With depression, what gets you through the lowest days?
September 20, 2017 1:02 PM   Subscribe

I have bipolar disorder and take mood stabilisers which helps with the mood swings, but sometimes out of nowhere my mood will totally plummet. There doesn't need to be any external cause although things like changes in sleep patterns can trigger it. Nothing that I usually enjoy (like cinema or music) makes me happy, the only thing that brings me comfort is overeating with takeaways and lying in bed all day trying to sleep it away, and my personal hygiene and self-care goes out the window. Obviously these are not good coping strategies. Thankfully I don't have issues with self-harm or self-medicating, but these episodes cause me a lot of emotional pain and I think my coping mechanisms make them last longer than they need to. I can't take anti-depressants with my illness because they can trigger a manic episode. What gets you through times like these, if you have this issue? At the moment I just have to ride them out but it gets exhausting.
posted by AuroraSky to Health & Fitness (27 answers total) 46 users marked this as a favorite
Try to practice mindfulness. My favorite part of mindfulness is becoming aware of what is going on around me (do I see an ant on the window? can I hear it? what kind of traffic can I hear from inside my room? etc.) and just contemplate it non-critically.

When I still feel capable of leaving the house I try to go for activities that stimulate / soothe my senses, become aware of those, and contemplate them non-critically. Stuff like going to the beach and walking barefoot for a few minutes, or walking through a pile of leaves, or burying my feet in snow, or going out to the fields and smelling the natural smells. Or going swimming, especially at a spa-like center, or just riding my bike in nature, or down the hill. With either one, certain conditions are essential: I don't push myself or let other people push me into speed or performance, but instead aim for thrills, pleasure, enjoyment. Go down the slide, lie on your back for 10 minutes and ignore the competitive swimmers who may want you to hurry up. Do the thing for its own sake.

Sometimes I'll deliberately walk or do other stuff in slow motion, just to see how slow I can get. Usually, I end up *really feeling* my body and connecting to it, and that often results in a weird sense of well-being that is super awesome and makes me feel slightly better every single time.
posted by ipsative at 1:18 PM on September 20, 2017 [4 favorites]

For me, it helps a lot to have other mentally-ill friends who are in treatment themselves, or working on recovery in a serious way on their own. It means there are people I can talk to on a bad day who will get it and be able to tell me from their own experience "Yeah, that shitty symptom happened to me / my partner / my friend once. It passed / XYZ helped / it kept coming back but they learned to cope."

Support groups are sometimes kind of bullshit, because they're usually drop-in and it's hard to connect emotionally with a whole roomful of people when people are appearing and disappearing every week. But one thing they're good for is for meeting people who might turn into that sort of friend. Maybe try one if you have access to one?
posted by nebulawindphone at 1:34 PM on September 20, 2017 [2 favorites]

Mindfulness and distraction help. You can narrate (in your head) what you're doing or seeing, you can count down from 100 by 7's, you can look at pictures of people/things you love, you can listen (and try to focus on) to a playlist or podcast you really like.

Depression is so hard because it feeds itself. Depression makes you want to nap, and eat, and sit around doing nothing. The best three things I've heard to try to do are: (1) Leave the house, (2) Do something, and (3) Be around other people. Those are really hard to do when you're not motivated, but if you can force yourself to do those things, in that order (that is, don't try to do all three if you're struggling just with the first one), it helps a ton. Making an activity schedule where you purposefully schedule daily activities, including personal hygiene and self-care as well as stuff that hits 1-3 above, helps. You could even share that schedule with a friend and have them check in with you to make sure you're sticking to it.

Working on these skills when you're NOT in a bad state will also help. You could even join a local DBT group to work on skills with others.
posted by violetish at 1:34 PM on September 20, 2017 [2 favorites]

Honestly, sometimes the best thing to do with days like that is whatever you want, knowing that they'll end. Bad coping strategies for one day isn't going to hurt your overall trajectory towards recovery. You know "sometimes all you did today was breathe, and that's fine"? Sometimes all you did today is eat takeaway and sleep, and that's also fine. You're sick. It's great to have alternate coping strategies but it's important to remember to be gentle and kind with yourself if for whatever reason you're low enough you can't access them.
posted by colorblock sock at 1:36 PM on September 20, 2017 [6 favorites]

Yeah, on non-preview, DBT skills groups are also great, and tend to have less turnover than drop-in support groups. Another good way to put yourself in supportive contact with people who've been there and get it.
posted by nebulawindphone at 1:36 PM on September 20, 2017

Everyone's depression is different so this might not work (or even be possible) for you. When I'm having a depressive phase, I make every attempt I can to do everything I normally. I've found that my internal narrative says something like "oh, I feel bad so I should let myself off the hook just this once. I'll be nice to myself and skip exercising or showering or visiting with friends." But what starts out feeling like being nice to myself ends up being the exact opposite of what I need.

