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I don't want to be sad anymore.
January 6, 2012 1:01 AM   Subscribe

How can I battle depression and insomnia (I think they're related, actually) without meds or doctors?

I'm beyond depressed right now. Today it was hard for me to not step in front of a bus that was going down the street. I feel... Hollow. I don't know how else to describe it. I've slept a total of 12 hours in the last three or four days. I'm used to a day or two a week of not being able to sleep, and I'm used to being mildly depressed. Hell, I'm even used to occasional thoughts of suicide. Right now I'm at the end of my rope. I don't know what to do.

Some significantly shitty things have happened in the last week or so, but I'd really rather not get into much detail. I'm fine putting myself out there, but other people are involved and I don't want to out them out there, dig it?

The thing is, I'm scared of doctors, hate taking medicine, and have had a terrible experience with a shrink in my past. How can I deal with this?

Oh yeah, I'm 26, married (on the rocks, but that's an issue for an entirely different thread...), working full-time, have a pretty ok social life, and am physically active.
posted by bryanthecook to Health & Fitness (36 answers total) 23 users marked this as a favorite
 
The answer to your question is "you probably can't." No offense, but you are *ill*. You need to see a shrink. You can deal with your reluctance by finding a better one. Please stop denying yourself medical care. If you could see yourself from the outside, you'd say "hm, he doesn't like taking medicine and doesn't like doctors...ok, is that worth being suicidally depressed and not having anything close to normal sleep, in other words, living a nightmare? um, fuck no. that person's priorities are completely broken." dude, get over your fears, they don't make any sense.
posted by facetious at 1:17 AM on January 6, 2012 [9 favorites]


if you had a festering sore on your leg that was turning green and the pus leaking out of it was all smelly and it hurt like the fucking dickens - you'd go to the doctor.

it's harder to see when our brains our screwed up and screwing up everything around us. that doesn't mean it's less urgent.

to get you through the time of making the appointment and going - try meditation, less caffeine, more exercise. watch your media intake. but, suicidal idealization is a big deal and you shouldn't ignore it, especially since it sounds like your support system isn't terribly supportive right now.
posted by nadawi at 1:24 AM on January 6, 2012 [2 favorites]


Depression has a 15-20% mortality rate. Suicide is the seventh most common cause of death for men in America today. If you had any other disease that carried a 15% chance of killing you, but was very treatable, I believe that you wouldn't let your fear of doctors and medicine kill you. Please don't let it do so here. Many different kinds of help are available, but it is absolutely necessary that you seek help from trained professionals who know how to deal with crises like the one you're in now. Please let someone help you.
posted by decathecting at 1:26 AM on January 6, 2012 [6 favorites]


Please know that there are many people out there, willing to help you through this.

I have to sleep now, but I'll be back here when I wake up. I know this seems like a lot to handle right now, but if you have support from other people, you can get through this.
posted by StrikeTheViol at 1:27 AM on January 6, 2012


I will counter what facetious said by saying "you can" because I did.

Many years ago I was actually very depressed myself and, much like you, there was a moment where I considered stepping infront of a bus. That was my wake up moment. Not wanting to use meds or doctors myself, I started reading up about meditation, and over the course of about two years I immersed myself in it, eventually coming out the other side a happy and healthy dude.

I stress this isn't for everyone, so YMMV. But that's what worked for me, so maybe give it a shot?
posted by Effigy2000 at 1:32 AM on January 6, 2012


Someone around here said something I thought was very wise a few months back - suicidal thoughts are the mental equivalent of chest pains, you need to treat them as acute symptoms and get thee to a doctor, pronto.

I'll just say that my wife is terrified of hospitals. If she's in unbearable pain I'm lucky if I can get her into an A&E department for two hours straight before the fear wins out over the pain.

She's being treated at the moment, and I've been incredibly impressed with my local hospital, who have bent over backwards to support her. Thing is, they didn't start doing this until they knew there was a problem. My suggestion is that you have a phone consultation with your doctor's surgery, explaining your problem. Tell them what you think might help (in my wife's case, a diazepam prescription to take before she goes to the hospital and a promise that she won't have to deal with unexpected crowds), and I'm pretty sure they'll try to accommodate you. If you're not up to the conversation, appoint someone to be your advocate. It may even take a couple of goes around before you're all on the same page, but don't give up.

