds. So meds aren't an option for me any longer.

What can I do to get past it so that it doesn't rule my days? I am really tired of this and although I will probably never get rid of it, I would like to know what people do to get a handle on it - I have tried counseling in the past and it didn't do much. My husband is very supportive and would help if I could tell him what I need. The problem is that I just have no idea. Can diet and exercise help?

All constructive and thoughtful advice is most appreciated.

Thank you, kind friends.

posted by anonymous to Health & Fitness (43 answers total)

Have you tried Cognitive Behavioral Therapy? There's a therapist finder here for US providers.

Diet and exercise can certainly help, but working on thought patterns that foster helplessness and hopelessness might help a lot more.

Feeling Good by David Burns, MD, is a great intro to some cognitive behavioral principles for coping with depression.
posted by Sidhedevil at 7:44 PM on January 18, 2010

Exercise is an incredibly powerful treatment for depression, easily as powerful (if not more) than medication alone. It will also help you with the extra weight.
posted by Miko at 7:46 PM on January 18, 2010

Nthing the exercise. It releases natural endorphins and will help so much with your self image.

Start off slow. Maybe just take a walk after dinner. Take the stairs when you can, or park farther away from the store. The times I have felt the best are when I'm doing some kind of moving.
posted by TooFewShoes at 7:50 PM on January 18, 2010

Nthing exercise and Feeling Good. Drugs (anti-depressants and anti-anxiety meds) gave me a temporary respite; embarking on a regular exercise program and Feeling Good put control of my well being in my own hands.
posted by hapax_legomenon at 8:01 PM on January 18, 2010

I also want to say that exercise helped me. I started off being completely sedentary, then started walking. I started feeling the most anti-depressive help when I had built up enough strength to be able to push myself -- to walk up a big hill without stopping (it took a while to build up to this), then to do a strenuous up-and-downhill walk for 45 minutes. Eventually I joined a gym and I find that the exercise that helps the most is that which is hardest for me -- the hard boot camp, the challenging yoga, etc. I tend not to push myself when working out alone, so I try to go to classes, telling myself, "Just do what the instructor says," even when I don't necessarily feel the motivation.
posted by BlahLaLa at 8:07 PM on January 18, 2010

Exercise, sleep, therapy, cut alcohol and some say caffeine. Eat better. Reduce stress however possible. Sometimes some form of artistic expression can help too. These work for some and not for others.

I have never found exercise has had any effect on depression, same with cutting alcohol and caffeine, but getting plenty of sleep is vital for me. Better diet has made no difference for me, but did serve to drop some pounds which made me happy. Yoga has helped in times of extreme stress. Occasionally very intense exercise will get me out of a bad head space, but that's rare and regularly keeping up a solid exercise routine has done nothing for my depression. I'm actually pretty jealous of people who can run their way to happiness and good health. Pure torture for me, but I still do it. I actually have to say a couple of glasses of wine is more likely to knock me out of a general dull depression than anything else, but the opposite is true for many people.
posted by whoaali at 8:11 PM on January 18, 2010

Nthing exercise - as cliched as it sounds, I've found that it trumps antidepressants handily. Get a pedometer, put together a playlist or mix CD of your favorite propulsive music, and go out and walk a few miles a day. I ditched Effexor last fall thanks to my daily exercise regiment.
posted by porn in the woods at 8:11 PM on January 18, 2010

Go to the gym.
posted by dfriedman at 8:13 PM on January 18, 2010

N+3ing exercise. I'm not talking about intense, spend-all-afternoon-in-the-gym-building-muscle-and-losing-weight exercise, but just hey-I-am-actually-using-my-body exercise. A vigorous walk. Biking. Dancing. Ideally something that makes you break a sweat. Ideally something that you can enjoy for its own sake as well.

It sounds like you've given meds more time than counseling. They supposedly work best in combination, but I'd give therapy another chance.

Also, don't rule out boring old medical causes of fatigue acting on a tendency for depression. Thyroid problems? Sleep apnea?
posted by hattifattener at 8:21 PM on January 18, 2010

You might want to look into sleep disorders. They are under-diagnosed - especially if you are female (many doctors still think it's only a problem for older, overweight males). The 'extra weight' you mention can make sleep issues more likely.

