Monday, November 10, 2008

Managing a Depressive Episode (Part 1)

In the last few years I've learned to think of depressive episodes in a new way. Rather than feeling there is nothing I can do about them--aside from taking medication and hoping it works--I now realize there's a lot I can do to minimize the symptoms.

In my case, during a depression, I take Adderall in order to get out of bed in the morning. For me, the depression saps so much energy that without the medication, I would sleep all day--until it lifts, and that's presuming it does lift.

However, unlike an antidepressant (when it's effective), Adderall doesn't make me feel happy, it just gives me energy. So, it's really important for me to start my day quickly and get out and about or at least begin moving.

First thing, I eat protein for breakfast, which is something I need. I also drink one cup of coffee. I need it as a stimulant although I only drink one cup a day. If I take more than 30 mg. of Adderall, I can't drink coffee, however, because the extra dosage gives me a "bad" stomach and the acidity of the coffee is too much. In that case, I eat yogurt for breakfast because it's soothing and I eat whole wheat toast for roughage.

During a depression, it's particularly important for me to make lists--before I go to bed--of what I'm going to accomplish the following day. When my son was younger, and when I worked as a freelance writer, I made different kinds of lists. Early on, I learned that depressive episodes affect my memory, so I made sure that I listed all the tasks I needed to do for my son, husband, and my clients.

Now that my son is older and I'm semi-retired, my lists are different. While I go to class twice a week, and while I am writing a book, I have far more freedom to do what I want during the day. But if I'm not feeling terribly well when I awaken, it's very important to know what tasks I want to accomplish, or what activities I want to participate in, so that my days are pleasurable, and yet I also feel I'm doing what needs to be done.

What I've learned is that if I have activities lined up, I'm always happier. If I complete tasks, I feel a sense of accomplishment. If the weather is good--and it usually is in Los Angeles--it's very important for me to spend part of the day outside--whether it's weeding, gardening, doing home improvement chores, or exercising. Sunlight is a key element of my wellness program, and the earlier in the day I spend time outside, the better I feel.

Unlike years past, the book I'm working on is a long-term project, and I don't have a deadline. So...I don't have to spend time indoors writing every day. And for me, that's very important. I spent about 20 years writing indoors--working at least eight hours a day--and I now know that it contributed to my depressions.

At the time, I was happy I could work even though I felt depressed. What I didn't know was how important sunshine is for my well being. Now that I do know it, I make sure I get enough sun to "melt the blues."

(to be continued)

14 comments:

NAVAL LANGA said...

To Ms. SUSAN BERNARD

I have just read some of your posts. I would like to read the rest later, as I liked the frankness and simply rich language you used while writing.

I am a writer. If you are interested in short stories and paintings, then a flying visit to my blogs would be a good idea.

Naval Langa

Wellness Writer said...

Dear Naval,
Thank you. It's almost midnight in Los Angeles so I will drop by your blog sometime tomorrow.

Susan

Mariposa said...

Hi Susan...

Just got back...has been around...and was lurking in your past posts...nice thoughts and I couldn't pull myself together to make some nice comments! LOL

But this...oh my! I love this post...and it's easier for me to relate to this...as you know, I've been "out" of medication and the approaches you mentioned here suits me well!

You are so true...I do take drugs and other supplements when I am about to hit my lows...but they don't make me happy...to do that would be to "fool" myself...and will not make me in control of what is really going on within me. I do however, take something that would be give me energy to keep my going and pre-occupied!

Coffee is one...of the many things that help my get by and keeps me going...

Making a list on what to do is very helpful as well! Before I go to bed...so down and not finding a reason to wake up the next day (yes, it does feel that way at times!) to have a list of what to do makes us feel wanted and needed! So most of the things I put in my list are things that I can do to people and society. It does the trick! :)

Oh...for other things that keeps me going aside from coffee...Vit. B Complex...I bombard myself with it! I sometimes get a shot from my doctor...aside from the oral pills I take! ;)

susan said...

Susan -

I would love to read your book! Do you have any for sale- at Amazon or Barnes and Noble?

I am working on 2 books right now, one fiction, one non fiction.

Only a Beeper would do that, right?

I lived in LA too- one year. Too much rocking and rolling for me and I am not talking about music!

-Susan S.

Wellness Writer said...

Dear Mariposa,
Glad to have you back. As far as I'm concerned, you never have to worry about writing "nice comments." I'm just glad to know you're here and that anything I'm writing is helping. Even if you just say, "Hello," it's enough. I realize that with shifting moods, sometimes "hello" is all we can say.

It's interesting that you and I both need stimulants, even if it's just coffee to get us going. And I have often wondered about whether Vitamin B complex shots would work. It truly makes sense to me.

Yes, lists are good, and activity is important in the "down" times. Since that's my normal state of being in the "up" times, sometimes it's just good to "model" that behavior when I'm feeling low. And surprisingly enough, once I do, I often better.

Susan

Wellness Writer said...

Dear Susan,
Both The Mommy Guide and The Mommy and Daddy Guide to Kindergarten are available through amazon.com., although they're out of print. But they're on parenting, and I'm not sure you'd enjoy them.

The book that you might enjoy is Bipolar Depression Unplugged: A Survivor Speaks Out. It's available as an eBook through chimpmunkapublishing.com.

Yes, it is only a "beeper" who would work on two books at once (smiling face).

I'm a rare breed: a native Los Angelino. My grandparents moved here in the 1920s. My parents were born here, and so was I. So, to me it's home. And...believe it or not...it's low-key and family-like.

Susan

Bradley said...

I agree that it's important to have a schedule. Each day I have one listed on my computer and it helps to motivate me on most days except for the occasional "can't get out of bed" ones.

Wellness Writer said...

Bradley,
Yes, we all have those days as well, but for me, they are now few and far between. It's truly a miracle. And, it's interesting to see how many people do use lists.

Susan
P.S. Hope you're recovering from the Proposition 8 fiasco. Glad to read in the Los Angeles Times about the demonstrations and the governor's comment that it may be illegal to change the California constitution.

naturalgal said...

I shouldn't drink coffee, but I do. I like the list idea. I try to do it but sometimes I get so busy I forget to look back on my list.
So if I just just set a timer ever hour to look at my list I would be more focused.

KJ said...

I love this. It is good advice for anyone and I intend to follow your example, but boy do I wish I could get Joe to take charge like this. Well done!

Wellness Writer said...

Dear Naturalgal,
Well, I can add you to the coffee drinker's list (just kidding). It does help to remember to look at the lists (smiling face), and the concept of using a timer is an interesting one.

Susan

Wellness Writer said...

Dear KJ,
As far as I can tell, the only way to truly control this condition is to take charge. I've been doing it for so long, I don't even think about it. It's just a part of my routine.

And in a way, I feel like monitoring my moods is somewhat like monitoring diabetes. Each morning my mother used to measure her blood sugar.

Each morning, I monitor my mood to figure out what I need to do to feel as well as I can.

Susan

Immi said...

Great tips, Susan.

As for the coffee-Adderall issue, have you tried a super-smooth coffee like Jamaican Blue Mountain or Sumatra Mandheling? They're two don't mess my stomach up in spite of my severe gastritis caused by, you guessed it, meds. The Jamaican Blue Mountain is best, but the most expensive. The Sumatra Mandheling from CoffeeAndTeaWareHouse.com is almost as good.

Wellness Writer said...

Dear Immi,
I haven't heard of either type of coffee. Thanks for letting me know.

Susan