Putting Pen to Paper

A woman sits alone in a quiet room, weighted down by a sadness that has come over her like a heavy, smothering wet blanket. She feels alone, hopeless, has no energy. She cries often. She has had bad things happen to her, feels like a failure, sees nothing but the dark days of winter and cold and isolation and shame ahead.
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Almost by accident, as if a force inside her was gently encouraging her to do it, she picks up a pen and opens an old notebook. Maybe one that her child abandoned when she moved away, maybe an old sheaf of paper. And for a time she merely doodles. Tries to draw, tries to focus her mind.
Finally, she writes, “What’s wrong?” on the paper. She starts listing all her faults. Her failings. Her losses, in love, in comfort. She nearly writes about some bad, horrible memories she may have…but at the last second her thoughts veer away.
After a time she puts down the pen. It’s enough. She may feel…just tired after that. She sleeps, even though it is the middle of the day. Later she wakes up and makes tea and stares out the window.
Or perhaps she does feel better. Just a bit. She glances at her list of faults and problems. Shrugs, and then decides she should make her bed. Maybe change the sheets. Feed the cat.

The complexity of depression
Many people with depression have had similar experiences. Sometimes a feeling of being overwhelmed, sometimes the near-opposite, a sense of flatness, numbness, emptiness. It is often the case that depression is mingled with other bad feelings and thoughts: anxiety, panic, fear. Old traumas that never seem to fade are often the distant cause of current depression, confusion, endless-seeming pain. The body is often affected in myriad ways as well, whether through chronic pain, cravings for toxic substances, headaches, fibromyalgia. Or just a constant fatigue, a need to sleep, an inability to sleep.
Depression’s complications are many — it is not simply a matter of a down mood or a few simple-to-identify bad thoughts or mental habits. It’s like a ball of yarn that’s been dragged out into the yard and forgotten for a season. It’s tangled, messy, dirty, knotted, and it smells bad.
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It is important to respect, and not to ignore, how complicated and tangled depressions usually are. They are like a tangle of yarn from four or five or ten different sources, mingled together. It is in fact the very complexity, the many many things that both cause and then result from depression, that makes it, often, so overwhelming.

Untangling the mess
I’m going to suggest a lot of things that might help you to feel better if you’re depressed. They will include very simple things you can do or think, and also some that, to work, will require that you learn a simple set of skills. (Nothing too hard, but probably things nobody taught you to do at home or in school.) In fact, my book will list over fifty things you can do to manage, or even eliminate, depression.
But one simple thing, one that many people do find helpful, is to write down the answers to two questions.
The first question is, “what’s wrong?”

From “What’s wrong with me?” to something else…

When we’re depressed, our first impulse when asking ourselves this question is to ask “what’s wrong with me? We tend to want to blame ourselves. This can, sometimes, lead to a litany of self-blaming statements that only sink us deeper into the blackness of our moods… much like struggling to pull your feet out of quicksand will only sink you deeper into it.
I would suggest a slight change in what you write. Just write the question this way:
What’s wrong in my life? What’s going on that is bothering me?

Then jot down anything that is troubling you. Be messy. If there are “external” problems like money or relationship worries, write them out — shorthand, or even drawings, can be enough. List names, list situations, list the sink full of dishes, the backache, the unpaid bills.

The point in writing out your problems this way is not to fuel more ruminating about them. The point is to clear your mind.

That’s all it’s for. For now, having things a bit out there, may be enough.

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When I was learning to be a therapist my favorite supervisor, Paul, explained something to me about doing a first interview with a patient. It has always stuck with me.
He advised me to start my intake interviews with one question: “What brings you in?” Then to just listen. Give the client the space to talk about it. All of it. All of the many things that are troubling them. And don’t start jumping in with a hundred questions and suggestions.
Paul said that you wait for the moment when the person has talked it out. The moment when they have listed, explained, talked about all the things that are troubling them. It might be one thing, or two, or fifty. But a moment wil come when they finally stop. They may audibly sigh. They relax.
It’s all out there. Finally.
Write until you get to that point. Until it’s all out there.
Maybe you cry. Or maybe it seems clearer now.
Then rest. Take a nap. Sip some tea.
That may be enough for now.

