As we saw in earlier chapters, the depressed brain state can be a kind of ‘go to the back of the cave and stay there’ state. We want to pull the covers over our head and wish the world would go away.
When we feel like this it helps to take a compassionate approach: in other words, to be very
understanding of such feelings but also to think what might be triggering this feeling and how to break out of it. Maybe we have been working too hard and are exhausted, or maybe life events, setbacks and conflicts have taken the wind out of our sails. Sometimes a mild depression tells us we are exhausted and we really need to find a way to slow down and get some rest, let our bodies recuperate. Humans are like other animals – we need chill-out time. It is amazing how, when people take longish breaks from work, they often say they feel themselves slowing down, and the pace of life is easier. We must admit to ourselves that, through no fault of our own, we are living in a ‘rush rush, hurry hurry’ society where we can get rather exhausted. Learning to take time out, respect our body and rest it as much as possible is important, and I agree – it is easier said than done. In particular, one of the problems of being a single parent is the sheer workload, and demands that can be exhausting. If burnout and
exhaustion are behind the depression, it’s important to see this and to address it in appropriate ways – without blaming oneself for being tired!
However, as we get depressed we can also stop doing various activities and disengage, and this adds to a depression cycle rather than helping it. We find resting is not helpful. When we are
depressed, daily activities can seem overwhelming. In these situations it can be very useful to
operate against the pull of depression. We need to encourage ourselves to do more not less, but the emphasis is on encouraging not bullying ourselves. This helps us to activate our drive system. It helps if we organize activities in such a way that they can be approached step by step. In the last 10 years or so therapies for depression have been developed which focus specifically on changing behavior.1 There are also self-help books dedicated to this type of ‘change your behavior, change your mood’ approach.2 It’s important, though, that you see this as helping you, not just as putting on a mask and carrying on regardless.
Tasks and goals
When therapists are trained, they are often taught to focus on three things: the bonds and relationships between patient and therapist; the tasks that need to be undertaken; and the goals and aims of the therapy. In helping yourself to get out of depression, you can take the same approach. The bonds and relationship you have with yourself have been the focus of earlier chapters, so now let’s look at tasks and goals.
Tasks
Often, as we move forward out of depression, there are various tasks that we can set for ourselves on our step-by-step journey. Here are some examples:
Learn to tune into and monitor your thoughts and feelings.
Write down your thoughts and feelings.
Try tape recording ideas that are good alternatives to your negative thoughts on a tape. When you feel down, play these alternatives to yourself.
Learn to be honest with yourself.
Learn how to take big problems and break them down into smaller ones.
Set yourself small things to do that operate against the depression each day.
Increase the time you spend talking with friends.
Make the phone calls you need to make to sort things out.
Learn to be more assertive or less self-attacking.
These are not easy things to do, so you may have to work hard. When we are depressed our
thoughts and feelings are very dismissive – they may say things like, ‘This won’t work for me; don’t be silly; I can’t do it; can’t be bothered; I’m too angry; it’s too difficult’. These are all very common thoughts. The way to deal with them is to expect them, to notice them, but focus on the task anyway. If you put a certain time aside, e.g., five minutes, plan to focus your time on the task. You might also think about whether this feeling is actually linked to angry rebellion and you are really saying, ‘Oh, sod it. I just don’t want to do it, so why should I!’ If that is true, then honestly acknowledge it – be compassionate and understanding of such feelings, but then take a breath and think about how to
actually help yourself move forward. Think also that there may have been many times in life when you predicted that things would not work out but they did.
Goals and commitments
Having small and achievable goals can be helpful as these are the things you want to achieve. At first, depressed people usually just want to feel better. But this large goal needs to be broken down into smaller ones. These smaller goals might be:
To do a little more each day.
To be more assertive with some other person(s).
To spend more time on something I enjoy.
To join a club or charity where I can get involved with other people and feel useful.
To spend more (or maybe less) time with my children.
The most important commitment is to put effort into transforming your depression by training your mind in helpful, compassionate actions. You do this in the knowledge that:
The way our brains have evolved over many millions of years can be very tough on us and give a host of unpleasant feelings and moods.
That is absolutely not our fault – we did not design our brain, choose our genes, or how our early relationships shape us.
But it is up to us to try as best we can to work with our minds to change our mental states.
