If you have been feeling down for two weeks pretty much every day and for most of the day, if you have thoughts of hurting yourself and/or others, or if you're having trouble functioning, please see your doctor right away - you may be dealing with clinical depression. If you are feeling that you might hurt yourself or someone else, please call 911. Please also realize that seeking help really is a sign of strength and belief in yourself and not a sign of weakness.
As part of my training and my work with people in various situations in their lives, I learned a lot about coping skills - the fancy name for "learning to deal with it" - whatever "it" is. As you might imagine, this is a pretty important topic for therapists and their clients. And to be honest - I practice what I preach, and use these myself. There are a LOT of good self-help workbooks out there - I'll give a list at the end of this post - and these may help you structure your coping, if that's what you need. So - on to the meat of the post:
Let's start with things that end up being harmful. Basically it boils down to two things: Stuff that gets you in trouble, and stuff that ends up hurting you and/or someone else. Stuff that gets you in trouble includes excessive drinking, using mind-altering substances, excessive spending, sex, gambling, not fulfilling responsibilities like going to work, etc. Stuff that hurts you and/or someone else includes: excessive eating or undereating, exercising too much or not enough, losing your temper and abusing yourself or someone else, physically hurting yourself or someone else, beating yourself or someone else up emotionally, getting caught up in or laying on guilt trips, calling names, insulting yourself or others, and talking or thinking in absolutes (like, "I'll never be able to get out of this hole" or "You always ruin my day"). If you're feeling out of control with these things, please find help for them, if for no other reason than it helps yourself and your loved ones.
So what are the things that may help?
First of all - when you're feeling down or really anxious, realize that emotions are like waves - they build up, peak, and then pass. This idea is not new; Marsha Linehan's "dialectical behavior therapy" uses this concept. To cope with strong emotions that really feel like they're going to knock you down, it can sometimes help to remind yourself that the emotion will not last forever, and that it WILL pass. You are not your emotions - your feelings are reactions to things in your environment. Just as your situations change, so will your feelings. For me, I visualize an ocean wave as it builds, swells, and washes over me. You might like this, or maybe a gust of wind - whatever works. The point is, the feelings WILL pass.
Second, you can help the wave pass by distracting yourself. There are many things you can do - I work in my journal, create art, go for a walk, listen to calming music, surf the internet, etc. What you want to do is find something that will take your mind off the "down" feelings - it doesn't have to last forever, but distracting yourself will pay off, even if you only are able to distract for a few minutes. It's at least a few minutes that you weren't focusing on feeling "down" or anxious, right? There are an infinite number of ways to distract yourself - just use your imagination and see what you can come up with (and yes, this in itself is a distraction!) However, be careful with distractions - don't let them turn into "target behaviors" (the things that get you in trouble or harm you or someone else.)
One thing is important if you're feeling "down" or super-anxious - do something positive for yourself every day, such as exercise, get involved in doing something you enjoy - a hobby or pastime - , enjoy some quiet time to yourself, etc. Treating yourself as you want other people to treat you (a twist on the golden rule) or as you would treat other people is very important - you really are worth the effort and deserve to be treated well.
Third, try reframing your thoughts. This is admittedly sometimes a tough thing to do, especially when things feel hopeless or that a situation will never change or end. Sometimes working on changing your thoughts is a conscious effort; if you keep at it, hopefully the positive thinking will feel more natural. If you're having a tough time doing this, try writing down all the negative things you tell yourself and then contradicting them. Here's an example: With my work life, I admit to feeling like sometimes I'm spinning my wheels and not getting anywhere. I remind myself of what I've done (developed a private practice and found work with an amazing group of women at Beyond the Mirror), what I've achieved (my Ph.D., passed my licensing exam), and where I realistically am at (working on new content, expanding into new areas like life coaching, and applying my passions to my work) Reminding myself of the postives can help contradict the negative feelings.
Many therapists recommend keeping a "mood diary" or "thought record" where you can keep track of the thoughts you have, the feelings associated with them, how you changed your thinking, and what the result of the change was. Again, if this works for you - if you need and/or want to see your progress - by all means do it. It can be very simple - a piece of notebook paper divided into four or five columns (if you want to include the dates), and simply keeping track. It can be more complex, for example setting up an Excel spreadsheet. Keep in mind that first, the very act of doing this at all is a distraction (being busy tends to distract us from our feelings) and second of all, productive because you're working on helping yourself.
Mary Ellen Copeland, a therapist who deals with bipolar disorder, has developed some excellent tools for dealing with stress. She recommends creating a "wellness action plan" that includes 5 distinct parts:
1) Developing a wellness toolbox (similar to the coping skills described above) and keeping track of your moods and activities on a daily basis (the "Daily Maintenance List")
2) Listing the things that trigger feeling rotten and planning on ways to deal with those
3) Listing the "Early Warning Signs" of impending mood changes, and planning on ways to cut off mood changes BEFORE they get too bad
4) What to do when things are breaking down - how to deal with crisis situations: what the signs of this are, who to call/contact in case of an emergency, and how to deal with this when/if it happens
5) Developing a Crisis Plan: How to help other people know when you're in crisis, how other people can help you, and again who to contact
Copeland's web site: http://www.copelandcenter.com has some excellent information and resources related to this program. She also has several workbooks in publication and again, I'll list those here at the end.
There are also the things that we hear everyday from all kinds of experts: eat well and moderately, exercise regularly (this really DOES work to help moods, by the way), limit how much alcohol and other substances you put in your body, get enough rest and/or sleep, and see your physician if you're having problems in any of these areas to rule out physical/medical causes.
Specifically getting involved things that are designed to be relaxing may also help. Again, listening to calming or relaxation music may help. Other tools include meditation, relaxing tense muscles/progressive relaxation (for example, tense and then relax each muscle group in turn, starting at head and working down), using deep breathing from your tummy (diaphramatic breathing) - all of these things (and more) help ease stress and help you cope with feeling in the dumps.
The bottom line is that working to change your thoughts, helping yourself relax, and soothing yourself by doing things that make you feel better help you deal with feeling down. These aren't a be-all and end-all to always feeling down, or a sure-fire "cure" for the blues. They ARE things that may help, though, and are time-tested tools that have been shown to help.
If you have any questions or comments, please contact me here or via email: firstname.lastname@example.org . I'll be happy to talk to you and listen to your input.
Please Note: The information on this blog is intended for informational purposes only. This is not therapy, and if you wish to work in therapy, please contact your local mental health agency or your physician for a referral. If you are in crisis or danger, please call 911 for immediate help. If you wish to contact me, you can call (970) 776-6043 or send email to: email@example.com
The Relaxation and Stress Reduction Workbook, 5th ed. - Martha Davis, Elizabeth Robbins Eshelman, & Matthew McKay
The Depression Workbook, 2nd ed. - Mary Ellen Copeland
Mind Over Mood - Dennis Greenberger & Christine A. Padewsky