Major Depressive Disorder - Single episode

Management and Resources

At home

When someone is depressed, it can be difficult to make behavior changes. Seemingly small tasks like taking a shower or making a meal might feel daunting. Even so, small tweaks to one’s daily routine may aid in their recovery. The following bite-size behavioral strategies can help make a difference to those struggling with their depressive symptoms:

Resolving to accomplish one thing each day

These can be simple actions like getting outside for a walk, going to the grocery store, or meeting a friend for coffee.

Doing one kind thing for someone else

Evidence shows that helping others can alleviate the feelings of worthlessness often associated with depression. This can be as small as a text message to say “I’m thinking of you,” or kind words over phone or email to a family member or friend. Some people feel better when they volunteer occasionally in their community. This helps focus thoughts away from oneself and, at the same time, help others in need.

Finding things to be grateful for

Studies have shown that gratitude, when practiced consistently, can help boost one’s mood. To keep the task simple and doable, resolve to express gratitude for one thing each day. This exercise can help to shift one’s focus from the negative to the positive, and the effects of this may compound over time. One may even consider writing down those thoughts in a gratitude journal that they can refer back to in difficult moments.

Diet & exercise

While many are aware of the vast, proven benefits of diet and exercise, taking these steps can be particularly difficult while depressed. However, our bodies need movement, sunshine, and nourishing foods. It can help to start small. Eat one vegetable or fruit per day; Walk one lap around the block. Tiny changes, over time, can make a real difference.

At work and school

Depression tends to affect all parts of one’s life, including life at work and school. It can lead to tardiness, missing details, and lower productivity. In some cases, challenging work and school scenarios can contribute to one’s depression. Unsupportive or highly competitive professional or academic cultures, or demanding environments can contribute to burnout, which can amplify the symptoms of depression.

When depressed, it is important to remember that getting treatment might make work feel more manageable. In the meantime, here are some practical ways to manage depression as it relates to one's professional and/or academic life:

At work: check with the human resources person or team at the company to find out whether they have an Employee Assistance Program or partner that offers mental health services. This is a benefit many organizations have begun to offer.
At school: school administrations usually offers student counseling services. Given the abundance of stress related to exams, and school performance, it is common for students to feel overwhelmed, depressed, and in need of support. Reach out to a dean or student services for information.
Take one day at a time. It can be particularly overwhelming for individuals with depression to manage large tasks. It can be helpful to break overwhelming projects into bite-size pieces that, on their own, feel much less distressing. Try to focus on what needs to be accomplished that day. Keep a to-do list and feel the satisfaction of crossing things off as they are completed.
An individual does not ever need to tell anyone at work or school about having depression, nor do they need to keep it a secret. The amount shared is their choice, though some people find it useful to share with a trusted colleague, supervisor, professor or teacher, that they are having a rough patch. These individuals understand that someone experiencing depression might need a modification in their responsibilities for a period of time.
Find support: Having a friend at work or school can lend many benefits. Getting the support of friends, family, and even online support groups can be a powerful way to listen to others and share one's stories in a confidential and dignified way.

If one finds themselves in an unsupportive work or school environment that they suspect may be contributing to, or exacerbating their depression, a change may be worth exploring. As a general rule, it’s best not to make life-changing decisions while depressed. This applies to work, school, and personal relationships. For this reason, it is ideal to discuss professional or academic modifications with an employer or professor before making a decision to change course... As one improves, they can feel more confident in their judgment. Involving friends or family members who know and care about their wellbeing is another way to ensure sound decision-making.

In relationships

Depression can have an impact on relationships in many ways. If an individual's partner or friend does not have depression, it can be difficult for them to understand what one is going through. They may expect the individual to be able to “snap out of it,” which can add to their feelings of loneliness or sadness. Even so, opening up about their experience can help bridge the gap in understanding -- although, sharing one's struggles is not always easy. An individual may feel like they are burdening others with their sadness or complaints, but this may not be the case. Sometimes being open during these struggles can fortify one's relationships.

The symptoms of depression may also bring challenges to a relationship If someone is depressed, they may be less likely to want to plan activities together or socialize with others. They may want to sleep more and eat less. It is important to recognize that one partner may make these choices because of their depression and not because they are choosing to withdraw from the other one. It is critical that both parties in the relationship focus on treatment, and to remember that this lack of interest is temporary. In most cases, the right combination of therapy and medication is restorative.

Couples counseling can be a fantastic tool for improving a relationship quality when one or more partners struggles with depression. It can help both parties empathize with the other, and find ways to best support one another.

For some people, having depression, and also taking antidepressants can impact their sex lives

If an individual is experiencing low libido or erectile dysfunction, there is hope: The first step to addressing this issue is to acknowledge it, but we know that sharing this type of sensitive information with one's partner or provider is not always easy. Some steps one might try include:

Trying a new routine with a partner such as exercising before sex, or incorporating new types of stimulation into the routine.
It is possible that when one's depression improves, their libido will also improve: Research has shown that depression can cause these effects with or without taking an antidepressant.
One's provider may adjust their dose of medication to find a level which balances effectiveness with libido. Some of the commonly known medications for erectile dysfunction can be helpful to antidepressant-induced sexual dysfunction in men.
If these recommendations don’t work, a different type of medication that has fewer sexual side effects might be the next step.

Depression can cause impaired self esteem, which can also challenge relationships. Individuals with depression may find themselves needing reassurance or outside validation during these episodes. Keep in mind that periods of depression will require tenderness in one's relationships.

Organizations

National Institute of Mental Health

American Psychological Association

Centers for Disease Control and Prevention (CDC)