In the fall of 2007 Mother Teresa graced the cover of Time magazine when her private writingswere published, many of the excerpts filled with surprising doubt, despair, and a kind of spiritual anguish. Some journalists questioned whether or not she was clinically depressed. Did this modern saint have an untreated mood disorder or did her pain fall into the category of a “dark night of the soul,” a concept introduced by Saint John of the Cross, a Carmelite friar who lived in Spain during the late 1500s? I believe it was the latter, given her incredible productivity in the years of her struggle.

The distinction is important, even as it can be impossible to make, because many religious and spiritual people forego treatment thinking that the pain they endure is necessary to purify their souls. For example, I thought that my desire to die as a young girl meant that I was a mystic.

Gerald May, MD, a retired psychiatrist and Senior Fellow in Contemplative Theology and Psychology, discusses both in his book, The Dark Night of the Soul. When a person is clinically depressed, he explains, she loses her sense of humor and the ability to see comedy in certain situations. The person is also too shut down to reach out to others who are in pain, to offer compassion to others. She can’t see beyond her own discomfort. Clinical depression can render an energetic, sensitive person apathetic so that all her senses are disabled. Her very being seems to disappear beneath her illness. With a dark night of the soul, the person stays in tact, even though she is hurting. While a person in the midst of a dark night of the soul knows, on some level, there is a purpose to the pain, the depressed person is embittered and wants to be relieved immediately. “In accompanying people through dark-night experiences, I never felt the negativity and resentment I often felt when working with depressed people,” explains Dr. May.

Kevin Culligan, OCD, a psychologist and the former chair of the Institute of Carmelite Studies, also distinguishes between the dark night and clinical depression in his chapter in the book, Carmelite Spirituality, edited by Keith Egan, a wonderful professor of mine at Saint Mary’s College, and my thesis director for a paper I wrote on John of the Cross’ The Dark Night. Fr. Culligan explains that a clinically depressed person has a loss of energy and pleasure in most things, including hobbies and sex. He will sometimes exhibit a dysphoric mood (think Eeyore) or psychomotor retardation. The person in the midst of a dark night experiences loss, too, but more as a loss of pleasure in the things of God. Culligan can often tell the difference between the two based on his response to the person with whom he’s interacting. After listening to a depressed person, he often becomes depressed, helpless, and hopeless himself. He feels the rejection of self, as if the depression is contagious. In contrast, he is not brought down when people speak of a spiritual aridity.

I found this paragraph in Culligan’s chapter to be especially helpful:

“In the dark night of spirit, there is painful awareness of one’s own incompleteness and imperfection in relation to God; however, one seldom utters morbid statements of abnormal guilt, self-loathing, worthlessness, and suicidal ideation that accompany serious depressive episodes. Thoughts of death do indeed occur in the dark night of the spirit, such as ‘death alone will free me from the pain of what I now see in myself,’ or ‘I long to die and be finished with life in this world so that I can be with God,’ but there is not the obsession with suicide or the intention to destroy oneself that is typical of depression. As a rule, the dark nights of sense and spirit do not, in themselves, involve eating and sleeping disturbances, weight fluctuations, and other physical symptoms (such as headaches, digestive disorders, and chronic pain).”

Psychologist Paula Bloom posted an article awhile back on PBS’s “This Emotional Life” platform called “Am I Depressed or Just Deep?” She talked about how people confuse being depressed with being philosophical or deep. And I would add, “spiritually sophisticated,” the kind of person who knows what a dark night is, and believes God has allowed it to happen for a reason. Dr. Bloom explains that life is hard, it involves inexplicable tragedies, and yes, to not ever feel fear or despair or anger in light of this might question a person’s humanity. But to stay in that place — disabled by life’s blows — may mean you’re dealing with a mood disorder, not a depth of perception. In her blog, she writes:

“There are a few basic existential realities we all confront: mortality, aloneness, and meaninglessness. Most people are aware of these things. A friend dies suddenly, a coworker commits suicide or some planes fly into tall buildings — these events shake most of us up and remind us of the basic realities. We deal, we grieve, we hold our kids tighter, remind ourselves that life is short and therefore to be enjoyed, and then we move on. Persistently not being able to put the existential realities aside to live and enjoy life, engage those around us or take care of ourselves just might be a sign of depression.”

