self care for major depression

May is Mental Health Awareness Month.  I have a mental illness - treatment resistant major depression.  In light of this month's awareness campaign, and inspired by Caitlin Marcoux's 10 Practical Steps for the First 10 Days of Cancer, I've been thinking about 10 of the self care tools I use to live with depression.

1) Go to the doctor, take my meds, treat my side effects:
There's no good reason to suffer from depression.  You can feel good.  You are allowed to feel good and to function fully in your life.

It's taken me a long time to be able to say that.  Mostly I just struggled on my own.  I dipped into therapy every 5 years or so and tried some medication once or twice.  But now that I'm a mom I feel even more sensitive about taking care of myself, including my moods and feelings.  I want to be whole, present, and engaged with my son, in a way that I didn't commit to my own life prior to him, not even with a partner.  Looking back I can only imagine how my relationships and career path could have been different, better, more true, had I enlisted a doctor to help me manage my depression.

Now I take 3 medications.  It's not perfect.  Depression breaks through. Side effects annoy me and require remedies.  It's an ongoing conversation with my psychiatrist.  But most days I feel better and it's certainly better to have someone facing it with me.

2) Tell the people close to me:
This one is particularly challenging for me.  There's no casual way to broach the subject in conversation.  Plus, there's still a stigma about mental illness that makes me not want to bring it up.  I do talk to my husband about it.  It helps him to know what to expect or how to understand my behavior or expression.  In return, sometimes he is the one to notice a pattern and nudge me back to the doctor's office for some help.

3) Move my body:
My new lunch break favorite activity is walking the mile from my office to bridge, running up the stairs, and then jogging back to the office.  It gets me out of the muck of the j-o-b.  Gets my endorphins up a little.  Wakes up my mind and my metabolism.  All good things for someone wrangling depression.

4) Establish healthy routines:
This one is best initiated on a good day.  I've set up some habits that make my life easier and require less conscious effort on a bad day. Some of them are packing my food for work the night before, listening to an affirmation meditation during the bus ride to the office, and exercising on my lunch break.  At their best, these habits also ensure that I'm continuing to live the way I want to live, despite what I might feel like doing (or not doing).  For example, on a bad day I might feel like eating junk food and not feel like eating nutritious food, but bringing some healthy food to the office makes it easy to eat the good stuff anyway.

5) Eat nutritious food:
It might be obvious - nutritious food is good for your body.  But on a bad day I really don't feel like eating healthfully, or doing anything that's good for me.  Committing to nutritious food is a commitment to my life and my health, regardless of how I feel.  And with the right choices, I might feel better.  There is some connection between diet and mood.

6) Practice yoga:
This is more than moving my body.  Yoga makes me feel like all the parts of my body are coordinated and working together.  But it also works on my mind, synching everything up, opening me for greater clarity and calm.  It's a bright little harbor in the midst of this storm.

7) Participate in therapy:
It's not easy to find a good match with a therapist.  I've had two, including my current therapist, that really "got" me and were able to both affirm me and challenge me in meaningful ways.  Good therapy helps me to untangle from my "stinkin thinkin," uncover patterns in my family and other relationships, and engage a sounding board to hear how I talk about myself, my feelings, and my life.

8) Collect evidence:
I use my day planner to keep track of what I do and how I feel.  I jot down things like what I eat and drink and my emotions (or lack of them) over the course of a day.  Then I can notice patterns, like a string of bad days or particular behavior that continues to appear and make a decision about what to do about it.  It also helps me to see when and what I've done well and what works to make me feel and do right for myself.

9) Inhabit time with good people:
Depression and isolation go hand-in-hand.  It's like being seen and communicating with other people just takes more energy and interest than I possess.  That said, the right people can be a balm.  And the exercise of getting out, hearing other people's lives, and sharing what I can of my own keeps me connected, affirming my value and visibility.

10) Indulge in creature comforts: 
comfy clothes and clogs, chocolate, '80s synth-pop on Pandora, plants, multi-colored pens, a favorite mug (usually half-full of coffee), walking on the beach, and hanging out with my guys.

I'm not successful in practicing all of these every day.  Some days all I get to is my creature comforts.  But having the list in front of me every day, in my day planner, puts good ideas in my head.  It encourages me to try these things regardless of how I feel.  Some days moving my body or sitting with some friends makes me feel better, other days I just get to tick off the list that I lived the way I wanted to despite depression.