(Exercise is supposed to help with depression at least as much as medication, but I have no personal experience of that.)
posted by Leon at 1:50 AM on January 6, 2012


I think you should address why you are scared of doctors, but sadly that is best done with a therapist. Also, your bad experience will probably (hopefully) not happen again.

Does listening to music help you at all? Music is so incredibly powerful for me. Recently I was suffering some severe depression when I realized I hadn't listened to music in about a month, and turning on some happy songs was like an instant lift.
posted by IndigoRain at 1:54 AM on January 6, 2012


Most therapists will tell you that common exercises to complement therapy are meditation and exercise. For the former, take a class or use the many available online resources to get started. For the latter, go for a run, join a 24-hour gym, or take up a martial art that you can practice by yourself.

That is the strict answer to your question. I would be remiss if I didn't say that I also hated therapy and medication, I'm doing both now, and things aren't great but they're better. I don't love that I have to do it, but I'm still here. For me, and I've been here a lot, end of my rope = time to do things I don't especially like in order to avoid more unpleasant alternatives. When I don't know what to do, that's a sign to me that I should let other people tell me what to do for a little bit. Be well.
posted by Errant at 1:56 AM on January 6, 2012 [2 favorites]


I do yoga on a daily basis, I commute to work most of the time via bike (6 miles one way), I do long distance rides for fun, and as a chef my job is physically demanding. It's not about a sedentary lifestyle. I try to meditate 30-45 minutes a day.

I purposely avoid the news because the world is depressing.

What effect does caffeine have on this? I ask because I drink a ton of it.

I know that a shrink is the best answer, but I'm honestly more scared of them than death. I've watched many friends/family members die in hospitals, I grew up with a medical professional parent who constantly talked about how dumb/careless her co-workers were, my sister died due to doctor negligence, and my wife nearly died from a misdiagnosis a few years ago. I feel that my fears are rational.

My support system is generally pretty good, but there are things going on that, if I were to involve them, it could potentially ruin other people's lives. I am one of those people that can't hurt the ones I care about, no matter what expense to myself.

I do have moments of happiness, and actually had a solid couple months of pure happiness recently (a new record!) but they're few and far between.

I just realized that I said "end of my rope" while talking about suicide. Heh...

FWIW, I've seen what suicide does to friends of the person doing it. I've been on that side of suicide more times than I care to remember. I'm not going to do it, it's just really tempting.

Just posting this thread and hearing that I'm not the only fucked up one has been one of the most cathartic things I've done in a while. Thanks.
posted by bryanthecook at 2:01 AM on January 6, 2012 [1 favorite]


And yes, listening to music helps. That's why it's constantly on. Lots of jazz. It relaxes me.

Oh also, I drink with a bit of regularity, but I've been purposely cutting back lately in an effort to be more healthy. No I'm not depressed that I'm drinking less.
posted by bryanthecook at 2:07 AM on January 6, 2012


even with a stack of stories, don't you have to logically admit that more people are saved by doctors than killed by them? also, there's not a lot of malpractice that can kill you with talk therapy.

sometimes it's helpful to think of depression like an addiction - a junkie will do anything to keep doing heroin. a depressed person will often do anything to stay depressed. your brain wants to keep itself in this cycle that hurts you. it's not looking out for your best interests and it's magnifying your fears about hospitals/doctors/drugs because that's your weak spot here. it's time to hand at least some of this load over to someone else and let them thumb through it for a minute.

i understand that's terrifying. it took me until some serious gastrointestinal distress and decades to tell my doctor i have pica. i hate doctors. i hate the whole thing. i don't trust medicine. but, at some point i had to admit i didn't have the tools to fix my problem. now i'm on some medicine and my life is greatly improved. add that to your stories about doctors.

as far as the caffeine - well the obvious is that it worsens the insomnia which feeds into the depression. but the other part is that it's a drug that's fucking with your natural impulses of fatigue. that can have other tie ins with the depression.
posted by nadawi at 2:11 AM on January 6, 2012 [10 favorites]


You make good points. I hadn't thought about the difference between mental health professionals and physical. I'll admit that the fear may be a little irrational, but it's still very real to me. You're talking to a man that's stitched his own hand because he didn't wanna go to the ER. I also had never thought about depression as an addiction. I mean, I don't want to be depressed. I want to be happy. I want to smile. I want to laugh. I want to not be a cynic about everything.

