Getting the Inside Dope on Ketamine’s Mysterious Ability to Rapidly Relieve Depression

Ketamine has been called the biggest thing to happen to psychiatry in 50 years, due to its uniquely rapid and sustained antidepressant effects.  However, although there are multiple theories, researchers do not quite know how ketamine combats depression.  It is therefore hoped that new research has uncovered a mechanism that may, in part, explain ketamine’s antidepressant properties.  Read about it here.

Finding Meaning in the Legal Profession:An Interview with Dr James Hollis

This is my interview with psychoanalyst, James Hollis, Ph.D., author of the best-selling books, “What Matters Most: Living a More Considered Life,” and “Finding Meaning in the Second Half of Life: How to Finally, Really Grow Up

Dan:  What is depression?

Jim:   I think first of all we have to differentiate between depressions because it‘s a blanket term which is used to describe many different experiences, different contexts and different internalized experiences of people.  First of all, there is the kind of depression that is driven by biological sources and it is still a mystery as to how that works.  We know it affects a certain number of people in profound ways.   Second, there is reactive depression which is the experience of a person who has suffered loss and as we invest energy in a relationship or a situation and for whatever reason, that other is taken away from us, that energy that was attached to him will invert as depression.  Reactive depression is actually normal.

We would have to figure out where that fine line is and where it might cross over into something that was more than normal.  When we say that a person is grieving too long or it is affecting their lives so profoundly, that’s a judgment call, of course, but we do know people that have been sort of destroyed by reactive depression because they had attached so much of their identity to the other, whatever it might be: a position in life that they lost or a relationship that was important.

But I think none of us can avoid occasional reactive depressions because life is a series of attachments and losses.  Most commonly, when we think about depression, however,

The Link Between Disorganization, Depression and Anxiety

Although it appears to be a mundane sort of thing, I find disorganization and chaos to be one of the biggest problems reported by depressed and anxious individuals. Emotional baggage has a way of building up and then expressing itself in an outward display of turmoil — as if a tornado had let loose in your brain and your surroundings.

The symptoms of feeling overwhelmed and not wanting to face the day often stem from not knowing where to start or not wanting to face the mountain of tasks that lay ahead.  I have found folks to be so bogged down with even the everyday task of leaving the house on time that their entire day is a mess before they ever get started. By 8 am they are frazzled.

There are screaming children, pets that need walking, work begins at a certain time, the laundry isn’t done, and available clothing is something picked out of the bin from the week before that didn’t make it to the dry cleaner.  Stress chemicals are running rampant, and irritability and panic set in as well as resentment of the household, job, family and everything else.

What is worse is that typically if disorganization is a problem at home it is a problem at work as well. A cluttered desk, half-finished tasks, and unmet deadlines are the career version of the problem and are also with you all day.

Does your automobile look like a homeless person’s shopping cart?  If so, none of your major environments is peaceful. There is nothing pleasant about your surroundings, and this is a major stressor.

The problem is not that you have too much to do or work full time, it is that you have not found a routine and effective organizational plan, or you found one but are not consistent in following the plan.

Running around willy-nilly, being chronically late, never being able to find things, and having a dirty or sloppy house are stressful conditions and contribute to the anxiety depression cycle. Things scattered about affect your ability to concentrate, and irritability sets in if not outright anger.

Simply put, the stress chemicals from disorganization eat up the good chemicals needed for mood stabilization. With that process in effect, you feel depressed and overwhelmed.

Look around your house. It should be your sanctuary, not a hell-hole screaming your name to come clean it.  The house and time management issues are all about the planning and execution of a schedule and routine. If something is not getting done or is causing you distress in the household it is because you have not found the right system for you.

Very simply, a place for everything and everything in its place is a good saying to live by. Think of the simplicity of that statement. Yet this is the biggest bug-a-boo I see, not knowing where you left your car keys, clothing, sports equipment, checkbook, you name it.

