My 10 Step to Do List for Enduring Depression

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My 10-Step to-Do List for Enduring Depression A plan of action to combat depression is necessary. While we may never be cured of this condition, we can take steps to suppress it. Some of these things may make us feel uncomfortable or at times seem down right pointless; however, I promise the more you do to actively combat your depression, the better you are going to feel in the long run.

As someone who has lived with depression for many years, I have learned there is no magical one-size-fits-all solution, but it’s my hope that implementing even one of these steps can help you on your own journey.
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Physical Activity and Diet

Physical Activity and Diet

Study after study has shown that exercise can help fight depression. It increases the endorphins or “feel good” chemicals flowing throughout our systems.

 I started out slow and am still not where I need to be, but have taken a step in the right direction. As the old saying goes: “The only bad workout is the one you didn’t do.” I push myself to go to the gym every other day, approximately three to four times a week, and do thirty minutes of cardio along with thirty minutes of weight training. Over time, I will increase the amount I work out, but for now, it’s just right for me. It energizes and motivates me to keep pushing forward.

Eating healthy is also important. I won’t sit here and say that I am a health nut; however, especially lately I have been trying to incorporate a more balanced diet into my health plan. I still fall prey to an occasional temptation for a sweet now and then, but overall, I feel better when I eat more healthfully. Cutting out soft drinks and junk food while increasing your intake of fruits and veggies are simple things you can do to set your diet back on track.

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Music is said to be the pathway to the soul, and I agree. Nothing gets my blood pumping more than uplifting music. As someone who has an hour commute to work every day, I have to find a way to keep myself occupied. Music invokes emotion, and while that can be counterproductive at times, it’s often helped me push through the depression. Soothing and relaxing music triggers good feelings and puts me in a peaceful state. As someone who has a love for the Mexican culture and the Spanish language, this incorporates the majority of what I listen to. Listen to whatever you enjoy because it will get you out of your mind’s thinking trap and take you to a state of being where your emotions have a voice.

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Build and Maintain a Support Network

Build and Maintain a Support Network

Building a support network is a big step that everyone living with depression should have in place. Whether it is a close friend, significant other, beloved family member or therapist, we all need someone we can trust and talk to. For me, a combination of all of these networks helps. At any given time, if I start to feel depressed, I know I have someone I can call and speak with or even visit to express my feelings. Make it clear with your networks what you want in return when you express how you are feeling. Most of the time, I just want someone to listen. And I am fortunate to have a great support network that will do just that.

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Get Creative

Get Creative

Whether it is writing, painting, drawing or singing, do something you love that can let your feelings flow. For me as a blogger and writer, that come’s in the form of written words and poetry. Putting my thoughts on paper is a way for me to fully work through my emotions and express what I am feeling inside. It’s not always the finished product but instead the process of writing that helps. Whatever might work for you, take up a creative hobby, and if you don’t know what yours is, begin the process of exploring one. You won’t regret it!

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Connect With Nature

Connect With Nature

The beauty of the outdoors brings a sense of mindfulness that I’ve found effective in my journey. Whether it is relaxing at our family cabin in Big Bear, swimming in the Pacific Ocean or exploring the beauty of Alaska aboard the annual HIV Poz Cruise, nature is important to me. I forget about the depression and for that moment focus solely on the beauty that surrounds me. It’s a very therapeutic exercise and fun at the same time.

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Whether you are a born-again Christian like me or hold no religious views, spirituality is something that can be beneficial to anyone living with depression. Spirituality is simply connecting with something bigger than us — connecting with our surroundings in a search for the meaning of life. Religion aside, it’s something that all humans experience on one level or another. It helps us to look at the big picture because, when we do, our problems do not seem so overwhelming. It helps us discover our purpose in life, which in turn inspires hope within us that, although we may be going through a tough time, things can change for the better just as quickly as they did for the worse. I personally practice praying, reading bible scriptures and focusing on improving my relationship with Jesus Christ.

