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5 Ways to Help Yourself Through Depression

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If you are going through depression, it's best to get help from a therapist . To get the most from your therapy, you can do things to help yourself too.

Here are 5 things you can do to feel better. They may seem simple, but they can help a lot.

• Exercise. Take a 15- to 30-minute brisk walk every day. Or you can dance, play a sport, stretch, or do yoga. People who are depressed may not feel much like being active. Try to get yourself to do it anyway. If you need a push, ask a friend to exercise with you. Getting any activity started helps boost your mood. Keep it going.
• Eat healthy foods and drink plenty of water.  Some people with depression don't feel much like eating. Some may overeat. But what you eat can affect your mood and energy. So with depression, you need to be sure to eat right. For most people, that means plenty of fruits, vegetables, and whole grains. Limit simple carbs and foods with added sugar, like “junk” food or desserts. Don't go for too long without eating. Even if you don't feel hungry, eat something light and healthy. And don’t forget to stay hydrated with lots of water. Avoid sugary and caffeinated drinks when possible. 
• Express yourself.  With depression, your creativity and sense of fun may seem blocked. But it can help to do things that get your creative juices flowing. Paint, draw, or doodle. Sew, cook, or bake. Write, dance, or compose music. Chat with a friend or play with a pet. Find something to laugh about. Watch a funny movie. Do things you can enjoy. Even a little. That helps turn depression around.
• Don't dwell on problems. It can feel good to talk through a problem with a caring friend. But depression can lead people to complain, blame, and rehash problems too much. It can keep you focused on what's wrong. It's OK to air your thoughts and feelings with people who care. But don't let problems be all you talk about. Talk about some good things too. Try to turn your negative thoughts into more positive ones. This can help your mood become more positive.
• Notice good things. Depression affects a person's view of things. Things can seem dismal, negative, and hopeless. To shift your view, make it a goal to notice 3 good things in every day. The more you notice what's good, the more good you will notice.

Most of all, if you're going through depression, show yourself some compassion and kindness. When you're going through a hard time, it helps to know you're not alone. Be patient with yourself. Depression takes time to heal.

Depression - treatment and management

Actions for this page.

• If you feel depressed, see your GP.
• Don’t delay. Seek support early to try to avoid symptoms becoming worse.
• Some symptoms of depression, such as fatigue, can be mistaken for a physical illness.
• Professional help is very important, but there are also things you can do every day to help your recovery.
• Education, lifestyle changes, social support and psychological therapy are important treatments for depression.
• People may also require antidepressant medication.
• Medications may take up to six weeks to be effective, so be patient.
• Take the time to find the treatment that’s right for you.

On this page

Depression is common, types of depression, treatment for depression, antidepressant medications, depression – coping and recovering, sleeping patterns and depression, negative thoughts and depression, where to get help.

People with depression can find it difficult to take the first step in seeking support. They may need to get help with the support of family members, friends or a health professional.

There is no one proven way that people recover from depression. The good news is that there is a range of treatments, health professionals and services available to help with depression. There are also many things that people with depression can do to help themselves.

In any one year, around one million people in Australia experience depression. One in six women and one in eight men experience depression at some time in their life. The good news is that just like a physical illness, depression is treatable and effective treatments are available.

The sooner a person with depression seeks support, the sooner they can recover.

There are different types of depression. The symptoms for each can range from relatively minor (but still disabling) through to very severe. The main types of depression are:

• major depression
• dysthymic disorder
• bipolar disorder (which used to be called manic depression)
• cyclothymic disorder
• seasonal affective disorder (SAD).

Depression is unlikely to simply go away on its own. In fact, if ignored and left untreated, depression can go on for months, sometimes years, and can have many negative effects on a person’s life.

Every person needs to find the treatment that’s right for them. It can take time and patience to find a treatment that works.

Different types of depression require different treatment. Mild symptoms may be relieved by:

• learning about the condition
• lifestyle changes (such as regular physical exercise)
• psychological therapy provided by a mental health professional or via online e-therapies.

For moderate to more severe depression, medical treatments are likely to be required, in combination with these other treatments.

Treatment for depression should start with seeing your doctor. Book an extended consultation to give you time to discuss your symptoms and treatment options. Your doctor may ask you to fill out a screening questionnaire or conduct some tests to rule out other conditions.

Your doctor may refer you to a psychologist, social worker, counsellor or psychiatrist. You can access a rebate to see most of these professionals through Medicare. This requires that your doctor writes you a GP Mental Health Plan – ask them for more details.