I do so much better when I stick to structure and routine during a depressive phase. I speak gently to myself but I keep myself going. I also try not to beat myself up when I'm not perfect at doing this.
posted by mcduff at 1:52 PM on September 20, 2017 [6 favorites]

I have treatment resistant bipolar II. I have a list of things I should do every day in order to maintain the most minimal level of physical and mental health. On the terrible days, I try to get two of those things done. My current list is: brush teeth, take shower, eat one healthy meal, take medications as prescribed, do my daily 15-minute clean. If I brush my teeth and take my meds, that's a win. If I can get them all done, that's a gold star in my bullet journal.

I also have a bunch of hobbies and find that the worst days are the best days for doing "hobby maintenance." Swatching new pencils, paints, and yarns, cleaning brushes, trying a new paper or technique I saw in a YT video, putting a fresh new ink in a dormant fountain pen, coloring in a page in a cheaper coloring book with cheap art supplies so I don't have to think up an original drawing, knitting a pattern I know by heart while I watch TV, that sort of thing. This type of thing keeps me occupied and focused but free of judgment about what I'm doing. I can't mess up swatching a set of watercolors. I don't care if my Barbie coloring book page is ugly. I actually save up new supplies just for such days, which I endure 5 or 6 times a month. Doing this sort of thing makes me feel productive despite the self-indulgence inherent in "play."
posted by xyzzy at 1:56 PM on September 20, 2017 [26 favorites]

When I was depressed, I liked taking really long, hot soothing showers. I'd lay down in the bath with the shower on. Maybe baths would appeal to you. But it could help with your personal hygiene issues, which I imagine only make you feel worse. Look at a shower as a more relaxing equivalent to laying in your bed when you don't have the energy to do anything, whilst also accomplishing something.
posted by AppleTurnover at 1:57 PM on September 20, 2017 [2 favorites]

Best answer: I can't do abstract mindfulness, but the worst days I find that just forgetting myself by doing Sudoku or Minesweeper or 2048 on the computer for, if necessary, hours at a time just gives my brain a bit of a break from hating on itself, and helps the recuperation process.

If I can put on some familiar, not especially emotional music on repeat, so much the better. Sometimes Bach, sometimes Camera Obscura, sometimes Elgar, but just, you know, kind and soothing.
posted by ambrosen at 2:00 PM on September 20, 2017 [3 favorites]

I am in the midst of my yearly battle with seasonal mood disorder related mini depressive episodes. The rest of the year my bipolar moods are more or less managed, but this time of year it's incredibly difficult to keep it together. My prescriber believes this is due to the massive changes in light that take place this time of year. I've been falling in and out of hypoarousal collapse state and it's really difficult. I'm studying right now how to regulate the nervous system through use of strategies that affect our vagus nerve.

This is the chart I use to figure out where my nervous system is and then I choose some of the suggestions on the other side to pull myself out, like naming my bodily sensations, and one of my personal favorites is doing an inversion, which I do by laying on a stability ball and letting my head go over upside down.

Chart of Nervous System States/Symptoms

Based in polyvagal theory, explained here:

Beginner's Guide to Polyvagal Theory

Here are some of the other things I've been doing to get myself through these times:

1) Made a list of fall events/ things I am (or would normally be) looking forward to, like times with friends, etc

2) Started some creative projects to have to do as I make my way thru the dark days

3) Made a list of things NOT to do that I know make my mood worse, like listen to Elliott Smith (sorry, Elliott, love!) and reminisce about past loves

4) Put up cute things that make me happy (or at least remember happy times) when I look at them, like Christmas lights at home and in my office, little reminders of friends like cards they've sent me, pictures of animals, anything that gives my system a little jolt that reminds me things haven't always been like this and they won't always be like this either.

5) Self-Holding Exercise

Good luck and be well!
posted by fairlynearlyready at 2:14 PM on September 20, 2017 [11 favorites]

YMMV, but at one time or another these things have helped on the worst days caused by depression and anxiety:
Listen to the Hamilton soundtrack. All the way through. Cry at the sad parts. It's okay.
Step outside on the deck/porch/balcony for 5 or 10 minutes of outside weather.
Pet something furry (dog, cat, etc.).
Drink water.
Even if you don't shower, change into some different clothes at some point, including clean underwear if you have any. (And by different clothes, I mean different comfy clothes, like sweatpants. )
Try showering not to get clean but just for the sensation of water on your skin.
Give yourself permission not to accomplish anything.

