On Mending: Tips for Managing Anxiety and Depression

Dealing with mental illness is an intensely distressing personal journey.

You will have days so hard and heavy you can’t breathe under the weight of them, days so fuzzy that it feels like you can’t remember entire months of your life. Everyone will tell you to take care of yourself, but that’s difficult when you feel as worn out as you do.

I don’t want to sugar coat things, because it doesn’t help. Recovery is hard. Recovery isn’t always entirely possible. You may never be who you were before you were mentally ill, if you can even remember a person who existed prior to this mountainous trek. Drinking a cup of warm tea with honey will not help you cure your depression, at least, not in the way you’re praying it will.

There is however, a significant amount of scientific research that confirms that some of the tips I scoffed at when I was at my most sick are genuinely helpful. These are the ones I want to put in front of you. I know that you don’t have the energy to do anything that won’t help, I know that you don’t have the energy to research. So if you’ve stumbled across this article, know that these are strategies that are (a) backed by actual legitimate research studies (examples of which are linked at the end of the article), and (b) tried and tested by yours truly.

Here are the coping strategies I’ve built over time, which are both healthy and likely to have a positive impact on moving forward with your mental health.


Disclaimer: these are focused on anxiety and depression, because they (initially alongside an eating disorder I’ve fully recovered from) are what I’ve personally dealt with and I’m not here to give you second rate advice on shit I haven’t lived. You get enough of that already.

#1: I know you’ve heard of mindfulness before. I know it seems stupid. Let me tell you, it’s not. If you’re not up with the lingo, or haven’t been put through years of therapy, mindfulness is paying active attention to the current moment, and accepting what is happening without trying to change it. Generally it’s associated with the act of meditating, which can feel pointless and stressful when you’re having serious issues.

The thing is, mindfulness meditation has been proven to improve mood even in severe depressive cases in a matter of weeks Download One Giant Mind for free from the App Store and have it play on your phone. You can do really short sessions, and they will still be hugely beneficial. You have to do this consistently, but you can do it just sitting in bed, at any time of day or night. I always liked to do it directly before sleeping, and it improved my sleep quality. I found this particularly useful when I was having a significant relapse with my Generalised Anxiety Disorder and I felt anxious more minutes than not.


#2: Use the Hands as Thoughts metaphor to guide your thinking. Put your hands, palms towards you, close to your face, so all you can see is your own skin. Then, push your hands out, palms still turned inwards, as far as you can. Hold this position until your arms hurt. Finally, put your hands in your lap. In this activity, your hands are your thoughts. Dwelling on your anxieties all the time can block the entire world from your view, but pushing thoughts away to the back of your mind requires a lot of energy and leaves you tired and sore. Rest your thoughts on your lap. Don’t try and challenge them. Acknowledge them, regardless of content. Neither pull them in nor push them away.

When you’re feeling truly overwhelmed, use your hands to categorise your thoughts and help yourself remember what you need to do.

 

#3: Here’s where your hot beverage can actually come in. Savour your drink slowly. Notice the sensations it brings (warmth on your hands, the sweet taste, the sound of you drinking). This is a grounding exercise used to stop panic attacks, converted into morning coffee time. If you spend ten minutes every morning slowly focusing on your drink, you’ve achieved ten minutes of mindfulness. Over time, you may find it gets easier and easier to slip into this quiet awareness. Combine this with gratefulness when you’re able, and you’ll likely see improvements in your mood and decreases in your anxiety levels.  

 

#4: Gratefulness seems like a hard thing when you’re down. The world is kind of shitty, and there’s not a lot to be excited about. However, studies have demonstrated that if you write down something you’re grateful for each day for a month, you’ll feel more satisfied with your life overall. Plus, you’ll have a “reasons I’m still alive” list personalised to you for your worst moments. Some of my sentences: I am grateful for the view from my house. I am grateful for cheese flavoured snacks. I am grateful for my little brother constantly tagging me in dog memes.

It doesn’t have to be big things. You just have to notice that there is something that doesn’t absolutely suck in every day, and then you realise there may be more good than you thought. 

 

#5: Everybody has something called a critical parent. I don’t mean an actual critical parent, although most of us have those too. It’s the voice in your head that tells you what you’re doing isn’t good enough, but it often takes on the voice of someone you know who has instilled certain values in you. Your job? Call it out. You may have seen a text post on tumblr about calling your critical parent Donald Trump and telling him to fuck off. That’s cool, I like it. That wouldn’t work for me, because I’m attached to my critical parent. She feels like half of me some days. It seems like she’s the one who makes me better, makes me try hard, makes me succeed. Pro tip: she’s not. Here’s a conversation we had recently, and that we’ve had many times before:

“You waste so much time reading fan fiction, it’s such a useless hobby. You should be reading classic books, or reading nonfiction and learning. Why don’t you know anything about history? Why haven’t you read the Charles Dickens Mum bought you?”


“Ya know, CP, I think the thing about life is not every single thing has to be productive. I don’t judge other people’s hobbies because it doesn’t matter. I wouldn’t be a better person if I’d read “Great Expectations”, I’d just be bored. There’s so much less fake dating in “Great Expectations”.”


