The (DIY) Depression Scale

“I’m usually not depressed.” I smile. “Most of the time, I’m fine.”

That feels like a good place to start the conversation. Manage expectations. Set the stage.

Depression is painfully common, but it’s still so mystified. We’re embarrassed to say we feel depressed (at least to each other’s faces), and do not even speak of suicidal ideation. (Most people are too shocked to be helpful, and end up saying things that cause more harm than good.)*

People assume we’re just sad all the time (although some people with depression never feel sad), or that we don’t get out of bed. (Say that to the parent who can’t afford to stay in bed, because there are small humans who need to eat.) During some of my hardest times, I was in school full-time, and working a side job. I was a walking shell of a person, but I did all the things I “should” be doing.

(Side note: that is not a judgement call. Sometimes people do have a huge amount of trouble getting out of bed, and that is equally valid. Just a reminder that you can’t judge the severity of somebody’s struggles by outward appearances.)

Most of the time, I’m okay. But I’m depression-sensitive, which means I always need to make a conscious effort to not be depressed.

Some people manage with medication, which – in conversation with your doctor or mental health professional – can be a really powerful decision.

For me, right now, I manage through lifestyle choices. Exercise in particular seems to be really helpful.

That’s great, but that does mean there are a couple of major risk factors. Illness, injury, burnout, and travel can throw off my (mental health) routines and make it easier to slip.

Sometimes, you just need a rest day (or two, or three), but it can be difficult to see how far you’re sliding down until you’re back at the bottom.

For this purpose, I made a Depression Scale. Mine has a four-point scale (with the bonus 0 being a healthy baseline, which I only included because depression makes you believe your baseline is depression – it’s selfish like that). It starts with the first signs of sliding (1) and ends with full-blown mental health crisis, don’t let me out of your sight (4).

I rarely make it to a 4, but I’ve been at a solid 3 throughout most of the past week or two and it’s been hard. After almost three years, I finally caught Covid, which really knocked me out. I recovered just in time to travel to New York, and then had a combination of post-Covid fatigue, jet lag, new-place-anxiety, and the sudden seasonal shift into darkness that messed with both my physical and mental health. On top of losing my grandfather (I’ve written about the grief before), not getting into my dream school, major work chaos, and a potential move to a new country, it’s been a lot.

How to make your own mental health scale

In the Depression Scale/Protection Plan document, each phase is accompanied by a few different categories:

  • Signs: the symptoms of each phase and how I can recognise them (e.g. anhedonia, exhaustion, social isolation, suicidal ideation)
  • Interventions: the things that might help me get back up to a “better” phase to slowly climb out of the hole (e.g. small positive habits, therapy, running, social support)
  • Risks: the tricky bits of each phase and how they can morph into a worse phase (e.g. lack of energy leading to negative feedback, negative feedback leading to shame spiral, shame spiral leading to even less positive action)
  • Protective measures: the specific things my loved ones can do in each stage to support me and minimise the risks (e.g. providing positive feedback during shame spiral, helping me complete small tasks, going for walks with me, helping me reach out to a professional)

The scale has been helpful for us.

When you’re already struggling, you don’t want to have to reinvent the wheel. That is not the time to come up with brilliant solutions, to look for a new therapist, or to have to explain exactly how your loved ones can help you. (I don’t know if the answer is “take me to therapy” or “bring me cupcakes”.)

Let your healthy self do the work.

If this is something that might be helpful for you too, I put a template down below that you can download for free. If mine doesn’t quite work for you, this website has a different option for a safety plan. (This is not a substitute for professional help. This is my personal experience + a little infographic to share.)

Sometimes I’m frustrated that I have to work so hard to be mentally healthy. (Especially when people ask “aren’t you just trying too hard?”. Girl, I’ve tried trying less hard, and I’m lucky I lived to tell the tale.)

My brain makes music and art, bad jokes, and slightly inappropriate comments. It makes me love deeply, create things that weren’t there before, and battle the stigma around mental health and neurodiversity. It makes me write, sing, fight for what I believe in, and take care of the people I love. And sometimes it tries to kill me.

Everything is always less black and white than it seems.

For now, let’s take care of ourselves and each other. Healing happens in community, and – if we aren’t lucky enough to have one – we can create our own. If you’re having a hard time making your own community (hello, depression-fuelled social isolation), it might be nice to check out Avril Heals. They are setting up amazing things (and they’re really wonderful people).

Love,
Flora

*If you have loved ones who struggle with depression and/or suicidal ideation, and you do want to be helpful (awesome, love that), here are some things to keep in mind:

  • Asking somebody about suicidal thoughts does not put the idea in their heads. People might actually be relieved that you asked.
  • Stay calm. I know it can be really hard to hear if a loved one is thinking about suicide or self-harm, but this is not about you. Shock tends to create more distance.
  • In her (highly recommended) book Maybe You Should Talk to Someone, writer and psychotherapist Lori Gottlieb writes: “Often people talk about suicide not because they want to be dead but because they want to end their pain. If they can find a way to do that, they very much want to be alive.” More than anything, depressed people need support in making their lives (feel like it’s) worth living again, so they have something to come back to.
  • I found this a helpful resource for friends and family.
  • Take care of yourself first. Make sure you have your own support system in place.

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