Mental illness is a lot more common than we think. During their lifetime, one in five Americans will be impacted by depression and 18.1% of Americans will be diagnosed with an anxiety disorder. I know from personal experience what it is like to cope with depression and anxiety. I understand that it is critical to get help and I recognize the importance of effective treatments.

My journey navigating depression and anxiety

After graduating from UC Berkeley in May of 2004, I faced multiple stressful changes in my life including starting a new job, living alone, and my parents getting divorced.

These events occurred over a period of a few months. By the end of December, I noticed that I had lost my appetite, had difficulty sleeping, severe anxiety attacks and overall low mood.

In January of 2005, I finally saw a doctor because my anxiety attacks were debilitating. I was fortunate because the doctor was compassionate and understanding. He listened and consoled me while I was crying, and gently suggested that I start seeing a therapist.

“Remember, you will not be like this forever. Your condition is fully treatable.”

Sophie Kinsella from “Finding Audrey“

I wish I could tell you that my depression and anxiety resolved quickly, but realistically it took a long time for me to find the appropriate tools to get better.

I hope that sharing my experience can help others who find themselves in this dark and scary place.

What is depression like?

The best way I can describe what it was like for me was like I was living in this deep, dark, isolated cave and I felt extremely sad and alone.

I did not feel like there was light at the end of this cave, and I literally felt like I would be there forever.

It is a terrible feeling and not one that I would wish even upon my worst enemy.

Have you ever seen the movie Batman?

Do you remember the scene when young Bruce Wayne falls into the well and he’s terrified because he’s not sure how he can get out?

Well, that’s what depression combined with anxiety felt like for me, except I did not see a light outside of my cave.

How do you know if you have depression?

It’s normal to feel sad or blue once in a while. These feelings are short-lived and typically pass within a couple of days.

“It won’t be forever. You’ll be in the dark for as long as it takes and then you’ll come out”

Sophie Kinsella from “Finding Audrey“

When you have depression, it interferes with your daily life and causes pain for both you and those who care about you.

To find out if you have depression, you can take a free test called the Patient Health Questionnaire (PHQ-9).

What I know now

Though I would never want to go through what felt like the depths of hell when I was learning to overcome depression and anxiety, I know now that it led me to where I am today personally and professionally.

My tips below on how to overcome depression and anxiety, are based on both my personal experience as well as my clinical expertise as a licensed clinical social worker.

1. Make an appointment with a doctor

The first step in overcoming a serious mental illness like depression and anxiety is to make an appointment with your doctor.

Some untreated medical conditions like hypothyroidism mimic depression and hyperthyroidism can feel a lot like anxiety.

When you see your doctor, you’ll get a physical exam and a lab order to get comprehensive blood work. The doctor can evaluate to see if you have an underlying medical condition that could be the cause of your depressed or anxious mood.

As a medical social worker, I’ve seen patients come in complaining of a depressed or anxious mood. If they are diagnosed and treated for a thyroid condition, their depression or anxious mood resolves.

It’s important to tell your doctor about your score on the PHQ-9 test, how you have been feeling lately and ask them to refer you to a therapist and/or psychiatrist.

2. Find a psychotherapist

Mental health is as important as your physical health.

If you’re in good physical health, but struggling with your mental health, your physical health is likely to deteriorate since your mind and body work in conjunction with one another.

Psychotherapy has been instrumental in my self-care. Once I was diagnosed with depression and anxiety in 2005, I was fortunate to find a compassionate therapist. Her understanding, unconditional devotion and guidance helped me get better.

How do I find a therapist?

First, contact your insurance and get a list of mental health providers that they are in network with. Next, check out psychologytoday.com and cross reference the providers that accept your insurance. You can learn more about the therapist’s background and experience. Third, ask trusted colleagues, friends or your Employee Assistance Program (EAP) for recommendations.

What do I do when I find a therapist?

Remember that most therapists don’t answer their phone, so you have to leave a voicemail message. Provide your name, phone number and ask if they are accepting new clients.

Once the therapist returns your call, tell them briefly why you’re seeking therapy, ask them about their availability, and see what it feels like just talking to them on the phone.

If it doesn’t feel comfortable talking to them, move onto the next person on your list until you find the right person.

