Try these self-guided practices in mindfulness and cognitive behavioral therapy.

By Seth J. Gillihan, Ph.D. (From Psychology Today Website)

If your mood has taken a serious hit in the past few months, you’re not alone. The predicted wave of depression appears to have arrived in the wake of the COVID pandemic. A recent report from the Centers for Disease Control and Prevention (CDC) signaled alarming rates of depression symptoms in the US. Overall, 24 percent of respondents reported marked symptoms of depression on a health questionnaire—four times as many as a year ago, when the world was mostly normal. Roughly the same number were experiencing high anxiety, which is triple the rate from last year.

The rates of reported depression symptoms were even higher among certain groups. Fully half of young adults (ages 18-24) showed relatively high scores for depression. Income was also significantly related to rates of depression, with those making less than $25,000 being nearly twice as likely to be classified as symptomatic by the researchers, compared to those making more than $200,000 (31% vs. 17%). About 45% of unpaid caregivers for an adult also met that bar, as did nearly 70% of those being treated for posttraumatic stress disorder (PTSD). (Surprisingly the rates for men and women were essentially equal, whereas women typically are about twice as likely as men to experience depression.)

If an evil villain wanted to create a depression epidemic, they might choose conditions that look a lot like the fallout from the COVID pandemic. Start with a tremendously stressful and uncertain situation. Then take away employment, enjoyable activities, and the physical presence of family and friends. And make sure there’s no end in sight for these disruptions. It’s no wonder so many are experiencing depression.

Common symptoms of depression include:

  • Feeling down, “blue,” or emotionally numb
  • Difficulty finding enjoyment in anything, even activities you usually enjoy
  • Trouble sleeping, or sleeping a lot more than usual
  • Changes in appetite—either increased or decreased
  • Difficulty concentrating, or trouble making decisions
  • Being physically slowed down, like you’re moving through mud; or, physical agitation, like it’s hard to sit still
  • Feeling terribly guilty, or thinking you’re worthless
  • Physical fatigue: feeling tired all the time
  • Thoughts of death or of ending your life

This mental health crisis is made worse by the difficulty millions of people are having in getting effective treatment. It wasn’t easy to find mental health treatment even before the pandemic, given the shortages of providers and the difficulty in affording costly services that are often out of network. Now there are additional barriers as people lose their jobs and their health insurance.

Thankfully there are effective treatments that can be self-administered. While therapy is valuable, research studies have shown that the proven techniques of mindfulness and cognitive behavioral therapy (CBT) can be helpful even without a therapist, especially for those with mild to moderate symptoms.   

Finding Relief

So what can help? Three approaches have substantial support for their effectiveness:

  • Think: Training the mind (cognitive therapy)
  • Act: Doing life-giving activities (behavioral activation)
  • Be: Practicing present awareness and openness (mindfulness)  

(For more on effective depression treatments see “27 Facts About the Best Ways to Treat Depression“.)

Here are five ways to put these approaches into action.

1.    Mind Your Thoughts

Our minds are constantly telling us stories. When we’re feeling down, the stories tend to be really negative:

  • Nothing ever works out in my life.
  • I’m such a failure.
  • This is hopeless.
  • People would be better off without me.

I know these thoughts well, not just as a therapist but from my own struggles with depression. Even though I know they’re probably not true, they sure feel true at the time. And they can contribute to depression.

We don’t have to convince ourselves that these stories are fiction. We can just remind ourselves that they’re creations of the mind. And there are alternative stories that aren’t so disheartening, and are probably more accurate.

Maybe we’ve had some failure in our lives … and also a lot of success.

It’s true that some things haven’t worked out … but other things do.

And while we may not be the person we wish we were right now … it’s categorically false that people would be better off if we ended our life.

Action Step: Start to notice the thoughts you’re having, especially when your mood takes a nosedive. What went through your mind just before? What did you tell yourself? And then write it down (that part is important). When we can capture these stories, we’re in a better position to start to question them, and to drain their power.

2.    Move Your Body

What’s as effective as antidepressant medication, has many positive side effects, and is available for free? Physical movement. Research has shown that walking, jogging, running, weight lifting, and other forms of exercise can reduce depression. More intense activity generally produces more benefit, but any movement is better than none.

