8 Ways to Persevere When Depression Persists


Neil Webb/Getty Images. Depression, treatment-resistant depression, depression coping strategiesAlthough I like to cling to the promise that my depression will get better — since it always has in the past — there are long, painful periods when it seems as though I’m going to have to live with these symptoms forever.

In the past, there was a time when I had been struggling with death thoughts for what seemed like forever. One afternoon, I panicked when I surmised that they might always be with me. I embraced the wisdom of Toni Bernhard, who wrote a brilliant handbook for all of us living with chronic illness, How to Be Sick. While reading her words, I mourned the life I once had and made room to live with symptoms of depression indefinitely.

The death thoughts did eventually disappear, but I’m always mindful of my depression. Every decision I make in a 24-hour period, from what I eat for breakfast to what time I go to bed, is driven by an effort to protect my mental health.

When I hit a painful stretch that feels like forever, I return to Bernhard’s insights and to my own strategies that have helped me persevere through rough patches along the way.

Here are some of them:

1. Revisit the Past

When we’re depressed, our perspective of the past is colored by melancholy, and we don’t see things accurately.

For example, if I’m in a low mood, I look back on those years when I experienced death thoughts and think that I felt nothing but depression for more than 1,000 days. It’s helpful to peak at my mood journals from that period to see that I did have some good days and good times scattered throughout the painful stretches, which means I will have good hours and days in coming hard periods as well.

I also look at photo albums that bring me back to moments of joy sprinkled in amidst the sadness; these give me hope that even though I’m still struggling, it’s possible to contribute a nice memory to my album.

2. Remember That Pain Isn’t Solid

Going through mood journals is also a good way to remind myself that pain isn’t solid. I may start the morning with excruciating anxiety, but by lunch I might be able to enjoy a nice reprieve. At night I may even be capable of laughing at a movie with the kids.

Bernhard compares the painful symptoms of her illness to the weather. “Weather practice is a powerful reminder of the fleeting nature of experience: how each moment arises and passes as quickly as a weather pattern,” she writes.

I like to think of my panic and depression as labor pains. I breathe through the anguish, trusting that the intensity will eventually fade. Hanging on to the concept of impermanence gives me consolation and relief in the midst of distress — that the emotions and thoughts and feelings I’m experiencing aren’t solid.

3. Maximize Periods of Wellness

Most people who have lived with treatment-resistant depression or another chronic illness have learned how to maximize their good moments. During painful stretches, I consider these moments to be the rest periods I need between contractions. I soak them in as much as humanly possible and let them carry me through the difficult hours ahead.

4. Act As If

Author and artist Vivian Greene has written, “Life isn’t about waiting for the storm to pass … It’s about learning to dance in the rain.”

That sums up living with a chronic illness.

There’s a fine line between pushing yourself too hard and not challenging yourself enough, but most of the time, I find that I feel better by “acting as if” I’m feeling okay.

So I sign up for a paddleboarding club even though I don’t want to; I have lunch with a friend even though I have no appetite; I show up to swim practice with tinted goggles in case I cry. I tell myself “do it anyway” and operate like I’m not depressed.

5. Embrace Uncertainty

Not until I read Bernhard’s book did I realize that much of my suffering comes from my desire for certainty and predictability. I want to know when my anxiety will abate, which medications will work, and when I’ll be able to sleep eight hours again. I’m wrestling for control over the steering wheel, and the fact that I don’t have it is killing me.

The flip side, though, is that if I can inch toward an acceptance of uncertainty and unpredictability, then I can lessen my suffering. Bernhard writes:

Just seeing the suffering in that desire loosens its hold on me, whether it’s wanting so badly to be at a family gathering or clinging to the hope for positive results from a medication or desiring for a doctor not to disappoint me. Once I see the [suffering] in the mind, I can begin to let go a little.

6. Stop Your Inner Meanie and Remember Self-Compassion

Like so many others who battle depression, I talk to myself in ways I wouldn’t even address an enemy. I call myself lazy, stupid, unmotivated, and deserving of suffering. The self-denigrating tapes are so automatic that I often don’t catch how harmful the dialogue is until I’m saying the words out loud to a friend or doctor.

We can relieve some of our suffering by addressing ourselves with the same compassion that we would offer a friend or a daughter. Lately, I’m trying to catch my inner meanie and instead offer myself kindness and gentleness.

7. Attach Yourself to a Purpose

Friedrich Nietzsche said, “He who has a why to live can bear almost any how.”

When my depression gets to be unbearable, I picture my two kids and my husband, and I tell myself that I have to stick around for them. It’s fine if I never wear one of those “Life Is Good” T-shirts. I have a higher purpose that I must complete, like a soldier in a battle. I must see my mission through to the end. Dedicating your life to a cause can keep you alive and give you the much-needed fuel to keep going.

8. Stay In the Present

If we can manage to stay in the present moment and focus only on the thing that is right in front of us, we eliminate much of our angst, because it’s almost always rooted in the past and in the future.

When I’m in a painful stretch, one day at a time is too long. I have to break it down into 15-minute periods. I tell myself that for the next 15 minutes, my only job is to do the thing in front of me, whether that’s helping my daughter with homework, doing the dishes, or writing a column. When 15 minutes are up, I commit to another 15 minutes. That way, I patch several days together, and before long, one of those days contains some joy.