We often allow our emotional state to dictate these sorts of practical matters. “I am so depressed I don’t care what the house looks like.” “I am so nervous I can’t concentrate.” “I am so ADD (Attention Deficit Disorder), I will never be able to organize myself.” It does not matter if you are depressed or anxious, your house and time need streamlining, and with that will come an improvement in your symptoms. You will feel an immediate shift just from the empowerment and taking control of your life. If you really are ADD then organization and time management are the very set of skills that you need.

Getting Started

To get started take an inventory of the areas where you need organizing. Maybe there is just one area out of control or maybe the entire place needs an overhaul. Either way, it can get done and not be overwhelming by breaking it down into sections and tasks. The major areas that cause disruption are your house, car, purse or wallet, finances, and paperwork.

I am now going to take you through a general plan that you can begin to institute immediately.

  1. Get out a pad of paper and look around. Jot down room by room what the major problems are such as laundry everywhere, kid’s toys, and paper clutter. Where are the major stressors?
  2. Now go to where these items would ideally reside. Is there enough room for them all to be put away at once? Do you need to get rid of some of it or do you need more space or better organization of it? If you have enough space, then it is probably more a problem of time management and routine. If there isn’t enough space, you may be keeping too much stuff or just not have the proper storage solutions.
  3. List all chores that require travel such as groceries and dry-cleaning. Can you do those on your way home from work? Can you do them all at once in order to be more efficient rather than make multiple trips?
  4. Think through your morning routine, this is usually where the day starts to go downhill. How much time do you need to get yourself ready? Pets? Kids? Breakfast? Pick up your house before you leave so as not to come home to a depressing mess. If you have a family, I suggest getting up 2 hours prior to when you need to leave or when they need to be out the door. This gives you time to get ready, get them up and ready, prepare and have breakfast as a family, and squeeze in a 30-minute walk or exercise of some sort. In order to do this, you will need to have already planned the night before for things such as:
  • Lunches
  • Clothing
  • Homework
  • Projects of your own
  • List of priorities for the day, knowing exactly where to focus your energies on any given day
  • Gas in the car

Now think through your evening routine. How do you get the above things done? Is there too much stuff in your evenings? Maybe the kids are in too many activities or you need help getting them around. Are you eating healthy food at night? Are you eating too late and not cleaning up because you are exhausted? Then you have to get up to a mess and again it’s all downhill from there. Remember you are in control of your schedule and your life, and sometimes too much is just too much. Even though you are trying to provide a quality of life by having many activities available for your family, it is not a quality of life if you are depressed and agitated and the house is a mess and you are eating takeout every night. Think about the memories you are creating.

Now you should have an idea of where the problem areas are and where your time is being utilized. Here are some general guidelines that will make a world of difference immediately if you put them to work for you.

House

  1. Keep dishes and plates put away all the time, fill dishwasher after every meal.
  2. Do a good cleaning once a week. Enlist the family, including children, to help especially in their own rooms. Many people feel guilty making their children learn chores but there is nothing to feel guilty about. They are simply participating in the household and will have to run their own households someday. If they learn now they will not have to struggle with these issues later.
  3. Keep money matters in one place as well as files for all your important papers and issues such as credit card information, taxes, medical, legal, travel, etc.… It is very nice to be able to put your hands right on something the minute you want it.
  4. A place for everything and everything in its place. It’s really that simple.
  5. Go with a schedule for cleaning, weekly daily, monthly and seasonally. Then stick to it.

Car

Does your car look like you live in it? This too is very stressful and carries chaos from your home into your driving. You will be more distracted and harried while driving if your car is a mess.

  1. Clean it out daily from anything you may have eaten, wrappers, coffee cups and work-related papers.
  2. Wipe console free of dust and grime with a wipe made for this to free your view of dirt.
  3. Take it to the car wash once a week if finances permit or at least every other week. Allow them to vacuum it and wipe it down.
  4. Each child riding in the car is responsible for his or her own seat area if old enough.
  5. Dog nose prints on window wiped off daily.

