When Depression Becomes Depressing
“I am larger and better than I thought.” ~ Walt Whitman
In the movie “All Is Lost” with Robert Redford, the vast expanse of the never-ending sea could serve as a metaphor for stretches of life when there seems to be nothing on the horizon but more depression and inevitable despair. The increasingly futility of his efforts to survive also can be compared to treating depression as a losing battle, considering the over 120 million sufferers worldwide and counting.
In his latest book, Out of the Blue, Bill O’Hanlon makes a valuable contribution to turning that tide. In his opening dedication he writes, “Let me reassure your soul that there is a way out.”
Then he goes on to provide several “non-medication ways to relieve depression.” It’s not that O’Hanlon rails against the “medical model,” it’s just that, as he reminds us, “There is nothing as dangerous as an idea when it’s the only one you have.”
The prevailing idea in conventional wisdom is that depression is a biochemical condition requiring antidepressant medication. Medication can certainly help, especially with severe cases, yet so can mindfulness meditation, brain cell regenerating exercise, daily doses of Omega-3, specialized gaming software, equine therapy, models of hope such as Abraham Lincoln, “mitzvah therapy” and a whole host of solution-oriented ways to gain positive momentum, which O’Hanlon reviews.
Consider that depression actually could be depressing, in more ways than one. What if it’s a matter of repeating ingrained self-defeating habits of mind and behavior, what O’Hanlon calls “doing depression”? It then creates grooves in the brain to the point of being literally stuck in a brain circuitry rut.
The traditional therapeutic model involves a lot of “problem talk” or problem-saturated dialogue in the name of cleansing still-festering past wounds. Yet the more people talk in detail about the sources of their depression, the more it can gain a hold over them. We can be paradoxically helping them do depression, since the brain becomes more efficient at whatever it does repeatedly.
It follows that there are ways to undo depression and displace it with strategic behavioral pattern breakers. This rewiring project is what Out of the Blue is all about. Here are some of the recommended ways to help motivate a depressed person:
- Discover times of non-depression. When was that? Why isn’t it worse now? Take turns talking about non-depressed and depressed times. Talk about the latter just enough for the person to get the sense that you hear their experience, and then move into non-depressed times so they get a sense of their strengths.
- Find evidence of times when the individual has shown up as their best self in spite of their depression — in other words, when have they held onto strengths and abilities?
- Keep one foot in the pain of the person’s experience (acknowledgment) and one foot in the realm of their potential for healing (possibilities).
- Introduce a little space into the stuck places by situating depressive feelings in the past tense: “I hear that you’ve been feeling defeated and could really use a glimmer of hope right now. If that miracle happened, what form it would take?”
- Isolate choice points. Do one thing differently. Encourage forays into the possibility of slight shifts in the viewing, doing or context of the issues.
- “I’m a loser.” Ask where the person might have heard that before (e.g. from a parent).
- Search for the unencumbered spot of pure goodness in the person.
- Invoke the nonjudgmental witness within — the clear-eyed, sane, mindful person, who is watching out for oneself and not defined by one’s life situation.
- Search for transpersonal connections through nature, faith, books, movies and art which speak to the person. Or encourage their own art, that can serve to carry the burden of angst instead.
- Suggest mitzvah therapy — helping others instead of focusing on the self.
- Encourage rituals of connection such as regular walks or prescheduled “movie nights” with a friend.
- Hear problems in terms of preferences, e.g. loneliness as the value of community.
- Engage in positive expectancy talk. Presume the person will get better or currently is getting better, and speak from that certainty.
- Recommend writing a letter from oneself 5 years from now to one’s present self.
- Foster the 3 C’s counteracting depression: connection, compassion, and contribution.
It all begins with a view to encouraging the depressed person. We want to know more about the person’s values, qualities, gifts, proven loyalty to themselves, past successes, competencies, skills, strengths in other settings, and remembering people in the present and past (or imagined self of the future) who believe in them and their capacity to get through the darkest of times.
The essence of O’Hanlon’s Possibility Therapy is a positive vision for what the person wants in life once therapy is done, as well as what’s not working and what they would like to see less of.
The focus then turns to exceptions to depression, and all the internal and external allies it takes to fight the good fight. There’s a bigger story to tell than depression’s incessant negative propaganda and Bill O’Hanlon is a worthy and dedicated spokesperson for it.
In the middle of Out of the Blue we find his informal mission statement:
Psychotherapy theories often dwell on what’s wrong with people, and all too often psychotherapists spend much time, energy, and attention of diagnosis and finding an explanation for the problem rather than on solving it. I found myself becoming frustrated and even angry at this state of affairs and resolved to change it by hook or by crook — or mostly by writing books (over thirty so far) and traveling around the world offering trainings designed to influence my field to become more effective and optimistic.
Speyer, C. (2014). When Depression Becomes Depressing. Psych Central. Retrieved on May 1, 2016, from http://psychcentral.com/blog/archives/2014/05/14/when-depression-becomes-depressing/