In 2011, after having experienced several bouts of mild-to-moderate depression, I was sure I understood it. And I was confident I knew how to beat it. My theory was that it was essentially a malady of egocentricity – i.e., of thinking too much about yourself.
So I wrote an essay laying out my suggestions for anyone suffering from “the blues”:
- First, do NOT complain about your problems. Instead, write them down. Then review them, noting which are external (“My company is downsizing”) and which are internal (“I’m afraid I’ll be fired”).
- Try to accept the external factors you can’t control, and think about ways to resolve your internal issues.
- Smile 25 times in a mirror.
- Take a long walk, trying to think of nothing.
- Count your blessings. Write them down. Read them aloud.
- Do something that requires your full attention – like practicing a challenging piece of music or playing chess.
- Imagine your funeral. Imagine what you want people to be saying about you. Start doing the things you want to be remembered for.
- Do something kind or beneficial for someone else.
That was written before I had my first experience with serious depression. Before I realized the huge difference between feeling sad (even very, very sad) and being clinically depressed.
I still believe that egocentricity is a common problem. But I no longer believe that those eight suggestions can work – at all – for deep depression. They may be helpful when you are sad or even moderately depressed. But they won’t work if you are seriously depressed. When you are that low, you won’t have the mental energy to get out of bed, let alone take charge of your thoughts and feelings.
That doesn’t mean you can’t do anything to help yourself. Here are just a few of the things that work for me:
- Be aware of your breathing. Try to breath slowly and deeply, bringing oxygen into your body and brain.
- Keep telling yourself that the depression is temporary. That, eventually, it will pass.
- Notice that the psychic pain you are feeling is not consistent but rises and falls throughout the day. When you are low, know that your mood will rise, if just a little, in a few hours.
- If possible, take a cold shower. As cold and as long as you can stand it. This will give you a temporary lift – from 15 minutes to an hour.
- If you can do it, very demanding physical exercise should help.
- Don’t feel bad about how much you want to sleep. Deep depression exhausts the body, just as any physical disease does. You need lots of rest.
After my third serious episode of deep depression in 2011, I wrote an in-depth essay about my experience with depression and the system I developed to overcome it. If you think it might be helpful for you or someone you know, I’ve reproduced it below…
How I Learned to Deal With Chronic Depression
By Mark Morgan Ford
Most people know little to nothing about mental illness. Ask 10 lay people the difference between psychosis and neurosis and just one or two would be able to give you the right answer. But there are two types of mental illness that most people think they understand but don’t. I’m talking about depression and anxiety.
Before I suffered from clinical depression and anxiety, I believed I understood those terms. Depression was feeling really bad about something. Anxiety was worrying about things you probably shouldn’t.
I thought of them not as mental illnesses but as mental weaknesses.
Depression was caused primarily by paying too much attention to yourself and your own problems. My solution, therefore, was to pay attention to other things.
Anxiety was caused by fearing things you shouldn’t. So my solution was exposure therapy.
But about five years ago, I experienced anxiety and depression at a rather severe level. And that made me realize that there is a difference between the natural depression and anxiety we feel when our brains are “healthy” and the deep depression and panic-level anxiety we feel when our brains are not.
Clinical (or deep) depression is a neurological malady, not mental weakness. It may be triggered by thoughts or memories or feelings. But the extreme pain you experience is the result of what is happening in your brain.
There is plenty of scientific evidence to support this. But two things really convinced me:
- My bouts of deep depression sometimes came out of the blue, without triggers. I had no troubles. Nothing to worry about. Everything was fine.
- The thoughts that occasionally triggered a deep descent had no effect whatsoever on me when I was not already depressed.
I endured my first bouts of depression without telling anyone, staying in bed for days and pretending I was physically sick. I did that because I believed my severely negative thoughts and feelings were caused by a weakness of my mind.
But then I came out of the closet to an increasingly wider group of people – my family, close friends and colleagues. I also decided to treat my depression like the illness it is, and began working with a psychiatrist and a psychologist on several therapies that had the potential to heal me.
So I could have a better understanding of what works for me and what doesn’t, I kept a detailed daily journal of not just my thoughts and feelings, but also of everything I was doing in terms of eating, sleeping, smoking, medications, etc.
By reviewing that journal over a two-month period, I was able to create a 10-point system that ranked the “level” of my mental health. Level 1 represented extreme pain and the nearly total inability to function. Level 10 represented euphoria.
In reviewing and refining this system I noticed several interesting things:
- There are three distinct aspects of my experience of deep depression: how I think, how I feel and how I function.
- Each changes, to some degree, depending on the level I’m at. At the lowest levels, for example, my thinking is extremely limited, dark and repetitive. I cannot engage in meaningful conversation because I cannot process information. And I’m in extreme emotional pain. At the upper levels, I can think clearly. I feel motivated (even sometimes overly ambitious) and I am fully functional.
- I never stay at the same level all day. There is some fluctuation, but it is rarely more than 2 points.
- There are things I could do (or ingest) that seem to bring me up. But most of the time I can go up only one level during a four-to-six-hour period.
- Healthy people normally range from Level 7 to Level 9. A really bad day might be a 5. Since they have never dropped below a 5, they don’t know what that’s like.