Purse/Wallet

Another war zone, filled with extra papers, bunched up money, cough drops, candy with dirt embedded in a wrapper, year-old receipts, hair items and cosmetics. This is a virtual dumping ground of things we collect daily. None of them should be here.

Go through all purses and wallets, and take out all junk. If you use multiple purses clean out one per day until they are all done.

Vacuum or wipe out purses as you go.

I know these things sound very simplistic and not the topic you might think to bring to a psychologist. But I really can’t tell you the number of times that I have seen clients experience great relief from their symptoms of depression, anxiety, and anger just from taking control of their life routines and belongings. It frees up your time for more constructive thinking, planning and daydreaming!

There are many books, as well as internet resources, pertaining to organization and time management. If this is an issue for you, begin reading one today! It’s never too soon to start, and you won’t believe how just 15 minutes a day dedicated to organizing your home can make you feel better fast!

About Audrey Sherman, Ph.D.

Sherman is a psychologist, speaker and author of the book Dysfunction Interrupted-How to Quickly Overcome Depression, Anxiety and Anger Starting Now. She has been working with individuals and families for over 20 years and her expertise is in helping others to overcome the emotional baggage that keeps them stuck in unhappy and unproductive relationships, jobs and more. She currently works with clients in person or via Skype or telephone. To learn more about Dr. Sherman, her book, and workshops you can visit her website, PsychSkills.com.

 

 

Procrastination, Depression and the Myth of Multitasking

Most people who are depressed have a hard time being productive. Work—and here I mean everything from paid employment to child-rearing and housekeeping to the kinds of “work” we assign ourselves, like reading a good book or planting a garden—is a chore to the depressed. It drains us, leaves us feeling as bad as before, physically worn out and emotionally depleted, instead of proud of ourselves and invigorated. Other people with depression seem to work very hard all the time, but there is little payoff for their efforts.  As with so much of depression, there is a real chicken-or-egg question—is work so difficult because we’re depressed, or are we depressed in part because we can’t accomplish anything? And as with so many chicken-or-egg situations, we face a false dichotomy: the truth is, poor work habits and depression reinforce each other.

Depressed people tend to be great procrastinators. Procrastination means putting off for a later time what “should” be done now. The “should” may come from without, as with the teenager who dawdles over homework, or from within, as with me planting my garden. When it comes from without, it’s easy to see the rebelliousness that procrastination expresses. When it comes from within, it’s hard to see immediately what purpose procrastination serves—but it may serve many.

False Assumptions

Procrastinators have some big false assumptions about how work works. They assume that really productive people are always in a positive, energetic frame of mind that lets them jump right into piles of paper and quickly do what needs to be done, only emerging when the task is accomplished. On the contrary, motivation follows action instead of the other way around. When we make ourselves face the task ahead of us, it usually isn’t as bad as we think, and we begin to feel good about the progress we start making. Work comes first, and then comes the positive frame of mind.

Closely allied to this misunderstanding about motivation is the idea that things should be easy. Depressed people assume that people who are good at work skills always feel confident and easily attain their goals; because they themselves don’t feel this way, they assume that they will never be successful. But again, most people who are really successful assume that there are going to be hard times, frustrations, and setbacks along the way. Knowing this in advance, they don’t get thrown for a loop and descend into self-blame whenever there’s a problem.  If we wait until we feel completely prepared and feeling really motivated, we’ll spend a lot of our lives waiting.  See my page on developing greater willpower.

Protecting Self-Esteem With Procrastination

Procrastination can also help protect the depressed person’s precarious self-esteem. We can always tell ourselves we would have done it better if. . .. The paradigm is the college term paper rushed together in a furious all-nighter. The student protects himself from the risk of exposing his best work by never having the time to do it right. This allows him to protect his fantasied sense of himself as special and uniquely gifted.  Procrastination is also a result of the depressed person’s tendency toward perfectionism, a crippling problem.  Research has shown that the more perfectionistic a depressed person is, the worse his chances of recovery.  Trying so hard to make every single little piece of a project perfect, we doom ourselves to disappointment and frustration.

