6 common pitfalls that make major depressive disorder worse

If you have major depressive disorder (MDD), youre probably well aware that proper treatment and management which may include talk therapy, medication, lifestyle changes, or a combination of these approaches can help reduce symptoms and improve your quality of life. But even when youre following your treatment and management plan, certain everyday habits and thought patterns can quietly work against your progress and make MDD harder to manage.

The good news is that many of these pitfalls can be addressed with awareness and support. Recognizing these habits, understanding how they can worsen symptoms, and taking steps to address them can help you stay on track with your treatment and better manage MDD.

1.Believing Depression Is a Personal or Moral Failure

2. Not Taking Care of Your Body

One of the most crucial mistakes is not taking care of yourself or practicing proper self-care, says Zishan Khan, MD, a psychiatrist with Mindpath Health in Frisco, Texas, who treats people with depression. If you are not sensitive to what your body needs and push it past its limits, it can very well worsen your depressive symptoms.

Several self-care strategies could help, he adds:

• Try to eat a nutrient-dense diet. One review found that people with depression who followed a Mediterranean-style diet rich in fruits, vegetables, whole grains, legumes, nuts, and fish experienced significant improvements in depressive symptoms compared with those who did not follow a nutritious diet.
• Aim to exercise most days of the week.Staying active for at least 30 minutes a day, three to five days a week, could substantially improve MDD symptoms.Anything from jogging or biking to gardening counts. Find something that you enjoy and brings you pleasure, so its easier to be consistent.
• Plan to practice good sleep hygiene. Research shows that poor sleep timing, duration, and quality can have a negative impact on mental health.To promote a good nights sleep, be sure to go to bed and wake up around the same times each day; keep your bedroom cool, dark, and quiet; and avoid alcohol and nicotine close to bedtime.

If youre having trouble making self-care a regular part of your routine, be sure to reach out to your mental health provider, who can help you make a plan thats manageable for you.

3. Judging Yourself for How Youre Feeling

Because having depression still carries a cultural stigma, its not surprising that someone with depression might judge themselves for having thoughts or feelings related to being depressed, says Alice Hua, PhD, a clinical psychologist and assistant director at the University of California San Francisco Medical Student Well-Being Program.

It might help to reflect on any self-critical thoughts youre having and reframe them in a more helpful way, Dr. Hua suggests.

For instance, she adds, try to limit any thoughts beginning with I must, I have to, or I should such as I should be feeling better or I have to start exercising because those thoughts reinforce self-judgment of depressive symptoms. Instead, try reframing those thoughts as empowering ones that start with I want to or I plan to such as I want to feel better or I plan to start exercising.

4. Isolating Yourself From Loved Ones

Social interaction with loved ones has beneficial effects on the brain. When we spend time with loved ones and friends, our posterior pituitary gland releases stored oxytocin, says Dr. Khan. This oxytocin, in turn, supports the secretion of serotonin, which is a neurotransmitter primarily responsible for regulating behavior and mood.

5. Trying to Avoid Your Feelings

She suggests spending some time reflecting on these feelings, as long as they dont totally consume you, or unpacking them with your mental health provider, who can suggest strategies for coping with them.

6. Turning to Alcohol or Drugs for Relief

While using alcohol or drugs may feel good in the moment, this often backfires over time. Its very easy to reach for that alcoholic drink to soothe the pain one feels inside, or to try and experience quick relief from a recreational drug, but this will likely only worsen your situation, says Khan.

• Having intense urges to use drugs or alcohol every day or multiple times a day, to the point where its hard to think about anything else
• Needing more drugs or alcohol over time to achieve the same effect or using more drugs or alcohol over a longer amount of time than intended
• Always making sure to have enough drugs or alcohol
• Spending money you dont have on drugs or alcohol
• Prioritizing drugs or alcohol over work, school, relationships, or other responsibilities
• Continuing to use drugs or alcohol even though youre aware of the negative effects theyve had on your life
• Doing things to get drugs or alcohol that are usually out of character for you
• Spending much of your time accessing the substance, using it, and recovering from its effects
• Driving under the influence
• Not being able to stop using drugs or alcohol
• Having withdrawal symptoms if you try to stop using drugs or alcohol

The Takeaway