My wife and I thought—hoped—we were going to be the exception, the “escapees.” I say “we” because depression is an individual, marital, and family experience. People I have cared deeply about have succumbed to the ravages of depression on the mind; and their families shared the experience with them in ways good and bad. All my biological siblings struggled with major depressive disorder, beginning in their twenties or even their teens. I had entered my thirties with no signs or symptoms yet. So we hoped to escape.
I remember age 33. There were gradual changes—blue days, down moods, treacherous thoughts. Yet the idea that this might be the beginning of depression didn’t occur at first. At first we laughed at my regular monthly downswing. Then the sky turned threatening. Bleak, dark, so dark. Empty. No motivation. Wanting badly to surrender, retreat—from life, from people, from work, from responsibility. I never imagined that there could be emotional and psychological pain so overwhelming it made me desperate for relief. I could and do understand how many people turn to various kinds of escape.
What overtook me felt like a demon. It was my family’s heritable brain illness—a predisposition to depression. I raced from depression like a skater on thin ice. Sometimes the ice was thick and I was safe, sometimes it was perilously thin, and I could hear it cracking behind me and I knew the cold and the darkness that lay just beneath that thin layer. Some days I was gasping for breath and hoping not to drown.
Ages 38 and 39 were the worst, and the hardest. Though I refused to contemplate ending life—I had so much and so many people to live for—I was struggling with the will to live, the joy to live. Depression saps the will to stay connected with life. I am grateful I was able to recognize it wasn’t life I wanted to be finished, but this painful distortion of life.
Quite a few times after work I had the impulse to just steer the car up the canyon and keep on driving, going from somewhere engaged and productive to nowhere in particular, escaping the responsibilities that depression magnified to what seemed like an Atlas weight. But then I didn’t. I turned toward home, and there I found a wife and family willing—and anxious—to help.
Self-Care in Four Dimensions
Together with my wife and children we began addressing what I’ve learned are the four dimensions of our existence—our biology, psychology, ecology, and spirituality. Each dimension contributes to our well-being. Each tends to get caught up somehow in any illness we struggle with. Each dimension plays a part in depression, and in turn each could help me in living well with depression.
Paradoxically, losing myself in love is my best self-care and healing prescription, not only alleviating but actually putting depression completely into remission for a time, replacing it with pure joy and fulfilling purpose.
No matter when or how depression gets started—in our body (biology, e.g. genetics, brain illness), from dark patterns of thinking or feeling (psychology), from a toxic environment or relationships (ecology), or from spiritual discontent, discouragement, or dissonance, or toxic perfectionism and shame (spirituality)—no matter where it starts, emotional and mental illness tends to spread out. Eventually, no part of our lives is likely untouched by depression. So it makes sense that self-care solutions need to address each area.
Depression can wreak havoc on our bodies and biology. In response, physical self-care is like an athlete’s pre-season conditioning, giving the patient a fighting chance against depression on game day. For me, regular physical exercise, good nutrition, healthy weight, adequate downtime, rest, recreation, and sleep all contribute to general physical, mental, and emotional well-being, helping immunize me against depression. Maintaining a daily routine also helps stabilize my mood. Like persons in recovery, these are my “dailies.”
For some, antidepressant medication is an important tool in their arsenal. Yet meds come with some side-effects, and they are not a magic pill restoring the brain or mind or life to the way it was before—you can’t just pop the pill and wait to be cured. Research confirms experience that when antidepressants work, they work best in combination with therapy and self-help work.
Each of my own adult siblings developed their own unique approach and had unique responses to medication, some for the better, some not. In my family, I observed that a “cocktail” of various medications could lead to unpredictable interactions that sometimes caused results difficult to distinguish or disentangle from depression itself. Expert medical oversight is critical. My own experience with antidepressant medication was disappointing, and among my siblings I had seen their depression grow along with their cocktail of meds, so my own journey—in consultation with medical professionals—led to a decision to rely, for now, on a more holistic self-care plan without the pharmacological element.
Depression involves distorted thinking and feeling. At first, I relied heavily on my wife in my psychological self-care. She provided perspective and alternate ways of viewing my experience, myself, and my relationships. Together, we were able to derail thinking that triggers and amplifies depression. Gradually, I learned to practice my wife’s, “Or, on the other hand” challenges to depressive thinking. Managing my thoughts went a long way to achieving emotional regulation. So did prayer and turning to God. More on that later.
