Spells and Charms

I thought I should follow up my previous post on depression with a more cheery sounding one on some combating techniques I use. I have had to come up with some of them on my own, while friends and doctors suggested the other strategies. Most of them have worked wonderfully well. I am still around, decently functional, and writing this! That’s quite fabulous, I think.

Physical Activity: Were I to be truly honest, I should have titled this “Exercise.” But I don’t always manage to motivate myself to exercise, so I decided to be honestly vague! What I manage to do every day is to get some form of physical activity which makes me sweat. Now, in a place like Madras, it is incredibly easy to sweat. You just have to be. So don’t fool yourself. At least, do a nice, brisk walk. If you can find enough motivation every day to work out, there’s nothing like it!

My discovery here is that finding the motivation to step out for some physical exercise is the most difficult part. Once I manage to push myself to do it, or someone else succeeds in kicking me out of the house for a little walk/ hike/ run, things get easier after that. I have spoken to a few other people who suffer from clinical depression, and they all seem to have similar experiences.

Even a little bit of the morning sun might be helpful. I find that my days are significantly better when I get some sun in the morning. Recently, I spent some time in the mountains, and there were added incentives to a morning walk. Everything was just overwhelmingly beautiful. Catching the gentle, morning sun on my skin was something I started looking forward to. In Madras, I wake up when the power goes off in the morning and the ceiling fan stops swirling the same stale air about. Also, cities in the morning scare me with all their haste and rush, unless I manage to wake up really early and step out before the traffic starts.

Seek Therapeutic Help: Here’s the truism – the first challenge is to accept that you might have depression or related issues. Most of us do not think twice about going to a doctor to help ourselves out of a physical ailment. But when it comes to issues of the mind, we feel it is entirely up to us to deal with it. We are also conditioned that way. Not only are we often told that it is all a question of attitude and of altering the state of mind, it is also drummed into our heads that, come what may, we should just brace ourselves up and face everything with great fortitude. Well, very admirable. But let’s get some perspective here. We are talking about the will to get through each day here, the will to get off the bed and walk the few steps to bathroom to brush one’s teeth. We are talking about not knowing what one is fighting. So, if you choose to seek some help, it is entirely your business, and you should commend yourself for opting to take good care of yourself.

It helps to talk to a good mental health professional even to understand what ‘depression’ really means in mental health terms. We use the ‘depression’ in a variety of ways every day. We watch a bad game and remark, “Oh this is depressing.” Some people do not read the newspapers first thing in the morning, because they find them “depressing.” We also feel “depressed” after a bad exam. The clinical kind of depression we are talking about here is not the same as any of these. While these are all responses to certain concrete external circumstances, clinical depression arises largely because of decrease in the levels of neurotransmitters in the brain. There are social, familial, and “nurture” factor, but the biological factor seems to be irreducible.

Like many others, I have found a combination of medication and therapy helpful. As I say this, I am conscious that this involves money. But my suggestion to you is, please do not let this deter you right away from even exploring your options. Speak to someone in the community; find out what kind of support is available. You might be surprised.

When I went to a therapist for the first time, I expected to lie on a couch. Actually, I didn’t know the differences between a therapist, a psychiatrist and a psychoanalyst. I still don’t have a clear idea, but since I work with a therapist as well as a psychiatrist, I have sort of inferred on my own that while a psychiatrist is a medically qualified doctor who can treat clinical mental illnesses with medication and other approved modes of treatment, a therapist is trained to help people by allowing them to talk through issues and to facilitate the healing process by non-medical means. It could be art therapy, psychodrama, etc.

Remember, not all depression needs to be treated medically. Only severe forms of clinical depression are treated with medication.

Don’t self-medicate: Please don’t ever self-medicate. An anti-depressant or a mood stabilizer that works for someone may not work for you. You might need your specific combination, which only a psychiatrist might be able to assess and prescribe for. Also, once you have started taking medication and you are beginning to feel better, do not think it is alright to stop taking it. That is not going to help at all. Please don’t attach any stigma to taking medication for a mental ailment. Not everything is under our control, and there is absolutely no shame in accepting help.

Don’t over-commit at work: Oh, I had to learn this the hard way. If you have clinical depression-related issues, your productivity levels probably fluctuate more than they do for someone who doesn’t have the issue. So what happens often is that we don’t get much done when we are going through our phases. Once we are out of them and feeling better, we have work to catch up with. Most unfortunately, the world out there valorizes this notion of productivity, which reduces us all to mere machines turning out work at some expected rate. We don’t have to subscribe to that, but if we are in jobs that demand an optimum level of productivity all the time, there is not much one can do about it. However, we can at least not make things worse for ourselves.

For instance, when you recover from a phase of depression and try to catch up with work, do not be consumed by guilt for having a backlog of work. Of course, you will feel bad. Just don’t let it consume you. Then – this is most crucial – in an attempt to regain (perceived) loss of credibility, do not let that guilt make you promise to deliver more work soon. Never ever do that. Don’t even let manipulative glances from people make you do that. Focus on the task at hand. It doesn’t matter, at least provisionally, what people think of you.

Be very good to yourself: Treat yourself very kindly. You deserve a lot of love and affection, and it has to start with you. I know it is very clichéd to say these things, but after sniggering at such remarks, I have come to really believe in them myself. Reward yourself. If you have managed to exercise all seven days of a week, reward yourself to something nice. Get creative.

I will see you soon with another post!

Orinam editors’ note: For readers who would like to learn more about coping with depression, a guide on mental health for LGBT people developed by Ireland’s Health Service Executive mental health project is available here. Resources for those of us in the Indian context are being developed by Orinam and will soon be available here.