Monday, April 7, 2014

Coping

“Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.” - St. Francis of Assisi

If you follow me on Twitter, you know that I talk about (and/or RT items of interest pertaining to) Depression weekly if not daily. That's because I struggle with it daily.

I was diagnosed a bit over ten years ago. For much of that time, I was medicated. It helped somewhat, but the side effects were too much to bear. In particular, I could not sleep through the night. My doc ordered a sleep study and found that I had approximately 80 arousals per hour, but I had no apnea.

Because of subsequent events, I learned that my antidepressants were causing the sleep disturbances. [Update (January 20, 2015): The New York Times profiled comedian Maria Bamford a few months ago. I found it interesting that she sleeps ten hours each night. It never occurred to me to schedule in extra hours of sleep so that I'd get enough, and none of my doctors recommended it. They only told me to take my meds at a different time of day (that didn't help), or turn my alarm clock around so I wouldn't realize I'd awakened during the night (WTF??), and take a pill to sleep (Ambien) and a pill to help me wake up (Nuvigil). However, with the number of arousals I experienced during my sleep study, I don't know that 10 hours would've been enough for me, personally. It is something I will try next time I need meds, though.] Now I don't take antidepressants, and I still struggle with Depression and Anxiety daily in one aspect or another.

Since I am intolerant of antidepressants, I have had to seek out other ways to help me feel better. Some people may consider these measure "woo-woo" since they're not pharmaceutical-based or therapy done with the guidance of a psychologist, but none of it is faith healing and crystals.

Here are some of the things I've done and how I think they help:

1. Greatly reduced sugar intake; helps prevent dips in energy that lead to low mood. My GP is on board with this and said that once I cut out sugar, my triglyceride, glucose, and A1C results improved.

2. Take vitamins and supplements daily.
  •    Vitamin D: my GP found that I had a deficiency probably caused by the medication I have to take for reflux. My GP said that Vitamin D can affect pain tolerance. I've read that emotional pain is real, physical pain, so it makes sense to try to increase my pain tolerance.
  •    Iron (every three days): my GP found that I was slightly anemic which can affect energy levels.
  •    Fish oil: I read that it can help heal the brain but, even if it doesn't, there are plenty of other possible potential health benefits.
  •    Prenatal multivitamin: My GP said to take one, and I do seem to have more energy when I take it than I do if I skip it. Please note, I am 40 and do not want children. My doctor knows this, but I did not ask why in particular I should use the prenatal vitamins, I just do it. 
  •    Potassium & magnesium supplements: I've read that magnesium chelate and potassium supplements are recommended for those who avoid grains.
  •  Melatonin: I guard my sleep jealously. I go to bed early so I'll have 9-10 hours in bed before I need to get up. I take melatonin an hour before I go to bed (ideally). Here's an article that suggests that there is a correlation between sleep quality and Depression. There are extended-release melatonin tablets as well as those that are absorbed more immediately. Personally, I cannot take the extended-release tablets because it stays in my system longer than I'm in bed. It gives me sort of a sleepy hangover, if you will, which is one reason I stopped taking Benadryl to help me sleep. It seems like not all brands of melatonin supplements work, either. The brand I've found that does seem to work is NatureMade. Note: Melatonin supplements did not work for me at all when I was on antidepressants. I don't know why, but I wouldn't doubt it's the same mechanism that caused sleep disturbances when I was on them, whatever that mechanism is. (Added 3/30/2017.)

3. Tetris. The article I read recommended it for traumatic experiences. But it seems like Depression makes me an exposed nerve, so every disappointment or rejection is potentially traumatic. Sometimes I have invasive thoughts about long-past events that still elicit a strong emotional response from me. For the past week or so, whenever I notice on of these popping into my head, I stop what I'm doing and play Tetris while I work through the feelings. I don't know how it works, but it seems to have helped a bit. I feel happier and my mind is clearer. Obviously I'm not miraculously cured of Depression and Anxiety, but I think it has helped.

4. SuperBetter.com. Check out Jane McGonigal's TED Talk on how games can add years to your life. SuperBetter gives me small, increasingly challenging daily goals that I can accomplish to help me build success and self esteem. It is helping me think of different aspects of my life that, because of the Depression and Anxiety, I may be actively avoiding or inadvertently neglecting. [Update (January 20, 2015): I haven't used SuperBetter in a long time, but I think it was one of the stepping stones to help me build confidence when I had none.]

5. I keep in daily contact with friends and family via texts, email, Facebook, and Twitter. My resources are quite limited right now, and none of my friends or family live within 30 miles of my home. I see my family about once per month. I limit my trips "to town" to once per week because gas is expensive. Keeping in touch online helps a lot.

6. I've fostered friendships on Twitter with people who have also experienced Depression and/or Anxiety. They are sort of my group therapy, and Twitter is available 24x7.

7. Offer encouragement to persevere to anyone who I perceive is struggling. Hearing encouragement pour through my own brain helps me convince myself that everyone has value and that life is worth living.

8. Comedy. Comedy podcasts, in particular. Most stand-up comedy in general. Many different kinds of podcasts in addition to the comedy ones. They are a welcome diversion, especially on my worst days. Sometimes they enable me to get a few chores done. I put in my earbuds, stick my phone in my pocket, and find out what The Nerdist or Marc Maron are up to. I have a list of some of my favorite podcasts here. If you want to know you're not alone, check out The Mental Illness Happy Hour. [Note: I added this item after I put out the link via Twitter. I can't believe I forgot to list it. Podcasts & comedy have been super important to my healing.]

9. Kindness. Be kind to others. Give them the benefit of the doubt. It becomes a habit and makes it easier to transition from negative to positive self-talk. Everyone is struggling with something. (Added 1/20/2015.)

I did not list it as something I do because it would be dishonest, but there is a lot of evidence to support exercising as a top way to work your way through Depression. I see being able to exercise as an ultimate goal. That is how deep in Depression I feel.  That's one reason why I use SuperBetter. I will get to the exercising regularly level someday.

I will never completely discount medication as an option. It did help me when I was first diagnosed. I think if I have a bad episode again, I will opt for medication. But until then I will rely heavily on my coping mechanisms and do what I can to make my brain physically healthy.

Wishing you peace.
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