6 More Ways to Manage Severe Depression


rain umbrellaIn a prior blog I listed seven ways to manage depression when you can’t get out of bed. The suggestions are different than the popular tips most depression experts give for boosting your mood, which are usually written for those with mild or moderate depression, or the really lucky people who just want to feel better. I thought it would be helpful to expand my list and give you six more ways to manage severe depression.

1. Remember your heroes

When making it to the breakfast table is a humble feat, it helps to remember I’m in good company with depressives past and present: Abraham Lincoln, Winston Churchill, Kay Redfield Jamison, Mike Wallace, William Styron, Art Buchwald, Robin Williams, Patty Duke, and Brooke Shields. They struggled with death thoughts, too, but they survived … and succeeded at so many things. They are missionaries of truth and perseverance. Abraham Lincoln wanted people to know that his melancholy was a “misfortune, not a fault,” and that his humor, his jokes, were the “vents of [his] moods and gloom.” British Prime Minster Winston Churchill referred to his deep melancholy as his “black dog.” It was his teacher of perseverance. Kay Redfield Jamison reminded folks that “tumultuousness, if coupled with discipline and a cool mind, is not such a bad sort of thing.” Without Lincoln, Churchill, Jamison, and the others, I’d think I really was going crazy and stand crippled, terrified in my darkness.

2. Accept every invitation

Every psychiatrist insists that severely depressed people shouldn’t isolate. It worsens your condition. However, when your insides are withering, it’s difficult to concentrate on or care about anything else but escaping the prison inside of which you’re trapped. Instead of picking up the phone to make plans (like that’s going to happen), I make a promise to myself that I will accept any invitation. That was my therapist’s idea. It’s a passive way of socializing that requires no decisions and no effort on my part. I think it’s acceptable to to make up an excuse as to why you have to leave early.  It’s fine to pray that no one asks you to do anything. However, that hour with some other human being means that you can look your shrink straight in the eye and say that you are definitely not isolating.

 3. Stay away from the future

Some anonymous person wrote, “When I am anxious, it is because I am living in the future. When I am depressed it is because I am living in the past.” I would amend that to say that both depression and anxiety exist in the past and in the future, but the future is especially problematic when you are severely depressed, because there is no hope there, and where there is no hope, there is despair. When I am most panicked and suicidal, I am in the future. And I’m incapable of seeing anything good there. I can’t even see my life with my children. All I see is myself as a failure, letting down my loved ones, and wanting so badly to relieve them of the burden of caring for me. That’s my thinking. If I were operating in the present, there would be some stuff there, but not the massive load of fears and potential tragedy that exists in the future.

 4. Delay all decisions

Making decisions when you are severely depressed is as excruciating as just about any activity, so I would avoid making as many as you can. Start with the decision to take your life. Postpone that for a day. Maybe an hour. If you can, hold off for a week. The next day do the same thing. That’s how I stayed alive. That’s how many people stay alive. They put off for tomorrow a decision they could have made that day. This goes for all major life decisions. Like quitting your job. I made the mistake of making a career change when I was depressed. I thought I would feel better, but my depression worsened. Many people leave their spouse thinking that’s the problem, only to end up alone and scared, full of regret. Postpone everything that you feel compelled to settle immediately.

 5. Reframe your suffering

Clearly one of the most difficult jobs when you’re in intense pain is to move outside that pain. It’s plain physiology. You leg is cut off—you concentrate on the leg. I used to compare my depression, or let’s say amputated leg, with other people’s pain. Sometimes I became bitter that my suffering was more intense. Other times I felt guilty and ashamed—that I wasn’t terminal like my neighbor with bone cancer, and yet I wanted to die. Slowly I began to reframe my suffering as part of a collective experience. When I saw the 13-year-old mentally disabled girl in a wheelchair at the grocery, I felt somewhat bonded to her, because I knew we were suffering together. It didn’t make my pain go away, of course. But it made me feel less alone, that these other people with cancer or special-needs kids or some other painful experiences were with me in the mission to stay alive as a somewhat positive, not jaded, person. In his book, “The Inner Voice of Love,” Henri Nouwen writes:

Paradoxically, therefore, healing means moving from YOUR pain to THE pain. When you keep focusing on the specific circumstances of your pain, you easily become angry, resentful, and even vindictive. You are inclined to do something about the externals of your pain in order to relieve it; this explains why you often seek revenge. But real healing comes from realizing that your particular pain is a share in humanity’s pain. That realization allows you to forgive your enemies and enter into a truly compassionate life.

6. Cry

I’m big on crying because I always feel better after a long session, preferably with snorts. Tears heal. They remove toxins from our body. Weeping can be considered one of nature’s way of cleansing the heart and mind when you consider that emotional tears (those formed in distress or grief) contain more toxic byproducts than tears of irritation, like when you peel an onion. Crying also lowers a person’s manganese level, and overexposure of this mineral can cause anxiety, nervousness, irritability, fatigue, and depression. Crying is also cathartic. It’s good stuff.

Originally published on “Sanity Break” on Everyday Health.

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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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1 Response
  1. Lilu

    Recently, I realized that I’m better off spending time alone and feeling peaceful, rather than forcing myself to do social activities that will leave me anxious, uncomfortable, irritable, or upset. I think it’s important to be very picky in choosing what and who to say yes to.