The last one is the one I find most difficult. If you can do it, it really helps. I hope you feel better soon.
posted by tuesdayschild at 2:14 PM on September 20, 2017 [1 favorite]

Best answer: I've gone in and out of depression my entire adult life. I've been there with the bed and the sleeping and the take out. (and the 2 1.75s of Johnny Walker a week to boot.) Here are the things that really seem to help me... I actually consider these things part of my meds... when I stop doing them I call it 'going off my meds' as it has just as much or more impact.

* Pema Chodron's book Living Beautifully. I read it every day in the morning before coffee for 5-10 minutes and then I sit meditation for 20 minutes. When I get to the end I start over. It makes every bit of difference in how the day goes.

* Keep a fridge full of whole ingredients. Join the coop or a CSA. Get into food and cook ALL your own meals. I do this Sunday afternoon/evening, which is a shit time of week for me and it makes me happy. Eat right (and well.) I switched to a vegan diet a year ago and do all my own cooking. I still eat too much or compulsively, but there's a difference between eating too much hummus and take out.

* Don't watch TV. Don't stay up late. Don't drink (especially if you're on drugs with interactions.) Leave your phone in the living room. I go to bed at 10pm and read the New York Review of Books or the London Review of Books with a dim light. I usually last about 10 minutes and sleep like a stone. Even getting one bad night's sleep can set me off... thinking back to when I would sleep 2-5 hours a night makes me wonder how I survived.

* Exercise every day. For me it's a bike ride (or a commute!) or a spin class. Every day, though—This is what I think makes the biggest difference of all for me. Also, I shower after exercise, so I get one of those every day, too.

I still get depressed, though. I have a bipolar diagnoses and I feel it all the time and sense the difference between me and other people. I'm going through a really rough month right now, actually, but by sticking to my program I've found that it doesn't get as bad and it passes more quickly. Still scares the shit out of me every time, though.

All best to you, OP. I'm sending the best energy I have to you.
posted by n9 at 2:33 PM on September 20, 2017 [28 favorites]

tiny actions
- go outside and get sunlight on your face as early as possible. even 10 minutes can change something.
- clean something. put one spoon in the dishwasher. wipe the bathroom mirror.

n+1 for mindfulness approaches.

exercise (even walking) can be a long reach. but, it's the wonder drug.
posted by j_curiouser at 2:50 PM on September 20, 2017 [4 favorites]

Everyone's depression is different, but I, personally, like the approach of pushing myself physically hard and fast.

Bc with my depression, I'm usually mad at myself for "not being able to get it together," which is a lie... but hey! Depression lies.

Therefore, I don't *want* to take care of myself with soothing baths. I want to make myself hurt in a good way! As in, I *will* beat this thing!

It's hard to motivate, believe. Like, it will probably take me all day to find leggings, put on socks, work up to tying my shoes... but eventually I can make it out the door to SPRINT. HARD.

It's not a jog or a run. It's a lunatic ostrich on the loose. I put the angriest metal I can find in my headphones and just haul ass.

Sometimes I give myself a goal: like make it to Xplace in Xminutes. I leap over trash bags, cut corners, fly in front of pedestrians. If I make it, I get immense satisfaction. (Self-esteem, check!)

I absolutely look nuts, but at the end I'm chugging water (Self-care, check!) and a shower feels reallllly good (Clean, check!), and I sleep like a stone (Rest, check!).

Anyway, I'm probably an outlier but I hope this helps!
posted by functionequalsform at 3:03 PM on September 20, 2017 [2 favorites]

I Am Not A Doctor. I Am Not Your Doctor. I Am A Person Who Suffers Manic Depression.

Okay, that's out the way. There is a huge palette of mood stabilizers now available; there is a very good chance that you can find one which will allow you to take an effective (for you) anti-depressant without triggering breakthrough mania.

It took a long time for me, working with both a really competent, very caring psychiatrist and also with the support of a really good psychotherapist. I (we) tried any number of mood stabilizers which were/are available at that time (2003). The frustration was huge, I wanted to quit, wanted to just bag it, throw in the towel, but I had their support, and also I couldn't bear the idea of living the rest of my life at the beck and call of profound depression, under its thumb.

Finally we found a mood stabilizer which I could tolerate and which allowed me to take an anti-depressant and not get shot over the moon. It's a huge difference, huge. It's not like my life is perfect, the manic depression still has sway over me. But the floor of the depression is raised, I now no longer am apt to cry for any reason, or no reason at all. I have a very different Normal. Depression is just so powerful, I remember clearly what I lived prior to reaching medicinal armistice with this son-of-a-bitching disease, so taking my medication is now religion to me.