Other treatment options include:

• your local community health centre – speak to someone at your local council for contact details
• your local mental health service triage service External Link – they can give you advice about your closest major hospital with a psychiatric department with staff available for mental health assessments.

In an emergency contact 000 or go to your nearest hospital emergency department to obtain a mental health assessment.

Psychological treatments for depression

Psychological treatments (also known as talking therapies) have been found to be an effective way to treat depression. They can help you change your thinking patterns and improve your coping skills so you're better equipped to deal with life's stresses and conflicts.

As well as supporting your recovery, psychological therapies can help you stay well by identifying and changing unhelpful thoughts and behaviour.

There are several different types of psychological treatments including:

• cognitive behaviour therapy (CBT)
• interpersonal therapy (IPT)
• behaviour therapy
• mindfulness-based cognitive therapy (MBCT).

CBT is one of the most commonly used psychological therapies. It helps people with depression to monitor and change negative patterns of thinking and improve their coping skills so they are better equipped to deal with life’s stresses and conflicts.

The main medical treatment for depression External Link is antidepressant medication. Antidepressant medication may be prescribed, along with psychological treatments, when a person experiences a moderate to severe episode of depression. Sometimes, antidepressants are prescribed when other treatments have not been successful or when psychological treatments are not possible due to the severity of the condition or a lack of access to the treatment.

People with more severe forms of depression (bipolar disorder and psychosis) generally need to be treated with medication. This may include one or a combination of mood stabilisers, antipsychotic drugs and antidepressants.

There are many types of antidepressants. Making a decision about which antidepressant is best for a person can be complex. The decision is made in consultation with a doctor, after careful assessment and consideration. Antidepressants take at least two weeks before they start to help, and it may also take some time for the doctor to find the most suitable medication and dosage.

Antidepressants can make people feel better, but they won’t change their personality or make them feel happy all the time. As with any other medication, some people will experience some side-effects.

Common side-effects, depending on which medication is taken, include:

• weight gain
• sexual difficulties (for example, difficulty becoming or staying aroused).

Some of these symptoms can be short-lived, but people who experience any of these symptoms should tell their doctor, as there are ways of minimising them. The likelihood of a particular side-effect happening varies between people and medication.

The length of time a person needs to take antidepressants for depends on the severity of the condition and how they respond to treatment. Antidepressants are safe, effective and not addictive. Stopping medication should only be done gradually, on a doctor’s recommendation and under supervision.

Every person needs to find the treatment that’s right for them. Just because a treatment has been shown to work scientifically doesn’t mean it will work equally well for every person. Some people will have complications, experience side-effects or find that the treatment does not fit in with their lifestyle. It can take time and patience to find a treatment that works.

After seeking appropriate advice, the best approach is to try a treatment you’re comfortable with and one that works for most people. If you do not recover quickly enough, or experience problems with the treatment, discuss this with your health professional and consider trying another option.

While psychological and medical treatment can help with a person’s recovery, there are many other ways people can help themselves to get better and stay well.

Staying active

When you are depressed, you may not enjoy activities that you once loved. You may also think you won’t enjoy something but, when you do it, you actually enjoy it more than you expected.

If you don’t try activities, you reduce the number of things that may help you cope with your depression. To increase the amount of activities you enjoy, you can:

• list activities you used to enjoy – include as many as possible
• plan one of these activities each day
• increase the amount of time available for activities you enjoy
• after an activity, think about or write down what you enjoyed about it
• talk to others about what activities they like.

If you keep going, it will help you get better. You will enjoy activities more as you recover.

Depression can disrupt sleep patterns. It’s essential to try to restore a regular sleep pattern to make a full recovery. Some tips for restoring a regular sleep pattern include:

• Try to go to sleep and get up at about the same time each day.
• If you’re worrying about things during the night, set aside some time for problem solving during the day.
• Avoid drinking caffeine after 4 pm and try not to drink more than two cups of caffeine-type drinks (such as coffee, strong tea, cola or energy drinks) each day.
• Avoid using alcohol to help you sleep. As the alcohol is broken down in your body, it causes you to sleep less deeply and to wake more frequently.
• Allow yourself time to wind down before going to bed. If you are working or studying, stop at least 30 minutes before bedtime and do something relaxing.
• Give your mind a break from online activity such as social media for an hour before bedtime, and consider putting your phone in a separate room from your bedroom at night time.

Worrying or thinking negatively is common in people with depression. This affects your ability to focus on getting better and makes you more vulnerable to unhealthy emotions.

