Self-Care Minimums and Dealing With Depression

self-careThis topic has come up multiples over the past week or so, both with clients and friends, so I thought I’d write about it.

One of the trickiest parts of dealing with depression is that it not only saps your motivation, but it makes you believe things that are untrue–things about yourself and your worth, things about your place in your community, and things about how to take care of yourself.

I like to broach this topic by sharing that I’ve noticed in myself and others that there are depression-promoting behaviours and depression-challenging behaviours. And that the really hard part is that depression makes us think depression-promoting behaviours are in our best interest.

When you’re depressed (or anxious, or triggered), staying in all weekend, not answering the phone, binge-watching TV, and not getting dressed sounds great. It might even sound like “self-care.” And aspects of it can be self-care. But self-care is not just about soothing yourself in the moment, it’s about setting up the supports and structures that let you be okay enough in your day-to-day life. So while depression says “let’s watch Buffy instead of doing the laundry” the reality is that tomorrow you’re going to wake up to clothes everywhere, nothing clean, and one more thing you haven’t done–which will add to the guilt and shame that seem to come hand-in-hand with depression.

On the other hand, depression-challenging behaviours are hard and not fun in the moment, but set you up to a) have small victories (SO important when dealing with mental health issues), b) have some structure and routine in your life, and c) set up the support and structure to let you deal with the root of your issues or cope with issues that aren’t going away anytime soon.

Going grocery shopping and eating enough nourishing food can feel insurmountable, but are going to be a lot better for your mental and physical health than subsisting on what you can get at the gas station at 2 am. Tidying your house and making sure you have clean dishes and clean clothes might feel like climbing Everest but the pay-off is immense (for me, at least, just being around clutter and dirty dishes is stressful). Reaching out to a friend or setting up a therapy appointment can feel like the hardest thing you will ever do, but they provide you the support not only to deal with what’s going on, but to have positive social interactions and, with your friends, to have some time when you aren’t “person dealing with depression/trauma/anxiety” you’re just “person who is hilarious and loves ice cream and action movies.”

I am, thankfully, in a really good place with my mental health, but I have a really emotionally demanding job that requires a lot of self-care, and I need to be mindful that my self-care is actually helping me to be sustainable in this job rather than applying a bandaid to deal with the stress of yesterday. To that end, I have “Self-Care Minimums” that I strive to hit every day, and I encourage my clients to consider if they would be useful for them. For me, my self-care minimums are:

AM
-Sunlight or SAD lamp in the morning
-Morning medications/supplements
-Emptying the dishrack
-Morning stretch/flow
Anytime
-Intentional movement/exercise
PM
-Cleaning the kitchen
-Tidying the living room
-Start bedtime routine at 9:30
-Turn off all screens at 10

These are the minimums I’ve established I need to feel good in my house (waking up to a clean kitchen is so important to my day) and good in my body (getting enough good-quality sleep, moving my body), to be able to show up every day for my clients, and to be able to show up every day for myself.

For some people these minimums may feel like maximums. For someone who’s really struggling their daily minimums might be:

-Brush teeth
-Talk to another person in person
-10 minute walk
-Eat breakfast

Your minimums will change with your mental and physical health, resilience, and individual life circumstances, but I think they can be a good way to make sure that you are including some depression-challenging behaviours (and/or sustainable mental health-promoting behaviours) in your life when things are hard, not just when things are good.

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This piece was inspired, in part, by this great piece called Everything is Awful and I’m Not Okay: Questions to ask before giving up which I have been recommending all over the place.

I am a big fan of lists and especially of lists that give me the satisfaction of checking things off of them. To that end, I used this template to make my Daily Minimums List, laminated it, and stuck it on my fridge.

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A Primer on Mental Health Hygiene

[content note: vague discussion of eating disorders, depression, PTSD, and sexualized violence]

We’ve all heard about Sleep Hygiene, right? You know, no drinking before bed, use your bed for sex and sleep only, take your TV out of your bedroom, etc. It’s amazing how many of us know these things (if only because we’ve seen it in a million magazines) but refuse to actually put them into practice (turning my computer off an hour before bedtime did WONDERS for my quality of sleep but my consistency could use some help). And it’s amazing how many of us have poor sleep hygiene, refuse to actually institute good habits, and then complain that NOTHING has ever helped our sleeping problem.

