I have felt it wash over me like a tsunami seeking to destroy, and at other times it cradles me silently as I try to fall to sleep, inevitably failing as it gags and strangles me till I am numb and empty. When the darkness comes I am lost with myself and an overwhelming sense of failure.

Over the past few months I have succumbed to a ruthless depression, similar to the one I lived through in my first and second years of university. The most marked change I have noticed is in my sleep routine: I am easily fatigued, generally lethargic and lacking energy throughout the day. I find it extremely difficult to fall asleep, have restless or interrupted sleep, wake early and find it difficult to fall back to sleep once awake. I have become hypersensitive to noise and temperature and I find things in my environment play a significant role in my ability to sleep. The dreams that accompany the little sleep I do get each night can only be explained as anxiety dreams, stemming predominately from my sense of failure, my perceived inadequacies, and my negative outlook on the future. Beck (1967) demonstrates that themes in our dreams have observable effects in waking life, through our behavior and mental activity. For instance, the individual who dreams of being ugly may demonstrate this belief in waking life with a constant concern over their physical appearance.

There are other qualifying features that accompany this depression such as my negative self image, exacerbated only by myself and the internalization of my problems. This results in unremitting feelings of inadequacy when compared to others, and the inclination to compare myself to others, of course with a negative result. There are no external cues for my negative self-image, there is no marked change significant enough to conclude that I have, in fact, become ghastly to look at. It is my understanding that this tendency towards self-deprecatory behaviour is characteristic of depression. It is cyclical in nature, there is no escape unless I decide I want out. There will eternally be environmental insults that contribute to negative self-image, sense of failure, anxieties and so forth. These are things we cannot control for. It is increasingly difficult to tear yourself away from the dark never-ending abyss when it is the only comfort you know. You become so comfortable with the absence of self-fulfillment, worth, self-love, that you begin to fear losing it. You no longer know what it feels like to experience joy, happiness, contentment — not only in things, but in yourself. You fervently convince yourself that the comfort you have found within this feeling of empty nothingness far exceeds the risk of failure or humiliation should you venture outside the comfort. There are temporary moments where joy and contentment are felt, with the persistent thought that it will not last.

My history with depression shows that its occurrence is directly related to an actual or perceived failure or series of failures that I do not respond to appropriately. My depression profile can be classified as a reactive depression: the depression is caused primarily by an external stress, such as loss of employment or financial reverses (Beck, 1967). In the past when the depression has dominated me entirely, I recognize the need for a change. In this current experience, I have been able to make a note of attitudinal and behavioural changes prior to such a debilitating change inevitably occurs. Beck (1967) informs us that while dealing with a depression, particularly a reactive depression, it is important to change routine and daily activities. He mentions the importance of redirecting one’s focus from self-preoccupation to the external world. This could include taking a walk, listening to music, experiencing an artistic or social event. Loeb et al (1966; as cited by Beck, 1967) suggest that successful completion of a task contributes to increases in optimism, performance on subsequent tasks and the level of aspiration displayed by the depressed patient, therefore it is important to keep the task within the realm of possibility. If the task is too stressful or the possibility for failure too high, it may cause greater upset (Beck, 1967). I believe it is important to start with tasks that are low in stress and high in probability of success, and to then gradually incorporate more complex tasks, especially tasks that you were able to complete successfully and enjoyed prior to the onset of depression.

Personally, I find nature and artistic activities to be a source of significant reprieve. I would like to outline a few tasks that instill positive feelings and can help in the alleviation of symptoms of depression.

First we will begin by detailing tasks that are low in stress and can be generalized as passive. These tasks are meant to create a connection with the self and the outside world, without focusing on negative thoughts or behaviours. These include: listening to music, viewing art, viewing a live performance, participating in social events with friends, and spending time in nature. These tasks are undemanding and can be escaped from easily with minimal consequence, should the task prove too difficult or taxing.  Artistic events are especially helpful because they evoke a sense of interconnectedness with the self and the rest of society, even the rest of humankind. It contributes a greater understanding of the self in relation to history and aesthetics. The viewer is very much needed in these instances, because without the viewer art would not be seen and music would not be heard. Sometimes it can be difficult to participate in social events because it can be emotionally and physically draining. Experiencing a live performance circumvents these issues to a degree, because nothing other than attention is being demanded of the viewer. Again, being surrounded by other people who are part of society contributes to the feeling and sense of participating in and contributing to the society. It is not demanded of you to talk to or interact with those around you, but the mere act of being with other people contributes to a feeling of community and participating in that community. Walking with and experiencing nature contributes to a sense of connectivity to the surrounding world, and helps you visualize your relationship with nature. You can notice cause and effect through the footprints you leave, and the way the wind feels on your face. It is an incredibly grounding experience that displays how present and real you are. Some depressions are accompanied by dissociative experiences, and in these cases this feeling of realness is tremendously important.

The more complex tasks I suggest are similar to the ones just suggested, but present more challenges and are more active than passive. These include: drawing or painting, writing, exercising in nature, attending a social event with the intent to act as host. The fact that I am an artistic person contributes to my proclivity for drawing, painting and writing, and this may not be the venue of choice for everyone. There are a number of artistic mediums that can be practiced, including crafting, knitting, glassblowing, woodworking and carving. The reason practicing art is so important is because upon completion, you have a physical representation of your successfully completed task. Art can be used to work through emotions, thoughts, and relationships.

The reason I suggest exercising in nature as a more complex task is because it is more demanding physically than merely loafing. Exercise has been proven to be helpful with mood and energy levels (Mayo clinic, 2014) as well as gaining self confidence and being more social. To exercise in nature only solidifies the connection one feels with the environment. The most interesting of these suggestions I think is attending a social event with the intent to act as host, and it can also prove to be the most difficult. The best way to successfully complete this task is to provide yourself with menial tasks such as: inviting guests, providing your guests with beverages and access to food, and introducing guests to each other. Choose a social event where you feel most comfortable, for instance an art show at a gallery, or a festival hosted by your city. The reason I suggest doing this at a social event is because you will not actually be hosting anyone, the event is the focus of the group. By acting as host in a social event you are practicing your social skills with very limited demands. You are not responsible for ensuring your guests are continually entertained: the live music, or art gallery will do the work for you. It allows you to increase your self-efficacy and self-confidence and provides you with a feeling of helpfulness and usefulness. This activity also helps you improve your relationships, which may be harder during periods of depression.

I do not believe that depression controls me, and in the past when I have experienced depressive episodes I have been able to pull myself through primarily with art and music. Each case is different, and it may be more difficult for you or someone you know to treat their depression. The suggestions I made here were made because they have helped me in the past, and are helping me now. It should always be remembered that you are not alone in these situations, and you have the power, not the depression.

References:

Beck, A.T. (1967). Depression: Clinical, Experimental and Theoretical Aspects. Harper & Row: New York, NY.

Loeb,A., Beck, A.T., Diggory, J. C., Tuthill, R. (1966). The effects of success and failure on mood, motivation, and performance as a function of predetermined level of depression. Unpublished study.

Mayo Clinic Staff. (2014). Depression and anxiety: Exercise eases symptoms. Retrieved from: http://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495