Not surprisingly, stress can have damaging effects on depression. That is, “stress hormones like cortisol can exacerbate the effects of an existing depression. Or if we’re not currently depressed, we can become more vulnerable to a future episode,” said Lee Coleman, Ph.D, a clinical psychologist and assistant director and director of training at the California Institute of Technology’s student counseling center.
Depression also comes with its own stressors. We might become self-critical because we aren’t able to function normally, he said. (And because depression sinks our self-esteem and fuels our inner critic.)
We might wonder what’s wrong with us, why we aren’t as excited about life anymore, and when we’ll stop feeling so bad. As Coleman said, naturally, “all of these are potentially stressful thoughts and feelings.”
But this doesn’t mean that your situation is hopeless. It isn’t. In fact, there are many things you can do. Below, Coleman and other therapists who specialize in depression shared five ways to effectively navigate the stress in your life.
1. Assess every piece of your life.
Psychologist Stephanie Smith, PsyD, suggested examining everything and everyone in your life and asking yourself these questions: “How much do I enjoy this activity or person? How much stress does it bring me? How do I feel after I spend time there or with that person? Does [that activity or person] add to my life?”
In other words, take a step back, and reevaluate your relationships, routines, job and other circumstances. Smith also suggested asking these questions: “Is this really what I want? What’s really the best thing for me right now?”
“[I]t doesn’t necessarily mean that after the evaluation period you will change everything about your life. But it does mean that the things in your life will be more intentional.”
2. Make tiny healthy shifts.
When you’re struggling with depression, it might be tough to make big decisions and take big steps. Instead set small, specific and feasible goals, said Smith, who practices in Erie, Colo.
She shared these examples: Spend 10 minutes outside every day; make an appointment with a psychologist this week; reach out to one friend or relative today; take a walk four days out of seven; and do one thing you enjoy each day.
Taking small steps also provides momentum for making bigger changes in the future, she said. But if you don’t meet your goals, be gentle with yourself. Depending on the severity of your depression, it might be tough to take action (or get out of bed). That’s when working with a psychologist who specializes in treating depression is critical.
3. Redirect your attention.
“Depression and stress thrive on wandering minds, especially on questions that don’t really have an easy answer, like, ‘Why is this happening?’ ‘When will I feel like myself again?’” said Coleman, author of Depression: A Guide for the Newly Diagnosed. Getting caught up in these questions releases stress hormones such as cortisol, and leads to feeling sadder, he said.
One way to redirect your attention is to focus on what you’re doing right now. For instance, give your full attention to mundane tasks and activities, such as walking, picking out produce and even breathing, Coleman said.
Another way is to redirect your attention to your physical sensations, he said. For instance, name what you’re experiencing: “Right now, my chest feels tight. I notice my jaw is tense, and my fists are balled up.”
Again, try not to get caught up in thoughts like “Why does this keep happening to me?” or “I can’t handle it!” he said. These thoughts only feed your stressful reactions. (And remember your depression likes to lie.) “Focusing on the physical aspects of stress keeps you grounded in the moment without adding that unhelpful second layer of negative appraisals.”
Don’t try to change the sensations you’re experiencing. Instead, try to keep a curious, accepting attitude. According to Coleman, this might look like: “OK, stress is here again. Where am I feeling it in my body this time?”
4. Try mindfulness apps.
Mindfulness (and exercise) “can be extremely helpful in relieving symptoms and creating the endorphins your brain needs to feel better,” said Robin Starkey Harpster, MA, MFT, a psychotherapist in Los Angeles.
5. Make a radical change.
Sometimes, drastic measures are necessary. Recently, author and Psych Central editor Therese Borchard penned this brilliant piece about what to do when your depression isn’t improving. For instance, it’s hard not to feel depressed when you’re working in a toxic environment. So, in this case, the best stress-reducing strategy might be to switch jobs. According to Borchard:
I don’t mean putting a few less to-do items on your list. I’m talking about radical lifestyle changes — like changing jobs in order to work in a less toxic and stressful environment, moving into a smaller home so that you don’t have to moonlight, deciding against adopting a rescue dog or having a third child. It can be practically impossible to keep your mood resilient if you are under chronic stress because it increases the connection between the hippocampus part of your brain and the amygdala (worry central), impairs your memory retention, affects your cortisol production (making it difficult for you to handle more stress), and weakens your immune system.
One of the most powerful tools for shrinking stress is treating yourself with patience and compassion. “You’re dealing with an illness that’s going to take some time to work through. And you can’t rush it by criticizing yourself or setting arbitrary deadlines for meeting certain goals,” Coleman said.
Plus, what you’re able to accomplish really depends on the severity of your depression. Don’t hesitate to seek professional support from a psychologist. And be flexible with yourself and remember that the smallest steps do add up, Coleman said.
This article originally appeared on psychcentral.com and was written by By Margarita Tartakovsky, M.S.