Chaining

There is a simple, useful process psychologists call chaining or making one event depend on another event’s being accomplished first. You can make chains that help you get a lot of work done. I want to go play Tomb Raider on my computer, but I’m going to let that be my reward for first going through the outdated magazines. As I go through the pile, I find there’s one I really must renew my subscription to. Now I have to do that as well before I play Tomb Raider. Renewing that subscription reminds me that I have a stack of unpaid bills nagging at me. Maybe I can’t get the bills all paid, but I can take twenty minutes to get them organized and make a commitment to myself to pay them tomorrow. Now I can go play my computer game feeling a little less overwhelmed by events and a little more deserving of some time to goof off.  As you get used to this practice, your chains can get longer and longer without getting burdensome.

Finally, there’s also the Irish way of overcoming procrastination.  Confronted with a wall too high to climb, the Irishman throws his hat over it.  Now he must find a way over the wall.  If I have to paint a room, I’ll likely get the paint and start the first coat as soon as I can, disrupting the whole household in the process.  That way I’m fully committed and have to finish quickly.

Gluing Yourself to Your Seat

Controlling procrastination is more like controlling eating or exercise than smoking or drinking; it’s impossible to never procrastinate.  For one thing, often it’s not clear which of two is the most important activity.  Study for the exam right now, or eat dinner and then study?  Or eat dinner, take out the garbage, walk the dog, call a friend, check Facebook, and then study?  But procrastination is a habit that can gradually be replaced by the habit of not putting things off.

Rita Emmett, in The Procrastinator’s Handbook, gives us Emmett’s Law:  “The dread of doing a task uses up more time and energy than doing the task itself.”  Here’s O’Connor’s corollary:  “It’s amazing what you can accomplish when you finally get down to work.”  So my first advice for overcoming procrastination is to glue your seat to the chair, ignore distractions, and work for five minutes.  Then you can take a short break if you feel it’s necessary, but put in another five minutes after your break.  The procrastinating impulse in your mindless self won’t respond to logical argument, but it may respond to a narrowing of focus.  You’ll get in a groove, start feeling productive, and the impulse to procrastinate further will dwindle.  If it doesn’t work today, try again tomorrow.

One Task At a Time

A second piece of advice:  while you’re sitting glued to your chair, you’re not allowed to do anything other than the task you’re there for, no matter what attractive distraction might come to mind.  You don’t have to work on your primary task, but you can’t do anything else.  This can be torture, but it’s great mental discipline.  You’ll quickly see how easily distracted you are, but you’re forced to develop the willpower to withstand temptation.  Eventually, you’ll get something constructive done.

Hold yourself to pre-commitments.  No television (Internet, email) until I’ve worked for a half hour.  If I get X done, I’ll reward myself with pizza tonight; otherwise, it’s peanut butter.  Be sure to keep these commitments reasonable and don’t set yourself up to fail.  If you practice and get consistent at this, you can start to up the ante.

Reward Yourself

Procrastinators don’t reward themselves for finishing.  A drink with friends, a special dessert—things that normal people might do to celebrate an accomplishment—these things don’t occur to procrastinators (partly because they’re never satisfied with their results).  But it’s important to practice these rituals because, in our minds, the pleasure that comes with the reward comes to be associated with doing a job well.  In this way, work itself becomes more satisfying.

The Stress of a Mess

Clutter is highly associated with procrastination.  Each of those extraneous items on your desk, workspace, or computer desktop is a distraction, a reminder of something else to do.  Mental clutter works the same way; if you have a set of nagging chores, just making a list will help you focus on the present.  The list will contain the nagging.  Every time we are distracted, we lose efficiency.  You can reduce your procrastination greatly by eliminating distracting cues.

