With depression we are told to “fake it til we make it,” to “act as if,” to go through the motions until we can feel again. But what if doing so sabotages your health? What if you push yourself straight into a wall of debilitating symptoms? Conversely, what if efforts to baby yourself keep you where you are?
This issue of knowing when to push yourself and when to coddle is undoubtedly one of the most challenging aspects of recovery from depression. I ask myself this question a few times a day.
When trying too hard backfires.
It turns out that trying too hard to reverse depressive ruminations can definitely backfire. A study published in August 2007 in The Journal of Neuroscience showed that there was a breakdown in normal patterns of emotional processing that prevented depressed and anxious people from suppressing negative emotions. In fact, the more they tried, the more they activated the fear center of their brain — the amygdala — which fed them more negative messages.
In the study, researchers examined depressed and non-depressed adults. Participants were asked to view a series of emotionally positive and negative images and then specify their reaction to each one. After the presentation of each picture, participants were asked to either increase their emotional response, to decrease it, or simply to continue watching the image. The results showed distinctive patterns of activity in the ventromedial prefrontal cortex (vmPFC) and the right prefrontal cortex (PFC), areas that regulate the emotional output generated from the amygdala.
It’s much like exercise. While regular and moderate exercise can boost longevity, cardiovascular health, and mood, long-term endurance exercise and working out too hard can actually harm our health.
What are your pressure points?
In pushing ourselves with depression, we need always be mindful of our pressure points, or vulnerabilities. For example, I know that when I work more than 50 hours a week for more than a month, my mood becomes fragile and the self-loathing tapes return. Stress is the ultimate pressure point. It compromises almost every biological system in our bodies.
So when deciding if you should push harder or not, evaluate your stress levels and the pressure points triggered (fragility and self-loathing, in my case). Rather than quitting or taking six months of medical leave, I first start with scaling back my hours. You might look for a compromise in your situation, a temporary arrangement that allows you to remain active while giving you the time and care you need.
Why flexibility is key.
Some days you may have the energy and determination to complete your responsibilities as if you don’t have symptoms. And other days you can hardly get out of bed. What’s really difficult is that you don’t know which day you’re getting until you open your eyes. That’s why it is really critical to be as flexible as you can, knowing that even though pushing made sense yesterday it might not today.
Trust yourself as much as possible. Don’t force progress if it doesn’t feel right. Instead, step aside and enjoy the view until you can get back into the race.
A cold or the flu?
Several months ago I attended a mental health conference. I was tempted to cancel, as I was having severe symptoms of depression. Even though I couldn’t quiet my ruminations, I made myself participate and found that the interaction with other people helped me. However, in the hotel room afterward, my symptoms returned. I couldn’t stop crying. I went to the airport seven hours early, hoping to catch an earlier flight. During the cab ride there, I beat myself up mercilessly for not being able to enjoy a new city. Shouldn’t this be a time when I push myself?
As soon as I arrived at the terminal I started to feel physically sick, with flu symptoms. Suddenly the self-bashing stopped, and I was able to be gentle with myself. I then thought about the trying harder versus coddling dilemma. When I have a cold, I push through and go to work. When I’m sick with the flu, I stay in bed and rest. Might it be the same with depression? Once we assess the severity of our symptoms we can determine if we have a cold or the flu.
In everything, self-compassion.
Self-compassion should be the ultimate compass behind your decision to call in sick or press on. In all situations, ask yourself, “What is the kinder act?” For example, some days self-compassion for me means swimming for an hour and other days it means going to the woods to have a good cry. Being kind to yourself can mean tackling the first item on your to-do list, or it could mean slashing that list in half.
Self-compassion is most challenging for me when I decide to rest because I undoubtedly start to obsess about copping out and giving in. That’s when you need to be extra compassionate and remind yourself that you have the flu.
Unfortunately, there’s no set rule on when to try harder and when to go easy with depression. Each situation requires careful discernment, assessing the severity of our symptoms. Sometimes faking it and pushing through delivers us to a better place. Other times trying too hard sabotages our health. One thing is for sure, though. We need always treat ourselves with kindness and compassion.