Both Culligan and May agree that a person can be experiencing BOTH a dark night and clinical depression, that sometimes they are impossible to tease apart. “Since the dark night and depression so often coexist, trying to distinguish one from the other is not as helpful as it might first appear,” writes May. “With today’s understanding of the causes and treatment of depression, it makes more sense simply to identify depression where it exists and to treat it appropriately, regardless of whether it is associated with a dark-night experience.”

Bipolar disorder is one of the most difficult illnesses to treat because by addressing the depression part of the illness, you can inadvertently trigger mania or hypomania. Even in Bipolar II, where the hypomania is less destabilizing than the often-psychotic manic episodes of Bipolar I, persons often experience from a debilitating depression that can’t be lifted by mood stabilizers and antipsychotics. Antidepressants, though, can cause a person with bipolar to cycle between hypomania and depression.

I have worked with psychiatrists who were too afraid of cycling to risk using antidepressants for bipolar patients. They put me strictly on mood stabilizers and antipsychotics. However, I did not get well. I stayed depressed, and all original thoughts in my brain vanished. My current psychiatrist knows that depression is my primary threat, not so much the hypomania, so she was able to pull me out of the depression with the right combination of antidepressants, but is vigilant for any signs of hypomania. Because I know how vulnerable I am to hypomania, I have learned several strategies to help me stay grounded. By making them part of my life, I have been able to take less lithium, my mood stabilizer, which ensures that I continue producing original thoughts and not get too medicated. Here are 10 tools I use to avert hypomania.

1. Practice Good Sleep Hygiene

Developing good sleep habits is by far the most potent tool for preventing mania and hypomania. There are a handful of studies documenting that sleep deprivation is associated with mania and hypomania. By going to bed at 10 every night and sleeping a good eight or nine hours, we have the power to stop rapid cycling and to reverse mania or hypomania. In a study published inBiological Psychiatry a rapid-cycling patient was asked to remain on bed rest in the dark for 14 hours each night (gradually reduced to 10 hours). Times of sleeping and waking were recorded with sleep logs, polygraphic recordings, and computer-based event recordings. His sleep and mood stabilized when he adhered to a regimen of long nightly periods of enforced bed rest in the dark. The abstract’s conclusion: “Fostered sleep and stabilizing its timing by scheduling regular nightly periods of enforced bed rest in the dark may help to prevent mania and rapid cycling in bipolar patients.”

Good sleep hygiene means you go to bed at the same time every night, ideally before 10:30 p.m. — not one night 2 a.m. and another night 7 p.m.; you sleep at least eight hours a night; and you wake at the same time in the morning. Since many folks with bipolar disorder have sleep disorders, a nighttime routine is often needed. For example, I shut down my computer at 8 p.m. and try not to check my emails or messages on my phone. Reading a disconcerting email at 9 p.m. will keep me up all night. It takes me a good two hours to calm down, so I get out the lavender oil around 8:30 p.m., pull out a real book (not an iBook), and begin to tell my body it needs to seriously chill out.

2. Limit Your Screen Time

CNN did a story a few years ago on iPads (or LCD screens) and sleep. Journalist John D. Sutter asked Phyllis Zee, MD, a neuroscience professor at Northwestern and director of the school’sCenter for Sleep & Circadian Biology, if our gadgets can disturb sleep patterns and exacerbateinsomnia. Dr. Zee said:

Potentially, yes, if you’re using [the iPad or a laptop] close to bedtime … that light can be sufficiently stimulating to the brain to make it more awake and delay your ability to sleep. And I think more importantly, it could also be sufficient to affect your circadian rhythm. This is the clock in your brain that determines when you sleep and when you wake up.

I absolutely know that to be true, because for awhile, I was reading iBooks for a half-hour before bed and staying awake until 2 a.m. My concern with LCD screens isn’t limited to bedtime. I know from people in my depression community that persons with bipolar disorder have to be careful with LCD screens at all times, as they can make the highly sensitive person hypomanic if the person doesn’t take a break from them. For me and for many fragile persons with bipolar, looking into an LCD screen for too long is like keeping your light therapy sunbox on all day. I made the mistake of firing up that baby from 9 p.m. to midnight right after I got it, and I did not sleep one iota the next day, and felt hypomanic all day long. Keep in mind that not only is the light stimulating, but so is all of the messages and tagging and poking — especially if you have as many social media handles as I do.