Fuck...

I do need a shrink. Anyone know a good one in Chicago that'll accept BC/BS?
posted by bryanthecook at 2:24 AM on January 6, 2012 [5 favorites]


Caffeine is a stimulant that affects certain neurotransmitter receptors also thought to be connected to depression. The obvious link is that caffeine is used to put off sleep, and sleeplessness tends to exacerbate depression. Withdrawal symptoms and the "crash" can also interact with depression, in much the same way as an alcohol "high" tends to expand depressive symptoms.

Depression is an illness that tends to warp perception and rationality. Your fears may well be rational. However, you know for a fact that some part of your mentality is not rational. It is therefore reasonable to suspect that other parts of your mentality may not be as rational as they seem. It is very, very difficult for depressed people to evaluate themselves realistically, and by extension their interactions with or avoidances of aspects of the world.

I've been suicidally depressed since I was 13. I'll be 33 relatively soon. My total time in therapy over that period is probably about 4 years, including the last 3, so I've spent more time surviving without therapy than with it. I don't think that therapy solves everything. I think that it can be a useful way to get a reality check during times of crisis, which is what this is, after which you can of course decide whether it will continue to be useful or not. Whether or not you pursue that: meditation and exercise will help.
posted by Errant at 2:26 AM on January 6, 2012


Blue Cross/Blue Shield therapists in Chicago. Just one list, there's likely many more, but Psychology Today is a pretty good resource for these kinds of things.
posted by Errant at 2:28 AM on January 6, 2012 [1 favorite]


Please see someone. Keep trying until you find one that you click with.

I too have seen the other side of suicide having had a brother and a few friends take their life. I had sworn that I would never do it. I've been depressed for most of my life but figured that I could always handle it. After two months of bad depression this fall and total lack of sleep for two weeks I attempted suicide in a split second where it was majorally tempting. I really didn't realize what I was doing. The lack of sleep had impaired my judgement greatly. Luckily I caught myself in time and went to the ER and ended up in intensive care.

Suicide is an insidious thing. It can take advantage of your sleepless addled mind and put up roadblocks to getting help. This is something you need to take seriously and find yourself a therapist.
posted by kanata at 2:30 AM on January 6, 2012


depression is a serious illness. and i say this as someone who has battled depression (with two severe years long bouts within the span of a decade) and dysthemia my most of my life: i get some of that reluctance. when i was sliding into my second bout of severe depression, i was in denial and refused to get treatment. but i'm convinced it was why that bout ended up so severe and so drawn out (it took me a good three years to recover and get my life back into working order) and subsequently, disastrous for my life, not just my emotional well-being. by the time i forced myself to seek treatment, i had already lost eight months of my life that i pretty much have no recollection of now, i was in such a haze.

look at it this way, if you had say, kidney disease, would you just ignore it and pretend that you can get along fine and continue to live without treatment? no, you'd get your ass some medical attention. severe depression isn't any less of an illness. so please do it.
posted by violetk at 2:40 AM on January 6, 2012


1) One shrink is not all shrinks. When looking for a place to live, sometimes you like the first place, other times the 10th place. There are good therapists out there that can help you. Ask for an assessment appointment. Treat it as an adventure. Follow your gut instinct.

There sometimes can be the feeling that in choosing to break up with a shrink means one does not want to help or is subtly self-sabotaging. BS. Psychological health services are services like any other -- you must find the right "product offer" for you.

2) Insomnia is a wretched condition that distorts everything else. It's a drag being tired. After a while, that tiredness can seem normal. One can even forget what it feels like to be well-rested. The world seems heavy and ladened. Short-term medication interventions can help break the pattern of insomnia and give one more space with which to sort out other life issues.

Medicinal interventions can be very short -- just enough time to knock down the problem a bit so that internal mechanisms can begin healing the problem. A bit like super-strong antibiotics are used to knock down infections to a point where the body can naturally handle them. Taking Cipro every day may be a terrible idea, but sometimes Cipro for a day or three is of great benefit.

Not all medication is forever. I am suspicious of permanent medication. Some people need it. Scares the hell out of me. However, I am a big fan of short-term medication. It's a tool. Use it!