Join Project Hope & Beyond, a depression community.

Illustration: Neil Webb/Getty Images

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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8 Responses
  1. Ted Baxter

    As a surviver of childhood abuse, these are powerful, powerful ways to help reframe the troubled self-messages we surge with. I thank you Therese for the insight and commitment to others that you share.

  2. Doing As Best I Can

    Hello, Therese and all here.

    I love, love, LOVE the work of Toni Bernhard. I first learned about her last year (I think) from you, Therese. Between the two of you, as well as a few other wonderful souls, I have been able to hold on.

    I know what I’m going to share next may sound a bit (or absolutely) crazy, especially depending upon one’s spiritual and/or religious beliefs, but something I tried this past summer kept me from ending it all. Here’s my story in case it can help someone:

    My cousin sadly committed suicide just after the Fourth of July. His death has devastated our family, and especially his mother and sister. His birthday would have been today. I had no idea he had been suffering so terribly. I had been focused on helping my sibling and my cousin’s sister whom I feared may have been suicidal. I did this all the while as I myself was struggling with my own desire to leave this world. Now, although I have not had suicidal ideation for quite a while, thanks to sites like this and all, but after my cousin’s suicide, I had two accidents that made me realize how close to my own edge I was.

    I don’t know exactly the details of how I got to this next part of my story, but after all that had happened, something made me look at an old astrology chart I had computer-generated many years ago. I have always had both religious and spiritual leanings in my life, but often tried to kill off one side over the other fearing hell-fire on one hand and other types of fears on the other hand. At this point in time, I felt such fears were no longer important and that I had to fight for my life and for some reason, this was where I felt called to look. So, I listened to my inner voice (or perhaps it was Spirit – a very good one too because it saved me at that point in time from ending it all).

    As I was looking at my chart, and reading some of the explanations that were generated by a computer program, I prayed to be led to an astrologer that was the best for me and my soul. I found her and her interpretation of my birth chart blew me out of the water. Everything from my depression to traumas to the situation around specific relationships and all could be gleaned from pondering my birth chart. It’s all too much to go into, but I left the meeting hating myself a whole lot less than I have been for almost 98% of my life…and I’m no youngster.

    This lovely woman did not predict my future. That wasn’t what I wanted and I also do not feel called to that type of questioning. It’s just not me because I believe in the power of something greater to be able to help me. (But I do so understand that everyone is different and some may want to know their future.). What I needed was to deal with the self-hatred that has plagued me most of my life because of my sensitive nature, my depressive nature, feeling overly responsible for everyone, etc., along with trying to understand past traumas.

    Finding out that my chart made sense, BUT ALSO that it was only a “blueprint” of what I came into this world with, and that knowing this information, I could have compassion for myself and know, “Okay, these are my challenges, some of which I already knew, but apparently my soul must have chose to deal with them for a reason, let me work with this.”. That’s the attitude that I’ve garnered from this experience. I’m not saying life has become any easier for me. However, the shift towards self-compassion has been a huge blessing for me. (Please NOTE that I’m not saying that my soul chose my traumas and all. I have no idea if that’s true and honestly, I personally can’t deal with the thought that we choose horrible things to happen to us. I know some people do believe that, but I do not believe that kind of thinking is good for my soul…and I’m all about trying to heal both my humanity and help my soul.).

    Perhaps I could have read a great book or gone to a great sermon or anything else, but apparently this was what my soul needed at this point in time. And I’m realizing that time is always moving and I am always changing. I just want so much to change for the better – but this new “better” is not the “better” I have been erroneously thinking the world needs from me (people pleaser and go-alonger – that’s been me). However, this new “better” is the “better” person I want to be in order to be able to live a good, loving and compassionate life so as to be the same to others and spreading that love even if it’s just in a smile or kind word.

    My journey has now shifted to some of Eckhart Tolle’s works, which I find funny because almost 20 years ago a religious psychologist recommended Mr. Tolle’s works to me. I poo-pooed it all back then. I see now I wasn’t ready for it on that part of my journey.

    It’s amazing for me to be able to say that, “…I wasn’t ready for it on that part of my journey.”. A few weeks ago I probably would have beaten myself up for not listening to that doctor. Now I understand that life is a journey and I need to grow as my soul leads me. Sometimes I may seem to “slide backward”, sometimes I may seem to “screw it all up”, etc. But I think more so now… I’m just doing my best as a soul with particular challenges to live in this human realm which can often be challenging if I lose my center and my connection to God/The Great Spirit/Universe/Higher Self/Etc.

    Peace to all!!!

  3. Love the article Therese – great tips!

    Our aim at Let The Stigma Slide is to raise awareness and educate society about mental health, especially regarding depression and suicide in young adults. We want to show how common mental health conditions are to make people realise there’s nothing so foreign about it, and there’s really nothing to be ashamed of. We want to help abolish the stigma surrounding mental illness to increasingly create conversations around what’s perceived as such a “taboo” topic. In a #stigmafreesociety, those who suffer from depression will no longer suffer in silence.

    Would love your support! Here are links to our Facebook and Twitter.

  4. Rachel

    Therese, you mentioned the mourning of depression free times, did that involve any jealousy of others who don’t experience it? Or anger at the seeming unfairness of it? I am really struggling with this, in that all I want to do is enjoy time with my husband, toddler and baby without my brain trying to convince me to end it all ?