Confidence (from School of Life)

I’m going to pick up next with my suggestions for trying some quick self-help ideas for managing depression. But I wanted to share a very short, useful video that I’ve just discovered and enjoyed on the subject of confidence. It comes from a YouTube channel put out by an organization called The School of Life, founded by philosopher and author Alain de Botton. (Who just did a great interview on Tim Ferriss’s podcast channel.) The “School of Life” is devoted to “developing emotional intelligence,” which of course would include many of the concepts that are very relevant to all forms of “high performance self help,” including overcoming depression, anxiety and other painful conditions.

It would also be related to the idea of developing one’s “social intelligence,” or that “superpower” of knowing how to live with and deal effectively with relationships, people and so on. Which I wrote about a few years ago in the Social IQ book (below).

(BTW, I don’t get anything from anybody for mentioning these guys’ stuff, if you’re worried. Though there is one exception: if a million people were to buy a digital or (if you can find any — they’re out of print) paper copy of my book The Complete Idiot’s Guide to Enhancing Your Social IQ, it might pay for a lunch or two. Those are here.)

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About that notebook…

Yesterday I talked about the importance of taking that first step to deal with feelings of depression. And how that can be difficult.

It’s actually difficult in many areas of life to take a “first step”to solve a problem or get something done — it’s not just something that happens when you’re depressed. Starting in on a little or a big project can be hard for lots of reasons. Even writing this post, I found that there were a bunch of reasons it was hard to get started, including:

  • It was the end of a long day at work and I hadn’t gotten any free time to work on it when I was fresher during the day… so I’m trying to do it when I’m tired (apologies in advance for mistakes)…
  • It seemed easier to tell myself that I can “get up early and do it tomorrow” (meaning now I also have to overcome the demon of procrastination)…
  • I didn’t have a clear outline or idea what to say. That’s especially true because what I need to explain seems kind of complicated, and so I want to get it right. (Even though it’s harder, I think, to explain than to actually do once you get it.)

Notice that none of these reasons for it being hard to start this post have anything to do with “depression.” I’m actually not feeling depressed this evening. Just tired and uninspired.

But depression brings its own special challenges. If I were feeling depressed, it would be like dealing with the three reasons for not writing above, plus all the reasons that tend to flow from depression. Such as self-doubt, pessimistic thoughts along the lines of “this will suck,” fears of things like failing, being embarrassed, “looking stupid,” making someone angry at me.. and a zillion other things.

See? It all adds up. “Regular” reasons for not getting started are there for most of us. “Depression-based” reasons just pile more, heavier weights on top of our minds.  The formula, if you like math, might be something like:

Regular problems starting + Depression based problems = MASSIVE problems getting started dealing with the problem

What to do, then? How can we ever hope to overcome depression?

Okay. Here I admit, I must pause and admit to some hesitation in starting to answer the question, because even to me, what I’m going to suggest may frankly sound overly simple. It would sound this way to anyone, with or without depression. But if you’re depressed, it’s really likely to sound simplistic. Stupid. Or even (here you can plug in your own favorite expletive…)

But so here goes: You take small steps…

Yeah. It sounds like “baby steps.” (“He said it! He actually said ‘baby steps.'”) Which no doubt reminds you of a certain movie, right?

But here’s the thing: there actually are some pretty well researched and effective approaches to dealing with depression. There’s actually a whole technology for treating depression. And most “technologies” really do amount to a bunch of “baby steps” — but “baby steps” that are organized. 

“Baby steps,” organized, become a technology.

They become a plan. And they turn into something that can be big and powerful.

And knowing how to do that, how to start, how to take one small step, then another, can lead to the solutions to major problems. In fact, it is almost always the case that the solutions to really big problems come about by a sequence of small steps.

So about that notebook…

Let’s assume that you went off to see a really good therapist. That you went to see them once a week for, maybe, several months. Or maybe even for a year. If you are like most people, you’re likely to find it helpful.

This can be for a lot of reasons, and it’s often due to a combination of reasons, actually. Just having someone to talk to, whom you learn to trust, who seems to have empathy or to understand you, is a big part of it. And hey, one bit of the “secret sauce” of therapists is that they also know that most depressions actually just go away by themselves over time. (We take credit, of course. But sometimes, people just start to feel better.)

But it’s also the case that very often, at the end of the therapy when you look back at all your discussions, you’ll find that there are probably just a few little things that you learned, that you discussed, or maybe that the therapist suggested, that really seemed major. Out of a hundred suggestions or questions the therapist might have asked you, the odds are that there will be a few that really stand out as helpful.