Unplugging

Of course, personal computers and wireless communication have created many more temptations to procrastinate—games, Facebook updates, checking on the news.   Tweets, cell phone calls, and instant messages constantly break our concentration.  If we really want to focus on something, we have to remove temptation and prevent interruptions.  If you work on your computer, turn off your Internet browser and make it difficult to get back on.  Put the phone on silent.  Multitasking is a myth.

By Richard O’Connor, Ph.D.  Dr. O’Connor is the author of Undoing Depression, Undoing Perpetual Stress, and Happy at Last. For fourteen years he was executive director of the Northwest Center for Family Service and Mental Health, a nonprofit mental health clinic, where he oversaw the work of twenty mental health professionals in treating almost a thousand patients per year. He is a practicing psychotherapist with offices in Connecticut and New York and lives in Lakeville, Connecticut.

Further Reading:

Get It Done When You’re Depressed – great book!

“Three Strategies For Getting Things Done When Depressed”Psycentral website

“Ten Ways To Get Things Done Despite Depression” – Everyday Health website

Top 5 Traps That People With Depression Fall Into

A trap for those suffering from depression and anxiety is that many of people’s natural coping reactions make the problem worse rather than better.   Here are a few examples of that, and some practical solutions.

Note: Please be compassionate with yourself if you can relate to any of these patterns. They’re common pitfalls, not an indictment on you as a person.

Number 1: You don’t fix problems that frustrate you.

Feeling irritable is one of the main symptoms of depression for many people. Some problems that trigger repeated irritation and frustration are easily fixable. However, people with depression often go into a passive “survival” mode and don’t address these issues, even though they could.

For example, you don’t have enough power outlets in the spot where everyone in your household likes to charge their devices. You’re constantly annoyed about people unplugging your device in favor of their own. This is the type of tension that can be solved by getting a multi-plug or another similar practical solution.

People with depression often just put up with this type of issue (and complain about it), rather than deploying a solution. It’s understandable to do this, but not very helpful.

Number 2: You’re waiting for your sleep to improve before you take other actions.

Difficulty sleeping is one of the most horrible symptoms of depression.  Unfortunately, it’s often the last symptom to resolve when people’s mood starts to improve. Therefore, even though it’s hard, it is important that you start other strategies even though you’re feeling tired and grumpy. For example, exercise. If you over-focus on getting your sleep right before you start other strategies, you’re setting yourself up to fail.

Number 3: Wanting a pill as a cure-all.

Medication is helpful for many people with depression but it certainly doesn’t address all of the thinking and behavioral patterns that are associated with depression. For example, you’ll likely still need psychological strategies to deal with tendencies towards rumination (overthinking) and avoidance/procrastination.

Solution: Try drawing a pie chart and estimating what role you think medication has in your depression recovery. Include whatever is relevant to you in your pie chart, such as thinking changes, exercise, meditationlaughter, problem-solving etc.  Your personal pie chart won’t be the same as someone else’s since everyone’s preferred mix of strategies for depression recovery is a little bit different. When you start adding all these other components to your pie chart, you’ll see that medication is only a part of the picture.

Number 4: Asking for help too often.

People with depression frequently struggle along on their own for far too long before seeking effective help, and may not realize they’re depressed. However, sometimes people can become over-reliant on others when their mood is low. Examples include too frequently asking for help with: making decisions, using technology, or reaching out socially (such as making phone calls).

The same person can be too resistant to seeking help in some respects and too reliant on others in other respects!

When someone who is depressed constantly leans on others it can create anger, resentment, and other problems in relationships. This is especially the case when the depressed person repeatedly asks the same people for help or asks for help with the same task that they could learn to do themselves.

This point relates to the next one, so keep reading to learn more.

Number 5: Putting life, learning, and projects completely on hold.

