Depression can be extremely debilitating, especially when we feel at rock-bottom and, when we reach that point, daily life can be pretty bleak. Gone is the ability to get out of bed, attend to our personal hygiene, eat breakfast, take the children to school, go to work, or whatever it is that gives us a sense of purpose. Our existence tends to be a reactive one; we shut down and withdraw from activity that keeps us feeling good about life.
It's true to say that depression often has a remitting and relapsing course. It may have no obvious cause, or it can be related to physical problems or various life events. Most people with depression will get better without treatment, although getting better may take several months or even longer. Living with symptoms in the meantime can have a heavy impact on the whole of our lives: relationships can suffer, our working life may be put at risk, together with our ability to pay the rent or the mortgage. I paint a bleak picture, I know, but such is the trauma that depression creates.
If we find ourselves in this situation, it can be very difficult to admit that we have a problem; our ego may well send us into denial, after all, who wants to be seen as weak? Of course, the first step to getting better is to acknowledge that we are ill and that we do need support to get well again. This acknowledgement is actually a sign of strength; it takes great strength to be honest about our vulnerability.
It is also helpful to talk to the GP; medication may well be suggested, especially if the depression is moderate to severe. This can be supplemented with counselling and it is thought that a combination of medication and counselling can be more effective than either treatment on its own. Given time, it is hoped that we will be fully functioning again and able to go about our daily lives in a more balanced way.
But it seems to me that the optimal time to manage our response to depression is when we are well. Counselling can actually be more helpful at this stage, simply because we have the head-space to be able to reflect around those issues that depress us. We have the opportunity to equip ourselves with strategies for managing our response to depression more effectively, becoming more proactive in the process.
I have found that one of the simplest and most effective tools we can use to prevent ourselves from slipping into the abyss is a mood diary. Producing our own journal can be both therapeutic and creative. But, more than anything, it is a practical tool that can alert us to changes in our mood and give us the opportunity to address any issues, before they spiral out of control.
Daily writing is recommended, particularly as it helps us keep the momentum going and it creates a daily habit. It can be helpful to write at the end of the day, which gives us the opportunity to reflect on what has been good about the day, what has been less helpful, whether we could have done things differently and whether there are lessons to be learned from it. Scaling our mood from 1-10 can also help us to think about what action we may need to take to prevent us from slipping down the scale. This could be something as simple as spending time with others, going for a walk, or simply relaxing in the bath with a nice candle and our favourite music.
Having said all of that, depression has a habit of coming back to bite us when we least expect it. Staying well is no easy task; it requires discipline and determination. Writing can be part of that discipline and persisting with it can ensure that we don't take our eye off the ball, as far as monitoring our mood is concerned. So, good luck with your "pen and paper" and I wish you a healthy future!