3. Avoid Certain People and Places

Most of us have a few people in our lives that appear as though they’ve downed three shots of espresso every time we see them. They are usually great fun and make us laugh. However, the hyperactivity isn’t what you need if you haven’t slept well in a few weeks and are trying to calm down your body and mind. Same goes with places. I don’t dare step foot inside the mall, for example, between Halloween and New Year’s. There is just too much stuff being forced in front of my face. I also hate Toys-R-Us. I still have nightmares about the time my husband pressed three dozen Tickle Me Elmos and the entire shelf began to shake.

4. Pay Attention to Your Body and Breathe Deeply

Before attending the mindfulness-based stress reduction (MBSR) program modeled after the one developed by Jon Kabat-Zinn at the University of Massachusetts Medical Center, I did not pay attention to my body’s cues preceding a hypomanic episode. In fact, it was usually another person who would point out the embarrassing truth — like the time my editor wrote a letter to my doctor after I started publishing eight blogs a day thinking my traffic would go up. Now, though, when my heart races and I feel as though I have consumed eight cups of coffee, I know this is my opportunity to reverse my symptoms by doing lots of deep breathing exercises.

Of all the automatic functions of the body — cardiovascular, digestive, hormonal, glandular, immune — only the breath can be easily controlled voluntarily, explain Richard P. Brown, MD, andPatricia L. Gerbarg, MD, in their book The Healing Power of the Breath. They write:

By voluntarily changing the rate, depth, and pattern of breathing, we can change the messages being sent from the body’s respiratory system to the brain. In this way, breathing techniques provide a portal to the autonomic communication network through which we can, by changing our breathing patterns, send specific messages to the brain using the language of the body, a language the brain understands and to which it responds. Messages from the respiratory system have rapid, powerful effects on major brain centers involved in thought, emotion, and behavior.

5. Eliminate Caffeine

A good caffeine rush mimics hypomania. You feel more alive, more alert, like you could actually contribute something of worth to the world. That’s all fine and dandy except when you are teetering on the hypomanic edge. Caffeine can provide the ever-so-subtle push to the other side, especially if you aren’t sleeping well, which is when most people most crave caffeine. Stephen Cherniske, MS, calls caffeine “America’s number one drug” in his book Caffeine Blues because of the withdrawal our body goes through three hours after we’ve drank a cup of coffee or a Diet Coke. Persons with bipolar are even more sensitive to amphetamine-like substances that raise dopamine levels, so the safest way to prevent hypomania is to eliminate the stuff altogether.

6. Exercise

My best workouts have been when I’m either on the verge of becoming hypomanic or when I am ticked off. My usual 10-minute mile goes down to an eight. I start passing people along my route, at the Naval Academy, feeling like Lynda Carter in her Wonder Woman getup. And my swim interval is consistent with the people who swam across the Chesapeake Bay in under two hours. The truth is I have averted many hypomanic episodes by working out until I collapse or at least become tired, which can take a few hours. Two years ago, the only way I was able to sleep was by swimming more than 300 laps a day. There are people for whom vigorous exercise triggers mania, but most experts report on the benefits of exercise for bipolar disorder.

7. Watch Your Sweets

There is a reason why ice cream, Swedish Fish, and animal crackers are comfort food for the bipolar person. The rush of insulin generated by those foods will calm those carbohydrate-craving brain pathways for a bit, until a crash in blood sugar has the person binging again on sweets. It’s a vicious cycle, one that can keep a bipolar person cycling indefinitely.

I will tell you a true story about sugar and bipolar. About 16 years ago, before I knew I wasallergic to sugar and that a high-carb diet was the worst thing I could do for my mental health, I would sometimes drink two bottles of Arizona Iced Tea and eat two or three chocolate-chip oatmeal bars for lunch. One day, there was a Horizon milk truck in front of our house with a large cow on the side. I started mooing at the cow. My new husband, behind me, was truly frightened by this and told me to lay off the Arizona Iced Teas and granola bars for awhile. I haven’t mooed at a truck since.

8. Be Careful With the Opposite Sex

I am all for good, healthy friendships between men and women. If you’re not bipolar. Consider me a prude, but I know how difficult it can be to be consistent with good boundaries if you are even the tiniest bit hypomanic. You sincerely didn’t mean for something you sent in an email to sound flirtatious — you were just being playful, like you are with your girlfriends. However, when you do get a reaction from a person of the opposite sex, something in the least bit flattering, that communication can ignite a rush that sends a signal throughout your entire body that you want more of the feel-good hormone it just experienced — dopamine, essentially. It’s even riskier if you have a history of substance abuse and bipolar — because your body will compromise any moral agreements you have signed off on prior to that email in order to get that damn rush again. If you’re not careful, this dangerous game will trigger a full blown manic episode. I have had the best intentions with 85-year-old men, and still, somehow, found myself in trouble. So for the time being, I’m sticking to female friendships.

