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How do I manage depressive episodes?


By Dan Collins, told to Hallie Levine

I have been living with major depressive disorder since I was 16 years old. My moment of critical mass was in the spring of 1991. I was 28 years old and still living at home. My life revolved around getting up, going to work, and going home. I fell down a rabbit hole of extreme depression and anxiety. I felt like I was being swallowed by waves of despair and panic that would never end.

I eventually ended up in the emergency room at the local hospital. They told me it would take me a few weeks to see a psychiatrist and I was horrified. The thought of waiting a month or two for this appointment, when she felt like she could barely last another minute, was terrifying.

My only refuge was sleep, which gave me no rest and left me without appetite or humor. To try to escape, I would get in my car and drive to the malls to buy books on mental health. I had decided that if I could understand what was happening to me, I would be able to get over it. Finally, my father told me, “You’re not going to think about how to get out of this,” and I realized that he was right.

Fortunately, this depressive episode occurred just as a new drug, Prozac, was gaining traction. I like to joke that I was the original Prozac nation. I was one of the lucky ones who responded well to this medication and quickly. One morning I woke up to find that the cloud of despair was no longer hanging over me.

That was 30 years ago. I’m still on Prozac, but I’ve also learned a lot of ways to manage my depressive episodes, so I’m not caught off guard when they happen. Depression is not like a cold that you recover from and it goes away. It can happen at any time, sometimes for no apparent reason. I am sharing what helps me in the hope that it will help you.

i stay active. Shortly after my diagnosis, I began competitive fencing. It was very uplifting. He’d always been the fat kid last picked for dodgeball. It felt good to be out there being active. But fencing also helped me control my depression because it honed my focus. It’s the kind of sport that when you do it, you can’t think about anything else. I could be in the eye of the storm with a depressive episode, but I would have to put those feelings out of my head to prevent my opponent from hitting me.

The social interaction also helped: I hung out with the other members of my fencing club after practice and on weekends. During the pandemic, I think one thing that helped me avoid slipping into another depressive episode was the fact that I was on my elliptical every morning for an hour to get those feel-good endorphins. (Research confirms this for me: Exercise has been shown to have a strong antidepressant effect among people with depression.)

But it goes beyond the simple exercise. When you have depression, the worst thing you can do is sit back and take it. When I was going through the worst of my depressive episodes in my 20s, I would stay home and stare at the wall. But once I started Prozac, I felt good enough and confident enough to sign up for an acting class. I realized that I needed to change my lonely lifestyle because that had played a big part in how depressed I had become in the first place. Even when I feel worse, I force myself to get out of bed and go to work. You need to divert your attention from your mood and emotions and focus on something else.

I have strong social relationships. When you’re depressed, it’s almost impossible to go out alone. You need other people to help you out. When I was diagnosed, I was lucky to have amazing parents who supported me. My father prided himself on being an amateur psychiatrist. He wanted to understand how I was feeling and encouraged me to seek help and improve.

I am also very lucky to have an amazing wife, Tina. She understands my condition because she has schizoaffective disorder. We monitor each other. We look for warning signs in others. We remind each other to take our medications and seek therapy when things get too difficult. I like to say that we don’t give depression a front seat, even though it is our traveling companion.

Tina in particular also has a caring personality. She always sends me interesting research articles on depression. If she senses that I am about to experience an episode, she encourages me to return to therapy. Many people with this condition do not have that level of support. It doesn’t help someone with depression to come home if she’s going home with the wrong person. I found exactly the right person, which is why I took until the age of 51 to get married.

I have the right treatment. I beat him out of the ballpark when it came to meds. I found a medicine that worked for me right away. The therapy was more challenging. Unfortunately, finding someone to click with can be more difficult than even finding the right primary care doctor. It took me years to find a therapist who understood me, only to have him pass away unexpectedly. I miss him every day, but luckily he has given me skills that get me through my toughest times.

You have to tell yourself, when you’re in the throes of depression, that you can’t give up. You may feel terrible for a few weeks or even months, but you’ll get over it. We are all stronger than we sometimes think.

Sometimes it also helps to be open about my depression. There is still a lot of stigma around the condition, especially among men – it is seen as a sign of weakness. But you need to talk about it to feel better. There is no shame in it. It’s like any other chronic condition like type 2 diabetes or high blood pressure. As with these illnesses, it’s okay to admit that you need help managing it.


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