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Antidepressants

Other strategies for managing depression

All of the people we spoke to were either currently taking an antidepressant or had taken one in the recent past. Although many felt that antidepressants helped, most believed that it was important to find other ways to help with symptoms of depression; to aid ‘recovery’, or to maintain a sense of wellbeing when they had stopped taking antidepressants. Typically people said it was important to have therapeutic support alongside taking an antidepressant, because taking medicines could relieve symptoms, but did not deal with ‘root causes’ of depression. Not everyone had access to therapeutic support, but some found that talking to friends and family was helpful. Emily makes a conscious effort to talk to others whereas in the past she often hid her feelings. ‘I make myself talk as well… make myself talk to my current boyfriend, and to my friends and my family’. 
 

Sharon’s therapist encouraged her to talk to other people about...

Sharon’s therapist encouraged her to talk to other people about...

Age at interview: 37
Sex: Female
Age at diagnosis: 22
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Another thing that the therapist taught me is to look out for signs of how I act, how I react and how I think about things and I can tell when I'm not quite right and having discussed that with my friends as well, my colleague at work, we're good friends, she knows just from when I walk in or even from a text message and my current partner will know if I'm not right because they know the signs to look for and then they can jump on it straight away and say, "Well hang on, you know, are you OK, are you struggling?" And I've learned to say, "Yeah I am struggling today," rather than just say, "No, no it's fine, it's fine," but admit that you know you can’t do everything all the time.
 
And you say you've got a new partner?
 
Yes
 
And is it easier to be with somebody that understands?
 
He's, I was very open with him right from the start and he said he wanted to know everything so I told him everything and he stayed, he didn't run off. He's very supportive, he doesn't know always know what to do but again he'll say, "I don't know what to do," rather than just ignore it or be quiet. Any reading or anything that I've pointed him to, to help he'll look at, he'll engage with it. He'll ask, he wants to know how he can help and what he can do.
 
Mm. Sometimes it's and people say you know it's not that you want someone else to fix things for you but just to hear you and listen.
 
Yeah just to listen and hear, not just let it wash over.
 

Stephen’s doctor didn’t just give...

Stephen’s doctor didn’t just give...

Age at interview: 48
Sex: Male
Age at diagnosis: 44
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My doctors have been my therapists because they are willing to spend the time. If I’d simply gone in and they said ‘oh you’ve got depression here’s some pills ‘then I might have said ‘oh is there anything else I can do’? But the fact they are willing to spend half an hour just chatting and talking through the problems, I won’t mention it here but I think some of the things that kicked off the depression years ago... I’ve discussed my doctor we, I think I know what caused the initial attack put it that way.
 
So you’ve had some discussions about not just medical things but about how you feel about things with your doctor and that’s helpful?
 
Yes.
 
And so is that to the extent to which you feel you need that kind of talking help or would you have liked to be able to have counselling or any kind of other therapy?
 
I don’t, as I say I get enough from my doctor but I’ve got my family at the other end of the phone line if I do feel low I just get on the phone and phone my mum or my dad or my brother or whatever and just have a 20 minute chat just talking things through, that helps. So I think I’ve got a very good family unit around me.
Many of the people we spoke to said they had found other ways to help boost or maintain positive mental health as well as taking antidepressants. Simon, who is a GP, advocates that everyone should be attentive to their mental health, regardless of whether they have experienced depression. ‘Even if you’ve never had a mental illness you may not be living a mentally very healthy lifestyle, there’s lots of things that we can do to improve our mental fitness’. Thomas decided antidepressants were not the answer for him, and felt that doctors should be more willing to ‘look at the bigger picture’ of people’s lives. He suggested that rather than prescribe antidepressants so readily, health professionals should spend more time giving people practical support. ‘[They could] write all sorts of letters which will help people get social housing, help get benefits. There are a whole range of things that everyone from a consultant psychiatrist to a CPN to a psychologist to a nurse can do for people that will help them in a practical base. Look at the practical things. That’s what’s going to help them in the longer term’. Gerry felt it could be all too easy to rely on antidepressants to solve things. (See ‘Talking therapies and antidepressants’, ‘Antidepressants: telling family and friends’, ‘Expectations about taking antidepressants’ and Feelings about using an antidepressant). 
 

Gerry thinks people have too...

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Gerry thinks people have too...