Your first few sentences sound alot like me a year ago: "impact my social life and interests outside of what MUST be done" and "hobbies that I could pursue if I had the energy to and didn't feel so overwhelmed by just getting through each day." I finally got a diagnosis and medication to get better quality sleep and it did wonders. I would recommend looking into it regardless, but especially if you have sleep related symptoms (snoring, insomnia, waking up unrefreshed). The medical community doesn't know as much about sleep and sleep disorders as you would think. My current doctor thinks anyone with unexplained fatigue or issues with stress should get a sleep test - regardless of any symptoms that would commonly call for it.
posted by ghostmanonsecond at 8:25 PM on January 18, 2010

Exercise! I'm like you -- consistent mild depression -- and I often found what it really boiled down to was a lack of energy. I didn't have the energy to do the things that I knew would make me feel good.

Now I do 10 minutes of cardio each morning (really, thats it!), and the difference is drastic. I'm actually sprightly! This is without drugs.
posted by dualityofmind at 8:25 PM on January 18, 2010

I have bipolar; these are some of the non-medicine things that help me when I'm feeling depressed or help me not feel as depressed. I will say, at the risk of sounding like a nag, it probably is worth talking to your doctor about these issues if you feel like they are having a serious impact on your life. Obviously taking medicine (or not taking medicine) is always your choice but please don't completely rule it out even if you've had some negative experiences.

• As others have mentioned, exercise is super helpful.
• I find that having a good routine is really, really beneficial to me. It sounds nerdy, but I actually have a weekly schedule I typed up with built in times for snacks, relaxing, exercising, cleaning, doing laundry, whatever (God help me, I take my schedule and routine very seriously so I actually have watching Jersey Shore officially typed in as part of my week). It helps keep me focused and makes tasks feel more manageable, plus I feel better when my apartment is a bit neater. This is really the biggest thing that helps me feel more stable and able to cope with things. Obviously it changes based on all sorts of things, but it gives me a structure and that really, really helps me manage my depression (and helps prevent my getting super manic).
• Spend some time alone each day. Not too much, but some, reading or doing a jigsaw puzzle or whatever.
• Don't laugh -- I find having a stuffed animal really reassuring. Yeah, I'm an adult, married woman and I still sleep with my stuffed duck (plus Paddington and a panda). It's kind of embarrassing, but having something cuddly to hold really does make me feel better. If you would feel too silly with a stuffed animal, maybe a cozy sweater? Something you can clutch.
• At specific moments when you feel badly, maybe try having some tea or hot chocolate? I find that having something warm is really soothing and the task of getting up and preparing it is enough to get me moving and take me out of myself just a bit as well as giving me something on which to focus without being completely overwhelming.
• I feel better when I eat more fruit (I would probably feel better if I ate more vegetables, but I am like a small child and it is really tough to get me to eat my veggies).

Please also feel free to MeFi mail me if I can help you with anything, or if you'd like to see a copy of my schedule or whatever. Good luck!
posted by Mrs. Pterodactyl at 8:25 PM on January 18, 2010

Exercise and B vitamins can go a surprisingly long way.
posted by dhammond at 8:29 PM on January 18, 2010

Several studies have demonstrated that exercise is as effective, or, over the long-term, more effective than medication for treating depression. I know motivating to exercise is difficult for most people, especially when you're depressed, so if I were you I'd try to choose an exercise modality based on how likely you are to keep doing it. Maybe join a group or take a class where you'd feel obligated to show up - either so you aren't letting other people down or so you're getting your money's worth (with the added benefit of social interaction which can't hurt either).
posted by serazin at 8:35 PM on January 18, 2010

5HTP in the morning and melatonin at night to help sleep. This helped turn me around to be able to manage the things mentioned upthread. It depends whether you consider these medication. Here they are OTC, but they have a different side effect range than many standard meds. Obviously, if this is too far on the med direction, you will rightly ignore this.
posted by kch at 8:39 PM on January 18, 2010

Exercise, sunlight, SAMe, fish oil, B complex, and D is how I manage without antidepressants.
posted by elsietheeel at 8:53 PM on January 18, 2010

Seconding the suggestion to look into a sleep disorder. I started waking up tired a couple years ago which is very unlike me. I started snoring and waking up in the middle of the night at the same time. eventually was diagnosed with some kind of rhinitis and got a nasal spray and it has made a huge difference.

