Coping with Depressive Episodes
It’ll probably become clear as you go through this that a lot of my perspective comes from coping with traumatic flashbacks and dissociation, but I have also dealt with my fair share of depressive episodes, and I think a lot of the techniques are transferable, and I hope that this all is helpful for you. I’m obviously not a therapist, but my - our - brain sure is fucked, so we’ve at least got a lot of experience with this stuff.
I’m also sure that a lot of this will be stuff you’ve come across before / already know. I hope that in each section I provide at least some small new idea, but the headings are also there for you to be able to take the parts you need and not be bothered with the rest. Okay, end of disclaimers.
So first off, I know from your description that this isn’t the case, but I figured I’d include this anyway: if you are feeling suicidal, you should contact a hotline. I know that phone calls are anxiety-inducing for you, so you can always text HOME to 741741.
Okay, but, assuming you’re not in that place, the best thing to start with is self-care. Depression and your physical wellbeing form a positive feedback loop. There are mental things to be tackled later, but improving your physical wellbeing is more straightforward (not to say it’s easy during a depressive episode: more that it’s less of a herculean task) than directly improving your mental state. So, drink something hydrating, eat something, go exercise, take a shower, take a walk.
If you can’t get yourself to do self-care activities, then you need to ground. A depressive episode pulls your attention fully to the mental side of things. You need to shock your body into dealing with the physical. Grounding will look different for everyone, but it generally falls into 2 categories.
Preventative grounding is for when you feel yourself starting to slip. If you can do self-care, do that, but if not, you want to prevent yourself from leaving the present. Preventative grounding is for when you haven’t receded fully into the mental space yet, but you’re starting to leave the present. So it typically involves getting yourself to think about your surroundings or the passage of time, and generally involve speaking out loud to make the exercise sensory in the present. Examples:
- Look around the room. Say (out loud) the colors of objects around the room. Do not take time to make any judgement about the colors or objects. Keep naming colors until you are back in the present, then go do self-care.
- Start counting. Say the numbers in full out loud. Keep counting until you are back in the present.
- Say an anchoring phrase, like “I’m Katherine Bertrand. I’m 27 years old. I live in Asheville, North Carolina. Today is Tuesday, February Second. It’s ten oh-five at night. I am sitting on the floor of my closet.” You can then extend this by factually describing your surroundings: “Chloe is sitting outside the door. There is a yellow hoodie hanging next to me. The blanket over my legs is green and blue plaid.” Stuff like that, until you are back in the present.
Shock grounding is for when a depressive episode is really getting into full swing. The goal here is to get your body to demand your brain’s attention and force it to reckon with the physical present.
- Stim. Clap, snap, flap your hands, whatever things you normally do.
- Splash your face with water. If you need to do this immediately, start with cold water. Otherwise, do warm water, then cold water, then warm again.
- Hold a piece of ice in your hands. If you have circulatory issues in your hands, lie down and place the ice on your sternum.
- Taste something highly acidic. Bite a lemon, take a sip of vinegar or lemon juice.
- Touch your body. All over. Touch everywhere you can. You can make this sexual or not, both ways work to get your brain to reckon with the physical present.
Keep in mind that these are all just examples. Find out what things work best for you personally. Also, remember after all of these that the point is to get yourself enough into the present to do self-care.
Finally, if none of these others work, you can of course shock-ground through pain. It’s not generally a good idea to make a habit of self-harm, but in extreme situations it is an effective way of becoming aware of your physical body. I would generally only advise employing physical self-harm as a grounding technique if you are suicidal, and you need to ground to get yourself to contact a hotline.
What to Do After Self-Care
Okay, so you’ve gotten yourself into the present, and you’ve taken care of your basic physical wellbeing. If The Thing (tm) is out of mind, great! You’ve averted the episode. But chances are The Thing (tm) is still there. You’re still not mentally okay. What you do next really depends on if The Thing (tm) is just making you depressed, or if it’s also making you anxious. If you’re anxious, there are some soothing things you can do to turn down the panic levels. The number one thing that has helped me with this is meditation.
So first, a note: ADHD brains have a quite difficult time with meditation, especially at first. My advice is to work out first, then immediately meditate. Aerobic stuff is especially good for this. Maybe you’ve done that as part of self-care. Okay, so, here’s a basic meditation (credit to my friend Sara):
Sit in a position that lets you relax. It can be in a chair or on the floor, whatever way is comfortable and allows you to sit upright with little effort. You can also lie on your back if sitting is uncomfortable. Your hands can be in any pose you choose as long as it’s comfortable. As long as you are comfortable doing so, close your eyes. Take three deep, slow breaths, mentally following the air as it enters and exits the body, allowing you mind to settle on the breath. After the third breath, allow your body to breath naturally without regulating it.
