Say “Yes” to Distress

Posted by fxckfeelings on March 27, 2014

Anxiety and depression can act like funhouse mirrors, distorting your thoughts and making it hard to perceive the benefits and obligations of social relationships. Some people can’t say no to social responsibility, no matter how unreasonable, and some people can’t say yes to it, even when it’s minimal. Regardless of the distortions that make you over- or under-embrace your social pleasures and responsibilities, use objective methods to figure out how much is good for you and how much is necessary. Then you can build a social life and discharge responsibilities without burning out or drying up, and substitute the funhouse for actual fun.
–Dr. Lastname

My elder brother was diagnosed with MS when he was in his 30s, and now he’s in a nursing home and a wheelchair. He’s given me his health care proxy and told me he was relying on me, calling me five times a day and giving me a hard time if I don’t answer, so now my anxiety has gone through the roof. He’s always been a spoiled brat and now it’s worse. His health care is actually pretty good, and there are people and activities in the nursing home to keep him occupied, but he expects me to drive 100 miles to visit whenever he asks. I’ve always been the one everyone turns to for help, but now I go around with a knot in my stomach and desperately need to take more medication, even though I know it’s addictive and likely to make me fall. My goal is to find some way to relieve my anxiety that doesn’t kill me.

If you’re an anxious person, then there’s no substance in the world—pill, liquid, magic bean—that can make you suddenly be a not-anxious person. Especially if you continue to do things that feed your anxiety, like say yes to anyone who needs your help because you’re too anxious to say no.

Sadly, the things that currently give you immediate relief are A, making others happy, and B, medications, both of which have side effects.

Instead of seeking relief and/or complete transformation, learn how to protect yourself from unreasonable demands and become a stronger, more well-defended person. In the long run, that will also give you better relief without the side effects (e.g., dry mouth, weight gain, the death penalty for when you snap and murder your demanding brother).

The first step for reining in the inner, compulsive help-giver is to assess what your brother needs both from you and from his own damn self. Gather whatever local resources are available into a plan that provides the basics, including emergency care, gives appropriate responsibility to your brother, and protects you from unreasonable demands. Once you know what’s in place and have assigned responsibility where it should go, don’t intervene unless it’s necessary.

If your brother tries to make you feel guilty, be ready with a positive, undefensive response, reminding him that you’re not always available, which is why you took the time to put in a careful system of caregivers who can handle emergencies and whom he needs to work with whenever possible so he can remain in control. If this plan doesn’t seem as good as having just you to rely on, it’s because it’s better.

If he calls too often, don’t answer any more often than necessary. His calls are a good opportunity for you to think hard about what’s necessary, not about making him happy so he won’t make you feel anxious and guilty. Expect to feel pangs of guilt and worry so extreme you’ll want a sedative, but don’t let them stop you from setting up rules, guidelines and procedures that protect you from your brother’s neediness.

Medication may help your anxiety, but it’s not a plan A; don’t use it until you’re committed to protecting yourself from burn-out. Before you try pills, set limits with your brother so he stops setting you on edge.

As an anxious person, worry more about what’s right for you and your sanity in the long run than what your brother wants right now.

STATEMENT:
“I hate turning aside a plea for help and always feel like I’m being mean if I do, but I also know how to allocate responsibility fairly. I will set up a fair and reasonable system for my brother, regardless of how he feels or makes me feel, and I will not let myself be pressured into doing more for him than is really necessary.”

Ever since I moved for this new job, I’ve been too depressed to develop a social life and I’m somewhat lonely. I like the job, so that’s not the issue, I just think I expected too much from this big step in my life and now I just feel let down. Between the lack of energy and the fact that I have nothing much to say and feel nervous about going out, I’ve kept to myself at work and want nothing more than to go home afterwards, shut the door, and watch TV. My goal is to get help for my depression so I can get out more, start a social life and get as much out of my new life as I can.

What hurts people with depression the most is not the symptoms, but the way they change beliefs and habits. Depression makes you feel like you don’t have much energy, interest in people, or desire to go out. It also gives you negative thoughts that tell you you’re more dull and boring than you really are, plus the irritability that makes you feel like a jerk who is bound to drive people away. If these symptoms influence your actions and self-image, you stop being a depressed person and start to become a depressive.

Medication may help your symptoms and, given the impact your symptoms have had on your life, it’s definitely worth a try. There are lots of unique antidepressants to try and that’s good, because each one has only a slightly better than 50:50 change of working and takes four weeks before you know. The good news is that the serious side-effect risk is very low.

Whether or not medication works, however, take back your life from the depressive symptoms. If you can handle a job, you can take on the task of re-activating your life in spite of your symptoms. Work with a coach on identifying and correcting the false beliefs you’ve acquired, and prepare an activities plan that will get you out and exercising (which is a great antidepressant) and meeting people. Stop doing what depression tells you and instead of learning to say no to people (see above), learn to push yourself to say yes to living.

What you’ve been doing is unfair to you and also dangerous, because if you let depression run your life, your life will become more depressing. Turn the vicious cycle around. Push yourself to live the life you think is meaningful by doing whatever is important, and prove to yourself that you can have friends and a social life even when you’re depressed, whether you feel like it or not.

Living a fuller life may not stop your depression, but it will certainly prevent your depression from becoming worse and/or taking over your identity. It takes extra work to live fully with depression, but it beats letting depression have a full life at your expense.

STATEMENT:
“I feel better when I keep to myself, but I know what’s good for me, and it isn’t to cut myself off from people. I will put together a regimen that will push me to do whatever I think is important and satisfy my social goals, whether I feel social or not.”