Your Depression Survival Guide - Warning: Nothing is Fail-safe

Patient Expert

A few days ago, I posted some thoughts on the suicide of Robin Williams. I did not speculate on any "what ifs." Instead, I reflected on the intense psychic distress he had to have felt in those final hours. A pain so strong and deep that the unthinkable presented itself as the rational choice.

Many of us know exactly what that is like. The rest of us have very strong insights. Knowing what we are up against, now is a good time to compile a sort of do-it-yourself depression survival guide.

Part One: Simple home truths

It is OK to feel depressed. Psychic pain is as real and valid as physical pain. In many cases, this type of pain is part of our long-term healing process. You should not feel that there is something wrong with you simply because you cannot make this pain magically go away.

Your current reality is real. Well-meaning people will try to impose their realities on you. But your reality - the sum total of your thoughts, feelings, and perceptions - is the one you have to live in and deal with.

There is a distinction between suicidal thinking and your emotions. Susan Rose Blauner, in her book "How I Stayed Alive When My Brain Was Trying to Kill Me," makes the important point that being suicidal is not a feeling such as anger or sadness. She says that we need to drive a wedge between our suicidal tendencies and our feelings. This will give us a bit of breathing room to deal with those feelings.

Part Two: Two essential survival tools

Mindfulness: Mindfulness is the mind watching the mind. Skilled practitioners are able to observe destructive thoughts and feelings as they arise and cultivate a sense of detachment. Cognitive behavioral therapy, which is based on mindfulness, focuses on replacing destructive thoughts with constructive thoughts.

A support network: Your family may not understand you, but they will probably be the ones who drive you to the emergency room. Make every effort to keep this lifeline open. In the meantime, work to cultivate a network of people who do understand. A DBSA support group is a good place to start.

Part Three: More on support

You may outgrow a support group or your current friends. But you will never outgrow your need for a support network. These are the people you can check in with, who know your dark side, who you feel safe in discussing your most distressing thoughts, or - for that matter - just the weather.

Back in the nineteenth century, author Joshua Shenk reports, depression was not a taboo subject. Males formed deep bonds with each other and were not afraid to share their innermost thoughts and feelings.

Mr Shenk wrote the book, "Lincoln's Melancholy." Significantly, Lincoln never had to face his colossal depressions alone. His friends rallied around him. They kept watch over him. They removed knives and weapons from his premises.

Ask yourself: How good is your support network?

Part Four: Make a survival pact

A study of 515 people who were stopped from jumping off the Golden Gate Bridge found that these people remained in a high risk category over the next six months. Nevertheless, 90 percent of the survivors did not die of suicide or other destructive acts.

The study concluded that "suicidal behavior is crisis-oriented and acute in nature."

In other words, even though our thoughts and feelings and perceptions are real, they are temporary and subject to change. Kevin Hines, who in 2000 survived the 200-foot drop, says that "the very second I let go, I knew I had made a big mistake."

Please, make a promise to yourself: Whatever you may feel like doing now, resolve to wait another day.

Part Five: Stand up for yourself

In a suicidal crisis, you need to be under emergency care. This may involve a bed in a psychiatric unit, if for no other reason than the fact that someone will be watching you.

Unfortunately, the economics of health care means many of us are turned away or released far too soon. Unfortunately again, deep depression is not conducive to asserting oneself. This is not the time to be polite and accommodating. Stand your ground.

Part Six: Play into your strengths

The fact that you are here reading this means you are far stronger than you give yourself credit for. Whatever you did to manage yourself through crisis on previous occasions will serve you well through your present or future ones. Figure out what you are doing right, and resolve to keep doing it.


I write this with considerable trepidation, knowing I am just one bad day away from not following my own advice. Such is the power of depression. Having said that, knowing what I am up against gives me incentive to plan ahead and prepare for the worst.

We're all in this together. Let's resolve to be there for one another.