Bouncing back after ... Depression

One of the worst things about depression is the fear of its return. But Suzanne Harrington, who suffers with mild depression, says learning the tools of resilience is the key

“If you can start the day without coffee / If you can always be cheerful, ignoring aches and pains / If you can take criticism and blame without resentment / If you can conquer tension without drugs / If you can relax without alcohol / If you can sleep without sleeping pills…./ Well, then, you’re probably the family dog.”

This is an abridged version of Inner Peace, an anonymous poem included in Matthew Johnstone’s latest publication, The Little Book of Resilience.

Johnstone is the Australian author and illustrator of I Had A Black Dog fame, the brilliantly simple book about depression. Resilience is his sixth book on the subject of mental health and wellness. Like his Black Dog books, it provides some humorous and beautifully illustrated insights into what emotional and psychological resilience really means.

It is not, he says, “the secret ingredient in a fancy age-defying face cream”, but your ability to deal well with whatever life throws at you without allowing events – good or bad – to define you. Life, Johnstone reminds us, is full of “hills and dales” – love, heartbreak, dreams, realities, success, failure, health, illness – none of which we have any real control over. Our only control lies within our own responses.

READ MORE: Depression has been my greatest teacher .

“We all set out with this ideal that life will work itself out, we’ll get the right job, meet the right person and live happily ever after but life doesn’t always play fair, and stuff happens along the way that can really test our metal,” Johnstone tells me. “Resilience is really about growing or bouncing back from something that challenges us.

“People often find they have inner strength they never knew they had. Lives can change for the better after an adverse event because it draws focus to what’s really important, it heightens values, we discover who our real support base is. Obviously there’s vastly different levels of adversity but whatever it is, it doesn’t need to define us; it may change us but with time, patience, understanding and a big dollop of vulnerability and self compassion, we can come out the other side kinder, wiser, stronger for it and live with more purpose.”

Johnstone has lived long term with bouts of depression – his black dog – but with resilience and what he terms ‘good life management’, he has used his depression to help others via his books and by founding the Black Dog Institute.

This is not, however, a call for people with serious depression to leap up and do something; serious depression requires serious treatment, and left untreated, can be fatal. It’s quite a spectrum: many people, myself included, have ongoing mild depression, which once diagnosed, is entirely manageable, whereas others have serious depression, which left untreated, can result in suicide (my former husband died of this illness) . Self-help is of little use to anyone needing hospitalisation – but as you recover, identification with others can help with a realisation you are not as isolated as you perhaps feel.

Matt Haig is the author of Reasons To Stay Alive, which outlines his serious breakdown at 24, suicidal intention, and slow recovery. “Minds are unique,” he writes. “They go wrong in unique ways... But I have found that by reading about other people who have suffered and overcome despair, I have felt comforted. It has given me hope.” Other tools to build resilience include training your mind to see difficulties as a challenge that can be overcome, working hard on being positive, developing goals in your life and sticking to them, learning that you can only ‘control the controllables’ and to stop blaming yourself when something goes wrong. Also on a bad day, remind yourself that , ‘this too will pass’.

Nor does depression automatically mean a lifetime of medication - a recent report in the Lancet outlines how mindfulness-based cognitive therapy could be used instead of medication in its treatment.

Over a two year period, a group of people with depression were split in two – half were treated with mindfulness, the other half with medication. The relapse rates were similar – 44% and 47% respectively.

“There is a significant demand for our courses and workshops, to build resilience and help weather the storms,” says Kathleen Fahy of Dublin’s Sanctuary Mindfulness and Meditation Centre. “It’s more formalised in the UK, where doctors regularly prescribe Mindfulness-Based Stress Reduction (MBSR) courses through the National Health Service. We get lots of people self-referring with anxiety or mild recurring depression who want to manage their condition. We also train professionals and there is a specially designed curriculum for children and teenagers.”

When it comes to good mental health and the ability to live life without frequently crumbling, the old cliches - attitude and outlook, diet and exercise, reflection and pause -linger for a reason. They work.

READ MORE: Depression has been my greatest teacher. 

Tips on how to manage your recovery:

1) Good communication: No one can help you if you’re not able to communicate what’s going on in your life. No one can help you if you don’t know how to ask for help. For many it’s incredible difficult to speak openly, honestly or from a place of truth or vulnerability. It’s not that we need to blab out our woes on social media, it’s more finding our circle of trust and being okay about asking for help should we need it.

2) Meditation: Sitting with yourself can be one of the hardest wellbeing activities because many of us have beehives for minds. People often say ‘I tried meditation once and I just couldn’t do it’. It’s like saying ‘I went for a run once and when I came back I wasn’t fit’. Meditation is literally and metaphorically a practice. In this modern age our minds are busier than ever. It’s not about turning off a tap of thought - it’s more taking a boiling pot of water down to a simmer. There is huge benefit in learning to quieten the mind. When we do we become calmer, happier, more engaged and more productive.

3) Mindfulness: One of the best by-products of meditation is mindfulness. In it’s simplest form, it is engaging with all your senses, in the here and now. It’s about accepting whatever you’re doing or feeling without judgment. We can practice it by slowly washing the dishes. Really listening to what’s being said in a conversation. Engaging with what you’re eating and eating it slowly. Bringing all your senses to the forefront of wherever you might be. Try slowly turning your shower from hot to cold and notice how heightened your senses become. It’s impossible to be present all the time but with practice we can become a lot more self-aware and in control of our emotions and situations that can catch us off guard.

4) Exercise: If I was really honest I’d have to say that I’m not naturally ‘fitness inclined’, but I do try some form of exercise four or five times a week, whether it’s going for a run with my dog, going to the gym, or going for a long walk with my family. Research shows regular exercise is as effective as antidepressants for mild to moderate depression or anxiety (and that doesn’t include the vast physical benefits). So walk to work, take the stairs, get off the bus/train a couple of stops early, don’t have lunch at your desk. Like meditation, start small and go from there.

5) Diet: If you eat a lot of rubbish there’s a fair chance you’re going to feel the same way. Australian author, David Gillespie who wrote Sweet Poison, says how in the 1800s we had about two teaspoons of sugar a day if we were lucky, but on average now we consume around 45 teaspoons a day which is wreaking havoc on our physical and mental wellbeing.

People would be amazed how amazing they would feel if they tried giving up the usual suspects of caffeine, sugar, wheat, meat, dairy and alcohol for four to six weeks. But all I can think of as I’m typing this is the panic of the people thinking ‘what would I eat?’. It’s not that you have to give up the bad stuff forever, but once you’ve outed it from your system you won’t feel like it as much and for that your body and mind will thank you.