Design a Self-Care Prescription for Depression

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PrescriptionRefill

As a therapist, Mary Pipher, Ph.D., designed “healing packages” for her patients: activities, resources, and comforts to help them recover from trauma. Then, after her book Reviving Ophelia became a runaway bestseller, she herself suffered from an episode of major depression and designed a healing package for herself. “The essence of my personal healing package,” she describes in her book Seeking Peace, “was to keep my life as simple and quiet as possible and to allow myself sensual and small pleasures.” She created a mini-retreat center in her home and modified the ancient ways of calming troubled nerves to to fit her lifestyle. Her healing package looked like this:

She accessed the healing power of water by walking at Holmes Lake Dam, swimming at the university’s indoor pool, and reading New Yorker magazine in the bathtub every morning.

She cooked familiar foods, dishes that reminded her of home: jaternice, sweetbreads, and perch; cornbread and pinto beans with ham hocks.

She unpacked her childhood teacup collection and displayed it near her computer desk to remind her of happy times and of people who loved her.

She reconnected with the natural world by walking many miles every week on the frozen prairie, watching the yellow aconites blossom in February and the daffodils and jonguils in March, following the cycles of the moon, and witnessing sunrises and sunsets.

She read biographies of heroes like Abe Lincoln, and read the poetry of Billy Collins, Robert Frost, Mary Oliver, and Ted Kooser.

She found role models for coping with adversity.

She limited her encounters with people and gave herself permission to skip holiday gatherings and postpone social obligations. She erased calendar engagements until she had three months of “white space” in her future.

She embraced her body through yoga and massage. She started to pay attention to tension in her neck and other cues from her body and let those signals teach her about herself.

She meditated every day.

These activities were exactly what she needed to emerge from the other side of depression. She writes:

After taking care of my body for several months, it began to take good care of me. My blood pressure improved and my heart problems disappeared. After a few months of my simple, relatively stress-free life and my healing package of activities, I felt my depression lifting. I enjoyed the return of positive emotions: contentment, joy, calmness and new sparks of curiosity and energy. I again felt a great tenderness toward others.

Psychiatrist James Gordon discusses similar healing packages in his bestselling book Unstuck. At the end of his first meetings with all of his patients, he will write out a “prescription of self-care,” which includes instructions on changing diet, advice about specific meditations or exercises recommended, and a list of supplements and herbs. “Among my recommendations, there are always actions, techniques, approaches, and attitudes that each person has told me—which she already knows—are helpful,” he explains. At the end of his introduction, he suggests each reader take some time to write out his or her own prescription. He supplies a form and everything. Mine looked like this:

table image 2 jpeg

Each person’s healing package is unique. For example, many of my friends have benefitted from more meditation and mindfulness exercises, psychotherapy sessions, and therapies like Eye Movement Desensitization and Reprocessing (EMDR) that help unclog the brain of painful memories. I do better with more physical exercise and nutritional changes. While mindfulness and meditation have certainly helped me become aware of my rumination patterns, the most profound changes in my own recovery in the last two years have come from the bags of dark, green leafy vegetables that I drink and eat every day and Bikram yoga, an intense sequence of 26 postures with two breathing exercises. My mind seems to sort itself out when my body is engaged, but many people do better by dedicating their time to cognitive behavioral therapy and meditation.

It’s empowering to know that we don’t need a doctor or any mental health professional to design a healing package for us. We are perfectly capable of writing this prescription ourselves. Sometimes (not always) all it takes are a few simple tweaks to our lifestyle over a period of time to pull us out of a crippling depression or unrelenting anxiety.

Write your own self-care prescription today!

Join ProjectBeyondBlue.com, the new depression community.

Originally published on Sanity Break.

 

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Therese Borchard
I am a writer and chaplain trying to live a simple life in Annapolis, Maryland.

