In my last blog I talked about depression, its nature, symptoms and causes. In this post, I am presenting strategies to overcome depression.

The good news about depression is that it is the most treatable of all mental disorders. In fact, 80% of people who suffer from this illness will achieve substantial, if not full recovery, within a few years of the initial diagnosis. Many will improve through self-treatment. Many from talking to a professional, sometimes taking a medication.

Below are several strategies to help you overcome depression. Let me offer a few qualifications. First, different methods work for different people so you need to find which strategies will work for you. Second, the best approach to overcoming depression is holistic, meaning it involves a combination of strategies, some which affect mind, some body and some spirit. Third, you cannot look at these strategies as a quick fix. They take time and commitment. Fourth, one challenge in overcoming depression is finding the motivation to move forward. By definition, depression implies a lack of motivation and hope about the future, so it takes a lot for someone to take steps that will help.

For that reason, I encourage you to read my list of strategies and find those that resonate the most with you. Take these steps first and they will become “wins” that will help improve how you feel and increase your motivation. The important thing is to start taking some kind of action even if you don’t feel like it. You can’t afford to wait.

And, if self-treatment isn’t working, then please follow step 12 and find a professional who can help. Working with a professional will both accelerate your progress and make your recovery more complete.

So here we go:

1. Get moving.

Rhythmic exercise in which you’re moving your arms and legs (walking, running, dancing, swimming, lifting weights) is a natural treatment for depression since movement increases serotonin in the brain. Many studies have even shown that it is as effective as medication for relieving depression and preventing relapse. So, figure out which exercise you would most enjoy and get started.

Make it okay to start small. I recently worked with depressed woman who also suffered from physical obesity, diabetes and heart disease. My instruction to her was to go outside and walk to the end of the block and back, a round trip of no more than 10 minutes, even at her slow pace. She began to feel better as she did so not only because she was walking, but from the sunlight and connecting with her neighbors. She was soon walking much longer distances and feeling better.

2.Find pleasure.

One of the hallmarks of depression is a loss of zest for life. To overcome it you have to do things you enjoy. If there is nothing that you enjoy today then think about activities you enjoyed in the past and do these, even if you don’t feel like it. This might include taking time to relax in a hot shower or warm bath. It might mean getting out in nature, playing a sport, reading a good book, watching a movie or favorite TV show and so on. It also helps to do hobbies or activities that require repetitive action and in which you lose track of time and put you in a state of flow. Identify such activities and carve out time to do them at least a few times a week.

3. Connect with others.

It is natural to withdraw and isolate from others when you are depressed. You may feel too exhausted to be with others or even shame about what you’re going through. But one of the most important things you can do is to connect with others in simple or meaningful ways. Here are some tips:

• Confide in someone who cares about you–a friend, family member, clergy, teacher, etc. Talk about what you’re dealing with and let this person know the best thing he/she can do is listen.
• Keep going to social events even when you don’t feel like it. It is hard, initially, but you’ll usually feel better following these events.
• Reconnect with an old friend through a phone call, text or email.
• Do something you enjoy such as a sporting event, concert, movie or dinner with a friend or loved one.
• Get a pet or take care of a pet. Animals make great companions. Of course, these should not replace face-to-face contact with people but may give you an outlet for expressing affection and feeling loved.
• Support others. Doing something for others is a bigger boost to our well-being than doing something for ourselves. So, look around and find something nice you can do for another person, be it lending a listening ear, offering a compliment, or doing some random act of kindness.
• Join a support group or social club. Being in a group in which you can receive support and advice as well as encourage others is a powerful way to feel less isolated and find better ways to cope. The club doesn’t have to be therapeutic. Find a cause to believe in and get out to be with other like-minded people.

4. Challenge your thinking.

I said in my last blog post that depression is less a disorder of mood and more of perception. Notice the cause-effect nature of the diagram below:

An event occurs and triggers thoughts and perceptions. We often aren’t aware of these thoughts because they happen spontaneously, even subliminally. Our thoughts cause our feelings. Our feelings drive our behavior which determines our results. Depending on what I think, feel and do, I will either regain my emotional balance or slip into greater anxiety and depression. (See article How to Overcome Negative Thinking.)

Here’s a simple example. I hear that some friends are going out to happy hour after work and they didn’t invite me. If I think: “They don’t want me with them. They don’t think I’m as cool as they are,” then I’m likely to feel hurt, rejected and alone. These feelings would result in withdrawing and being less friendly in the future. The result is less connection with my co-workers which sets up similar events in the future. My thoughts become a self-fulfilling prophecy.