Commitment is linked to the value we put on things. For example, if I ask you not to express your anger for a week, or to go out even if you’re depressed, you might be uncertain. What about if I
offered you £10? Okay £100? Not enough? Okay £1 million. Of course I can’t do that, but think about it – if there is a really big payoff you might put a lot of effort into something. We have to be honest about this. Like a person training to get physically fit, some days will be harder than others – but the clear goal keeps them going. For working on a depressed state of mind, focus on how it will help you to get better and really make that your goal – think of all the benefits – imagine (and see) yourself as
‘feeling better’ and what you are doing now you are better. It is easy to let these slip from one’s mind when it gets tough. It can be useful to set yourself a couple of goals at the beginning of each day or week. Start by setting small goals – the smaller, the better. If things are difficult or you don’t reach your goals, ask yourself some questions.
Were the goals too ambitious?
Could I have broken them down further?
Did I run into unexpected problems?
Did I put enough effort into achieving them?
In my heart of hearts, did I think that achieving them wouldn’t really help?
If it did not go as I wanted, am I being compassionate with myself?
Behavioral experiments
Many therapists encourage us to try what we call behavioral experiments. This means trying out different things, keeping an eye on what works for us, how we might do things differently to make them work better for us, and tailoring them to our needs. This does not mean doing things simply because we’re told to, but trying to see the point of what we’re doing. For example, if you want to get physically fit you might go to the gym and really push yourself even though it’s not entirely
comfortable. You learn what works for you and put up with the discomfort because you understand what you’re trying to achieve. Indeed, the discomfort may actually inspire you because you feel it is helping you move forward in your goal of ‘getting fitter and stronger’. We can approach depression like this too.
Take staying in bed. If staying in bed helps you feel better, all well and good, but often in
depression it does not. We simply use bed, not to rest and regenerate our energies, but to hide away from the world. Then we feel guilty and attack ourselves for not doing the things we have to do. When you are lying in bed, you may tend to brood on your problems. Although bed can seem like a safe place to be, it can actually make you feel much worse in the long run. The most important step is to try to get up and plan to do one positive thing each day. Remember, your brain is telling you that you can’t do things and to give up trying. You will slowly show that part of yourself that you can do things, bit by bit.
Occasionally, however, because depressed people often bully themselves out of bed with thoughts such as, ‘Get up, you lazy bum, how can you just lie there?’, it can be useful to try the opposite tack.
This is to learn to stay in bed for a while, at least one day a week, and enjoy it – read a magazine or listen to the radio and allow yourself to feel the pleasure of it. To practise being able to lie in bed
without feeling guilty can be helpful for some people. Imagine that you are exercising that pleasure area of your brain, which really needs exercise.
Designing experiments
It is useful to work on and against our depressive ideas by setting experiments: that is, testing things out and rehearsing new skills. A useful motto here is, ‘Challenging but not overwhelming’. Remember – design your experiments – things to have a go at – to take you forward step by step, rather than rushing into something that has a high risk of failure. Don’t worry if the steps seem too small. If things go a bit pear-shaped, remember it was just an experiment and think about how to learn from it.
Experiments don’t always work out as we hope they will. When I was a shy young student at
college, a good friend encouraged me to ask a woman to dance at our college dance. It was noisy, but I got my request across. She turned to her friend, looked at me, looked back at her friend, laughed – and they both got up and walked to the bar! Oh dear. On another occasion I had learned some
assertiveness and was in a shop queue when an older man pushed to the front of the queue. People were irritated. I need to do something here, I thought. I’m a psychologist and an assertive one. I left my position at the back and said to the man, quite kindly I thought, ‘Excuse me, look, I’m sorry but there is a queue.’ He looked at me and then said, ‘Why don’t you eff off, you four-eyed git, before I smash your face in.’ My response was of course to say, ‘Absolutely – look – I’m off right now!’ So even the best-intended plans don’t always work out!
If we try things and they don’t work out, we can try to find out why. Was there anything about it that was a success? For ex ample, you did try and you can learn to cope with these setbacks and try again in the future. One can learn not to be so fearful of failing or rejection – it is unpleasant but nothing more. My college friend thought it was funny that the girls walked off but said, ‘That’s typical, you’ve just got to keep trying. Somewhere in the hall a girl will want to dance with you, you’ve just got to find her. On attempt 252 maybe.’
We also need to think whether we were attempting too much. Were our expectations too high? In the case of tackling the aggressive man the answer is probably yes – he was a big fellow, and I am by nature a coward. Did your negative thoughts overwhelm you? Did you really put the effort into it that you needed to?
