Lesson 5.3: I Have Major Depression- The DOS (Part 2)
For the members of the international community in Beijing suffering from depression, external resources are limited. Quality counselling and psychiatry is available at international hospitals but the cost is prohibitive. Treatment at Chinese hospitals is more affordable but there is an obvious language barrier.
This is why knowing how to deal with major depression disorder is so important. Self-help plays a very important role in recovery, and one can even come out of it with stronger self-awareness that can improve life significantly.
Our previous two lessons, have been trying to answer the question: “I have major depression. What do I do?”
• In lesson 5.1, we talked about the DON’TS
• In lesson 5.2 we talked about the DOS
• Lesson of 5.3 will continue with the DOS
Everybody has different ways of coping. Instead of prescribing a (not-so-useful) manual, we decided to give you some real life examples by inviting Xiaojie to share her experiences.
Let’s welcome Xiaojie back!
Using the right attitude and knowledge to create charts and checklists to help structure your day can be useful provided that your current state of mind gives you the capacity to follow them.
Everybody’s checklist will be different, but they generally look similar to the following:
I tried to stick to the following list:
Try to keep up my routine.
I honestly didn’t feel like it at all. I was only able to keep up with about 10-20% of my routine. Here’s the thing: when you have MDD, you don’t even want to be awake. Everything is difficult; doing anything takes a toll on you. I knew I had to go out, but I couldn’t. It’s an hourly struggle to try to ”do the right thing”. I only managed go to a social dance once a week, do yoga and go to work. There were mornings that I woke up and couldn’t go to work. But on the majority of mornings I forced myself to go. Only now can I say that I am glad I didn’t quit. Imagine if I had to deal with the financial stress that this would have induced.
Do more yoga, lots of yoga.
I got into yoga in 2008, but was not a regular practitioner. It wasn’t until late 2013 that I started to do it weekly. In early 2014, I fell into a depression but I kept on doing yoga. Yoga seemed to be the one place that I could at least feel a tiny sense of calm.
I remember one time going to the yoga class at my regular studio and crying during the practice. There were so many emotions coming up. I knew it was a good thing because I was able to let go of the negative emotions. The rest of the time, I couldn’t cry. I was not sad, not frustrated, and not resentful. I was just numb, and felt like a walking zombie.
April 2015 at the foot of The Great Wall China
Reaching out for help:
I didn’t tell my friends about my depression (read Lesson 4.1, for To Tell or Not To Tell guidance). I may have briefly mentioned it to a few close friends but no one knew the degree of my depression. I felt like no one would be able to help me, what would they even say if I told them? It‘d just be an awkward conversation and I’d feel anxious.
I looked online for support groups. I couldn’t find any in Beijing for the international community. There are Chinese-speaking communities, but given that I had reverse culture shock, I didn’t think it would be a good idea to place myself in an environment that might cause social anxiety. I did email a few people that I found online who were conscious of mental health and asked them for advice and information.
A man replied with a very long and caring email. I felt genuine concern and care for me when I read his words. He had never met me but because of his own struggle with depression he was able to understand me and care for me as another struggling fellow.
Emails turned into coffee conversations. He became my guardian angel that never judged me, but was just there to listen, to support. They say that people with depression withdraw but this is not always the case. People with depression can be concerned about others who are suffering. They know it is a lonely place. I didn’t want to socialize with others, not even through texting but being in daily contact with him made me less anxious and less lonely. I was in a dark place but I felt like he was waiting for me to come out. He became very worried one day when I didn’t reply to his messages. He was worried that I had committed suicide. He was not overreacting as just weeks before I had been calling the suicide prevention hotline. I have known people who have taken their own lives. In reality I was just in a meeting and hadn’t been checking my phone but I was touched that he cared and had been looking out for signs of suicide danger.
There were many more instances like this that got me through my depression. I couldn’t have imagined going through it without him. Now he’s one of my best friends!
I am glad I looked for support, and I was lucky to find it.
Since Oct 2015, I have been running a peer support group for people with depression, mania and severe anxiety in Beijing. I couldn’t find one when I needed it and so a year later, I created one.
Take a break from life:
I wanted to take a break from everything. I googled “run away” “travel” “take a long break”. Nothing seemed like a good option. I felt so stuck and helpless. I couldn’t t just stay at home, or just travel without purpose. At an office lunch one day, my colleague mentioned a mindfulness center in Thailand. It’s yoga, meditation, agriculture, art workshops for people with addiction and depression. I looked up online, and sent out the email immediately. I finally found a place to lay down my soul.
I registered in June, and earliest I could go was September. In between, I would open their website every day, just to look at the pictures and blog posts. It’s something that I actually was looking forward to, the only thing! Every day, I looked at their website, knowing that I was going somewhere allowed me to take a deep breath. Looking forward to something got me through each day in hell.
I was no longer in my depression by the time September arrived. I still went to Thailand for the planned month. That turned out to be the best thing I’d ever done. Take a look at the center here. (http://www.newlifethaifoundation.com/). I integrated mindfulness into daily practice, and I met so many inspiring people each of whom had their own stories.