3) Caffeine will keep your body in an overly-arroused state and may contribute significantly to anxiety (which itself will contribute to both insomnia and depression). Basically, if you are taking in too much caffeine, you may be pushing your body into a state of physical anxiety. Many people seem to live like this in our society.

If you want to reduce caffeine a bit and see if it help, watch for the line between slowness and depression. When one first backs off caffeine, there can be a lot of tiredness and overall slowness that feels like depression. That is the body readjusting and catching up on rest. Slowness that persists after a few days or does not show incremental improvement will be the slowness related to the depression. It helps to keep them separate.

4) Overall, sounds like you need to give yourself some space to sort a few things out. There's a couple of things here, anxiety, depression, insomnia. Perhaps it is not ideal to try and sort them all out at once, but to tackle one of them.

If you want to tackle the depression, find a therapist (date a few) and tackle that with the knowledge that you will have to endure the insomnia for a bit.

If you want to tackle the insomnia, see a doctor about a short-term medicinal intervention and tackle that with the knowledge that fixing the insomnia will help sort out the depression.

Overall, I'm not going to say don't be depressed or any of the other stuff people say because I hate it when people say that shit to me. So be depressed for the moment and realise that whilst it may feel like you are in a deep hole, that is the nexus of the depression and the insomnia talking. Your worldview is distorted right now and you need a bit of space to let your self-healing mechanisms kick in.

Thus, however you find that wiggle room, set about finding it. You don't need much to get started.

Rock on man. This is temporary.
posted by nickrussell at 3:17 AM on January 6, 2012 [5 favorites]


I would add that it might be beneficial to get a doctor, shrink or medical, to run through all of your vitamin and other blood levels first, before going the SSRI route. I think any good doctor would do that anyway. Low vitamin D levels can mimic depression and this is just the right time of year when it sets in. There are other physical conditions that can cause depression as well (thyroid levels, etc.).

Was reading somewhere recently that low D levels can cause winter insomnia.
posted by Marie Mon Dieu at 3:57 AM on January 6, 2012


I want to second Marie Mon Dieu. I recently spent a few months believing I was going crazy. It was my thyroid, plus I was low on Vitamin D. Getting that sorted out has made the difference between normal and ... something else entirely.

You can be very cautious with your therapist. You can show up for a few sessions and get a feel for them. You can challenge them if they say something that does not sound right to you. You are still pretty much in control of the sessions. They can't change your life without your consent and participation. You can quit if you decide it's not a good fit.

A doctor can prescribe a medication, but they can't force you to take it. If you go to a primary care doc they will likely have a conversation with you about your situation, take some blood, and maybe give you something for insomnia. You can try the meds - you can even do your own research on them - and decide if they work for you or not. If your doctor says something that makes no sense, or doesn't line up with the reading you've done, you can ask about it.

I say all of this just to emphasize how much power you do have in these relationships. I'm hoping that this can help you feel more comfortable about making some appointments and just taking the initial steps towards getting care.

Good luck. I really mean it.
posted by bunderful at 4:44 AM on January 6, 2012


Yes, insomnia can be related to depression. And yes, it can be causative.

And yes, caffeine causes insomnia, and is linked with depression, but don't stop drinking it cold turkey, you don't want to go into withdrawal (and in normal amounts it's negatively correlated with suicide attempts. Yay!).
Cutting back after mid-day is a good step. Further, up your local health food shop for .3 mg of Melatonin (yes, they'll sell in in 1/5/10mg doses, so get the smallest and cut it. More just has more side-effects), and take it an hour or so before bed. And wear shades at night. I'm not kidding, that, or dim the lights hard. Other people are dealing with other points, but sleep. Get some!
And, it may not feel like it, but resting, with your eyes closed, even if you aren't sleeping, is still good for your body, so don't stress yourself further by worrying about not sleeping! You're doing what you can, and you can just daydream.

Chef work in a kitchen is pretty stressful, as well as physically demanding, so get chill-out space and time when and where you can.