- Most healthy people, when they see this ranking system for the first time, say that they have been down in the 3s and 4s. But if you ask them about their functionality, you can help them understand that they were never really that low.
- A notable functional difference is the difference between Level 5 and Level 6. At 6 you can hide your depression from others. You can fake it. At 5 you cannot. However hard you try, people will be asking you, “What’s wrong?”
- The remedies that work at one level do not necessarily work on other levels. I’ve found, for example, that I cannot meditate when I’m below Level 5.
When I’m at a low point, the 10-point system has made it easy for me to communicate my incapacities to the people close to me. All I have to do is tell them the level I’m at. And many people, including my psychologist, have found the system to be helpful as a tool for other people that suffer from deep depression and anxiety.
Here it is…
The System: 10 Levels of Functionality
Below Level 4, thoughts are merely the repetition of one or a handful of negative thoughts. Feelings are great-to-extreme pain and functionality is nearly zero.
Level 1: You are suicidal. You have hit rock bottom and have no hope that you will recover.
Level 2: You are physically exhausted and in great mental pain. You find it difficult to get out of bed, and do so only to go to the bathroom. If you are hiding your depression, you pretend you have a bad cold or flu. In fact, your body feels that way. You are weak. You ache. Your mind is plagued with the darkest thoughts and feelings. You cannot do anything productive. You dread interaction with others and cannot do so except to express your basic needs. You spend most of the day sleeping. You think, “I’d rather die than endure this pain much longer.”
Level 3: You are deeply depressed and cannot think coherently or communicate. You wake up tired. You don’t want to get out of bed, but you can. You can move around the house but you want to be alone and dread social interaction. You cannot read. You cannot write. You find it difficult to look others in the eyes. You cannot answer questions because you cannot process language fluently. It is obvious to anyone that something is seriously wrong with you. You can do some limited mechanical activities like driving or playing solitaire. But you cannot play games that require thinking such as chess, poker or bridge. The day feels like a week of suffering. You look forward to going to bed and sleeping.
From Level 4 to Level 6, your emotions interfere. You are fearful. You feel vulnerable. You are anxious.
Level 4: You are depressed but can do simple work and have minimal conversations. You wake up feeling gloomy and tired. Your mood does not improve, regardless of what you do. You feel anxious and sad. Problems seem insurmountable. Challenges are frightening. Your mind keeps gravitating towards dark thoughts and feelings. You cannot plan ahead because the very thought of doing almost anything makes you anxious. You can function but at a rudimentary level. You cannot do anything complex or challenging. You dread socializing. And if you do, you can only operate at a minimal level. You find it difficult to watch television and read.
Level 5: You feel “sad,” but are able to function at a moderate level. You wake up feeling low but not terrible. Throughout the day you feel a discernable undercurrent of sadness/anxiety that may translate into a feeling of “I don’t care about anything.” And it can last all day. You can do most work but you don’t care about it and you’d rather be in bed. If your work is solitary, like writing, you may find that your mood will rise up a level simply by working. If your work requires you to interact with others, you can “fake” normalcy. But your performance will be mediocre. You recognize that you feel considerably better than you did at Level 3 and Level 4. But you worry that you will drop back there. By putting on a game face you can convey normality to most people. You can watch television and you can read.
Level 6: You feel “okay.” You wake up with a fair amount of energy. But you are not happy. There is a faint disturbance in the back of your mind. It may feel like sadness or anxiety or both. But you are not afraid of what you have to do or whom you have to meet. You can function normally, including participating in working or socializing situations. For healthy people this is what feeling “gloomy” feels like.
Level 7 is a neutral state. You think well, have almost no noticeable emotions and can function fully. Oddly enough, the prime level for being productive is not 9 or 10 or even 8 but 7. That may seem odd until you realize that 7 is the level where you feel fine and open to anything. But you have no strong emotions, either positive or negative.
Level 7: You feel “good.” You wake up feeling fine. Not charged up and ready to go, but fine. You continue to feel fine all day unless something good or bad happens that could bump you up or down a level or even two. You can function comfortably, socially or in business situations. This is the level healthy people feel as “normal.”
Level 8: You feel “happy.” You wake up energized and eager to get on with the day. You want to work and can work productively. You are sociable and look forward to pleasant social situations. You find all sorts of things to be interesting and are willing to take on new responsibilities. You feel relatively optimistic about your future.
At Level 9, you can get really busy and feel really good about it. But it’s the sort of frenetic work that, when you look back at it, you think, “Gee, this wasn’t as good as I thought.”
Level 9: You feel “great,” almost invincible. You are eager to take on all challenges. You think, literally, “It’s so good to be alive!” You want to do more of everything – work, hobbies, sporting activities, social engagements, etc. You feel confident you can succeed at everything and that good things will come to you. You have no worries or doubts. You can be insensitive to others at this level or you can be very considerate and caring.
Level 10: You are euphoric and, therefore, dysfunctional. You are on cloud nine. If there is a heaven, this is what it must feel like. You can’t do anything because you are dancing around, telling others how wonderful you feel. This stage generally doesn’t last.
