Managing Depression Practically
In the ministry, I see depression as a complexity problem. When life becomes overloaded with complexity (you just found out that you have cancer, and two of your family members passes on in a period of the last year, etc.), life becomes difficult to navigate, and depression sets in with root. For those depressed, antidepressants work for many, and there are many reasons for that. I have found psychotherapy, and related systems work for half of the people I work with.
There is a standard set of questions I ask. (In no way, I am minimizing your experiences or what you are diagnosed with by providing you this list). I ask the following:
Do you have a job? If you don’t have a job, your biological setting tend to go off balance. There is not a reason for you to wake up in the morning. No reason for a set time to go to bed at night. For some, not waking up at the same time messes up their biological rhythms. That is enough to make them depressed, especially if they tend to nap throughout the day. Without a job, people tend to lose purpose. And people are not good without a purpose. This is due to the positive circuitry of emotion. The most positive emotions that anyone experiences will not be the consequence of attaining things. Most positive emotion is due to seeing order and progress towards a goal you value. Most positive emotions are found in goal pursuit. So, if you don’t have a job you have no structure. And that is not good. Plus, you tend not to have a point. So your overwhelmed by the chaotic lack of structure and don’t have any positive emotion.
Do you have any friends?
Do you have any health problems?
Do you have any a drug and/or alcohol problems?
Sometimes we see people without a job. Without any friends or an intimate relationship. They have an additional health problem. And they have a drug and/or alcohol problem. In my experience, when you have three of those problems it is difficult to help you - humanly speaking. You are so deeply set in the chaos you can not directly get out. You gain some traction in one area/problem, and the other problem pulls you down back-under. But hope is not lost. In fact, I would encourage you never to sacrifice you stability and neglect one of these essentials (questions posed above). Find a job, or stick to the one you get or have, even if it is one you don’t like. Find some friends, and see if you can establish an intimate relationship. Put together some of the items that are like pillars that your life rests. At this point, I would say that it is important to define your fears instead of your goals. Why? Most of us have no idea want we even want. But we do have a real sense of our fears. Define your fears. Paint a picture of the hell you want to stay away from. Specify your long-term ideal (the goal) and then the micro-habits that will perhaps keep you from the hell you want to stay away from. Goals give the conditions of failure, that is why we do not make them. But we have to make goals if we want to overcome. We are scared of failing, but we are scared more of the threat of death (aka - the worst of your fears [spiritually, emotionally, physically, etc.]). Our fear of the uncomfortable consequences of not changing will soon outweigh the consequences of not changing. Soon, we learn that we can withstand the threat of death when we are responsive in thought and then in action. Figure out your aims. If you're depressed and feel like you have no aims, pick the least objectionable of the aims. Then act it out for a while. See what happens. Sometimes your emotional systems are so mixed up that you'll have to act out the thing before you begin to believe it. Assuming that one wants to get better, there is usually something that one can make a step towards. A concrete goal. A behavioral assumption is that small, accruing gains which repeat are very impactful. Most of us know what is wrong with our reality. And it is only a matter of paying attention, which we will find what we can fix. Make sure you are fixing the right thing. Many will try to change the world without making up their bed first. And there is a gap there. So, make sure to make sacrifices, the right sacrifices. But those things that we need to fix will yell at us. No sweat needed. No brain strain. I would also encourage you to learn how to negotiate with yourself. That this is something that's very useful to know. Now, what you come up with, you can tyrannize yourself into doing things, but that wouldn't be something I would recommend. What I would recommend instead, is that you ask yourself what you willing to do. Have a conversation with yourself. Talk as if you don’t know yourself. In all of us, there is a boss that always cracks the whip and the worker who just shrinks back. A lot of people don't like themselves because they don't negotiate with the two. Negotiate with yourself! Learn to like yourself by negotiating with yourself. None of us goes to work because we like the boss with the cracking whip, we work because there is a reward that gives us meaning to work. So, schedule responsibility, but also schedule a "balanced reward." It is an effective technique. In fact, it is like meditative techniques. So, for example. In the morning, you say "Well you know, I would like to do this to the day today, so I would like to go to bed tonight without feeling guilty..." You know you would do some things you are supposed to do, and you also know what you will like to have an interesting day today. So, in order to having an interesting day, and you will fulfill some responsibilities, and make your day enjoyable. Then you can ask yourself “Well okay, but what will I have to do for that happen? Something I would do." And the probability, if you practice this for three or four days, is your brain will just tell you the things that will help you, as you become more aware and conscious about yourself and your possibilities. Environment. We are unbelievably sensitive to the narrative our environment is telling us. The environment is filled not with objects. The environment is filled with obstacles and tools. And a human is a tool orientated creature. We are a tool seeking and perceiving creature. If you pay attention to your environment - which is you, only in an extended form - it will tell you what you should do. All that you have to do is just do it. But then you will decide whether or not you want to do it. There are four things highly anxious over-thinkers (and drinkers) must do:
Get up at the same time every day. I would recommend in the morning because that's when everyone does and it is good to do what everyone else does.