Age at interview: 31
Sex: Male
Age at diagnosis: 29
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I do believe this like depression is, is one of those illnesses where you can, it’s like you can live with it for years and almost become a victim of it, you know, and maybe that’s where antidepressants don’t help as well, you know you can I don’t know you can almost see it as an easy way out, you know, ‘things aren’t going well for me I, you know I’m suffering from depression I’ll just take some antidepressants and I’ll feel better.’ I definitely think that you as an individual need to take ownership of it as a condition and seek, and seek help and never ever look to blame depression for what, do you know what I mean, that is quite important to realise you’ve got it to realise it’s an illness and realise you can get better rather than keep going on ‘oh I’m really prone to depression and the reason I’m doing or I’m feeling like this or I’m not doing well and not getting a job is because I’m depressed’ because then it becomes sort of self-reinforcing.
 
Yes I see what you mean, so it’s no good just taking tablets and then expecting them to do all the work for you and kind of address your life in some way.
 
Yes, yes exactly. You’ve got to really take ownership of it. Otherwise it’s just, you know, like I say the analogy of it’s just like getting a heart operation but not doing anything about changing your lifestyle, you know, what’s, what’s the point.
Some felt that taking an antidepressant had helped them to start to think more clearly about their lives and to reach a headspace where they could begin to work through problems, but they had also come to recognise the importance of engaging in activities that helped them to feel more positive about life. Thomas disagreed with the traditional ways of thinking about how to treat depression.’ I don’t think it’s a science. I don’t think it’s something that you can treat. It’s not a condition, it’s something which is so tied up with so many other things in your life, your housing, where you live, how many friends you’ve got, that’s really, it something huge, and that has to be treated in a kind a completely kind of individualistic and holistic way’. Some said that their therapist or counsellor had helped them to appreciate the importance of finding ways to help them move forward. Melanie was taking steps to set herself goals, albeit small ones such as walking to the shops, but said when you’re depressed it’s sometimes difficult to motivate yourself. ‘I’ve got the sensibility to know that that’s what I should be doing but at the same time my minds not always, you know, allowing me to do that’. Andrew had begun to think more carefully about his diet. ‘I’ve got a diet sheet and I’m going to try and follow that. And until, until you know quite recently now I would have just felt, nothing could help me, nothing could help me’.
 
There are numerous strategies that people can adopt that help promote positive mental health. Mind, and other mental health organisations provide lots of advice about different strategies that can help. These include;
 
  • Building healthy relationships with people – friends, family and work colleagues.
  • Looking after your physical health – sleep, diet and physical exercise.
  • Doing things you enjoy.
  • Doing things for others.
  • Setting yourself a challenge.
  • Learning relaxation techniques.
  • Identifying mood triggers and learning to be self- aware.
  • Looking after yourself during difficult times.
  • Learning to accept yourself.
 
People we spoke to had discovered a range of activities and strategies that helped including; going to the gym, walking, running, martial arts, talking to friends, family or colleagues, setting themselves challenges, meditation or visualisation techniques, mindfulness, acupuncture, aromatherapy, yoga, reading, writing, keeping a journal or mood diary, joining a book club and volunteering. Some said that they had changed jobs or thrown themselves into work as a distraction from difficult things that were going on in their lives. Andrew took up a new hobby. 
 

‘At work I knew another person who was interested in playing...

‘At work I knew another person who was interested in playing...

Age at interview: 50
Sex: Male
Age at diagnosis: 49
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I’ve started to play the ukulele and so I go to this thing on a Monday which I would never have done when I was depressed at all - never have dared go along to something like that because I, you know, would have been terrified about what they thought of me which is ludicrous because everyone who has a passion wants to share it so if you have a passion going along to a club but shares your passion because people just embrace you so anyway. So I thought let’s start a club at work I knew another person who was interested in playing the ukulele so we sent an e-mail around and suddenly ten of these people who were interested in playing the ukulele, came out of the woodwork, came along and so we’ve got a group that’s going to meet weekly.
 
And that sounds like something you, you know, like you said you would never have organised when you were feeling.....
 
No I would never have organised it.
 
When you were feeling bad.
 
No, no, no, no.
Andrew had also started to be more appreciative of small everyday things that he felt now enhanced his sense of wellbeing. ‘When I walk to and from work I try and make a point of seeing something new and you can do it, you know, it’s astonishing actually what you don’t see and what you do see’. Stuart keeps a mood diary and finds it helps to be able to look back and notice patterns, to see the ‘ups and downs’. 
 

Simon says that keeping a mood diary can help promote positive thinking.

Simon says that keeping a mood diary can help promote positive thinking.

