Preparing Myself for Oncoming Depression
(The following information is my specific treatment plan and isn’t recommended for anyone else. If you need help, reach out to your healthcare provider.)
I recently realized that out of the past three autumns, I struggled with depression during two of them. I’ve read that fall is particularly difficult for people with bipolar because of the shift brought upon by DST and how it affects sleeping schedules, as well as the change in the amount of daylight we’re exposed to. I know people without bipolar experience Seasonal Affective Disorder too. Last week, in an attempt at preventative maintenance, I took a large step to improve my mental health.
I met with a therapist. Online, naturally, because of the pandemic.
While filling out my pre-appointment paperwork, I included information about my history with ACEs, which stands for “adverse childhood experiences.” I first came across the term while reading an article on Medium. Intrigued, I searched for more information online and discovered Dr. Nadine Burke Harris’s work.
Dr. Burke Harris, California’s first surgeon general, is one of the leading proponents of routinely screening for ACEs as standard pediatric treatment. She discusses her experience with ACEs in this sixteen-minute TED Talk video.
Basically, ACEs are traumatic experiences children suffer, whether it’s living with a parent who abuses alcohol or illegal substances, having an incarcerated parent, experiencing some form of neglect or abuse, and growing up in a home with domestic violence, among others. This website explains ACEs as “a cholesterol score for childhood toxic stress” (para. 10). The CDC conducted an ACEs study on 17,000 people and discovered that two-thirds of the subjects scored at least one on the scale, and 87 percent of those had more than one (para. 9). (If you’re interested, you can take the ACEs test here and find your score.)
Researchers discovered that the higher a person’s ACEs score, the greater their risk for chronic health problems as adults. For example, adults with an ACEs score of four (out of ten) or higher have an increased risk of heart disease, diabetes, cancer, depression, suicide, and early death than those with a 0 score.
My score?
Eight.
I always was an overachiever.
Desperate to know more, I read Dr. Burke Harris’s book The Deepest Well, which gave me a greater understanding of ACEs and how they can affect my health. I decided to change my lifestyle. For example, I run now. (Runners are cool.) I don’t run well, and certainly not quickly, but I do it. I weight train. I walk outside in the fresh air and soak up Vitamin D at least five days a week.
However, I still eat a terrible diet, and my sleep schedule is a wreck, especially lately. So, when my therapist and I discussed my pre-appointment paperwork, he made several suggestions:
- I need to practice visualization. Currently, I feel relaxed and peaceful when sitting on the beach watching the waves, so when I feel anxious, I need to a) go to the beach, or b) engage my five senses and visualize myself sitting in the sand. Easy-peasy.
Additionally, when I experience negative or intrusive thoughts, I need to visualize removing them from my brain, placing them in a Mason jar, and screwing the lid on tightly. (Too bad Dumbledore’s Pensieve isn’t real.)
- I need to practice breathing techniques. For now, this means breathing deeply and slowly and expanding my diaphragm. Since I sang in choirs for many years, I know how to do this. Score one for me.
- I need to follow my bedtime routine, as well as follow a strict sleeping schedule of going to bed and getting up at the same time daily. No sleeping in for me. No naps. Yes, it breaks my heart too. Maintaining a regular sleep schedule is something I’ve struggled with since my teens, so this will take a lot of work.
- I need to add more fruits and veggies to my diet. As such, I bought a blender, a ton of frozen fruit, and fresh spinach. I generally don’t eat breakfast, so I’m going to add smoothies to my mornings. I’m aiming for three to four times a week to start.
- Finally, I need to research EMDR therapy, which I may write about here in the future.
I’m sure many people know these basics already, but knowing them and implementing them are vastly different. Additionally, many of these activities are useful for managing depression.
After my first therapy session, I asked JC if I am worth all the effort, time, and expense that therapy involves, as well as if he believes I actually can get better. He said yes.
I say yes too.
In fact, I’m excited to start this work. I’m researching my family’s medical history, looking up recipes on Pinterest, buying whole foods over processed foods. I don’t know what it is about my personality that I have to be “assigned” homework by an accountability partner in order to make changes. Maybe that’s something I can work on in therapy.
In the meantime, do you have any smoothie recipes to share? If so, please comment below.
Also, the next several days have the potential to be difficult for people, especially we Americans. Please, be gentle with yourselves. Stop doomscrolling, if you can, and take time to do something nice for yourself, even if it’s just stepping away from the computer or your smartphone for a while.