For the past several months, I have been experiencing depression and anxiety like I never have before. I have had short-lived periods of it, mostly situational, but they resolved and in general I have always thought of myself as being free from mental health problems.

At first I thought that it was normal hormonal stuff, because it was coming cyclically. But it kept getting worse, so I finally went to see my OB/Gyn about it. She tested my hormones, which all came back normal, and didn’t end up prescribing me anything because my description of it didn’t sound like typical PMDD. I have known this doctor for about seven years, we have had fairly frequent contact, and I trust her. She ended up referring me to a psychiatrist because she suspects I have underlying anxiety or depression that needs to be dealt with. She suggested that I normally cope with it very well, but when I experience hormonal withdrawal I lose the mental resources to function as usual.

I am grateful that I made that psychiatrist appointment back when I was feeling better, because it was hard to find one and there was over a month waiting period to get in. At this point I am open to medication because I know that although I may be strong, I am not stronger than serotonin and dopamine.

Why am I depressed? I don’t know exactly, but I have an idea. It was this time last year that my husband relapsed into addiction, kicking off an extremely difficult year – traumatic, really. At the time, I was in survival mode and adrenaline took over. My emotions shut down, denial ramped up, and I single-mothered like a boss. When he came home from rehab, I went through a couple of months of severe depression which I understood to be the processing of the entire event. The fog lifted, and I thought I was back to normal. My husband is doing well, so I didn’t expect to through that again.

However, witnessing the tragedy of Hurricane Harvey so close to home brought up all the feelings of my own personal trauma. Pair that with the season, and it is becoming clear that I have much more to work through than I thought.

All of that was just an extended introduction, because I am actually writing today to share what I’ve been doing to help myself through this. All of these items are things I’ve done, and while nothing has “fixed” me, I do think I’m in a better place because of them.

1. See a doctor, consider medication

In some cases, it is at heart a matter of brain chemistry and nothing else is going to make as much of a difference as this. I suspect that I need this temporarily to return to baseline and reset my body. Just having the appointment set up has given me hope.

2. Therapy and groups

I went to individual therapy all spring and summer, and it really helped at the time. Currently I’m not attending for financial reasons, but groups have been influential in my process. Every Saturday I attend a group process meeting for spouses of addicts, and I have decided to also start attending Al-Anon. It is through these groups that I am reminded that I’m not alone and what I’m going through is normal.

3. Exercise

One of the first things anyone will tell you to do for depression is exercise. It’s usually the last thing you feel like doing, but it can naturally alter your brain chemistry in a good way more than anything else. I was in a steady exercise routine prior to the hurricane, and although I took a week off because we were stuck inside, I was able to resume a regular schedule of it. I can’t say that I’ve felt wonderful after working out, but at least I can feel proud of myself for doing it.

4. Reach out to friends

For me, this is something that has made the most difference. When I feel depressed, I tend to isolate myself. I can go weeks without talking to a friend. Then I start to tell myself that no one cares about me, that I’m not worthy of friendship. It’s a very negative cycle, and it was made worse for me by the hurricane when everyone was so consumed with their own families and helping those who were flooded. Plus, you couldn’t go anywhere.

However, I had some moments when I got up the courage to text friends about what I was going through, and their responses were hugely uplifting. Also, it can be hard to pray when I’m feeling so down, so prayers of those who love me can carry me spiritually. I do want to note that friends won’t make everything better. They won’t fulfill all your expectations and needs, but they can definitely help.

5. Spiritual life

Sometimes when I’m depressed I can’t even pray, but I can still read the words of God. It reminds me of his promises. This is also when I find pre-written prayers to be so helpful, because I don’t need to come up with the words on my own. Attending church even when I don’t feel like it allows me to meet with God. I imagine that taking the Eucharist would be an especially important means of receiving grace during times like these. (And I will be able to in only 202 days, but who is counting?) And finally, uniting my suffering to that of Jesus gives it all meaning. I think that I can endure anything if only it has real meaning.

6. Read

I have let almost all of my hobbies drop except for reading. I read spiritual books and self-help books, and I read comfort books like fantasy to help me escape. I find much value in both.

7. Meditation and visualization

I randomly came across an app for Alexa called My Morning. It leads you through five minutes of meditation, visualization, gratitude, affirmation, and goal-setting. I have found that it helps center me at the beginning of the day, especially when I wake up with a twisty knot in my stomach. I have also tried other guided meditation apps such as Calm and Headspace, and I’m always glad when I do them.

8. Go outside

Nature almost always lifts me out of myself. Now that our rain has passed, we have been having gorgeous days and I am so grateful.

9. Make a list of goals and do them

This might be my nature, but I almost always feel better when I’m productive. Even if I have very little energy, if I can just start then momentum usually carries me through. I like to make simple and achievable goals for the day, like hitting a step goal, texting with my husband about something positive, going for a walk, getting one chore done.

10. Rest, wallow, and cry when needed

Finally, I have to give myself the grace to do what my body needs. Sometimes I need to lock myself in my room and cry. Sometimes I need to nap. Sometimes I do need to get up and be productive, but sometimes I need to wallow in my misery. It’s okay. I need to feel the things I feel.