Again, I'm not a doctor. Maybe you and your psychiatrist have tried and tried to find a mood stabilizer that can give you firm ground to be based upon. But if you haven't really gone after it hard and heavy, you're not really giving yourself a chance to live with the floor of your depression raised to a more tolerable level.

Good luck.
posted by dancestoblue at 3:04 PM on September 20, 2017 [10 favorites]

Small goals on bad days, and making sure I verbalise them or note them down. Because otherwise I sit there thinking "I did nothing for a week" when I did actually take all my meds on time, ate at least two meals each day (cereal is a meal), I did laundry, I drew a picture, I talked to someone online. Those are all hard things to do on bad days.

I also try and prep for the bad days when I am having good days. I am staring down the barrel of a three month stint basically guaranteed to trigger off some of the worst of my brain stuff. But I am having okay days at the moment which means I am setting up my wardrobe to be as low-decision as possible, I am tidying desks so I can sit and work without my brain going haywire, I am going to cook up stuff to go in the freezer so I can eat food.

The latter tends to make the bad days easier. Because I can throw a thing in the oven and have a meal with protein and carbs and fat, cushioning my brain from eating itself. I have removed all the awkwardness from my wardrobe so in the morning I am not faced with any decision harder than 'pants or dress' and no body-thoughts either, because everything there fits right and is comfortable. It means I have clean sheets in the house, and towels, so I can swap those out at least.

Sure, I live my life basically prepping for the worst, but my brain is what it is. That sucks, but I have done all I can to change it and I am at a point where i do have enough good days that I can help me and my family ride out the bad ones.

I focus on the satisfaction of minor things too. Hanging the laundry just so, folding things, sorting things. It all makes bits and pieces of my brain slot together better too (I will also go wander Ikea at slow times, because all the organised things make my brain settle a bit more).
posted by geek anachronism at 3:55 PM on September 20, 2017 [3 favorites]

Physical exercise in the form of a long walk (preferably in or to a nice place). If that's not possible, some barbell training at home.
posted by turbid dahlia at 4:30 PM on September 20, 2017 [1 favorite]

Hi, I suffer from chronic, severe depression. I take meds, go to therapy, and have a host of strategies to work through it and am mostly okay these last few years. But I have found, when I am at the bottom of it, that indulging in my depression for a little bit helps. Depression can turn indulgence in it into a perverse sort of pleasure. Why yes, I will engage in self-destructive behavior! Staying up until 2AM drinking on a Wednesday, yes please!

I will make sure I eat right, exercise, and play with a dog. But I will also give myself a portion of time to listen to that Yo La Tango song that hits me in the gut every time, or permission to take a walk in the rain. But only for a short period of time, and only once a day. It scratches that itch, without ripping the wound open.
posted by munchingzombie at 4:42 PM on September 20, 2017 [1 favorite]

Seconding a lot of what other people wrote. I have depression and comorbid (undiagnosed as of yet) chronic pain, making my bed feel like heaven on the bad days. Few things that I have found work for me:

a. In terms of exercise, find something that you enjoy doing / find a rewarding challenge. I pole dance because I love it; the 'exercise' component is ancillary; I love to dance. It doesn't seem like a chore because I love it.

b. I found that watching videos on depression to understand underlying mechanisms really helps me to contextualize my experience and understand that it's not my fault (if you're like me, beating up on yourself is a problem). I recommend Robert Sapolsky.

c. Support groups! But positive ones. Sometimes depression can catch people in cycles of pain which can be toxic if the support around you feeds into it. I am in several chronic pain FB groups and it makes me feel less alone, and more supported.

d. I read somewhere something about developing relationships around activities as opposed to solely talking or venting with friends. I've been trying to base more of my relationships on shared experiences as opposed to bonding over trauma, etc. I think this can help get me out of my head.

e. I have a 'depression cheat sheet' which is an ongoing google doc I've kept up for years, filled with tips and tricks and notes on depression, written from both sides of the coin, depression / non-depression. This is a helpful resource for me.

f. Telling myself that I am a "well person with pain." Reframing the issue helps from compounding it and letting it make you feel defective and hopeless, or at least, for me.

g. Z-ing the call for drug combinations. Find an attentive doctor. Don't let your clinicians slip up and write you off; this has happened to me many times. Drugs made a world of difference, in the right combo, for me, too.