Tips to help you control worry and reduce negative thinking include:

• Write down what you are worried about. Go through each concern and think about how realistic your negative thoughts are. Explore alternative thoughts and explanations.
• Try not to focus on the things you cannot change.
• Focus on the present. Accept your thoughts without actively engaging with them.
• Write down your problems and brainstorm solutions. Jot down the pros and cons with each option and choose the one that seems the best. Review whether it worked to overcome the problem.
• Avoid making major decisions about your life at this time.

Dealing with irritability

Some people with depression may experience irritability. These feelings can become worse because of changes in sleeping patterns and lifestyle.

Help yourself to deal with this by:

• telling your friends, family and colleagues what you are going through and that you may appear to be irritable
• if you feel yourself getting angry, stopping and taking some time out to settle yourself down
• practising regular relaxation to reduce the effects of irritating or frustrating situations
• talking to people who are supportive.

Many people with depression can also simultaneously experience anxiety conditions. In most cases the treatment for anxiety is similar to the treatment for depression, but it is important to tell your doctor or mental health professional about any anxiety symptoms so they tailor the treatment to both conditions.

• Your GP (doctor)
• Your local community health centre
• beyondblue Support Service External Link Tel. 1300 22 4636
• Lifeline External Link Tel. 13 11 14
• Kids Helpline External Link Tel. 1800 55 1800
• SuicideLine External Link Tel. 1300 651 251
• SANE Australia External Link Helpline Tel. 1800 187 263
• Australian Psychological Society External Link – Find a psychologist service External Link Tel. 1800 333 497 (outside Melbourne) or (03) 8662 3300 (in Melbourne)
• Mind Australia External Link Tel. 1300 286 463
• Depression External Link , Black Dog Institute, Australia.
• Depression: signs and symptoms External Link , beyondblue.
• Kegel M, Dam H, Ali F, et al. 2009, ' The prevalence of seasonal affective disorder (SAD) in Greenland is related to latitude External Link ', Nordic Journal of Psychiatry, vol. 63, no. 4, pp. 331–335.
• Depression External Link , The Australian Psychological Society.
• Types of depression External Link , beyondblue, Australia.
• Depression: what you need to know External Link , 2011, National Institute of Mental Health, National Institutes of Health (NIH), Department of Health and Human Services, USA.
• National survey of mental health and wellbeing: summary of results External Link , 2007, 2008, Australian Bureau of Statistics, cat. no. 4326.0, Canberra.

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More information, related information.

Know that you are not alone, push through the anxiety of sharing to get help. Know it will shift and change, and that these feelings are not forever.

Improve your understanding of anxiety and depression, then take action.

Bipolar disorder is a type of psychosis, which means the person?s perception of reality is altered. It is characterised by extreme mood swings

Cognitive behaviour therapy (CBT) can help you change unhelpful or unhealthy habits of thinking, feeling and behaving.

David shares his experience with mental health and how being honest about what he was going through empowered him to find the help he needed.

Support groups

• External Link beyondblue online forums

From other websites

• External Link beyondblue.
• External Link beyondblue web chat - available between 3pm and midnight AEST
• External Link Black Dog Institute
• External Link Headspace – National Youth Mental Health Foundation
• External Link Life: Living is for everyone.

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Content on this website is provided for information purposes only. Information about a therapy, service, product or treatment does not in any way endorse or support such therapy, service, product or treatment and is not intended to replace advice from your doctor or other registered health professional. The information and materials contained on this website are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product or treatment described on the website. All users are urged to always seek advice from a registered health care professional for diagnosis and answers to their medical questions and to ascertain whether the particular therapy, service, product or treatment described on the website is suitable in their circumstances. The State of Victoria and the Department of Health shall not bear any liability for reliance by any user on the materials contained on this website.

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By Tricia Moceo

Being sad is a normal human emotion. It’s natural to feel despondent when someone you love dies or you’re dealing with life-altering events such as an illness or divorce. While these challenges are never forgotten the subsequent emotional distress usually dissipates over a normal period of time. However, if your sadness is constant, intense, and never seems to go away then you may be suffering from depression. In this article we will explore some treatment options and solutions for depression that can help you recover both safely and effectively.

A recent study revealed that depression was prevelant in 1 in 10 Americans . Overwhelming feelings of sorrow and a loss of interest in activities that were once enjoyable are common symptoms of depression. If you are suffering from depression, you may begin abusing substances in hopes of relieving the disparaging feelings. However, self-medicating with drugs and alcohol will exacerbate the symptoms of depression which may ultimately lead to persistent feelings that life isn’t worth living. Fortunately, there is a way out. Depression can be mitigated with a proper diagnosis and treatment.

