If I had a friend struggling with depression, this is what I would say to them.
I am not a doctor, nor a mental health professional. The writing below is based on my own personal experiences with severe major depression. I have provided references to professionals who helped me below, but please do your own research and be your own advocate. If you are considering ending your life, please make one phone call first: 988. Just call 988 before you make a permanent choice based on a temporary feeling.
I do a few things boring, basic things pretty well; for instance, I know my way around the kitchen enough to make a really great blueberry muffin. Everyone likes a good muffin. Then there are other less flattering skills I’ve picked up; I’m an expert in dealing with my own, life-threatening depression. I’ve been living with Major Depressive Disorder since 2014, and Generalized Anxiety Disorder for as long as I can remember. This year, MDD teamed up with a toxic business partnership my ego had let fester for too long and the combination nearly took me out. May 9th was the first of what would be three instances in four months where I began planning and/or took steps to unalive myself. The weight didn’t just drag me down, it took prisoners; I was rolled off a board I had served on for eight years due to performance issues, I got dumped over text weeks after an argument that I was no longer “enjoyable”, someone I care about and mentored felt ditched because I could barely help myself, let alone them. It was gruesome.
For some people, MDD is a one-time deal, typically situational (loss of job, divorce, death). For others, like me, it's more of a life-long condition that I will be managing until my grave with a little luck and a lot of work. I have C-PTSD (Complex Post Traumatic Stress Disorder), which is incredibly difficult to treat, making how I experience life and manage myself more challenging than it would be for most people. Because it’s a trigger-happy condition, if I don’t stay on top of my mental health or let my achievement-driven ego run the show, MDD can post up in me and eat half my snacks before I even realize it’s there. Keeping myself alive, and maintaining a life worth living, has become its own kind of special skill set. Not a skill that most people want, but one I have nonetheless.
This summer, fighting for my life, I used every available resource I could find. The same day I picked up my new Adderal prescription, I left crystals under the moonlight to charge. I hired and fired psychiatrists and therapists, asked for referrals and listened to music on my inner goddess. I lit candles and took workshops on managing my emotions. I learned, I worked on myself, and eventually, I survived. I’m no expert, but I found my way (for now, at least). If one of my friends was struggling with depression, and they came to me for advice, this is what I’d say to them:
Physical Needs.
The first thing I’d ask my friend about would be their habits. Are they drinking booze more than once or twice a week? Are they doing some kind of exercise, even if it’s just a 30-minute walk? Is their diet garbage? Are they sleepy? Sometimes depression is a biochemical occurrence rooted in deep trauma. Sometimes people feel like shit because they are making shitty choices. I haven’t found a single deeply happy person hitting up the drive-through on the way home from the bar on the regular. We can’t yank ourselves out of the saddies if we are tied up holding a bottle and a bag.
Depression can cause these bad habits - if you’re dead inside all week, a greasy bag of fries at the bottom of a bottle might be the only thing that takes the edge off. One thing’s for sure though; no one is out there acting a fool and overcoming their depression. Poor sleep hygiene alone can wreak biochemical havoc on our personalities. There is no one in their #healingera who slept like shit the night before because their digestive tract was having a nervous breakdown trying to make sense of the five martinis, two beers, three cigarettes, and four chalupa supremes it got served the night before. ***
Sometimes it really is depression, but sometimes also we just need to lay off the booze, make a f*cking salad, hydrate our crusty skin, and get our asses to bed early so we can get a walk in before work the next day.
If all these things were already happening, I’d encourage my friend to get some bloodwork done and start a supplement routine. Getting blood labs ordered is very accessible and affordable these days, with lots of online options, and the results could tell you a lot about why you feel like crap. Low on Vitamin D? Magnesium level looking sketch? Just getting those levels up could be enough to lift the spirit.
Large doses of Vitamin D and Omega 3 have been shown to be just as effective in treating depression as most conventional SSRIs. Then there are the “energy” vitamins, B12 and Iron. When those levels go down, they take our mood with them. In a world where food logos are green and “packaging is made with recycled materials”, it can be easy to kid ourselves into thinking we are consuming everything we need. Most of us aren’t. We don’t live in a natural world anymore, so to think we are meeting all of our vitamins and mineral needs through diet alone is just another form of virtue-signaling. If our nutrition has to come out of a pill bottle instead of a pan, so be it. Sure, aim to eat healthily, but don’t let self-righteousness stop you from getting your needs met, either.
