Cause and Order

Posted by fxckfeelings on April 9, 2015

Looking for insight into how your mind works is like giving your brain a colonic; it’s uncomfortable, and while it feels like it should be beneficial, it usually just creates an unnecessary mess. Skip the mental probe and instead assess the risks and benefits, which is an unavoidable and valuable part of every treatment decision. Be prepared to distinguish between the kind of analysis that makes problems worse and the kind that you can’t do without. Then you’ll be ready to use your head, not waste time getting it out of your ass.
–Dr. Lastname

I can’t understand why I keep a friendship going with this rather self-centered woman at work. I’m always vaguely resentful about the one-sidedness of our relationship, but she doesn’t realize it and thinks she’s a wonderful friend and things are great between us. I know better than to make an issue of the inequality—everyone knows she’s self-centered and clueless—but what bothers me is why I keep on inviting her over for dinner and investing in a friendship that always leaves me unhappy and resentful. My goal is to understand my needs better so that I can finally let go of someone I know can’t really give me what I want.

Unfortunately, having a superior understanding of something doesn’t give you greater control over it; then meteorologists could have kept this past winter from being record-breaking-ly miserable in New England, Billy Beane would win every world series, and the “Grizzly Man” would still be alive.

That’s why understanding why we want something unhealthy is usually a huge waste of time; not only doesn’t it stop us from reaching for it, but the quest for further understanding becomes one more excuse for not stopping our pursuit in the first place.

So ask yourself whether you’ve been chasing one-sided relationships with self-centered people for many years. If the answer is yes, and you’ve been wondering why for almost as many years, then the answer is that you’ve got a bad habit that’s hard to break. It doesn’t matter why you do it, only that you stop doing it as soon as possible.

Instead of seeking answers, read up on methods for breaking bad habits. Begin by not blaming yourself while looking for triggers, such as loneliness or a lack of better relationships. Seek support from friends while describing your wish to stop one-sided socializing. Review your criteria for a give-and-take relationship and consciously look for better friendship candidates.

Don’t be surprised or critical if you slip back into old habits after a period of better self-control; as with any addiction, cure is an unrealistic goal. Get coaching from therapists or friends who seem to have good ideas for managing bad habits and be proud whenever you’re able to find yourself a good friend and avoid the temptation to talk to someone who asks for more than they deliver. Every day that you avoid calling your self-centered friend is a good day, and it’s even better if you can call someone who has more to give.

You may never get over your old habits—or even get to the bottom of them—or get them totally under your control, but you can stop them from controlling you.

STATEMENT:
“There’s something natural and comfortable about calling up my old non-friend, but I know what’s good for me and I’m determined to build better relationships, even if I go through a period of loneliness.”

I’m very depressed but treatment hasn’t been able to help me. After the third doctor I’ve seen in four years prescribed yet another antidepressant which, like all the others, gave me side effects and didn’t seem to do anything, I couldn’t see any reason to continue treatment. My wife says I should keep on trying, but I don’t see the point—nothing seems to help, nobody has any good ideas, and it’s all a giant waste of time. My goal is to spare myself from useless treatment and figure out how to live with this painful reality.

If all treatments for depression were alike, or anyone guaranteed you that three medication trials are bound to work, then you’d have good reason for losing faith in medical recommendations and deciding that additional treatment is not worthwhile. And if depression weren’t so inherently likely to make you apathetic and hopeless, then you’d have every reason to trust your negative conclusion about treatment.

Unfortunately, medication trials for depression are very iffy (each antidepressant medication has a 50:50 chance of helping) and even medications in the same class, such as SSRIs, do not have the same effect on the same person. That means that many people do not respond to three medication trials and yet may still respond to a fourth or fifth. It also means that depressives are required to keep a certain level of determination and optimism that would be difficult for a healthy person, let alone someone whose brain is currently programmed to give up.

Of course, I’m not advising you to follow medical advice no matter what, just to consider whether even a 30% possibility of successful treatment is worth pursuing. Factor in the severity of your depression, its impact on your life, and the relatively low risk of most antidepressant medications.

Depression tells you that treatment doesn’t matter because nothing seems to matter, but depression gives shitty advice; instead, give yourself the same respect you would give a friend. Probably, if a treatment was not risky and had a 30 percent chance of helping, you would want your friend to have it. Don’t get treatment because your wife wants you to. If, however, you think your depression has been painful and crippling, and you know the risk of antidepressant trials is low, then you have good reason to keep on trying.

Respect yourself for making a good decision, whether or not you’re lucky enough to get a good result. Don’t give up because you’re fed up, at least not unless you have good reason to think you’ve run out of low-risk options. If that happens, you’ll still know you’ve done right by yourself and that you’re ready to take good care of a bad illness.

STATEMENT:
“I’m very down on treatment but then again, depression make me feel down on everything. I will try any treatment that has a reasonable chance of helping me after examining its possible risks and benefits, and I will never let despair interfere with my decisions.”