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It is well known that there is a close correlation between those living with depression and our pets. I always had animals growing up; however, I never experienced a stronger bond than in the years of enduring depression. I have two dogs named Lobo and Lacy; they both play a vital role in my health care and have been there for me through my worst. They simply want to love and to be loved, the most basic principles of life itself. When I feel down and drained of energy, seeing the smiles on their faces is an amazing feeling. They define what it means to live in the moment, and simply by being with them that energy transfers to me. Nothing like a good fluffy hug to lift my spirits.

I love the story of six-year-old child who asks his parent why dogs die at such a young age. The boy says, “People are born so that they can learn how to live a good life — like loving everybody all the time and being nice, right?” The child continues, “Well, dogs already know how to do that, so they don’t have to stay as long.”

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The Power of Positive Thinking

The Power of Positive Thinking

I know this step seems cliché, and I agree that it is not enough to shake the depression at times. However, I have realized that surrounding myself with positive people and filtering out the negativity and toxicity changes how my mind thinks. Sometimes it may seem as if there is nothing positive in our lives, but I guarantee you there is if you would only look for it. I suggest writing down three things you are grateful for. Regardless of how big or small, over time this will change the way you see the world. This is more of a mindset than an individual practice, but when implemented, you will notice the change.

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Stepping Outside My Comfort Zone

Stepping Outside My Comfort Zone

Depression and isolation often go hand and hand. It’s actually something that I’ve practiced in the past because I don’t want others to suffer. I’d rather block them out, ignore them and fall into a state of nothingness. It’s easier to do that than to accept that, to fully get ahold of my depression, I have to interact with society. As a social media advocate, this also means taking a break from the digital world. Although inside I may not be feeling it, the benefits of physically interacting with others are enormous. It could be as simple as hanging out with friends or giving to someone who is less fortunate. Doing these things serves as a distraction, as the focus and attention shifts from my own thoughts to the lives of others.

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Recognition and Acceptance

Recognition and Acceptance

Awareness and recognition of what triggers my depression is important. This not only helps me better understand my condition, but also helps me formulate a better response the next time it happens. For many, recognizing when depression is sinking in can be a hard task. For me, I now know almost automatically. It’s been a learning process to get to this point; however, I can now accept when it is hitting and implement the steps above to suppress it to the best of my ability.

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Every 40 Seconds

Every Forty Seconds
“We need to raise awareness about the other epidemic—depression”
by Joshua Middleton

Article written for and property of A&U:America’s AIDS Magazine : Original Article Link  can be found  by clicking here 

am HIV-positive and, yes, I also live with depression. That’s right, I said it. The big “D” word that no one wants to say. Let me share with you my perspective on an epidemic possibly far bigger than any we have ever faced before.

Joshua bicycled across the Golden Gate on a recent trip to San Francisco. Photo courtesy J. Middleton


On a recent trip, as I bicycled over the Golden Gate Bridge, the reality of what has become such a taboo subject really hit home. The architectural masterpiece that is visited by swarms of tourists a year also sits above a graveyard where thousands have succumbed to the seemingly neverending battle with mental health issues, namely depression.

Just as the marine layer began to lift, I peered over to my right towards another iconic Bay Area piece of history, the infamous Alcatraz Prison. Imagine being imprisoned in such a place. Four walls confining you from freedom with only a glimpse of the outside world. A place that has entrances and exits but, despite knowing how to get out, you can’t seem to accomplish it. Happiness and joy are taken from you and the reality is the vastness of time that is ahead of you. It seems you are just going through the motions. The worst part of it is, no one talks about what you are going through; it’s as if you don’t exist. You are left with a feeling of isolation, cast out from society. Now you know what it is like for someone who lives with depression.

Ironically, both are located in San Francisco, a city that has been majorly affected by the virus since the beginning of the AIDS epidemic. Although some statistics show that sixty percent of individuals who are living with HIV are also living with depression and that we are three times more likely to become depressed, society as a whole doesn’t care to talk about it. It’s uncomfortable, awkward, and foreign to those who haven’t experienced it.

Its effects on someone living with HIV range from the extreme cases of suicide to other issues such a decline in treatment adherence, substance abuse, and an overall reduction to quality of life.