Devotees of conventional antidepressants will say it would take weeks for supplements to kick in and improve our mood… but so do antidepressants. Never mind that getting on an SSRI usually takes a few different tries to find the right one, and comes with all kinds of weird side effects and risks. You know what doesn’t have a risk, even if it doesn’t work? Vitamin D. It’s cheap and doesn’t require waiting to get in to see a doctor.
Once my friend is hydrated, well fed, on a regular exercise schedule, slipping Omega’s into their smoothies, getting at least seven hours of sleep, and done acting like Taco Tuesday is a very personal triple-dog-dare, if they are still feeling like shit I’d say…
Audit external circumstances.
We could all be living our healthiest lives but if we have to go into eight hours of living hell with narcissistic work relationships (hint: I’ve been there, know that, check your ego) every day, our misery will continue. There isn’t a supplement or a fitness routine in the world that can withstand chronically toxic situations. Allowing ourselves to be eroded by others is as unhealthy as substance abuse.
It’s not just work; most of us have had that “friend” who always has a bit of a put-down whom we’ve had around so long they are more of a habit than a meaningful relationship. Maybe it’s a loveless marriage. If you’ve clearly articulated your needs to your partner and they are point blank refusing to meet them, it may be time to reconsider the relationship or find a great therapist. These are big-deal choices, and probably start with something that sounds like: Do I get help or get out?
* Yeah, but also, check yourself. How much would it suck to find out that you’re the one that’s toxic? Here’s a hint; if everyone around you is supposedly toxic, they ain’t the ones with the problem. You are. Shitting on people and then ignoring them in the name of “protecting your peace” isn’t you being a spiritual badass, it’s just you being an ass. Avoiding owning up to your own shit is like taking poison every day and waiting for everyone else to die. You’ll go first. Probably alone or with other toxic company, because healthy people always find a way out of that shit. Don’t die in an echo chamber.
An honest assessment of the lives we have created for ourselves is hard work. It’s confrontational, sometimes grief-stricken, and can be logistically difficult to navigate. Leaving a toxic work situation for most people will require finding a new job first. Choosing to end a committed relationship because needs aren’t being met may involve finding a new place to live. It may even require hiring someone to help navigate the upcoming difficulties; finding a recruiter to land a new job, or a great therapist, or a badass attorney. But, like my psychologist said: Emotions are powerful tools. They signal that something is not right. We get to choose our hards here. It can be really hard for a little while, or it can be kind of hard for the rest of our lives.
At-home ketamine therapy.
Psychedelic therapy saved my life. Full stop.
Ketamine as a psychedelic-assisted therapy is widely accessible now both financially and physically. It’s an extremely safe, non-habit-forming way to receive a long-lasting antidepressant effect while providing optimal conditions for changing thought and behavior patterns that cause depression. Going back to step one, if my friend could not shake their drinking habit, no matter how hard they tried, I’d send them straight to ketamine (and offer to be their wing woman for their first few AA meetings). In fact, if there was any habit they were struggling to obtain and sustain and just could not make it stick, I’ll tell them to get at-home ketamine therapy ASAP. The fast-acting antidepressant impact coupled with the available neuroplasticity after, with little to no side effects makes ketamine my drug of choice for depression and anxiety.
However, despite my waxing poetic about how ketamine appears to be a panacea for all our emotional ills, it’s not without work. Integration, the act of applying changes in a meaningful way after a psychedelic session, plays a huge role in sustaining the positive benefits of ketamine long after dosing. For that reason, it’s essential that any ketamine therapy be coupled with a ketamine-informed psychologist, an integration circle, or some other integration coaching or guide included with the at-home program. While hooking up to an IV and launching to the moon for an hour may sound appealing, eventually the effects will wear off and without integration, a person could find themselves right where they left off.
