There are literally dozens of articles with similar headings to the one above. When I see them I immediately wonder if the writer has ever been depressed. Mental illness is anything but simple. Depression describes a broad spectrum of mood disorders, and there are many and varied treatments that provide different levels of success. Any “tip sheet” is by its nature superficial.

At the same time, such articles can be helpful. They aren’t normally written by medical or health professionals, so they provide input from outside traditional medicine. They give many ideas for lifestyle changes; ideas that won’t necessarily overcome depression by themselves, but nonetheless may be helpful to differing degrees for different people.

I’ve put links to a sample of articles below; some good and others pretty poor. I’ve summarized the tips from each so you can easily look further into what interests you.

You might also like to read my previous post What Works for Depression which is based on 2 research studies.

Please feel free to share your thoughts and ideas in the comments section below.

Top 5 Tips to Beat Depression
This is the only article in the 20 or so that I’ve read that suggests researching your illness and keeping a mood diary. Both of these are very underrated strategies that can get a person well on the road to recovery. The writer is also only one of two to discuss triggers. If you only read one of these articles then this should be the one.
Research depression, talk with someone, try different things to get well, mood diary, improved diet.

Ten Tips For Managing Your Depression
Of all the articles that I’ve read this is my favorite. It is well written and has a range of good, helpful strategies.
Sleep, exercise, less refined sugar, reach out to someone else, nutritious food, Omega 3, sunlight, yoga, meditation / prayer, professional help.

10 All Natural Ways to Stop Feeling Depressed
“The Blues” would be a better term than “Depressed” but there are still some helpful lifestyle ideas.
Emotional cycle, being with positive people, reflecting on past successes, gratitude, change of scenery, break in routine, animals and nature, get up and at it, find perspective, take action to help yourself.

10 Chemical-Free Strategies to Trick Yourself Out of the Blues
This writer doesn’t seem to understand depression. A couple of good points, but most strategies are ordinary at best and even bizarre.
Wear blue, take time out mentally, verbalise your anger to a friend, force your smiles, remove clutter, music, experiment with food, a concentration exercize, DIY aromatherapy, get in touch with your primal self through cooking.

Feeling Down? 7 Ways to Pick Yourself Back Up!
Another one that is more about “the blues” than depression, but the writer acknowledges the limitations of his advice. Some good ideas.
Make a list, take action, exercise, clean and straighten yourself up, get out of the house, lively music, talk about it with someone close.

Top 8 Tips for Living with Depression
This writer has a good range ideas, all of which can have an impact on depression.
Support group, manage stress, sleep, diet, control negative thoughts, stop procrastinating, learn to forgive

Top 10 Tips to Overcome Depression
Some interesting ideas, but the tips are a bit light for someone with true depression.
Talk, exercise, cry, sunlight, music, activity, write, balanced diet, affection, professional help.

5 Tips for Staving Off a Depression
Sound tips on how the writer deals with her own depression, before relying on medicine.
Work outdoors, eliminate the triggers, play music, exercise, maintain a positive attitude.

Five Tips for Reducing Depression
This one takes a different angle with the first two tips focusing on the media. There are some good ideas, but the article as a whole is weak in relation to depression.
Don’t read newspapers, turn off the television, be positive towards others, exercise, breathing and relaxation techniques.

Five Self-Care Strategies For Depression
Sound advice which includes exercise and adequate sleep – two of the most important.
Keep active, eat well, adequate sleep, minimize stress, maintain positive relationships.

Top 10 Tips for Beating Depression
This would be the worst article. The writer doesn’t seem to understand depression, viewing it more as a character flaw than a disease.
Develop interests, stay positive, fix your personal problems, create a positive social life, stop bad behavior, be realistic, make changes, become active, fix your diet, control your thinking.

It seems intuitive that personality plays a part in whether a person develops depression. There is a huge gap between someone who is optimistic and active in making their situation better, and another who feels helpless and passive about their circumstances.

It follows that analysis of your personality may give you a better understanding of the causes of your depression, to the extent that it is caused by personality factors. And understanding these causes will help you to more effectively treat your illness.

The Black Dog survey examines 8 personality categories relevant to depression – anxious worrying, irritability, social avoidance, personal reserve, self-criticism, perfectionism, interpersonal sensitivity and self-focus.

My score on irritability was high, which I expected. Thankfully there were no other areas of concern, but admittedly when I took the survey I had been stable for a while. As a check I asked Anna to repeat the survey based on how she sees me. The scores were very close, which gives me comfort. It seems that I view myself in a similar way to others, which surprises me.

The survey would suit anyone willing to look in the mirror and make changes for the better. It was designed as a depression tool, but I think anyone could make good use of it.

For more background information about the survey download the news release or go directly to the start page.

The basic idea is to identify things that work well for you in your fight with depression. Things like taking your prescribed medicines, therapy sessions, exercise, meditation, massage or relaxation. There are many possibilities.

