Depression Self-Management.  If you experience moderate to severe depression, please seek help.

Despite the development of various self-management programmes that attempt to ameliorate symptoms of patients with chronic major depressive disorder (MDD), little is known about what these patients perceive as helpful in their struggle during daily live. The present study aims to explore what patients believe they can do themselves to cope with enduring MDD besides professional treatment, and which self-management strategies patients perceive as being most helpful to cope with their MDD.

MDD patients believe they can use various strategies to cope with enduring MDD in daily life. Although current developments in e-health occur, patients emphasise on face-to-face treatments and long-term relations, being engaged in social and working life, and involving their family, friends, colleagues and clinicians in their disease management. Our findings may help clinicians to improve their knowledge about what patients consider beneficial to cope with enduring MDD and to incorporate these suggested self-management strategies in their treatments.

An overview of patients’ responses to what helped them manage MDD include:

1. Being aware that my depression needs active coping: Comprising strategies focussing on active coping to be considered as helpful, such as take the signals of depression seriously (st. 46) and engaging in a structured form of meditation (st. 39).

2. Active coping with professional treatment: strategies in this cluster indicate that maintaining long-term professional support (st. 28), with a therapist with whom the participant feels connected (st. 7), as well as keeping informed about depression (st. 14) and medication (st. 8) is perceived as important.

3. Active self-care, structure and planning: These strategies indicate the importance to maintain daily self-care, such as get dressed every day (st. 19), healthy eating (st. 30) and structure and planning, such as making sure to have a good day/night rhythm (st. 26) and making an adjusted activity schedule (st. 4).

 4. Social engagement: Participants perceive social contacts to be very helpful in coping with their depression and consider strategies such as informing and explaining the depression to close family and friends (st. 6 and 50) and their involvement in treatment (st. 25) as being important.

5. Free time activities: Strategies in this cluster relate to engaging in depression-independent free time activities, such as sports activities (st.10) and exploring creative hobbies (st. 16).

6. Work-related activities: This cluster emphasizes the importance of investing in work-related activities, ranging from finding occupations for participants without a job (st. 21), to explaining the depression to my manager (st. 32) and close colleagues (st. 5) while having a job.

The present study shows that patients believe they can use a variety of helpful strategies to cope with a mostly moderate to severe type of MDD that has not or only partly responded to at least two different treatments. These coping strategies can be summarized into three main themes: A focus on the depression, comprising ‘Being aware that my depression needs active coping’ and ‘Active coping with professional treatment’; An active lifestyle, comprising ‘Active self-care, structure and planning’ and ‘Free time activities’ and; Participation in everyday social life, including ‘Social engagement’ and ‘Work-related activities’. Although this wide range of themes indicate that coping with MDD involves various aspects of daily life, patients consider the first theme, A focus on the depression, with its two clusters emphasizing an active coping with depression and professional treatment, both with nearly the same mean priority scores, to be the most helpful. The most important strategies from the patients’ point of view are also from these two clusters: ‘Take the signals of my depression seriously’ and ‘Maintaining long-term professional support’.

Medscape posted 3/24/15 From Helpful Self-management Strategies to Cope With Enduring Depression From the Patients’ Point of View: A Concept Map Study
Rosa A van Grieken, Anneloes CE Kirkenier, Maarten WJ Koeter, Aart H Schene BMC Psychiatry. 2014;14(331)

This study states that depression is often chronic and requires long-term management.  Again, please seek help to manage depression.