And further, yes, I've gone through multiple periods of depression, and yes it took me years before I got around my head around being able to go to a Dr and get treatment, and even then, only when I was feeling good and could feel it creeping up on me (after a few times, it was, oh - here we go again!). When I was depressed, I could come up with so many reasons why the meds wouldn't work, the shrinks would be crap, I wasn't really depressed anyway, I was just a legitimately sucky person. All that crap. Sometimes I genuinely couldn't remember things being different. Because of the depression. For me, it was an acid trip that let me step out of the hole for a moment, and realise that I was clearly far more unwell than well, I was during the trip, and I wrote up a todo list from myself, of things like talking to friends, going to drs, trying meds.
I didn't want to tell my friends how I was, because I didn't want to drag them down. Then I realised, if they were feeling this crappy, wouldn't I want to know? Wouldn't I want to help them? Furthermore, if someone is healthy and well themselves, they'll feel compassion for me, but fortunately people aren't telepathic enough for me to drag them down to how I'm feeling.

And yes I had some crappy counsellors, and meds, and y'know what? You give it up to 6 weeks, and then you try another one.
I put my nihilism to good use, by deciding, fuck it. If I'm going to 'not care' about anything, why shouldn't it be 'will this thing work or not?'. I'll just try it anyway. Meds, therapists, acupuncture, I don't care, I'll try it.

those people that can't hurt the ones I care about, no matter what expense to myself.
Treat yourself as you treat others, for a change. Don't hurt yourself, and find out ways you can be supported before you break, because there is no way you want that for your friends and family. Over developed sense of responsibility, I know how that is.
Sometimes I think it's because, I'd rather feel like it's my fault, because then at least I'm theoretically the one in control of the situation, rather than accepting, that actually - I'm not. Damn, not explaining myself very well. I can only do what I can do, and I should aim for my best, but ultimately, what happens, happens.
So yeah, I feel for you. Reach out.
posted by Elysum at 5:09 AM on January 6, 2012 [1 favorite]


I'm sorry you're going through such a terrible time. Seeing a doctor can help -- some are just pill pushers, but most can change your life. I've never dealt with serious depression, but I do have an eating disorder. Just talking to my doctor about it was the best thing I could do.

Other then the obvious "See a doctor", things like working out and eating better has been known to help with depression. Going for a brisk walk and changing your diet might help improve your mental state.
posted by Danithegirl at 5:53 AM on January 6, 2012


I won't repeat what others have said, but I'm really surprised that Feeling Good hasn't shown up in this thread yet. As someone who suffers from periodic (and chronic) depression and anxiety issues, this book really *does* help. Usual caveats applies: you *d0* actually have to physically write down the answers to the various exercises. And of course, YMMV.

Good luck--I know how horrible it is to be stuck in the pit, flailing. Reach out if you need to talk to someone. We're all pulling for you.
posted by smirkette at 5:57 AM on January 6, 2012


Bryan, also consider that if going to the shrink is very stressful for you, you can take a friend (or your spouse, depending on how that situation is). I have driven a friend to the psychiatrist, waiting for an hour for her in the waiting room, and taken her out to lunch afterwards, because it was too hard a trip for her to make on her own while she was depressed. It was not even an imposition; I was worried about her, and I basically just sat in a quiet waiting room and read my book, which was frankly a bit of a luxury. I would have gone in to the shrink's office with her if she'd needed it. (I've also taken friends to the injury-and-illness doctor and gone in with them to advocate for them in a stressful situation for them.)

I didn't need to know what her specific details were -- we're still very close, and I still don't know exactly what the triggering situation was. But I'd be happy to do it again. If you need help to get over the initial "going to the doctor" hump, don't be afraid to reach out to your friends and family.
posted by Eyebrows McGee at 5:58 AM on January 6, 2012 [3 favorites]


Yes, you can battle your way out of depression without meds... but it is really hard. When you are so depressed you are contemplating stepping in front of a bus, you are playing Russian Roulette by not seeking medical care! Moderate depression, treat at home; major depression, GET HELP. It is time to do meds for a while and THEN focus on other ways to treat your depression. If you are afraid of SSRI's, the older tricyclic meds like Pamelor have more annoying side effects (like dry mouth, weird dreams) but fewer emotional/behavioral side effect (like panic attacks). Or at least that was what I found. I tried 5 different meds before I found the right one last time I was majorly depressed.

See if you can find someone who practices CBT - Cognitive Behavioural Therapy. I have a terrible fear of doctors, too coupled with a huge distrust of the psychiatric profession based on some really bad experiences in my late teens and I found CBT practitioners easier to work with because they focus on specific, current behaviours instead of on your childhood. Again, YMMV.