I also started taking vitamin D, I was mildly beneficent and it does a wonderful job of evening out my energy levels.
posted by fshgrl at 8:55 PM on January 18, 2010

What worked for me in treating my depression and chronic anxiety was keeping a positive mentality. Not a fake positive mentality but actually telling myself I will get better in the next 5 years where I can handle any anxious or depressed feeling. I got serious about mentally getting better and focused less on outside pressures and stressors. Being a bit selfish was crucial for me as I was used to putting everyone else's needs over mine. Put some needed time for your space and privacy. Own up to anything that bothers you and own up to any feelings. I used to be hard on myself for not feeling up and ready to hit the world because I was in such a fog. I stopped fighting my feelings and let it flowed without thinking what my next step had to be. Once I accepted what I was feeling, it would pass and finally made way to do what I wanted or needed for the day.

I tried going for Cognitive Therapy but ended up just talking with a therapist and finding out it was more how I was feeling that people besides myself, have to accept. I used to worry that my feelings were irrational and she made me believe in my feelings and reminded me not to judge them or even my thoughts. Basically, whenever I found myself questioning and doubting myself she would ask, "What is it that you want?" Basically, she gave me confidence to allow myself to feel the depression and anxious moments. By doing that, a lot of my symptoms passed. You have to accept that you will always feel this way. Even though I havent had any anxiety for the past year because I got better with time, I still understand that I'll always have OCD. Knowing that, actually calms me and my feelings are in check. Also, I find I feel so much better when I have more fiber in my diet.
posted by InterestedInKnowing at 9:04 PM on January 18, 2010

In the winter I try to have plenty of light -- not the "light box" therapy, but more lights on around me, and getting outside under a blue sky (not available in some areas). I have an Ott-light work lamp that I put at a high angle over my desk, in addition to several other lamps.
posted by yohko at 9:05 PM on January 18, 2010

One more thing;
You don't say if you are taking hormonal birth control, but it's notorious for causing depression. Try something else.
posted by yohko at 9:07 PM on January 18, 2010

Exercise, sleep, therapy, cut alcohol and some say caffeine. Eat better. Reduce stress however possible. Sometimes some form of artistic expression can help too.

Yes, yes, yes, yes, yes, yes, yes, and yes. All of these. Hell, if you do most of them with any regularity, you probably can skip the therapy.
posted by hermitosis at 9:18 PM on January 18, 2010

In addition to exercise, I would try going to see a massage therapist or acupuncturist. It's really good for your body, and the act of scheduling something that makes your body feel realy really good could help you value other aspects of happiness and feel more motivated to keep with an excercise routine, good eating, etc.

I'm also getting over some past trauma and starting with neurofeedback therapy. It's totally non-invasive, and I don't have to go over all my past experiences, but I *feel better* on a level I didn't think possible. I'm not done with the therapy yet, so I am going to keep from being too excited about it, but so far I've noticed a significant increase in energy levels and ability to direct that energy to things that are important to me. Feel free to PM me if you want to know more about it.
posted by ohisee at 9:19 PM on January 18, 2010

Your schedule might actually be too light.

When I first went to a doctor with similar problems, adamant that I didn't want antidepressants, she wrote me the following "prescription".

1) Achievment. Do things which give you a sense of achievement, however big or small.

2) Pleasure. Do things which would normally bring you joy.

3) Contact. Do things which allow you to connect socially with other people.

To be taken daily, without exception.

It helped. To her very wise prescription, I would add:

4) Exercise. Do at least 30 minutes of cardio activity every day.

5) Nutrition. Eat nutritious meals, including breakfast.