Did you know that suicide is a leading cause of death? In 2014 alone there were over one million deaths a year, which breaks down to one death by suicide approximately every forty seconds. In two-thirds of the cases, depression was an underlying factor at the time they ended their lives. By the time you finish reading this article theoretically five more will be gone because they couldn’t hold on any longer. They were strong for far too long.

That’s right, strong. You didn’t misread and no it wasn’t a typo. Enduring depression takes strength. It’s not a sign of weakness and it’s the very stigma that tells us these things that is keeping many in the shadows of silence. We need a new approach to how we look at this condition. We need to encourage people to speak up and seek help whenever possible.

How can we expect people to adhere to treatment when taking a pill appears as difficult as climbing a mountain? Why would substance abuse not be on the rise when people are feeling so low in their lives that they find a way to get a temporary high and mask their pain? How can we tell people to look at the positives in life when the world seems to be crumbling before them?

Understandably, HIV is a life-changing diagnosis. It’s a virus that has been stigmatized from the very beginning and for various reasons it can trigger depression. Integral care of both physical and mental health from the beginning of diagnosis is vital. There is help out there, but people will only reach out for it when they are ready but are often held back by the stigma.

What can you do to help someone with depression? Listen. Yes, it’s that simple. Realize that a nonjudgmental and impartial ear is crucial. One that isn’t there to offer unwanted opinions or advice but just to offer an open line of communication and give a hug when needed. With this one simple step. you have validated someone’s feelings in knowing that there is no shame in saying, “I have depression and it’s okay to talk about it.”

If we are serious about reaching our goal of zero then we must start by talking about depression!

Change starts with a conversation and recognition of the problem—it starts here!

Are you in search of mental health/substance abuse services? Call SAMHSA National Hotline toll-free at 1 (800) 662-HELP. Are you experiencing a mental health crisis right now or feeling suicidal? Need someone to talk to? Please call toll-free 1 (800) 273-8255.

Relentless Adversaries: HIV & Depression

depressionA dark cloud hovering over the life of someone day in and day out like a bad dream that never goes away. It is like a tree that is receiving no water and is simply withering away inside little by little until it comes to a breaking point. The world around seems to be passing by while the mind is simply going through the motions to survive from one day to the next. A fatigued body that has been battered by months or even years of storms that seem to get bigger every time they roll in, shadow the mind from finding the true roots of the problem. You know something is wrong but you somehow convince yourself that if you just suffer in silence for long enough, if you simply toughen up, you can overcome this demon that has overtaken your life. Even when you recognize your enemy you feel helpless as countless attempts to defeat it have proven pointless. While it may be subdued for a short time you know the feeling when it creeps back into your life like a thief in the night, without warning or notice.

Your mind struggles to find a solution but due to a chemical imbalance becomes overwhelmed with the thought of facing the tyrant once more, and simply often surrenders in defeat. As a prisoner in your own mind, restrained in a bondage to depression, you have lost the love for yourself in the process. People know something is different about you but the front you put on makes it seem like as if everything is fine, they don’t know the true struggle do they ? The struggle of depression is real and can have drastic consequences in not only the individual’s life but the lives of those that surround them. It can turn into a downward spiral like an airplane that has lost its wing, doomed for disaster with nothing able to stop the inevitable. Depression isn’t simply a condition that can affect ones life, it can take over ones being and mind. The struggles of day-to-day life and constant obstacles including a major life changing event such as a HIV diagnosis, simply trigger the sleeping giant. Are you someone who is living with HIV & depression? I urge you to keep reading.


Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest (Mayo) . It is an illness that has been spoken about in one form or another since the Greek physician Hypocrites in 1400 BC. Through the years those who have suffered from it’s rathe have been judged, stigmatized, and misunderstood. The medical history of coming to comprehend the true causes and mechanisms of how depression works have only recently developed within the last century. Some medical professionals would argue that we still truly do not understand to the fullest extent how depression works however scientifically we have much more information available to us today than ever before. It is an umbrella mental health disorder that contains many subcategories but in general carry the same identifying characteristics.

