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Jul 30 2013

Trying to Apply an Insight About Depression

So I’m going through a mild depressive stretch right now, for the last couple of weeks, and I had this insight about my depression, and I wanted to share with the rest of the class and see if it resonated with anyone else. I think it’s a useful insight, but I’m having some trouble applying it, and I’d love some feedback from other depressives, or other people who are familiar with depression, on how to translate it into action.

The conundrum, which I think almost everyone with depression will recognize: The very things I need to do to alleviate my depression — exercise, getting outside, socializing, taking care of business and battling entropy, even just getting showered and dressed — are things that the depression makes more difficult to do. Depression, among other things, saps motivation, and makes it difficult to do… well, anything. When I’m having a depressive episode, no activity feels good; everything I do makes me feel restless and twitchy and uncomfortable and like I’d rather be doing something else. When I’m active, I get tired and want to sit down; when I’m sitting down, I feel restless. When I’m with other people, I feel overwhelmed and like I want to be alone; when I’m alone, I feel isolated.

The insight: Since nothing I do feels good anyway, I might as well do the things that have a chance of snapping me out of the depressive episode, and of making me feel better in the long run (and indeed in the medium run).

When I’m in the middle of a depressive episode, being active and inactive, social and solitary, outside and inside, all kind of suck. So I might as well be active, be social, go outside. It’s not like being inactive and solitary and indoors are actually going to alleviate that twitchy, uncomfortable, restless-but-exhausted, “something isn’t right” feeling. They’re not. When I’m in the middle of a depressive episode, I carry that feeling with me wherever I go. And being active, being social, going outside, are all things that might actually drive the feeling away, or dial it down.

A very perceptive insight. But it’s still not getting me off the sofa. Thoughts on how to translate the insight into action?

18 comments

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  1. 1
    cottonnero

    There’s that line, “You can’t reason someone out of a position they didn’t reason themselves into.” I think it may apply here too. I know the feeling, though, of knowing that doing the thing I don’t want to do might move me out of the depressive state I’m in, but still not wanting to.

  2. 2
    Emu Sam

    I recently got to that point. I was sitting there, vaguely frustrated that I hated reading (a sign that I was really badly off) and I wanted to do anything but what I was doing.

    So I sort of said “five minutes” and took the landlady’s dog for a walk. I let the dog pull me uphill, then we were both out of breath and headed home. Five minutes turned into ten minutes, and then I was motivated enough to take a bath, and soon almost half an hour passed.

    I still didn’t feel like reading. There was no way to sleep. I wrote up bits and pieces of what I was going to tell my doctor. She’s now trying me on a new medication.

    So I got my heart rate up, and it didn’t help immediately, but I’m probably a little better each time I say ‘five minutes.’ If I just can’t do it, then at least I’ve tried for five minutes, and I can say as much to myself and others. But more often than not, five minutes turns into a little bit longer. And every time I follow through, I reinforce that path, and it’s easier to think of it, and easier to make the first move.

    Baby steps. Little improvements. No commitment except to the first step. An enthusiastic partner who has no expectations but would be delighted to keep going doesn’t hurt. I promised her I’d take her for another walk after the sun goes down if my medicine leaves me awake.

  3. 3
    researchtobedone

    I have a lot of good ideas for self motivating in this regard. That said, self motivating isn’t the only option – maybe call someone and tell them not to let you off the phone until you’ve gotten yourself on the way to doing something social?

    Also, this post is the best description of the way this problem works I have ever seen: http://miliat.tumblr.com/post/13352035025/lack-of-motivation-is-a-generally-misunderstood

  4. 4
    researchtobedone

    Shit, how does one edit? That sentence should have a “don’t” in it.

  5. 5
    Daniel Schealler

    For me it goes something like this:

    1) Everything sucks
    2) I should go exercise. Everything sucks, but at least that sucky thing might do some good.
    3) Meh. Don’t wanna.
    4) Do something else that I typically enjoy (read/tv/movie/video game)
    5) Wait… I’m not enjoying this.
    6) Do something else that I typically enjoy (read/tv/movie/video game)
    7) Seriously?
    8) Eat something really bad for me.
    9) It tasted good, but I barely enjoyed that!
    10) Come on, this is getting ridiculous.
    11) OMG DEPRESSION IS STEALING THE JOY FROM MY LIFE
    12) FUCKING DEPRESSION!
    13) Depression, I’m so going to kick your miserable ass.
    14) *goes to the gym*
    15) Endorphins!
    16) Self esteem!
    17) Yay!