Find the area in your body that allows you to feel the breath most vividly and focus your attention on that spot, watching the air pass into and out of your body. Thoughts will come and go, but that is natural. Don’t try to clear your mind or dictate your thoughts. Allow them to come and go at their own pace and maintain your focus on your breathing. If you find your mind has wondered, that’s okay. Just notice where you are and gently bring your attention back to the breath.
For a simple meditations practice, you can maintain this focus for as long as is comfortable. You can time yourself with a quiet alarm to signal the end of your meditation. When you are ready, take a slow deep breath and slowly bring your attention back to your surroundings. Open your eyes and reflect on how you feel and how your thoughts have shifted. Then go about your day.
Your brain probably wants to resolve The Thing (tm), but the fact of the matter is, you’re probably not going to be able to process it in a healthy way if you’re depressed. But a depressive episode is temporary (and recognizing that is an important step in getting out of it). Time is an effective tool you have. Distract yourself.
Make a list of things you enjoy doing that you can distract yourself with. Here’s mine. Obviously this will be very personal:
- Talk to a friend
- Go outside and watch the clouds
- Go hiking
- Go for a drive
- Cook something familiar
- Cook something new
- Watch anime
- Listen to a podcast (NOT Robert Evans)
- Play a game w/ a friend
- Create website stuff
- Read a book (ADHD disclaimer: if you can’t, do something else)
- Make tea
- Visit a museum / art gallery (this one will have to wait)
- Connect with my UU congregation
- Learn a language
- Sing a song
- Play the piano
- Listen to upbeat / hopeful music (you can start with the sad shit, but play it ONCE)
- Dance in my room
- Take photographs
- Paint my nails
- Draw freeform
- Have sex with someone I care about
- Do something nice for someone
- Clean some part of the house
- Rebuild a computer
- Install a new OS
- Unjudgementally write code
In addition, if you have work that needs doing, absorbing yourself in work can be an excellent way to distract yourself. It’s important not to lean on this too much, as that can lead to burnout, but still, it can be a good distraction.
Processing The Thing
There will come a time when the depression will pass. When you are sufficiently out of the episode, you still need to process The Thing (tm), but now you’re in a better headspace to do it.
The first and most important thing is allow yourself the space to process or grieve. Some things are bigger than others, and it’ll be up to you to determine how much space is reasonable. Some things take minutes to process; some things take years (though, if you’re dealing with that scale of Thing, we should have another talk about dealing with complex trauma). Most things you’ll be actively needing to use these coping skills for will be somewhere in the middle. Hours, maybe days. The most important thing to understand is that you’re allowed to be upset. It’s important to do things to avoid spiralling, but you will be upset and that is normal and okay. It is upsetting. Grieve. When you feel ready, talk to people you trust about it.
I’m going to start by saying: do not just skip to this part. This is for when you’ve averted or gotten out of the depressive episode, and made time for yourself to process the rejection.
The first step of processing rejection (and a lot of things) is accepting that it happened. The worst thing you can do when handling rejection is holding onto the possibility that you weren’t really rejected. If it’s ambiguous, accept the rejection early.
Side note on this: do some gut-checks or talk to some people to ensure you’re not seeing a rejection that isn’t there. Not everything is about childhood, but this is a very common thing with people who had very disorganized attachment to their caregivers from an early age, so be careful of this.
As above, allow the appropriate time to be upset, and then close the case. It’s done. This step doesn’t make the rejection hurt any less, but it does ensure you’re not holding open the wound.
If you’ve figured out your spiralling red flags, watch out for them as you process rejection. It’s easy to fall into catastrophic thinking or negative self-talk when dealing with rejection. The most helpful thing I have found is recognizing that rejection isn’t about you. That doesn’t mean it doesn’t affect you or that you shouldn’t be upset about it, but it does mean that the rejecting party made their decision for themselves. It isn’t an attack on you as a person. Try to contextualize the rejection. Reframe it as something someone did in a particular situation, and not something they did to you.
Whether personal, professional, or otherwise, moving on from rejection doesn’t mean giving up on your goals, it just means moving on from pursuing those goals with the party you approached. While you are processing the rejection, you can make note of things that you can learn, but separate those lessons from the rejection itself. I know that I often hold onto memories of rejection and replay them over and over under the guise of trying to learn from them, but all I’m doing is hurting myself. Learn what you can, and then let go. Do not allow a single incident to define how you move forward (I really need to practice what I preach huh).