Therapy has been proven to be effective in helping people productively manage stress, challenge cognitive distortions (what some refer to as “stinkin’ thinkin”), and effectively curb or manage anxiety, all of which can be triggers to depressive mood. Self-help application of therapy in-session training is essential.
Finally, I was quite surprised to recognize and learn that I had to resist a certain psychological seductiveness to depression. Who would have thought depression could be seductive?! Like a drug, it promised escape from life and all its struggle. All I needed to do was surrender to it, let it take over, and indulge in its permission to retreat and disappear from life.
Life is hard. I came to accept that, and to experience, validate, and find joy in the nobility of striving, even when it didn’t seem to make the difference I deeply wanted. Showing up was success; then gearing up; then gradually finding momentum for the moment. My psychological self-care included resisting surrender to the symptoms, even if it wasn’t yet a complete cure of this brain illness. Get out of bed, get dressed, get out the door. Walk, run. Engage with life, do what I can. Each day’s efforts flow powerfully into the next. Sustaining momentum, no matter how small, is critical. Depression feeds on coming to a standstill, and things only get harder from there. I have learned to accept that I’m not entirely in control of this brain sickness, but I can choose to curtail its influence and the symptoms that flow from it.
Relationship and Ecological Self-Care
Just like we learned in high school biology, life exists in ecological—environmental and relationship—systems. A good ecology with strong relationships sustains us. Connection and belonging, not just in the abstract, but in daily practice, are powerful. In my marriage and family, we all lean on each other from time to time; yet we avoid falling over on each other or overtaxing any one person. In marriage in particular, it is unfair and weakens sustaining relationships to allow the burden of depression to be carried by a loving spouse too much or too often. Together, we’ve gotten better and better—me not looking to my wife to be ‘responsible’ to make me happy; her accepting that while her love makes her want to take on that task, she can’t and shouldn’t shoulder it exclusively. Yet she’s there for me, and she has learned in good humor to swat at the depression from time to time like a fly in her kitchen—and it makes me laugh.
In terms of my daily ecology, I allowed my marriage and family responsibilities to ‘force me’ to get up and go to work—and that compelling sense of duty has proved one of my greatest blessings. My professional activities as a teacher and a marriage and family therapist time and again took me outside myself and proved to be a miraculously transformative and healing influence. While depression was still part of my mortal makeup, the joy of giving myself in love and service transcended that mortal reality and I found myself rising above and entirely out of depression. Even in the face of daunting days, I have found helping others to be a reliable pathway to joy. Pouring myself into the art and practice of loving others lifts my spirits, turns my mind and heart, and brings relief and sustaining packets of joy. In a kind of spiritual apprenticeship and mentoring, the hint of depression came to be a signal that I needed the rejuvenating spiritual exercise of ‘getting outside myself.’
Other daily ecological self-care included working hard to surrender perfectionism, competitive striving—including competitive Christianity—and frenetic “busyness” as markers of a worthwhile life. I learned to be more dismissive of artificial markers and external benchmarks “imposed” by institutions and other people. In place of these I focused on identifying and living congruent with my own values and in peace and joy with my wife and my Maker.
I cultivated serenity, personal peace, and expansive love; and I determined to make relationships the most important consideration in every context. I chose to be liberal in enjoying the pleasure of deeply and authentically connecting with people, everyone my life came in contact with. I discovered I could live well with depression through nurturing caring relationships. I came to appreciate the scenic beauty of our relationships and penned these thoughts:
the world’s most awe-inspiring destination,
life’s “can’t miss” experience,
is the landscape of the human heart,
the unfolding panorama of the eternal soul,
the breathtaking beauty of love
Pouring myself into marriage and family life, and letting my wife and children pull me in, too, is a lifeline—drawing me out of that inward-focused spiral that seems to be part of the etiology of depression, at least for me. The key ingredient here seems to be pouring myself into my relationships. It’s not about relying on others’ choices to make me happy, but about pouring my capacity for caring into them. The perfect family is an illusion but joy is not illusory as long as we continue giving ourselves.
There were quite a few practical elements of a healthy ecology for me, too. Recently, I’ve found that steering clear of the anger and acrimony so abundant on the internet helps avoid a negativity that can trigger a depressive mood. Social media can also be a trigger for depression for some; we would do well to emphasize face-to-face time over Facebook and avoid comparing ourselves and our lives to high-gloss self-presentations in social media.
