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Isabella Redgate has a toolkit of strategies for managing her depression and anxiety.

“It’s ike you’re being slowly pushed down in mud and you’re drowning.” That’s how university student Isabella Redgate describes an episode of depression. “There’s no panic. It’s just that everything is awful. It’s a sticky kind of sad. You can’t shake it or leave it behind. It feels like everything is grey like you’re living in a black and white movie.” An episode of depression can last for days and keep her from studying, working, eating or even getting out of bed.

Isabella has lived with depression and its companion, anxiety, for more than five years. According to Statistics Canada’s 2012 survey, 3.2 million Canadians reported symptoms consistent with depression. Of the 2.4 million Canadians who report symptoms of generalized anxiety disorder during their lifetimes, 52.6 per cent also met the criteria for depression. “This co-occurrence of depression and generalized anxiety disorder is a commonly found pattern in other research.”

As an example of an anxiety episode, Isabella says, “All of a sudden, it feels like someone rips the carpet out from under you.” For her, this kind of episode includes physical symptoms such as difficulty breathing, inability to focus on a conversation and the sensation of a crushing weight. “It’s like an anvil on your throat.” An episode of anxiety can last anywhere from 15 minutes to a full day.

Medication helps reduce the symptoms of anxiety and depression. She takes Cipralex, a low dosage of 15 milligrams a day. “It makes me functional,” says Isabella. “The first step for me was to find a medication that worked. Luckily for me, it was the first. When I first started feeling good, it was such a foreign feeling. The mud was thinner.”

The mud was thinner, but it didn’t dry up and blow away. She says medication makes it possible for her to get up and function well enough to take care of herself by rejoining her life and engaging in other kinds of therapy that piggyback on the medication. Like most people with depression and anxiety, Isabella uses a combination of medication and other therapies to cope with her illness. Some find these therapies can even replace medication.

University student Isabella Redgate deals with anxiety and depression. “It’s like an anvil on your throat,” she says of having an anxiety episode.

Full disclosure – Isabella is my stepdaughter. She eagerly accepted my offer to share her experiences of anxiety and depression because she believes that the more mental illnesses are discussed in the open, the better it will be for those living with them. She was also keen to share the toolkit she has developed so others might benefit from them.

Cognitive Behavioural Therapy (CBT)

Isabella takes advantage of the services offered by her university’s counselling office to engage in what she calls talk therapy every couple of weeks. During these sessions, she talks to a psychologist about the things she believes have contributed to or perpetuate her illness. She says it’s important to feel that a professional validates her experiences.

“It means that you validate your own feelings.”

Jillian Rankin, a counsellor at Mount Saint Vincent University, explains, “There are a bunch of therapies that would fall under talk therapy because what we’re doing is discussing the origins of their difficulties, what is happening now and trying to figure out strategies to move forward.”

Talk Therapy includes Cognitive Behaviour Therapy and other kinds of counselling. “CBT examines how our thought processes affect our emotions and behaviour,” Rankin adds. In this kind of therapy, a counsellor helps a client discover and then change their thought processes, which then changes emotions and the behaviours that arise from them.

Journaling

As with talk therapy, Isabella discovered that keeping a journal can help reduce symptoms of anxiety and depression. “It’s similar to having somebody there listening to you,” she says. “It helps in the future to read over them as a reminder that this has happened before and I worked through it.”

Because journaling is so accessible and immediate, Isabella can put it to use even in the middle of an episode, as long as she’s alone. “It’s an outlet,” says Rankin. “It’s a way to discuss with themselves and write out their feelings and thoughts.”

Exercise

Jillian Rankin says exercise is very important, but not just because it’s therapeutic. “Mental health is a part of physical health.” As she explains, “When people have anxiety, they perceive there is a threat and the body is in fight or flight mode, which can be very exhausting. With exercise, they can regain energy to cope better.” She adds that eating well and getting enough sleep are important parts of maintaining physical health.

It’s important to find an enjoyable activity, Rankin stresses. “If you have to force yourself to exercise, you’re not likely to stick with it.” Isabella used to enjoy running when she was younger, partly because it got her out of her head and into nature. “Now I find running awful,” she says. “I’m not young and thin like I was, so it’s uncomfortable. Running is anxiety inducing because men will look at you, which makes it worse. No matter how hard I try, I’m disappointed in myself because I should have been able to go longer.”

“Yoga and meditation help people quiet their minds. It’s a way to feel in that moment and not think about things that are bothering them.”

Yoga and Meditation

Lately, Isabella has turned to yoga as her exercise of choice. “It shifts concentration. It takes my mind off myself so I’m not downward spiraling.” According to Rankin, “Yoga and meditation help people quiet their minds. It’s a way to feel in that moment and not think about things that are bothering them.” Physiologically, yoga and meditation also quiet the fight or flight mechanism of the body. In an anxiety episode, she says, many people have difficulty breathing and experience increased respiration and heart rate. “Yoga and meditation are counter to anxiety – they slow all of those physiological processes.”

As with yoga, Isabella finds that at times, meditation can keep her thoughts from spiraling out of control. “It makes me slow down and keeps me connected to reality.” By sitting still and focusing on one’s breathing, many have found relief. But Isabella has found she needs to be cautious and use it only when she is functioning well because it can trigger the very experiences it is meant to avoid. “I’ll try and try,” she says, “and suddenly I’m anxious about breathing. I feel like I just failed at meditation. It will leave me feeling disappointed in myself. It’ll also scare me.” Her thoughts will spiral through self doubt all the way to feeling a total failure and leave her in a state of deep hopelessness.

Jillian Rankin recommends a specific mental exercise as a solution to such experiences. “Grounding exercises take you out of that spiral. When you’re having those thoughts, think of five things you can hear, see or feel in this moment to get back into your body and out of those racing thoughts.”

Nature

One of the easiest and most effective therapies for Isabella is going outside. Rankin says when someone is depressed, “It’s very easy to stay inside all day. Even taking a five minute walk outside to shut down, reconnect, feel the ground under your feet, the sun on your face is calming for people.” The reason it works for Isabella seems counterintuitive because it’s about feeling insignificant. She finds sitting next to the ocean or walking under the stars particularly effective. She calls it a circle-of-life reality check. “That vastness reminds you of how small you are, which I find immensely comforting. It’s very reassuring that you’re just part of a cycle. There are so many things in the world, how can I possibly hold myself above all of that?” Rankin adds, “It’s about perspective.”

Avoiding Triggers

Getting to know things that trigger anxiety or depression is as important to Isabella as developing a toolkit of therapies. She stopped drinking caffeinated beverages because they make her feel anxious. The lightheaded feeling that comes with alcohol consumption makes her feel out of control, so she avoids it. Most importantly, she has learned that other people can trigger her. She avoids large crowds like at concerts or big parties. She seeks out people who are understanding and will validate her illness without making it a big issue. if she has to change plans. “People need to understand I can’t always make it to things. I cancel plans a lot.”

Rankin says when it comes to triggers, “It’s very dependent on the individual.” While reluctant to identify common triggers of anxiety and depression, she does suggest reducing screen time by taking holidays from the phone and computer, especially before sleep. “Social media makes everything immediate. You can get news and find out what everybody is doing all the time.” Social media users tend to share the best aspects of their lives. Those with anxiety and depression compare themselves to such one-sided representations and find themselves wanting.

Medication and alternative therapies work together to keep those living with anxiety and depression functional and healthy. “Medication improves the physical health of the brain,” Rankin says, “and therapy provides support to develop coping mechanisms.” Isabella has worked on doing more things she enjoys with people she enjoys.

For her, practicing wellness is the best way to be well.

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