Best of luck to you. Have a thousand cozy hugs!
posted by erattacorrige at 4:51 PM on September 20, 2017 [2 favorites]

b. I found that watching videos on depression to understand underlying mechanisms really helps me to contextualize my experience and understand that it's not my fault (if you're like me, beating up on yourself is a problem). I recommend Robert Sapolsky.
posted by erattacorrige at 6:51 PM on September 20
Can you give any specific recommendations on Sapolsky videos? Is it like a TED Talk(s) or something else? I listened to one of his classes once on Audible and thought he was/is brilliant, but the topic wasn't even in the neighborhood of depression/mental illness.

Any input appreciated -- thx!
posted by dancestoblue at 6:05 PM on September 20, 2017

For sure: https://www.youtube.com/watch?v=NOAgplgTxfc&t=280s
posted by erattacorrige at 6:16 PM on September 20, 2017 [3 favorites]

posted by erattacorrige at 8:16 PM on September 20
Unreal great information there, Sapolsky as good as ever he is. I've watched it once now but I'm going to be going back over it, going to fwd to my shrink also. Thank you for that, errattacorrige.
posted by dancestoblue at 7:24 PM on September 20, 2017 [1 favorite]

This is not for long-term depression, but for the type of sudden, episodic depression that used to plague me. What often worked best was what I mentally referred to as "taking a holiday from myself."

That is: whatever pointless, mindless, self-indulgent activities will keep me from self criticism, over-thinking and merciless analysis. For me that's sitting around, reading dopey fiction and eating junk food. When things were at their worst, I colored in grown-up coloring books.

Obviously this isn't a strategy you want to employ too often, or for more than a day at a time. I also had to be careful I didn't fall into the trap of self criticism the next day, over how unproductive I had been. I would say to myself, "what did I get done yesterday? I survived depression. And didn't hurt anyone in doing it. That's an accomplishment."

It's worth one day of sloth and poor nutrition if it gets one through the low spot.
posted by wjm at 11:07 PM on September 20, 2017

I have chronic depression and chronic pain. I think other people have had fabulous advice, especially xyzzy, so I just want to recommend a book: Kate Bornstein's Hello Cruel World. It is the only resource on depression I have encountered that has been useful to me.
posted by bile and syntax at 8:38 AM on September 21, 2017 [1 favorite]

I don't have clinical depression, I don't think, but I do have these periods of torpor where I either cannot or will not, I have never been able to determine which, do much of anything for days and days. I love when they end, and I suffer while they are upon me.

We just got done preparing the house for Irma, and now it's destroyed (no, no, no, very poor word choice, what I mean is, everything that had been on a south or a west wall is now in the middle of the floor or jammed somewhere where it would fit because I became convinced that the south and west windows were going to blow in), and I realize I need to assemble a hurricane kit. I have most of the components of a hurricane kit, but they're all over the house. I want special, hurricane-only flashlights and batteries and candles and all that stuff assembled and in one easily accessible place so I'm not having to hunt for things when I can't hunt for things because there's no power and all the windows on the south and west sides of the house blew in (this did not happen, in point of fact), or god forbid trying to BUY things in the week leading up to the storm.

Your question made me think, why not, while I'm at it, assemble a lassitude kit? It would have really good nonperishable snacks and sudoku books and books on tape and a boxed set of Fawlty Towers, in my case. It would have a week's supply of clean underwear. I would also include a guest book in my kit. Every time I used my kit, after the "storm" (really about as close to the opposite of a storm as you can get), I'd stock it up again and write a short note in the guest book to future users (all of them me) with any tips picked up from the latest go-around that made things easier or harder. And a note of good will about how it will end and to enjoy the snacks.
posted by Don Pepino at 9:07 AM on September 21, 2017 [7 favorites]

Popping back in to second dancestoblue's suggestion to pursue a mood stabilizer that works for you if you haven't. I have been through the ringer of trying different ones and for me it's Lamictal. I can say that as horrible as trying different ones was, now that I have been steady on Lamictal for quite some time (with Zoloft to manage the depressive part) my life is infinitely better. Take care.
posted by fairlynearlyready at 9:17 AM on September 21, 2017 [2 favorites]

The Virtual Hope Box has helped although I initially scoffed at it. I use the app to keep the “moments” that I can count on to keep me connected to a better time all in one place. Videos of my family, pets, only the uplifting soundtracks, photos that are inspiring.... If I’m down, I wouldn’t bother to find all this stuff. But I can manage to open one app. The app has other features but I haven’t used them much. It’s free and available for both iOS and Android. #bettertomorrows
posted by Kalatraz at 4:43 PM on September 27, 2017 [2 favorites]

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