Building Mental Tools
Okay, so obviously part of building resilience is going to be practicing all of the above coping skills, making lists of things, finding what techniques work best for you. But there are also some other things that you can do to prepare your mind for future depressive episodes.
Recognizing Red Flags
Learn what your red flags are that indicate you’re slipping into a depressive episode. Some common signs are catastrophic thinking (“I didn’t get this done on time. The project’s never going to get done. I’m going to lose my job. I’ll stop being able to pay for my housing. I’ll never be able to get another job.”) and excessive negative self talk (“I’m a burden on others. Everyone is just tolerating me. I’m a toxic person, and my friends would be better off cutting me out of their lives.”). There are plenty of other red flags. Take note of what your brain is doing when you’ve started to slip into depressive episodes.
Building an Inner Safe Place
So, this is another meditation from Sara. She made it for a mutual friend of ours who also has OSDD, but singlets can also have inner worlds, yours just won’t, y’know, have alters in it. And yours also probably won’t feature quite as many horrors since it’s only you creating it, and not you and a bunch of other horribly traumatized people. Having a safe inner world allows you to retreat to that place within your mind to achieve some level of soothing without having to ground and return to the physical present. Anyways, here is the meditation:
Inner Sanctuary Meditation - Cottage
This version of this meditation was written to help a friend with their specific interest in mind, but the meditation is very flexible. The sanctuary can be any kind of place and in any environment. Mine is inside a massive tree trunk and extending into caverns below in the roots. If it’s hard to visualize, ask your intuition if you’re in the right place and if not let it guide you where you need to be.
Inner Temple Meditation - Forest Cottage
Begin by entering a meditative state. Once you have relaxed your awareness, imagine yourself in a deep forest. Picture the trees and other plants around you. Hear the birds and other animals come and go. You find yourself on a path through the trees leading into the woods. Follow the path and take note of the sights, sounds, and smells around you. Allow the path to lead you on its own, whether it’s straight and clear or twisted and overgrown. Simply follow your instincts and go where your intuition leads you.
You may see some cottages or treehouses or other structures as you pass. You can note these as you go. Or, there may be nothing but nature the whole way. This is your inner world. It will come to you as it is. Eventually, you will find the one that is yours. Allow your intuition to tell you this is the one. Like an old home you haven’t visited in some time but always know it’s there waiting for you.
Take in the appearance of the structure. Is it big or small? Is it made from logs, stones, brick, or even a mushroom? Walk around the structure to look at windows and furnishings outside. If anything catches your interest, take a moment to see what makes this thing stand out to you.
When you are ready, enter your sanctuary. Take in the scene that is before you. Is it warm, like it’s heated from a fireplace or a hearth? Is it well lit, or is the sun and the stars the only illumination? Look at the furniture. Touch them and feel their texture, the wood of a chair or the feathers in a down blanket. Look at the various items and decorations about the room. Pick them up and inspect them. Are they hard or soft? Warm to the touch or cold? Do any of them contain thoughts, memories, or emotions?
Are there other rooms? If so, explore them one by one the same way as the first. Don’t try to build the place or force it to have things you want. Simply let it reveal itself to you for now. Your intuition will provide you with the things you need every time you visit. Sometimes things will shift, rooms will move or appear, or pictures will change. This is normal. Your inner world is not static and fixed. It is fluid and can change to suit your needs and moods. For now, simply see what your mind has given you and appreciate it.
When you feel ready, thank your sanctuary for what it has given you and the journey here. If you have anything in your pocket, set it somewhere special as a gift to yourself and fill the space with love and gratitude. Then, leave the sanctuary and follow whatever path you find out. As you walk, slowly bring your awareness back out to your surroundings. Take a few slow, deep breaths and slowly open your eyes.
Remember that you can return to your sanctuary at any time whenever you want or need. It is always within your mind and always has exactly what you need.
It really can be anything. Mine works a bit differently because of OSDD, but it’s a beach and a desert with lots of weird little alabaster structures.
Experiencing gratitude seems to be an incredibly important part of mental health. Gratitude journals are great and you should do them. At their most basic, just write down something you are grateful for every day. You can make them more complicated, but honestly, it’s like maintaining a healthy diet. It’s more important that you actually do it than it is to get it perfect.
But of course, I also have a related meditation courtesy of Sara:
Meditation on Loving Kindness
Begin by entering a basic meditative state. Take a moment to observe your breathing and prepare your mind for cultivation and focus.