    That’s pretty much my cycle, which plays out over a 2-3 day stretch.

    Looking at it from the outside, it seems crazy that it takes so long for me to freak out about losing the joy in the simple things in life. But from the inside, it just seems to take that long spent in grim determination attempting to rediscover a hint of ‘fun’ in something that I normally enjoy before the panic kicks in.

  6. 6
    keelychaisson

    I’ve had the same insight, and similar problems putting it into action. As cottonnero mentioned and as I know you’re aware, depression doesn’t give a crap about your logic. That said, I usually combine this insight with the practice of making deals with myself in order to get myself off the couch. Something along the lines of “ok, self, I know you don’t want to do anything, but since we’re going to be miserable anyways, let’s do ONE THING that might help get us out of this. After that, you have permission to wallow or sleep or whatever for the rest of the [morning/evening/day... whatever is applicable at the time].” And that is usually enough to at least get me to START something.

    Which I suppose is my other “insight”… when you’re depressed you usually don’t feel like making decisions, so sometimes once you’ve started doing a thing, it’s easier to keep going than to stop. Some blogger I used to read who is slipping my mind now used to say that all she told herself she HAD to do for working out was put on her shoes and step out the door. Because 9/10, that was enough to make her go through with the whole run. It doesn’t work for everything, but it works sometimes.

  7. 7
    sugarloaf

    Break it down into smaller steps. If you can’t bring yourself to go to the gym, do as much of the following as helps or you’re able to. a) find your gym gear, b) put on/ pack your gym gear, c) get in the car to go to/ walk to the gym, d) go into the gym and get ready, e) warm up/ do a small work out, f) do an easier but full work out, g) do a normal workout. Even if you only get your gym shoes on, that’s a little victory against depression, and is a step in the right direction. For me, depression is predominantly exhaustion, and forcing yourself too hard through that may only make it worse. A journey of a thousand miles begins with a single step. Take single steps, and see how you go.

  8. 8
    CaitieCat, getaway driver

    Definitely understood, and this is a common problem for me. I’ve actually tried applying the principle, “Act less depressed and maybe you’ll be less depressed”, but found that it was hard to fake the motivation for long enough to get much effect. I’m a straight-up depressive, rather than someone who goes in and out of it, so that response may not have much value to you applying it, as it sounds like you experience it more in a sometimes-y sort of way (not trying to minimize its effects on you, more that you might find the principle more effective, given you have some periods where you’re not depressive already).

    Anyway, at its base, I totally get it, and I’ve had the same insight. I hope it works better for you! Well, I hope it works better for both of us, really. :)

  9. 9
    tengalaxies

    I’ve found that, for me, making social plans in advance (long enough advance that I think by that time I might feel like doing the thing) really helps. Then when it comes down to it, I might not want to go, but I feel obligated.

    Also works a bit for exercise if I can either pay in advance for a class or make an appointment to do something (walk, run, bike ride) with a friend.

  10. 10
    raj

    I only have mild depression (and it’s usually late at night, so I just go to sleep and everything usually is at least a little better the next day). I know this tells you that I can’t really relate, but I think I can, in a different way.

    I can certainly relate (as can a lot of people) to the general lack of motivation. I have this so often that I started studying up on methods of getting things done. The best advice I read, which seems to actually work, is to start small, just as “sugarloaf” said. If you can’t find the motivation to do something, which you need to do. Just start on it anyway, knowing you’re going to put it down again “soon”. Many times, if you can do just a little on it, you’ll get caught up in it, suddenly finding that you’ve done a lot more than you expected. This gives you some positive feedback and helps to motivate for doing more.

  11. 11
    Yvonne Rathbone

    I’m working on solutions to just this problem with my own depressions. I think this is tied to having a messed up (or “neurologically atypical”) dopamine reward system.

    First off, I’ve developed (when not depressed) a routine for morning and evening to take care of several maintenance tasks which if left unchecked during a long depression would really reduce living quality. In the morning: shower, basic toiletries, high protein breakfast, I’m able to walk out the door when I’m done, but I don’t have to. In the evening, toiletries, dishes, coffee ready to brew the next morning. I do these things as routine. I don’t let myself think too much. It’s just the routine. It’s important here to learn to expect the routine so that you don’t have as much initiation resistance when you’re depressed. There are times when it feels easier to just do these things because I’m used to doing them. Not doing them becomes a chore. This gives me more freedom to be a slug if I need to because I will at least have had a good breakfast.

