On Depression

This is a comment I made to a post on reddit.com/r/depression:

Background: I've been depressed since my teens, but I wasn't diagnosed and treated until my late 20's. I am now almost 46, but just before I turned 40, a good friend committed suicide and shortly after that I was hospitalized for eight days for threatening to cut my own throat at work - I did not hurt myself or have ever attempted suicide, however I know exactly how I would do it if I ever chose to do it, although it is an option I no longer accept.

Current status: I am comfortable and having frequently more good days than bad. The thought of wanting to die is less persistent for me, although it is still there but more as an annoying thought, like a song that's stuck in your head.

Methods: I'll share what has been most effective for me, in no particular order:

• Finding the right medication (I tried several, Lexapro has worked best for me).
• Finding a therapist that acts as coach and shares your general views in life. I am a skeptic and an atheist and I was unable to find a therapist that wasn't religious or believed in pseudo-science,- I've seen about a dozen different therapist and eventually I tire them out or I just plain quit.
• Learning to be my own "care-taker" - Buddhism based mindfulness teachings have helped me a great deal - not the supernatural crap, but the practical stuff like learning to let go of emotional and personal attachments, learning to judge people less, specially myself. Detaching myself from my anger. The best source to learn this for me has been podcast by Gil Fronsdal out of Red Wood City, CA, he's a Buddhist teacher who explains the teachings of the Buddha without supernatural junk.
• Eating well and doing some exercise; much like depression is a vicious circle where it feeds and grows on itself - healthy living is also a self-sustaining circle. I don't do this nearly enough, I am overweight but having had a particularly bad end of 2012, this last few months have been better because of this.
• Reaching out to people without sharing my pain - you'll eventually find someone with whom you safely can do so.
• Finding a creative outlet or an outlet for something you like to do. For me this was Improv. Using that outlet to "vent" those negative thoughts, sometimes writing them down and tossing the paper away or deleting the file is surprisingly effective.
• Constant self education about depression and how our brain works, read up on human perception and logical fallacies.
• Some of these realizations came from or were enforced by a book called The Four Agreements - there's a lot of useless shamanic crap in it, but the agreements themselves are quite powerful;

1. Be Impeccable with your Word: Speak with integrity. Say only what you mean. Avoid using the Word to speak against yourself or to gossip about others. Use the power of your Word in the direction of truth and love.
2. Don’t Take Anything Personally Nothing others do is because of you. What others say and do is a projection of their own reality, their own dream. When you are immune to the opinions and actions of others, you won’t be the victim of needless suffering.
3. Don’t Make Assumptions Find the courage to ask questions and to express what you really want. Communicate with others as clearly as you can to avoid misunderstandings, sadness and drama. With just this one agreement, you can completely transform your life.
4. Always Do Your Best Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do your best, and you will avoid self-judgment, self-abuse, and regret.

• I have added two of my own agreements:
  1. Live Bravely Learn to recognize and manage your fears and DON'T JUDGE yourself for having them.
  2. Be your own best friend Sometimes people with the right shoulder to lean on or the right ear for that moment will not be available. When you are bummed out or down most people will just not want to be around you, this is when you have to step up and be your own best friend - engage in something that generates happiness, specially when you just don't feel like it.
• Learn some mental gymnastics that you can accept as healthy: I don't ever expect to "be" happy - I treat happiness as a byproduct of doing stuff that is good for me like visiting with friends and family, seeing my nieces and nephew, going to a show or concert, going on a road trip - doing stuff that's the opposite of what makes me feel unhappy. I actively try to look for "beauty" (can't think of a better word) around me: in nature, in people and in whatever I can find.

Not any one of these "discoveries" will work for everyone, it is a cumulative process that has worked for me. We are on an extremely difficult road and it is nearly impossible to get off. I have resolved to "manage" it and that has been working for me. I hope my "methods" work for you and anyone who reads them - feel free to PM me if I you have any questions.

• Patience Be patient with yourself, this leads to calm which helps you recognize when you're mulling over negative thoughts. Be patient with others. As you can tell by the responses here, there is a lot of us in the same boat and it is unlikely that any two of us will deal with it the same way which I call that the 'spicy food theory'; I can eat spicier/hotter food than many of my friends and most of my family, e.g.; I can tolerate more of that kind of pain than those friends/family can. The same way some of us are able to tolerate what life throws at you.

An important clarification on JUDGING. Judging yourself and others gets better the less you do it. When you are learning to accept and use this notion it doesn't only apply to negative judging, i.e. you're dumb, that person is X, etc... Judging also applies to positive thoughts: i.e. I'm better looking than I thought, I am good - he/she is awesome. This is because positive judging can more readily turn to a negative if the thing we judged as good, stops being so even for a second - it is part of managing expectations which are in themselves a type of judging.