How to climb out of severe depression?

July 9, 2008 8:05 PM

How to climb out of severe depression?

I am severely depressed, to the point where I've been forced to leave my job and move back in with family members. I am seeing a therapist and am on medication, but so far have experienced few positive results. I basically am completely unmotivated to do anything but surf the internet, watch TV, and exercise. I've gone from being a successful young professional to doing essentially nothing, all day, every day. This feeling of "doing nothing" worsens the depression, and I'm thinking that achieving some simple goals might help by giving me some small feeling of accomplishment, which might improve my depression. What are some simple goals that I can set or simple projects to attempt so that I can feel like I am doing something? Preferably things that don't require leaving home, because I'm also dealing with social anxiety, but anything is welcome. Also welcome are alternative suggestions for dealing with the depression, besides the standard "exercise" or "get outside". Thanks so much.

posted by anonymous to health & fitness (21 answers total)

How long have you been on medication? It can take 4-6 weeks to know whether it's working.
posted by desjardins at 8:20 PM on July 9, 2008

You could foster some orphan kittens! Guaranteed to a) keep you busy b) give you some smiles and c) make you feel like you are doing a good thing. I work with a foster group and they are desperate for foster people with lots of time on their hands every summer.
posted by fshgrl at 8:21 PM on July 9, 2008 [5 favorites]

If you can still bring yourself to exercise, then the situation is far from unsalvageable. Accomplishing small goals is definitely a good way to boost your self-esteem, and I'd start by (and this is what I do when I feel unmotivated) writing a list of things I need to do. They're usually really really small things, or small steps in big things. Stuff like "Pay phone bill online" and "change trash". Stuff that doesn't take more than five minutes to do. But crossing these things off after I finish them feels great, like I'm in control of what I want.

I know it seems silly, especially when taken in context of "I am depressed and need help, and you're telling me to change the trash?!" But the underlying point is convincing your subconscious that you're not useless and lame, and that you are capable of doing something after all. So maybe make it a point to clean your room. If you're back with your parents, maybe sort through the boxes of old stuff of yours they still keep around.

From there, still keeping in line with the theme of making lists, move onto more... creative, I s'pose, projects. Not necessarily stuff that'll get you somewhere, that are useful. But things you'll enjoy taking on and which don't take long. "Update site." "Learn CSS." "Create a better format for resume." Get used to doing again, rather than just observing passively.

And finally, dealing with depression. You're seeing a therapist and are on medication, but these aren't really miracle cures. It takes a lot of work to find a therapist, a drug that'll work for you specifically, and even then it takes a lot of work to climb back out of things. It's not easy, no matter what aids you have at your disposal. But it is possible. Millions of people have done it before, millions will continue to do so afterwards. Do you honestly believe things CAN improve for you? Or are you at a point of despair where you're asking the anon question for the sake of being able to say "There, I tried everything, and it still won't work"? Obviously, clinical depression involves chemical imbalances you have no control over, but getting caught in the despair is just counterproductive. Try to find a few things each day that make you smile, genuinely smile, even when it's something as silly as lolcats. And then say to yourself "see, life isn't all bad".

Neat tidbit: If you force your face into the position of a smile, move all the right muscles to create an upward movement of the corners of your lips, you'll actually feel better, really quickly. Next time you feel on the verge of tears, or something like that, give this a shot. It really works.
posted by Phire at 8:33 PM on July 9, 2008

I can only speak from personal experience, tell you about what worked for me. I had to find out what the root of my depression was. Ultimately, it turned out to be financial woes, though there were a lot of other contributors that compounded it. When I was able to resolve the root cause, I began to get better.

Anti-depressant medications were a mixed bag for me. Paxil sent me to the rubber room, I gained 50 pounds while on Wellbutrin, Zoloft made me downright stupid and Celexa messed with my digestive system to the point of dehydration. Psychoanalysis was beneficial, on occasion, but eventually it evolves into nothing more than banter with the analyst. It is only valuable as long as learning and insight are occurring; getting to that root cause that I mentioned.

I got better by mobilizing what little energy I had, then taking action to improve my condition. I forced myself to contact those who could be of benefit; family, therapists, medical doctors, financial advisors. There were many helpers. I eventually got off the meds completely, improving my physical health. I worked on the causes of stress in my life and found methods of counteracting them. I opened new channels of communication and expanded old ones by networking more. I sought second opinions and received more thorough examinations, including discovery that my adrenal glands weren't functioning properly. At first, I had to downright make myself do things I didn't feel like doing, eventually motivators returned.