So, what can you do here? Step one, listen out for your critical parent. Step two, rationalise with your critical parent and explain why they’re wrong (they are wrong, promise). Step three, get better over time at both steps one and two until you can actually win the argument, and CP seems less distressing and more just like a distant pal you have to remind not to be so mean to themselves. 

 

#6: This is by far my least favourite strategy, in part because of how hard I fought against it when I was first in therapy. How many times have you heard exercise helps depression? How many times did you want to punch them in the face? Mine were the exact same amount of times. Like, friendo, I can’t get out of bed, come on.

Alas, starting a behavioural activation cycle is the absolute first treatment for depression. Basically: you gotta get yourself moving, because otherwise you’re moping, and it’s all very cyclical. You are getting no positive vibes from the world, because you’re not engaging with the world. Depending on how bad you’re doing right now, your goals are different.

If you haven’t left bed yet today: go to the kitchen and eat some food. If you haven’t showered in a couple of days: get in, immediately. Go. Stop reading this. Not because you smell bad, but because until you fake being a human you won’t feel like one. That’s the key to this stuff, fake it till you feel it. If you’re slightly ahead of all that, go outside and catch some Pokémon. I’m proud of you. 

These strategies are a combination of tools and attitudes from Cognitive Behavioural Therapy and Acceptance and Commitment Therapy, picked up from a combination of seeing therapists for five years and having a psychology degree.

These tips are how I’ve made sense of years of mental illness, and they don’t begin to cover everything. They are, however, darn good stepping stones to helping yourself feel slightly more like a human and slightly less like a caterpillar sitting on a wet leaf (uncomfortable and overwhelmed by surrounding stimuli, anxiously awaiting the future. I may be projecting onto insects these days). I guess the takeaway from this is not all self care is bullshit, and you can influence how you feel, even if you can’t control it.

You got the power, and I believe in you.

 


Paige is a 21 year old sweet tooth, bunny lover and university student. Her life motto is stolen from Cinderella, but “have courage and be kind” is a pretty good philosophy. You can find her at @allgrownpup on tumblr.

And you can follow Loud and Alive on Tumblr, Twitter and Facebook, too!

 


Suggested reading for the curious:

#1:
Examples of studies showing the mindfulness and meditation stuff works:
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness-based therapy on anxiety and depression: A meta-analytic review. 
– Khoury, B., Lecomte, T., Fortin, G., Masse, M., Therien, P., Bouchard, V., … & Hofmann, S. G. (2013). Mindfulness-based therapy: a comprehensive meta-analysis. 
– Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. 


#2:
This is an exercise from Acceptance and Commitment Therapy, check it out. 

 

#3:
This is an exercise from Cognitive Behavioural Therapy, see the link for more grounding exercises. I’ve put my own spin on grounding by focusing it on hot beverages, but you can use many different techniques.


#4:
Examples of studies showing the gratitude stuff works:
– Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: an experimental investigation of gratitude and subjective well-being in daily life. 

– Toepfer, S. M., Cichy, K., & Peters, P. (2012). Letters of gratitude: Further evidence for author benefits.

#5:
Again, this is from Cognitive Behavioural Therapy, it’s described here:

– Vyskocilova, J., & Prasko, J. (2013). Countertransference, schema modes and ethical considerations in cognitive behavioral therapy.

#6:
You can read about behavioural activation as a model and treatment here:

– Dimidjian, S., Hollon, S. D., Dobson, K. S., Schmaling, K. B., Kohlenberg, R. J., Addis, M. E., … & Atkins, D. C. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. 

– Manos, R. C., Kanter, J. W., & Busch, A. M. (2010). A critical review of assessment strategies to measure the behavioral activation model of depression. 

– Mazzucchelli, T., Kane, R., & Rees, C. (2009). Behavioral activation treatments for depression in adults: a meta‐analysis and review. 

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2 thoughts on “On Mending: Tips for Managing Anxiety and Depression

  1. Scarlet Ramírez says:

    Hey Paige! What a great articule. I love that you included external references which are always appreciated. I also have trouble with the exercising part since it’s the most mentally exhausting one for me. I wanted to recommend you something, I hope you don’t mind. I, too, practice mindfulness meditation and I used to do it just like you, right before I went to sleep. While I recognize it improves sleep, my therapist recommended to practise it also in a non-sleeping context (like on the bus, on the park, etc.) since the goal is to keep your mind on the present and not to relax you to the point of unconsciousness hahaha. Hope you have a nice week and thanks for this article! ❤

    Like

    • Paige says:

      I’m glad you enjoyed the article Scarlet! Definitely agree with moving away from sleep-centred meditation where possible. I think starting with it sleep focused is a good way to recognise its benefits, and then once you’ve been converted to the meditation life its really useful to start trialling it elsewhere. You’re going to see a larger anxiety reduction during the day if you successfully meditate in the morning than if you do it at night after all! Thanks so much for your comment, good luck with your health and enjoy your week too ❤

      Like

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