Depression and Decision-Making: 4 Questions to Ask Yourself First

This is the second in a five-part series about the most common mental mistakes that can lead to depression, keep you depressed, or make you more vulnerable to relapse. The five patterns are based on a presentation by Dr. Michael Yapko, an internationally known expert on depression, for the Australian Psychological Society.

In the first article, we focused on the habit of believing what your depression is telling you through your thoughts or emotions. Depression often lies to you, and you can get stuck in the absoluteness of those beliefs and the feelings that go along with them.

The second of those five patterns is what Yapko calls “stress generation.”

What does that mean? It’s a cycle in which depression and decision-making begin to feed each other. The “don’t care” or “don’t know” of depression affects your choices, those choices create more stress, and the added stress can deepen the depression.

It becomes a cycle.

 

It becomes a depression and poor decision-making downward spiral.

Stress generation is when you don’t recognize whether the next thing you’re about to say or do, or not say or not do, is likely to head you in a healthier direction or be self-destructive.

That lack of being able to predict the likely outcome is – to say the least – stressful.

I ask my own clients to consider this before making a choice?

“Is this likely to create chaos?”

Maybe that chaos is spending money you don’t have. Or texting an old abusive partner. Or ordering delivered meals for two when there is only one of you.

Depression affects your thinking: indecisiveness, foggy thinking, or feeling as if your mind is dull or murky. It’s like trudging through a swamp.

Yet you can still try to be aware of the decisions you do make, and recognize that continuing to make the same unhealthy decisions can make your depression worse.

Understanding the impact of depression on decision-making

I once had a patient I’ll call Mark who told me that his life didn’t seem to be following a plan. He was twenty-nine and stuck comparing himself to friends who were getting married, having children, or buying homes…the “markers,” for some, that you’re successful. His life was very different.

He was trying to follow a different path but was staying up too late after work. He’d recently ended a five-year relationship and was beginning to feel despondent and unmotivated.

So I started asking him specific questions about basic self-care: eating, sleeping, and what substances he might use.

His response was, “Oh, I smoke weed every night.”

I asked what effect that might be having on his life.

“I don’t know. I don’t think it has much to do with it. Except I stay up later when I smoke. And then I can’t get up and get things done.”

This isn’t a referendum on weed. What I want you to hear is that Mark could see how this choice was changing basic things in his life that were important for his well-being. But he was stuck.

His decisions were generating stress and pulling him farther away from what he said he wanted.

Now, let me be the first to say that none of us make great decisions all the time. No one.

But habits that contradict your own best interests can lead to more depression. You can enable your depression to stay put or get worse by not evaluating how your decision-making may affect it.

Sometimes the “safer” decision creates more stress

Let me use myself as an example, although depression isn’t my problem. Anxiety is.

I have performance anxiety. I can feel highly panicked if the spotlight is on me…not just a case of nerves, but shaking, sweating.

Years ago, I could have decided to avoid that anxiety entirely. No more being in plays or in the public eye. Certainly no writing or speaking about a book. A podcast? No, no, no.

Those decisions might have made me feel safer. But they wouldn’t have been good decisions for me. They would have generated more stress and made my life feel as if it was getting smaller and smaller.

The decision that reduces discomfort right now isn’t always the decision that leads you where you want to go.

When severe depression makes everything difficult

Severe depression can be mind-numbing. Writer Andrew Solomon, who has struggled with it himself, has described being unable to find the energy to brush his teeth and then, a day or week later, wondering why that had seemed so difficult.

This isn’t about shaming yourself for choices you’ve made while depressed. It’s about remaining conscious, when you can, of small decisions that could lead to healthier outcomes and recognizing that “no decision” is a decision in and of itself.

Mark’s goal was to get a better day job and put his life back on a track headed in the direction he wanted. What choices would be steps toward that goal rather than choices made from, “I don’t care” or, “I don’t know why I do it”?

Building self-efficacy one decision at a time

Self-efficacy is believing that your actions, and your decisions, can help you reach the goals you want to achieve.

You believe that if you walk more often, your legs will get stronger.

You believe that if you join a team or take an art class, you can meet people who enjoy the same things and make friends.

You believe that if you challenge yourself to do things that make you anxious, you’ll get better at handling your anxiety.

You believe that even though you’re depressed, if you make small choices that lead yourself in a healthier direction, you can learn to better manage your depression.

Your choices matter. That’s self-efficacy.

Psychologist Albert Bandura identified several ways we can build it:

• Do hard things and recognize your successes. How many times do I hear, “I just can’t stand this”? And I have to remind them, “You are standing it.” You don’t like it, and it may hurt dreadfully, but you’re standing in it.
• Learn from people who have overcome obstacles. They don’t have to be your parents, your friends, your coworkers, or anyone. You can learn from people you know, books you read, or honest accounts of real challenges.
• Allow supportive people to believe in you. Hearing “You can do it” can increase your own confidence and willingness to persevere.

This is what I offered to Mark, which is something some of you have heard me say before:

“It’s not where you go. It’s that you go.”

A different decision, a different choice, proves to you that you can change. That you can move.

Depression can tell you that things are hopeless. That you can’t change anything. That you have no ability to move toward what you want.

So you start small. One tiny step at a time. You grow self-efficacy by proving that your actions and decisions, as small as they may be, can challenge the hold depression has on you.

Before your next decision, pause and ask:

• Is this likely to create chaos?
• Will this choice move me toward what I say I want…or away from it?
• Am I choosing what feels safest right now, even if it may make my life smaller?
• What is one tiny decision I could make in a healthier direction?

Your choices matter. Not because you’ll always make the right ones, but because each small decision is a chance to begin moving again.

By the way… 

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