Planning and Executing A Strategy Against Your Depression

To repeat: the sadness in depression is caused by (a) making negative comparisons between (i) your perceived actual circumstances, and (ii) some hypothetical circumstances--for example, what you would like to be, or what you think you ought to be, or what you are accustomed to -- in combination with (b) a sense that you must do better and are helpless to change the actual or hypothetical circumstances. There is a variety of possible reasons for making such negative comparisons persistently.

This chapter outlines a step-by-step strategy for fighting depression. The first two steps inquire into the unfavorable self-comparisons, asking: Which particular negative self- comparisons are most frequently in your mind when you are depressed? and Why do you persistently make these negative comparisons between your actual state and your benchmark state? The third step examines whether there are side-benefits of depression you must deal with. Step four inquires into the sense of helplessness that converts your negative self-comparisons into sadness. Step five is the preparation of a plan of intervention into your thinking process. And step 6 swings you into action, both in dealing actively with your thinking processes and also in getting you off your depressed duff into a more active and pleasurable mode of life which helps counteract depression.

Six Steps in Fighting the Depression

Step 1): Find out which negative self-comparisons you are making, and in which ways you feel helpless to achieve what you think you must achieve.

As described in Chapter 10, you do this by writing them down as in Table 10-1. A therapist can help by urging or encouraging. If you have trouble stating the neg-comps, a therapist can use the tools of the clinical art to learn the content of the your consciousness--that is, what you think about while feeling sad.

Of course, this may require some probing. For example, you may immediately say that you are suffering because a beloved spouse has died. But instead, you may say (as many do) that you think poorly of yourself because you are depressed, in which case further inquiry is needed. This may lead to such negative self-comparisons as that you feel like a failure in your work, or you feel that your life has no meaning, or that you are guilty of dishonest conduct.

The particular negative self-comparisons you are making may not be of importance in themselves, and they may change over time. But inquiry into these self-comparisons can help you, or your counselor, trace the causes of your depression.

Notice how this first step requires observing yourself, and noting the thoughts that lie in your mind.

Concerning the sense of helplessness, notice your reactions when you contemplate your negative self-comparisons and ask yourself why you do not change your actual or hypothetical circumstances. Observe yourself saying that you cannot, must not, are unable to, are not allowed to, and so on -- all manifestations of feeling helpless to do anything about your condition, and therefore hopeless about improving your life and mood.

Step 2): Try to learn the causes of the negative self- comparisons, and of the helpless attitude.

By self-inquiry, or in discussion with a counselor, try to trace the causes of your making the negative self-comparisons. Perhaps you (and your counselor, if you have one) can figure out, for example, whether as a child you were frequently rebuked by your parents, whether you have work goals which seem very difficult for you to attain, whether you interpret your everyday experiences in a reasonably objective fashion, whether it is reasonable for you to feel unable to improve your circumstances, and so on. In this diagnostic state, the categories discussed in earlier chapters (and portrayed in the various boxes in Appendix A) may serve as guides to the inquiry.

A systematic attempt to diagnose the causes of the depression using these categories--or any categories---was not part of traditional psychoanalysis. Freudians have assumed that the therapist knows in advance what the cause is--childhood loss of a parent or of parental love. But I hope that by now you are persuaded that there are many, rather than just one, possible causal elements involved in depression.

Cognitive-behavioral therapists tend not to seek the original causes of a person's depression. And I agree that depression can often be cured without knowing the original causes, by focusing only on the present thought patterns. But sometimes learning the original cause illuminates the present situation. For example, when I realized that my over-demanding work goals stemmed from the ought's my mother urged on me, I immediately saw that I should not continue to enslave myself to them, and in that moment I gained a great sense of freedom which sent me on my way out of depression.

In this diagnostic stage you must use your entire store of wisdom, insight, and experience. Counselors have a store of experience that non-psychologists lack, and that is one way they can be helpful. Another way they can be helpful is to offer a less biased interpretation of events in the past and present than a person has himself.

Step 3): Check whether there are any "beneficial" aspects of depression which act as obstacles to letting go of your depression (see Chapter 9).

If there are--for example, the desire for the fruit of depression-causing overwork, or the pleasantness of self-pity-- then you must choose between staying depressed and giving up the benefits of depression.

If you discover such a benefit which presents an obstacle to the cure of your depression, you must be honest enough to acknowledge that you can't have it both ways; you can't have both the cure and the fruits of depression. With this acknowledgment may come some sensible compromises. In the case of the depressed adult who fears punishment for some actual deed, it may be possible to tackle the possibility of legal or moral punishment head-on to ascertain what (if any) punishment may really be warranted, and to get it over with if possible. In the case of overwork, understanding the obstacle to a cure may lead to a choice of work level that will be an optimal combination of work output and depression.

Giving up the state of depression, and fighting it off when it threatens to come back, has costs. I repeat this because it is important to understand that it is so. An important cost is the energy required to grapple with the depression, just as it takes work and energy to staunch the bleeding from a wound. It is often easier to let the blood flow, than to repair the wound-- that is, easier to let the negative self-comparisons course through one's mind than to examine them and either rebut or repress them.

Depressives are not skilled at staunching their mental bleeding--their negative self-comparisons. Everyone gets battered and cut in the world of people and work, but the depressive tends to let the bleeding go on and on. And it takes much work to change one's habits in this respect. But it must be done; it is the price that must be paid if you are to escape from depression. More about this in the next section.