9. Use a Shopping List

One of the most common manic behaviors is uncontrollable spending or shopping. Therefore, it is sometimes helpful for persons with bipolar disorder to make out a list beforehand of the items you absolutely need to buy — be it a grocery list, a Home Depot run, or a mission to get a your daughter’s friend a birthday gift. That way you won’t end up with 20 different kinds of paint swatches for the kitchen and living room you’ve decided to paint while you were at the store.

10. Allow Time to Decompress

This one is probably the second most important for me to prevent mania. I would say meditate, but that word produces too much expectation and pressure for me right now. Decompressing means after you finish something like a blog post or after you’ve forced yourself to be social for a few hours at a party that you didn’t want to attend, you allow yourselves 15 to 30 minutes to look at the ceiling fan in your bedroom and think about just that: the ceiling fan.

The case has been made that persons with bipolar disorder are creative and therefore need more chill time than the average person. Our brains are operating at a faster pace and more intensely than our non-bipolar friends for the periods of time where we must appear normal. So it is absolutely imperative that we allow some time where nothing is required — where we can drool, or lie in the grass, or doodle, or collapse in front of the front door. Although it seems as though these hours are unproductive, this activity will rebuild the gray matter of our brains and safeguard us from a manic episode.

Four years ago, a good friend of mine put her 10-year-old son on Prozac (fluoxetine). He had always suffered from anxiety and anger outbursts, but at age 9, his behavior turned violent, and his ruminations were keeping him up at night. My friend and her husband went to a variety of child psychologists, but the cognitive behavioral therapy wasn’t enough. Finally, they got a referral to a psychiatrist, who diagnosed the boy with attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and generalized anxiety disorder (GAD). The doctor prescribed both Ritalin (methylphenidate) and Prozac.

The boy’s behavior was much better initially, but the drugs presented other problems: His weight dropped, and he stopped growing. Once a kid who was born with a healthy appetite and would try any food, such as chicken curry at age 1, his parents now couldn’t get him to eat anything. He went from being in the back row of his basketball photos, where the tall kids line up, to the front line, where the short kids kneel. And after six months, his old behavior returned.

The parents weaned him off the Ritalin, and the boy’s appetite returned. They tried to get him to eliminate gluten and sugar as much as possible, and have him load up on protein. They began giving him fish oil supplements, a multivitamin, and a probiotic. The dietary changes had a substantial impact on his behavior.

A few months later, they decided to try to taper him off the Prozac. He did fine initially, and the parents thought they were home free. But two months after he was off the Prozac, their son’s worrisome behavior returned — and it was worse than ever. My friend thought that they should take him back to the psychiatrist, but her husband disagreed. He had researched the half-life of Prozac and other withdrawal stories, and told her that many people go through a delayed withdrawal two to three months after taking the last pill. Unfortunately, he said, they would have to tolerate the bad behavior for a few months until the synapses in his brain made the adjustments.

The husband was right. The boy had two-and-a-half rough months, but he pulled through. Today he is eating, growing, and thriving — managing his anxiety some days better than others.

I remembered her story because I recently tapered off of one of my antidepressants. A month off, I was doing fine when all of a sudden I was hit with some acute anxiety. I wondered, “could it be a delayed withdrawal symptom?” I brought this up to my fellow depression warriors on Group Beyond Blue and ProjectBeyondBlue.com, and received confirmation: When you have tapered off an antidepressant, it is incredibly difficult to know whether you are relapsing into a depression, or if you are merely experiencing withdrawal symptoms that will go away in a few weeks or months.

My friend Margarita Tartakovsy interviewed Ross Baldessarini, MD, professor of psychiatry and neuroscience at Harvard Medical School, and director of the psychopharmacology program at McLean Hospital, for an article on Psych Centraldistinguishing withdrawal symptoms from depression. Dr. Baldessarini believes that when the depression re-emerges quickly, it’s easier to identify as withdrawal. If it happens weeks to months after discontinuation, then he thinks there is much more risk of its being a relapse.

