Out of Depression

The ebb and flow of bipolar disorder can create a challenging facet of life. While the manic highs feel invigorating, the depressive lows can be so debilitating that it can seem difficult to drag yourself out of bed.

Part of effectively managing your bipolar disorder is being able to continue on living your life as you see fit, through the highs and the lows. Here are some ways to help you through depression:

The PLEASE Method

Dr. Jason Evan Mihalko, Psy.D., a licensed psychologist in Cambridge, Mass., said during times of depression it's helpful to work towards reducing your emotional vulnerability.

“There are a variety of things someone can do,” he said.

Some of these things are easily remembered with the acronym PLEASE:

  • treat Physical iLlness (take medicine as prescribed, manage colds, aches, and pains as recommended by a doctor, etc.).
  • Eat three meals a day.
  • Avoid mood-altering substances (obviously, of course, taking medication as prescribed).
  • Get enough Sleep each and every night, and try to get on a regular sleep schedule.
  • Exercise at least 20 minutes a day.

“These simple things won't undo depression, but it can help reduce emotional vulnerability so the depression doesn't get worse,” Dr. Mihalko said.

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Do the Opposite

Dr. Mihalko said sometimes the best intervention is doing the opposite to what the current emotion is, no matter how difficult it might be. For example, getting up out of bed and showering first thing in the morning can be a start at building a new outlook for the day, he said.

“Sometimes when we engage in an activity when we are depressed we can move our energy to a new place—and if not, than we can at least manage not make things worse,” Dr. Mihalko said. “In terms of balance, I think cultivating a sense of radical acceptance from moment to moment is important: a depressed mood doesn't last forever (even though it might seem it will).”

Think Objectively

Bipolar disorder is a difficult disorder because the emotional turmoil can interfere with your life. That emotional clouding can make it difficult to see things how they really are, and trap you in a cycle of responding to things based on your current mood.

When depression sinks in, it can seem challenging to look beyond your current situation and see a way out.  

One technique to eliminating an unnecessary emotional response is to step back from your situation and view it objectively. This may take a few breaths, but the more objectivity you can put into your situation, the easier it can feel to see a way out. 

Giving your current situation an objective eye can help you identify if you’re overreacting, under-reacting, or simply not reacting at all.

For example, if you’re upset about something someone did or did not do, consider that they may have done it by accident. With most people, there is often little malice in action, but there is often ignorance. Basically, if someone is upsetting you, they often don’t realize it.

If it is related to your job, realizing that you need your job helps you afford to do the things you enjoy.

Make a List

Depression can make anything seem difficult, but lengthy periods can rob you of motivation and cause setbacks in your goals. The key is to stay focused, even through depression.

Write down what is important to you and what you must do to maintain it.  Don’t list every single thing as your list may become too daunting, but listing the general idea and purpose could help.  The most important thing is to list why it is important. 

For example, you could write:

  • Taking care of my family—I love them and they depend on me.
  • Doing well at work—I enjoy what I do and it gives me a sense of purpose.
  • Volunteering—I am fortunate, so I should give back.

Let the list serve as a reminder of what you have, and how important it is to continually care for it.

Exercise

Depression comes with an array of symptoms, including fatigue, irritability, sleep problems, and body pains. While these symptoms only further your desire to stay in bed or do little, this is the most important time to get moving.

“Do something each and every day that makes you feel confident and competent (taking a walk, reading the paper, knitting, 10 minutes of a crossword puzzle, etc.),” Dr. Mihalko said.

Exercise is often the first course of treatment a doctor advises for the treatment of depression, and people with bipolar disorder should do the same, especially during times of depression.

Finding an exercise you thoroughly enjoy is the best way to not only lighten your mood, but also accelerates the production of dopamine, adrenaline, and other feel-good chemicals in your brain.

You don’t have to get out of bed and start a marathon. Walking with a friend, or even a stroll through your neighborhood, is a great way to start.

Meditate

You can’t control many things in the world, but you can control your reaction to it.

The goal of meditation isn’t to solve your problems, but rather to accept the realities of life and appreciate the experience of it by understanding it.

Meditation doesn’t have to be a standardized process. It can be as simple as sitting in a quiet room with your eyes closed while listening to the faint sounds around you. It gives you the chance to stop projecting out into the world and having a moment to absorb the world around you.

If you want to explore easy ways to meditate, we suggest reading Ven. Henepola Gunaratana’s Mindfulness in Plain English. You can read it for free here.

If You Feel Suicidal

Suicidal thoughts and ideas are serious and should not be dismissed. Even if you are merely entertaining the idea, you should talk to someone you trust about getting help.

These feelings are serious and should be evaluated by a trained mental health professional.