As someone with Bipolar Disorder, I am no stranger to depression. Although Bipolar depression has its differences, it shares many factors with Major Depressive Disorders: isolation, changes in appetite, poor sleep, feelings of hopelessness, lethargy, disinterest, which sometimes culminating into suicidal ideation. Sometimes it creeps up slowly as life stressors build, sometimes it is a tidal wave of negative emotions for seemingly no reason.

Everyone has different tools and suggestions because depression is so common. Sometimes it feels overwhelming to get the advice others are so eager to give. A yoga class? But I can barely get out of bed. Talk to a friend? They will think I am a burden. There is a wide spectrum of severity of depression, and the following suggestions are for those who are struggling to move from the couch to check the mail as their crowning daily achievement.

1. No matter when you wake up, do your morning routine

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If it’s 3 P.M. and you are lying in bed in the grips of anxiety and depression, getting up seems impossible – and pointless. The point of getting up and going through your routine – take a shower, brush your teeth, get dressed – is to enforce the idea that you haven’t wasted a day. Your day is always worthy of a new start. Even if you don’t accomplish anything else, you may feel better just for the sake of feeling more like yourself.

2. Know your medications

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If you are one in 6 Americans on psychiatric drugs, it is important to learn as much as possible about the medications you’re on. Ask your doctor, your pharmacist, and visit websites such as the National Institute of Mental Health (NIMH) or the National Alliance on Mental Illness (NAMI). The goal here is to be well-versed in how long your medication may take to work (usually 4-6 weeks), how it interacts with other drugs, and how long you can expect to stay on an antidepressant or another psychiatric drug.

3. If you can’t reach out in person, reach out online

In the deepest depths of depression, interacting with others seems too daunting a task, requiring energy to mask the depression. You can join the depression forum online and learn more about how you can cope with depression from people who are dealing or have experienced it. The Reachout App is a solid tool to connect with others with stories similar to your own. For other specific topics, Depressionforums.org is a large forum split into helpful categories where you can post and read stories and questions. Both online services can ease you back into being social with a population that knows something about what you’re going through.

4. Review your course of illness with a mental health professional

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What patterns of depression have you seen throughout your life? Have they been situational? Seasonal? Random? At what age did you first experience depression? Sitting down with a therapist to work through these questions may give you a better understanding of the course of illness and start to predict triggers. You may never rid yourself of depression completely, but if you understand its temporary nature it may be easier to cope.

5. If things get serious, have a crisis plan

When depression is at its worst, people may feel so hopeless that they begin to think about suicide or hurting someone else. At this point, inpatient hospitalization for a few days is usually warranted. Know where your nearest hospital is and if they have a psychiatric unit.

You should also:
• Have a list of 3-5 people to call during in an emergency
• Save the National Suicide Prevention Lifeline number: 1-800-273-8255
• Take deep breaths and realize that professionals are waiting to help you. Hospitalization can be scary the first time, but it’s just a tool like anything else.

6. Remember your worth

If you can’t exercise and socialize every day, or if taking Fish Oil supplements hasn’t helped your depression, you’re not alone. Those things do help, absolutely. But for a certain depressed population threshold, small steps can lead to big victories. Keeping a routine, being educated, and having a plan can reinforce your sense of worth even as you battle through the worst of a black depression.

I’ve been living with Bipolar Depression for 20 years, and though it hasn’t abated completely, tracking my moods and working with a therapist and psychiatrist has helped me cope with the fact that I’ll probably need medication for life. There’s no shame in that. Mental illness is like any other illness, and there’s a long way to go in terms of research and medicine. For now, remember your worth and your strengths, and take baby steps toward recovery from each episode.

Helpful sources to remember:

• www.reachout.life or the Reachout App
• NAMI – medications: http://www.nami.org/Learn-More/Treatment/Mental-Health-Medications
• NIMH – medications: https://www.nimh.nih.gov/health/topics/mental-health-medications/index.shtml
• Depression Forums: https://www.depressionforums.org/
• National Suicide Prevention Lifeline: 1-800-273-8255