On the other hand, perhaps I think “I’m not sure what my friends are planning or why no one talked to me. Maybe someone forgot to mention it. Who knows? It’s okay. I’ve got lots to do tonight.” These thoughts would result in feelings of trust, acceptance and connection and result in friendly and assertive behavior.  The result would be inclusion, clearer communication and stronger friendships.

The entire chain begins with how I talk to myself.  If I talk to myself in negative and pessimistic ways then I’ll actually create that reality. If I talk to myself from a realistic but also positive and objective way then I’ll create a more positive reality.

People who are depressed are caught up in negative interpretations of themselves, life and others. These interpretations set up a vicious cycle of moods and behavior that reinforce their negative perceptions.

So, the question is, what would you need to think and believe to overcome your depression? How would your thoughts need to change to begin feeling better?

Here are a few questions you can ask yourself to challenge your thinking when you’re reacting to a challenging situation. “Is such and such a thought about this situation true? How can I know? Is there evidence that it is not true? What are the consequences of holding this thought? Who would I be without this thought?”

Then generate a few competing, more objective thoughts and ask yourself: “Which of these is most believable? Could it be true? What evidence can I gather that it is true? How would I feel if this thought were true? How would I act? What results would I get? Which of these competing thoughts do I want to believe?”

Changing our thoughts takes work but is very much at the heart of overcoming depression. In fact, Cognitive Behavior Therapy, perhaps the most powerful treatment of depression, is all about challenging negative and distorted thinking.

5. Practice meditation and mindfulness.

Meditation is a powerful practice that can impact many areas of our lives—blood pressure, sleep, stress and anxiety, and mood. People who meditate are less likely to get depressed and have a powerful technique for dealing with it.

Of course, you may think that meditation takes too much time and is too difficult to learn. But actually, it need not be difficult to learn basic meditation. All you need to do is close your eyes and take a few deep breaths. Then let your attention focus on your breathing by either counting your breaths or saying in your mind, “I’m now taking a long breath in and I’m now taking a long breath out.” Do this for just five to ten minutes. Thoughts will randomly intrude. Simply notice the thoughts and bring your attention back to your breathing.

Meditation does not have to be difficult, especially as you get started. As you begin to see some positive results you can learn more and expand your practice. Plus, there are some good apps out there that are guided meditations, an easy and effective way to get started.

6. Take care of your health.

There is a strong relationship between physical, mental and emotional health. Taking care of your body in ways besides exercise is also helpful to overcoming depression. Diet impacts your mood. So here are a few tips:

• Don’t skip meals which will lower your blood sugar and make you feel tired and irritable.
• Cut back on sugar and refined carbohydrates (baked goods, fries, shakes) which make you feel good temporarily but are not nutritious for your body and will result in a crash in your mood and energy.
• Eat mood-boosting foods which have been proven to help regulate the neurochemical balance in your brain. These include lean proteins like turkey and chicken, low fat dairy, dark chocolate and omega-3 fatty acids (fatty fish, flax and chia seeds, walnuts and soy products) which help stabilize mood.

Another way to take care of your health is to get enough sleep. Of course, this is not always easy in our fast-paced and stressed-out lives. Although you may not be able to control how easily you fall asleep or how early you awaken on a given night, you can establish a good nightly routine. By following it consistently you’ll make progress. This includes setting a regular bedtime, removing technology from your bedroom, avoiding screen-time an hour or so before going to sleep, making sure the room is dark and temperature is ideal for sleeping and so on. Here’s a good article for more information on this topic.

7. Make a decision.

You feel stuck, helpless and powerless when you’re depressed. It’s hard to make a decision because it feels like it takes too much energy or you’re afraid of making a mistake. Instead you spin your wheels in unproductive rumination without moving forward. You’re overwhelmed by even small decisions.

 So, choose to make a decision, even a small decision like what to wear or where you’d like to go for dinner. Just making a decision can feel like a win. Decide. See how it feels. Make another decision later in the day and see how that feels. Soon you begin to feel like you’re taking control of your life again.

8. Process your feelings.

Sometimes you need to do some emotion work. You’ve experienced some kind of loss or trauma, whether recent or in the past, and the depression comes from keeping your feelings all bottled up inside. We tend to buffer our feelings by over-eating, drinking, working too much, exercising, watching porn, or engaging in other forms of addictive behaviors which allow us to avoid but not resolve our feelings. I teach a five-step process for dealing with difficult situations that includes: face it (admit an ugly reality); feel it (by being compassionately aware of your feelings); reframe it (by viewing it in a different way); accepting it; and acting on it (reclaiming your power by taking some time of action regarding this situation). Sometimes it is helpful to do this with the support of someone, like a good therapist who can guide you through such a process.