Here are the 5 most common solutions for depression:

Living with depression can feel like living under a dark, desolate, isolating cloud of doom. However, even the most severe depression is treatable. If your depression is interfering with your quality of life it is extremely important that you seek professional help. It is important to remember that just as depression affects each individual differently, there is no one-size-fits-all approach to treatment. Becoming well informed about the various treatment options and solutions for depression will help you overcome this mental health condition, feel better, and reclaim your life. 

Medication Management

The most common treatment for depression is the use of antidepressants. There are various prescription medications utilized in in the treatment of depression. These drugs work by balancing chemicals in your brain called neurotransmitters that affect mood and emotions. A few of the most common medications used for treating depression  are: 

• Selective Serotonin Reuptake Inhibitors (SSRI’s)
• Serotonin-norepinephrine Reuptake Inhibitors (SNRI’s)
• Atypical antidepressants
• Serotonin modulators

There are several categories of antidepressants. The best way to find out which one could work for you is consulting your psychiatrist or physician and obtaining a prescription. Antidepressants take an average of 2 to 4 weeks before you will notice a change in your mood. Most people with depression find that medication is an effective treatment method.

Therapy can be a very effective treatment for depression . Most therapists require you meet with them in person on a regular basis or over the Internet via telecommunication. Weekly sessions can help you deal with stressful situations, address your negative beliefs, cope with challenges, and increase your self-esteem—all of which help in treating depression. There are other types of therapy that have also proven helpful, such as Cognitive Behavioral Therapy, Eye Movement Desensitization and Reprocessing, and Group Therapy, the latter of which provides a safe environment to share your feelings with people who can relate to what you’re going through and it helps to not feel so alone.

Another available therapeutic option is online depression treatment. This has gained popularity in the past few years. Especially since the onset of COVID-19 and constantly evolving technologies. Depression treatment is accessible online from the comfort of one’s home. 

You may ask: “ Why would someone seek online treatment instead of in-person treatment? ” The reality is that many individuals do not have access to depression treatment in the vicinity and, instead of using distance as a barrier to seeking help, choose to participate in online treatment. Additionally, for someone suffering with depression, leaving the home can be intolerable. Online treatment eliminates the need for an individual to leave the home and still allows for therapeutic interaction. 

Lifestyle Changes

In addition to medication and therapy, changing some of your negative behaviors and habits can help with treating depression.

Some of these changes would be:

• Get a Routine: When you’re depressed your days become similar in their lack of enjoyment and hard to distinguish from one another. Setting a daily schedule can help you get active and become involved with your life. Your routine could include: getting up at the same time every day, scheduling an activity for each night of the week, getting up to shower, and making one phone call a day to a supportive friend or relative.
• Set Goals: A major symptom of depression is the sense you can’t accomplish anything and because of that you feel bad about yourself. Setting small daily goals such as making the bed, taking a shower, or going for a walk can help. By completing small contrary acts you’ll feel better about your abilities and in turn feel better about yourself.
• Eat Healthy: When you’re depressed the last thing you probably want to do is eat healthy. Regrettably eating overly processed foods like fast foods and sugary sweets may be adding to your depression. Processed foods contain refined carbohydrates that have no nutritional value, and unhealthy levels of sugar and salt. Clinical studies have found that a diet high in refined foods impairs brain function and encourages depression. Eating healthy foods has been shown to reverse these issues. What you eat directly affects your brain and your mood.

More wellness solutions

• Avoid Drugs and Alcohol : People who suffer from depression desperately want to alter the way they feel. Many turn to drugs and alcohol as a solution. Unfortunately alcohol, tranquilizers, and opiates act as depressant to your nervous system and make your symptoms worse. Amphetamines can give the illusion they reduce depression, however the come down, the physical toll on your body, and the withdrawal, result in an even worse depression. Adding drugs to your already depressed system never helps. 
• Exercise: Regular exercise boosts the naturally produced endorphins that your body uses to help you feel better and less depressed. Endorphins interact with your brain’s receptors and trigger positive feelings. Exercising, especially outdoors and in sunlight, invigorates your body. You don’t need to compete in a triathlon; something as simple as walking for an hour every other day can help get your endorphins flowing.
• Sleep: It’s recommended you get 6 to 8 hours of sleep a night. But depression can make it hard to sleep, and with too little sleep your depression can get worse. This is where setting a routine can help. Try going to bed and getting up at the same time every day. Do not take naps as they can alter your sleep schedule. Sometimes, getting rid of the distractions you engage in at night before sleep—watching TV, looking at your cell phone, or shopping on your computer—helps to calm your mind and it’s easier to get a good night’s sleep.