Finally, realise that all of this may not be enough, and for your own safety and sanity, you might eventually need to go back on the meds.
posted by embrangled at 9:35 PM on January 18, 2010

Most people have to try a number of therapists and therapies until they find one that works. Both cognitive therapy and cognitive behavioral therapy have been found to be effective in rigorous empirical research, but they are not consistently offered to depressed patients. While therapy alone and medicine alone can be helpful, together they are highly effective.

Cites available upon request.
posted by emilyd22222 at 9:37 PM on January 18, 2010

I empathize with you. I had depression once, so I know all too well what it's like to suffer from a depression. I had it as a young adult (so like, we're talking mid-20s here), but in what may give you a whole lot of hope, I got over it without using meds.

My depression came about because of a break-up with a girl I thought I loved. I know now that I didn't, but when I was with her the world seemed so blissfully excellent that my brain equated it to mean it was possibly love. So naturally, when it ended, I was devastated and ended up living with depression for sometime, simply not even trying to do anything about it. It wasn't until my lowest point when, for the briefest of moments, I contemplated ending it all that I decided to try and beat it.

I know a lot of people think prescription drugs are the key to coping with depression and even recovering from it. I am not one of those people. I believed then and I believe now that the human body has it within itself to recover from depression, amongst many other things. However, I recognise that for many people with depression, many of my friends included, drugs are necessary and I do not begrudge them that. I decided to explore other avenues, however.

I instead started looking into things such as meditation to treat my depression. And so I immersed myself in that line of study, reading everything and anything I could to overcome it. And then I started to meditate, spending many hours in solitude (something I had become used to anyway), meditating and simply trying to find my inner-self.

It was not an overnight fix, or an end to itself. It was a long road to my recovery and my livejournal and my other writing projects were instrumental in helping myself to overcome my depression. But I got there. It helped me get back into my University studies and even ended up taking on an Honours degree. And then, one and a half years after beginning to immerse myself in meditative practices, I was writing a post in my livejournal wherein I realised that I was no longer depressed. I was actually happy, and had been for quite some time. I was happy being me, with how I looked and being single and pretty much everything to do with my life. And I haven't looked back.

Again, this is something that may not work for everyone, but it worked for me and I offer it up to you purely in that context.
posted by Effigy2000 at 9:41 PM on January 18, 2010

Seconding elsietheeel! That's my exact regimen as well (exercise, SAMe, fishoil, B complex, and outside...although I occasionally have a modafinil if I'm getting into a 'not getting things done' place)...

Really though, I'll hop on the bandwagon here and say E X E R C I S E !

Its hard, it can be boring and its repetitive...but you just GOT to do it! Once you get into it you're going to love it. Do what you got to do to keep it interesting...switch it up and bounce back and forth between different forms of exercise - cross training, circuit training, martial arts, yoga, hiking, biking. It will change your life.
posted by jnnla at 9:53 PM on January 18, 2010

I was a long-term resident of the 'not getting things done' place, but now I have Adderall. ;)

However, I managed my depression for over a year with the aforementioned regimen before they put me on Adderall for ADHD. Mood's the same since I've been on it, but I no longer have executive function issues. My house has never been cleaner!

Outside exercise will do you a world of good, too. Take up a sporty hobby like cycling, rollerblading, hiking, or my personal favorite, kayaking.

Although kayaking isn't the best one to rely on year-round; winter can be awful cold for paddling.
posted by elsietheeel at 10:04 PM on January 18, 2010

This is close to what everyone else has said, but pwally's comment in this thread is a fairly specific and enormously helpful list of directions.
posted by punchdrunkhistory at 11:22 PM on January 18, 2010

I'm getting out of something very similar to what you're going through, and in retrospect I wish I'd have done the following things sooner, as to not waste a year:
-Exercised regularly, eaten better. Even a few extra pounds can really affect your energy.
-Made much more social contact. It sounds like you don't have a lot, and social ties have been proven to act as a buffer against depression in women.
-Having your spouse be your main, and even only, source of social support can really strain a marriage.
-Watching less TV also reduces your risk of depression, and not just in teens.
-Read and followed The Happiness Project.
posted by blazingunicorn at 12:40 AM on January 19, 2010