Other practical elements included finding contentment and calm as we avoided debt and learned to live well within our means. Connecting with the natural world in my exercise and recreation—mostly quietly, but sometimes rambunctiously—was so powerful that my wife encouraged me no matter the seeming sacrifice of time. I found solo and social recreation remarkably rejuvenating, providing relief and renewal that brought more packets of pure joy. In time, these activities entirely erased from my mind and heart former fantasies and impulses of driving away from it all and abandoning responsibility.
Spiritual Self-Care and Grace
Depression manifests itself spiritually, too, and can wreak havoc on our spirits. The spiritual experience of depression can be a particular torment, leaving a person feeling lost to God. Our spiritual experience may be thought of as comprised of three elements: (a) living in harmony with core life values and aspirations (congruence); (b) seeking a life of Christlike purpose, meaning, and relevance (consecration); and through these, (c) reaching heavenward and achieving an experienced connection (communion) with the Divine. I found I could rely on congruence, consecration, and communion to refresh peace, joy, and love in my life.
Congruence, consecration, and communion require consistent spiritual nourishment. My spiritual dailies consist of contemplative scripture study and truly personal prayer, including ‘listening up!’—an hour every morning that grows sweeter by the year. Weeklies include temple worship and service—with COVID-19 I am trying to find an alternative to that safe haven and secure base—and church attendance and service with a focus on worship and uplifting others. I am richly blessed and profoundly grateful for a career that contributes deeply to consecration and communion. My professional work as a therapist and a teacher brings the joy of a purposeful, generative life and a blessed opportunity to love and serve others, and rebounds to me as spiritual self-care for depression. Experience has taught me that if I muster the momentum to show up, and then give myself to the work I am called upon to do, it will make all the difference—sometimes quickly, sometimes gradually. Altogether, combined spiritual nourishment contributes to all three elements of spiritual well-being and pushes back against dark days.
Yet, aside from all reason and reality, the brain illness of depression can threaten each of these three elements, filling my heart and mind with a torment of believing I don’t measure up to my values or my potential, producing a feeling of disconnect from the divine, and conjuring dark nihilistic feelings about my existence itself and the significance, worth, or value of my life. Emptiness, purposelessness, disconnection, and loneliness would enter my life when depression spilled over its biological bounds and began attacking me spiritually.
Subsequently, spiritual self-care also came to mean learning I had to accept sometimes feeling disconnected, without supposing it must mean something was wrong in my life. I learned to accept doubt as part of life and have a peaceable relationship with it. I strive for integrity to core values even in the face of doubt and weakness. I learned to carefully and critically examine and distinguish between my need for personal change (repentance) and the self-condemning, self-harming self-talk depression brings. As Apostle Neal A. Maxwell expressed, we must differentiate between “divine discontent and the devil’s dissonance” (1976, para. 26).
I strive to live worthy of communion and participate in spiritual community, even if I can’t always feel either. I maintain spiritual routines even though a present moment of depression can make them seem somewhat empty. Always, my wife provides an invaluable reality check on the spiritual despondency and nihilism depression can bring. She hates the spiritual toll she sees depression take sometimes. She musters me and together we push back.
Spiritual self-care for depression has also included recognizing that some of the dark brooding of my depression directed toward others is inconsistent with the pure love of Christ, and I needed to chase it away with charity. Together, my wife and I have learned to detect these dangerous thought detours and instigate a u-turn to more wholesome, sanctified thoughts and pure love toward all around us. The gospel and life of Jesus Christ are a Liahona compass pointing the way to thoughts and feelings toward others that rescue me from a depressive downturn. The pure love Christ lived by is a gift of God that requires real spiritual exertion; finding it helps me live well with depression.
The spiritual communion and witness most significant to my living well with depression is a threefold spiritual witness and experience of (a) the loving Father my God is; (b) the relationship flowing from knowing I am his son; and (c) God’s provision for compassion and forgiveness through the atonement of Jesus Christ. As this witness has grown in my life, it has become a powerful palliative and at times curative antidote to depression. Among other outcomes, Christ’s atonement invites me to practice developmental patience with persistence, releasing me from the iron fist of perfectionism.
Clinging and cleaving to these experienced truths, the affliction of depression is tempered and even given meaning and purpose as a temporary inherited opposition I can strive to rise above. Over many years, and from being a parent myself, I have come to sweetly understand the infinite love of the Father and the Son and rejoice in the abundance and sufficiency of grace along our pathway to sanctification and exaltation. Faith in Christ brings hope in Christ, as expressed by Alma:
The spirits of all men, as soon as they are departed from this mortal body, yea, the spirits of all men, whether they be good or evil, are taken home to that God who gave them life.
