I posted tips on managing depression awhile back, and Chad gave his perspective on them. I got to thinking that perhaps the list — which I inherited — would benefit from some elaboration.

1. Set goals and priorities.

   When a person has depression, even minor tasks can appear mountainous. A goal might be something basic, such as setting a goal to get out of bed and bathe. You lie in bed, talking to yourself: “Okay, in five minutes I will get out bed. I will walk to the bathroom.” Then you get out of bed, and once in the bathroom, coach yourself to turn on the water. There are days when depression can be that intense. In general, having some ideas of what you want to do adds structure, which can help when you are robbed of natural motivation. Have a plan for the week. What do you want to accomplish? Laundry? Going to a museum? Calling a friend? Taking out the garbage? I recommend people keep a notebook in which they make note of everything accomplished each day, no matter how small. That way, when you feel that you’re totally useless, you have evidence that you, in fact, are not.

2. Meditate.

   What is meditation? It is a process of becoming aware and experiencing insight. You don’t do it perfectly; it is a learning process. Mindfulness is accomplished when you learn to quiet the mind by becoming still and breathing, to notice what’s going on internally, and to develop a nonjudgmental attitude toward yourself. Two of the best books I’ve ever used on meditation are: Mindfulness in Plain English and The Zen Path Through Depression.

3. Do it now. Don’t procrastinate.

   Again, depression robs a person of “juice,” of zest for life. And part of that occurs in the thinking process — too much thinking. You sit and tell yourself that it’s not worth going out to the cafe to be around people because you don’t feel good, you feel fat, you’re stupid and can’t make small talk. That’s the time to tell that part of yourself to “talk to the hand,” and just do it (yes, it was an ad slogan in the 1980s, but that doesn’t nullify the concept).

4. Keep a regular sleep schedule.

   People vary in the amount of sleep they need. One symptom of depression is a disruption in the usual amount you’re accustomed to — the inability to sleep when you used to be able to, or not being able to remain awake when you formerly could. The body is a rhythmic entity and consistency is essential. You may find that if you keep a regular bedtime and follow other good sleep habits, it might mediate some of the sleep problems related to deperssion.

5. Look good and feel good.

   This is perhaps the most superficial of the ten tips. You’re depressed. You read this and think, “Uh, right. If I could do this, then I wouldn’t be depressed. True enough. Still, on any given day, if you are able to garner the energy and make the effort to behave as if you feel good, it might nudge you one step closer to mental health.

6. Exercise.

   Your body was made to move. Exercise improves all bodily systems, brings oxygen into your cells, releases endorphins that improve mood, and tires you physically (improving nighttime sleep).

7. Take prescribed medication.

   If you have been prescribed an antidepressant and agreed to take it, then be committed to taking it for the course of treatment. Don’t stop simply because you feel better. Depression is a serious illness; typically doctors advise a six to nine month course of treatment. After that, you can taper off and hopefully will never have another episode. If you do have a second episode, and if depression runs in your family, chances are you will have a chronic condition, and you need to decide whether to take medication indefinitely to manage it, or deal with each episode. Unmedicated depression tends to worsen over time. You may have a condition known as dysthymia, a low level chronic depression. Some antidepressants have been helpful in alleviating the symptoms. Whatever you do, don’t abruptly stop taking medication. It can be dangerous, and at the very least uncomfortable. Talk with your doctor and follow her instructions on how to stop. Also, there are many more antidepressants available than two decades ago; each has side effects, and each person responds uniquely to medication. If one medication makes you feel stoned and lethargic or hyper and “over-caffeinated”, then request a change until you get one that works. I believe that depression is significantly helped with psychotherapy and do not favor immediately “throwing medicine” at the problem. On the other hand, you are entitled to investigate all resources that might help you.

8. Be honest.

   This one is self-explanatory, I think. Aspects of honesty are acting with integrity toward yourself and others and being clear in your communication.

9. Think “I can,” versus “I can’t.”

   As simplistic as it sounds, so much of depression is related to how one thinks.

10. Nourish relationships — with yourself and others.

    Why nourish a relationship with yourself? Because the one person who is going to be with you your entire life, through the good and bad, is yourself. Nourshing relationship with yourself involves many things, some stated above: treat your body well; develop compassion for yourself; identify what pleases you and enjoy that; take time to learn what you think and believe and assess if that is really you, rather than what you grew up being told. Know thyself. As for relationship with others, people vary in their need. But all of us, to some degree, have a need for social connection. You may not want to invite people into your home — it is a special place. If you don’t like people in general and are satisfied with that, then it’s a non-issue. In my experience, though, people who say they don’t like people have reason to: they’ve been hurt. To not have relationship with others because of that is understandable, but it deprives you of much joy as well. It might be worth looking into this. However, if you find yourself wishing for friends but not having any, take time to learn why, and learn how to meet that need. In either case, professional counseling can be of help.

These tips are intended to help a person manage depression. Clinical depression is a serious illness and needs professional attention. These tips are intended as a guide to keep in mind in order to make progress. Even small steps count.