YMMV, but here are things that work for me to keep major depression at bay:
- strenuous aerobic exercise -- biking is great but the only thing that works for me to combat depression is running. Boxing also works really well.
- light therapy (SAD light, the expensive kind) from October till April
- going outside every day during bad weather.
- Sometimes I will do yoga on the back deck even in the middle of winter as long as there is no snow on the ground and the temps are above 15F.
- Get as much sunlight as you can.
- eat lots of Omega rich foods in the Fall/Winter/Spring months
- alcohol and caffeine are your enemies. Limit them.
- TV and screen time are also your enemies. As is high-stress like your job.

tl;dr please go to a doctor today. Once you are on the mend, then come back and find lifestyle changes to help keep the next bout at bay.
posted by LittleMy at 6:01 AM on January 6, 2012 [1 favorite]


Please see a doctor. Either a shrink or a standard MD will likely prescribe you a sleep aid, which may get you enough back on your feet to get through the depression.

You are ill right now, and illnesses sometimes need professional intervention. You can work with a doctor and still be in control of your treatment, but you need more tools than you have available right now.
posted by freshwater at 6:19 AM on January 6, 2012


Start eating foods with tryptophan. Every meal. Eggs and chicken, steak and fish. Plus multivitamins and/or lots of vegetables. Cut unnecessary carbs.

Give yourself a week to try this. If you don't start feeling even a little better, go to a doctor.

And in the meantime, work on changing your thought patterns. Whenever you start getting into that thing where ProblemX starts spinning around in your head incessantly, distract yourself with something else. Go for a walk, and think of nothing besides the feelings of your feet hitting the pavement, the birds in the trees, etc. Give yourself permission to not worry about your troubles for a little while.
posted by gjc at 6:26 AM on January 6, 2012


My favorite take on this problem is James Altucher's thought filter: classify thoughts as "useful" or "not useful", and simply stop yourself short when you're on a "not useful" thought. It takes some practice, but so much of what we do and think is habitual. And it's comfortable to be held and confined and understood by the box of sadness and depression.

See: http://techcrunch.com/2011/12/03/how-entrepreneurs-can-increase-productivity-by-500/

Yeah, it's written in the context of entrepreneurship, but if you read it, it's pretty clearly a mood hack.
posted by trevyn at 6:27 AM on January 6, 2012


I know that a shrink is the best answer, but I'm honestly more scared of them than death. I've watched many friends/family members die in hospitals, I grew up with a medical professional parent who constantly talked about how dumb/careless her co-workers were, my sister died due to doctor negligence, and my wife nearly died from a misdiagnosis a few years ago. I feel that my fears are rational.

They may be (mostly) rational for you, but your sample is small and biased. Doctors saved my friend L from dying of cancer. My friend M tried to commit suicide, was treated at an in-patient unit, and is now much better. Doctors couldn't save the baby boy of friends of mine, who was born with terrible complications, but the compassion and care they gave his parents was endless. I was kept from falling ever deeper into depression after my mom died by an excellent therapist (there was lots of talk, and no meds; TMMV).

If there's an employee assistance line available through your job, please make use of it. If there isn't, please, please enlist a friend to help you find a couple-three therapists to talk with/interview.

And yes, back off on the caffeine, because caffeine will not help your insomnia and sleep deprivation and really fuck you up. Please, please get some help as soon as possible. Whatever your depression is telling you (doctors won't help, meds will make me worse, I don't have time to go to the doctor, I don't know how to find a good one, etc.), it's lying to you.
posted by rtha at 6:30 AM on January 6, 2012 [1 favorite]


A change in diet has helped me. Is it possible to eat organic for you? I also stay away from items with gluten, because gluten seems to fog up my brain by decreasing oxygen flow to it. It makes me tired and down. Caffeine I definitely stay away from. Also, forcing yourself to do the things that scare you helps. It's called Exposure therapy. A shrink can help you through this in understanding what's going on. Do not be afraid to search for someone better. Yoga and meditation won't help unless there are some basic fears that you must face head on. I've had to face a lot of my fears in getting over my depression. It's partly chemical and part trauma rooted in childhood. It was hard but with the help of finally finding a great therapist, I was well on my way, in allowing myself to be ok with... myself.
posted by InterestedInKnowing at 7:29 AM on January 6, 2012


