Depression Prevention

If you've ever suffered from a depression, you don't want to go there again. Even if you haven't but you're dealing with precursors to depression - stress and fatigue - then you want to find ways to beat back the "black dogs" (as Winston Churchill called his depressive episodes) before they attack.

If you don't get enough sleep, eat erratically and exercise by tapping on a keyboard, you're setting yourself up for a fall. Although it's not proven that fatigue, for example, causes depression, common sense tells you that enough sleep, the right food fuel and activity will help you stay on an even keel.

We all know people who cut into their sleep, skip meals and don't exercise so that they can accomplish everything on their list, usually a list of others' needs and wants. Their lists are long because they have partners who don't help enough, kids who live for their ballet and hockey and soccer, bosses who don't understand their other obligations and parents who need their attention. I've written sympathetically about the difficulties of balancing it all for years. But as I've come back to this issue over and over in the course of writing this book, my sympathy is waning. How much help can one be living in a black funk or, perhaps worse, suffering from a heart condition? Don't get me wrong. If together you're dealing with an illness, deep financial trouble or some other life crisis, you deserve sympathy and support for the load you're carrying. But if you're two people in a stable relationship without the wolves at the door, you need to rethink priorities to look after yourselves, too. And that's as much our responsibility as all the other responsibilities we're so willing to take on. End of sermon.

Learn the power of what the experts call positive self-talk. Most are unaware of the tape that's running in our head, telling us "You'll never finish the project. Your body is unattractive. Your conversation is uninteresting." When you first tune in to that nasty voice questioning your every move, you may be shocked at the cruel things you think about yourself. But if you decide to, you can change the tape to much more positive messages. "You have an excellent record of finishing on time even when a project has a setback. You have a great smile. Your conversation is warm and engaging."

To change the tape, write down your inner negative thoughts to bring them out into the open. Then beside them, write down your new way of thinking. If your thoughts have become a downward spiral of negativity ("I'll never, I can't, I shouldn't have"), you can take some action: clap your hands and yell "Stop" to break the pattern and reprogram the messages. It's hard work to make yourself so selfaware, but the payoff is huge because you reclaim your energies to get on with your life rather than sabotaging your own efforts.

Be good to each other. Your relationship can be a huge source of strength in managing stress and fatigue and preventing depression. Many studies have attempted to codify how men and women support each other within the relationship, some concluding that men receive more support than they provide to women in the same circumstances. However, a recent study published in Social Science & Medicine looked at couples sharing "severely threatening life events" and found that good-quality relationships meant lower rates of depression for both men and women, although the overall rate of depression for women was stilI higher.

Certainly, having already learned to divvy up work and family responsibilities in a way that feels fair to each of you goes a long way to providing a solid base for dealing with new stresses and responsibilities. And remember the measure of a healthy relationship is the handling of disagreements. Knowing how to fight fair keeps arguments from spinning out of control in a way that sends both your stress meters skyrocketing.

It's so easy to let friendships and time with extended family slide, especially when you're already pulled in too many directions. But having a network of support is the most important way to prevent depression. It may be hard to believe that picking up the phone and calling your sister will be a deposit in your anti-depression bank but it's true. It's also true that making time for fun - as simple as telling a joke at dinner - will put more deposits in the bank. Finally, losing yourself in an activity - reading, assembling model cars, playing bridge, whatever - allows you to concentrate on something other than worries and lose yourself in the moment.

Exercise has been shown to be as effective in fighting mild depression as Prozac. And it's thought to be effective at keeping depression at bay in the first place.