But after weighing in with several of the members on both forums, I’m not so sure I agree with Baldessarini.

For example, one woman went off her antidepressant in March, and got really depressed and anxious in July. Her doctor said this is to be expected and is not unusual at all — that it’s a natural part of the brain’s readjusting process. According to her doctor, it takes a few months for the brain to realize something is missing, and to start the readjusting. The whole process can last six months to a year.

That makes a lot of sense to me. There are so many organic changes going on in the gray matter of your brain when you stop taking an antidepressant. For people like me who have a significant response to a teaspoon of sugar or three bites of pumpkin pie, think about the mayhem that’s going on inside the limbic system of my brain as it tries to reorganize all the synapses after it’s no longer getting a hefty dose of a powerful psychotropic drug. Although I don’t believe most classifications of antidepressants to be addictive — unlike benzodiazepines — I do believe your brain becomes dependent on them, so that it needs to relearn how to ride the bike again without training wheels when you go off them. Lots of skinned knees…

Of course, the withdrawal process is different for everyone. Much has to do with how long a person has been taking the medication, and at what dose. Obviously, someone who was taking 60 milligrams (mg) of Prozac for 20 years might need to wean much more slowly and endure many more withdrawal symptoms (and for much longer) than a person who was taking 10 mgs for a few months.

For some, the withdrawal symptoms are very distinct from the symptoms that they were experiencing before. They might resemble that of the flu: headaches, dizziness, nausea, or fatigue. In fact, Baldessarini discusses the “SSRI Discontinuation Syndrome” in his interview with Margarita that occurs in 20 percent of people who withdraw from antidepressants. A person may become agitated and angry more than depressed (if he or she was depressed before), or sad and lethargic more than anxious (if he or she was primarily anxious before). If a person is suddenly having crying spells after going off a medication that treated her anxiety and insomnia, chances are she is experiencing withdrawal symptoms rather than a relapse of her condition.

After reading dozens of articles on typical withdrawal times, and corresponding with dozens of folks, it seems as though three months is the average recommended time (and this begins once you start having symptoms, which could be two months after you’ve weaned off your drug) to wait to see if the symptoms clear up.

Jim Kelly, a member of my forum and a mental health advocate and speaker living in Westchester, Illinois, never agrees to a medication change without a transition plan.

“Changing medications, either starting or ending, cannot be fully assessed until two or three months in; that’s for me,” Kelly says. “And I always request some transitional medication in a small dose to ease side effects.”

Kelly has learned to be patient with the ugly process.

‪”I’m undergoing a change right now, and two weeks in I feel terrible,” he explains. “It feels like withdrawal from the old, rather than anything to do with the new…yet. I wish the two or three months would go faster, but it is what it is.”

Ultimately, I think you know yourself better than anyone and can tease apart the difference between withdrawal or relapse more easily than you think you can. After comparing my symptoms this week to the symptoms of depression I’ve had for so much of my life (for this reason, it’s important to keep a mood journal!), and assessing other things going on in my life (different diet, changes in schedule, etc.), I could recognize it was my brain just readjusting to a different chemistry, and that I’m on the right track.

Much like my friend’s son.

When we discuss the advantages of regular exercise, it’s usually the benefits to physical well-being that take centre stage, and for obvious reasons.

Most are aware that physical exertion can aid cardiovascular health and protect against a plethora of hypertensive conditions. These reasons, alongside wanting to lose weight and improve the way we look, are among the chief motivations for embarking on an exercise program.

But perhaps lesser known and lesser discussed are the benefits regular exertion can have on mental wellbeing, which are numerous. In fact, courses of regular exercise are becoming a more utilized tool in the treatment of mental health issues, for a variety of reasons.

As we’ll discuss, regular exercise needn’t constitute arduous back-to-back shifts in the gym. Just 30 minutes a day can have a range of benefits on mental health.

Mood improvement

Firstly, physical exertion is thought to stimulate the release and activity of endorphins. This process, referred to as the ‘endorphin hypothesis’ and explained by Anderson and Shivakumar as the ‘binding of [endogenous opioids] to their receptor sites in the brain’, has been explored in several analyses.

Besides their analgesic effect on physical pain, the increased activity of endorphins during exercise is also credited for improving the mood of the person practicing it. For instance, one study examining patients living with clinical depressionfound a convincing link between 30 minutes of aerobic exercise performed on a daily basis and “substantial” mood improvement.