How to find a therapist if you’re uninsured

If you’re uninsured, there are agencies like Catholic Charities, Salvation Army or local universities that offer low cost counseling. You will be assigned to a social work or psychology graduate student who is obtaining their clinical hours.

To find a counseling center, search for “low cost or free counseling agencies.” Next, call and speak with someone about why you want to get therapy. Typically, you’ll receive a call within 3-5 business days to set up your first appointment.

How do I know if I have the right therapist?

The most important part of therapy is the relationship. It doesn’t matter if the therapist is a student intern and has limited experience or a seasoned clinician with over 20 years of experience. Research has shown that the therapeutic rapport (relationship) is the most important part of healing and recovery.

You’ll know when it feels “right” because you will feel comfortable and safe talking with your therapist. You will feel like you can say anything to them because you trust them, and you know that you will not be judged.

3. Talk to a psychiatrist about medication

If you took the PHQ-9 test and your depression score is high moderate to severe, then psychotropic medication (antidepressants) can really help.

“Medication is the ladder to get you out of the dark hole of depression and psychotherapy helps you stay out of it.”

Dr. Robert Nagy

It is very challenging to make lifestyle changes when you’re in a dark hole of depression. You can talk to your physician about starting you on medication, but I highly recommend seeing a psychiatrist as they have the expertise and are trained on the most up to date psychotropic medications.

How do I find a psychiatrist?

It is hard to get an appointment with a psychiatrist because there’s a large demand and low supply. Therefore, if you’re even considering this step, ask your physician to refer you and make an appointment ASAP.

Medication-friend or foe?

Medication is effective at treating mental illness when used as directed, and with the supervision of a physician or psychiatrist.

If you’re still debating whether or not you want to take the medication, ask yourself the following: how badly are you willing to feel until you try something that will help you feel better?

Perhaps you have a high tolerance for severe depression, or you’ve lived like this for so long, so you feel like it’s your new normal.

I can promise you that you can feel better, you just have to be willing to be proactive at treating your mental health with the right tools.

Also, it is helpful to remember that you won’t be taking medication forever. Keep in mind that psychotropic medications, like any medication, have side effects. You may need to try a few different ones until the right dosage and combination work for you.

If you have poor insurance coverage for medication, Costco offers a program for uninsured people. You don’t need a Costco membership to use their pharmacy. You can also try goodrx.com for coupons or asking for samples from your physician.

4. Prioritize your sleep

A lot of research has demonstrated that inadequate sleep leads to mental health issues. Dr. Matthew Walker, a neuroscientist and professor of psychology at UC Berkeley wrote an incredible book on “Why We Sleep” which has changed my life.

Quality sleep is the most important part of my daily self-care and wellness. I know that if I get less than 8 hours of sleep a night, my anxiety is elevated, and I get triggered a lot more quickly.

If you’re unsure if this is an issue for you, check out the National Sleep Foundation, which offers various resources including a free sleep journal.

If you’re having a hard time falling or staying asleep, try meditation, sleep hypnosis, yoga for sleep or melatonin.

I DO NOT recommend sleep medication like tranquilizers or sedatives. As the video above explained, sleeping pills have long-term side effects including the risk of cancer and other diseases.

5. Start exercising

Exercise is like a drug in that the benefits for your brain are equivalent to taking a low dose antidepressant. Going to exercise classes is a critical part of my self-care and wellness. You should check out my article and read more about this on “Abandon New Years Resolutions and do these 6 things instead.”

Research has shown that if you have low to low moderate depression, vigorous exercise induces dopamine and serotonin, the feel good brain chemicals that elevate mood. Therefore, when you exercise, the beneficial physiological changes in your brain are equivalent to taking an antidepressant without any negative side effects!

However, if you’re high moderate to severely depressed, the last thing you want to do is go to the gym.

When I was severely depressed, I dreaded mornings because I did not want to get out of bed. If you had suggested to me to go exercise, I would have just put the bedcovers over my face and ignored you.

Taking the first steps to exercise

If you’re not sure where to start, I recommend putting on your walking shoes and just going outside for a walk. You can read my article and get some helpful suggestions on “How to practice walking mindfully.”

Going outside and getting exposure to sunlight are effective ways at improving your mood.