Stress and anxiety are major triggers for depression, and meditation has been proven to alter your reaction to those feelings. When you’re stressed the body produces a hormone called cortisol, and meditation lowers cortisol. During meditation your brain is also producing theta waves that usually only occur when you’re asleep, and alpha waves like when you’re daydreaming. When your body gets as relaxed as when it’s sleeping or daydreaming it starts producing dopamine; a neurotransmitter that’s released into your body during pleasurable situations. If you add all those together meditation is probably the best natural treatment for reducing depression. 

Challenging Negative Thoughts

A lot of the work in treating depression is changing how you think. When you’re depressed, you embrace worst-case scenarios and obsessively dwell on the negative. Challenging these negative thoughts is a common treatment for depression. You feel no one loves you, but what real evidence do you have? You think you’re a worthless horrible person, but is that really the truth? Try challenging these beliefs and ideas. 

When the thoughts come say, “No, we’re not doing this today.” When you’re telling yourself what a terrible person you are, think about how you would respond if a friend talked about themselves that way. You would probably tell them to stop being so negative. Apply the same logic to your own thoughts. It takes practice, but if you address the negative thoughts head on, don’t embrace them, or indulge, they’ll eventually become less persuasive.

The majority of people suffering from depression will not see a doctor or a therapist or ask anyone for help. Left untreated, depression can be detrimental to your mental and physical health. The over all consequences are not worth the risk. If you are depressed, feel that you may be depressed, or just can’t seem to find joy in anything—its probably time you talked with a professional. 

Get The Assistance You Deserve in California Today

Our compassionate team at CAST Centers understands that depression affects each individual differently, which is why we offer comprehensive treatment options for all of our clients. If depression is interfering with the quality of your life, contact us today to learn more about our depression treatment options!

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483000/

https://www.health.harvard.edu/blog/nutritional-psychiatry-your-brain-on-food-201511168626#:~:text=Multiple%20studies%20have%20found%20a,mood%20disorders%2C%20such%20as%20depression.

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How to cope with depression

Try these coping strategies if you're feeling depressed.

Stay in touch

Don't withdraw from life. Socialising can improve your mood. Keeping in touch with friends and family means you have someone to talk to when you feel low.  

Be more active

Take up some form of exercise. There's evidence that exercise can help lift your mood. If you haven't exercised for a while, start gently by walking for 20 minutes every day. 

Read about  exercise for depression .

Face your fears

Don't avoid the things you find difficult. When people feel low or anxious, they sometimes avoid talking to other people. Some people can lose their confidence in going out, driving or travelling.

If this starts to happen, facing up to these situations will help them become easier.

Don't drink too much alcohol

For some people, alcohol can become a problem. You may drink more than usual as a way of coping with or hiding your emotions, or just to fill time. But alcohol won't help you solve your problems and could also make you feel more depressed.

Read some  tips on cutting down on alcohol .

Try to eat a healthy diet

Some people don't feel like eating when they're depressed and are at risk of becoming underweight. Others find comfort in food and can put on excess weight.

Antidepressants can also affect your appetite.

If you're concerned about weight loss, weight gain or how antidepressants are affecting your appetite, talk to your GP.

See tips on how to eat more healthily .

Have a routine

When people feel down, they can get into poor sleep patterns, staying up late and sleeping during the day. Try to get up at your normal time and stick to your routine as much as possible.

Not having a routine can affect your eating. Try to carry on cooking and eating regular meals.

Seeking help for depression

Get help if you're still feeling down or depressed after a couple of weeks.

Treatments for depression include talking therapies and antidepressants .

You can refer yourself for talking therapies like cognitive behavioural therapy (CBT) or counselling on the NHS. You don't need a referral from your GP.

If you’re under 18, or want to get help for someone under 18, find out how to get mental health support for children and young people .

You can talk it through with your GP first if you prefer. Your GP can also tell you about antidepressants .

If you start to feel that your life isn't worth living or about harming yourself , get help straight away.

• contact Samaritans on 116 123 for 24-hour confidential, non-judgemental emotional support
• call your GP and ask for an emergency appointment
• call 111 out of hours – they will help you find the support and help you need

Audio: Self-help for low mood and depression

In this audio guide, a doctor explains what you can do to help yourself cope with low mood and depression.

Page last reviewed: 6 September 2022 Next review due: 6 September 2025

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7 Ways to Overcome Depression Without Medication

By Bryan Bushman, PhD

May 15, 2017

Updated Nov 17, 2023

Many psychological interventions can help promote improved mental well-being with or without antidepressants.

