Self-help can make a real difference to depression. Regular movement, staying connected with people, a steady daily routine, decent food, meaningful activity and skills such as mindfulness all have evidence behind them, and for mild depression they are often the first things a doctor will suggest. For moderate or severe depression, though, prescribed treatment, usually talking therapy, antidepressants or both, tends to work better than self-help alone. The ten steps below are best seen as things to do alongside professional care, not instead of it.
One important safety point first: if you already take an antidepressant, do not stop suddenly or on your own. Stopping abruptly can cause withdrawal symptoms, and doses should be reduced gradually with a doctor's guidance.
Antidepressants: what the evidence actually says
For years, people were told that depression is caused by a simple "chemical imbalance", usually low serotonin, and that pills correct it. That explanation is now considered outdated: the evidence does not support the idea that depression is just a serotonin shortage. Some articles have jumped from there to claiming that antidepressants do not work or do more harm than good. That conclusion is wrong.
The UK's National Health Service says most people benefit from antidepressants, although not everyone does and some need to try more than one. Their effect over placebo is modest in milder depression and clearer in severe depression, and researchers think they work through more complex changes in how brain cells function rather than by "topping up" a chemical. For severe depression, the NHS notes that combining medication with talking therapy usually works better than either alone.
Cost is a fair concern in some countries, but many common antidepressants are now available as inexpensive generics. If price is a barrier, it is worth raising with your doctor or pharmacist.
Steps 1 to 3: calm the mind and stay connected
1. Practise mindfulness
Depression often brings a flood of self-critical, repetitive thoughts. Mindfulness trains you to notice those thoughts and return your attention to the present, such as your breath or the sounds in the room, instead of being swept along by them. Psychologist Katie Sparks, quoted in the original version of this article, said she had found it very beneficial in group work because it calms the mind.
The best-studied approach is mindfulness-based cognitive therapy, an eight-week course that combines meditation with CBT ideas and has been researched mainly for preventing relapse in people who have had depression before. You do not need a special posture or chant: ten minutes sitting comfortably with an app or recording is a reasonable start.
2. Make room for laughter
A comedy you love, a funny friend or a silly video will not cure depression, but laughter can briefly lift mood and break a cycle of rumination. Some small studies of "laughter therapy" report short-term benefits; the evidence is limited, so treat it as a pleasant extra rather than a treatment. What makes you laugh does not have to be sophisticated.
3. Don't cut yourself off
Depression tends to persuade people that they are a burden and should keep away from others. Withdrawal usually makes it worse. Psychologist Stephen Ilardi, author of The Depression Cure, has put it this way: "In depression, social isolation typically serves to worsen the illness and how we feel." Keep in touch with the people who matter to you, even by short messages, and let at least one person know honestly how you are.
Step 4: choose supportive company
Being around people who dismiss depression as laziness, or tell you to "just snap out of it", can deepen shame. Depression is a health condition, and you would not expect someone to think their way out of diabetes. You do not always have to cut people out, but you can limit time with those who belittle you and seek out those who listen.
Psychologist Deborah Serani, author of Living with Depression, stresses that part of recovery is learning to reframe negative thoughts, and that having affirming, accepting people around you creates a better environment for healing. If you cannot find that support among friends or family, a support group or therapist can provide it.
Step 5: be cautious about cannabis and psychedelics
Older versions of this list suggested cannabis and magic mushrooms as alternatives to antidepressants. That needs correcting. Cannabis is not a recognised treatment for depression, and heavy use is linked to worse mental health in some people, particularly young people and those prone to psychosis.
Psilocybin, the active compound in magic mushrooms, is being studied seriously. In the United States, regulators granted it "breakthrough therapy" status to speed up research; Australia allows specially authorised psychiatrists to prescribe it for treatment-resistant depression; and Oregon permits supervised use at licensed centres. In all these settings it is given in carefully controlled sessions with trained therapists and screening. Self-treating with psychedelics is a very different thing and can be risky. If you are curious about these treatments, talk to a doctor about clinical trials.
Steps 6 and 7: food and acupuncture
6. Eat in a way that supports your brain
Deficiencies in nutrients such as vitamin D, folate, vitamin B12, iron and omega-3 fats have been linked with low mood, and a doctor can check for them with a simple blood test. Beyond that, an eating pattern rich in vegetables, fruit, whole grains, legumes, fish and olive oil, similar to a Mediterranean diet, has been associated with lower rates of depression, and a small Australian trial in 2017 found mood improved in people who switched to it.
Heavy drinking, by contrast, worsens depression, and diets dominated by ultra-processed food and sugar may not help either. Avoid starting supplements in large doses without advice, as some interact with medication.
7. Consider acupuncture, with realistic expectations
A US trial published in Obstetrics & Gynecology in 2010 gave depression-specific acupuncture to pregnant women and reported that about 63 percent responded, compared with a lower rate in comparison groups. Results across acupuncture studies are mixed and hard to blind, so it is not a first-line treatment, but some people find it helpful alongside other care. If you try it, use a licensed practitioner.
Steps 8 to 10: move, grow and give
8. Get moving
Exercise is one of the best-supported self-help steps. The NHS lists it as a main treatment for mild depression and may refer people to group exercise classes. Some trials have found regular aerobic exercise works about as well as medication for mild to moderate depression, though results vary. Low energy makes starting hard, so begin with something tiny, such as a ten-minute walk, and build up.
9. Grow something
Gardening combines light activity, daylight, routine and the satisfaction of watching something grow, and surveys suggest gardeners report better wellbeing. If you lack a garden, a few pots on a windowsill or a community allotment can work. Any absorbing, gentle hobby, from cooking to drawing, can play a similar role.
10. Volunteer for something you care about
Helping others gives structure, purpose and new social contact. A 2013 review in BMC Public Health found volunteering was linked with lower depression and better wellbeing, and with about a 22 percent lower risk of death in cohort studies, though it could not prove cause and effect. Start with a few hours a month so it feels manageable.
Keep going, and know when to ask for more help
Depression can return, and recovery is rarely a straight line. The habits above are worth keeping even on good days, because they make relapse less likely and easier to spot. Talk to a doctor if your mood stays low for more than a couple of weeks, if self-help is not enough, or if you are already on treatment that does not seem to work.
If you have thoughts of harming yourself or not wanting to live, seek help immediately. In the US you can call or text 988 for free, confidential support; elsewhere, contact a doctor, a local crisis line or emergency services.
The original list was written by Sarah Landrum, a freelance writer and the founder of the career site Punched Clocks.
Sources: Original list by Sarah Landrum, first published by Waking Times (2015); NHS: Treatment for depression; Wikipedia: Monoamine hypothesis; Wikipedia: Psilocybin therapy; Jenkinson et al., BMC Public Health (2013): volunteering and health; 988 Suicide & Crisis Lifeline.
Related:
COMMENTS