“When you’re emerging from a depressive episode, how do you know when to push yourself — in terms of commitments and challenges — and when to be gentle with yourself?” someone asked recently on my depression community, Project Beyond Blue.

That’s one of the toughest questions facing people who have repeated depressive episodes because, no matter what they choose, they are sure it was the wrong choice. If you don’t take that night course, you feel like you wussed out. But the stress of studying for exams when your cognitive functions are in the toilet doesn’t really get you far either.

It’s the third part of the Serenity Prayer: knowing the difference between those things you have to accept because you can’t change them (your illness, your limitations), and the things that you can change (appropriate challenges).

It’s about wisdom, which is different than knowledge. Leo Tolstoy said it best: “We can know only that we know nothing. And that is the highest degree of human wisdom.”

The summer before last, when I was deep into a depressive episode, crying 10 times a day or more, I was asked to give a talk several months later at a mental health conference. I panicked, as I didn’t know if I would be better by then. My depressive episodes, on average, seem to last two years.

“What should I do?” I asked my doctor.

“You will be feeling better by then,” she said. “And if you’re not, you can always back out at the last minute and say you got hit with the flu.”

So I agreed to do it. And then for two weeks I obsessed constantly about it, and felt horribly anxious thinking about it. The stress of having that impending deadline was not helping me get better. It was making things worse. So I called back the woman and said that I was sorry, but I had a conflict that day.

I felt like a total wuss.

Come November (the month of the conference), I was feeling a little better, but not good enough to give a talk, and I was glad I had backed out.

It feels a little bit like a card game when you are in that place of limbo:

You’ve got to know when to hold ’em

Know when to fold ’em

Know when to walk away

Know when to run …

I channeled Kenny Rogers yesterday because I laid my cards on the table in a BIG way when I held the first board meeting of Beyond Blue Foundation, a nonprofit dedicated to supporting persons with chronic depression and mood disorders (the difficult and complicated cases that often fall through the cracks of today’s medical system), and felt that familiar I-need-to-puke feeling.

“Affluent and connected people like Kennedys and Shrivers build foundations,” my inner critic reminded me, “not people who are extremely fragile, who have mental breakdowns on a consistent basis that last for two years, and definitely not people who need to produce income to support their family. What in the hell were you thinking?”

It was the same feeling I had when I told the woman I would speak at the conference a year ago. The same feeling as when I agreed to be the commencement speaker at my alma mater, Saint Mary’s College, after my first breakdown. “How in God’s name are you going to pull this off?” my inner critic asked. “You don’t know which days your mind is your friend and which days it is the administrative assistant for the enemy (despair).”

As I hung up from a conference call with nine overachievers, who have done everything from start an online community of 300,000 members to give seminars to thousands of people on Capitol Hill, Members of Congress, and their Chiefs of Staff, I felt my smallness, my fragility, my overshadowing illness that is always there to second-guess every move I make, and I started to cry.

Can we, who keep mood journals recording our every thought and food and activity, really aspire to do anything good without getting tripped up from symptoms that surprise us out of the blue? Am I locked in to a simple and safe life in order to prevent getting myself too far deep into something I might not be able to do?

One of the board members must be psychic because he sent me a text somewhere in all this anxiety I was feeling which said: “I know this sounds a bit overwhelming. But it will all come together. You have good people involved here. Believe!”

He should know. He lost his daughter to suicide four years ago and has been giving “Believe” talks to schools and places where young people need to hear that message.

“Believe there is a great power silently working all things for good, behave yourself and never mind the rest,” wrote Beatrix Potter.

There are times it is appropriate to say no, to forgo the night class if it’s going to produce too much stress, to save speaking for when you have most of your marbles back in your head. But there is also that good anxiety that comes with stretching yourself, and proving your inner critic wrong, the I-have-to-throw-up sensation that needs to be felt in order to push through to a new beginning.

The wisdom, though, is in realizing there is no right and wrong, that we can only know that we know nothing, and just try our best.

Continue the conversation on Project Beyond Blue, the new depression community.

Originally posted on Sanity Break at Everyday Health.

Balloon image available from Shutterstock