I’d like to offer some advice on coping with depression and anxiety based on my own experiences. I hope it proves of use to someone. I’ve not formally studied mental illness nor am I a mental health professional, and so I do not claim to be formally qualified to offer advice on mental health. However, I am well versed in trying to cope with depression and anxiety, having experienced them on a regular basis since my teens. I have had CBT and NLP therapy, and have spent a good deal of time analysing my own thinking and behavior. I’m now in my early thirties and enjoying the best mental health of my life. Therefore I feel I can offer some useful guidance on managing and overcoming anxiety and depression.
First of all, let’s define what depression is. I broadly agree with the definition offered by mentalhealth.org.uk:
“The term ‘depression’ is used to describe a range of moods, ranging from low spirits to more severe mood problems that interfere with everyday life. Symptoms may include a loss of interest and pleasure, excessive feelings of worthlessness and guilt, hopelessness, morbid and suicidal thoughts, and weight loss or weight gain. A depressive episode is diagnosed if at least two out of three core symptoms have been experienced for most of the day, nearly every day, for at least two weeks. These core symptoms are:
• Low mood
• Fatigue or lack of energy
• Lack of interest or enjoyment in life
A depressive episode may be classed as mild, moderate or severe, depending on the number and intensity of associated symptoms, such as sleep disturbance, appetite and weight change, anxiety, poor concentration, irritability and suicidal thoughts.”
In my case my feelings of depression have never disturbed my sleep or led to weight loss, I don’t know why that is the case. However, depression has rendered me less able to concentrate, sometimes quite severely, and has led to irritability – again sometimes quite severely. I have fairly regularly experienced excessive feelings of worthlessness and hopelessness for prolonged periods also. As for suicide, I have been tempted on only a few occasions, and only to the point of momentarily imagining what it would feel like if I stepped out in front of that passing car. Suicide is an alluring prospect to the mind that is not feeling any positive emotions; it’s a siren call that tells you it’s a way to end your suffering and a perversely rational option if life/existence appears unbearable.
Anxiety is defined as:
“Anxiety is a normal response to threat or danger and part of the usual human experience, but it can become a mental health problem if the response is exaggerated, lasts more than three weeks and interferes with daily life. Anxiety is characterised by worry and agitation, often accompanied by physical symptoms such as rapid breathing and a fast heartbeat or hot and cold sweats. ‘Stress’ is not considered a mental health problem in its own right, but long-term stress may be associated with anxiety or depression.
• Generalised anxiety disorder (GAD) is diagnosed after a person has on most days for at least six months experienced extreme tension (increased fatigue, trembling, restlessness, muscle tension), worry, and feelings of apprehension about everyday problems. The person is anxious in most situations, and there is no particular trigger for anxiety.
• People who experience anxiety usually have symptoms that fit into more than one category of anxiety disorder, and are usually diagnosed with at least one other mental disorder, most commonly depression.
• Social phobia, a persistent fear of being seen negatively or humiliated in social or performance situations, is the third most commonly diagnosed mental disorder in adults worldwide, with a lifetime prevalence of at least 5%.”
The anxiety I experience stems almost exclusively from a social phobia. I can easily become very fearful of “being seen negatively or humiliated in social or performance situations”. If I find myself in a situation where I’m being criticised or someone is upset with me, or I see potential for humiliation, then I suffer physical symptoms. I can experience some degree of sick feeling in the stomach, sweating, and my heart beating harder and more rapidly. If I’m having negative thoughts about some potential future scenario, then it affects my physical well-being in a different way. It usually leads to a slight headache, tension across the neck and shoulders, and feeling fatigued.
In my experience feelings of depression or anxiety arise whenever you think about or focus on depressing memories or thoughts about the future. What forms the content of a depressing thought depends on the particulars of your life, but its structure is that it’s usually something that either happened in the past or might happen in the future. There’s a Lao Tzu quote that says:
“If you are depressed you are living in the past, if you are anxious you are living in the future, if you are at peace you are living in the present.”
I would go as far as to say that it’s almost impossible to be depressed or anxious if your mind is fully immersed in some task (e.g. a job or a hobby). This is an important thing to remember when you’re having a particularly tough time with depression or anxiety, and it’s something I’ll talk more about the utility of later.
Thinking about something adverse, sad or frightening that happened in the past tends to lead to feelings of depression, whereas positing a negative future scenario tends to lead to anxiety. The latter is expecting something bad to happen or predicting failure and imagining how that might feel. Whereas the former is remembering something bad that happened to you and re-experiencing or re-living how that felt. The difference between anxiety stemming from thinking about the future and depression is that the bad thing you’re anxious about happening might not happen, whereas the bad thing you’re depressed about did happen and is now over. This is a positive perspective on life. The bad thing might not happen, and the bad thing that did happen is over. Even if the bad thing is more likely to happen or not, or even inevitable, a time will come when it is over. It won’t last forever. Again, this is choosing to take the positive perspective, which I think is crucial to minimising the impact of feelings of depression and anxiety on your well-being.
