Falling in love
Financial difficulties
Loneliness
Negative thoughts or daydreams floating through your mind
An unexpected promotion
Wonderful (or lousy!) weather
Work hassles
John suspects that he may have a problem, so he tracks his mood and finds a few interesting patterns. For an example of one week in John’s mood diary, look at Table 2-2.
Table 2-2 John’s Weekly Mood Diary
Day
Mood Rating
Notes (Events or Thoughts)
Sunday
20
Not a good day. I just hung around and worried about getting my tax return in for the deadline. And I felt horribly guilty about not finishing off the last bits of the decorating.
Monday
30 (a.m.)
45 (p.m.)
The day started miserably. I got stuck in traffic and was late for work. In the afternoon, things seemed to go more smoothly, though I can’t say I felt brilliant.
Tuesday
40
Nothing good, nothing bad today. Just the usual blah blah blah.
Wednesday
30 (a.m.)
40 (p.m.)
I woke up panicking about the new project deadline. I don’t know how I’ll ever get it done. By the afternoon I’d made a little progress, but I still worry about it.
Thursday
35 (a.m.)
45 (p.m.)
I was thinking about how the days just seem to drag by. I don’t look forward to much. To my surprise, in the evening I did enjoy a phone conversation with a friend.
Friday
50
Somehow, by a miracle, I completed the project four hours early. My boss was really impressed with my work – said it was the best yet. But I bet he doesn’t think much of the rest of my work.
Saturday
40
Finally got the decorating finished. That felt good, but then I had all this time on my hands and started to worry again.
Coping with grief when a child dies
The loss of a child may be the most profound loss that anyone ever experiences. The grief following a child’s death is thought to be more intense, more complicated, and longer lasting than other profound losses. The anguish and loneliness may seem utterly intolerable. Parents may question the value of living. Others who haven’t had such a loss may be sympathetic, but they sometimes fail to understand and appreciate the intensity and duration of this type of grief.
We suggest that parents who have lost a child consider contacting a support group such as The Compassionate Friends (www.tcf.org.uk). This group helps bereaved parents and siblings deal with their loss in a supportive environment.
John goes through several weeks of mood diaries. He notices that he usually feels down and miserable on Sunday afternoons. He realises that on Sundays he typically spends time alone and mulls over anticipated difficulties for the next week. He also discovers that mornings aren’t exactly the best time of the day, because he worries about the rest of the day. Interestingly, his worries often involve catastrophic predictions (like not meeting deadlines) that rarely come true. Finally, he sees that his mood improves when he tackles projects he’s been putting off, like completing the decorating.
You can track your progress whether you’re working on your own or with a professional. If you get bogged down, please seek help or discuss the problem with your therapist.
Chapter 3
Breaking Barriers to Change
In This Chapter
Discovering surprising obstacles to recovery
Finding out what people do to avoid change
Getting round, over, under, or through the obstacles
In this chapter, we explain why the prospect of change is so intimidating – and the lengths that some people go to avoid facing up to the illness. We show you the reasoning behind the fears that feed procrastination, hopelessness, avoidance, and other self-limiting strategies. And we discuss how certain beliefs, myths, and misconceptions can paralyse your ability to feel better. But most importantly, we show you how to find out which of these problems are blocking your path to progress, and what you can do to overcome them.
Alex has been feeling moderately depressed for the past two years. She reluctantly tried medication for a short time, but didn’t like the side effects. She’s sure therapy would be an exhausting, long process. She bought a self-help book, but it’s sitting on her desk collecting dust. She feels guilty about not reading it, but is convinced no book can possibly help her – no one else can understand her experiences. She sees her situation as hopelessly inescapable.
Alex work as a nurse, and over the years she’s seen many depressed patients benefit from self-help, medication, and therapy. Yet Alex still feels stuck and unable to tackle her depression.
Because she’s fully aware that effective treatments exist, you may wonder whether Alex actually wants to remain depressed. Nothing is further from the truth. Nobody – and we mean nobody – prefers depression to normal moods.
Then why does Alex avoid tackling her depression? She does so for some very common reasons. Indeed, most people with depression are initially slow to start working on overcoming their depression. And when they do tackle it, they frequently slip back into inaction for varying periods of time.