Stress reduction

In addition to the stimulation of endorphins, exercise is also known to have a direct effect on the presence of cortisol and adrenaline in the body. These are natural stress hormones, often referred to as the “fight or flight” chemicals which can be triggered by a range of stimuli, including danger or emotional trauma. In persons with chronic stress or anxiety, levels of these hormones may be continually raised.

Intense physical exertion is thought to acutely increase cortisol levels, which is perhaps unsurprising due to the strain the body is being put under.

However, performing 30 minutes of low intensity exercise has been linked by one study with reduced cortisol levels.

Furthermore, regular exercise has been associated with a decreased overall presence of cortisol levels in the long term, as the body will become more used to physical exertion and not need to produce as much. So for those who make a habit of exercise, their resting levels of these stress hormones may significantly decrease.

Raised self-esteem

Another mental benefit of frequent physical activity is that it improves body image, and consequently this aids self-esteem.

One analysis undertaken by researchers at the University of Florida found that exercise at all levels had a positive effect on the way people felt about their bodies; and their results suggested that this wasn’t limited just to those who undertake exercise on a regular basis.

However, most will know from experience that one-off episodes of physical activity aren’t enough to sustain these feelings over the long term, and a person’s positive self-image may wear off after a prolonged period of inactivity.

Frequent exercise on the other hand contributes towards higher energy levels and better overall physical health; and the better we feel, the more comfortable we are about the way we look.

Increased social interaction

One particular advantage of participating in a team sport is that it raises our level of social contact with others.

Recently, I headed an investigation into the calorie-burning value of participating in 28 different olympic activities for 30 minutes each, which celebrated in particular the role team sports can play in helping someone to maintain a regular fitness regime.

The social interaction hypothesis is a term sometimes to describe the link between physical activity in a communal setting and improved mental health. By facilitating the development of social relationships through team and communal fitness activities, exercise can help to reduce feelings of isolation and provide a supportive environment.

Regular social contact is of course more beneficial, but team sports don’t have to account for every session of someone’s entire workout routine. Participating in just one communal activity per week can contribute towards better mental health.

One of the worst parts about depression — and there are certainly many — is that it robs you of hope. Hope that you’ll actually feel better. Hope that the darkness will lift. Hope that the emptiness will fill up and you’ll feel motivated and excited. Hope that it won’t be like this forever. Hope that you’ll get through it.

“I’ve been struggling with depression for almost 35 years,” said Douglas Cootey, who pens the award-winning blog A Splintered Mind. “In that time, I have often felt hopeless, usually during times of suicidal ideation…Depression has a way of warping our outlook so that we only notice the bleakest parts of the world.”

The darkness stops feeling like a lens that distorts your reality, and starts to become your reality, said John A. Lundin, Psy.D, a psychologist who specializes in treating depression andanxiety in adults, teens and children in San Francisco and Oakland, Calif.

“Depression often robs you of the memory of joy or happiness, so it becomes difficult to draw on happy memories to give one hope for the future,” Lundin said. Depression even makes hope seem foolish, like an illusion, he said.

Many people with depression aren’t able to articulate that they feel hopeless. Because doing so requires putting “words to an experience that just feels as real and encompassing as the air they breathe.” Saying you feel hopeless, Lundin said, can actually be a positive step. “[I]t holds the implication that hope is something that is possible.”

“Depression can be overwhelming,” said Cootey, also author of Saying No to Suicide: Coping Strategies for People Dealing with Suicidism and for the Loved Ones Who Support Them. “All those negative emotions are suffocating. This makes it difficult to believe that things will get better.”

Most of Rebecca Rabe’s clients say they’ve lost hope because they feel alone. They feel like no one understands what they’re going through. They feel like they can’t talk to anyone.

Loss of hope also might represent a loss of belief that you matter or that you can be loved, Lundin said. (This is something he works on with clients, helping them understand why they don’t feel adequate or lovable.)

What can you do when hope feels unfamiliar or impossible? What can you do when you’re in the middle of the storm?

Cootey stressed the importance of using a wide variety of coping strategies. “When I use my coping strategies to overcome depression, the next day isn’t a prison of more of the same. It’s a brand new day free of the sadness.”