9. Be more assertive.

You may feel depressed because you don’t sense that you’re in charge of your life. You’re living from “shoulds” and “oughts” that originate from someone else. You are stifling your authenticity and what is really important to you. Set a boundary when someone is not treating you well. Say “no” to an expectation or obligation that doesn’t feel right to you. Act on your needs. Pursue something that matters to you in spite of what others around you think. Put yourself first. Some people look at this as being selfish. I don’t. It is finding ways to value and honor yourself. You will feel better about yourself as you assert yourself and take care of your needs.

10. Seek positive input.

We live in a society in which we’re bombarded with negative information daily. The news and media are always available and many of their messages are both negative and sensationalized. They gradually, almost imperceptibly, wear us down and leave us depleted. Take breaks. Turn it off and enjoy more quiet time. And listen to listen to podcasts, view Ted-Talks or read articles and books that are uplifting and empowering. Positive information is abundant and at our finger tips. I know I always feel good for a number of hours after listening to a good podcast or reading an inspiring article or chapter in a book. Not only do I feel better but am more likely to take positive action.

11. Notice and express gratitude.

There is a lot of research on gratitude which concludes that gratitude is more highly linked with mental health and well-being than any other character trait. As I said above, when depressed, you see life through a negative filter. You see problems, threats, dangers and what is wrong about life. But this negative spin becomes so big as to overshadow everything. By being grateful we are noticing the good, which forces our brains out of a negative spiral so we can find greater optimism, hope and peace.

There are lots of gratitude strategies that have been used with normal and clinically depressed populations. One is to take some time each morning or evening to see, even speak aloud the in your life. Another is to keep a gratitude journal and write daily or weekly about what you’re grateful for. Another is a gratitude visit. Identify someone to whom you are grateful and write a gratitude letter. Visit that person and express your gratitude. If it’s impossible to make a visit, call them and read your letter over the phone.

Another strategy is to take time to savor a pleasant experience instead of rushing. It might be eating a meal, bathing, walking out doors, etc. Then write down what you enjoyed about the experience.

These and other strategies work because they interrupt the downward spiral of negativity. There are lots of good things that happen in each of our lives. Gratitude is noticing these, a response opposite of that which produces feelings of depression.

12. Seek professional help.

Some people have a hard time asking for help. It is as though asking and relying on someone else is a sign of weakness. And yet I know that I could not have cured myself from rheumatic fever as a four-year old boy. Although my body had an incredible ability to heal, I’m also grateful for a medical doctor who was able to prescribe a course of treatment and medication that saved the valves of my heart.

Likewise, your brain has an incredible ability to heal from depression. Yet a trained doctor or therapist who understands the workings of depression and has treated many people may be exactly what you need to fully recover from your depression.  A doctor cannot do your healing. That is on you. But there is no shame in letting him/her be an ally in this process.

13. Evaluate the need for medication.

Anti-depressants have reduced or eliminated symptoms in millions of people. These medications work best for people suffering from chronic or moderate to severe depression and are not as likely to work for people who are mildly depressed. For many, medication is a “jump start” that helps them feel better and find the motivation to follow other strategies. Unless their depression is more severe, many people choose to stay on medication for just a year or two.

Of course, a medical doctor has to prescribe a medication. I recommend making an appointment with a psychiatrist who is experienced in working with depression, rather than relying on a family doctor. A psychiatrist is trained to not only prescribe but monitor and adjust the medication to find the right prescription for a given individual.

In conclusion

I believe in the incredible power of the mind and resilience of the human spirit.  I have witnessed many people free themselves from the strangle-hold of depression through the steps I’m recommending. Although depression is real, it need not be permanent.

Recognize that the negative thinking that pervades your day-to-day consciousness is your depression speaking. It is not the truth about who you are and what your life has in store. Begin to tell yourself a new story. You have the ability to change how you think and feel. You are not a flawed human being but an imperfect person with an incredible mind, body and spirit. And you are not alone but there are many people who are willing to support and help you in this journey towards wholeness. Look around and see who they are.

So, I encourage you face this demon called depression. Your brain will heal but you have to help it by being willing to take some positive action, albeit small steps to get started. Pick three or four of my recommendations and commit to them for the next few weeks. Then continue down this path until you feel better, knowing that through your hard work you will feel better.