One of the goals of depression treatment is emotional and psychological flexibility.  When the depression shows up, you don’t give all your energy to trying to get rid of or avoid or lessen the depression.  Instead, you have enough emotional flexibility to let go of the struggle with the depression. 

One of the things that is true for most people who suffer from depression is that they can be really hard on themselves.  You look at how your life is controlled by the depression and it is easy to become harsh and self-critical.  You can ruminate on your failures, playing them over and over in your mind.  This can lead to a judgmental attitude where you begin to decide that you are lacking in some way, that there is something wrong with who you are as a person. 

Let’s begin with an exercise. Read the following statement and do all that you can to believe that it is completely true. As you do this, notice the thoughts that come to you: I am a perfectly capable, loving, and worthy person. What did you notice? If you are like most people, the more positive the thought you try to believe, the more resistance your mind offers.

Stories are the way we make meaning. Who am I and how will I be in the world? The answers to those questions come in the form of stories. Let’s imagine we are at a party. When you ask me who I am, I don’t respond by saying, “I am a 66-year-old white male, 5’11’’, with a thin frame, and salt and pepper colored hair.” I would probably share something like this, “My name is Gary. I have lived in this area for 17 years; originally, I am from Mississippi. I enjoy working out and playing golf.” In other words, I tell you a rudimentary story…and you would do the same.

In an earlier blog, I described the problem of living on autopilot and how it can contribute to depression (Depression and Living on Autopilot). Autopilot is going through the motions of life with limited awareness or intentionality. Now there is a way that autopilot is a good thing; it allows you to build rhythms and routines in your life. But these routines can become ruts. These habitual behaviors dominate each day, and it is easy to end up filling your life with activities that have little or no connection to your values. Or at least you don’t see how they can be connected to giving your life meaning.

Several years ago, I was working with a client who was struggling with depression. During our first session, I asked him to describe what it was like when the depression was there. He described not having any energy and not being able to get out of bed. He mentioned feel sad and despairing. He talked about not wanting to see anyone; instead, he would sit in his house alone. His posture changed as he described the depression, shoulders slouching and head lowering. His voice got lower. He was not that way when we began the session. It was almost like the depression was showing up, and he was allowing it to take over as he talked.

If you struggle with depression, it is not just about the feelings of depression; it is also about the thoughts you have that can keep you depressed. For people with depression, there is the tendency to be harsh and judgmental about the thoughts and feelings that you are struggling with. You have thoughts of wanting to fight the depression because you know how it feels when you get caught up it. You start to get mad at yourself and judging yourself for letting the depression win again. You wonder what is wrong with you; why you are so weak that you can’t overcome these feelings.

Over the last few days, I have posted several blogs that deal with the place of values in our lives. I have talked about how naming and giving expression to our values can help with anxiety, depression, and relationships. For example, living without a sense of purpose and meaning is true for lots of people with depression. You may want to put a lot of energy into figuring out where the depression comes from and come up with strategies to avoid it or at least control it. But it is just as important to consider what you would doing, how would you be living and ordering your life if the depression were not there, or if you decided not to spend all your energy controlling it. The answers to that question would be an expression of your values.

All these efforts to overcome depression are about controlling or managing your thoughts and feelings. You try to control by avoiding or pushing them away. You try to control by identifying and replacing with different ones. You try to control by understanding them which will lead to more positive thoughts and feelings. But here’s the thing.  Let’s say I run into you in ten years and ask you how are doing with your depression.  My guess is that you don’t want your answer to be: Well, for the most part I am managing and controlling it and getting through life.  You want to be able to speak about how your life has a sense of meaning and vitality. 

When people come to me for depression treatment, many of them are taking an antidepressant medication prescribed by a psychiatrist or a primary care physician. Often I will have people ask me whether they should take one of these medications. Will it help with my depression? Will it make it go away?