During this challenging time, I share this post again in the hope of helping those of you already suffering from depression, for whom that depression might be worsened by anxiety and isolation, and even for those who want to stave off potential depression as we all manage greater levels of ambiguity and fear. Take good care.
It has many ways that it can be created. Years of abuse, a debilitating illness, a child with a drug problem, divorce, the death of someone you love, neglect, bullying, discrimination, never feeling adequate. The list goes on and on.
It has many faces. Agitation, anxiety, anger, not caring, giving up, sadness, melancholy, needing to look perfect, not feeling anything at all.
It has many ways you can try to avoid it. Drugs, alcohol, working all the time, never sitting still, distracting yourself with social media, denial, discounting, labeling it “weak,” or going back to bed after you take the kids to school.
It has many ways it can get your attention. Becoming suicidal, having a panic attack, wondering what it would be like to simply drive away. Gaining weight, losing weight, never sleeping, always wanting to sleep. Not being able to focus. Not getting things done that normally you’d have no trouble accomplishing. Not caring what happens to the people you love. Hating your life. Feeling a tremendous but secret loneliness.
And yet, you can heal. It’s hard work. And it becomes more complicated when the depression you experience is recurrent or happens in a cycle. But there are many paths to recovery — to healing.
Watch this wonderful tale of the black dog of depression by Mathew Johnstone and published by the World Health Organization. https://www.youtube.com/watch?v=XiCrniLQGYc
Many experts detail, as does this video, how to gradually but persistently confront the depression that can haunt you. But people struggle to do it. Or they count far too much on antidepressants or anti anxiety meds — when studies show that medications may be helpful, but for what reason, we really don’t know. And in more moderate depressions, they may not be helpful at all.
To fight depression, you’re supposed to exercise, to move, to get enough rest, to journal, to go into therapy, to consider medications, to grieve, to recognize trauma, and to reach out to friends. You know these things. But maybe you can’t make yourself do it. Or do it consistently.
It’s the difficult thing about classic depression. You’re fighting to become engaged outwardly, while struggling to break free of depression’s internal grip — a hold that can keep you paralyzed.
“I know I should exercise. It’s hard to make myself want to do it.”
“I don’t like to journal. I do it, but nothing changes.”
“Therapy doesn’t work. And it’s too expensive.” Or, “I took pills one time and they made me sick.“
Three Hurdles to Taming Depression…
All of these statements are common to hear. Here are the hurdles they reflect — and what you can do about them.
Waiting to feel motivated.
If you’re actively trying to confront your depression but are waiting to somehow be magically motivated to change, nothing will happen. You have to make yourself do the things that are likely to help, even when you don’t have a lot of energy or even hope. It’s tough. But putting motivation before action is putting the cart before the horse.
Afterwards, you’ll be enjoying the benefits of walking a mile, swimming a lap, or making yourself get out of bed. Whether it’s getting dressed for the day, or calling an old friend whose friendship you’ve let slip, action creates motivation.
Kate fought me tooth and nail over the importance of exercise in managing her depression. Then one day, after a couple of years struggling with suicidal thoughts, she came in. “Well, I made myself put on a bathing suit and get into the pool. And it really helped. I’ve always loved to swim and suddenly, I found myself energized. I have to get up really early to get it done and I still have to make myself go sometimes, but after it’s over, I feel so much better.”
Getting regular physical exercise didn’t “cure” Kate, but it helped a lot. Just as importantly, it gave her a sense of control and a sense of hope-– when her depression seemed unmanageable.
Discounting small changes.
Healing usually involves a cumulative effect of many small changes. I wish I had a nickel for every time a patient had said, “This isn’t really a big deal, but yesterday I….” Any change, any risk is a big deal. Because you’re confronting your depression or anxiety in small ways. Those changes add up.
What can seem unimportant — what you tell yourself is no big deal — can be a very big deal. I once had a patient who came into therapy after reading about perfectly hidden depression and said, “This may not sound important, but the other day, I actually told my husband I didn’t have the same perspective he did, and I couldn’t go along with what he was saying. We talked and it went pretty well. He told me later that he couldn’t believe I actually said what I was feeling. He doesn’t think he knows me. And actually, he’s right. Because I don’t let him know me.”
Maybe this sounds easy for some. But it’s not for someone who’s been hiding what they really feel for years. It was a huge deal for both of them.
Giving up because you had one experience that wasn’t helpful.
Part of depression can look like tunnel vision; a tunnel where you only see the negative. But mistakenly deciding that nothing will work because your one attempt wasn’t effective is a common reaction, and one that’s problematic and paralyzing. I don’t think any of you would parent in this way. You wouldn’t say to a child you cared about, “If one idea doesn’t work, don’t bother trying any more.” Or, “If you can’t do it easily the first time, give up.”
Nope. Persistence can pay off.
Sometimes this is an excuse because it’s so hard to admit there’s something wrong. You did it once and you don’t want to reveal another so-called failure all over again.
So it takes courage to continue; it takes courage to not give up.
If one therapist doesn’t help, ask around and find one with a different style or treatment regimen. If you found yoga boring, take a Zumba class. If you’re nervous about prescription medications, then look for homeopathic alternatives. Sometimes you’ll be surprised at what actually helps. Sitting in the sunshine, writing a note to someone who’s in the hospital, striking up conversation with the six year-old next door, striking up any conversation in fact.. engagement is what’s important.
Engaging with life, with others, with nature.
Andrew Solomon wrote in his book The Noonday Demon, “The opposite of depression isn’t happiness, it’s vitality.”
Engagement brings with it vitality and hope.
You can hear more about mental health and many other topics by listening to my podcast, SelfWork with Dr. Margaret Rutherford. Subscribe to my website and receive one weekly newsletter including my weekly blog post and podcast! If you’d like to join my FaceBook closed group, then click here and answer the membership questions! Welcome!
My new book entitled Perfectly Hidden Depression has arrived and you can order here! Its message is specifically for those with a struggle with strong perfectionism which acts to mask underlying emotional pain. But the many self-help techniques described can be used by everyone who chooses to begin to address emotions long hidden away that are clouding and sabotaging your current life.
And there’s a new way to send me a message! You can record by clicking below and ask your question or make a comment. You’ll have 90 seconds to do so and that time goes quickly. By recording, you’re giving SelfWork (and me) permission to use your voice on the podcast. I’ll look forward to hearing from you!
Originally published on October 7, 2018; updated and republished on March 21, 2020.