Being depressed for a long time, and being depressed off and on for literally years on end, is boring. I don’t want to spend my whole life like this. Up until now, I have thought that I was doing something, by going to therapy and taking medications (currently trazodone, clonazapam and venlafaxine, but I’ve tried a variety of pharmaceuticals over the years). But this latest setback has made me re-evaluate. I think I’ve been too passively waiting for the medical miracle to fix me. I’ve not taken an active enough role in creating and sustaining a healthy life for myself.

It’s hard, of course, to be active when I’m at the bottom of the pit. But when I’m not at the bottom, or even when I’m on a downward slide but still hanging in there, I can check that certain core elements are in place. As long as I know what those core elements are. I’ve been spending a lot of time thinking about that over the past few days. What would it mean for me to commit to a program of radical self-care? What would it look to provide myself the kind of schedule and supports that I would want to create for a dear friend who suffered from recurrent major depression?

I’m still mulling that over. I know that a regular relationship with my journal is a key feature. I am able to process a lot there, and when I go back and read my old journals, it’s true that I see a lot of pain and self-recrimination. But I also (sometimes) see myself using what I’ve in my 10 zillion hours of therapy. It’s good to make myself write at least three pages, which seems to be about the point when I have gone beyond simply recording an event or emotion and have reached a deeper level of understanding.

Side note: It was interesting that in The Artist’s Way (http://bit.ly/RGfCJt), Julia Cameron also recommends about three “morning pages” per day. And here I thought that was my own insightful discovery.

Something else I need is sufficient rest. It almost scares me to acknowledge that, because meeting that need will require some restructuring on my daily life. I allow work to take over other aspects of my life, not once in a while, but every single week. Even though I don’t truly believe it, I fall into the trap of thinking that working more and more proves what a “good” employee I am, regardless of the cost to myself. I honestly don’t know how I will make this change either, because everything about my job encourages me to push harder, do more, faster.

Everyone knows exercise is important for dealing with depression. I have been trying to take more walks–but they, like everything else, often fall away before the greediness of the job. I used to ride my bike to work and think it would be helpful to start it up again, especially with the good weather. You know what I need most of all? I need to return to a regular yoga practice. I used to go to Iyengar yoga class three times a week, plus practice at home. It wasn’t only my time shortage that put a stop to it. My wonderful teacher also moved to Chicago. But all the busy-ness of work did interfere with me looking seriously for a substitute.

Quiet time on the weekends is essential.  I am fundamentally an introvert.  I like people and don’t mind that my job asks me to interact with many people in a variety of ways. But I can only keep it up if I have quiet time to think and process and put all the pieces together. I need time to get into a state of flow.  That can come from art projects (haven’t been seriously drawing or painting for at least five years) or writing. It can come from working in my garden. But it doesn’t come from answering emails from colleagues at 10pm. I need time away from the computer and smartphone. I need to keep reading books, especially books that challenge me and bring me hope. And then with all that, of course I need time with my family and with good friends.

It’s not that I don’t need my therapist, and my trusty pillbox; I just can’t rely on them alone, as I’ve been doing the past year or more.

I know what elements make me sane (well, relatively speaking). The biggest questions for me are how to combine them with my job, protect them despite daily stress, and keep going back to them even when I feel lethargic or anxious or self-destructive. After all this time, I still don’t know how to do that. That’s why I think it would be a radical move to implement a self-care program that incorporated all these healthy elements into my life.