Untying the Knots: Revealing Reasons for Avoidance
At first glance, it may seem strange that you’d avoid searching for a way out if you suffer from depression. Given how horrible being depressed feels, who’d want to stay in this state? But if you do find yourself backpedalling and procrastinating when you think about trying to challenge your depression, it’s for good reasons. Fear of change, change-blocking beliefs, and myths commonly underlie failure to take action against depression. You’ll discover that reasons for avoidance make far more sense than you may think.
Facing the fear of change
Fear is the key factor underlying inaction and avoidance. We can understand why you may feel both scared and hopeless about working on your depression, and procrastinating about doing anything. But is beating yourself up for avoiding the task of getting your depression under control helpful? Of course not, you’re experiencing a normal, human fear of change. This doesn’t mean, however, that it’s quite okay for your fear to keep you out of the fray on the sidelines, feeling hopeless and avoiding the scariness of change?
In the following sections, we tell you about the two most common types of fear that may be stopping you from taking action.
Fearing more losses
If you have significant depression, you have no doubt experienced profound losses of various types. Such losses may include:
Belief in positive possibilities
Relationships
Security
Self-esteem
Status
You understandably fear more loss, and find your mind inevitably overestimating the difficulty of making changes and underestimating your ability to succeed. The fear of hope itself is a big obstacle, because you assume that dashed hopes are far worse than no hope at all. Perhaps you, like many who are depressed, believe that:
If you look for friendship, you’re likely to be rejected . . . again.
If you find a new job, you’ll make a mess of it.
If you take a chance, you’re sure to fail and be humiliated.
If you work on your problems, your efforts may be useless.
If you dare hope, your hopes are going to be shattered making you feel even worse.
If these beliefs apply to you, it’s no wonder that you’re avoiding the challenge of change. The fear of additional losses or failures is no trivial matter. It’s so easy to decide that not trying at all is better than trying and failing. Your depressed mind tells you that making no attempt at least preserves a small amount of self-esteem. On the other hand, you fear that working hard to improve, and then failing, means that you sink even further into
the abyss of the ‘ins’ wherein dwell incompetence, ineffectiveness, incapability, insufficiency, inferiority, and even – strange as it may sound – incongruity.
Avoiding incongruity
The experience of incongruity is another factor that frequently holds back attempts at recovery. That sounds a bit strange, doesn’t it? Psychologists have known for decades that people look for consistency in their behaviours and beliefs. When things are congruent, all the pieces fit together as part of a whole, and this simplifies the world. Congruity also makes life feel more predictable.
The preference for congruence can feed the depression. If you’re depressed, you’re probably discount any positive evidence about you or your world. You may dismiss it, because it contradicts your deep-seated negative view of yourself.
Measuring moods
Two interesting experiments comparing people who did and did not have a low mood have highlighted this. In one experiment, the two groups were shown the same ambiguous picture for a fraction of a section. In the other experiment, both groups were played two simultaneous lists of words, one into their left and one into their right ear.
There was a difference between what the two groups both saw, heard, and remembered. Those with a low mood saw a sad event in the ambiguous picture, and heard and remembered more of the list of negative words. People who had a normal mood did the opposite – seeing celebratory events in the ambiguous picture, and hearing and remembering words from the positive list.
Maintaining stability: Homeostasis
Our bodies try to maintain a consistent, stable state – a process known as homeostasis. When significant fluctuations occur in temperature, hormone levels, fluids, and so on, the body generally tries to reestablish the proper level. Homeostasis may well operate at all levels, from the cellular level to the psychological level, and even interpersonally, in social situations.
The work of Clinical Psychologist Professor Mark Williams and colleagues in Oxford has thrown a very interesting light on these links. Once a person has recovered from an episode of depression, relatively small amounts of negative mood can trigger large numbers of negative thoughts (e.g. ‘I am a failure/weak/worthless) along with bodily sensations of weakness, fatigue, or unexplained pain. Both the negative thoughts and the fatigue often seem out of proportion to the situation. People who believed they’d recovered may feel ‘back to square one’. Their thinking loops endlessly through such questions as ‘What has gone wrong?’ ‘Why is this happening to me?’ ‘Where will it all end?’ It feels constructive, as if going over such circular, or ruminative thoughts should help them find an answer. But in reality, it all only succeeds in prolonging and deepening the mood disturbance.