If you prefer to listen to this article, click on the SoundCloud player below.

To overcome depression, it helps to know the facts. Depression is a medical condition and not “laziness” or a temporary response to normal grief and/or discouragement.

Symptoms of Depression

A major depressive episode is defined as experiencing five or more of the following symptoms every day (or most days) for two weeks or more:

• Depressed or irritable mood
• Sleep problems (i.e., sleeping too much or too little; sleeping mainly during the day)
• Change in interests (i.e., not being interested in what you used to enjoy) or low motivation
• Excessive guilt or unrealistically low self-image
• Significantly low energy and/or change in self-care (i.e., not showering anymore)
• Significantly worse concentration (i.e., sharp decline in grades or performance)
• Changes in appetite (i.e., eating too much or too little)
• Agitation or severe anxiety/panic attacks
• Suicidal thoughts, plans or behaviors — including self-harm (i.e., intentionally cutting or burning yourself)

It’s important to remember that not everyone who is depressed is suicidal. You can still seek help even if you haven’t demonstrated any specific suicidal or self-harm behaviors, or even if your symptoms aren’t as severe or persistent as the symptoms noted above.   

OK, I’m feeling depressed… so now what?

Now that you know the symptoms of depression, some positive coping skills can be useful. All of the following techniques are supported by scientific research and medication prescribers — like psychiatrists — and these skills are frequently recommended as important parts of treatment even for patients who continue to take antidepressant medications.

WARNING: Do not suddenly go off your prescribed antidepressant medications without first talking to your medical provider. Discuss any questions or concerns about the side effects of your medications with your provider.   

Practice These Coping Skills Every Day

I recommend doing many — if not all — of the following coping skills and techniques once a day when experiencing depression. It’s important to know you probably won’t be motivated to do any of them at first because depression frequently saps motivation. In other words, know that it’s normal to feel unmotivated until you’re halfway done.

The patients I work with who frequently practice these coping skills get better. The seven techniques can be memorized with the acronym MY PEERS.

1. Meaning: Find small ways to be of service to others . 

Find personal meaning by serving something larger than yourself. Remember service doesn’t have to be big to count. Consider this, “ Success, like happiness, cannot be pursued; it must ensue… as the unintended side effect of one’s personal dedication to a course greater than oneself.” – Viktor E. Frankl,  Man’s Search for Meaning

2. Your goals: Find workable goals that give you a sense of accomplishment.

Most people feel guilty when talking about goals because they set unreasonable or unworkable goals. A goal is workable if it’s:

• Something you can control (i.e., it doesn’t depend on others)
• Manageable (i.e., not overwhelming)
• Realistic for you (not for someone else)
• Measurable (i.e., you know whether or not it is done or getting done)

If something goes wrong with your goal, adopt a “what can I learn from this?” attitude (versus a judgmental, “this is why I’m horrible” attitude). Also, be careful when comparing your progress with others. We usually compare our biggest weakness with another person’s biggest strength. This is unfair (and usually not accurate anyhow).

3. Pleasant Events: Schedule pleasant activities or events.

Don’t wait for yourself to be “in the mood.” For example, give yourself permission for a 30-minute “vacation” or schedule a healthy hobby every day. Just remember to do these activities with the right attitude (see Engagement).  Also, practice gratitude — take time to notice what went well today, not just what went wrong.  Consider keeping a gratitude journal.  Know that being grateful for your blessings doesn’t mean you have to discount your problems.

4. E ngagement: Stay in the present.

This practice is sometimes called mindfulness. As best you can, during activities try not to be in your head with self-judgment. You may not be able to turn off the self-judgment, but you can notice it and bring yourself gently back to the present.  Research shows that people with higher self-compassion also have higher self-worth or self-confidence. 

For those who have difficulty with self-compassion or healthy engagement, you can find self-compassion exercises on Kristin D. Neff’s website here . Mindfulness Based Stress reduction courses are also available throughout Utah. 

5. E xercise: And, eat right too.

Doing moderate exercise about five times a week (30 minutes a pop) can dramatically help your mood.  Moderate exercise is a level of activity where it is difficult to sing from your diaphragm while doing it.  Also pay attention to how the type of food or drink you’re eating influences your mood.  You don’t have to do fad diets, but anyone will be depressed if they frequently binge on carbs, junk food, and energy drinks. Remember the virtue of moderation.