Sometimes depression is a progressive disease that gets worse over time. You may be able to cope using just therapy and positive self talk for now but find yourself deep in the soup later. So please don't limit your options when you don't have to. For now, try to find a Cognitive Behavioral therapist.
posted by RussHy at 2:54 AM on January 19, 2010

I see that some people have been talking about vitamin D and fish oil. I have Asperger syndrome and mild depression, and have recently started to take extra high strength cod liver oil, which has a high amount of vitamin D in it. I read about a study which found that cod liver oil is effective in increasing social ability, concentration and also alleviating depression. I'd like to know whether any of you have tried cod liver oil for AS and how long it took you for either yourself or someone else to notice a marked difference. Also, how did it affect your depression if you had it before?
posted by jpcooper at 3:30 AM on January 19, 2010

You sound really bored with your schedule. I know when I start feeling this way, I get pretty surly, mopey and difficult to be around. In addition to all the fine advice above, I'd suggest shaking things up a bit - perhaps in connection with exercise (and this is where Mr. Onymous can step up and help/enable/foster). For me, when exercise actually serves a proximal purpose other than exercising, it's easier and more pleasurable. If you can, strap on a backpack and walk or ride your bike to run small errands.
posted by Emperor SnooKloze at 3:51 AM on January 19, 2010

Plain old exercise is boring as fuck.

Try exploratory, mandatory homing exercises. You take public transport (or get a ride from someone) to some remote point and then you have to make it back. You can take a phone, I suppose, if you're paranoid about being far away from help, but no cheating with GPS and you can't take money for snacks or transport. Take light food and some water with you. If you're a little more daring, a friend blindfolds you, takes you there, and dumps you. You get exercise and, at least while you're out of the house, you get no overeating.

You could do it with a friend for companionship and safety -- you both pack what you'll need for a day's hike, get in the car, someone blindfolds the two of you, you relax while your friend drives you to the drop-off point, and then you and your companion are kicked out and left to fend for yourselves.

And do reduced sets during the week, when you have less time: public transport or a friend takes you somewhere not too far away and then (because you have no money for the return trip) you have no choice but to walk or bike (if you took one) all the way home. If you're lazy, you sleep in the bushes or you call for a ride home and look extremely pathetic: "It's getting dark and I'm in the woods and waaahhhh."
posted by pracowity at 7:07 AM on January 19, 2010

sit on the bed and watch tv or write

Are you writing in a journal? I know that some people recommend keeping one during depression, but I found that it just fed the obsessively gloomy thoughts that depression can cause. You might try replacing both the TV and the writing with exercise, preferably social exercise accompanied by music.

Contra dancing is easy and sociable and available in most US cities and college towns. You could also look for gyms or studios that offer Bollywood workouts or Latin-based aerobics like Zumba.

Finally, if you don't have a sleep disorder, you might try limiting the amount you sleep and see if that helps. My mood is better when I regularly get about 7.5 hours than when I'm sleeping 9-10 hours a night.
posted by PatoPata at 7:11 AM on January 19, 2010

Everyone else has great suggestions. But consider also that you may just need to help yourself get over the hump in the short term, enough that you can get motivated to start doing your hobbies (esp. social hobbies) -- and that once they're part of your routine, having those activities in your life will be good for your mental health.

(YMMV, but once I added a couple social/artistic hobbies to my regular routine, I found that I got a lot less depression-prone.)
posted by anotherthink at 7:58 AM on January 19, 2010

I have gotten great results with supplements that I identified with this book: The Mood Cure.
posted by Wordwoman at 8:08 AM on January 19, 2010

Exercise, AND some tricks of the mind. This is a sort of personal Cognitive Therapy, of a sort, and helped me with some of the same issues. Make three connections to better mental health: mental, visual, and auditory.

The first (mental) is self-affirmation (yes, Stuart Smalley style). Tell yourself good things, throughout the day. This is not like "You are less of a dork than you used to be", it's "I'm smart, attractive, and a decent human being".

Second is visual...you want to find something to look at that affirms a better state of mind, and that needs to be something you don't normally look at (which reaffirms past problem states). For me, this was standing under a tree and looking up. Simple, beautiful, and not associated with anything previous.