Colleen King, LMFT, a psychotherapist who specializes in mood disorders and also has bipolar disorder, stressed the importance of having a treatment team and support system. This might include a therapist, doctor and several friends and family. Ask them to help you remember the times when you’ve felt better, she said. Ask them to “encourage you to be in the moment when you do experience temporary joy, even if it’s for a few minutes.”

Both King and Lundin suggested participating in activities that feel nourishing to your soul, activities that you love to do when you’re not depressed. Do them even if you don’t feel like it, King said. “You will most likely alter your mood at least a little bit, and [the activity] may be a welcome distraction from depression.” Plus, it helps to “arouse glimmers of hope that you can feel whole and healthy, again.”

It often feels like depression will last forever, King said. Which is why she also suggested placing prompts at home and work to remind yourself “that you are having a depressive episode and that it’s not a permanent state of being.”

Don’t underestimate the power of small steps. Rabe, LMFT, who specializes in treating children, teens and young adults with depression, anxiety and trauma, shared this example: She worked with a woman who was struggling with depression and complained about “not being able to do anything.”

They worked on tracking small but significant accomplishments and setting small goals. “For example, she would strive to check 10 things off her list. Sometimes just getting to therapy got her these 10 checks.” After all, getting to therapy is anything but trivial. It involves getting up, showering, getting dressed, driving to the office, making the appointment on time, talking in session and driving home, among other tasks. Her client also started reaching out to supportive loved ones (instead of isolating herself); taking walks; and writing in her journal—all of which has helped to diminish her depression and create a more positive outlook.

“I’ve been through the worst my mind can throw at me. I’ve felt the pain of suicidal depression,” Cootey said. “I’ve wished and even planned for my own death, yet I learned an important truth: Depression lies to us.” This is another reason it’s helpful to surround yourself with support: These individuals can help you see through the lies, he said.

“You do have worth. You will overcome this. You won’t be sad forever.”

There is always hope for someone struggling with depression, Rabe said. “People are resilient human beings, and they can do so much more than they think they’re capable of.”

Also, remember that “how hopeless you feel does not correlate to whether you can feel better,” Lundin said. Depression is an illness that extinguishes hope. It’s the nature of the disorder.

Thankfully, therapy and medication can help. So can participating in support groups. “Some depression requires a short treatment to work, and other takes a long time. But I have never met a patient who didn’t see significant progress if they stuck with it.”

If your therapist or doctor doesn’t seem to be helping, seek out new providers, King said. “Having a trusting and caring treatment team greatly assists with creating confidence and hope for the future.”

For people who don’t respond to therapy and medication, other treatments are available, such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), Lundin said.

With good treatment, effective and varied coping strategies and compassionate support, you can feel better. The heaviness gets lighter.  The world becomes brighter.

So no matter how hopeless you feel right now, please don’t throw away your shot. Hope and relief are not some foolish illusion. They are real. They are possible.

Have you ever driven your car somewhere and arrived at your destination only to realise you remember nothing about your journey? Or started eating a packet of chips and then suddenly noticed all you had left in your hands was an empty packet? Most of us have!

These are some common examples of ‘mindlessness’ – A state we also often refer to as being on ‘autopilot.’

When we slip into autopilot (and research shows that the average person is in autopilot 47% of the time (1)) our attention is absorbed in our wandering minds and we are not really ‘present’ in our own lives.

Some teachers talk about autopilot as being a dreamlike state because in that mode we’re simply not fully ‘there’ in that moment.

In this busy, hyper connnected world we live in it’s all too easy to lose ourselves in autopilot for much of the day….every day.

Living this way we often fail to notice the beauty of life, fail to hear what our bodies are telling us and we all too often become stuck in mechanical conditioned ways of thinking and living that may be harmful to ourselves or others.

On autopilot we tend to get lost in ‘doing’ so we find ourselves constantly striving and struggling and ‘getting stuff done’ instead of really living.

We also become vulnerable to anxiety, stress, depression and reactivity. Research shows, in fact, that the more our minds wander, the less happy we are (1).

What Is Mindfulness?

Mindfulness is the opposite of mindlessness.

It means waking up out of autopilot and ‘taking the steering wheel’ of our attention again.

We practice mindfulness by maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations and the surrounding environment.

Mindfulness also involves non-judgment, meaning that we pay attention to our thoughts and feelings with the attitude of an impartial witness — without believing them or taking them personally.

Jon Kabat Zinn defines mindfulness as:

“Paying attention;

On purpose,

in the present moment, and

non-judgmentally.”