People can generate and write down alternative thoughts and ideas and behaviors. They may be very casual about it and just look at the words without thinking their meaning through, or trying to put feelings of kindness and understanding into those alternatives. In the back of our minds might be a thought, ‘This approach can’t work.’ So we stack the experiment against ourselves before we begin.
So we may need to use the courageous part of our compassionate mind to tell ourselves in a friendly, supportive way:
Look, I know this is hard, and yes, it is a shit being depressed, but let’s not stack things against myself. Let’s give it a fair go.
After all, what have I got to lose? If I were helping a friend, I’d know how tough it is but I’d also encourage them to give it a go.
Let’s go through this step by step.
Getting out of depression takes effort, and this is especially true if you are trying to help yourself. It is the same with getting physically fit. It would be no good putting on your trainers and running to the garden gate and back – you have to push yourself more than that (assuming you don’t live in a stately home where the garden gate is a mile away). It is very understandable to find this tough going, and it may be that there are times when we need some extra help from friends or professionals. There’s no
point in berating ourselves if we’ve tried our best and have found it too hard.
Blocks to becoming active
To become more active, it helps to decide on a specific activity and the time you are going to do it.
For example, go shopping at 10 a.m. on Tuesday. Visit a friend at 2.30 on Wednesday afternoon. When the time comes, go for it. Each day, do some things that invite you to operate against depression. Make a plan for the week, and when you get to the time do whatever it is you’ve chosen to do. Try to engage in each activity in a spirit of encouragement and support.
You may well have some extremely understandable but unhelpful or irritable thoughts: ‘Nothing I do to help myself will help me – so it is not worth trying.’ If you do, be compassionate and shift to your compassionate self (see pages 149–155). Recognize that all over the world depressed people think like this, because that is how the depressed mind thinks- so it is perfectly understandable to think like this. But it is only one possible pattern in your mind, so consider also:
Am I defeating myself before I start? Probably if I am honest. Huff.
Let’s get helpful here and try to be supportive.
Do I really have enough evidence to say this or that can’t work, or is this just how I feel about it?
What have I got to lose by trying? If I put effort into this and it doesn’t work out, I’ll certainly be no worse off and might have gained something.
If I try, at least I’ll know I made the effort even if things don’t work out.
I can go one step at a time. If I break my problems down into smaller ones, they may not seem so overwhelming. I don’t have to try to do too much at once.
I may feel better if I try to do something rather than nothing.
I can praise myself for effort.
Now try this. Spend a moment on your soothing breathing rhythm and connect with your
compassionate self, no matter how minimally (see pages 149–55) Read through these ideas (on page 253) with as much warmth, care and concern as you can, and as if you really wanted to help a friend.
How do they seem to you now?
Learning how to do things we don’t want to do
To reach our goals in life we often have to do things we don’t want to. People who want to be
successful at sport, playing an instrument or passing exams have to practise and study even when they don’t want to. Many of us feel very anxious when we start learning to drive a car. When I started, my leg shook so much I could hardly push in the clutch! However, we accept those things – because of our goal to be able to drive and be mobile. And of course there are many small things that we may not want to do such as getting up to go to school or college, studying for exams, going to work, or getting the children up and out for school. Even making the effort to socialize can seem like a hurdle.
Step 1: Develop your vision
When engaging in disliked activities, focus on the benefits of doing them (rather than the difficulties),
and think about how you will feel if you complete a task. Think how your actions can take you nearer to your goals, while avoiding things won’t actually help you get better – although you may temporarily feel less anxious (or whatever).
Karen felt tired and a little anxious about going to the shops. So she created in her mind a vision of herself coming home with the bags of food and making something enjoyable to eat with the family and tried to hold that in mind while doing the shopping. She saw that as an achievement. It really helps if we can think of a goal and commit ourselves to it. Otherwise what’s the point of engaging in
difficulties unless you can really see the benefits and focus on those? That’s true for all things in life, of course.
Sue kept in mind how good she would feel in a few months when she had left her husband and worked through his threats. ‘It was keeping that vision of being free and living alone, doing my own things, that helped get me through and take difficult decisions,’ she said.
Step 2: Develop the feelings of support and helpfulness
Focus on creating inside you feelings that will help you. When engaging with activities you’re not too keen on, spend a moment really trying to contact and create within you your compassionate self. Then
Focus on creating inside you feelings that will help you. When engaging with activities you’re not too keen on, spend a moment really trying to contact and create within you your compassionate self. Then