People often feel like their brain is foggy and their concentration is impaired when they’re depressed.  Therefore, it’s natural that people withdraw and think they’ll put off working on projects or learning anything new until they’re feeling better.

When you’re depressed, it’s a great idea to go easy on yourself and resist taking on too much. This does not mean putting off anything and everything challenging or unfamiliar. If you do this, you’ll, unfortunately, dig yourself into a very big hole, where you withdraw from life and avoid, and your confidence and energy erode further.

Don’t push yourself too hard, but understand that experiences of both pleasure and mastery are incredibly important for mood hygiene and depression recovery.

Solution: For this tip, I like to think of each day in three chunks – morning, afternoon, and evening.  Aim to have one experience of pleasure and one experience of mastery in each of these chunks.  These can be tiny, like canceling a subscription you’ve been paying for but not using.

You can actually fold other advice for alleviating depression into this strategy. For example, exercise could be either a pleasure or mastery experience for you or both. Something like taking the stairs rather than the elevator could be counted.

If you include mastery experiences in your day, you’re not likely to fall into the traps of asking for help too much or failing to solve easily fixable problems that trigger your irritability.

Wrapping Up

Which of these problems seems most relevant to you or your loved one? Which of the solutions presented seems most important for you to try? How can you implement that in the easiest way possible? How can you bypass the most likely obstacle to your succeeding with your strategy?

 

By Alice Boyes, Ph.D. Alice has had her research about couples published in leading international journals, including Journal of Personality and Social Psychology.Her work focuses on how people can use tips from social, clinical and positive psychology research in their everyday lives and romantic relationships. She is regularly interviewed for magazines and radio about a wide range of social, clinical, positive, and relationships psychology topics. She can be contacted for media interviews by emailing admin@aliceboyes.com

 

 

 

10 Tips for Dealing with Depression During the Holidays

While most of us are so busy with doing that, we have little time for being, the days surrounding major holidays can feel especially overwhelming. Most of us seem to lose touch with our connection to the natural world until we experience a life-changing event that locks that moment down into the month or the season. “The Holiday Season,” with capital letters, is one of those markers that is meant to provide a space for reflection, wonder, and deep joy. Advertisers capitalize on our sentiment through advertisers using images of families or neighbors coming together to cheer up individuals who are portrayed as alone and lonely, if not downright abandoned.

Unfortunately, many lonely people do not have a cheering group of neighbors, friends, or families eager to surprise them with holiday lights, tins of cookies, or invitations to join them for a holiday meal. Loneliness and hopelessness can increase while images of altruistic concern and heartwarming moments seem to be the bar against which all holiday experiences should be measured.

Once the first day of winter arrives, the shortened days and decreased exposure to sunlight generate unexpected feelings of depression for many along with lethargy that comes from the resultant vitamin D production in the body. If you have experienced loss, heartache, or depression, the change in season can send you spiraling deep into a very dark place. Putting on a brave face for others can be especially difficult when the world is blasting us with images of group hugs and the memory of your final hug with someone you love is all that you can think about.

No matter what the cause of your holiday lows might be, here are ten tips that might help you cope during this season:

Don’t completely isolate yourself from other people. Social connection has great healing power – attend a faith-based service, even if you are not committed to a particular religion, just to experience the positive feelings of being surrounded by others.

Allow yourself space to acknowledge any losses, despair, or hurt you are feeling, but do not let yourself use the loss as an excuse to escape through alcohol or other addictive substances.

If a particular ritual is just too painful to try and continue this year, accept that there are limits to what you are capable of doing and forgive yourself for that.

Don’t allow yourself to use any holiday-related time off from work as an excuse to hide from the world – stick to as regular a schedule as you can.

Don’t binge eat or binge drink – while these may offer a sense of temporary escape, they are not healthy coping methods.

If you’re recovering from a broken relationship, it’s especially important not to dwell on the past, an imagined future, or thoughts of revenge. Make sure that your ex’s contact information is wiped from your phone to help you avoid any temptation to make any desperate attempts at reaching out.

