Coping Skills for Depression: Evidence-Based Strategies That Help

Coping skills are practical techniques that help you manage depression symptoms, regulate difficult emotions, and improve your overall mental well-being. While coping skills alone aren't a substitute for professional treatment, they serve as valuable tools that work alongside therapy and medication to help you navigate the challenges of depression.

Research suggests that coping strategies can help reduce symptom severity, support daily functioning, and complement relapse-prevention efforts, particularly when combined with evidence-based treatment. According to the National Institute of Mental Health, around 21 million U.S. adults (8.3%) had at least one major depressive episode in 2021, making effective coping skills an essential component of comprehensive mental health care.

Key Takeaways

• Active and passive coping differ: Active coping skills like exercise, mindfulness, cognitive restructuring, and social connection are generally associated with better long-term outcomes than passive avoidance-based coping, which, when relied on persistently, can worsen depression over time.

• Small steps matter: Depression makes even simple tasks feel overwhelming, so starting with manageable 5-10 minute activities and gradually building can create meaningful change without triggering discouragement.

• Combination approach works best: Research shows that coping skills are most effective when used alongside professional treatment like therapy or medication, creating a comprehensive approach to managing depression.

Cognitive and Emotional Coping Skills

Mental strategies help you manage the thought patterns and emotional experiences that characterize depression.

Mindfulness and Meditation

Mindfulness involves paying attention to the present moment without judgment. Research shows that mindfulness-based interventions can reduce depression symptoms and prevent relapse. A study in JAMA Psychiatry found that mindfulness-based cognitive therapy (MBCT) was comparable to maintenance antidepressant medication in preventing depression relapse in people with recurrent depression currently in remission. 

While mindfulness-based cognitive therapy is typically an 8-week program administered by a therapist, mindfulness techniques can be incorporated into daily life to cope with negative thought patterns. The practice helps you observe negative thoughts without becoming overwhelmed by them. It equips you to respond to sadness or negative thoughts with calmness and compassion.

Mindfulness techniques for depression:

• Body scan meditation to increase body awareness

• Mindful breathing exercises for immediate calm

• Observing thoughts without engaging or judging them

• Using mindfulness apps for guided practice

• Starting with just 5 minutes daily and building gradually

Cognitive Restructuring

This technique, central to cognitive-behavioral therapy (CBT), involves identifying and challenging negative thought patterns that fuel depression. Cognitive restructuring helps you develop a realistic way of evaluating negative thoughts rather than putting a “positive spin” on them, which may be counterproductive.

Steps for cognitive restructuring:

• Notice automatic negative thoughts as they arise

• Examine the evidence for and against these thoughts

• Consider alternative, more balanced perspectives

• Replace distorted thinking with realistic appraisals

For example, the thought "I'm completely worthless" might be challenged with evidence of past accomplishments, relationships, and qualities you possess, leading to a more balanced thought like "I'm struggling right now, but I have value and have succeeded in the past."

Emotional Regulation Techniques

Depression can make emotions feel overwhelming and unmanageable. Specific techniques can help you tolerate and regulate intense feelings.

Effective emotional regulation strategies:

• Deep breathing exercises (4-7-8 breathing, box breathing)

• Progressive muscle relaxation

• Grounding techniques using the 5-4-3-2-1 method

• Naming and acknowledging emotions rather than suppressing them

• Using a mood journal to track patterns and triggers

Emotional regulation techniques can help calm your nervous system, activate the vagus nerve (which is associated with stress release), and disrupt negative thoughts before they get out of hand.

Note: These techniques may provide short-term relief but are not substitutes for treatment in moderate to severe depression.

Social and Interpersonal Coping Skills

Connection with others is crucial for managing depression, even when isolation feels more comfortable.

Maintaining Social Connections

Depression often makes you want to withdraw, but social isolation typically worsens symptoms. Research consistently shows that strong social support is associated with lower depression risk and better outcomes, though it does not eliminate risk.

Strategies for staying connected:

• Schedule regular check-ins with friends or family, even brief ones

• Join support groups for people with depression

• Engage in group activities aligned with your interests

• Be honest with trusted people about what you're experiencing

• Accept help when offered, even for small tasks

Setting Boundaries

While connection is important, protecting your energy and setting appropriate boundaries is equally crucial when managing depression.

