Know PTSD: 25 tools for fighting depression

It is very common for people with PTSD to also be struggling with depression.  Depression and PTSD are present together about 50% of the time.  There are several possible explanations for this:

• The criteria of the two diagnoses overlap so much that it is easy for both possible mental health issues to fit one presenting problem. This is why it can be useful to get a careful expert diagnosis.  There are distinct differences that should be discernable when carefully explored.
• The struggle of living with PTSD wears a person down and creates a situation ripe for developing depression.
• People with Depression are more prone to feel they cannot positively impact their lives, so they are less likely to take steps to keep themselves safer, and thus more likely to experience traumatic events.
• Possible biological and genetic predispositions to both mental health disorders.

There is research to support each of these possible causes for the high frequency people with PTSD also having depression.  But in the end if you are struggling with both the why is not all that important.  What really matters is getting tools to manage them both. 

25 Tips, Tools, & Steps to help fight your depression

• Improve your eating: It is very common to eat less healthy food when depressed. Partially because junk food, particularly carbs and sweets, actually gives your body a temporary lift which improves your mood over the short term (but the sugar crash afterwards can actually feel worse, setting up a bad cycle of needing more junk food) and partially because when we are depressed we care less about taking care of our bodies by eating right.

1. Healthier earlier: It can be easier to eat healthier earlier in the day. Will power wears out so add fruit, vegetables and other healthy food when your will power is strongest.

2. Make it easy: Don’t require yourself to cook a healthy meal. Microwave some frozen veggies or even eat some veggies right from the can.

3. Trade for permission: Give yourself permission to junk food out in exchange for this one healthy food item. An apple, a pre-made salad, a can of “Veg-All”, a sub or whatever is the purchase price for not beating yourself up for the rest of the junk food.  Then when you are getting on yourself for the bad food you’re consuming remind yourself that you held up your end of the bargain by eating that healthier food so now you need to hold up the other end and let yourself have the junk.

• Stay connected: Depression often leads to isolation and that feeds the depression and makes it worse.  Staying connected to friends and loved ones is important but doing so can be very hard and going out with a bunch of friends or to a huge get together can be more overwhelming than helpful.

4. Have a friend over: Ask a supportive friend over.  Pick the friend/family member carefully.  Pick the person who will best fit what you need and is most willing to help in the way you need, not in the way they believe you should need.  Set some parameters such as: I don’t want to talk about what’s wrong.  I want to just watch this movie with you.  Letting them know ahead of time can help increase the likelihood of getting the connection you need.

5. Talk on the phone: If your most supportive friend is far away or having someone over is more than you can tolerate; call them instead.  Not feeling up to talking, ask them to share funny or happy stories that you can mostly just listen to.

6. Text at least: Reach out to a couple of friends through text.  We are social beings and text does not provide much of the connection that we need, but when everything else feels too challenging texting is a good option.

7. Fur connection: Got a cat or a dog?  Spend some time petting and loving on them.  Study after study shows the beneficial effects of “fur therapy”.

• Get out: The other part of isolation is the tendency to shut yourself up inside your apartment or home and only step out when you absolutely must (and with amazon and delivery that can be vary rarely). 

8. Do it how you like it: Was there a way that you used to like to get out before you got really depressed? Can you do a smaller version of that now?

9. Get out in nature: Are their places to hike or fish near you?

10. Go to the park: Many parks have walking trails, playgrounds, and benches where you can connect to nature and be closer to other people.

11. Go People watch: Go to a mall or coffee shop (outside seating even better) and just watch people.

12. Go around the block: Walk through your neighborhood (or go walk through another neighborhood if you don’t want to talk with people you know)

13. Sit outside: Not up to going anywhere, that’s okay.  How about you just go sit in the sun for 15 minutes.

• Move More: Yep this is the recommendation to exercise.  You can combine this one with the above “get out” if you want to, but you don’t have to.  Start small, any exercise is an improvement if you are currently not exercising at all.

14. Hike or walk: Go for a hike or walk in nature, walk in a park or around the block. Take a run, a jog or a relaxed stroll.

15. Use that membership/unbury that machine: Got a gym membership, a gym in your apartment complex, or an exercise machine buried somewhere in your home?  If you already have it, go use it.  If you don’t already have a membership or piece of exercise equipment, I would be cautious about buying one.  It may become just one more thing you get on yourself for not doing.

16. Get the mail: Walk to your mailbox each day.  No mailbox?  How about just to the end of your driveway.

17. Move during commercials: Does all that feel too much? How about just standing up and walking around during commercial breaks or for 5 minutes between episodes of binge watching shows.

• Self-care: One part of depression is a tendency to neglect your personal hygiene and how you look. 

18. Clean up: It can take more effort than we want to expend but it is also often very beneficial to wash up, brush our teeth and hair, and get on clean clothes.

19. Do favorite part: Is there one personal pampering thing that you used to love?  Bubble bath or manicure?  Do that one thing.

20. Face & Hands: Does all of that feel really hard? How about just washing your face and hands.  If that is what you can do right now, then do that.

• Neaten your space: Depression can make it really hard to put out the effort and clean up your space.  But a messy dirty space can add to our negative feelings and deepen our depression. 

21. One room: Pick one room and clean that space.

22. Fake it for the neighbors: Weed the flowerbeds, mow the lawn, or just do enough so there are uglier yards than your in the neighborhood.

23. Just 1 part: Just pick up trash, just sweep, just collect dirty dishes.  Do just 1 aspect of cleaning up.

24. Just 10 Minutes: Set a timer and just keep cleaning until the timer goes off then you’re done.

25. Commercial clean up: Just do a little cleaning during a commercial break or for 5 minutes between streaming episodes.

Digging your way out of depression can be challenging.  Doing so while also struggling with PTSD can be even harder.  It can be easy to notice how hard it is and berate ourselves for our weakness or for not measuring up to some other standard.  As tempting as that can be, it will not help.  It will make things harder.  Trying to force ourselves to make great leaps forward will most likely only lead to failure and further rebuke.  Small steps, even tiny steps that we actually do are far better than any grand change that never occurs.  Pick one or two of the small improvements list above.  Make the small changes that you can manage and acknowledge each step for the accomplishment that it truly is.

If you are not already working with a therapist or counselor to treat your PTSD and depression, I strongly recommend it.  It may also be worth it to consider speaking with your doctor about adding medications to help manage your symptoms.  PTSD is hard.  Depression is hard!  The two together is really f@*%ing hard.  It does not have to be a battle you wage alone.

I am a therapist in Austin Texas. I specialize in helping adults heal from difficult childhoods, childhood trauma, CSA (Childhood Sexual Abuse), sexual assault, PTSD (Post Traumatic Stress Disorder), and cPTSD (complex PTSD).  Contact me to schedule your free 30-minute, in person, consultation to discuss how I may be able to help you address your depression or PTSD.