Advice for those who are depressed: My interview with Psych Central
The following is a transcript of an interview I did with Psych Central about advice around depression. The Psych Central article is forthcoming, and I will provide a link as soon as it’s up.
PC: What do your clients typically say about hope or their struggles with depression?
JL: Many of my clients, especially when beginning therapy, have been in a rut for some time, and are sometimes convinced that their depression won’t lift, or that their depressed state is simply how life feels. Depression often robs you of the memory of joy or happiness, so it becomes difficult to draw on happy memories to give one hope for the future. Most patients also are very confused about how they became depressed, believe there is something fundamentally wrong with them, and may even be beating themselves up for feeling that way, which makes them feel worse.
PC: What reasons do they give for losing hope?
JL: Most patients don’t know how they became depressed, while other have theories that are often incomplete. Often, depression makes hope feel futile as if hope is foolish or an illusion. The whole world can feel like a very dark place. The darkness feels like reality, not simply a lens which is distorting reality. That is how profound the experience of depression is. Even to say that one is hopeless requires a capacity that many depressed people don’t have: to put words to an experience that just feels as real and encompassing as the air they breathe. Saying one feels hopeless is often a positive step because it holds the implication that hope is something that is possible.
PC: What encouraging words can you share with readers who have lost hope and are struggling?
JL: That your readers are reading this means that they do have some hope that something can help them. People suffering from depression often receive well-meaning but simplistic advice which would make healing from depression seem easy or quick. “Just look on the bright side”, “Try to appreciate what you have,” etc. I am careful not to give advice that can feel simplistic because that can minimize their experience of depression and can increase their sense of hopelessness if the advice doesn’t work. To the degree that patients are able to take good care of themselves, great, and the more the better, but I want you feeling worse just because the quick fixes don’t help.
I often encourage them to try to be patient with themselves in the process of healing from depression, and that at the same time, tell them that therapy really works. Sometimes, depression can lift fairly quickly with insight, and other times it takes a while, but if you stick with a good therapist, you will nearly always find relief.
We get messages from our culture that somehow we should be in control of whether we are depressed, flip some sort of switch through sheer will power but I’ve never met anyone who has located such a switch, and such a message can be very destructive. Some people are capable of pushing through their symptoms to function, but that doesn’t mean they are happy, and others simply are not in a place to do it. If you accept your feelings as they are, then you have just conquered an important layer of your depression.
Most often, a loss of hope represents a loss of belief that you matter in the world, that you can be loved. Everyone, of course, is born lovable, but through the message, we receive we’re often made to believe that we need to perform to a certain level to be worthy of love. I have never met a person who feels lovable and is depressed at the same time. I tell my depressed patients that in our work, we will understand together the reasons that they don’t feel adequate or lovable and that the relationship between us will be the arena in which we will learn.
A loss of hope or meaning is often an indication that hope and meaning are being attacked by internal forces. Depression is most often the result of relentless internal attacks on the self, positive feelings, and positive thoughts. Bearing this in mind can be important because it offers a solution to the problem that you and your therapist can do something about by catching these attacks when they happen. Often, when you are beating up on yourself, you are really angry at someone else, and taking it out on yourself without knowing it.
As you are probably gathering, I offer hope through showing you that insight is possible and helpful and that you are worthy of attention and affection. Having said all this, I do offer, under some circumstances and when the timing is right, specific advice around self-care that can sometimes help to take the edge off of depressive symptoms or help to manage them. One piece of advice I often give is to take some time every day for activities that feel comforting or nurturing to your soul. It is also important to resist the temptation to isolate, if possible. Reaching out to people who are safe and loving often helps. If they lack those people, I try to help them figure out the obstacles to finding those relationships. Ideally, we all have someone we can just be with, without feeling the need to perform.
PC: If you didn’t mention this above, why is there always hope for someone struggling with depression?
JL: I would say there is always hope simply because high-quality treatment is effective for the vast majority of people suffering from depression. Some depression requires a short treatment to work, and other takes a long time, but I have never met a patient who didn’t see significant progress if they stuck with it. Again, how hopeless you feel does not correlate to whether you can feel better. Other treatments are also available for patients whose depression does not respond to therapy and medication, such as Transcranial Magnetic Stimulation, or Electroconvulsive Therapy, to name just two.
PC: Anything else you’d like readers to know about depression and getting better?
JL: Again, under the appropriate circumstances, I tell patients that in addition to getting therapy and finding good relationships, getting exercise, watching one’s diet, and getting a good sleep are very important in terms of one’s day to day moods, since the mind and body are closely connected. Blood sugar levels are particularly important for some people since a low blood sugar level can increase depressive symptoms. Poorly regulated caffeine intake can also cause fluctuation in moods, and alcohol can affect sleep and leave one feeling depressed for up to 24 hours afterwards.
You should also bear in mind that many people have even used their experience of depression to fuel tremendous accomplishments, as well as their empathy for the suffering of others. Not only are you in good company, but incredible things can come out of your battle with depression. Try to bear in mind that what you are going through is a normal part of the human condition, as painful as it is. There are support groups and people who you can find who will care. You are valuable and deserve to be happy and loved. You only have to remove the obstacles to believing this yourself.