    The other part is harder for me, but I’m chipping away at it. It starts with the realization that doing certain things seems to bring a bit of relief. If I’m really sluggish, can’t get off the couch, I do something to organize my space. Something *small*. One thing. I throw a piece of trash away, put dishes in the sink, straighten some surface. It needs to be small and contained if I’m really low. But doing it makes me feel a little better. I hold onto that while I lay back on the couch. I think “I can make myself feel better, that’s cool.” But I don’t get hung up if I can’t do it again. This cycle has led me to be able to more complex tasks. They have to be ones I don’t have initiation resistance to, so things I know how to do that doesn’t cause anxiety. Anything finanical is out. That costs too much neural energy. Usually I end up doing some housekeeping, but not always. While I lay on the couch, I cast about for things I might do, not with any sense of “I need to clean up this place” but “what might feel good to have done”. Once it’s done, I pat myself on the back and reward myself with more sluggishness if that’s what I want. I can afford to; I’ve already had a good breakfast.

  12. 12
    rebeccahensler

    Write a blog post about it so your friend invites you out to dinner.

  13. 13
    sheila

    I know this is really unhelpful at this point, but much the most effective technique is to spot the early warning signs of depression and head it off while you still have some motivation. Obviously this is no help once you’re in it, or if it happens without warning, or if you don’t know your warning signs (yet). But if you can spot your own warning signs, you need to make socialising and exercise huge priorities.

    Once you’re in it, yeah, baby steps, and setting the bar really, really low.

  14. 14
    mare_vaporium

    I have written checklists all over my apartment. They are short so I don’t get overwhelmed, but they certainly help me get through the day when I’m stuck in a black cloud. I also have awesome friends that refuse to do certain things that I enjoy without me since it is ‘our’ thing to do and it wouldn’t be the same otherwise. Even if I am being a grumpy, uncommunicative, bordering-on-the-verge-of-tears-for-no-reason, dead weight that is slowing everyone else down. They don’t cheerlead me, and I appreciate that. They simply encourage with a word here and there, and go at my pace until I’m feeling better.

    In perverse sort of way, reminding myself that I’m not going to enjoy it any more than staying home helps me get out the door.

  15. 15
    Nathaniel Frein

    I will have to remember this. In itself, it might not get me off the sofa, but if I’m in that state, and doing something productive, it should help to remind myself that while I’m not enjoying being productive, taking a break is pointless if I won’t benefit from the break, either.

  16. 16
    Olivia James

    So there is something in DBT called “opposite to emotion action” which is essentially doing exactly what your’e talking about: doing things that you don’t feel like doing. If you’re in a DBT course, they go through and break down exactly the appropriate actions to take to act opposite to each kind of emotion, but I think in general some of the things that are most helpful are to do things like “fake it till you make it”, (which again is not easy but can make the rest of the action easier) by purposefully thinking about whether your body is tense or tight, or reacting in some other way to your situation, and then relaxing your body so that it’s appearing and seeming open. It can also help to just review the facts while you’re in a situation, and tell yourself over and over what will be helpful in the long run vs what won’t. Asking for help can also be good: if you can get yourself one time to ask someone to pull you along to the gym once a week, you’re set up for a while.
    Hope that helps :)

  17. 17
    carpenterman

    If you can’t get off the couch, try doing something from there.
    Keep a small weight or two next to the couch. Pick one up and lift it while sprawling out. Screw proper form or counting your reps. Just pick the damn thing up a few times. You’ll either stop, or say “screw this” and get up and lift a bit. You won’t enjoy it, but you’ll have exercised a little.
    Keep a couple of pop-history and pop-science type books by the couch; the types that are full of semi-random facts that you can jump into anywhere. Read for a minute or three. Or watch a show on cable, one you haven’t seen before; what we used to call “educational TV”. Again, you may get bored and frustrated after a few minutes, but you can say, “I just learned some thing new.”
    Masturbate. Don’t worry if you don’t actually get off. It will give you something to do with your hands for a few minutes and it’s healthier (and cheaper) than smoking.
    I know how awful it is when the depression drags you down. It’s as if someone turned up the gravity. So don’t fight the couch; accept it’s soft comfort, and let it cushion you from the hard, unyielding earth as you push yourself up again.

  18. 18
    malta

    Well, if it’s going to suck, perhaps pick the essential stuff first? I find that it helps to start on the activities that I know I have to do, like grocery shopping, recycling, or laundry. I like the boost of having accomplished something at the end of it. Or maybe it would help to offer to run an errand for someone else? Knowing that they’re depending on you gives you an extra incentive to get it done.

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