Managing Your Depression (18 page)

With depression, feeling “good” is alien and may feel uncomfortable at first. You are not used to it and may feel anxious. The brain sees it as different and “not right,” so the tendency is to go back. Don’t. You have to push yourself.

Here, a therapist was preparing me for the idea of making progress in therapy. The statement points out that when you are immersed
in a mind state like depression for a long time, the brain gets used to it and sees any change from depression as “different.” So, when you start to feel good, that new “feel good” state may feel “bad” or uncomfortable to you. You might feel anxious, irritable, and out of sorts. You might feel like retreating back to your old depressed self, which is familiar. Do not allow that to happen. You have to push yourself to get used to the new idea of feeling “good,” or at least “better,” and eventually you will adjust to it. After all, that is your ultimate goal.

Practice consciously endorsing yourself.

Most people who suffer from depression are very good at negative self-talk. Finding negative, critical things to say about themselves seems to come easily. “I am a loser” and “I am no good” are fairly universal (and inaccurate) beliefs among those who have this illness. But this is not healthy for you. With depression, you have to learn to think about yourself in more positive terms and to give yourself credit for your accomplishments, no matter how small. You have to practice endorsing yourself, on purpose, consciously, and get comfortable having those positive thoughts in your head. Practice saying “I am a good ________” (fill in the blank) several times a day until it feels natural to you. That is what my therapist was trying to say in this statement.

Action precedes motivation.

This is said so often, it has become the mantra of the McLean Hospital Partial Hospital Program. It is meant to address the inertia that comes with depression, the lack of interest in life and in doing things (called anhedonia). What it means is that even when you are depressed and don’t feel like doing anything, you should go ahead and do something anyway. Do not wait until you feel like doing it, because in depression, that will not come for a very long time. If you begin to do things, eventually the motivation to do them will follow. It is far easier to stay in bed or on the couch, but that is
not in your best interest. Just get going on some small thing and eventually the interest in doing it will follow, and you will become interested in more things. Start with one small thing at a time, and the motivation for doing it will later appear.

Sometimes we experience a combination of physical, emotional, and interpersonal symptoms for such a long time that we don’t even recognize them as symptoms. We get used to them and think they are normal.

We discussed this in group therapy years ago, and I just now discovered who wrote it, although it is taken from a book I have not read. I know that it is very true in depression. When symptoms persist for a long time, and your memory gets fuzzy, it is hard to remember what your past self is like. When you get used to the symptoms of longstanding depression, you may think of it as your “normal” self. Remember—that is not true. It is not your normal self. The exercise in
chapter 3
is designed to help you define your baseline healthy self and have that as a goal to work toward during your recovery.

Courage doesn’t always roar. Sometimes courage is the quiet voice at the end of the day saying “I will try again tomorrow.”

This quotation speaks volumes to me. Depression is the kind of illness that requires a lot of courage. Many of us go around with this illness in silence, not mentioning it to any but a few of our closest friends and family, quietly struggling. It takes a lot of effort just to get up each day, to get showered and dressed and try. It takes enormous courage to get up and face another day of depression, of darkness and despair and hopelessness. When you are willing to do that day after day, you have courage unlike any other. You do not have to shout it from the rooftops—you show it quietly by your efforts.

You cannot absorb praise unless you decide to believe and validate what is being said.

A psychiatry resident said this to me one day during one of my major struggles. It is meaningful to those with depression who are overwhelmed with negative self-talk and beliefs that interfere with their ability to receive praise or a compliment. She meant to say that you need to be able to respect and believe what the other person is saying, and validate them, before you can absorb the positive comments they are offering you. That is not easy to do. Once you decide that you can trust and believe the other person, then you can accept their words as accurate and complimentary.

There is Hope because … we see you in a different way than you see yourself, and if you were to see yourself as we see you, then you could believe and hope that life could be different.

I was struggling terribly with the idea of having no hope for a life when this wise psychiatrist said this to me. I had to learn and later accept that he saw me in a different way than I saw myself. I was looking through depressed glasses and could not see things as he did, a common problem in depression. And since he saw me differently, he saw a potential for life and hope that I was unable to envision when depressed. I am still learning to see myself through his eyes and the eyes of others who see me this way, to see my potential through their point of view.

That is just the way you have come to regard yourself. It is not necessarily true.

Another physician, who did not know me at all, picked up on the extremely negative view of myself that in depression my brain had come to believe as true. In one brief encounter, she understood that my self-view was an inaccurate distortion. It blew the roof off my long-held premise that the whole world knew me to be as I
saw myself when she challenged it. It became a turning point for me, to have someone quickly see through to the “old” me, who was not as my depressed self envisioned. I have to constantly remind myself of her words that this is “not necessarily true.”

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