Self-Managing Depression

For the last two weeks, we’ve been talking about causes of depression. Now let’s see what we can do about it.

In my view, depression is a symptom of powerlessness. It’s nothing to be ashamed of. You can manage and overcome depression, just like you can with physical symptoms. In this blog entry, I’ll give some ideas about managing and treating the symptoms of depression. Next week, we’ll deal with treating the causes.


Self-monitoring means keeping track of how you’re doing and how different things in your environment (such as foods, medicines, people, stresses, etc.) affect your symptoms. Just like you keep track of your blood glucose levels, you can monitor your mood and your depression by keeping a log.

A really good depression screening test is available online here. It will give you a score from 0 to 100, so you can see if you’re getting more or less depressed. It’s 85 questions long and takes about 30 minutes to complete. Kind of long, but you could do it once every two weeks or so. A shorter online depression screener is available here. It has 18 questions and takes about 10 minutes. You may also be able to get a depression screening tool from your doctor. By keeping track of your depression symptoms, you will learn how to get over them better.

It would be great if some of you could try these tests and report back what you find.

Physical activity is the best treatment for most kinds of depression, as has been shown in several studies. According to Mayo Clinic psychologist Kristin Vickers-Douglas, Ph.D., “It’s not a magic bullet, but increasing physical activity is a positive and active strategy to help manage depression and anxiety.”

The Mayo article continues: “Exercise may…boost feel-good chemicals like endorphins, release tension in muscles, help you sleep better and reduce levels of the stress hormone cortisol. …All of these changes in your mind and body can improve such symptoms as sadness, anxiety, irritability, stress, fatigue, anger, self-doubt and hopelessness.”

To learn more about how to start exercising, check out the Mayo article, my blog entry about physical activity, or Diabetes Self-Management’s articles about exercise.

Sunlight is one of the best mood raisers of all. Rates of depression go up dramatically in the winter, when there is less sun. This is called seasonal affective disorder, or SAD.

But most of us don’t get much sun, even in the summer! Try to get as much natural sunshine as you can. If sunshine isn’t available, or you have to work inside during daylight hours, there are special full spectrum light boxes that provide some of the benefits of sunlight. Look up SAD light in your phone book or on the Web for more information.

Social Contact
In one study, people with the least contact with other people had up to 13 times the rate of depression as people with the most social contact. Like all primates, people tend to be happier and less anxious when we have other people around.

Of course, it’s not easy to go out and meet people when you’re depressed. We may think nobody would want to be with us, or we may feel too tired to be with them. It’s usually easier to start with people you already know and like than it is to meet new ones.

You can combine exercise, sunlight, and social contact by arranging to go for a walk in the park or a window-shopping trip with someone you know.

There are also many medical and herbal treatments you might want to try, as I’ll discuss in the future. All these ideas are just treatments for symptoms, though. What about dealing with the root causes of depression: the powerlessness or hopelessness that so many of us feel? How can we self-manage those? Check out next week’s blog entry for some ideas.

For now, how have you managed or coped with depression? What has worked for you and what hasn’t? Let us know by commenting here.

  • Ephrenia

    You said it… when I start getting depressed, I want to “hibernate”… stay inside, in bed, I don’t want to be around people, not even on the internet.

    When I start feeling that way, I KNOW I need to do the opposite of what I FEEL like doing.

    The hard part is finding the MOTIVATION to DO it when you are depressed!

    SUPPORT STRUCTURE is one thing you left off your recommendations.

    Luckily, I have keyed some friends into my “hibernation pattern”. They know that if they notice me withdrawing, how they can help me by creating a need for me to go somewhere with them.

  • john

    Green vegetables alkalise and re-mineralise, which is vital for good health. At least one green drink daily is ideal – try fresh vegetable juice, a green smoothie or simply green powder like spirulina/green superfood mixture with water. Eat greens too, but know that having them as liquids means you can ingest larger quantities, with more assimilable nutrients.

    Key for losing weight and keeping it off. Try not to eat after around 7-8pm, as digestive power is weaker at night. Avoid going to sleep on a full stomach. Foods eaten late at night ‘stick’ to the body much more.

    I believe we’re here to enjoy ourselves. Avoid feelings of restriction and ‘deprivation’ by being creative and playful with foods. This is a big lifestyle change for many and if you’re not having fun, it’s not likely you’ll sustain it, so ENJOY!

  • David Spero RN

    Ephrenia – You’re right about social support. I’ll write about it next week. John, I like your ideas for getting more vegetables. Have you noticed that eating that way helps with depression?

  • susycue

    I just took the 10 min. depression screening quiz and my score was 4 = not depressed. I didn’t think I was, but a number of years ago, I was diagnosed with mild depression. I got over it, and now I try to be alert to changes in myself. I am dissatisfied with certain parts of my job and am looking around for another. My work environment is very stressful at times. My T2 diagnosis was 1.5 years ago and I can control the sugars well with diet and exercise. Working fulltime and getting enough exercise takes nearly all of my life, when you add in taking care of a house and yard and living alone. I find myself longing for some of the hobbies and activities I used to do when I was younger and everything took less time (I’ll be 60 in December). I really miss some of those things and sometimes I get kind of “depressed”, sad, angry about it. Right now I’m ready to cry. Most of the time I just stuff it and carry on with the tasks at hand.

  • David Spero RN

    Thanks for writing, Susy. I hope you can find a better job – that’s usually the #1 thing you can do for yourself, if it works out.

    Would it help you to rent some space to someone who can help with yard work etc.?

    I don’t like the idea of “stuffing” emotions. Find time to laugh and cry. I keep music and videos around that I know make me cry, just for that purpose. I’ll be writing more about emotions in coming weeks.

    Good luck,

  • mellonie

    I have been depressed alot lately. It is winter and i just started using insulin. I try to excercise here at home,but I get down on myself and do not stick with it. I think if I had a partner that understood or going thru what Iam things would be easier. But, since this isn’t possible, I keep trying. Spring is on the way and I hope things start looking up. I have alot to look forward to and I know I can make things better. Keep your fingers crossed! Mellonie Quary