Depression is probably the most common mental health issue and it seems like everyone’s got it these days to a varying degree. It’s obviously totally normal to feel sad every now and then but if you’re feeling hopeless and unmotivated everyday, chances are you might be struggling with depression. Depression occurs on a spectrum.
This spectrum is interesting, to say the least. It’s not linear and each one is uniquely debilitating. Everyone has heard of Major Depressive Disorder or Major Depression. This is THE depression diagnosis. To get this diagnosis, you’ve got to have 5/7 symptoms for 2 weeks. This is treated with a combo of therapy and anti-depressants. It’s easy to diagnose, but not easy to treat and definitely not easy to live with.
Also on the spectrum, there is dysthmia (aka persistent depressive disorder), bipolar depression, seasonal affective depression (SAD), pre-menstrual dysphoric disorder (PMDD), post-partum (PPD) and psychotic depression.
Yeah, it’s a whole thing.
I have persistent bipolar depression that gets extra aggravated during winter months. Three disorders come to unite to make one Master of Depression.
The DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) is the book that psychiatrists use to diagnose their patients. This is what the DSM-5 has to say about diagnosing depression:
The individual must be experiencing five or more symptoms during the same 2-week period and at least one of the symptoms should be either (1) depressed mood or (2) loss of interest or pleasure.
Depressed mood most of the day, nearly every day.
Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
Significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day.
A slowing down of thought and a reduction of physical movement (observable by others, not merely subjective feelings of restlessness or being slowed down).
Fatigue or loss of energy nearly every day.
Feelings of worthlessness or excessive or inappropriate guilt nearly every day.
Diminished ability to think or concentrate, or indecisiveness, nearly every day.
Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
To receive a diagnosis of depression, these symptoms must cause the individual clinically significant distress or impairment in social, occupational, or other important areas of functioning. The symptoms must also not be a result of substance abuse or another medical condition.
People with depression also sometimes experience irritability and physical pain. Because there are so many variables that go into diagnosing depression, you get many, many variations of depression. It manifests differenly in each person. Everything does, really.
Persistent Depression (Dysthmia)
Dysthmia, or persistent depressive disorder, occurs when someone has had depressive symptoms for two years or longer at a time without relief for at least 2 months at a time. It’s a chronic form of depression. I have been depressed for almost 19 years (onset age 8) and the only times I have had a genuine relief from depression, I was manic. So not really relief. And the longest consecutive time I’ve been manic was almost 2 months. *eyeroll emoji*
Persistent depression is a pretty low-grade form of depression, usually pretty mild. It is, however, still debilitating because it’s a more chronic form of depression and comes with all the same symptoms. Suicidal thoughts, lack of motivation, sleep issues. But, generally, it’s manageable. I’d be willing to bet that a lot of people struggle with undiagnosed dysthmia and have just accepted that that’s who they are and leave it at that. It’s understandably easy to do.
Bipolar depression is classified as a more severe type of depression. The reason for this is because major depression is unipolar mood disorder. One pole. Bipolar is two opposite poles: depression and mania. Mania is the exact opposite of depression. It makes you feel like an invicible god so, in comparison to that extreme high, the extreme low feels extra extra low.
My bipolar depression is both luckily and unluckily stabilized. I’m stabley depressed. My last manic epsidoe was years ago so I don’t really remember how it feels to be that “happy.” But my last severe depressive episode was pretty much all of 2018 and I don’t feel like that anymore. I’m very grateful.
Seasonal Affective Depression (SAD)
SAD is when depressive symptoms and episodes happen while the seasons change or at about the same time each year. Wintertime is the time of gloominess for most sufferers of seasonal depression. However, it’s important to note that some people’s SAD gets triggered by the warmer seasons.
I always notice that my mood starts to decline in the middle of October. Which really sucks because it’s the start of all the fun things. Canadian thanksgiving, Halloween. I try to stay positive through spooky szn because that is MY SHIT. I love halloween. But from then on, it just gets worse and worse until xmas and then stays stagnant. It generally starts to get better in the spring. I hate being cooped up all winter but I’m trying to use my happy daylight lamp and it honestly does make a difference.
