Thursday, 31 January 2013
Creating motivation when feeling depressed can be one of the most difficult things a person can do. An episode of depression can be physically and emotionally draining.
The simplest of tasks seem to take maximum effort, and sometimes even beyond maximum. Some may feel lethargic. It may be tough make meals, or clean up at home, or take showers, or even get out of bed.
Navigating motivation when depressed can be tough because the instinct is to wait for the energy to return.
People who are depressed often fall into the trap of trying to wait it out — that if you give in to the urge to stay in bed for a few days, that you’ll be re-energized and recharged, believing you’ll have exorcised the depression demons by just “going with it”.
Unfortunately, it’s not usually as simple as this. If everybody tried to wait out their depressive episodes, some people would be in bed for 20 years, realizing somewhere along the way that depression actually tends to breed depression if it’s not actively confronted. That’s right, catering to our depressive urges actually reinforces them.
Obviously, actively doing anything doesn’t sound so desirable when feeling depressed, let alone confronting our depressive urges head-on. While it’s important to give depressive symptoms their attention and get to understand and learn about what’s underlying the depressive episode, the concept of “mind over matter” can help create motivation when depressed.
I have seen evidence with many people that creating a change in mindset with small, manageable, behavioral steps can change a whole experience of depression. For some it’s brought their symptoms entirely into remission. This doesn’t replace taking the steps to learn more about what’s causing the episodes, but these steps can help us move on with our lives while we continue to work on the underlying issues.
Let’s look at some steps that can help break an episode or a cycle of depression.
1) Opposite Action – In Dialectical-Behavioral Therapy (an offshoot of Cognitive-Behavioral Therapy), Opposite Action is the idea of forcing yourself to do something that you know is good for you, in order to prevent the reinforcement of a bad habit. For example, if you want to stay on the couch and watch tv all day, when realizing this only gives in to depression, opposite action would say to get up and go out, knowing it would be a healthier behavior. It’s very much a “just to the opposite of your unhealthy urge” technique. In CBT, the principle is that your behaviors can create positive changes in your emotions.
2) Set an Alarm – This isn’t only for getting out of bed. The alarm can be for anything that marks a symptom of depression. You might set an alarm to wake yourself up at a certain time to make sure you get out of bed in the morning; or you might set an alarm to signal a meal time if you’re missing meals, or signal time to do laundry, or run a particular set of errands, and so on. The alarm serves as a cue to draw your attention to a target area where you want to become more active in change.
3) Make Your Bed – Getting out of bed can be very tough with depression. The first step to take is to sit up on the bed, put your feet on the floor, and visualize leaving all of your troubles and thoughts behind you in the bed. Then, get up and nicely make your bed, leaving the troubles behind for the day. Making the bed is essential in this process, as it signals to your brain that there isn’t an option to get back in the bed for the day. As you make your bed, it can also be helpful to imagine the troubles you’re left behind dissipating as the covers are pulled up.
4) Wash Up – The more routine-setting steps you’re able to add on after you make your bed, the better. Try washing your face and brushing your teeth to help wake you up. With these kind of steps you’re training your brain to understand that you’re getting ready for “something,” rather than simply a day laying around.
5) Get Dressed – This is a crucial step in separating from the bed to the day. Sitting around in pajamas on the couch is still possible, even if you escape the bedroom. Getting dressed decreases the urge to lounge, because again you’re reinforcing in your brain that you’re getting ready for something.
6) Go Outside – This can be one of the toughest steps for people who struggle with depression — actually leaving the house. One of the problems with this step is that people are easily held back by not having a place to go. “Okay, I can go outside…..but then what?” So for this step, the idea is to not have a place to go. The goal is going outside, not the particular place you go once you’re outside. Go outside, close the door behind you, and do whatever comes to mind — a walk around the block, down the street, pacing in front of your house, getting in your car and driving on an errand, and so on. It can be anything or nothing at all, but the goal is to spend at least ten minutes outside before going back in.
7) Choose One Exercise – Getting your body moving is a good way to start feeling better. Choose an exercise that works for you: walking, running, swimming, jump-roping, etc. Whatever you choose to do, make it a point to do it every day when you go outside. And if it’s an indoor exercise (like a treadmill), do it before you go outside.
8) Make a List of Activities – Brainstorm activities that you’d enjoy doing. Include things to do at home and out with people. Try to generate a list of things that includes others and that gives you some time to yourself. The activities can be a mix of productive (e.g. work-related) activities, and hobbies, and self-care.
9) Schedule Activities – Schedule the activities throughout the week. Try to plan out either one or two weeks ahead of time and actually write the activities into your calendar with specific days and times. Spread them out as much as possible and make sure to stick to the schedule.
10) Daily Necessity Schedule – This schedule is if you’re having trouble getting motivated to do your daily activities — such as eating, cooking, showering, or other household chores. For this, you’re creating a daily home schedule. Choose the specific times you’re going to do each activity every day. It can be as specific as you feel you need: time to get dressed, brush your teeth, start cooking, eating, showering, turning off the tv before bed, and so on. This is to help you get your daily necessities actually functioning on a daily basis.
11) See Family and Friends – This one is more about the people than the activity. Being around other people is often helpful for mood improvement. Schedule specific dates and times with friends and family, outside of the house. The more you can remove yourself from the environment of depression (usually the home and bedroom), the better chance of overcoming it.
12) Psychotherapy – It’s important to keep in mind that the desire to stay inside and and lay around isn’t what causes depression — it is a symptom of depression. Psychotherapy remains a necessary step throughout the process of dealing with depression in order to prevent further episodes, reduce severity, and hopefully be rid of depression altogether. Even if we can resolve some of the motivational issues through pushing ourselves to take behavioral steps, the internal issues that are causing the depression still need to be addressed. Otherwise, when our motivation drops, the depression may return if we don’t have a handle on the underlying issues.
What’s most important to keep in mind is that you’re not going to feel like doing anything discussed above. If you’re going to wait to “feel like it”, then it may not happen.
Using opposite action will be the necessary first step to conquering depression — knowing in your mind that it will be good for you to take the steps to move forward, and just doing it.
By also engaging in psychotherapy, you’re still able to give appropriate attention to what’s happening inside of you, including if medication therapy may (or may not) also be helpful. Y
ou do have the power to increase your motivation and to break out of depression. It may take some effort, but the opportunity is there for you to reclaim your life.