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2 Responses
  1. Rod

    This is a great idea and one I’ve done before. Unfortunately, I had a careless Sr that prescribed a dangerous combo of pills that became more dangerous with his advice. I had a severe reaction and the local hospital never took it seriously and even tried to cover it up, same goes for the Dr and pharmacy…all tried to cover it up.
    Ever since this happened, I tried hard to recover but even with trying my best I still couldn’t get past what happened and how it destroyed my life…I think I even let myself down as well. When I look at articles like this I get sad because it seems like I should’ve just stuck to taking natural supplements instead of nasty pharmaceuticals that don’t provide healing but sure offer some questionable side effects.
    Wow, I just feel lost and before my reaction I would be gung ho upon reading this and basically was doing it. I never sued the Dr, hospital or pharmacy because I was just going to take my life anyways. Now, the time to sue has passed and I’m still here and regrets are huge. I wish my Dr was paying more attention to me instead of being concerned about paying his taxes (I found out later he was in financial distress). After taking his terrible advice, two days later while on vacation with my fiance, I started feeling very sick from the meds. I told my fiance that I wanted to stop the meds since they were making me sick, she became angry and demanded I keep taking them.
    The day before (the day after taking the meds initially at bedtime), I had terrible nightmares and couldn’t for the life of me wake up in the morning. My fiance screamed at me to get up (she had anger, control and lack of empathy issues, along with unhealthy ways of dealing with work related stress…in which I took the brunt of, especially this morning) so that I would tidy the house for the person watching the house while we were gone.
    I somehow managed to get myself out of bed, tidy the house, shower, shave and pack…but this wasn’t good enough. My fiance came upstairs and was furious(I thought she would be pleased?!) and things took a very bad turn for the worse. I knew something was wrong right away but was too out of it to do anything, we got in the car and the silent treatment started…that went on for six solid hours.
    After arriving at the first destination, she insisted on going for a walk and a few minutes into the walk she mentioned she wanted to break up with me. I was very messed up by the meds and was shocked considering that I treated her like gold (flowers every month) never got upset with her and even tolerated her controlling, anger filled encounters when she was stressed from things that had zero to do with me.
    She then said we didn’t have to break up and then went back to the hotel to sleep, after taking the offending meds. I then woke up (barely) and went for a workout in the gym, something was very wrong. It felt like my muscles were not functioning properly and my nervous system…well it felt off as well.
    The tiredness was extreme and I did not feel well at all. We left after breakfast and drove another eight hours after getting a bit lost along the way (if it was my fault, I would never had heard the end of it). Upon arriving at a bed and breakfast, we met the gracious owners and were shown our room. She went online and I pulled out my meds and stared at them. I made the mistake of saying they were making me sick and I didn’t want to take them anymore (out loud), and she became angry and demanded I continue taking them.
    Being shocked at her response, I asked her to look up the meds and and how dangerous they were online before she demanded I keep taking them. She refused and insisted I keep taking them. I then looked at the bottles ( knowing I had read some not so great reviews of the meds, while also remembering the horrible previous day and the painful silent treatment) and figured that at this point I wasn’t prepared for anymore of her anger.
    Two weeks later I was rushed to the hospital (the hospital never took it seriously, blew off my concerns, yelled at me and left me in a wheelchair for hours at the back of the general waiting room before I finally saw a dr that said to go home since i was having a panic attack. I tried to tell him it wasnt a panic attack but he said I can believe what i want to believe but I could go home) with brain injury, muscle shrinkage and wasting, nerve damage, kidney damage and a few other painful injuries that have barely subsided. This happened when she was out on another business trip and I was home alone.
    I didn’t want to worry her when she was away and waited three days till I picked her up at the airport and went for dinner…then I brought up the reaction. Her reply was ” aren’t you going to ask about my trip?” I was blown away by this and realized I was on my own with this incredible damage I was living with.
    A couple of days later I saw my Dr and mentioned that I was brought to hospital by ambulance and had a terrible reaction that made me horribly sick. I told him I stopped ALL meds and was devastated. He never even mentioned that I might get withdrawals after stopping the anxiety med cold turkey…and did I ever.
    My Dr then mentioned he gave me bad advice and I could sue them…I told him I just wanted him to help me get better. He did his best to NOT help me get better at all and violently refused to properly check my kidneys in which I continued insisting until almost 4 months later he agreed…sure enough, I had kidney damage.
    Things at home were terrible, I couldn’t sleep more than two hours a night, was seeing a cousellor that tried to help me but there was too much damage to move forward. My fiance then insisted I see some completely untrained therapist (zero credentials) that was referred by her friend. The first thing the person (Im being polite here) said to me was “I know your type and have seen it before”
    My type?! (I’m white, he was native or aboriginal). I asked what he meant by my type and he just said he knew my type. He then began attacking me personally and after a certain length of time I calmly said “you’re attacking me and I don’t need this” my fiance was right there and agreed with this so-called counsellor that his goal was to help me.
    I got up and left while my fiance kept talking with him. I started to walk home and it was freezing cold outside. After walking for 30 minutes I decided to walk back and still waited outside for another 20 minutes.
    When we got in the car, she explained he was trying to help me and there was no attacking going on. I could not believe someone could not see the reality of what had just gone on. I couldn’t believe that a person that was supposed to care and be on my side was anything but.
    After mentioning it was a harrowing experience, she gave me an ultimatum of seeing him again or we break up. This was the first of many ultimatums that would follow. I then tried to recover the damage by spending tens of thousands of dollars on alternative treatments and were most likely a complete waste of money. There was a naturopath Dr that I had seen in the past but for some unknown reason, I failed to make an appointment with her…this person looking back was the only person qualified enough to help me.