I chose to get my ketamine-based psychedelic therapy from Mindbloom, a virtual provider with comprehensive wrap-around programming. In addition to a massive content library, guided audio, prep content, and an at-home kit, I also received care from a medical clinician, a psychedelic guide, and access to virtual group sessions. Later, for a deeper experience and a quantum leap forward, I went on a psilocybin retreat created by the founders of EQNMT. The psychedelic experience was more intense, but so were the surrounding workshops and therapy sessions. Both of these providers are experts in their field, provide wrap-around care, and include engagement with licensed professionals. Both of them serve an independent purpose and were important experiences to pull me out of the depths, fast.
“Medicine-woman Kayla” with the Special K and the magic mushrooms that you met at a rave last year ain’t the same thing. Be smart.
Psychiatric care.
If, after making sure my friend was hydrated and rested and left their negligent partnership and stopped talking to the racist family member and completed a ketamine program with a genuine focus on their integration, and they were still experiencing depression, I would tell them to seek psychiatric care. This, for me, would be the absolute last resort when it comes to addressing depression. In my highly unprofessional, amateur-hour opinion and based solely on my own personal experiences, this should be the last possible solution but it is still a solution.
Psychiatry and psychology are two different professions, which I thought was both extremely odd and a crock of horseshit when I first realized it. Psychiatry is the medical practice of treating emotional dysregulation, whereas psychology is the study of the mind and behavior. Said another way; we go to psychologists to figure out what’s wrong with us, then we take that info to a psychiatrist to fix it. One could see where there would be a lot of room for error.
Horseshit, like I said.
Lithium, Prozac, Welbutrin, Zoloft and all the other medications have saved millions of lives. I am not insinuating that they are inherently evil. I am saying that on the road to recovery, if traveled by way of conventional SSRIs, a person could pick up diabetes, a low libido, hair loss, and a handful of seizures. SSRIs often take the scenic route, too; it takes a while for them to kick in, and only weeks into a course of treatment do we get to find out if we gambled on the right pill or not. And, they are a tourniquet. Sure, they’ll shut off the bad feelings, but they could shut off the good ones, too. Like cutting off the blood supply from an infected limb so it doesn’t spread and kill off the rest of the body, amputation is still a life-saving solution that also results in the loss of a part of who we are. And if that’s the remaining option, it’s still worth it. Get on the pills. Do whatever it takes to save your life.
Of course, I wouldn’t be able to tell my friend any of this if they had gone and unalived themselves.
My bedroom has both wood shutters and black-out curtains. It’s really convenient for depression because no matter how bright the day is, I can crawl into a bed in a completely dark room at any hour. My head always pounds after a hard cry, and one day in early August I laid there, limp on a wet pillow, feeling the thud over and over again. In the eerie and calm darkness, I knew for certain that I would not survive. Something was going to change. My life was going to end, or the depression was going to end. Either way, I had to find an out.
If my life was going to end (thud) there was nothing left to lose (thud). If it was all over anyway (thud) what was the worst thing that could happen if I gave it just thirty more days (thud)? I could throw everything I had at it (thud). I could journal (thud). I could meditate (thud). I could talk to my clinician (thud) about my ketamine therapy and let her tell me what to do now (thud). I could lay low low low and focus like crazy on myself (thud). I could make absolutely everything about my mental health for thirty days (thud). I could do yoga and take long walks (thud).
To anyone and everyone who has ever stared frankly at the plan of ending their life, I see you. I know you. I am you.
If you already know the plan is to end it, there’s nothing left to lose. Give it everything you’ve got. Do all the things at the same time. Get off the alcohol. Buy some fruit. Start your vitamins. Get with a ketamine provider. Find a therapist. Take melatonin and get some sleep. Don’t be a punk and leave this world without even really trying. You owe it to yourself, and the people that love you. Just try.
We live in the time of miracles. We get to be our own greatest love story. And, if I knew my friend was struggling with life-threatening depression, I would tell them everything I did to save my own life, in hopes that it saves theirs, too.
*** If you think you have a problem with alcohol, please do not try to go after it all on your own. Alcohol withdrawal can cause severe physical impairment, and people with a support group are far more likely to get and stay sober. In the right group, you’ll have access to information and resources to keep you safe while you detox. Look up a local AA chapter, and if you’re feeling shy, phone a close friend to go with you to your first meeting. Just get there. AA works. Let yourself be helped.