“Our eyes and brains were designed by natural selection to derive the benefits that follow from regular bright light exposure”

Dr. Stephen S. Ilardi

In his book “The Depression Cure”, Dr. Illardi demonstrates that social connection is a critical part of improving our mental health. So, when you decide to take a walk, invite a friend to walk with you.

If you have the financial resources, consider hiring a personal trainer. These folks are coaches that will support you, hold you accountable and workout alongside with you.

If you’re motivated to start exercising, check out a local gym or yoga studio. Going to the YMCA group classes or a yoga studio motivate me to keep exercising. You should read about what happened when I did hot yoga at CorePower for 2 weeks!?

Before you sign up for a membership, you can always ask for a free trial and try out a few classes at a gym or yoga studio.

6. Take a look at your diet

Are you eating a plant-based Mediterranean diet? Great, move onto step #7.

If you’re eating a diet made up of highly processed food, then you may want to look at changing your diet, since inflammation in the body and mind are correlated to mental illness.

Food is medicine and is a natural way to improve your physical and mental health. Making dietary changes can be hard, so equip yourself with the right tools by doing some research and talking to your physician.

7. Vitamins and supplements

If you’ve had your comprehensive blood work done, your doctor will tell you if you’re vitamin D deficient or have low levels of HDL. These are important as research has shown that having normal levels of Vitamin D and HDL help improve mood and enhance sleep.

Omega-3 fatty acid in the form of eicosapentaenoic acid (EPA) has been found to be helpful in treating depression. The only brand of fish oil that I take regularly are Nordic Naturals, which don’t have a gross aftertaste.

Ideally, it’s best to get your EPA from eating fish a few times a week. If you don’t like fish or aren’t able to eat it several times a week, over the counter (OTC) fish oil is the easiest way to consume EPA.

8. Herbal remedies

Be cautious about taking OTC herbal remedies like St. John’s Wort, since they are not regulated by the FDA, so it’s uncertain how effective they are or the potential side effects.

If you’re already taking medication prescribed by your physician, talk to them BEFORE you add any herbal remedies since there can be lethal combinations.

If you prefer Eastern medicine, talk to an Integrative Medicine Doctor, Doctor of Osteopathy or an acupuncturist. Some of these practitioners have expertise on treating mental illness and can offer you various treatment options or refer you to other providers.

9. Practice mindfulness meditation

Mindfulness is about having present moment awareness and acceptance without judgement.

When we’re depressed, we often ruminate about the past. When we’re anxious, we’re worried about the future. Mindfulness is a loving practice of coming back to the present moment, again and again.

One study of mindfulness meditation showed it works better than medication for relief of anxiety. Furthermore, the researchers showed that meditation lacked the side effects of medications and it produced long-lasting benefits for the brain.

If you’re new to mindfulness meditation, I recommend trying apps like Headspace or Insight Timer. If you’re experienced in meditation, then try Meditation Studio, which is one of my daily self-care tools.

Wrap-up

It’s been 15 years since I was diagnosed with major depressive disorder and generalized anxiety. I’m proud to say that I overcame depression with the help of an amazing psychiatrist, psychotherapist as well as unconditional love and support of my family and friends. I have not felt the depth and despair of depression for over 13 years.

I wish I could say the same about my anxiety.

I’ve learned to cope with anxiety by befriending it. It’s uncomfortable, especially when I feel highly anxious, but I know that it is temporary and not permanent. I also know that I have some amazing tools that I use every day to manage it, like prioritizing my sleep, exercising regularly and eating a healthy diet.

To overcome depression and anxiety, it is important to first see a doctor to rule out any underlying medical condition. Next, find a good therapist and psychiatrist to work with you to navigate this uncharted territory. Third, work on lifestyle changes including prioritizing your sleep, improving your diet and exercising regularly. Lastly, talk to your doctor about trying different vitamins, supplements or herbal remedies. Most importantly, practice mindfulness meditation to orient yourself to the here and now.

If you’re reading this and struggling with depression or anxiety, I want you to know that you’re not alone. You are brave, important and loved. You’re courageous and have taken the first step in healing by reading this article.

The next step is to look for professional help. I recommend checking out the emergency mental health resources. I promise that in time, you will get better. Just hang in there.

Have you or your loved one struggled with depression and anxiety? What types of treatments worked? What alternative approaches did you try that you liked? Please share your stories and comments below.