6. Relationships: Focus on people who lift you up.

Interact frequently with others that bring you up (not people that bring you down). While it’s OK to have some alone time, find a balance and don’t isolate yourself or the depression will linger. 

7. S leep Regularly: Try to keep a regular sleep schedule.

Keep a balance with not too little and not too much sleep. Staying up late one night and then sleeping in excessively the next day is a sure-fire way to feed depression.  Also, don’t try to solve problems late at night when your brain is half-asleep.

As you practice these coping skills, know that you’re on the path to overcoming depression

In contrast, depression tends to linger when patients make up a reason why they can’t do these things.  No matter what medication you’re taking, doing several of these activities every day — especially when you don’t feel like it — is vital to the treatment of depression.  These positive coping skills may take time and practice, but if we don’t take the time to be well now, the periods of “unwellness” may be forced upon us later.

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• Depression (major depressive disorder)

Your doctor may determine a diagnosis of depression based on:

• Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.
• Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.
• Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.
• DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:

• Anxious distress — depression with unusual restlessness or worry about possible events or loss of control
• Mixed features — simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy
• Melancholic features — severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness
• Atypical features — depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs
• Psychotic features — depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes
• Catatonia — depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture
• Peripartum onset — depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)
• Seasonal pattern — depression related to changes in seasons and reduced exposure to sunlight

Other disorders that cause depression symptoms

Several other disorders, such as those below, include depression as a symptom. It's important to get an accurate diagnosis, so you can get appropriate treatment.

• Bipolar I and II disorders. These mood disorders include mood swings that range from highs (mania) to lows (depression). It's sometimes difficult to distinguish between bipolar disorder and depression.
• Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.
• Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.
• Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest.
• Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period.
• Other depression disorders. This includes depression that's caused by the use of recreational drugs, some prescribed medications or another medical condition.
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• Complete blood count (CBC)

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.

Here's a closer look at depression treatment options.

Medications

Many types of antidepressants are available, including those below. Be sure to discuss possible major side effects with your doctor or pharmacist.

• Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).
• Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).
• Atypical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. They include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).
• Tricyclic antidepressants. These drugs — such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) — can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.
• Monoamine oxidase inhibitors (MAOIs). MAOIs — such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) — may be prescribed, typically when other drugs haven't worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods — such as certain cheeses, pickles and wines — and some medications and herbal supplements. Selegiline (Emsam), a newer MAOI that sticks on the skin as a patch, may cause fewer side effects than other MAOIs do. These medications can't be combined with SSRIs.
• Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

Finding the right medication

If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.

Risks of abruptly stopping medication

Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur.

Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression. Work with your doctor to gradually and safely decrease your dose.

Antidepressants and pregnancy

If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you're planning to become pregnant.

Antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers and young adults under age 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when starting a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

• Psychotherapy

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.

Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies. Psychotherapy can help you:

• Adjust to a crisis or other current difficulty
• Identify negative beliefs and behaviors and replace them with healthy, positive ones
• Explore relationships and experiences, and develop positive interactions with others
• Find better ways to cope and solve problems
• Identify issues that contribute to your depression and change behaviors that make it worse
• Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger
• Learn to set realistic goals for your life
• Develop the ability to tolerate and accept distress using healthier behaviors

Alternate formats for therapy

Formats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective option for some people. Therapy can be provided, for example, as a computer program, by online sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or totally independent.

Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. Also, ask your therapist if he or she can recommend a trusted source or program. Some may not be covered by your insurance and not all developers and online therapists have the proper credentials or training.

Smartphones and tablets that offer mobile health apps, such as support and general education about depression, are not a substitute for seeing your doctor or therapist.

Hospital and residential treatment

In some people, depression is so severe that a hospital stay is needed. This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

Partial hospitalization or day treatment programs also may help some people. These programs provide the outpatient support and counseling needed to get symptoms under control.

Other treatment options

For some people, other procedures, sometimes called brain stimulation therapies, may be suggested:

• Electroconvulsive therapy (ECT). In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.
• Transcranial magnetic stimulation (TMS). TMS may be an option for those who haven't responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.
• Antidepressants: Selecting one that's right for you
• Antidepressants: Side effects
• Atypical antidepressants
• Monoamine oxidase inhibitors (MAOIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Treatment-resistant depression
• Tricyclic antidepressants and tetracyclic antidepressants
• Antidepressant withdrawal: Is there such a thing?
• Antidepressants and alcohol: What's the concern?
• Antidepressants and weight gain: What causes it?
• Antidepressants: Can they stop working?
• MAOIs and diet: Is it necessary to restrict tyramine?
• Electroconvulsive therapy (ECT)
• Transcranial magnetic stimulation
• Vagus nerve stimulation

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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Depression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help:

• Stick to your treatment plan. Don't skip psychotherapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. Recognize that it will take time to feel better.
• Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and support you.
• Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask relatives or friends to help watch for warning signs.
• Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance use.
• Take care of yourself. Eat healthy, be physically active and get plenty of sleep. Consider walking, jogging, swimming, gardening or another activity that you enjoy. Sleeping well is important for both your physical and mental well-being. If you're having trouble sleeping, talk to your doctor about what you can do.
• Depression, anxiety and exercise

Alternative medicine

Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine — sometimes called integrative medicine.

Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for medical care.

Supplements

Examples of supplements that are sometimes used for depression include:

• St. John's wort. Although this herbal supplement isn't approved by the Food and Drug Administration (FDA) to treat depression in the U.S., it may be helpful for mild or moderate depression. But if you choose to use it, be careful — St. John's wort can interfere with a number of medications, such as heart drugs, blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medications and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John's wort while taking antidepressants because the combination can cause serious side effects.
• SAMe. Pronounced "sam-E," this dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe isn't approved by the FDA to treat depression in the U.S. It may be helpful, but more research is needed. SAMe may trigger mania in people with bipolar disorder.
• Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. While considered generally safe, in high doses, omega-3 supplements may interact with other medications. More research is needed to determine if eating foods with omega-3 fatty acids can help relieve depression.

Nutritional and dietary products aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your doctor or pharmacist before taking any supplements.

Mind-body connections

Integrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

• Acupuncture
• Relaxation techniques such as yoga or tai chi
• Guided imagery
• Massage therapy
• Music or art therapy
• Spirituality
• Aerobic exercise

Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy.

• Natural remedies for depression: Are they effective?

Coping and support

Talk with your doctor or therapist about improving your coping skills, and try these tips:

• Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.
• Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.
• Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.
• Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.
• Don't become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.
• Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.
• Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.
• Don't make important decisions when you're down. Avoid decision-making when you're feeling depressed, since you may not be thinking clearly.

Preparing for your appointment

You may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

• Any symptoms you've had, including any that may seem unrelated to the reason for your appointment
• Key personal information, including any major stresses or recent life changes
• All medications, vitamins or other supplements that you're taking, including dosages
• Questions to ask your doctor or mental health professional

Take a family member or friend along, if possible, to help you remember all of the information provided during the appointment.

Some basic questions to ask your doctor include:

• Is depression the most likely cause of my symptoms?
• What are other possible causes for my symptoms?
• What kinds of tests will I need?
• What treatment is likely to work best for me?
• What are the alternatives to the primary approach that you're suggesting?
• I have these other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a psychiatrist or other mental health professional?
• What are the main side effects of the medications you're recommending?
• Is there a generic alternative to the medicine you're prescribing?
• Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

• When did you or your loved ones first notice your symptoms of depression?
• How long have you felt depressed? Do you generally always feel down, or does your mood fluctuate?
• Does your mood ever swing from feeling down to feeling intensely happy (euphoric) and full of energy?
• Do you ever have suicidal thoughts when you're feeling down?
• Do your symptoms interfere with your daily life or relationships?
• Do you have any blood relatives with depression or another mood disorder?
• What other mental or physical health conditions do you have?
• Do you drink alcohol or use recreational drugs?
• How much do you sleep at night? Does it change over time?
• What, if anything, seems to improve your symptoms?
• What, if anything, appears to worsen your symptoms?
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• Simon G, et al. Unipolar depression in adults: Choosing initial treatment. http://www.uptodate.com/home. Accessed Jan. 23, 2017.
• Stewart D, et al. Risks of antidepressants during pregnancy: Selective serotonin reuptake inhibitors (SSRIs). http://www.uptodate.com/home. Accessed Jan. 23, 2017.
• Kimmel MC, et al. Safety of infant exposure to antidepressants and benzodiazepines through breastfeeding. http://www.uptodate.com/home. Accessed Jan. 23, 2017.
• Bipolar and related disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed Jan. 23, 2017.
• Hirsch M, et al. Monoamine oxidase inhibitors (MAOIs) for treating depressed adults. http://www.uptodate.com/home. Accessed Jan. 24, 2017.
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• Krieger CA (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 2, 2017.
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• Depression in women: Understanding the gender gap
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• Male depression: Understanding the issues
• Marijuana and depression
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• Pain and depression: Is there a link?
• Vitamin B-12 and depression
• What is depression? A Mayo Clinic expert explains.

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