    I can almost guarantee that she would’ve taken my situation seriously and provided outstanding care. Along with advice that would create as much healing as possible while saving me thousands on unnecessary treatments. I have no idea why I didn’t make that appt. After seeing real therapists, the unanimous statement given to me was “sue the dr!”
    Around eight months after the reaction, I made an appointment with a malpractice lawyer that indeed saw a potential case. Two days after that appointment (in which my fiance attended with me) I mentioned to my fiance that I wanted to sue the Dr. “If I sue the Dr we are breaking up”, was her reply. I had gotten used to ultimatums.
    The one thing the lawyer said to me was ” the Dr will change his notes on you…you’ll see, it will happen”. The next Dr’s appt, I asked to see the clinical notes on the day I was given the terrible advice, they were right near the top of the file…very odd.
    I saw the Dr that day at 12:45, the notes said 8am. I then read more, I told my Dr during the appt that my sleep was fine…he wrote; I couldn’t eat or sleep. He then paraphrased something I said…only thing was, I didn’t say that. He then never wrote down that I was taking supplements even though I remember he wrote it down originally and said it was “absolutely safe” to take with the meds.
    I caught him. He panicked and ran out of the office with a few pages of my file and photocopied them, returned and gave me the originals of some of them. This didn’t look good at all….there was no way I was there at the time he wrote down since it wasn’t my usual appt day because if the previous holiday.
    A day later I received a letter in the mail warning me that he sent a letter to the college as well as to me regarding he couldn’t see me anymore due to the fact I didn’t believe his notes. Either he was still a child, was worried about the repercussions, or both but this was a nightmare.
    I needed a Dr so I had called him and asked what this was about. He mentioned that he won’t see me anymore if I don’t believe his notes. I mentioned they were very incorrect and he countered then, he can’t see me. Realising I needed at least someone who knew what I was going through…I shut my mouth and continued seeing the Dr (child).
    The next appt I told my Dr that the damage was still making my life impossible. He made a joke, ” at least you font have to worry about your depression anymore!” and started laughing out loud. I told him I did not find that funny at all…in which he claimed it was a bad joke…and he was Irish.
    A few more months of this hell and I had had enough. I never wanted or sunscribed to this damage, the support I received was mostly getting screamed at daily, I had trouble functioning and I wanted out of this hell. I made a plan to die and it was interrupted with myself being brought to the hospital.
    My fiance arrived to pick me up in the morning and brought me home without saying much at all. Upon arriving home, she said ” now, you will sleep on the couch” and we broke up basically right then.
    I frantically searched for a place and even though I found one and just had to wait for a move in date and approval…I was screamed at daily and I mean screamed at!!! The only thing stable during all of this was my job, I was still on partial disability since my insurance company lied and said I had to keep working since I went back to work and therefore proved I could work.
    Upon moving out, I was lost. I couldn’t function, didn’t care for eating much, I just wanted to die. Everyday, I planned on dying and kept moving it forward, I knew there was no hope. I started seeing a psychologist that insisted I smoke marijuana for the nerve damage…finding out later he smoked it as well.
    I told him marijuana made me feel sick but he insisted my body will get used to it. About 6 months later I went hypomanic and started going out of control. Spent money like crazy and the crowning glory was when I quit my awesome job after running into an acquaintance that offered me a job in sales that was at best interesting and at worst was a lesson in dishonesty.
    The loss of the job was extreme and not long after, wondered just what was I thinking?! I was given a lead on another job but it required I move out of the city since the commute was pretty great. The job was gruelling and the owner treated staff like animals but I needed the job so I stuck it out.
    A severe depression followed right after seeing a chiropractor for an injury that I suffered at the job just before getting laid off. I didn’t see my regular chiropractor since I found one closer and it was more convenient. The chiropractor seemed very interested in maximum profit and recommended ultrasound to treat the injury.
    His receptionist entered the room right after he said “he gets the girls to perform the ultrasound”. She started doing the treatment and a few minutes in, I started experiencing extreme pain and said to stop.
    She then said she would turn down the intensity and continued to perform the treatment in which the pain became excruciating.
    I insisted she stop and she said ” this has never happened before”, of course not…this was probably her first time and it was the Dr’s job to perform this procedure…not her’s in the first place. Right after this my sleep went right back to 2 hours per night and continued for months until I was a complete mess. I’m not sure if the permanent muscle/nerve damage that just happened caused more kidney damage or not but something wax seriously wrong.
    I later took a medication that the pharmacy never warned me about not eating grapefruit with…I then suffered more brain injury. This, has been a complete nightmare, now since this last brain injury I am not convinced it will heal nor do I even care.
    What did I learn from this and what inspired me to write this? Upon discovering this awesome blog written by someone that understands how an illness can be tough to navigate through, I normally would be happy to stumble upon this. But now, since things have been beyond tough considering the nightmare I have already encountered. I wanted to add that the prescription that you give yourself should include making sure your partner is the right partner for you in the first place.
    It’s not an easy fix once you are involved with someone and things start eating away inside of you. You need someone with compassion and patience…it’s not a lot to ask and I can bet you might be better off alone than with someone that doesn’t take your side or best interests to heart.
    Last but not least. If a Dr prescribes you something out of the blue and you start feeling sick, make sure you stop the med immediately while phoning the Dr at the same time. No one should force anyone to take meds if they don’t agree with you. These can make you sick and/or kill you…I’m still trying to decide just what exactly is worse. Because, the reaction killing me doesn’t seem like too bad of a fate after what I’ve been through.
    Take care.

  2. Laura

    What about the self care topic of sex and intimacy? Which are all emotionally, physically and mentally affecting our souls? Where do we account for sex and self pleasure in our activity log?