Third is auditory...I found specific music that was helpful and had a positive effect on my mental state. Then I listened to it A LOT, excluding all other music. I doubt my choice would be applicable for you though, so I leave that to you to determine.
posted by swimming naked when the tide goes out at 9:04 AM on January 19, 2010

I am also prone to low levels of depression. If I exercise, this does not happen. Any exercise is good, but the exercise that makes me feel best are when I can really just clear my mind completely. For me this is swimming and yoga.

In addition, food can really make a difference. There are some studies on this, but you should do some research to try to figure out what you can eat that will make you feel better. I suggest going to a holistic doctor.

I would say that generally, eating more vegetables and less processed foods makes a difference.
posted by hazyspring at 9:34 AM on January 19, 2010

There's a book called "The Mindful Way Through Depression" (you can find it on amazon) that teaches techniques for using meditation and mindfulness to cope with depression. It comes with a CD of guided meditations (and I was able to find a few more I liked on iTunes free).

I do use medication (and have done therapy), but I found this book a very helpful adjunct to my more traditional treatment, particularly at times when I felt overwhelmed or the depression was particularly bad.

It's not for everyone, but I did find it very helpful, and I think it's probably particularly good for people who are somewhat spiritual (not necessarily religious), and who find that dealing with the spiritual side of their nature (in addition to the physical/mental aspects) is helpful in treating depression.
posted by Eyebrows McGee at 10:04 AM on January 19, 2010

i'm yet another "yes, exercise!" person, but i'd also like to advocate that you find an activity that works for you. it took me a long time to find activities that worked for me; a lot of things frustrated me and made me me feel useless/more depressed and i'd give up on them. it took a lot of trial and error to figure out that my magic bullet was a combo of dance and yoga. don't get discouraged if you take up exercising and don't like it/struggle with it, just keep trying different things until you find YOUR magic bullet! it's really made all the difference in the world for me.
posted by raw sugar at 10:21 AM on January 19, 2010

The "prescription" that always help me get through a difficult spot is making sure to do something that satisfies the following four categories, everyday. (Also, I write them down at the end of each day to show myself how much I'm accomplishing.)

Every day, do something:
1. Social - (phone call with friends, coffee date, movie night, dinner party, after-work stroll)
2. Creative - (write in journal, draw a picture, take a great photo, decorate a cake, whatever)
3. Healthy - (eat a super healthy meal, exercise, research healthy recipes, stretch)
4. Spiritual - (meditate, go on a lovely nature walk, deep breathing, write lists of everything you're grateful for, pray, etc.)

It works for me. Like, big time.
posted by np312 at 11:03 AM on January 19, 2010

I know you said you have tried counseling, but sometimes you got make a commitment to go for like several months, or longer. And also, the right therapist (I know, it's hard to find the "right" one and it can get frustrating looking around). But I think cognitive therapy is OK and definitely works for some people, but maybe a more off beat, fun, spiritual therapist in addition to exercise, drinking a lot of fresh water, eating as well as possible (that includes dark chocolate and wine!!) Sounds like you need to have some fun.
posted by Rocket26 at 3:05 PM on January 19, 2010

Human beings aren't designed to be sedentary, and that's what you've described. Exercise and get some sunlight regularly. Eat healthy. Doctors prescribing drugs without hitting the basics always seems so strange.

That said, exercise and nutrition can be tough to work into a routine. Mine's pretty simple, and I'd recommend it to friends.

Stop watching TV. Don't even turn it on. Watch movies if you can't get by without the television on; they're fixed duration, and don't have continual draw week to week. Otherwise, watch television all you want, but put an exercise bike in front of it, and require yourself to keep up 70 rpm or so while the TV is on.

Eating healthy is also pretty easy. Don't buy unhealthy foods, and don't ever eat as a secondary activity. If nothing unhealthy is around the house, you won't be eating it. As "secondary activity", I mean "don't eat snacks while watching TV", basically; if your focus is on something else, you'll eat more than you would have otherwise.
posted by talldean at 7:06 PM on February 4, 2010