And on the last session, when your therapist asks if anything was particularly helpful, that you remember, you will probably cite that one thing. The thing you learned to do. The suggestion, or reminder, or vision, or mantra that has stuck with you.

That happens, in my experience, much of the time in treatment. A lot of things a therapist suggests may help you a bit, some won’t help a lot at all. But a few will be really a great fit for you. And years later, if someone asked, you’ll say “this is what helps me…”

So one of the reasons I suggest finding a notebook (or keeping some kind of notes on your laptop or phone, or carve them into the bark of a nearby tree), is as a kind of “lab notebook.” Someplace that you can start to learn about your moods, to take some organized notes, and to write out some thoughts and exercises that you may find helpful. Even though right now, it may sound like those stupid “baby steps.” Even though you have nothing in particular to write.

Especially if you are depressed, you are actually not likely to remember what ideas, insights, or little experiments helped you to feel better. (And I will have lots of experiments to suggest.) I’ll talk more about this, the memory problems of depression, in a bit.

But for now… here’s an example I already shared of one famous (and really, quite realistic) fictional use of a notebook for coping with depression.

Next… How to do a little experiment and see if it helps your mood.

 

Taking the First Step

Replying to yesterday’s post, Valory sent in a comment:

“Taking that first small step, i.e., thinking about how to do something to feel better, rather than thinking about all the reasons you don’t feel “good/OK/happy/content,” is the most important and, sometimes , the most difficult step.”

I agree!

Very often, first steps can be the most difficult and even scary. Especially when depression is involved.

When we are depressed we may even feel paralyzed, unable to do literally anything to change our situation. In fact, the feeling that “there is nothing I can do that will make me feel better” is actually one of the primary symptoms of depression.

That is often why people with depression tend to look for solutions that require almost no effort on their parts. Because well, if “nothing I can do will help,” the only help seems like it has to come from somewhere else, right?

I even think that a lot of the popularity of antidepressant meds, both with patients and doctors, comes from their shared (yeah, doctors feel  it too!) assumption that there is nothing that the patient can do on their own that will matter. Under those conditions, taking a pill often seems like the only way to get some relief.

Now, it is often true that the meds may help people. But it can be a big mistake to assume that medications are the only, or even the best approach. Many research studies have shown that this is not true. There is a lot that a person can do on their own that may help.

I have learned a lot from my clients over the years (well, ahem, decades) of being a psychologist about ways people often learn to manage their own moods. Very often, people discover that they can at least feel a bit better by doing some fairly simple things to cope with a depression.

In future posts and my book, I’m going to list a number of things that often help people manage their moods. But the first, biggest step is often deciding that one is willing to give something a try. To experiment.

Different things work better, in different amounts, for different people. What helps me might not help you, but you might find that something you do that I’d find unhelpful, for you is actually a life-changing idea.

My first suggestion, then, is to get a notebook. Or find some way to keep some notes. I’ll tell you why soon.

The “Five Stroke Depression Cure” – update

I’ve mentioned my pending book, The Five-Stroke Depression Cure, in the past. I’d expected to have it done and published by now, but it’s been lagging. I admit that I tend to get caught up in the daily grind, especially my own psychology practice, and so it’s been a long time coming. (Particularly for what is supposed to be a “short” book of suggestions.)

Possibly people with depression can relate to that thing where you say you are going to get around to doing something and never seem to get it done. But this is not necessarily a sign of depression (which I’m not, I think)… it’s just life. (Though over time, it can actually be a bit of a depression-causing habit.)

I admit I tend to be a bit “OCD” and so tend to go over and over a bit of writing, sometimes when it’d be better to just dump something out there and settle for “good enough.” That is actually, very often, a more effective way of living — not letting your perfectionism (the belief that it’s wrong if it is less than perfect) interfere with functioning.

So I’ve decided to start sharing. I’m going to start here in the blog, bits of the book.

The basic idea of “The Five Stroke Depression Cure” is to suggest things that a person can do that will hopefully improve their mood. Mostly, these will be small, fairly easy things.

As a “starter idea” (imagine planting one tiny seed), I’d like to make a suggestion. Ask yourself this question:

If there was one small thing that you could do that, if you did it, it might improve your mood, would you do it? 

Would you try it right now?