When you're in the depths of that deep, black hole it seems there is nothing that can get you out. But you have to trust others, and trust yourself, that you can get your mind working like it once did. Accept the hands that are reaching out to help pull you from the hole, rather than trying to climb its slippery sides alone. Figure out what originally sent you into the spiral and work on correcting it. And be patient. It takes time. You won't get well overnight, but rest easily knowing that you will get well.
posted by netbros at 8:33 PM on July 9, 2008 [2 favorites]

When I went through a major depression in my early to mid twenties, one thing that helped me have a sense of accomplishment was (don't laugh) cross-stitch and needlepoint. There was something incredibly comforting about counting out rows and stitches and seeing a finished product. Any progress was visible immediately, but also the next day. Emotions were shallow but immediately lifted and gratified by the accomplishment of, say, 50 rows, or all the bird's feathers, or the entire background of the piece. It was the one thing in my day that I could be proud of, especially on the days I couldn't even get out of my nightgown. It was very important to have something I could respect myself for on those dark days.

If the idea of needlework doesn't appeal to you, think of any crafty thing you could involve yourself in that relies on some creativity but not inventing ideas from scratch. Model airplanes? Model trains? Paint by numbers? Origami? Knitting? Maybe wander the aisles of your local craft store chain and get some kind of kit that would ease you into something.
posted by ImproviseOrDie at 8:33 PM on July 9, 2008

1) stick with the meds. seriously. if they aren't working after a month, see if you can try some different ones.
2) 2nd getting a cat. maybe not a kitten, but definitely something that depends on you.
3) find something to clean/work on/fix/cook as often as possible. do the dishes, make the bed, anything. the object is to feel you accomplished something. Make your bed as soon as you get up.
4) you'll get a lot of suggestions for 'exercise' around here. I never had much luck with it myself. get outside, not necessarily to do anything, just to get out.
posted by ArgentCorvid at 8:39 PM on July 9, 2008

Turn off the computer and television for starters. They are pacifiers that distract you from other goals.
posted by wfrgms at 8:39 PM on July 9, 2008 [5 favorites]

The fact that you wrote this message is a very good start.

I can only tell you what has worked for me - and it's along the lines of what Phire said. Get up in the morning, take a shower and get dressed. Make your bed, clean your room, take out the trash. Go for a walk (early in the morning if you want to avoid any people) or just stand in the backyard/on the step for a little while, if going out is too much. You might need to work your way up to these things. If so, then start with the shower and get dressed, little by little add to the routine.

Step away from the computer/tv and talk to someone - your mom, dad, anyone. It's very important to actually speak to another person - I don't know if I would have been able to pull myself out if I didn't do that. You may need to work up to it, and you will most likely feel anxious and averse to doing it, but make a goal of talking to one person per day - even if you just go and buy a pack of gum at the store and say "thank you" to the checker. Online doesn't count - phone is ok if it's all you can do, but actually speaking to someone else's face is a huge help.

Treat yourself as if you are recovering from a long illness, not as an invalid. You may need to go slow and build up your strength, but make a goal of getting stronger day by day.

I wish you good luck.
posted by The Light Fantastic at 8:56 PM on July 9, 2008

Document your progress to mark your accomplishments, however small. And pets really help, especially dogs, since they're such social creatures who need to be out in the world.
posted by judith at 9:16 PM on July 9, 2008 [1 favorite]

Making a list of little things to do each day or certain days the week can help get you up and moving as well as letting you know that you accomplished something. Small and detailed is good - Get out of bed, take meds, brush teeth, shower, get dressed, start coffee, make bed, eat breakfast. So that would be 8 things accomplished in the first half hour. Offer to run errands for the family at least twice a week (having specific errand days will make it easier to make yourself do it. Do at least one thing each day that you would normally find fun (read a book, go to a movie - put yourself in the way of something you might enjoy, even if it doesn't cheer you up this time.)

One thing way to do a check list is to write out the list and slide into a plastic page protector. then you can use a dry erase marker to check things off and just wipe it clear each night.
posted by metahawk at 9:47 PM on July 9, 2008

I'm not an expert, but I think going out is pretty important. Sunlight makes a difference and so does social interaction. Can you do your exercise outside - running, biking, swimming, etc? What about starting a plot at the local community garden? It's limited how much you have to talk to folks, but it will force you to get out of the house and take on a small and rewarding task in the sun and fresh air.