If you’re recovering from grief at the loss of a loved one, create a special new ritual that honors the person who is no longer there. Light a special candle and offer a silent or spoken tribute to this person. Add a special decoration to your collection and display it in this person’s honor. Choose a special recipe that was always a favorite and prepare it each year – saying a special prayer in their honor before consuming it.

Reflect on what has brought the most joy to you during this season in past, happier years. Force yourself to engage in this aspect of the holiday with as much energy and commitment that you can muster. If it was the lights of the season, throw your heart into decorating your home with the lights that always brought a smile! If it was the cookies, bake your heart out – even if you aren’t the most talented chef, enjoy doing something that your loved one would have enjoyed seeing happen. If it was the carols and songs of the season, let the CDs, Sirius, or Pandora serenade the silence with the songs this person loved.

Remind yourself that at this time of year, the shortest day falls on the last day of autumn. Winter may bring the coldest weather, the deepest hibernation of animal life, the barren trees may stand out starkly against the winter sky, but remind yourself that once the first day of winter has arrived, the days are once again growing in length and the nights are beginning to shorten. This is a magic time when we can feel the change in the natural world on a very deep level. The feelings of depression or deep grief you feel may ebb and flow like a tide, but remind yourself that there is a natural rhythm in life and it truly is always darkest before the dawn.

Honor your feelings, but don’t allow yourself to get so wrapped up in despair or hopelessness that you retreat fully from the world around you. When we let ourselves get sucked into a place of abject despair and darkness, we are sacrificing the potential for joy that others might bring you – or that you, yourself, could bring others.

If your holiday season is a time of depression, grief, or hurt, know that you are not alone. Others also are suffering as the world blares entreaties to be “merry and bright,” but sadness and heartache are filling your heart. Keep active over this period, show up in life, and remind yourself that each day that you do, it’s one less day you’ve given depression the power to take from your life.

By Suzanne Degges-White, Ph.D., LPC, LMHC, NCC. Susan is professor and chair of the Counseling, Adult and Higher Education department at Northern Illinois University. She is a licensed counselor whose focus includes working with individuals and families facing transitions. Her academic research explores development over the lifespan with a strong focus on women’s relationships and women’s developmental transitions. She is currently president of the Association for Adult Development and Aging, a division of the American Counseling Association.

 

 

 

 

Emotion Rules When There is Depression

Stuck in a negative network, changing thoughts or actions is just plain hard.

Pexels

“I cannot do what you suggest – I know it won’t work.”

That was Jon’s mantra as he sat in my office and said that he can never be happy. The one thing he wants – a wife and family – will never happen because fate has determined he is not going to achieve that goal. Yet most opportunities he gets to meet someone new, he believes will not work.

Why is he resisting meeting new people when someday one might be interested in him? His inability to move from one idea to another to create a change in thinking or in attitude is typical for depression. And, as in Jon’s case, it seems like it’s intentional. Or at least that’s what family and friends see when they tell their depressed loved ones to “Just do it!” It is easy to judge from the outside, but it is hard to see on the inside of a person with depression.

That stuckness is a feature of underlying neurobiology. All of us think in networks: when we start to think about a topic, we enter a network of related concepts that allows thinking to be efficient and helpful. Ideas are linked and things we need to know are easier to access when we enter a network of similar ideas, experiences, or emotions. That is why when people are trying to develop a creative solution to a problem, they brainstorm. That is, they utter or write every idea that pops into their minds about solving a problem – no matter how ridiculous it sounds on the surface – and do not assess the idea until they have a long list of options. Brainstorming is valuable because it helps us remove ourselves from the already framed network and helps create a new one.

That same efficient brain that networks and categorizes also causes a problem when depression hits. Entering a negative network that connects similar thoughts, experiences and emotions result in a depressed person linking negative networks. It promotes the discouraged outlook that is typical of depression. And, unfortunately, in depression, the ability to move to another more positive network is impaired. The weakened activity of the neurotransmitters causes “stuckness” in the pathway in the brain that allows shifting of thought and emotion.