It may be helpful not to think of it as “exercise,” which often sounds like a chore—something you “should do” but don’t want to. Instead, ask yourself what type of movement your body is craving. Is it walking with a friend? Dancing in your kitchen? An online yoga video in your living room? Find any way to move the body, especially in ways that are fun. In addition to the mood boost, it’s also helpful for sleep.

Action Step: Plan one step to increase your movement today. Make it as small as necessary to make it doable. Maybe that means a five-minute walk around the block. Just take the first step (pun sort of intended).

3.    Consecrate Your Sleep

Speaking of sleep, there’s a close connection between sleep and depression. We often sleep worse when we’re depressed, and poor sleep can contribute to depression. And while we can’t guarantee sound sleep every night, there are things we can do to sleep more soundly.

First, treat sleep like it’s sacred. Make space for this rest between the day behind you and the day ahead. Treat it as an exercise in trust—that you can let go of doing, worrying, and problem solving. To this end, set aside a time for winding down at the end of the day as a buffer before bedtime. Stop working. Put screens away. Take 30 to 60 minutes to read, enjoy low-key conversation, do bedtime yoga, or anything else you find calming. And then open to receive the gift of sound sleep.

Other specific practices that make for healthy sleep include:

  • Keep a consistent bedtime and wake-up time. This will create a strong circadian rhythm, which helps your body and mind know when to expect sleep. Aim to stick to this schedule even after a poor night’s sleep.
  • In general, avoid daytime naps. Sleeping in the day tends to interfere with solid sleep at night. If you do nap, keep it short, and do it earlier in the day.
  • Get out of bed if you’re not able to sleep. Staying in bed when we’re awake and frustrated can cause us to associate the bed with being awake and stressed out. Do something relaxing like reading for a half-hour or so before going back to bed.
  • Beware of short-term “sleep aids.” Chemicals like alcohol may knock you out, but they don’t provide high quality sleep. And in the long run they can create an unhealthy dependence.

Action Step: Take some time to plan an enjoyable winding-down routine that will prepare you for sleep.

4.    Be With People

Good relationships are antidepressants. Aim to spend more time with those you love, whether in person (if possible), or by phone or video conference. Be creative if need be—go for a social distance walk with a friend, speaking by phone within sight of each other. Watch a movie “together” with someone, even if you’re not in the same location.

And as hard as it might be, look for ways to improve others’ lives—yes, even when you’re struggling. The self-focus of depression is its own form of punishment, and frankly gets boring, as I know from personal experience. Look for any opportunity to show kindness to people in your life. Research shows that helping others is a powerful mood enhancer.

Action Step: Text a friend or family member to set up a time to talk, whether in person, by phone, or by video. Be sure to ask how they’re doing.

5.    Open to the Present

Finally, step into the moment, exactly where you are. Depression is made worse when we’re focused on the future, imagining we’ll always feel this way and that things will never get better. There are countless ways to practice presence, including meditation. Any activity is an invitation to really do what we’re doing, rather than being stuck in our minds and an imagined future.

Being present isn’t just about not living in the future. It’s really about coming home to yourself, because you only exist in the present: your body, your feelings, your thought processes. We can find our spirits there, too—the deepest parts of ourselves that are always with us, and that are undiminished by any challenges we’re facing. That’s where we find our strength and resolve to keep facing each moment of our lives.

Action Step: When you wake up in the morning, greet yourself before you start the day. Take five calm, deliberate breaths, slowing down the exhale. Notice how things are for you—thoughts, feelings, physical sensations. Begin your day from a grounded place of connection with yourself. (For more on mindfulness and stress reduction, see “5 Simple Ways to Manage Stress and Anxiety Every Day.”)

More than anything, be good to yourself—now and always. These are stressful times. This is hard. None of us have done this before. And we’re doing the best we can to figure things out. Whatever you do, don’t give up on yourself. You’re worth more than you can imagine. You’re here because the universe imagined you into being. And there’s more strength in you than you know, the strength to face the challenges of each day.

If you’re experiencing significant symptoms of depression, contact your doctor to discuss options for treatment. You can also search for a therapist with Psychology Today’s Find a Therapist search feature.

References

Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon