What Choices Do I Have When I'm Depressed?

John Folk-Williams Health Guide
  • I’ve written here before about the folks who believe that there’s no such thing as depression. They tell us - or at least imply - that it’s a choice we’re making out of fear and weakness. and that we can choose instead to get our act together and deal with the hard stuff in life like everyone else.

    Some people with depression can dismiss remarks like that: “They just don’t get it. They think I can snap out of this illness whenever I want. They don’t know that depression is an illness and requires treatment like any other.” I used to say things like that too. The trouble is that I didn’t always believe them.

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    Too often, I used to be stung by those remarks because I believed deep down, despite knowing better, that this claim about depression as a choice was true. I shared the contempt of the people who “just don’t get it.” I could easily accept the idea that my depression was a fake, that I ought to be able to snap out of it. I’d tell myself that I’m hiding, I’m a coward, I’m running from life.

    I stamped myself with the stigma, the stain, of being weak and worthless, of wanting to escape by choosing to shut down. I knew that thinking so negatively was a mark of depression itself, but that didn’t matter when I was down. It’s hard to imagine now the self-hate and contempt I could feel.

    But even while condemning myself for not choosing to get out of depression, I also believed that I had no choice, that the illness prevented me from doing anything by robbing me of willpower and energy. So I gave myself a double punch: both trapped as the helpless victim of depression and worthless for not snapping out of it.

    I capped off those beliefs with one more - that any therapy I did try wouldn’t work.

    If medication helped for a while, my body would adapt to it eventually, and it would lose effectiveness. If I felt good after a therapy session, I’d forget before long whatever I’d felt good about and be right back where I started. Coming back from a run or a long walk, I’d be ready for anything - until a couple of hours later. The same with yoga and eating right and meditation. Nothing would work, it was all hopeless. Why should I try?

    In doing all those things, however, I was at least taking action. I had choices, a lot of them, and I could make them. But I ignored that reality because I didn’t believe these choices were mine. I was going along with the recommended therapies and believed it was up to each treatment to stop depression, not up to me. No surprise then when, in fact, none of them worked. I got to a point where there seemed to be no more options.

    Then I started to feel hopeless, desperate. Nothing could cure me. Those were the rock bottom moments.

    What choices were left? Become even more passive by checking into a hospital? That sounded so restful in one of my fantasies. Someone else would take over, and I could just stay there. While driving to work some mornings I often thought about turning off toward this make-believe hospital instead. But what would really happen there? Meds, therapy, group activities - I wanted escape, not more of the same old thing.

  • So then what? NO - I wasn’t going to murder myself, either all at once or slowly with alcohol and drugs.

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    I had to be that far gone before waking up to one more choice.

    I could stop waiting for a cure to arrive. I could take charge, sort through the therapies that had done the most for me and put them together in the way that worked best.

    I realized that the problem with my earlier efforts had been expecting too much, too soon. I would try each therapy for a while but then stop after feeling no obvious change. I decided that I had to be active and stick with whichever ones I chose. I had to put up with disappointments, false starts, setbacks. This was exciting, and I was eager to start.

    But it wasn’t so easy to go from idea to practice. The excitement about taking charge could disappear completely. I could dismiss it as just another fantasy. After all, I was great at big ideas, moments of inspiration, the dream of triumph that was once again, too much, too soon. When it came to the step by step follow-through, a depressed spirit was there to take over. Who was I kidding?

    However, this wasn’t quite the same as hitting rock bottom. However faint the hope was, I still knew deep down that this was not just a pipe dream but a choice I could turn into action.

    Ok, ok - maybe all at once, I needed the patience to get ready. It’s like resolving to exercise every day. You don’t start with the 10k race. You have to get in shape to get in shape. Do the small stuff first, the stretches, warmups and round-the-block jogs before the long run.

    My mindset had to start changing. I wasn’t either a contemptible slacker or a helpless victim, but I wasn’t all of a sudden a cured person either. I was on the mend, just starting to learn new skills of survival, and getting better would be a long process.

    It was true that I couldn’t wish depression away or will its end, but I did have meaningful choices. I could be active in small ways to start with, I did not have to wait passively for a cure to be handed to me. When these idea really settled in - when I came to believe that I could get better by working hard, the self-stigma and contempt also began to be less intense.

    My ability to choose action over passivity in the long process of recovery was empowering.  Constantly condemning myself was a belief that lost credibility as I felt a new energy - however tentative and erratic - begin to flow.

    I can’t emphasize enough how many starts and stops, how many relapses I had to go through before finally feeling like a whole person once again. The thing that sustained me was the belief that I could get up and keep going after falling flat on my face. Lying there in the same spot had never worked. Going backwards could only mean self-destruction, and I wasn’t going to let that happen.

    This is not the same thing as saying that depression is a choice. It’s obviously not. The choice is to stand up on unsteady legs and take the first hesitant step.

Published On: January 13, 2011