You may be less privy, however, to the subtle things you’re doing that are actually working against you and making your symptoms worse, despite treatment. Here, mental health professionals who treat people with MDD share the six common pitfalls they see most often that make life with the condition harder — and how to avoid these traps. Rather, an assortment of factors that aren’t within your control are thought to play a role in causing depression, says Alice Hua, PhD , a licensed psychologist with Deeper Than Color, a private practice in Oakland, California:
Brain chemistryHormonesStressful or traumatic life eventsHaving a chronic or acute illnessFor marginalized communities, the effects of systemic oppression, including racism, sexism, transphobia, ableism, etc.
“Although the cause does not take away from the pain of experiencing depression, understanding that depression is not a personal or moral failing can help to destigmatize this condition,” says Dr. Hua. Realizing that depression does not reflect a personal failure can also remove an unnecessary layer of suffering.
Pitfall #2: Not Taking Care of Your Body
Fatigue and lack of energy are common symptoms of MDD, and if you have this condition, you may find it difficult to even get out of bed, let alone attend to your body’s needs like personal hygiene, nutrition, and exercise. But paying attention to those very things, while not a cure for depression, can help you feel a lot better. “One of the most crucial mistakes is not taking care of yourself or practicing proper self-care,” says Zishan Khan, MD , a psychiatrist with Mindpath Health in Frisco, Texas, who treats people with depression. “If you are not sensitive to what your body needs and push it past its limits, it can very well worsen your depressive symptoms.” Several self-care strategies could help, adds Dr. Khan:
Try to eat more fruits, vegetables, whole grains, and lean proteins. People with depression who adhered to a brief dietary intervention rich in these foods experienced significantly lower depressive symptoms than those who did not, according to a study published in 2019 in PLOS One.Aim to exercise on most days of the week. Breaking a sweat for at least 30 minutes a day, three to five days a week, could substantially improve symptoms, say Mayo Clinic experts. Anything from jogging to biking to gardening counts — just aim to find something you enjoy so that it brings you pleasure and it’s easier to be consistent.Practice good sleep hygiene. This includes going to bed and waking up at the same times each day, keeping your bedroom cool, quiet, and dark, and not drinking alcohol before bed.
If you’re having trouble making self-care a regular part of your routine, be sure to reach out to your mental health provider, suggest experts at the National Institute of Mental Health. Your provider could help you make a plan that’s manageable for you.
Pitfall #3: Judging Yourself for How You’re Feeling
It’s not uncommon for people with MDD to be hard on themselves for how their depression affects them and their ability to function. But judging yourself for having depression or struggling with your symptoms can make life with the condition even harder. “Because having depression still carries a cultural stigma, it’s not surprising that someone with depression might judge themselves for having thoughts or feelings related to being depressed,” says Hua. It might help to reflect on any self-critical thoughts you’re having and reframe them in a more helpful way, suggests Hua. For instance, adds Hua, try to limit any thoughts beginning with “I must,” “I have to,” or “I should” — such as “I should be feeling better” or “I have to start exercising” — because those thoughts reinforce self-judgment of depressive symptoms. Instead, try replacing those thoughts with ones that start with “I want to” or “I plan” — such as “I want to feel better” or “I plan to start exercising.”
Pitfall #4: Isolating Yourself From Loved Ones
Social withdrawal is a hallmark sign of MDD. While trying to be present with others can be challenging, it’s still important to stay in touch with people around you, even if only in a limited capacity such as a text or Zoom call. Social interaction with loved ones has beneficial effects on the brain. “When we spend time with loved ones and friends, our posterior pituitary gland releases stored oxytocin,” says Khan. “This oxytocin in turn supports the secretion of serotonin, which is a neurotransmitter primarily responsible for regulating behavior and mood." Having more frequent and fulfilling social interactions with others appears to protect against depressed mood and loneliness, according to the results of a study of 515 adults published in 2021 in the Journal of Social and Personal Relationships.
Pitfall #5: Trying to Avoid Your Feelings
People with MDD often struggle with feelings of guilt, unworthiness, loneliness, and sadness. While these feelings can be hard to sit with, trying to push them away can actually make things worse. “It can actually lead to feeling worse and a desire to continue avoiding these feelings, which can become a perpetuating cycle,” says Hua. Hua suggests you spend some time reflecting on these feelings, as long as they don’t totally consume you, or unpacking them with your mental health provider, who can suggest strategies for coping with them.
Pitfall #6: Turning to Alcohol or Drugs for Relief
One thing people often do to avoid tough feelings is misuse substances like drugs and alcohol. In fact, it’s very common for people with MDD to also have a substance use disorder, according to a systematic review and meta-analysis published in 2020 in the Journal of Affective Disorders. While using alcohol or drugs may feel good in the moment, this often backfires over time. “It is very easy to reach for that alcoholic drink to soothe the pain one feels inside, or to try and experience quick relief from a recreational drug, but this will likely only worsen your situation,” says Khan. If you struggle with substance use as a means of coping with your mental health, it’s very important to let your doctor know, especially if you take antidepressants, as this could lead to negative drug interactions. And if you think you may have a substance use disorder, your doctor may be able to suggest dual-diagnosis treatment programs that could help you learn to manage both MDD and your substance use disorder. The symptoms of a substance use disorder, according to the Mayo Clinic , are:
Intense urges to use drugs or alcohol every day or multiple times a day, to the point it’s hard to think about anything elseNeeding more drugs or alcohol over time to achieve the same effect, or using more drugs or alcohol over a longer amount of time than you meant toAlways making sure to have enough drugs or alcoholSpending money you don’t have on drugs or alcoholPrioritizing drugs or alcohol over work, school, relationships, or other responsibilitiesContinuing to use drugs or alcohol even though you’re aware of the negative effects they’ve had on your lifeDoing things that are usually out of character for you, just to get drugs or alcoholDriving under the influenceNot being able to stop using drugs or alcohol, despite prior attemptsHaving withdrawal symptoms if you try to stop using drugs or alcohol