Also, I recommend taking responsibility for someone or something else. Getting a pet you have to take care of is a start. Pets bring cheer to a lot of people, and also help you focus on the ways that other beings have needs too - and sometimes you have to put those needs first even when you feel like hiding on the couch. Helping to care for another human could also help if you can find a limited way to start. Meals on wheels? Collaborating on a project with someone you trust?

My guess is that the internet and TV are not helping you right now. Temporarily shut off cable and internet connection?

Good luck to you!
posted by serazin at 9:47 PM on July 9, 2008

When you weren't depressed, what did you do -- what was your profession? Are you looking forward to getting back into it, or changing it? If you weren't depressed, how do you see yourself living your life? IE, what would you like to be doing, ideally? Maybe if you tell us these things, people would have some specific suggestions for interesting stuff to motivate you. If you want to mail me, I'll post it here. If not, no sweat.

Try to pamper yourself a bit every day. Do what you wish someone else would do for you if you had someone at your beck and call.
posted by Listener at 9:58 PM on July 9, 2008

I basically am completely unmotivated to do anything but surf the internet, watch TV, and exercise...

What are some simple goals that I can set or simple projects to attempt so that I can feel like I am doing something?

So, do all three things you're still motivated to do, at the same time, and combine them into a muscle- and fitness-building program whose results you will see and feel. Pump serious iron while watching TV. Ride an exercise bike while surfing the internet. Document your increasing endurance and strength, and get used to the idea that spending time doing nothing but getting stronger is truly a worthwhile project.

And if you ever feel the slightest desire to get out of the house and go for a walk just to see what you can see, give in to it immediately.

Completely out of left field: I've always found that when I'm having one of those deep-black mood months, spending time with horses is a guaranteed mood lifter.
posted by flabdablet at 10:04 PM on July 9, 2008

Also recommending that you get a pet of some kind -- or, if your living situation won't permit pets, seek out the nearest bookstore-[or other-store-]with-a-cat and go visit often.

Educate yourself on your condition and "be your own scientist." I got to the point where I could anticipate what questions my psychiatrist would ask me and in what order she would ask them. In bad times I just typed up a list of the general subject areas and my answers/symptoms; I could go in and hand her the list and not have to talk for a little bit. This also helped me to give a clearer picture of what was happening rather than try to remember through my fog if some particular aspect of life was getting better or worse. My doctors always look surprised and pleased (and say "Can I keep this paper?") when I give them a list.

Try to get some novelty in your life -- try new weird foods (hey, what can it hurt?) and read some completely ridiculous magazines ("Golf Course Aficionado" or "Best Hairstyles for Busy Midwestern Stay-At-Home Moms" or whatever) upon occasion. Walking around different neighborhoods is an even better option.

Do not drink grapefruit juice if you are taking certain kinds of SSRI antidepressants.

Re: easily-completable activities that will keep your brain engaged: I would second the suggestion of needlepoint (or another kind of craft you know how to do), but I must also say (with some degree of embarrassment) that if/when you're not up to an actual skilled craft, buy a coloring book and markers. There are Dover geometric-pattern ones and there are cool mandala-pattern ones you can get through amazon.com. This is a good stopgap kind of activity for passing the time.

Disconnect the dumb TV and announce to yourself that you're going to *learn* something instead. Set out to learn it. In ten years or so, whatever you casually study now may very well become useful in your personal life or career. You WILL be shocked to look back and realize that there was some ridiculously tiny benefit to having a terrible time in your life.

Another ridiculous benefit to the !@##$ you're dealing with: when you are feeling better, and in the years to come, you will be able to take a great deal of pleasure in the smallest possible positive sign. One icecream cone will cheer you up for an entire day. A postcard in the mail will make your whole week better. People will be envious of this.

Last thing, but something to take seriously: go help someone else. Focus on helping someone else with something, anything, that they can't do but that you could help them with -- give advice for a friend's troubled relationship, do internet research for an elderly relative, teach someone clumsy how to assemble a bookcase because you know they'd never even attempt it. Somebody out there needs help from you and you have the power to make their life better.
posted by oldtimey at 10:37 PM on July 9, 2008

Seriously, you aren't doing anything wrong. But you do have to realize a few things:

1. You recognized the problem and you're getting help. Excellent. Give it time, its not an overnight solution.

2. You are EXERCISING. You do more physical activity than a good portion of americans. You aren't that unmotivated. Keep it up.

3. Do something that you enjoy. You like tv, you like going on the internet, you like exercising. Why not look to do something that can integrate 2-3 of the things you do on a normal basis?
How about being a bike courier? How about blogging? How about an x-files blog?