That pathway includes a part of the brain called the anterior cingulate cortex (ACC) that should allow for rapid shifting between emotion and thinking and should aid in developing creative problem-solving. But when people suffer depression, this pathway of the brain is impaired. It may be overactive – spinning in place without creating movement. Or it may be sluggish and unable pass along cognitive decisions like, “I will try something new,” to the emotional part of the brain that generates the discouraged, “I never have good results.”

Emotion rules when there is depression. The negative “It won’t work for me,” style of thinking seems to have more power than the optimistic, “Just give it a try,” method of thinking.

Sitting with Jon, I want to say, “Just do what I am suggesting!” I want him to borrow my ability to generate a new idea, but some things have to change before he can try something new. He cannot respond to “just do it” while his negative networking is making him believe that his case is different. His notions about how to act are the ones in the network of what he has typically done, which is a very negative network.

How can he get out of this?

He needs a MAP.

When you use a map – even your navigator – you have to know where you are starting and where you are going. Jon needs to know he is currently stuck and that another way just might be possible. But where is he going? He needs to believe in a reasonable solution. In our conversations, Jon is beginning to believe that his depressed thinking is a problem.

Medication might help him be less negative – it can correct the neurotransmitter problems that cause the sluggish or overactive pathway to prevent new ideas. (Supplements and nutrition and sunlight can also help!) Next, he needs to redefine his goal. If marriage to exactly the right person is the only thing that will make him happy, then I cannot help him. He needs a matchmaker and a lot of money for that. If he wants to redefine what a happy life looks like to him, therapy can guide him. But once he can see the need for help to navigate his goal of a happy life, he needs to find a map. This map will need to take him toward feeling better and developing a more flexible, creative way of thinking. If he can get out of the negative network he will be more able to generate new actions and take charge of his discouraged mood.
MAP – Move, Ask, Play

M – (You may want to consider medication as the first M and then go to this one)

Jon needs to move. Literally, move his body. The stuck brain finds it easier to shift gears when the physical body is moving. Walking, swimming, bike riding can all be good. Try movement without earbuds pumping music. The creative brain will take over and just might jump the tracks of negativity while you move. And vigorous exercise has a way of pumping up energy that lightens depression.

A – Ask for input. When we brainstorm it works better if we have more than one person adding ideas. We spur each other into different networks. Jon might benefit if he shares his challenge of being stuck with a friend or three. And it will be good for him to ask people what gives them happiness or satisfaction. He might hear that there are many ways to be content.

P – Play around with different options. Jon does not have to commit to an idea of what is fun or pleasurable or satisfying. He would benefit from playing with the children in his life whose joy is infectious. Play sports or games. Playing stimulates different networks and may result in some changes in his mood or thoughts that may help him be less depressed.

There is a saying that life is a journey, not a destination. I do not know Jon’s ultimate destination, nor does he. The outcome of this MAP will help him find a better, more creative, and less depressed way of living his life.

By Margaret Wehrenberg, Psy.D. Margaret is the author of 5 books published by W.W. Norton, includingThe 10 Best Ever Anxiety ManagementTechniques, The 10 Best Ever Depression Management Techniques and her most recent 10 Best Anxiety Busters, an ideal book for the general public. She earned her M.A. studying psychodrama and bioenergetics, and had years of experience as a certified drug and alcoholism counselor, before earning her Psy.D. She now specializes in treating anxiety and depression and has a private practice in Naperville, IL. She is a frequent contributor of articles to The Psychotherapy Networker magazine, has contributed a chapter to Clinical Pearls of Wisdom (Ed. M. Kerman), and has produced CD for breathing, muscle relaxation and imagery for anxiety management.

This article originally appeared in Psychology Today magazine.

 

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