HS & Depression Part 2: Tips To Deal With Depression During A Flare

In case you missed it, check out Part 1 of this series!

Depression and HS are a tough combination. Dealing with the physical pain of HS and the emotional anguish of depression at the same time can feel like taking on a heavyweight boxer who keeps hitting you with the 1-2 combo- one to the head and one to the gut, over and over and over. More than 50% of people who deal with HS will be diagnosed with depression at some point in their life, so I know I am not alone in this experience. I wanted to share some tips to help push through the darker times and get you back to the light.

Reach out to your support systems

This might seem like a no-brainer, but anyone who has been in a depressive episode knows how difficult that can be. You feel like a burden, a downer, ungrateful, etc. It can be scary to think that people might react poorly or judge you for your mental state, and that risk of rejection can make everything feel worse. I have found, however, that the old statement rings true - “People who mind don’t matter, and the people who truly matter don’t mind.”

Send a text to your best friend explaining why you’ve been distant. Put a call out on Facebook for funny memes or pet photos. Call a family member who you love to catch up with and be honest about how you’re feeling. Getting things off your chest and having a support system can make all the difference when a flare gets you down.

Use TIPP skills

An incredibly useful DBT (Dialectical Behavior Therapy) skill, TIPP, stands for:

T - Temperature change: use ice packs on your chest or the back of your neck to calm your nervous system, splash cold water on your face, wrap yourself in a heated blanket, or take a nice warm bath.

I - Intense Exercise: This just means get your body moving in any way you can. Even if it is just bed Pilates (Check out Activelyautoimmune on Instagram for some great in bed exercises) going for a short walk or something more vigorous, the endorphins from exercise can boost your mood!

P - Paced breathing: Breathe in for 5, hold it for 5, and breathe out for 7. Do this 5 to 10 times in a row. This is a breathing technique that has been shown to calm the nervous system and improve your mood.

P - Paired muscle relaxation: This can be paired with paced breathing, or you can just follow your natural breathing pattern. As you breathe in, slowly tense up your muscles, and as you breathe out slowly relax them. You can do your whole body at once or focus on specific muscle groups.

Work with your hidradenitis suppurativa team

Antidepressants saved my life. There is NO shame in needing professional help for depression. Talking to a doctor doesn’t have to lead to anything you don’t want it to! You won’t be whisked away to an inpatient facility (although there is nothing wrong with needing that type of care either - I’ve been admitted three times!) or forced to take medication if you don’t want to.

Medical professionals are there to help guide your treatment plan, not run it like a dictatorship (even if it can feel like that sometimes) so you will always have a say in your mental health care.

Write out a WRAP plan

WRAP Stands for Wellness Recovery Action Plan. There are three levels:

1. Green: A list of things you can do and how you know when things are going well. This is your baseline. Include a daily maintenance plan - a minimum of 5 things you need to do every day to make yourself feel well. Mine includes showering, doing some personal reading, making sure I eat breakfast, and cuddling my pets!
2. Yellow: These are your warning signs that you’re heading towards a depressive episode. Maybe you start oversleeping, your appetite dips, you find it harder to get chores done around the house. Include the emotions you notice as things slide towards depression - I know that I personally become more irritable as I sink into depression.
3. Red: These are the things you do (or can’t do) and the emotions you notice that let you know you’ve hit bottom. The important thing to include here is what you need to do to pull yourself out of it - what supports can you reach out to, do you have access to rescue medications, what can you do to keep yourself safe? I find it helpful to have someone write this plan with you because your loved ones will notice things you may not see yourself.

I hope these tips can bring you closer to the happiness you so greatly deserve, and remember, on the dark days that you are not alone.