This fairly extensive post is intended to provide a guided journey to resolve depressive symptoms. Please note that each person’s journey will be unique, but this general guide will likely be helpful in laying out some predictable stages, critical understanding, and needed skills, practices, nutrition, and resources for the journey.

Outline of contents

Understanding depression
Where to Begin?
Phase 1 Stabilize and Strengthen: Notice and and interrupt depressive feedback loops.
Phase 2 Resolve and Repair: Identify and resolve memory anchored stories and drivers of depressive symptoms
Phase 3 Expand: Take back lost areas of your life and give back to others.
Conclusion.

Introduction

Understanding Depression:

Depression involves a combination symptoms that generally include low energy, lack of motivation or interest in things previously enjoyable activities, isolation, negative thoughts about self, other, and world, irritability, sleep difficulties, feelings of hopelessness, and at times suicidal thoughts. Depressive symptoms exist on a continuum from mild to severe. Major depressive disorder is when there are enough of these symptoms and they are severe enough to validate an official diagnosis. However, even mild depressive symptoms can really reduce the quality of your life and make you feel like you are dragging a heavy weight behind you wherever you go. If your symptoms are mild to moderate, it is ‘somewhat easier’ to take action to make changes that will interrupt the downward spiral and even get it moving in an upward direction to the point of resolving the depression. If you are in more severe states of depression, it becomes increasingly difficult, though NEVER impossible to take helpful action to change your mood and circumstances.

For moderate to severe depression I strongly recommend seeking professional help which should definitely include a mental health professional but could also include a consult with a doctor or psychiatrist regarding medications, an evening or half day outpatient program, a partial hospitalization program, or even a few weeks in an in-patient treatment center if needed. Medications can be a helpful solution to give you the needed boost to take the needed steps such as the ones below to start improving your life and symptoms. Once you are in a better place you can consult with your doctor/psychiatrist and therapist about whether and how to wean down on medications given that you are in a have adequately resolved the underlying causes of the depression and established healthy life practices to keep your brain, body, and nervous system in a well-balanced state.

Our nervous system has 3 primary states that exist in a hierarchy often called a ladder. At the top of the ladder is the ideal default state of safe/connected. In the middle is feeling unsafe and mobilized, and at the bottom is feeling unsafe and shut down. This is critical to understand and I strongly recommend reviewing the page What is State Shifting for a good understanding of this based on Stephen Porges polyvagal theory. From a nervous system perspective, depression involves being stuck a lot of the day or all day at the bottom of the nervous system ladder in a shut down (dorsal vagal dominant state). This means that your nervous system is trying to conserve energy, reduce activity, and keep energy levels low. Higher level functions like creativity, social engagement, and mobilizing energy to move toward goals are difficult to engage in a dorsal vagal dominant state. The overall goal is to move back up the nervous system ladder through some form of mobilization and then up to feeling safe and connected/ventral vagal. Below you will find several exercises to manually shift your nervous system in the right direction.

From the perspective of neurochemistry, there can be a number of things going on with depression, but the bottom line is that systems like dopamine, serotonin, norepinephrine, and cortisol are out of balance. The brain (and gut) have an amazing ability to re-balance these chemicals given the right ingredients including the following:

Enough sleep
Activities that promote production of the right amounts of neuro-transmitters at the right times including early morning sunlight, exercise, social engagement with an attuned and caring person.
My keystone habits are designed to be a very easy way to start the upward spiral.
Give the body the nutrients and minerals it needs to create and balance necessary hormones, energy, etc. (Critical nutrients like Vitamin D3, zinc, and magnesium and EPA omegas are often low.)
A healthy gut microbiome which has a diversity of the right kinds of good bacteria is increasingly shown by research to be helpful for mood and energy levels.
Increase internal cues of safety and well-being by resetting nervous system.
Increasing external cues of safety and reducing external cues of danger.
Reduction of internally imagined cues that signal danger to the brain causing floods of stress hormones. This includes resolving triggers from unresolved memories, and noticing/testing/adjusting the unhelpful and stress inducing stories our brain is generating.