Why do people remain vulnerable to relapse? During an episode of depression, negative mood occurs alongside negative thinking and bodily sensations of sluggishness and fatigue. When the episode is past, and the mood has returned to normal, the negative thinking and body sensations tend to disappear as well. However, during the episode an association has been learned, and a link set up, between the various symptoms. This means that when negative mood happens again (for any reason), it will tend to trigger all the other symptoms in proportion to the strength of association. When this happens, the old habits of negative thinking will start up again, negative thinking gets into the same rut, and a full-blown episode of depression may be the result.
The discovery that even when people feel well, the link between negative moods and negative thoughts remains ready to be re-activated is of enormous importance. It means that sustaining recovery from depression depends on learning how to keep mild states of depression from spiralling out of control. This is one of our key aims – to enable you to develop your abilities and skills to do just that. We also believe that you can then start gaining the confidence to believe you will be successful in the future too, based on your new successful experiences.
Although you certainly don’t like being depressed, up until now it’s probably felt familiar and predictable, while happiness and fulfilment probably sound anything but! Staying stuck in depression’s pretty painful, but at least you feel as though you have a little more control, and know what to expect – even it is very little!
We have written this book because we believe wholeheartedly that you can change the state you are in and overcome your depression. Each chapter’s packed with techniques and exercises for doing just that.
Identifying change-blocking beliefs
People who are suffering from depression usually have a number of deep-seated beliefs that support and sustain their low mood, and fuel the fears of change. When you’re not depressed, the beliefs lurk in the background, and usually don’t interfere with your life. But when depression takes hold, the limiting beliefs come to the fore, sabotaging your attempts at recovery.
Change-blocking beliefs are the thoughts and negative expectations you have about yourself and the world that make change seem impossible. Even though you may have first become depressed many years after childhood, these beliefs often stem back to your early years. Exploring the childhood roots of your change-blocking beliefs can help you discover where your beliefs come from, and how these beliefs have more to do with a child’s interpretation of events than with everyday reality.
Occasionally, change-blocking beliefs have roots in adulthood. Usually, traumatic events or chronic, repeated occurrences are responsible for these beliefs surfacing in later life. Change-blocking beliefs developed in adulthood can be dealt with in much the same way as the more common, change-blocking beliefs that originate in childhood.
The following sections describe what the most common change-blocking beliefs. We describe each one and give you some tools to deal with them. Then, in the ‘Analysing your findings’ section, we give you an exercise allowing you to challenge any or all these beliefs if they ever dare try getting in your way.
You may be able to think of additional change-blocking beliefs to the ones we list. For example, in Chapter 7 we discuss the core beliefs that often intensify depression and hinder your attempts to get better. Any of your core beliefs may also be change-blocking beliefs. Carefully review each of the beliefs we list to see if they’re making you want to avoid, procrastinate, or see your situation as hopeless. After you’ve worked on this list, you may also find it useful to review and work on the beliefs in Chapter 7.
Dealing with dependency and inadequacy
Unfortunately, feelings of dependency and inadequacy are very common in people who have depression. If you feel dependent, you probably believe that someone other than yourself must cure your depression. And if you think of yourself as inadequate, you probably feel incapable of doing anything for yourself.
Believing in your feelings of dependency or inadequacy, you quickly stop taking risks. These change-blocking beliefs make taking risks (like working on your depression and risking failure) seem particularly scary. You feel extremely reluctant, if not totally unable, to independently tackle difficult, challenging tasks.
Dependency and inadequacy beliefs usually accompany such thoughts as:
Whatever I try, I make a mess of it.
I can’t do this without a lot of help.
I need help, but no one can help me enough.
I don’t want to take this risk; I know I’m going to fail and then feel worse than ever.
I’m just not strong enough to do this.
The dependency and inadequacy beliefs, and the related thoughts can paralyse you and stop you taking action. And the belief fuels the fear of change because of the assumption that failure is inevitable.
After Donald’s father dies when Donald is only 5 years old, his mother becomes increasingly close to him. As a result, she can’t bear to see him trying to deal with pain or frustration. If he cries or even whimpers, she rushes to give him comfort. If Donald wants sweets or an ice-cream, she gives them to him – anything to make sure he doesn’t get upset. Later, when he’s stuck with his homework, she does it for him. Altho
ugh she has the very best of intentions, she inadvertently fosters the development of Donald’s dependency and inadequacy beliefs.
Overcoming Depression For Dummies Page 8