I like this definition because it allows us to see exactly what the components of mindfulness are. Through this definition Jon shows us that there are three specific ways in which our attention ‘shifts gears’ when we practice mindfulness.

Firstly our attention is held…

1. On Purpose

Mindfulness involves the conscious and deliberate direction of our attention.

When we’re on autopilot our attention is being swept up by a never ending (and not always positive) current of thought processes but when we’re mindful we ‘wake up’ and step out of that current, placing attention where we choose.

Another way of saying ‘on purpose’ is consciously. We are living more consciously, more awake, more fully ourselves when we pay attention in this way.

Secondly our attention is immersed…

2. In The Present Moment

If we leave it to it’s own devices our mind habitually wanders away from the present moment. It constantly gets caught up in the replaying the past and the projecting into the future. In other words, we’re very rarely fully present in the moment.

Mindful attention, however, is completely engaged in the present moment experience – the here and now. We let go of the tension caused by wanting things to be different, the tension of constantly wanting more, and instead we accept the present moment as it is.

And third, our attention is held…

3. Non Judgmentally

When practicing mindfulness we’re not aiming to control or suppress or stop our thoughts.

We simply aim to pay attention to our experiences as they arise without judging or labelling them in any way.

Mindfulness then allows us to become the watcher of sense perceptions, thoughts and emotions as they arise without getting caught up in them and being swept away in their current.

Becoming the watcher in this way, we’re less likely to mechanically play out old habitual ways of thinking and living. It opens up a new freedom and choice in our lives.

 How Do You Practice Mindfulness?

There are two forms of mindfulness practice. The first is the formal practice of mindfulness, which is commonly referred to as meditation.

A meditation practice is commonly done sitting, usually with eyes closed, but can also be done lying down or even walking. some meditation practices also involve mantra (sound) or movement.

The informal practice is the rest of your life! You see, anything we do in daily life with full awareness can be said to be mindfulness practice.

You can do the dishes mindfully, wait at the traffic lights or go for your morning walk mindfully. Any routine activity can be made into a mindfulness practice when you bring your full attention to it.

What Can Mindfulness Do For You?

Thanks to research and exposure from the media, mindfulness is no longer hidden in ancient spiritual texts, monasteries and ashrams. Today, it is practiced by millions of people the world over.

It is now being taught in schools, in workplaces, in hospitals and in homes all over the world. As people continue to discover for themselves the incredible benefits of living mindfully, the interest continues to skyrocket.

There is now a huge body of research on the benefits of mindfulness.

Here are some of the proven ways that mindfulness can benefit you…

-Mindfulness reduces stress, anxiety and other destructive emotions (2). (Mindfulness actually shrinks the the brain’s “fight or flight” center, the amygdala. This primal region of the brain, associated with fear and emotion, is involved in the initiation of the body’s response to stress.; this is the part of the brain responsible for so many destructive emotions like fear, unhappiness and anger.)(3)

-Mindfulness reduces depression (clinical trials are showing that mindfulness is as effective as medication with no side effects!). (4)

-Mindfulness reduces insomnia (4), increases your sense of well being (1), reduces lethargy and increases energy both mentally and physically.

-Mindfulness is also very effective for pain management. (5)

-Mindfulness sharpens your memory (6) and increases your focus and attention(7).

-Mindfulness improves your emotional and social intelligence and develops your empathy and compassion (8). It is also shown to improve realtionships (9).

-Mindfulness improves health and boosts immunity (10). In fact, mindfulness is shown to have beneficial effects on many serious illnesses such as cancer and heart disease (11).

-Mindfulness creates clearer, more focused thinking and improves efficiency at work and at home (6).

-Mindfulness improves confidence and emeotional resilience (12).

-Mindfulness reduces compulsive and addictive tendencies (13) and has also been shown to work better than any diet for effective long-term weight loss (14).

-Mindfulness turns out to also be the single most important determining factor in whether or not you will be happy in your life (once your survival needs are met).

In other words, the more mindful you are the happier you are (1).

Mindfulness can literally transform your entire world from the inside out and for the millions of mindfulness practitioners around the world it’s doing just that!

If you haven’t already, why not find out for yourself, the first hand, what it’s all about?

You might just discover the most incredible and wonderful surprise. That everything you’ve been searching for ‘out there’ — feelings of fulfillment, peace and wholeness — have been within you all along.

Warmly, Melli