Look within your heart. Find within yourself a vast vibrant field of flowers. For some people, it is an endless well-tended garden, for others, an untamed meadow of color and life. Each flower represents an act of love, kindness, and compassion. Look around and note how the field goes on forever. You could pick each flower one by one and never find an ending. Take a moment to smell the fragrance in the wind, feel the warmth of the afternoon sun, and drink in the peace of the moment.
Picture the person you hold most dear and most cherished. It can be a significant other, a best friend, a beloved sibling, anyone. See that person before you and pick them flowers of every type and color until you have a vibrant bouquet of compassion, kindness, and understanding. Give them this bouquet freely. Take a moment to observe how you feel in this moment and reflect on the countless acts of love you could do for this cherished person.
Picture your cherished family, whether by birth or by choice. Picture those people who support you and build you up to be the best person you can be. Pick each of them a bouquet of flowers and present it to each person individually. Think of the moments of compassion and understanding you can give to these people without expectation or obligation.
Think of your friends, coworkers, and other family members. Those who, even if you’re not particularly close with, they still leave a positive impact on your life. Think of those here now, those who are no longer with us, and those who’ve simply drifted away with time and obligations through no one’s fault, simply time and circumstance. Pick each of them a bouquet as vibrant and lively as all the others you’ve picked so far and present one to each of the people before you.
Picture those in your community, your local store, your past, anyone who you see or have seen that may or may not have left any real impact on your life. Think of the way they may have connections with those you have already seen today, of those who they love but you may not know. Consider how they, too, are deserving of compassion and patience from those they are close to. Pick each of them a bountiful bouquet and present it to them so that they may know they are loved and understood in their lives.
Picture all the people you have never met. Think of children and parents; of friends, lovers, and rivals. Think of the multitude of people and how each of them plays a part in the lives of those around them. Think of the countless stories of triumph and tragedy and how each person is simply trying their best to live for happiness and fulfillment. One by one, pick each of them a bountiful bouquet and give it to each of them with loving kindness.
Picture yourself. Think of those you have helped and loved. Think of how, from the outside, your story is just a full and vibrant as any of the countless others you have met in this meditation. Think of those you are close to and how their love is shown in your life each day. Think of those you have never met and how any number of them could be feeling nearly the same as you are now about where they are in their lives. With kindness, love, compassion, and understand, pick a bouquet of beautiful, fragrant flowers and give it to yourself. Tell this person they are as deserving of these things as each and every person you have seen today in your reflections on love and kindness.
Look around at your field one more time. See how the flowers grow endlessly to every horizon. Look at how new flowers have already begun to grow where you have already picked your bouquets. Compassion is boundless and unending. You can give all you have and always return to find more then it is needed. Feel the warmth of the sun, the coolness of the breeze, and the fragrance of the life around you. Leave your field in peace and slowly return to the outer world around you.
I have a real hard time with this one. But it was written by someone who has been hurt. I do not know how she holds compassion in her heart for the people who have hurt her, to recognize the divine spark within them as humans. I struggle with that for the people who have hurt me. It does not mean not allowing myself to be angry, or excusing what they did to me. I certainly does NOT mean allowing them anywhere near me, but it does mean accepting that they are human. I know you do not share my beliefs. Maybe this is not for you, but maybe parts of it are helpful. I hope so.
This is at the end, but is probably the most important thing. I know it may be difficult to think this when in the midst of a depressive episode, but how you are right now is valid and acceptable. In this moment, you do not have to be anything other than what you are.
There are a million arguments your brain can and will come up with against this in the moment, but radical self-acceptance is the most important tool I have personally for being okay.
This Shit Is a Lot
Mental health, especially for those of us who are neurodivergent, is a lifelong project. This shit is a lot. It takes a lot of work. Don’t expect yourself to nail all this stuff immediately, or even quickly. I’ve been working on this stuff for as long as I can remember, and it’s still a constant struggle for me. What matters is getting a little better.
Sometimes You’re a Mess and That’s Okay
I’ve now expended far more words on this than is probably warranted by a text message, and I do hope that this is helpful to you, but, the fact of the matter is, sometimes you’re going to be a mess. Sometimes you’re going to cry for 4 hours straight. And while I can certainly understand the desire to avoid that, sometimes it’s going to happen. It’s okay. You’re human. If it gets to the point you’re suicidal, please do contact a hotline, but short of that, sometimes you’re gonna be a mess, and that’s okay. It will pass. It sucks to go through, but it will pass, and you’ll live another day.
I hope this helps. –Gardenia, of Embers Forum