How I Manage Depressive Episodes

By Dan Collins, as told to Hallie Levine I’ve been living with major depressive disorder since I was 16.  My moment of critical mass was in the spring of 1991. I was 28 and still living at home. My life revolved around getting up, going to work, and returning to my house. I fell down a rabbit hole of extreme depression and anxiety. I felt like I was being devoured by waves of despair and panic that would never end.
I finally ended up at the local hospital’s ER. I was told it would take a few weeks to get me in to see a psychiatrist, and I was horrified. The idea of waiting a month or two for this appointment, when I felt that I could barely last another minute, was terrifying.
My only refuge was sleep that provided no rest and left me without any appetite or humor. To try to escape, I’d jump in my car and drive to malls to purchase books on mental health. I had decided that if I could understand what was happening to me, I’d be able to overcome it. Eventually, my father told me, “You are not going to think your way out of this,” and I realized he was right. Thankfully, this depressive episode happened right around the time a new drug, Prozac, was gaining steam. I like to joke that I was the original Prozac nation. I was one of the lucky ones who responded well to this medication, and quickly. One morning I woke up and realized that the cloud of despair wasn’t hanging over me anymore.
That was 30 years ago. I’m still on Prozac, but I’ve also learned many ways to manage my depressive episodes, so I’m not caught off guard when they happen. Depression isn’t like a cold in that you recover from and it goes away. It can happen at any time, sometimes without any apparent reason. I’m sharing what helps me in the hope that it will help you. I stay active. Soon after my diagnosis, I took up competitive fencing. It was very uplifting. I’d always been the fat kid picked last for dodgeball. It felt good to be out there being active. But fencing also helped me manage my depression because it honed my focus. It’s the kind of sport that when you do it, you can’t think of anything else. I might be in the eye of the storm with a depressive episode, but I’d have to push those feelings to the back of my head to avoid getting clobbered by my opponent. The social interaction helped, too: I’d hang out with the other members of my fencing club after practice and on weekends. During the pandemic, I think one thing that helped prevent me from sliding into another depressive episode was the fact that I was on my elliptical machine every morning for an hour to get those feel-good endorphins going. (Research bears me out on this: Exercise has been shown to have a strong antidepressant effect among people with depression.)
But it goes beyond just exercise. When you have depression, the worst thing you can do is just sit and stew in it. When I was going through the worst of my depressive episodes in my 20s, I’d stay home and stare at the wall. But once I started Prozac, I felt good enough, and confident enough, to sign up for an acting class. I realized that I needed to change my solitary lifestyle because that had played a big role in how depressed I’d become in the first place. Even when I feel my worst, I force myself to get out of bed and go to work. You need to get your focus away from your mood and emotions and on something else. I have strong social relationships. When you’re depressed, it’s almost impossible to lift yourself out of it alone. You need other people to help drag you out. I was lucky when I was diagnosed to have amazing, supportive parents. My father prided himself on being an amateur psychiatrist. He wanted to understand how I felt and encouraged me to get help and get better. I’m also very lucky to have an amazing wife, Tina. She understands my condition because she has schizoaffective disorder. We monitor each other. We look for warning signs in one another. We remind each other to take our medications and seek out therapy when the going gets too tough. I like to say that we don’t give depression a front seat, even though it’s our traveling companion.
Tina in particular also has a caretaker personality. She’s always sending me articles with interesting research about depression. If she senses I’m about to experience an episode, she encourages me to go back to therapy. Many people with this condition don’t have that level of support. It doesn’t help someone with depression to come home if they’re coming home to the wrong person. I found the exact right person, which is why I took me until age 51 to get married. I have the travel right treatment. I hit it out of the ballpark when it came to medication. I found a drug that worked for me right off the bat. Therapy was more challenging. Unfortunately, finding someone that you click with can be more difficult than even finding the right primary care doctor. It took me years to find a therapist who understood me, only to have him pass away unexpectedly. I miss him every day, but thankfully he’s provided me with skills that help me get through my toughest moments. You have to tell yourself, when you are in the throes of depression, that you cannot give up. You may feel terrible for a few weeks or even months, but you will get through this. We are all stronger than we sometimes think.
Sometimes, it also helps to be open about my depression. There’s still a lot of stigma surrounding the condition, especially among men: It’s seen as a sign of weakness. But you need to talk about it in order to feel better. There’s no shame in it. It’s like any other chronic condition such as type 2 diabetes or high blood pressure. Just like these diseases, it’s OK to admit that you need help managing it.