No good can come from choosing a negative perspective, but much good can come from choosing a positive one. You can choose. You’re not stuck with the perspective your mind automatically chose. And you don’t have to believe everything you think. Sometimes we forget this.
For me, a depressing memory or a depression pondering of the future is like a ticking time bomb. If I allow it to be the thought at the centre of my mind for long enough, then it explodes and completely changes the way I see the world. Before the explosion I was seeing a rational, healthy and balanced view of a world (and a future) made up of good and bad. But after it, I cannot see the good for the bad. Effectively, the good has ceased to be. Present good and future good all gone. Vanished. Dead. Invisible. Whatever. It’s just not there. Given this bleak, hopeless vista, it’s no wonder that the storm clouds of depression gather quickly and the relentless rain sets in. Everything looks, nay is, shit and hopeless, therefore feeling shit and hopeless, and even suicidal, is a perfectly reasonable response. Never underestimate the power of the mind to rationalise anything. It will do, relentlessly. After all, that is its modus operandi.
For a long time I was unaware of what was going on in my mind at any given moment, especially those crucial moments when a time bomb was ticking away. It seemed to me that depression and/or anxiety could just appear out of nowhere and whack me for six. Believing this to be true led to further depression and anxiety because I felt utterly defenseless, and powerless to change things for the better.
The truth is: we are not powerless to change our thinking.
It’s true that a great deal of what is going on in our minds is subconscious or bubbles up from the subconscious, but once it’s in your conscious mind you have the power of veto. You can decide whether any given thought stays in the centre of your mind or whether it needs to be replaced by a positive, useful one. Remember, depression is of no use what so ever. There’s no point in feeling sad or afraid now just because you once felt sad or afraid in the past. Likewise with anxiety. There’s no point feeling sad or afraid now just because you might do so in the future.
The key to being able to stop your own ticking time bombs of depression and anxiety from going off is developing the habit of being aware of what you’re thinking at any given moment. This, like any skill, takes time to acquire and needs to be practiced. Developing this kind of awareness is not easy as our minds just want to work on automatic – because that’s the most efficient way. But for people suffering from depression and anxiety, and indeed anyone wishing to achieve greater peace of mind, our automatic thinking must be tackled.
As philosopher Jules Evans put it so succinctly “we need to make the automatic conscious, and then make the conscious automatic.”
Our automatic thinking is initially the problem, then, but we can later harness it to become part of the solution. Once awareness becomes a habit it will be automatic. How long it takes to develop this habit varies for each individual mind. It’ll probably take a few months at least, but may take much longer, and it needs to be continually practiced otherwise you will lose the habit and revert to your old ways. This I know from experience. Seeing awareness as a muscle that needs to be regularly exercised in order to remain in good functioning order is a good way to think about it.
The way to develop awareness is to talk about your thoughts and feelings with someone, preferably a therapist, but anyone who is a good listener and sympathetic will do, on a regular basis. You can also write about your thoughts and feelings as if you are talking to someone. If you prefer one or the other, then do that, but doing both is even better. Talking and writing about your thoughts is crucial because the less able you are to describe what you’re thinking, the harder it’ll be to be aware of your thoughts. Awareness means to be knowledgeable about your thoughts, and we express knowledge (either to others or to ourselves) through language. The more time you’ve spent describing and analysing your thinking the more quickly and effectively you’ll be able to identify and replace those ticking time bombs when they occur.
This brings me to the title of this post: Find And Replace. I’m borrowing the name of a well-known tool that all word processing software has. As you probably know, this tool finds and replaces any given word with another. It occurred to me that this is a good analogy for the way I manage depressing or anxiety-inducing thoughts. I find them, using my awareness, and then replace them using the power of my will and my imagination. I usually do this in real-time as they pop-up throughout the day, but it can also be done by setting aside some time to systematically search through your mind. Here’s an example. Let’s say you find yourself thinking about how would feel if you fail a forthcoming exam. Before your body starts to react as if that is happening now or has happened, conjure up the positive version of this thought and overwrite the negative one with it – i.e. think about how you will feel if you pass the exam. Really wallow in that thought. conjure up as much detail as you can because the effort of doing this will push the negative thought out from the centre of your mind. Once it floats away and out of your conscious mind the job is done. You can carry on knowing you’ve expertly diffused that time bomb and averted a bout of depression or anxiety.
Here the analogy breaks down a little because ‘find and replace’ in Word is permanent, whereas my find and replace mental technique is, for the time being at least, an ongoing process. I do find myself repeatedly having to replace the same thoughts, which is to say those harmful thoughts don’t get ‘erased’ from my mind. That would be ideal, of course, but for the moment that isn’t happening. However, who’s to say that after some time consistently practicing this technique and making it automatic that my mind won’t select the positive thought over the negative one without me being conscious of it having done so. I’ve successfully developed other habits and so I don’t see why this should be any different. Even if automation is never achieved, I still have a tool to manage my time bombs, and that’s the main thing.
