More than 20 million people in the U.S. suffer from depression. Risk factors include a family history of depression, major life changes or trauma and certain illnesses or medications. A few members told us how they handle depression.

Please note that the following tips from members do not necessarily reflect the opinion of Blue Cross and Blue Shield. These tips are intended as general information only. Please consult your physician for specific advice. 

I manage my depression with regular exercise and visits with my therapist.

— Eve P.

I have suffered from depression since puberty. But I denied I was depressed each time a doctor brought it up. "I'm not depressed," I would say. "I hardly ever cry." So the first breakthrough was to admit I was a depressive.

The second breakthrough came from researching the topic. I learned that depression doesn’t necessarily mean crying all the time. It can result in irritability, sleep problems, issues with personal relationships, difficulty holding down a job. There are, in fact, a host of symptoms that can be caused by depression.

A third breakthrough was identifying the type of depression from which I suffer. I have Double Depression. While I have dysthymia (chronic low-grade depression), I still have major depressive episodes.

Dysthymia colors my world grey. I don’t often have ugly, black moods. I tend to be somewhat depressed even when good things are happening. I have found cognitive behavioral therapy (CBT) to be more effective than antidepressants for this part of the disorder.

When I have had major depressive events, CBT was not particularly helpful. Instead, I sought the help of a psychiatrist. They could not only prescribe medication, but also help me figure out which meds work best to keep me stabilized and productive in all parts of my life.

Living with depression is a constant battle. It doesn’t help that people will tell you it’s all in your head. They have no idea what it is like to walk in your shoes.

I urge others to be open to a suggestion from a qualified professional that they may be depressed. I also suggest that they learn what it means to be a depressive and identify what type of depression is involved. Finally, I would tell them to seek help, and remain compliant when medication is prescribed.

— Stephanie B.

Depression seems to be a disorder that strikes when I’m not taking care of my surroundings, mind and body... but it’s much more than that.

I’ve noticed my triggers are anxiety and disorder. My key managers are plenty of sleep, a diet filled with more fruits and vegetables, weight lifting, and more than adequate hydration. I also take medications to help with anxiety.

The anxiety that comes with depression is crippling and only pushes me into a depression faster. It is important for me not to get overwhelmed even with all of these helpful things. I have a family. I work full-time. I have a household to manage, too. My mental health affects everything, and everything affects my mental health.

I keep order in everything I am doing. I mentally tell myself to be strong and that I can do this (my family, work, home, animals, the shopping, caring for all their needs) because I float on the edge of daily work, family needs and activities being “too much” to even think about doing. I’d much rather stay home. Still, others depend on me, and I refuse to let them down.

Mental health has become less taboo over the past few years. Although most people don’t know that I suffer, most people can see something is “off” about me at times. Having a partner, a boss and friends who support you or make allowances (e.g., time alone or flexible work schedules) really help me.

I guess my point in all of this is that managing depression is more than a laundry list of “do this, not that.” Many outside factors play a vital role in managing my mental health.

— Carla S.