There are some skills I’ve learned in one of my group therapy DBT sessions. And I use them quite a lot. Honestly, it’s been such a great tool in my recovery. I’m gonna share the 4 best skills I learned and use to manage my depression daily.
Distracting is a good skill to use when your emotions are getting high and you need to be professional at work or out being social or, you know, anywhere else where you’re experiencing distressing emotions. This is a Distress Tolerance skill.
It’s a very appealing skill and easy to fall on as a habit because it feels much better than feeling negative emotions. Distracting is only a temporary solution though. It’s important to never forget that. It will not offer a solution to your problem. I used to use distract “until I don’t care about it anymore” (ie time heals all wounds). Time doesn’t heal shit, let me tell you. Working on shit and putting effort into your healing is what actually heals. So you can distract until it’s repressed but it’s going to come up eventually and it’s going to suck.
Still, it’s a good tool to have when the time is right so I’ve left a DBT worksheet to help stir up new ways to distract, to keep it fresh.
I really don’t know how to describe mindfulness. It’s the purposeful paying attention to something without getting too overhwlemed. It’s a way of meditation and it truly does work if you practice regularly. I love the app Headspace and everyone should try it out. It’s my go-to for mindfulness. It’s the simplest introduction to mindfulness meditation and has 3 free basics courses (10 sessions each). I play them over and over again tbh. I used to practice mindfulness everyday until it started becoming habit. But then I fell back into bad habits and lost the skill. 2020 is gonna be the year of back to meditating for me.
This skill is an Emotional Regulation skill. It has two versions, long term and short term. For this, I’m only going to look at the short term because we’re looking for a more instant relief.
For this, the focus is to increase positive experiences now. Do at least one thing off this pleasant activities list. Try to do one a day. Add things that you enjoy. For me, my go to is playing Just Dance on my wii (or youtubing videos and dancing along). It’s important to stay mindful while you’re doing the activity and unmindful of the worries like how positive times never last (neither do the bad though).
I’m gonna be real with you, this is the hardest skill to master and, no, I’m not good at it. But that’s why I have to practice. The idea behind it is very simple though: accept things as they are; it is what it is. It’s another Distress Tolerance skill.
There really is no point in stressing over things you cannot control. Easier said than done, I know. That’s not some revelation that’ll make people stop stressing but it’s true. When you have no control over something, the best way to cope with it is to go with the flow; accept that that’s how things are, things aren’t going to plan and adapt.
Radical acceptance is NOT approval, compassion, love or forgiveness.
It is entirely possible to accept something (ex. a traumatic event occuring) without loving it or thinking that “it’s okay.” It’s simply acknowledging that the thing happened and there’s nothing anyone can do to change it.
The thing is, rejecting things doesn’t change them. You can wish and wish, for example, that your friend would stop smoking. You can stress about it and crawl up your friend’s ass about it but that won’t make them stop smoking. If you accept it, it still won’t fix the smnoking problem, sure, BUT you will be less stressed about it. And that’s the goal here.
Radical acceptance is my least favourite skill to practice because I am a recovering perfectionist, but I’ll be honest. It works. It doesn’t work the first couple of times you try it (at least for me) but the first time it did work and I actually noticed a difference… wow. I was mindblown, I don’t even know how else to put it. I’m not just talking out of my ass here. I was the biggest skeptic of all; I thought all this was bullshit. Give it a shot like I did though. You don’t lose anything from trying.
Remember also, also getting sunlight and fresh air is important to help your brain produce happy-feeling hormones.
So while depression is getting more talked about, there’s still lots of people out there silently suffering. These are my go-to skills I (try) to practice to combat my depression. Hopefully they work for you. If they don’t, remember we’re different people. What works for you might not work for me, might not work for your friend. I’m just putting ideas out there. If you have any other skills that you use, comment them below. It might help me or someone else reading this!