As a psychiatrist trained in psychopharmacology, it would be easy for me to rely exclusively on psychiatric medications as the be-all, end-all treatment option for patients with mood disorders. Psychiatric medications work, and they work fast, and I use them regularly in my practice to treat a host of problems and conditions, from depression and anxiety to bipolar disorder and chronic insomnia. That being said, I am always mindful of other, equally significant ways to enhance mood and wellbeing, specifically methods related to our ways of thinking and daily behaviors. Here then are my top 10 recommendations for improving depression and anxiety, sans medication:
1. Limit Your Time on Facebook
A recent cover article in The Atlantic magazine asked, "Is Facebook Making Us Lonely?" and confirms what I have been seeing in my own practice over the last several years. When Facebook is used as a casual tool to keep in touch with friends or stay in the social loop, it can be a useful distraction. However, when Facebook is used to keep constant tabs on others or to promote a certain self-image, it can lead to an unconscious need to compare ourselves to everyone in our social network. This frequently leads to jealousy, insecurity, misplaced feelings of superiority or alternatively, feelings of inadequacy. Limiting time on ubiquitous social media sites like Facebook may be hard at first, but it may be one of the best things you do for your mental health.
2. Stop Living Someone Else's Life
Often, depression occurs when we wake up one day and realize we aren't living our own dreams but are instead trying to please our parents, our spouse, our children, or our friends. Your life is yours; you are the sole creator or destroyer, no one else. If you need to set boundaries or disengage with certain negative influences in your life, so be it. Developing the courage to follow our own personal lodestar has a way of lifting our spirits and reducing feelings of being trapped and "stuck," two of the leading causes of depression and anxiety.
3. Write It Out
Keeping a private diary or a written record of your thoughts can be one of the most effective ways of dealing with mood disorders. The mere act of writing down our thoughts and feelings can serve as a profound catharsis, and is especially helpful if we are uncomfortable expressing ourselves verbally. Often we simply feel better and less stressed after systematically sorting through our emotions on the written page. In fact, there is an entire field of psychotherapy called Journal Therapy, developed by Dr. Ira Progoff, which specializes in helping patients write their way to better mental health.
4. Stop Comparing Yourself to Others
Comparing ourselves to other people is one of the fastest ways to worsen depression and anxiety. Sure, it can sometimes impel us to work harder or get motivated, but more often than not, we feel inadequate and "less than." This is unnecessary and a tremendous waste of time and energy. As a psychiatrist, I can assure you that the neighbor or friend you envy for their fancy car or huge house or perfect body has just as many problems as you (if not more). Try to focus on yourself, your own betterment, and your own life. Don't obsess about other people.
5. Take Your Vitamins
I routinely recommend both fish oil and the B vitamins to patients experiencing depression and anxiety (in conjunction with psychiatric medications if those are needed), and the results have been very positive. Study after study has shown that taking a high quality fish oil supplement containing both the potent omega-3 fatty acids EPA and DHA can help with symptoms of depression and anxiety and even bipolar disorder. In addition, the entire range of B vitamins, including vitamins B12, B6, and folate, may also be helpful in regulating mood. If you are looking to go the natural route, I would recommend you give fish oil and the B vitamins a try!
6. Talk to People, Any People
So many depressed patients I see feel lonely, alone, and unloved. They can go days or sometimes even weeks without having a conversation with another human being. This degree of isolation exponentially worsens mood. The mere act of talking to another person, of opening your mouth and letting words come out, can lift mood instantly. Say hi to the friendly clerk at the grocery store, or casually compliment someone on their outfit, or just smile at a stranger. Notice how you feel better instantly!
7. Pick a Goal, Any Goal
It doesn't really matter if you have a small goal or a big goal or a medium-sized goal, but whatever it is, try to work towards it, day by day, little by little. A life spent wandering aimlessly and without purpose creates a sense of unease and frustration, contributing significantly to feelings of depression and anxiety. Even a goal as simple as "I want to lose four pounds in two months" is a great way to bust out of the blues. If you dedicate yourself to something that has personal significance to you, your life will have more direction and focus. Pick achievable goals that are easy to bite off and chew, and watch your mood lift over time.
8. Read About Spirituality and/or Astronomy
This may seem like an odd suggestion, but even for the diehard atheists and agnostics out there, reading books on spirituality and/or astronomy can help us see the big, cosmic, universal picture and can, (somewhat ironically) help us regain a sense of comfort and mastery in our own lives. Pondering the big questions of life and coming to terms with the enormity and complexity of the universe may help us take our little old selves a little less seriously!
9. Experience the Bliss of Quiet Time
People who take time out for themselves on a daily or weekly basis, whether through yoga, meditation, reading a good book, daily prayer, or even a warm bath, often feel calmer and more at peace with themselves and the world. Time out helps you to see the big picture and prevents you from letting the daily difficulties and petty squabbles of life get you down. Even if just for 15 minutes a day, quiet time can instantly transform your state of mind and helps you retain control over your life.
10. You have to work on your happiness, it won't just happen on its own
Happiness is a state of mind that takes practice, effort, and vigilance. You have to be willing to take a hard look at your life, cut out bad habits and people, and make changes in your own internal expectations and behavior. But relax! You have all the time in the world. My most urgent recommendation to patients is to not take things so urgently and to stop making life such a serious production. Ten thousand years from now, or 20,000 years from now, you won't be here. Heck, the entire human race may not even be here! So why stress out? Try to have as pleasant and peaceful a time as you can during your short time on planet earth... you deserve it!
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