I have had depression (off and on) for as long as I can remember but have recently started treatment for it (three years now). The treatment is really helping and I know I am making progress because of it. My depression has manifested itself as fatigue, low-motivation, low self-esteem and a disinterest in things outside the house. I may also be a perfectionist, but I haven’t really looked at that one yet. I have an undergraduate degree and graduated with honors. I just feel as thought my connection to all things work-related is simply missing. I know that this is due to my depression. And while I feel myself coming out of my depression, I also feel frustrated that my interest in things has not followed. I know I need to take baby steps in order to “get back into the world” but do you have any suggestions as to what this looks like? I have considered speaking with a career counselor but I am a bit nervous that it will leave me feeling totally overwhelmed and ready to retreat back into my shell again. (The last time I met with a career counselor I ended up crying uncontrollably in her office). I feel sad for the time I have wasted with this affliction, disgruntled about how depression has stripped me of my ability to “tackle” the work world and unsure of how to proceed in this new tentative period of healing. Thank You.
“If I had not been already been meditating, I would certainly have had to start. I’ve treated my own depression for many years with exercise and meditation, and I’ve found that to be a tremendous help. ” –Judy Collins
I am sorry your depression is so weighty, but admire the strength and resilience you are showing by combating it in therapy. Depression that has a centrifugal nature to it needs to be addressed at many levels. The fact that you are in individual therapy is excellent. Here are 7 other features you may want to consider:
- When a depression is so pervasive we need an equally robust offense on the thought process. What I am recommending is a daily dose of strategies from positive psychology specifically designed to shift your thoughts and feelings toward a more positive framework. This isn’t a simplistic “think-happy-thoughts” approach, but rather a focused effort at cognitive restructuring of your thought process. Here is a link to a series of articles looking at the direct application of techniques from the sub-field of positive psychology.
Think of it as an ongoing process as we do with physical hygiene. You may have taken a terrific shower on Monday, but by Wednesday you will need another. It is the same with positive mental hygiene. We need to generate a critical mass of positive thoughts on a regular basis. One of these articles will highlight the fact that it takes three positive thoughts to overcome every negative one, thus the need for daily strategies.
- I did not read that you are taking an antidepressant. I would definitely consider this if you haven’t as the research demonstrates quite clearly that the strongest combination is that of therapy and an antidepressant in the approach to coping with depression. With the new medicines being introduced there may be one that suits you.
- If you do not want to take an antidepressant there are several homeopathic or herbal alternatives that may be helpful. For these you will want to consult a registered dietitian. Many of the better health food stores have either access to a RD or make available such information. There is some interesting research by the federal Department of Health and Human Services on a supplement known as SAM-E. But please be sure to consult someone knowledgeable in these matters. There may be contraindications if you are taking antidepressants already (or other kinds of medicine) or have certain medical conditions.
- You may want to consider group therapy as a means of supplementing your individual therapy. Group therapy is different in that there is an interactive feature that can’t be duplicated in individual therapy, and it often provides a vehicle for support as you begin to make changes in your life. Your therapist may know someone he or she can refer you to in your area.
- Meditate. Learning how to self-soothe your emotional turmoil is perhaps the most important skill you can learn. There are dozens of meditation practices and you may have to experiment with several before you find one that you like. Here is a link on meditation to give you a starting point.
- Aerobic exercise. The value of exercise in combating depression is very well documented and this is particularly true for any exercise involving aerobic displacement. If you are okay to do this medically, exercise in any form will help.
- Review your diet. No one gets depressed, puts the back of their hand to their head and says: “ I am so depressed, I need to have a piece of lettuce.” Our emotional life often changes our craving for various foods, which may not have the best impact on our biochemistry. Again, I would check in with a registered dietitian to be certain your diet is supporting your mental well-being.
Even if you can’t implement all of these things, pick one that isn’t part of your approach right now and begin there. Depression is a formidable foe, but developing these habits for dealing with the symptoms can make the difference.
Wishing you patience and peace,
Dr. Dan