The title is a little mass-markety, but the content is good and based on research: The Depression Cure. The author identifies and, importantly, prioritizes practical, achievable changes like taking fish oil (it seems to be helping me), bright light exposure, and vitamin D, along with suggestions for ways to stop unhealthy thoughts.
posted by ceiba at 8:31 AM on January 6, 2012


The Family Institute (run by Northwestern) accepts BCBS and has a wide range of counselors and psychiatrists. You start by doing an intake interview over the phone, where they assess what kind of help you need and set you up with a particular clinician. If the thought of narrowing down a huge list of potential therapists is overwhelming to you, this might be an easier option. A non-psychiatrist isn't going to push medication on you; they might suggest it as an option, and discuss your fears surrounding it, but they're going to focus on the non-medical side of things.
posted by enlarged to show texture at 8:32 AM on January 6, 2012 [2 favorites]


>YMMV, but here are things that work for me to keep major depression at bay:
- strenuous aerobic exercise -- biking is great but the only thing that works for me to combat depression is running. Boxing also works really well.
- light therapy (SAD light, the expensive kind) from October till April
- going outside every day during bad weather.
- Sometimes I will do yoga on the back deck even in the middle of winter as long as there is no snow on the ground and the temps are above 15F.
- Get as much sunlight as you can.
- eat lots of Omega rich foods in the Fall/Winter/Spring months
- alcohol and caffeine are your enemies. Limit them.
- TV and screen time are also your enemies. As is high-stress like your job.


If I could favorite this advice 1 million times, I would. And it applies to you exponentially more because (I'm assuming) you work a bassackward schedule, in which you are on the job at night, on holidays and on weekends.

I work afternoons/nights -- every weekend and many holidays -- as a journalist (copy editor/page designer), and I can tell you that this schedule is not easy. I got 2.4 million hits when I googled "shift work syndrome." Even if you don't have depression, shift work is a bitch. And if you do have depression, as you and I do, shift work will aggravate it. It feeds on itself. I sleep less restfully, so when I get up, I have less energy to do things to take care of myself, especially exercise, which would help me sleep better ... and so it goes.

I'm glad to read that you have a good social life, because one of the worst things for me has been trying to keep in touch with people when they work 9-5, Monday-Friday, and I work 3-11, 4-12, or 6-2 (depending on the day) and my days off are Wednesday and Thursday. Contact (especially face to face) with people who care about you can make the difference between thinking, "This sucks, but it's going to get better" and believing it.

I am going to print out LittleMy's comment and post copies of this list everywhere I can read it. And I am going to hope that the clouds lift for you, soon. You'll be in my thoughts.
posted by virago at 1:00 PM on January 6, 2012


Wow... Between replies here, MeFi messages, Twitter DM's, phone calls, texts and emails, I've had no leas than 100 people contact me today about this. Posting this and admitting that I need help and, in fact, have for quite some time has helped significantly. I've gotten many recommendations for doctors, and I'm going to do some research on them over the weekend. Just knowing that people actually do care is a huge help for me. Thanks everyone. I appreciate it more than most of you will ever be able to understand.
posted by bryanthecook at 3:22 PM on January 6, 2012 [9 favorites]


Also, rather than respond to the (literally) dozen people that I don't know that sent recommendations and positive words via MeMail individually, ill just thank you all here.
posted by bryanthecook at 3:25 PM on January 6, 2012


Nthing the vitamin D. It may not help all of it, but it makes a big difference and makes everything else you do for depression more effective. Even if you spend a considerable amount of time outside, at that latitude and especially in winter you are probably deficient. It is cheap and easy and you don't have to go to a doctor, so it is something you can start now. It isn't a substitute for a good psychiatrist, but it is a start.
posted by monopas at 5:03 PM on January 6, 2012


I don't really know what to tell you beyond what others have offered on this thread. I'm still battling severe depression and am currently in the depths of a particularly vicious cycle, so vicious in fact that I probably shouldn't be posting a response to your question at all. That being said, best of luck to you and I hope you find the answer that still seems to elude me.
posted by befuddledmind at 8:26 PM on January 8, 2012


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