I have laid out my standard protocol for resolving depression based on studying and integrating a wide range of approaches and knowledge in the field of mental health. Please note that this template may need to be re-ordered depending on what are the primary drivers of each individuals depressive symptoms, and additional resources may need to be brought in at times, but I believe anyone struggling with depression will find the following information very helpful and if followed may well be adequate to fully resolve or greatly improve their depressive symptoms. As always please take full responsibility for your own well-being and choices. This information is designed to be a resource but not a replacement for professional counseling.

Where to Begin:

When it comes to depression, the problem tends to be lack of hope, low energy, and low motivation therefore it is probably best to start really really simple with the lowest hanging, most easily accessible plan. The first step I recommend is to assess the severity of the depression. Here is a link to a Mental Health America’s free depression screener. MHA is a non-profit with a lot of good resources including free screeners. If symptoms are moderate or higher I would immediately recommend seeking help from a mental health professional and notifying your doctor. Once those are in place you may review the following.

Phase 1 Stabilize and Strengthen:

Phase 1 is about stabilizing and strengthening. Stabilization involves noticing and interrupting negative feedback loops that keep you stuck in a cycle of depressive thoughts and feelings. This includes stabilizing your neurochemistry, resetting your body clock, routine resets of your nervous system, and routine resets of your thoughts. I start with 3 simple keystone habits to accomplish these goals in a way that is not overwhelming. Phase 1 also involves strengthening which includes increasing your internal and external support system by giving your brain and body what they need to naturally produce changes that make you feel better. Strengthening can involves changing your environment, adjusting your posture, and ideally engaging some critical social support to help you feel more powerful, hopeful, and secure.

Start Stabilization with 3 Keystone Habits

I have identified 3 key habits that take 5 minutes at a time that I think are critical starting points for people. These are designed to be implemented over the course of 6 weeks so you can observe the effect of each one. For full details about this visit the page Keystone Habits.

Direct sunlight in the morning as early as you can after you wake up. (First two weeks)
Add 5 Minute Walks (Second two weeks)
Add 5 Minutes of gratitude. (Third two weeks)

Getting your body clock set.

View Sunlight for 2-10 minutes daily upon waking as early in the day as possible. (Extremely Important VIDEO please watch.)

Below is additional information on the first keystone habit of early morning sunlight as well as a few additional tips for getting your body’s internal clocks set correctly to improve both energy levels and sleep. Sounds pretty good doesn’t it 🙂 You can do it. Start really simple with just going outside first thing when you wake up and looking toward, (though not directly at) the sun.

This will trigger the right amount of cortisol to be released early in the day to promote wakefulness. Shifting cortisol pulse to earlier in the day is shown to improve depression. Sunlight exposure also triggers dopamine release which increases motivation, and starts a timer for melatonin to release (16 hours later) at the correct time to sleep at night which makes it easier to fall asleep. This is why earlier is better when it comes to sunlight exposure. Note that if you can’t wake up early, don’t stress, just start going out for a few minutes as soon as you can after waking to start your body working in the right direction.

Additional ways to set your body clock: you may want to do the following early in the day-exercise, eating, and social cues (some form of social connection even with a pet).

In the evening you want to reduce lighting especially blue light or screens. You especially want to avoid any light exposure between 11pm and 4am. Light/screen exposure during these times is shown to contribute to depression, difficulty learning, etc. in following days.

Increase internal cues of safety and well-being:

If you have more of an anxious depression where you feel on edge, irritable, or unsafe in some way you probably want to try some of the following:

Increase energy levels in the body

Practices to Increase Energy Levels: In addition to the early morning sunlight, improving sleep, and nutrition, there are manual ways to increase energy in the body. The first is any form of movement including walking, running, exercise or the above nervous system resets. Please see the page Practices to Increase Energy Levels for some short 5 minute practices you can do to increase energy levels in the body. You will probably find these practices helpful, especially if you have more of an apathetic, lethargic, shut down type of depression.

Diet: Give Your Brain and Body The Necessary Building Blocks (Omegas, vitamins, probiotics.)