It’s been two years since then. I am a lot more advanced in my mindfulness practice. This has helped me to stabilize my mood in a significant way. I am now an advocate for mindfulness as a tool for mental health.
Continuing on from the strategies mentioned in Lesson 5.2, we will not look at some more methods.
Depression Strategy #3: Practice Taking a break from stressors, keeping a routine, and reaching out for help are common ways to cope and heal. When you are on a break, manage your daily schedule with a healthy routine. If you can’t, go stay with people who can help you, or go to a mindfulness center or a rehab center that has a structure for you.
At New Life Foundation in 2014
Medication: will it help?
It had been a question for me for years! I had always been a bit anti-medicine, even when I was in the major depressive mood. “I don’t know if it will work”, “It will give me so many side effects”, “I don’t know if I can trust the doctors, what if I get a bad one?” “I have to take them for years, don’t I? I don’t want that” ”My friends who have been on meds told me to be careful…so I don’t know” these were the questions that I had in mind. It had been a long and slow process for me to think it through, and I still could never make up my mind.
I read countless research papers about the effectiveness of anti-depressants and this only made me even more confused. Taking meds is trial and error and you cannot be certain about what will happen when you start. I decided that is was time to have an answer and that the only way to find out what that answer would be was to give meds a try if I had another encounter with major depressive disorder.
The decision was based on:
I will risk my life again if I don’t let the professionals try. I will be in no place to decide for myself.
I can’t decide from fear. Hope for the best is a better strategy.
Accept that meds won’t always work, and give space for failure.
I started to get low again just a few months later and I adopted my new strategy, I responded accordingly. I went to the hospital, and the doctor prescribed me a mood stabilizer. Very fortunately, I responded to the meds so well that I felt normal again after just a few days.
However, do not count on medication to do all the work for you. It can only help you get up on your feet. You will still have to do the walking. So going back to the well-being list, this is when you start to tick the things off.
Depression Strategy 4: Don’t be afraid to try medication Go for professional help, and do not fear medication. The person prescribing the meds is a psychologist, or psychiatrist and they have the skills required to help you. Know that they are trying their best, but even so, will not always be able to find the best solution for you right away. They learn from the failed prescriptions, and this knowledge helps them to figure out what will be best for you. Give them and yourself the space and patience for failures. It’s very difficult to have patience in this sort of situation but there are ways to cultivate it.
Mindfulness has been used in eastern culture for thousands of years for mental well-being. Mindfulness can help you to cultivate patience.
I mentioned how yoga helped me to cope during my MDD, but it’s not only for when you are already in a depression. It can also be used to keep us healthy. I completely trust the healing power of our body and mind if we listen to its signals and nurture it.
Meditation intro workshop by CandleX in March 2016
I have been practicing mindfulness intensively since late 2013. Now almost every day, I do yoga and/or meditation for at least 1 hour; I have been on many mindfulness trips to Thailand, and I am going to go on more. I have started to lead yoga session in Beijing as a volunteer teacher, and have organized workshops on meditation so more people can learn about this tool for their well-being.
What have I gotten out of it?
It pulls me out of burn out by quieting my thoughts for a moment on a daily basis. It’s like turning off your computer Meditation intro workshop by CandleX in March 2016every day to give it a rest so you can use it again tomorrow. Overuse of your computer can lead to serious crash. For our mind, we call this crash a nervous breakdown. Our mind is that computer, and any moment we create a space of emptiness, we are resting our minds so that we sustain optimal function.
It stabilizes my mood and equips me with emergency toolkits. I am impatient, competitive, highly sensitive and a perfectionist. These are all characteristics of people who are at a higher risk of depression. Yoga has helped me to learn to be patient.
In 2014, when my boss told me that meditation would help me, I didn’t think so at all. I was so depressed that I found meditation impossible. However, now mindfulness practice are the tool for me to use to cultivate all that I need to get me through difficult times.
I think of this as a first aid bag. When times get rough, I need to open it. If I don’t cultivate self-awareness, acceptance patience, love, kindness, and forgiveness, on a daily basis then my bag will be empty.
Depression Strategy 5: Mindfulness Practice You will find meditation difficult if you are already in a depression. So yoga is a better choice. When you are in remission, it’s the best time to embed a mindfulness practice into your weekly schedule to raise your threshold for depression.
I made it. I came through depression. Never would I have imagined that I would create a community organization to advocate for mental health, and provide psychosocial support for people with depression. Looking back on my story with depression, it has torn everything down so I could build something even more beautiful. Trust life.
So there it is, Xiaojie’s experience in dealing with depression. To summarize, there are 5 major factors that had an impact on her healing process: attitude, knowledge, medical care, practice and mindfulness.
Attitude – accepting, patience
Knowledge- understanding of depression
Practice- Take a break from stressors, Keep a routine, reach out for help
Medication- Don’t be afraid of professional help, but be prepared for try and error
Mindfulness– prepare your first-aid bag
With depression, there’s no going over it, or going around it, there’s only going through it. Live your life one day at a time, try to do the right thing. There is a light at the end of the tunnel even though you can’t always feel it, just trust it.