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When interviewing a prospective psychiatrist or therapist, I start my story in the third grade. That year one of my parents would frequently be called to come get me from school -- I was crying uncontrollably and could not explain what was wrong. Back then, "neurosis" or "anxiety" were the common diagnoses. I was not diagnosed as having Depressive Illness until well into my thirties. Finally, there was a reason for my inexplicable and uncontrollable misery. Antidepressants and therapy were prescribed and life has improved.

As I am told by the pros, though DI is incurable, it is treatable and manageable. You just have to take your meds, collect your bag of tricks, and take enough distance from a depressive episode to remember to use them. Here is a list of some of the tricks that have helped me to cope, and more, to live a productive and sometimes peaceful and satisfying life.


Support Network

My support network includes a therapist or psychiatrist and friends who will understand and not judge. With episodes of major depression there's always concern that I might burn my closest friends out so I spread my "help" phone calls out so as not to overburden any one of them. Whom to tell? The easiest people to talk to are other women who also have DI. We reciprocate and, fortunately, our depressions are staggered so that one of us is likely to be up while the other is down. I'm very discriminating in my choice of friends. Early on I test the waters by talking about the major characteristics of my depression without explicitly naming the clinical diagnosis, Depressive Illness. So, for example, I might divulge that I am depressed this week because I seem to have misplaced my self-confidence and feel quite inferior to the rest of the human race. Without labeling myself as "mentally ill" the response I often get is compassionate and commiserative.

A lot of high-functioning, intelligent, educated, and productive people have these kinds of feelings. Keeping the medical diagnosis out of the conversation and talking heart-to-heart, I find out that I'm not so different from the average Jane after all. After a friendship has become established I can call a friend when I'm in pretty bad shape and cry my little heart out. I can be honest about love affair breakups, problems at work, lack of motivation, and I'm understood. These kinds of phone calls are made intuitively, like grabbing on a life raft in the ocean, and they have saved me again and again for thirty years.


Take It Easy

I've learned over the years that a depressive episode has a beginning and an end. I've learned to allow myself some leeway in the level of activity I expect of myself. When it's PMS and depression at the same time, I permit myself to be lazy and lie in front of the TV for a day or two. I can now do this because I know my body and soul need this and if I fulfill that need the depression will pass-my energy will increase and in a couple of days I will be able to resume my life. Mind you, in my state of despair I am unable to feel that the depression will wane. But I use my rational mind to repeat the mantra: This will pass soon. Respect it, indulge it just a bit, and give it a chance to diminish. It always does.


Forced Activity-Acting As If

Although I give myself some time off to take it easy, if my mood doesn't lift after a day or two it's time to get tough. Sometimes a depression can become habitual. There's a fine line to walk on between resting and overindulgence. When it gets to the point where I'm tired of my own laments, it's time to give myself a push. Sometimes acting as if I feel better will get me up and out the door and the activity I force myself to do becomes the very thing that breaks the depression. I recognize that morning when I need to throw the covers back instead of hiding under them.

When enough is enough I resolve to take my shower and get dressed. Before that, I might sit down and make a list of the things I'm going to do. If it's a work day, work is the fourth item on the list, after shower, dress, and eat breakfast. Everything goes on the list. Making a commitment to a schedule on paper relieves me of some of the responsibility of trying to feel better. I'm only following orders, this is what my list is telling me to do. It's amazing how the rational mind can trick my depressed and exhausted mind. Like a good little girl, I obey the list, even though I don't feel up to it. By the time I get to my destination, work, errands, a meeting with a friend, the very act of being in motion has improved my sense of well being.

Physical activity is a great ruse to undermine depression. The body in motion will begin to heal the mind with the neurochemicals it makes. Miraculous! The cure was within me all along (along with the meds)! But, you might say, I'm feeling so low I can't push myself to do any of this. Yes, sometimes a friend has to intercede on my behalf and I might ask one to drag me out of the house to help me in that first and most difficult step to break the depression. And if I'm not up to reaching out to a friend, necessity forces me out and saves the day. There are only so many days one can avoid food shopping or doing the laundry and either of these tasks can be a first step.

Small interactions with strangers quickens the recovery. I exchange "have a good day" with the woman at the check-out counter and find myself feeling slightly more human and able to come out of my shell. The child on line with his mother at the bank locks eyes with mine for a moment and folds into his mother's skirt forcing me to exchange smiles with her and the other people on line. Every gesture of human interaction adds a little more courage, a little more appreciation of life, a little less self-deprecation. The big trick in my bag is to keep this going, to find ways to trick myself into interaction with other people. The physical act of spreading one's lips into a smile triggers changes in neurochemistry.


Living is the best medicine against dying.

Over many years of ups and downs, I have begun to believe in my bag of tricks. I pull them out in shorter order and trust that they will work.