Eat a large breakfast. Light on carbs. Heavy on the fat and protein. If your an anxious person and stress yourself out, your body overproduces insulin, taking all the blood sugar out of your blood, that deregulates your metabolism for the entire day. And it doesn’t reset until at night when you are sleeping. A large breakfast has "cured" many over-analytical people from depression and anxiety.
Exercise. It will help! Weight-lifting is good for anxiety.
Make a schedule. And tend to your daily micro-routines.
Now, you have to figure out why you have an overactive mind. I would caution you at this point, being that this is not a diagnostic comment, and I would not know you well enough to know that type of information about you. I would recommend seeing a therapist should you be screened for depression. Depression is very hard on people, and rough on the body, in that the body produces stress hormones that can hurt you. Life can be meaningful enough to justify its suffering. Someone tells you that you can be happy. That is false. Things will come by and knock you out all the time, in a way so hard that you're not happy then. Then there is no reason to live, that is if you have to be happy. (I was hit by almost everything this summer that nearly knocked out every pillar of my life, so I understand the reality and weight of this.) Life is not about being happy. In regards to meaning, we all know what is meaningful. We just need to do more of it. There are two choices people have:
Nothing is meaningful (e.i. - existential angst). You have no meaning and therefore have no responsibility, and this is a small price to pay for being useless (insert laugh here).
Everything you do matters. If you make a mistake, it is a real mistake. If you betray a friend, you lean the world closer to evil (this is not to say we have that much control, but do we, figuratively?). If you live life with this understanding, there is meaning, but this requires some seriousness. It means what you do and say is important. You have responsibility.
For those will PTSD. I recommend Cognitive-behavior therapy (CBT). Beyond the spiritual reasons behind it, if you have found some relief meeting with a church and becoming involved with a church, it is probably because of how you have experienced certain techniques which contributes to good mental hygiene - that which our brain is already wired to need, to live and heal. (I am a Christian. So I advocate interaction with the Church. If you want to know my spiritual understanding, feel free to comment below [comments are only public when approved, and you may state you desire to keep your comment confidential.]) CBT was researched, by this author, as an effective treatment, in the context of treating post-traumatic stress disorder. CBT is an evidence-based form of psychotherapy used for many disorders but most used as the treatment of choice for a post-traumatic stress disorder. Empirical studies of CBT from the past three decades have revealed that CBT not only can be used as a pre-treatment but also as a post-treatment for PTSD. Together, CBT has proved itself to be a reliable first-line approach for the treatment of PTSD and has shown stable, positive results in its three major treatments: Stress inoculation training, cognitive therapy, prolonged exposure therapy. Cognitive-behavior therapy (CBT) refers to a family of interventions that combine a variety of cognitive, behavioral, and emotion-focused techniques. The underlying cause of PTSD symptoms is due to how maladaptive cognitions contribute to the maintenance of emotional distress and behavioral problems. CBT helps to change maladaptive cognitions for a patient with PTSD which decreases the anxiety that would previously lead to emotional distress and problematic behaviors. CBT is a treatment approach for PTSD which includes three treatments: Stress inoculation training, cognitive therapy, prolonged exposure therapy. I have crafted a document in which all three treatments and their techniques were researched and are presented, in the context of treating post-traumatic stress disorder. If you would like to learn more about this, comment below, and we will find a way to give you the download for my document.