And then shall it come to pass, that the spirits of those who are righteous are received into a state of happiness, which is called paradise, a state of rest, a state of peace, where they shall rest from all their troubles and from all care, and sorrow (Alma 40:11–12).
As I practice gratitude, I discover an abundance of grace in my life.
Through It All
Through it all, I am deeply sustained in knowing that from time to time I will experience a happy reunion with uplifting feelings—sourced from biological, psychological, relationship, and spiritual efforts—just as though those feelings and I had never become strangers to each other.
For difficult days, I store up and treasure little notes, cards, letters, and photographs that come—commendations large and small that describe positive influences of my life, work, and relationships. These are my memorabilia against depression. When doubts assail me, sometimes just opening the file cabinet and seeing that growing file folder there helps; other times, I retrieve and read a few. Reassurances have repeatedly been sent by way of these notes, and the “divine coincidence” of their timely arrival in my precise moment of doubt and need is astounding. Such miracles have abounded, a repeated testament to the goodness of both God and neighbor.
My Own Reliable Antidote Actions
Along my journey with depression, I have discovered personal dailies that are reliable antidote actions. Each person can discover their own. For me, forcing myself to get out of bed and engage with life is my starting point. That is mostly important because it puts me where I can get outside myself and available to others. Serving, helping, lifting others through my profession as a teacher and therapist lifts me, amazingly and reliably. Paradoxically, losing myself in love is my best self-care and healing prescription, not only alleviating but actually putting depression completely into remission for a time, replacing it with pure joy and fulfilling purpose.
Overall, I and my wife and family believe in and practice a holistic health approach to my depression. We live with depression as a temporary mortal companion, with healing underway already in mortality. Depression doesn’t define me; it isn’t my identity; it just describes my personal odyssey. Success is, of course, staying alive, but far more than that, it is finding packets of joy in experiences large and small, obvious and hidden, each day. Tucked away in every day are reasons to rejoice in being alive. Sometimes I have to pull the blinders of depression off to see it. My wife and I still know that my Eeyore self is there, but we try to keep that part of me at a “lovable and livable” level. My brain’s vulnerability to depression never goes away entirely—I still have those times—though I feel myself growing closer to something that feels like being healed. Always, though, through holistic self-care, we strive for management and remission. Together we can live well with depression.
Everyone’s experience with emotional sickness and illness is unique. I do not know the magnitude or difficulty of anyone else’s experience. I understand that my journey and the solutions that have helped me aren’t a mirror image for anyone else. Rather, they are more a sympathetic resonance that hopefully sheds light toward holistic self-care that is uniquely your own, and an encouragement to keep trying and discovering.
Our mortal gifts and limitations exist along a broad continuum ranging from aspects that we experience complete control over to elements where we perceive little to no influence. For example, certain limitations are inextricably rooted in genetics—e.g. Down’s syndrome—or injury or disease—e.g. traumatic brain injuries—and are not within the reach of “bootstrap” resolutions. Depression is a brain impairment affecting our thoughts, emotions, motivation, and experience of life, and where depression lies along the continuum can vary from one person to the next. Hope is imperative, yet with ourselves and with others it ought to be a forbearing rather than a demanding hope. We can never perfectly know the limitations of another person and the degree to which their experience lies within the realm of their proactive efforts. Neuroplasticity is a hopeful reality—our bodies and our brains are responsive to our proactivity—yet it is not a complete elasticity.
When a person experiences a life-changing limitation, for a period of time they may experience helplessness and hopelessness and ‘give up.’ As one person commented, “My suicidal thoughts started the same day my doctor told me my depression would be life-long.” Yet as we see time and again in the athletic realm, the human spirit is resilient, and our nature can inspire us to rise to the challenge of transforming our limitations into a personal measured success. We can and will find joy in doing the best we can with what we face in life, even when our limitations may be lifelong. We need to know that while depression may remain with us, we may discover that we can measurably alter its contours, enabling us to truly live well with depression. Some may even be surprised to hear us say it is our struggle!
For me, the measure of healing I have experienced is no less miraculous for being incremental and developmental—iterative, ongoing, evolving—no less a witness of grace for it requiring all I can do, patiently and persistently. Along the way, there have been many meaningful self-discoveries—about my biological, psychological, relational, spiritual, and ecological being and well-being. Through holistic self-care and the Gift of God—even Jesus Christ—my brain and body are being renewed beginning in this life, while perfect healing for all of us awaits the resurrection.