Psych Central


A Note to the Severely Depressed: Don't Try So HardI don’t know about you, but when I’m severely depressed 90 percent of my negative thinking is based on the fact that I am a failure because all my cognitive-behavioral strategies and positive thinking and mindfulness attempts aren’t working. I discussed this with Dr. Smith yesterday and she reminded me, once more, that severe depression can’t be treated in a mind-over-matter way. Her compassionate logic made me review the pages of my forthcoming book, Beyond Blue, where I list the neurological and scientific reasons why.

And I breathed a much-needed sigh of relief.

You deserve one too.

Here’s my passage:

Trying too hard was precisely my problem. It was the mind over matter issue again. In my mind, I was failing because I couldn’t think myself to perfect health. I couldn’t do it all myself.

Dr. Smith salvaged the last crumb of my self-esteem with this compassionate statement:

“Mindful meditation, yoga, and cognitive-behavioral therapy are extremely helpful for people with mild to moderate depression. But they don’t work for people such as yourself who are suicidal or severely depressed.”

Her advice was grounded in neuroscience.

One research study at the University of Wisconsin-Madison, in particular, used high-definition brain imaging to reveal a breakdown in the emotional processing that impairs the depressive’s ability to suppress negative emotions. In fact, the more effort that depressives put into reframing thoughts–the harder they tried to think positive–the more activation there was in the amygdala, regarded by neurobiologists as a person’s “fear center.” Says Tom Johnstone, Ph.D. the lead study author at the University of Wisconsin:

Healthy individuals putting more cognitive effort into [reframing the content] get a bigger payoff in terms of decreasing activity in the brain’s emotional response centers. In the depressed individuals, you find the exact opposite.

And then Dr. Smith asked me this: if I had been in a terrible automobile accident would I be so hard on myself?

“If you were in a wheelchair with casts on each of your limbs,” she said, “would you beat yourself up for not healing yourself with your thoughts? For not thinking yourself into perfect condition?”

Of course not.

When I injured my knee while training for a marathon, I didn’t expect myself to visualize my tendonitis away so that I could run. I dropped out of the race to rest my joints and muscles so I wouldn’t further damage them.

Yet I expected myself to think away my mood disorder, which involved a disease in my brain, an organ just like my heart, lungs, and kidneys.

“What’s most important is to find a medication combination that works so that you can be able to do all that other stuff to feel even better,” she said. “I will give you a list of books you should read if you want to study depression. Until you feel stronger, I suggest you stay away from the type of self-help literature you have brought it because those texts can do further damage if read in a very depressed state.”

Here, then, are my three words for the severely depressed: Distract, don’t think. And surround yourself with people who truly understand mood disorders until you can believe in yourself again.

At least that’s what my doctor told me.

 


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    Last reviewed: By John M. Grohol, Psy.D. on 23 Nov 2009
    Published on PsychCentral.com. All rights reserved.

APA Reference
Borchard, T. (2009). A Note to the Severely Depressed: Don’t Try So Hard. Psych Central. Retrieved on April 16, 2014, from http://psychcentral.com/blog/archives/2009/11/27/a-note-to-the-severely-depressed-dont-try-so-hard/

 

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