I got to thinking last night, as I broke one of my cardinal mental health rules (no reading triggering things right before bed) that maybe a mental health hygiene guideline would be helpful for folks. Obviously this is no substitute for mental healthcare from a licensed practitioner, but it may be something to add to your toolkit. Mainly this is written for folks with ED histories and/or trauma histories, but I can imagine there are pieces that may be useful for folks with other mental health stuff going on (e.g. depression). So here it is:

MENTAL HEALTH HYGIENE GUIDELINES

The Basics:
-eat enough to support your activity
-get enough sleep
-be active in ways that make you feel good (one of the best tools for overall wellbeing–if you have dealt with obsessive exercising/overexercising in the past work with your treatment team to determine what level of movement is safe for you)
-cultivate a network of friends and family that can support you and love you as you are
-utilize your treatment team as necessary

Self-Care is Important
-go on Facebook, cull every group or “celebrity” that does not make you feel good. If you’re dealing with ED, leave/unlike/unfollow any group or person that talks about cleanses, “clean eating”, eating “naughty” food, having “cheat days”, “toning those trouble spots”, and anything else that gives off even a whiff of body-shaming. Do the same with blogs, magazines, shows, and books.
-if you have friends/family members/colleagues who post things on facebook that make you feel bad, unfriend if you can, unfollow and hide if you can’t. You owe no one your attention at the expense of your mental health
-if you have a history of violent trauma STOP WATCHING LAW AND ORDER: SVU and any other movie/show that uses rape as a proxy for character development for women, or as a symbol of “WORST THING EVER” for male characters. It’s lazy, it’s damaging, and it can be triggering as hell.
-do not, I repeat, do not watch or read things you know will trigger you right before you go to bed.
-more generally, if you do not have the emotional resources to read something triggering, don’t read it.
-learn how to set healthy boundaries.
-speak to yourself like you would a child–gently and with love.
-create a toolbox of coping mechanisms: journaling, having a bath, walking your dog, chatting with your friend, making an elaborate ritual out of teatime, screaming into a pillow, punching a heavy bag, meditating, cleaning–these are all safe, positive ways to deal with scary/sad/bad feelings.
-when you go for a negative coping mechanism instead, understand the miracle of poor coping mechanisms and come up with a better plan for next time

Fake It Til You Make It
-don’t isolate yourself. Many mental health challenges try to trick us into isolating ourselves but that just makes it worse.
-if you have crazy-brain happening (ED, PTSD, depression) don’t trust it. Ask a trusted friend or family member if what your brain is telling you makes sense. When you’re stressed out and tired and scared your brain telling you 800 calories a day is enough may sound reasonable, but your best friend is going to tell you that’s just crazy-brain talking. (DISCLAIMER: only take your crazy-brain questions to people who aren’t battling their own crazy brain.)
-don’t wallow. This is a hard one. Many mental health challenges rely on and reinforce negative views of self. We feel bad so we tell ourselves how bad we are which makes us feel worse. Stop that. Here’s my script: “Hey! That’s not a very nice thing to say. You’re not ______(bad/stupid/worthless) you’re having a hard time and healing from _______ (ED/physical health stuff/trauma/depression). These voices are normal but they aren’t right.” Say it until you mean it. Then keep saying it until you believe it.
-keep a regular schedule. For some folks depression leads to staying up all night then sleeping all day which leaves you disoriented and socially isolated.
-act like the healthy, happy person you want to be: get enough sleep, don’t engage in negative self-talk, exercise, etc. etc. Some days it will seem impossible. Do ONE THING. Make yourself a meal, even if that’s toast with butter. Clean your bathroom sink. Phone your grandma to wish her a happy birthday. When crazy brain is screaming, ask yourself “what would a happy, healthy person do right now?”
-have hope. Even if you feel like you have no reason to have hope right now, do it anyway. Do it because some stranger on the internet told you to. Do it because continuing on like this is too hard. Do it because you deserve better. Do it because it will be sunny one day.

If you have other ideas, feel free to leave them in the comments! Take care of yourself and each other.