Age at interview: 31
Sex: Male
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A couple of strategies that I put into practice, one was having a well- being diary, so one of the things that people who are depressed including myself often do is go to bed thinking about everything that went wrong during the day and all of the things they have to do tomorrow and worrying about how I’m going to make my life better. So it’s making a deliberate effort to say okay what went right today, why did it go right, you know, and especially looking for reasons within yourself when things go right.
 
Writing down when you have a tendency towards pessimism which, which I do and I think most people who suffer depression often do. When something good happens it happened just that once and it was because of somebody else and it will probably never happen again. When something bad happens it was because of you and it happens all the time in every area of your life, okay. so the using the gratitude diary is actually saying okay this has happened and it happened for a reason and that reason was something to do with me, even if that was just, you know, I was walking home and there was a really beautiful, you know, autumn trees there and I noticed them and it was great and the sun, you know, and I noticed that because I wasn’t looking down at my feet worrying about tomorrow I was looking up and I was paying attention to the world around me and that was something that I’d chosen to do okay. So looking for the positive aspects of the day and recording them and writing them down. and doing other things such as writing a thank you letter to somebody that you’ve never properly thanked for something as well, yes it has a big impact on them but it also has a big impact on you and one that lasts. So they’re what I mean by the kind of gratitude interventions.
 

Stuart recommends a website that helps track your mood

Stuart recommends a website that helps track your mood

Age at interview: 52
Sex: Male
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Will you explain what the mood diary’s all about?
 
Yes I, since that first episode every day I keep a record on a one to five score where three is okay as sort of the average how I’ve felt on average that day and then I just put that into a spreadsheet and just produce a little graph from it so I can see what’s happened over the year. I now use a website called Moodscope which does all that for, you produces all the graphs and Moodscope’s very good because it also, you can set it up to send an e-mail to someone else so I have it set up so that every time I, they have a questionnaire for determining your mood, but every time I do that and get a score it gets e-mailed to my wife [name] And actually that works well for a depressive because when you’re going down sometimes you start to withdraw and actually you may not talk about it but [wife] will know that I’m going down and so she can, she can sort of step in and say ‘Look your scores are going down we need to be aware of that,’ and ‘What’s happening?’ and so.
 
That sounds really useful.
 
It is, very yes.
Taking regular exercise was one of the most popular activities that people said had brought tangible benefits. It doesn’t need to be anything too energetic, some people said it helped just to take a walk to the shops and get some fresh air. Stephen feels that ‘It’s been exercise for me rather than tablets that’s helped’. Emily now takes regular exercise especially when she starts feeling a bit low. ’ I go to the gym a lot regularly, structured and, you know, if I start to feel really down I do something’. Thomas felt it was easier to see the benefits of something like exercise than taking an antidepressant. ‘Gradually seeing the increase yourself in your fitness and being able to see it in the mirror. It’s all completely in your face. Tangible. You can see it in a mirror. Whereas with the antidepressants I saw nothing’. Going to a gym or an exercise class can also provide important social contact with others. As Thomas pointed out ‘It’s an isolating condition. Well most psychiatric diagnoses are, they’re isolating. They make you withdraw from people. So you don’t get the opportunity - really to do what to you need to do, which is to talk to people’. 
 

Olivia X goes to a yoga class, which is relaxing and calming...

Olivia X goes to a yoga class, which is relaxing and calming...

Age at interview: 45
Sex: Female
Age at diagnosis: 40
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Oh yes, yes yoga. So I got introduced to it at the private clinic and I carried on with it.
 
And how would that, do you think that benefitted you in any way?
 
What’s lovely about that is I’ve actually found a class where the ladies are just, they’re not like physically perfect and so you’re not feeling like you’ve, you know. They’re obviously hale and hearty women who’ve played hockey when they were at school and they’re really nice and solid.
 
Keeping active
 
Yes exactly they’ve got this, one of them, they pair up in the class and one of them is very gentle, very nurturing and the other is very ‘come on we can strengthen and we can do it.’ But it’s non-competitive so you’re all doing it at your own level and just being in a room with 20 people who are not competing with each other, they’re not trying to prove anything to each other, on a weekly basis is actually lovely.
 
Calming for the mind.
 
Calming for the mind because you know very often when you‘re socialising, you’re socialising at parties you’re sort of trying to prove yourself or keep up with the flow or, there’s nothing like that ....we’re all just at peace in a room. We don’t really, you know, everybody is like affable they say hello, they say goodbye you sometimes support each other with activities but mainly you’re in, you’re just in a space with no one critiquing you, no one.
 
It sounds valuable.
 
