It is important to remember, when working through a resource list like this, that some things may work for you and others may not – a treatment for depression should start with professional help. Irrespective of this, it’s important to be involved in learning about your illness, including the treatments available. It seems that those who actively participate in their treatments have the most success in maintaining good health. Good luck!

THE BIG PICTURE

Large Website Resources
National Institute of Mental Health
National Alliance on Mental Illness
Medline Plus
MayoClinic.com
Blackdog Institute

Comprehensive PDF publications
National Institute of Mental Health
Mental Health Foundation – Dealing with Depression
HereToHelp – Depression Toolkit
Understanding Major Depression and Recovery

PDF Fact Sheets
Mind (National Association for Mental Health)
National Institute of Mental Health
SANE Australia
Black Dog Institute
Beyond Blue

Staying Well Plans
National Mental Health Information Center – Self-Help Guide
SANE Australia – Mental Illness and Keeping Well
Black Dog Institute – Ways of Staying Well
Sarah Russell – “Staying well with bipolar disorder”
(5th article from the top. Very applicable to depression.)

EVERYDAY LIFE

Exercise
MayoClinic.com – Depression and Exercise
Better Health – Depression and Exercise
MIND – The Mind Guide to Physical Activity
Mental Health Foundation UK – Up and Running!

Food
Mental Health Foundation – Healthy Eating and Depression
MIND – The Mind Guide to Food and Mood
MyPyramid.gov – Healthy Diet Plan

Stress Management and Relaxation
MIND – The Mind Guide to Managing Stress
MIND – The Mind Guide to Relaxation
Families for Depression Awareness – Coping With Stress

Sleep
HelpGuide – Tips for a Good Night Sleep
National Sleep Foundation – All About Sleep

TRUSTED BOOKS (links to Amazon)

Dealing with Depression: A Commonsense Guide to Mood Disorders

Living Well with Depression and Bipolar Disorder: What Your Doctor Doesn’t Tell You…That You Need to Know (Living Well)

The Relaxation & Stress Reduction Workbook

A Lifelong Journey: Staying Well With Manic Depression/bipolar Disorder

Loving Someone With Bipolar Disorder

PHYSICAL TREATMENTS

Medicines
National Alliance on Mental Illness – Information on Specific Medicines
Drug Digest – Information on Specific Medicines
National Institute of Mental Health – Detailed Information on Types of Medicines
Beyond Blue – Brief Introduction to Types of Medicines
MayoClinic – Brief but Helpful video on Understanding Antidepressants

Electroconvulsive therapy
MayoClinic.com Overview
MayoClinic.com Video
infrapsych

Vagus Nerve Stimulation
MayoClinic.com – VNS: A New Depression Treatment Option

Transcranial magnetic stimulation
National Alliance on Mental Illness – TMS
MayoClinic.com – TMS: An experimental depression treatment

PSYCHOLOGICAL TREATMENTS

Overview
APA – How Psychotherapy Helps People Recover From Depression
APA – How to Find Help Through Psychotherapy
Mental Health Foundation – We Need to Talk PDF

Cognitive Behavior Therapy (CBT)
National Alliance on Mental Illness – About CBT Treatments
National Association of Cognitive-Behavioral Therapists
MoodGym program – free online CBT course
Living Life to the Full – free online CBT course
liveandworkwell.com – Steps to Change: free online CBT course

ALTERNATIVE, COMPLEMENTARY AND SELF-HELP TREATMENTS

Overview
Healthy Place
National Mental Health Information Center
New Hope – Natural Remedies for Depression
Introduction to Dietary Supplements

Bibliotherapy
Holistic Online – Bibliotherapy

Omega-3
Medline Plus
Black Dog Institute – The Role of Omega-3 Fatty Acids as a Treatment for Bipolar Disorder
(Online presentation also applicable to unipolar depression)

Vitamin B6
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

Vitamin B12
National Institute of Health – Dietary Supplement Fact Sheet
Medline Plus

SAMe
Drug Digest – Article on SAM-e

DHEA
Medline Plus – DHEA Overview
MedPage Today – DHEA Effective for Midlife-Onset Depression

Ginkgo Biloba
Medline Plus – Ginkgo Overview
NCCAM – Herbs at a Glance: Ginkgo

St John’s Wort
National Center for Complementary and Alternative Medicine – St John’s Wort
Drug Digest – St John’s Wort

Light therapy
MayoClinic – Seasonal Affective Disorder
PsychEducation.org – Light Therapies for Depression

Yoga
Better Health Channel – General Article on Yoga
The MIND Guide to Yoga

Aromatherapy
Holistic Online – Depression Remedies
Wavelengths Natural Therapy – How to use Aromatherapy for Depression
depression-guide.com – Depression and Aromatherapy

Massage therapy
National Center for Complementary and Alternative Medicine
Medline Massage Therapy Interactive Tutorials

Spirituality
Mental Health Foundation – The Impact of Spirituality on Mental Health

Creative Therapies
American Art Therapy Association
American Music Therapy Association
American Dance Therapy Association

Acupuncture
National Center for Complementary and Alternative Medicine
Acupuncture.com – Depression and the Five Elements

Meditation and Relaxation
National Center for Complementary and Alternative Medicine
MayoClinic online meditation video
MayoClinic Relaxation Techniques

Progressive Relaxation, Guided Imagery and Autogenic Relaxation
Calming.org
McMaster University – Relaxation: Physical and Mental

Ecotherapy
Mind (National Association for Mental Health)

Keep this list expanding! If you have another resource that you’d like to share please add it in the comments.

I’ve been expanding my “stay-well plan” to include more of the things that I’ve blogged about. Taking my own medicine, so to speak. One of them is going outside, or getting light into my eyes, as soon as I wake up. (See the earlier post “Dim Bulb or Bright Light“.)