Healthy boundary-setting includes:

• Saying no to commitments that feel overwhelming

• Limiting time with people who drain your energy

• Communicating your needs clearly to others

• Taking breaks from social media when needed

• Recognizing that it's okay to prioritize your well-being

Seeking Support

Reaching out for help is an active coping skill that demonstrates strength, not weakness.

Types of support to consider:

• Professional therapy or counseling

• Psychiatric medication management when appropriate

• Peer support groups (in-person or online)

• Crisis hotlines during acute distress

• Trusted friends, family, or community members

Behavioral Activation Coping Skills

Behavioral activation is an evidence-based approach that involves gradually increasing engagement in meaningful activities, even when you don't feel motivated. It is usually practiced under the guidance of a therapist who assigns activities based on individual choice. Once learned, these skills can be integrated into your coping toolkit. 

Behavioral activation is increasingly seen as an effective self-help intervention for depression that can be provided through web-based services and mobile applications.

Understanding Behavioral Activation

Depression often creates a cycle where low mood leads to withdrawal from activities, which further decreases mood and motivation. Behavioral activation breaks this cycle by encouraging action before motivation returns.

Research shows that behavioral activation is an effective psychological therapy for depression and is particularly helpful for people with chronic depression who struggle with complex cognitive techniques. The benefits of behavioral activation last almost as long as cognitive therapy, and are effective at preventing relapse compared to medication withdrawal.

Practical Behavioral Activation Steps

Start by identifying activities in three categories:

• Necessary activities (basic self-care, work responsibilities)

• Pleasurable activities (things you used to enjoy)

• Meaningful activities (aligned with your values and goals)

Create an action plan:

• Choose one small activity to start with

• Schedule specific times to do the activity

• Commit to doing it regardless of how you feel

• Notice any mood changes afterward

• Gradually add more activities over time

The key is starting with manageable tasks, even washing one dish or walking to the mailbox counts. Small successes build momentum and increase motivation for larger activities.

Creative and Expressive Coping Skills

Creative expression provides healthy outlets for difficult emotions and can improve mood through engagement and accomplishment.

Journaling and Writing

Expressive writing has been shown to reduce depression symptoms and improve emotional processing. Writing helps externalize thoughts, identify patterns, and gain perspective on experiences. In a study on 40 people diagnosed with major depressive disorder, expressive writing about their deepest thoughts and feelings surrounding an emotional event was shown to significantly reduce their depression scores. 

Effective journaling approaches:

• Stream-of-consciousness writing without self-editing

• Gratitude journaling to shift focus toward positive experiences

• Tracking mood patterns and triggers

• Writing letters you don't send to express difficult emotions

• Using writing prompts when you're unsure where to start

Art and Music

Engaging with art and music activates different parts of the brain and can provide relief when words feel inadequate.

Creative coping activities include:

• Drawing, painting, or coloring without concern for quality

• Playing or listening to music that matches or shifts your mood

• Dancing or moving to music

• Creating playlists for different emotional states

• Engaging in crafts or hands-on creative projects

Developing Your Personal Coping Toolkit

The most effective coping strategy is the one you'll actually use. Building a personalized toolkit involves experimentation, self-awareness, and flexibility.

Creating Your Plan

Steps for developing effective coping skills:

• Try different strategies to see what resonates with you

• Create a written list of your most helpful coping skills

• Plan ahead for what you'll do during difficult moments

• Identify early warning signs that you need extra support

• Practice coping skills when you're feeling okay, not just in crisis

When Coping Skills Aren't Enough

While coping skills are valuable tools, they work best as part of comprehensive treatment and may not be sufficient on their own for moderate to severe depression.

Signs you need additional professional support:

• Coping skills aren't reducing symptom severity

• You're having thoughts of self-harm or suicide

• Depression is significantly interfering with work, relationships, or daily functioning

• You're unable to care for yourself or maintain basic activities

• Symptoms have lasted more than two weeks or longer and are significantly impairing your functioning

• You're using substances to cope with emotions

Professional treatment options include psychotherapy (especially cognitive-behavioral therapy, interpersonal therapy, or other evidence-based approaches), psychiatric medication, or a combination of both approaches.