It’s very good, very, very good.
Several people had learned not to be too hard on themselves, and to develop greater self-awareness. Lucy Y felt she had learned a lot about herself since her first episode of depression. ‘The biggest change for me in the last few years has been being able to see beyond the end of it, having enough, having enough solid experience of good times to know that, you know, not only will it pass but it will pass and life will be meaningful and joyous and that, that is a possibility at the end of it.’ Catherine described building up a ‘toolbox’ of strategies over time through learning what works and what doesn’t. 
 

Catherine has tried a number of different things to improve...

Catherine has tried a number of different things to improve...

Age at interview: 41
Sex: Female
Age at diagnosis: 14
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It’s like being asked the question “what’s going to make you better?” I don’t know. You’re asked well, doesn’t necessarily make your cold better but what’s going to help your cold, well I’ll get a Lemsip or whatever, it doesn’t work the same for depression, anxiety, sleep, it doesn’t.
 
You know everybody’s responses are so different so that’s really a question that can’t be answered until you actually build up these tools and actually what we have to remember is there are some tools I’ve thrown out because I have tried things. I tried reflexology, it wasn’t for me and yet other people it is for them so that’s out my toolbox but I’ve tried it and I think that’s what you have to do, you have to try things in order to throw it at your toolbox because you just don’t know, you don’t know these things, you can only, it is a bit of trial and error, which is, is, is actually the frustration with depression and anxiety, is the fact that you have to trial things because there’s nothing worse than feeling utterly miserable and what you’ve got to do is spend weeks trialling things, you want to feel better like yesterday and it doesn’t, it doesn’t work, it doesn’t happen that way and that’s probably the most miserable thing that is about depression, is it can take, it can take a while and that’s horrible thinking about that.
Some people had used their own experiences to help others and felt they had benefited immensely from ‘giving something back’. Both Catherine and Hannah are now involved in producing websites about mental health issues. Thomas has worked as an advocate for people who use mental health services and Stuart gives talks and does voluntary activities to raise money for mental health charities. 
 

Stuart walked 2500 miles to raise money for mental health...

Stuart walked 2500 miles to raise money for mental health...

Age at interview: 52
Sex: Male
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I did the charity walk around England I now do a number of, you know, I’ve been asked to do a number of talks to various groups locally. I talk about the walk but I also mainly focus on my experience of meeting people with mental health problems and talking to people with mental health problems. And also just a bit of education in terms of how prevalent it is so the groups vary from next week I’m talking to some HR professionals, people who are involved in companies and through to public talks and Rotary and various different things. So it’s really just trying to do a little bit in terms of breaking down the stigma and just saying ‘hey, you know, I’m a mental health patient but I’m not that’, well maybe I am a bit strange but, you know, it’s normal almost.
 
Yeah…
 
Yes, yes.
 
So when you did the walk did you just, when you stopped off each day did you just chat to people or?
 
Well it was varied... I did, I met up with some, various groups along the way but a lot of it was talking to people, a lot of it through I was walking with my puppy, my springer spaniel, so dogs are great ice breakers so I had a lot of conversations where people would stop and pat the dog and talk about the dog and then say ‘what are you doing’ and, ‘I’m walking two and a half thousand miles’, ‘why are you doing it’.
 
That actually brings to mind two things I was just thinking off the top of my head. One is that you were walking miles.
 
Yes.
 
How many miles was it?
 
Two and a half thousand.
 
One of the things that is often suggested to help with depression is exercise.
 
Yes.
 
And do you feel that that was helpful?
 
Absolutely walking has been one of my main ways of, of dealing with it, one of my main therapies if you like. So I know that when I’m feeling down if I go out walking, unfortunately it seems to have to be a reasonably long walk, you know, a stroll around the park doesn’t do very much, I have to sort, but if I’m on a, you know, a reasonable hike then that seems to have some kind of calming effect on me.
 
And then the other thing that came to mind was pets.
 
Pets yes absolutely.
 
You know how the combination of both there but they do say that they’re good company and…..
 
Yes and actually I was doing this walk for eight months and living in a camper van and my wife was joining me one week a month and meeting up with various people but if you look at my mood diary for those eight months it’s very consistently above average for precisely that reason. And also that I had a, a very clear sense of purpose, you know, a sort of project to do and you know why you’re doing it, it’s not like going to work in a job where I’m just going there to earn, earn the daily bread for instance and being out in the fresh air and walking every day and having the dog. And these are all good things for mental health.


Last reviewed June 2016.
​Last updated June 2016.
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