I have had one hell of a week. It has been a week of emotional lows with very few highs. It has been a week where I have had to use all of my coping with depression skills.

I have never been thin. Nor overly large (I hate the word "fat"). I'm 49 years old, I'm in perimenopause and lately, it seems like everything I put in my mouth ends up as another half pound on the scale. It's so depressing!

Lately, I have written blogs about having a good support system, practicing positivity and knowing your dark thoughts / depression triggers. These are all important aspects of continued treatment for my depression. Another aspect of depression treatment is to try to get involved in a charity or cause. The obvious benefit of said involvement is to the benefactor. What makes this an important part of coping with depression is that we are exposed to the needs of others.

There are many depression-management techniques available; antidepressant medication, cognitive behavioral therapy (CBT), exercise and a proper diet, relaxation and general wellness treatments (eg. massage therapy, hypnosis, meditation, aromatherapy, etc.), and so on. Among these therapy techniques is group therapy. But... group therapy for depression? Is it a help or a hindrance?

Quitting your depression medication without the doctor's help can lead to trouble. In fact, getting off your antidepressant medication on your own is a very bad idea. I know, because I did it.

Depression often leads to thoughts of suicide, or in the most dire of cases, taking one’s own life. Around this time last year, in April of 2012, just as I was coming out of my last major depressive episode, I actually considered suicide. I didn’t just think about it, as in, “I wonder what would happen if I drive my car off this cliff,” but I actually contemplated a viable method and a plan to make it happen. Now, some people would think that the car/cliff thought was, in and of itself, a cry of desperation. For me, going that next step beyond pondering to planning, was the very lowest of all my very low moments.

This is not to say that anger is not real or normal. It is. And often justified. But anger comes second after a primary emotion comes first. Sometimes that primary emotion isn’t even recognized or realized because it is below the surface. Imagine a tree, with its trunk and branches tall and large above the ground, and the roots under the Earth. What do those roots do for the tree? They feed it, right? So imagine the trunk and branches are the anger on your outside, the part that people see. But below the surface is the root of the anger, fueling it. If a student was walking down the hall at school and someone tripped him, he might jump up in anger ready to fight, angry. But right before that, he might have felt embarrassment. If a teenager is late for curfew and her parents have been pacing the house, when she walks in late they might argue and be mad and punish her. But right before that, they were worried. There can be any number of emotions below that surface that trigger anger, and depression is one of them.

You walk into the counselor’s office to talk about your depression. Your symptoms include fatigue, poor concentration, decreased libido, moodiness, sleep disturbance, appetite change, nervousness, disorganization, relationship conflict, irritability, poor work performance, withdrawal from others. Yep, your counselor agrees, you have symptoms of depression. The next step should be to figure out WHY you have these symptoms of depression.

Something triggers a bad day. A poor night’s sleep. Receiving bad news. Stress at work. Relationship worries. It could be anything. We would hope that if we are going to be upset, it would stick to that one trigger and we can figure it out and get over it. But it doesn’t work that way, does it? Depression is a sneaky little monster that whispers negative, depressing thoughts in your ear, feeding and fueling itself, and pretty soon you are not just thinking about what triggered you, you are spiraling, going round and round in your head about every other thing that has ever gone wrong in your life. Depression Monster wins again.

It has been nearly three weeks since my last of six ECT treatments. And I feel great! ECT (Electroconvulsive Therapy) may be the most controversial treatment that exists for mental illness. In my case, it was severe depression that did not respond to antidepressants and talk therapy.