While I cannot give personalized medical advice or recommendations I can refer to several studies that seem to indicate certain critical building blocks for improving depression and overall mental and physical health.

Take 1-2 grams of EPA Omega 3 fatty acids such as fish oil. View short video below for more info.

Our brain desperately needs enough of the right kinds of fats to run smoothly and to create the right neurochemicals to improve our mood, memory, etc. If you look at the label on bottle of fish oil or krill oil, or other source of omega fatty acids you will see several types of omegas one of which will be called EPA. You want to be getting at least 1,000 mg of EPA each day either through your diet or supplementation. EPA is found naturally in foods such as fish, especially with the skin on, but is probably easiest to get through supplementation sources such as fish oil or krill oil.

Here is a link to Mayo Clinic’s website for some additional info about Omega 3’s https://www.mayoclinic.org/drugs-supplements-fish-oil/art-20364810. I highly recommend this as a supplement for anyone, ESPECIALLY if you are dealing with depression. According to Dr Huberman, some studies have shown that taking at least 1,000 mg (1gram) of EPA omega fatty acid has been shown to improve depression as much as prescription SSRI medication.

https://youtu.be/aMfV_nkC7mU?si=uhPwwlG_ZbbYte8a

Exercise:

Exercise has been shown to have profoundly positive effects on depression. When it comes to the question of how much, any exercise is exponentially better than no exercise even if you are just getting out for a 5 minute brisk walk. When it comes to the research findings, Dr Huberman cites the research as showing that the optimal goal is to get between 150-180 minutes a week of zone 2 cardio exercise. Zone 2 means that you are exercising hard enough that you could still hold a conversation with someone but it would be somewhat difficult to talk and breathe hard at the same time. This information can be reviewed at 1 hour 9 minutes of Dr Huberman’s podcast on depression here. If you break it down, this is approximately 30 minutes 5-6 days a week of medium cardio exercise such as brisk walking, jogging, swimming, cycling, etc. Research has shown that adequate exercise like this can significantly improve depressive symptoms. As a side note, I also encourage people whenever possible to exercise outdoors via jogging or brisk walking as there are several additional benefits. Sunlight exposure for at least 30 minutes a day has been shown to significantly increase dopamine levels, walking or running gives the sense of moving forward which is stress relieving for the brain, and lateral eye movements during walking or running are very calming for the brain and seem to help the brain process thoughts and feelings.

Additionally a review of several studies on examine.com have found that exercise compares to standard prescription medications such as Zoloft for resolving depression¹

Phase 2 Recognize, Resolve, and Repair:

In my experience, there are often a combination of factors contributing to depression including difficulty maintaining self care habits such as diet, sleep wake cycles, exercise, social connection, etc. that tend to be exacerbated by just not having energy or motivation to do them. But underneath this stuck in the mud feeling, there seems to always be a part of the person that feels fairly hopeless about getting some fundamental need or desire met. Part of the work in phase 2 is about coming to recognize what the underlying needs are or were, and how to address them in a healthy way that adequately takes care of the need. This is where the help of a skilled, attuned professional counselor can be exceedingly valuable. The short summary is that these fundamental needs tend to be either past needs that weren’t met, present needs that aren’t being met, future needs/hopes/desires that the person has little hope of being met, or a combination of these. The solution tends to involve a combination of new and healthy experiences that mismatch, and/or fill in the old expectations. Please see the post on memory reconsolidation for more about how this can often work. Skill building can also be a critical part of this growth as people learn that by building missing skills they can actually get their needs/hopes/desires met now in ways they weren’t able to in the past.

Additional Resources:

The following video by Dr Andrew Huberman provides an excellent source ofinformation about depression as well as interventions to improve it. Much of the knowledge included on this page, especially regarding Phase 1 strengthening interventions is from Dr Huberman’s podcast and work. I highly encourage you to watch it to gain greater understanding about how to resolve depression.

Footnotes:

https://examine.com/conditions/depression/faq/how-does-exercise-compare-to-antidepressant-medication-or-psychotherapy-for-treating-depression/ ↩︎