All you need to do is:

a. relax
b. figure out what you LIKE, and do that.

Good luck.


PS. If you were "forced" to leave your job, why don't you use one whole day to psych yourself up. The next day, get your job back. If you can't, cool...you were forced out for a disability (even though its temporary, depression does count, especially if you are going to a doc). Threaten to sue. Make this your project. It'll help you climb out.
posted by hal_c_on at 12:35 AM on July 10, 2008

When severely depressed, give yourself time. It is ok if it takes two years to be "productive" again and from a distance I've noticed that people in U.S. (a guess) are far more worried about goals and accomplishments than necessary. It will be a slow climb back and worrying about time spent not doing things while actually climbing out of depression is countereffective.

I'd suggest that you take advices about having small tasks and setting goals when your depression is mediocre or light.
posted by Free word order! at 1:03 AM on July 10, 2008

A volunteer gig you can handle right now.

1) Gets you out of the house in a structured, regular fashion
2) Exposes you to other kind, do-gooder folks for safe social interaction
3) Feel like you're doing something of value for society (you mention losing your identity as a "successful young professional"
4) If you choose something like food prep for a soup kitchen, pitching in on a neighborhood cleanup, etc.....tangible accomplishment at the end of each day! (it's like altruistic needlepoint, so to speak)

Your local united way has a web page full of options in your community. It can be as little as once a week.
posted by availablelight at 5:47 AM on July 10, 2008

Lots of good advice above. Stay on your meds, even if you start to feel better. Get out and see people. Go to church, if you believe, or find a support group.
posted by RussHy at 6:36 AM on July 10, 2008

Since you're already exercising, what about training for an event - like a 10K or half-marathon? There are lots of 10-12 week training programs online that you can follow. I trained for a half-marathon during one terrible summer. I was not an athlete at all, but running gave me something new to think and learn about. I would remind myself during the actual runs that the physical discomfort I felt was way better than the emotional pain of sitting around my house feeling depressed. I would also focus on how proud I was going to feel when I finally crossed the finish line. By the day of the race, I really did feel a lot better about myself and I was so proud that I was able to set and accomplish such a difficult (for me) goal.
posted by jrichards at 6:42 AM on July 10, 2008

From a former sufferer...get out into as much sunlight as you can. Without sunglasses.

Drink plenty of water, take B vitamins, also add ground flaxseed or flaxseed oil to your diet.

Kudos on exercising, btw...
posted by konolia at 6:51 AM on July 10, 2008

I was somewhat of the same situation about a year ago - got laid off, ran out of money, had to move back in with my parents.

Okay, how bad is your social anxiety? Is there a place nearby that is virtually deserted that you can go to at the same time everyday (at least during the work week)? The library was a good place for me to go when I was able to leave the house. Pick a library that has a crummy kids section (or doesn't have many programs for kids), and the place will be deserted during the summer. The people there will be quiet and focusing on books; the librarians will leave you alone if you walk past them quickly as though you know what you're going for. In short, no one will be looking at you or paying attention to you (this was a huge anxiety-causer for me). The bonus is that if you take out some books, you have to return them eventually, so you'll have to force yourself to leave the house.

I ended up taking out a few books about knitting and taught myself (puttering around the Internet is pretty helpful for learning how to knit as well - lots of videos on youtube). Like ImproviseOrDie said above, using your hands and counting is incredibly relaxing. So, if you have to be somewhere that will cause you stress (crowded waiting room at the doctor's?), bring your knitting with you. I managed to stay mostly calm through a 90 minute waiting room of hell by knitting a scarf. Like an entire scarf in 90 minutes. Use big needles and chunky yarn and you'll feel super-productive. Oh, the craft store is also a good quiet place to go to when you're feeling up to leaving the house. Bonus: cheap holiday-of-your-choice presents for friends and family.

I also had to be up at the same time every morning so I could drive my SO to work. When I got home, I'd do everything possible to make sure I didn't go back to sleep. Wake up at the same time everyday, and make sure you at least move to a room where you'll get a good amount of sunlight.

Definitely talk to your doctor if you've been taking your medication for a few weeks and haven't seen any improvement. My experience was that every SSRI I tried made me feel exhausted and made me forget everything, so definitely be open to switching medications. If possible, get a thyroid test. Hypothyroidism causes depression, anxiety and fatigue.

Best of luck, anon. I hope you find something that works for you.
posted by giraffe at 7:46 AM on July 10, 2008