In my Points Plan I’ve also included things that are reliable triggers for my depressive episodes. These are having a bad argument with someone (major trigger), not getting adequate sleep for days on end, or any kind of very stressful situation.

As you can see from the table I’ve allocated points to items according to their impact on my health. The only exception is medicine, which I’ve downgraded even though it’s crucial for me. It’s too easy to pick up those points each day.

The maximum amount of points in my table is 140 each day or 980 for the week. This is before deducting points for the triggers. I’ve set my aim for the week at 50% of total available points. If I can reach this then I’ll increase it next week. It might be worth adding in a reward for some motivatation.

I honestly think if I can consistently reach such a target, then I am well on the way to more stable health. And by relying on a range of positive strategies, I won’t be pinning my hopes on any single one.

So I’m off to do some exercise – something I haven’t done for months now – but it’s at the very top of my list.

If you want this simple template I’ve saved it for download as a Microsoft Excel file.

• I’ve learned how to say no. If you are good at something, like work, then people ask you to do more. It builds up over time. I’ve learnt to say no. I can’t. I have bipolar. Sorry.
• I don’t worry about what I’m going to wear, and I don’t have to keep track of my clothes cycle. I don’t care what I’m going to eat for dinner, whether I need a bigger television or a new car. If I didn’t have bipolar these things might continue to consume me as they once did.
• My marriage is far stronger today than it would have been if I didn’t have bipolar. Apparently 90% of marriages where one partner has bipolar end in divorce. That is truly tragic and saddening. My wife had lots of reasons to leave me when I was ill for prolonged periods, but she stayed even though she didn’t understand what was wrong with me. Her perseverance has been a blessing to our marriage.
• I have great relationships with my kids and time with them is invaluable. Unfortunately most Dads don’t spend more than a few minutes a day giving their kids undivided attention. Learning that I had bipolar was a good wake-up call. I now spend more time on things that are important to me.
• I’ve slowed down a lot. I stopped wearing a watch some years ago and haven’t missed it. Losing track of time rarely causes problems; if I’m 10 or 15 minutes late for the doctor, it doesn’t matter. He works to the same system anyway.
• I take my physical health more seriously than I used to. I’m frustrated by my lack of action on exercise, but I’m thinking about physical health every day, even when its hard to follow through with action.
• I’ve always been very open about having a mental illness, and I’ve actually never felt the stigma that is so widespread. I’m fortunate in that respect. When I converted to Christianity about 20 years ago I lost most of my good friends who had an issue with it. Since I’ve been telling people that I have bipolar I’ve gained at least the same number. Go figure.
• I’ve learned to be thankful for what I have and not yearn for what I don’t.
• The best thing must be the ability to empathize with others who are facing the same problems.
• I was once very guarded with what I said, often checking myself from saying anything that could offend or impact a person’s view of me. I’ve really lightened up and feel liberated. I’m rarely inappropriate (except when ill), but even if I am, I sense that nobody really cares.
• In the Bible, in Romans 5:3-4 it says:
  “We rejoice in our sufferings, because we know that suffering produces perseverance; perseverance, character; and character, hope.”
• Being engaged with the world is good. I think more deeply about things like inequality, poverty, the environment and mental illness. (The downside of course is feeling let down by those in positions of power who continually fail us.)
• Life is absurd. My life is absurd. I’ve learned to laugh at both.

We have some friends who for many years had a very, very messy house. 3 young girls – cooking, dress-ups, paint, craft, clothes, toys – you know the rest. They would unashamedly invite friends over for meals, joking that they offered an important service to other parents. It helped their friends feel better about their own messy houses.

In a similar vein I found this in another blog:
“When you’re mentally ill you are constantly doing social work just by existing. I realize that often, when you’re crazy you actually need social services for yourself, but just by talking about yourself to people who aren’t feeling that great about themselves, you are able to instantly make them feel glad they aren’t you. That’s a great service to offer.”

A final word is that I definitely don’t have it all together, and I still have episodes now and then – although less severe – in both directions. I didn’t write this post to give a different impression, but just to put some ideas out there for looking at illness from a different angle.

If you don’t already know, an internet meme is a piece of digital content that spreads quickly, widely and organically from person to person.

So, here are the five best ways that I know of to “raise my vibes”.

5. Music

My taste in music is very eclectic, so I have something for just about every occasion or frame of mind. There are a dozen or so songs that, played with volume, really raise my vibes.

4. Exercise

I’m always amazed at how much better I feel after exercise than I did before starting. It must be the endorphins. And the virtuous feelings. There is nothing that I find harder than overcoming the mental barrier that stops me from exercising. It’s a barrier that shouldn’t be there given that exercise is so beneficial, in the near-term and long-term. My lazy instinct must be stronger.

