Upper Management

Posted by fxckfeelings on January 5, 2012

Whether you take pride in controlling your health with the latest developments in modern medicine, ancient holistic treatments, or the dictums of Xenu, you’re making the same basic mistake in thinking that you control your health. Depression is especially insidious, because there’s no amount of will power or even therapy that can make for a perfect solution. So gather techniques wherever you may using whatever works to deal with what ails you, just remember that the goal isn’t finding a cure, but the best methods to help you cope.
–Dr. Lastname

I have suffered from anxiety and depression much of my life. My most recent (and most devastating) bout was a couple of years ago, when I worked with a therapist and managed to heave myself out of it without the use of antidepressants (which I had been on in the past and want to learn to live without.) Now I find myself slipping back in. My biggest issue seems to be that I put too much stock in what others think of me or might think of me (I’m really good at fabricating things people might be saying about me.) I also had a baby last year, which has prevented me from pursuing my career fully, so when I hear of the successes of others (or see them on Facebook) I get very anxious and feel that the universe is unjust. I want to be a good mom, and I want to be good at my job, but I feel I am failing at both and resenting others who are great at either. I was made fun of a lot when I was a kid and I think I still carry some of this baggage around, like whatever decision I make is the wrong one because I’m basically a loser. How can I focus on myself and my own life without worrying about what everyone else is up to or what they may think about me?

While you already have a good idea of what to do about your negative thinking, you still need to protect yourself from two bad ideas that you express here. Unfortunately, those two ideas are also your “goals.”

First, disavow yourself of the notions that you should be able to stop depression without using medication and that you should find a way to be less, for lack of a better word, insecure. In doing so, you won’t be giving up—you’ll be giving yourself some relief.

The good idea, and better goal, is to train yourself to fight negative thinking, and there are lots of ways to do that. A therapist can help, but so can the right kind of friends, readings, church, and/or spouse. Though you can’t make the negative thoughts go away, you can assemble a strategy (and maybe team) to help you handle them.

Develop a routine for reminding yourself that you’re the one who’s managing your life and working with your unique gifts and disabilities, and that you’re the only one who can judge whether you’re doing your best. Then, when you start to compare yourself to the better gifted, give yourself a dose of positive reality. Nobody else can judge you, not even Facebook.

The sad truth is that depression could sweep you away, regardless of what treatment you use and how motivated you are in pursuing it. It’s scary, but it’s also liberating; you’re responsible for doing your best with depression, not making it go away. Cancer patients don’t set performance goals, and neither should you.

Instead, set your goals in terms of the process of managing, rather than the outcome, of recovery, using non-medical and other minimal risk treatments whenever possible. Then go ahead and choose riskier treatments if and only if you think they’re necessary. Don’t let fear or guilt prevent you from choosing what’s best for you.

Don’t always listen to your doctor, because your doctor doesn’t know how much pain your depression is causing or how much it has disrupted your work and relationships, so it’s your tough decision. All the doctor can do is tell you the relative risk of the treatment, compared to your symptoms, and what he or she would do in your place.

Embrace the fact that every parent with a career has to contend with bad feelings about difficult compromises. The challenge for you is to accept those bad feelings and the fact that there’s always someone out there who can do things better than you, then learn how to manage yourself positively and tell Facebook to go fuck itself.

STATEMENT:
“I don’t often feel good about my performance at home or at work, but that’s my nature. I’m proud I’ve taken on parenthood and that I’m doing OK, whatever my insecurities tell me. I know I try hard and that I’ve made good decisions and I will use those facts to lift myself up when depression tries to tear me down.”

I shouldn’t be writing you about my depression because I have no reason to be depressed. I’m a lucky person with a good job and great boyfriend. I eat a healthy diet, exercise every day, and work hard to stay healthy, mentally as much as physically. I had a severe depression as a teenager but I worked hard in therapy (and still do all I can to keep those negative thoughts at bay), took my medications as directed, and have been much better since. So now, 10 years later, there’s no reason I should be unhappy, tearful, and unmotivated to do anything but go back to bed, but no matter how much I exercise or try to stay positive, I can’t get ahead of this thing. I must have missed something. My goal is to figure out what.

The one big thing you’ve failed to understand is that depression, like most illnesses, can’t be controlled. You can be careful, do everything right, avoid giving into negative thoughts and actions, but still feel like shit. It’s not fair, but it’s the nature of the beast.

Just in case this sad fact depresses you, think about how, just like the person above, you’re depressing yourself even more by holding yourself responsible for staying healthy. Maybe you want to assume that awesome responsibility because you wish you had the power to stay healthy, but you don’t, because nobody does. Even those people who follow all the rules and work their butts off.

Luckily, staying healthy is not part of your job description; coping with illness is, so stop telling yourself you shouldn’t be depressed. What you should be doing is reviewing what you need to do to cope with depression, and realizing that you’re probably doing most of those things.

You sound like the kind of person who tries hard to keep working, relating, and parenting regardless of how you feel. If that’s true, you’re doing most of what you need to do already. You’ve probably talked things over and tried to figure out whether something’s getting you down that you don’t know about, which takes care of another basic self-management task.

Decide whether to try any new medications (see above case), using the same procedure you would use for weighing the risks and management of any treatment. Don’t be a sissy about your dislike for treatment—no one likes treatment—so just add up the risks and benefits, and don’t let fear make your decision for you.

Finally, keep working on how to think positively, beginning with the most positive statement of all: you aren’t responsible for your illness, and despite bad results, you’re doing your best. You’ll quickly discover you’re doing a much better job of coping with depression than you realize, and while the situation may still seem unfair, your efforts are all that matter.

STATEMENT:
“I never expected to get depressed again, but I realize now that I didn’t fail to prevent depression, I failed to give myself reasonable expectations and responsibilities. Now that I know what to do, I have little to fault myself for and I can be legitimately hopeful about finding new tools for managing depression.”