Mental Health: Field Notes on Depression

DEPRESSION: Field Notes from My Lived Experience

In 2017 I experienced a major depressive episode. It is easily the worst thing that ever happened to me. I did not see it coming, which was weird because it’s literally my job to see these things coming. It was next-level - other worldly - terrifying. I felt inhuman.

I’m better now, thankfully. Five years later and a lot of hindsight, these are my field notes: Depression is biology, not bad choices or weak-mindedness. It is not your enemy, it is an ally, and its message is this: Girl, you need to slow down. Therapy helps in the way that it always helps to ask for directions when you’re lost. Medicine helps in the way that it always helps to eat when you’re hungry. Finding the right medicine will feel like a chemistry experiment, but stick with it. Depression is completely solvable, but the solution is more than therapy, more than meds; it’s a whole way of life. Finally, and perhaps most importantly, there are things every woman can do right now to prevent and improve depression. Take notes, Sisters:

Vitamin D. You need it. Not having enough of it puts you at risk. Ask your favorite doctor for a Complete Metabolic Panel. It will assess for vitamin D and a bunch of other important things.

Thyroid. A 2019 Harvard Medical School report found that many women are taking antidepressants when really they should be taking thyroid medication. Before you accept a mental health diagnosis, check your thyroid levels with the aforementioned metabolic panel.

Blood sugar. Unstable blood sugar levels could result in unstable moods (and yeast infections). That magical metabolic panel will also assess blood glucose so you can take care of your mind and your vagina!

Your Period. Women have been taught that our periods are supposed to suck, but, in actuality, they shouldn’t. If your cycle is off, something is wrong. If someone diagnoses you with a mental health condition without asking about your period, get a second opinion.

Your Tummy. Food allergies, bloating, constipation, bacteria, digestive enzyme - all of these are factors that affect your mood. In fact, every single thing you put in your body affects your mood so consider making some changes to your diet before (or in addition to) taking meds.

Your Immune System. The link between autoimmune disorders and mental health is irrefutable. If your body can’t regulate inflammation, it can’t regulate your mood either. This is an important conversation to have with your doctor, especially if you have a family history of autoimmune disease.

Your Chemistry. Acetylcholine, dopamine, gammaaminobutyric acid (GABA), glutamate, histamine, norepinephrine, and serotonin - these guys regulate a wide range of body functions. Talk to your doctor or therapist about tests that can assess your body’s capacity for making the proper amounts of neurochemistry.

Don’t Stay in Relationships with A-holes. Relationships can’t cause depression but before you accept a diagnosis or start a medication, make sure you’re not in a relationship with an asshole. Studies show that unhappy or abusive relationships dramatically impact mental health outcomes.

Lay Off the Sauce. If you’re partying Thursday to Sunday, your M-Tu-W mood is going to suck. Alcohol is a depressant. Depressants + Depression = More Depression.

Sleep. You cannot separate your mental health from your sleep. If you’re not sleeping or you’re sleeping too much (or you’re sleeping with an asshole), you are at a greater risk for a wide range of mental health problems.

Movement. When you live with depression, exercise feels impossible but stretching totally counts. One of the many benefits of stretching - a decrease in depression and menopause-related symptoms!

Collect Data. My philosophy is this - When it comes to your mental health, we can’t skip any steps. Investigate, collect data and commit to help. If you’re not sure you’re depressed, try this for a week: Measure your mood on a scale of 0-10, where 0 is suicidal, and 10 is ecstatic joy. Make 5 (neutral) your goal (neutrality is an underrated sweet spot). If you’re spending more than two days a week under 5, you might be depressed. Pick up the phone and call your therapist or doctor.

Michelli Ramon is a clinical social worker and nationally recognized educator on mental health. Her work has been featured on a variety of media platforms, including A&E’s Emmy Award-winning program, “Intervention.” To learn more, visit michelliramon.com.