Over the last few weeks I’ve been opening the curtains first thing in the morning, then going back to bed for “just another 10 minutes”. Instead of sleeping I look out the window, at the winter sun streaming into our bedroom. (Australia.) I do the same thing in the family room. I eat breakfast facing the window and looking outside. (I had to swipe my 3 year-old daughter’s spot).

There has been a big improvement in my mood in the mornings. I’ve actually been civil at work, and I’ve maintained an awful lot of eye contact. Yesterday when I arrived at work I coated the insides of my car with a large espresso, and I actually laughed.

If light isn’t the reason for my newfound regularity then it must be the arrival of a modern mattress. We’ve been out of the mattress market for about 10 years, and had never even heard of a “comfort layer”. Comfort it is. I don’t think it’s helped my health an awful lot, except now I sleep for 5 or 6 hours, instead of 4 or 5.

Why do people love massage? Is it a physiological response or a psychological one? Is it both? Is it due to the fact that someone else is touching you? Absolutely. All of the above.

The literature shows that massage has a noticeable effect on the chemical balance in your body. It reduces the levels of stress hormones like adrenaline, cortisol and norepinephrine. These stress hormones can trigger depression in some people. It also releases serotonin (our favorite neurotransmitter) and endorphins (our built-in pain relievers). The physical effects include reduced muscle tension, improved circulation, a slower heart rate and increased joint mobility and flexibility. Not to mention the warmth of another person’s hands indulging your body.

It has been shown that two sessions a week reduces the rate of depression for women who have just given birth. In light of the chemical benefits to the body, these results probably apply across the spectrum of mood disorders. The cost of sessions may be expensive, but if it can make a difference to your health then it could be worth trying. If you have a partner perhaps you can learn together.

A good dose of caffeine stimulates your adrenal glands to pump out adrenaline. Adrenaline is a stress hormone that primes us for “fight or flight” from an external threat. Even if you’re sitting at a desk working.

When you drink coffee throughout the day the adrenal glands, and the stress response, are continually triggered.

So What?

I’ve enjoyed 4 espressos today, and coffee is a big part of my life, so this news is hard. After all, a good cup of coffee feels like instant therapy. Unfortunately for people like me with a mood disorder drinking too much coffee can be a real problem.

After drinking coffee the caffeine initially clears your head and makes you alert. As the adrenalin hormone kicks in your muscles tense, your breathing and heart rates increase, and your blood sugar level elevates. Insulin is released, pushing your blood sugar right down. A normal response is to grab another coffee or something sweet to compensate. This can give you a sugar roller-coaster over the day, which obviously affects your mood.

This is the basic, very simplified cycle. If it continues over the long term then the adrenal gland can get exhausted, and health problems can arise. These include chronic fatigue, irritability and headaches, anxiety, depression and sleep disturbance. Sleep problems are often due to drinking coffee late in the day, and lack of sleep is one of the very common triggers for a depressive, or even manic, episode. Lots of coffee can quickly cause lots of problems.

There is sort of a consensus in the depression literature that 2 cups of coffee in the morning should be OK for someone with depression. Obviously it varies between individuals. Definitely nothing after 4pm!

So what do you do?

If you’re like me, it’s tough. I’m not going near coffee substitutes.

• There is some nice coffee around that has been decaffeinated using the Swiss water method. If you source it fresh and grind it yourself you may be surprised. Beware of the chemical based method of decaffeinating (most common method). It’s done with something akin to dry cleaning fluid!

• Try to source coffee that is naturally low in caffeine, not decaffeinated. We have growers in Australia that produce low caffeine coffee, and I believe there is a small industry of growers in South America.

• Only drink 2 cups before noon!

My wife is a childbirth educator; she teaches new parents how to look after their babies. And guess what? Babies have to be taught how to sleep. Or more correctly, how to fall asleep, stay asleep and develop a sleep pattern. Seems amazing doesn’t it?

The Chicken or the Egg?
Many adults also have trouble getting to sleep and staying that way, and often enough it can be linked to depression. It’s the chicken or the egg thing here. Which came first, the depression or the sleep disorder? The answer can be hard to figure out, since the relationship between them will be different for each individual. For some the sleep disorder will be a cause of depression, for others it will be a symptom, for others still it will be both.

It’s a fact that most people with depression also have insomnia or at least some kind of sleep disturbance. This can take shape as difficulty in getting to sleep, waking early and not getting back to sleep, frequently waking during the night, or poor quality sleep. All of these can affect a person’s ability to function well on the following day, with common problems like:

• Tiredness
• Irritability
• Poor concentration
• Worse mood
• Increased susceptibility to illness.

Tips for dealing with sleeping problems
There is a great fact sheet on the Beyond Blue website that gives some useful tips:

• Wake at a regular time and do something outside pretty much straight away. The light of day is a cue to the brain to wake up.

• Be physically active during the day. Exercise is a great help, although it stimulates your body so not just before you go to bed.

• If there are issues that you stew over in bed then solve them during the day.

• Don’t drink coffee or other caffeinated drinks after about 4pm. Limit your caffeinated drinks to 2 a day.

• Your bed should be for sleep and sex only. Whatever you do, don’t work in your bedroom!

Some other things that I’ve found helpful

• Having a clean & comfortable bed
• Turning the lights off and using candlelight for the last hour or so before bedtime
• Keeping bed clothes to a comfortable minimum so I don’t end up hot.

I take sleep medication occasionally if my insomnia is out of control. I realize this is a stumbling block for some, because such medicine can be addictive. But it’s better for me to at least get some sleep and stay well, than risk being tipped over into a more serious depressive episode. It’s something that works for me.