The World Health Organization’s most recent estimate from 2012 show that globally over 350 million people of all ages suffer from depression. Not everyone’s severity of depression is the same however it can range from mild, moderate, major, to severe. It has the potential to cause suicide which account for 1 million deaths a year. In the United States alone the number of depression is skyrocketing in percentages compared to other areas of the world however what is more alarming is the number of HIV positive patients suffering from depression compared to that of the general population. Those living with HIV are three times more likely to suffer from depression and one in every four living within the US has experienced some form of depression (CDC Study March 2014). Although the percentages vary for studies of depression in HIV + patients it is believed to be as high as 60 % of all patients living with HIV currently suffer from depression. They are two completely separate treatable conditions however if left untreated depression can lead to inability to adhere to HAART medications as well as quality of life & lifespans. Symptoms can differ in men and women in terms of prevalence however in general can encompass constant sadness, hopelessness, irritability, overeating, sleep disorders, and loss in interest.

It is an unforgiving condition that is can affect anyone and leave a catastrophe in its wake. I myself have suffered from depression ever since my mid teenage years but it truly went into full swing after surviving Necrotizing Fasciitis in 2010. I would classify my depression as mild however it is not to say that it has not been a struggle. As the years have went on and life has presented more obstacles depression has tried to take a hold time after time. My HIV diagnosis was simply another trigger that threw my mind back into the maze of depression that one can truly never escape from. With such a life changing diagnosis grieving is normal however when symptoms of depression begin to appear, it is a red flag to halt it in its tracks. It can bring the strongest athlete in the world to his knees and it has the ability to alter someones mind forever if left untreated long enough.

Although someone may be able to put on a front for so long eventually the reality of the situation has to be unmasked. Even after my depressive episode after being diagnosed in 2012, I thought I had been through the hardest obstacle of them all, I was wrong. Losing our baby in February re triggered those thoughts and put me back on the battlefield which I continue to fight on a daily basis. Although the enemy may try to persist I will not allow it to win. I am a big advocate of people speaking with their doctor about mental health and getting the proper referrals if needed. Speaking with a psychiatrist to explore treatment options, going to therapy sessions with a psychologist/therapist, and opening up about ones feelings is one of the most important steps one can take. In my own experience a combination of medication, therapy, and relationship with Jesus have served useful.


In conclusion depression is one of the most serious conditions one can face and the consequences if left untreated can be as severe as if HIV takes control of ones body. The first step is recognizing the problem and that can only be diagnosed by a medical professional. We need to learn that putting an emphasis on our mental health and addressing the root of the problems are as important as facing the triggers. This may take a course of time in your life when antidepressants are necessary, therapy may need to be in place to help one deal with obstacles facing ones life, but above all it takes the will to say depression will not run my life. We deserve so much more than what our mind wants to convince us we are worth. Living with HIV can be a major challenge but confronting other impedance in our life will help us not only to grow but to turn our mindset from a victim to a survivor. It isn’t an easy battle and I know this from personal experience.

No one can completely understand what you are going through except you yourself. You are capable of being able to love yourself again, begin to heal the wounds of the past, and move forward as a triumphant warrior. It is not to say that you will never face a depressive episode again because in all reality you most likely will, but with the proper therapy you will have the tools necessary to better fight it every time. If you feel you are going through depression speak with your medical professional for a course of action, take that first step in repairing the love for yourself. Don’t become another statistic but a shining light for others to know that surviving depression is possible. Share your feelings with someone close to you and let them know those thoughts that constantly are racing through the head. You are no stronger suffering in silence and no matter how much weight you try to carry on your shoulders, even the strongest need a helping hand from time to time. Make today the day you say that depression does not define you, there is hope, and yes even if you are HIV + and depressed. We are in this fight together so gear up soldiers , victory awaits !

Below are some helpful links for those who wish to learn more about depression including symptoms (NIH), as well as resources for seeking help. Simply click any of the logos below for more information. If you currently are suicidal and or contemplating suicide I would urge you to dial 911 (or local emergency phone number for your country) or dial the National Suicide Prevention Lifeline @ (800) 273-8255 . If located outside of the US please visit the International Suicide Hotline’s Page for resources near you. Thank you as always for reading my blog and I hope everyone has a blessed rest of the week.

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