3. Go to a Bookshop

Ah, yes. I could spend a whole day in a bookshop, given a large range of books and a cafe that serves good coffee. I just love looking at books, dreaming, not even buying necessarily. I also spend an awful lot of time on Amazon and Audible during the day. As I part own a family business I have to monitor my own internet activity, which hasn’t caused any problems yet.

2. Drink water

Water, water and more water. I almost never drink enough, but when I do I feel fantastic. That makes a lot of sense since I’m normally dehydrated, and water makes up 75% of the body and 85% of the brain. Eating watermelon makes me feel great as well!

1. Have a long, important conversation with someone

No matter how good or bad my mood is to start with I feel greatly energized if I can help someone else through conversation. I’ve experienced this more and more, as people who I know have asked me questions about mental health, and have found my answers to be helpful.

That’s my 5. If I could just include them all in my day, everyday, I would be jumping out of my skin with energy.

Here are the 3 that just missed out on the top 5.

Sleep
Believe it or not lack of sleep energizes me (for the first week or so).

Reading books
Not just looking.

Spending time with family
Taking my kids out just about anywhere. Going for coffee with my wife.

I now have 6 blogs (not 5) that I’m going to tag.

I love the recent blog on Beyond Blue titled “My Depression Toolbox“. I’m convinced that the best way to maintain good mental health is to monitor depression triggers and have strategies at the ready to mitigate them when they appear. This post gives a great example of a “stay well plan” that does exactly that.

On the Dr Shock blog there is an interesting article about Activity Scheduling. This is another positive approach that aims to re-energize the depressed person by building pleasurable activities into their daily routine. (Thanks for the referral at the bottom of the post!)

I’m fascinated by the The Pursuit of Happiness, a personal, moving blog by a depressed man trying to work out what exactly is wrong with him and what kind of treatment he should seek. I recommend starting with the first post.

At Space and Time Melissa writes short posts about anything and everything, and sometimes even nothing. (Sorry Melissa). Her writing is personal, humorous and self-deprecating.

Rachel keeps me laughing, entertained and engaged with life at Frizzy Logic. I especially like her post from a week ago on an amazing infinite energy generating machine, that could be housed in a gallery, but never fulfilled its potential.

Finally, Anna at Widows Quest has written a brief post “How to Stop Feeling Tired“. She summarizes a great point from another article on how doing things for other people will energize you in a number of ways. I couldn’t agree more. This may be the reason that I have helping others in conversation as my Number 1 energizer.

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.

There are many alternatives for depression that work well in addition to or in place of anti-depressants. For me it takes a combination of treatments to stay well; medication plus a healthy lifestyle ( good food, exercise, less coffee, more sunlight, avoiding stress).

Before I continue, let me make a clarifying point. A small proportion of people with depression have what is termed melancholic or biological depression. This includes people with bipolar disorder. For such people medicine is almost always needed to reach or remain in good health, while non-medical treatments are considered to be supplementary. For the more usual non-melancholic depression, treatments that use strategies other than medication are common.

Anyway, back to the merits of different treatments. If you want to look up one of the following terms the Medicine Net medical dictionary should have a definition.

The Centre for Mental Health Research (link below) did a survey of the scientific literature available, and ranked treatments according to the depth and quality of evidence supporting them.

Medical treatments

Antidepressants and electro-convulsive therapy are both ranked highly with strong scientific evidence for their effectiveness.

Psychological treatments

Cognitive behavioral therapy ranks highest with strong evidence for being very effective. Interpersonal psychotherapy, psychodynamic psychotherapy and bibliotherapy are all on the next tier. They are supported by scientific evidence as being effective, but the evidence is not as strong.

Lifestyle & Alternative Therapies

Exercise, light therapy and St John’s Wort are ranked on the second tier as useful treatments, with good evidence but not as strong as for, say, antidepressants. On the third tier there is a large group of other promising treatments with less evidence in support. It includes acupuncture, alcohol avoidance, massage therapy, relaxation therapy, vitamins and yoga.

The Black Dog Institute took a different approach, surveying what patients rated as the most helpful treatments. The leader of the study Professor Gordon Parker said that patients “do not necessarily share the views of professionals about effective therapies for depression”. Yes, we can be fairly incisive about what is or isn’t working!

2,692 individuals took part in the survey. Leaving aside medicines and “talk” therapies, people with depression rated exercise as being the most helpful. They considered yoga, meditation, relaxation and massage to be the next most beneficial. Acupuncture and homeopathy followed with moderate ranking scores, while the various herbal and Omega 3 preparations returned the lowest rankings.

So there you have it. My experience is that it takes more than drugs to get well. The more aggressively you pursue all of the the things that work for you, the more likely you are to maintain good health. Putting it into practice is the hard part!

Centre for Mental Health Research
Black Dog Institute (see the news release dated 18/2/07)
Previous post on green exercise