03 September 2011

8 tips to manage the blues

You have seen your doctor and are on antidepressants. Things are going OK, but they could be going great. We show you how with eight lifestyle guidelines.


The good news is that depression is highly treatable. Between 80 to 90% of all depressed people respond to medication and psychotherapy and experience some relief from depression symptoms.

But treatment does not stop with medication and psychotherapy. By making a few lifestyle changes, you can feel great more quickly. Why not try the following?

1. You don't snooze, you lose
Insomnia is a common complaint amongst depressed people. The South African Memory Resource Centre suggests a number of useful tips to get you to the Land of Nod:

  • Discontinue unhealthy sleep habits. Don't lie in bed for long periods if you cannot fall asleep. Your brain quickly associates your bed with lying awake and not being able to sleep. Break this habit by getting out of bed if no sleep occurs after about 10 minutes (do not watch the clock, but rather estimate the time). Carry out a non-interesting activity such as reading a boring book, until drowsiness returns and then go back to bed. Repeat this pattern until sleep takes place.
  • Follow the same routine at night before trying to sleep. Your mind and body will connect this routine with sleeping.
  • Don't take any stimulants, such as coffee, before going to bed. Also steer clear of alcohol, as it doesn't lead to a good night's sleep.
  • Don’t eat a huge meal close to bedtime.
  • Your couch potato days are over. Get a bit of exercise and you will not only fall asleep more easily, but also sleep better.
  • Take a warm bath before bedtime.
  • Keep a notebook next to your bed and write down any worries that you may have before trying to sleep.
  • Daytime naps will make it more difficult for you to sleep at night.
  • Make sure that your bedroom is comfortable and dark and quiet.
  • Wake up the same time each day.

2. Get Active: Exercise
Exercise gets those endorphins into your bloodstream. These are the feel-good hormones. But when you feel depressed, really depressed, it's difficult to motivate yourself to brush your teeth, let alone go for a walk or a run. But don't get caught in this vicious cycle of feeling unmotivated and wanting to camp on the couch – it will make you feel more depressed. Once you've broken this cycle by exercising a little bit every day, you won't believe the difference. Begin gradually (even 10 minutes will be OK as a start) and slowly increase the intensity and amount of time spent exercising.

3. Watch your eating plan
When you're feeling depressed, you often either lose you appetite, or eat like a horse. This can make you feel even worse. Eat correctly and you can help to combat weight problems. But how?

  • If you are overweight, lose weight.
  • Eat at least five portions of fruit and vegetables daily (a portion size is a fist size).
  • Complex carbohydrates (wholewheat grains) should form the basis of every meal. These include porridge, wholewheat bread, brown rice, pasta and jacket potatoes.
  • Eat plant and animal protein foods (fish, meat, eggs poultry), but avoid excessive saturated fat intake. Do not eat red meat more than once or twice a week. Replace it with fish.
  • Limit your fat intake to less than six teaspoons per day.
  • Make sure that you drink at least six glasses of water per day

Eating a high carbohydrate diet (wholewheat bread, unsifted maize meal, brown rice) boosts the production of serotonin in the brain which makes you feel more positive. Eating plenty of protein (meat, fish, eggs, cheese, yoghurt, milk) to increase amino acid intake has the same effect.

In addition, B vitamins, especially B12, B6 and folic acid, can help combat psychological disturbances, so take a complete vitamin and mineral supplement. Essential fatty acids, especially omega-3, may also help, and the best source is salmon oil capsules. Foods rich in omega-3 are:

  • all types of fish and seafood, but particularly fatty fish such as salmon and snoek
  • fish oils (tuna, cod liver and salmon oils)
  • plant oils (flaxseed, canola, walnut, soya oils)
  • food fortified with omega-3 (eggs, milk and bread – check the label)
  • salmon oil supplements

Alcohol and some drugs (recreational and prescription) can cause or worsen depression. This is possibly because it changes the balance of brain chemicals or the physical structure of the brain.

Too many changes in your insulin levels can lead to mood swings and fatigue. To avoid these you should:

  • rather eat five to six smaller meals per day than two to three big ones.
  • rather eat carbohydrates with a low glycaemic index (GI) than with a high GI.
  • *rather eat wholewheat pasta than white or wholewheat bread, rather Basmati rice or couscous than white or brown rice, rather fruit than sweets, rather oats porridge or bran cereals than other cereals.

What you eat and drink can interfere with your medication. Ask your doctor if there are any foods that need to be avoided. Some antidepressants can make you feel drowsy and alcohol will make matters worse. Alcohol could also slow the metabolism of some antidepressants.

4. Check your medicine cabinet
Many types of medication (including natural remedies) interfere with antidepressants – some could reduce the effect of your medication, others could even lead to poisoning. Make sure to tell your doctor what you are taking.

5. Learn to relax
Relaxation decreases tension and anxiety and improves sleep. Try meditation, yoga or specific relaxation exercises. Long, hot baths with aromatherapy oils or a massage will also do wonders.

6. Be gentle on yourself
You may need to expect less from yourself. Think again about what's important to you and rather set small, realistic goals. Also postpone major plans and life changes such as changing jobs or starting a family.

Don’t be scared to ask for help. Delegate tasks and ask your support network to help with childcare, chores and other responsibilities. You will be able to return the favour when you are better.

7. Don’t try to do it all by yourself
Share your feelings with friends and family. Ask your doctor to refer you to a support group. The South African Depression and Anxiety Group has support groups throughout the country. They also have a telephonic counselling line.

8. Don’t give up hope
Don’t feel discouraged if you don’t feel better immediately. Treatment takes time and some antidepressants take a few weeks before they make you feel better. If you don’t see an improvement within six weeks of being on antidepressants, discuss your concerns with your doctor. He or she will be able to prescribe another antidepressant which might be more suitable.

If you stick to your treatment and follow these lifestyle guidelines, you are bound to feel better soon. - (Ilse Pauw, Health24, updated September 2011)

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