Let’s discuss positive thinking for a moment. Thinking positively – i.e. visualising success, happiness or some kind of gain – is what leads to motivation, and motivation is necessary to get done what you need to in order to achieve your goal. If you believe you will pass the exam, or at least have a good chance of passing it, then you will be motivated to put in the study required. If you believe you’re going to fail or have a slim chance of passing, then you’re not going to put the study in because there’s no point in doing something boring and time-consuming for no gain or little chance of gain.
Several years ago before I began to work on developing awareness of my own thinking, pursuing self-knowledge, and using techniques to change my thought patterns, my depression and anxiety was the most severe it had ever been. During this time there were a few things that I now realise were essential to my survival, and to eventually finding a way onto a path to improved mental well-being. These were:
– other people to talk to (ideally a therapist)
– structure (i.e a job or any task that takes up most of your day)
– access to natural surroundings (ideally a river or lake, or the sea)
– and exercise (ideally with others)
These are the things that kept me going and kept me sane; the things that injected the faintest moments of colour into an otherwise relentlessly grey outlook during the period of my life when I was suffering the most as a result of depression and anxiety.
I’m very glad I found the courage to seek therapy because it helped me enormously. The first few sessions were tough. I felt stupid and weak. I felt like a failure who couldn’t deal with life as I believed everyone else could. Thankfully, I had a good therapist. He just listened and he didn’t judge me ( which at that time confounded my ingrained preconceptions and expectations of people). He gently challenged various beliefs I had about myself, which prompted me to question their validity. He asked questions on occasion, but often I would talk for almost the full hour. After a few sessions like this I started to see the value in talking about ones feelings and thoughts, which to me as someone who had hardly ever discussed their feelings with anyone, was nothing short of an epiphany. I felt the benefit physically. I felt more relaxed and more at ease with myself. I saw hope again and started to question whether I really was powerless. Crucially, I began to talk to one or two people about what I was going through. One of those people eventually became my partner whom I have now been enjoying a wonderful relationship with for six years.
Therapy was essential, but so too, in a different way, was having a job. It was an enormously boring job, which I eventually quit, but it ensured I had regular contact with people. This was important because it kept me from becoming entirely self-focussed. It kept me aware that other people have problems too, sometimes worse problems. It gave me a glimpse of a crucial perspective on myself and my own difficulties. It stopped me losing all perspective on my own troubles and perceiving them as giants that filled all time and space.
At this time I lived in a small coastal town, which meant I could easily walk or drive to the sea. I don’t know what it is about observing and being in the presence of a large body of water but it’s relaxing. Perhaps it’s the undulating, smooth and slow motion of the water that serves as some kind of hypnotherapy, I don’t know. I haven’t Googled it. Whatever it is, water works. It reduces anxiety and depression, and focuses your mind back on the present. Even now I often walk down to the river Thames here in London on my lunch break. Small things like this can make a big difference if you’re feeling low.
Exercise or sport also has the effect of reducing anxiety and depression. It doesn’t even have to be particularly rigorous exercise, it can just be a stroll through pleasant or interesting surroundings. Science tells us that when you exercise, your body releases chemicals called endorphins. These endorphins interact with the receptors in your brain that reduce your perception of pain. Endorphins also trigger a positive feeling in the body, similar to that of morphine. I think the fact that exercise or sport usually requires you to focus your conscious mind on the present is also a reason why it reduces depression and anxiety. I find swimming is particularly good in this respect because you have to focus on and regulate your breathing more so than other forms of exercising.
From reading many self-help books and having two different kinds of therapy (CBT and NLP) I’ve learned that everyone’s battled with depression and anxiety, and pursuit of improved mental health, is unique. Some therapies and methods work for some people and not for others. For instance I found CBT interesting and empowering, but NLP not so much. If you find that my ‘find and replace’ technique doesn’t really work for you, then you can try other methods like Three Minute Therapy (see below), which I would recommend. Or, you can even use both. Whatever works.
We all have to find our own particular path to inner serenity because we’re all unique, but I hope this account of my own experiences will provide some hope, help and guidance to anyone who is struggling with depression and/or anxiety. Take it from me, someone who has many times felt utterly powerless against the suffering my own thinking was inflicting upon me, you do have the power to change your thinking. And you can change how you feel and act based on your thinking. You are not condemned to suffer for the rest of your life. You can change your life.
One last important thing to remember. As novelist William Gibson once so amusingly advised: “before you diagnose yourself with depression or low self esteem, first make sure that you are not, in fact, just surrounding yourself with assholes.”
Seriously. Make sure that this isn’t the case.