Blossom Health: Professional Support for Depression

If depression is affecting your daily life despite using coping skills, professional treatment can provide the additional support you need. Blossom Health connects you with board-certified psychiatrists who can evaluate your symptoms, recommend evidence-based treatments, and prescribe medications when appropriate through convenient virtual appointments covered by in-network insurance.

Our psychiatric providers work with you to develop comprehensive treatment plans that combine professional care with effective coping strategies. Whether you're seeking therapy, medication management, or both, we're here to help you find relief from depression.

Medical Disclaimer

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. If you are experiencing a mental health crisis or having thoughts of self-harm, contact the 988 Suicide and Crisis Lifeline by calling or texting 988, or call 911 for immediate assistance.

Sources

1. National Institute of Mental Health. (2023, July). Major depression statistics. U.S. Department of Health and Human Services, National Institutes of Health. https://www.nimh.nih.gov/health/statistics/major-depression

2. American Psychological Association. (n.d.). Overcoming depression: How psychologists help with depressive disorders. https://www.apa.org/topics/depression/overcoming

3. Holahan, C. J., Moos, R. H., Holahan, C. K., Brennan, P. L., & Schutte, K. K. (2005). Stress generation, avoidance coping, and depressive symptoms: a 10-year model. Journal of consulting and clinical psychology, 73(4), 658–666. https://pmc.ncbi.nlm.nih.gov/articles/PMC3035563/ 

4. Preventing relapse: Depression in adults: Evidence review C. London: National Institute for Health and Care Excellence (NICE); 2022 Jun. (NICE Guideline, No. 222.)    Available from: https://www.ncbi.nlm.nih.gov/books/NBK583073 

5. Schuch, F. B., Vancampfort, D., Firth, J., Rosenbaum, S., Stubbs, B., et al. (2018). Physical activity and incident depression: A meta-analysis of prospective cohort studies. American Journal of Psychiatry, 175(7), 631–648. https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2018.17111194 

6. Kuyken, W., Warren, F. C., Taylor, R. S., Whalley, B., et al. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565–574. https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2517515 

7. Choi, K. W., Stein, M. B., Nishimi, K. M., Ge, T., Coleman, J. R. I., et al. (2020). An exposure-wide and Mendelian randomization approach to identifying modifiable factors for the prevention of depression. American Journal of Psychiatry, 177(10), 944–954.           https://psychiatryonline.org/doi/10.1176/appi.ajp.2020.19111158 

8. Wang, X., & Feng, Z. (2022). A Narrative Review of Empirical Literature of Behavioral Activation Treatment for Depression. Frontiers in psychiatry, 13, 845138. https://pmc.ncbi.nlm.nih.gov/articles/PMC9082162 

9. Ekers, D., Webster, L., van Straten, A., Cuijpers, P., et al. (2014). Behavioural activation for depression: An update of meta-analysis of effectiveness and subgroup analysis. PLOS ONE, 9(6), e100100. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0100100 

10. Dobson, K. S., Hollon, S. D., Dimidjian, S., Jacobson, N. S., et al. (2008). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of consulting and clinical psychology, 76(3), 468–477.    https://pmc.ncbi.nlm.nih.gov/articles/PMC2648513/ 

11. Krpan, K. M., Kross, E., Berman, M. G., Deldin, P. J., Askren, M. K., & Jonides, J. (2013). An everyday activity as a treatment for depression: The benefits of expressive writing for people diagnosed with major depressive disorder. Journal of Affective Disorders, 150(3), 1148–1151. https://www.sciencedirect.com/science/article/abs/pii/S0165032713004448

12. Mayo Clinic. (2023, April 05). Depression: Supporting a family member or friend. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20045943 

13. National Institute of Mental Health. (2024, February). Psychotherapies. National Institutes of Health. https://www.nimh.nih.gov/health/topics/psychotherapies 

14. Cleveland Clinic. (2023, January 13). Depression. https://my.clevelandclinic.org/health/diseases/9290-depression 

15. Harvard Health Publishing. (2021, February 2). Exercise is an all-natural treatment to fight depression. Harvard Medical School. https://www.health.harvard.edu/mind-and-mood/exercise-is-an-all-natural-treatment-to-fight-depression