by Robert Duff
I hope you can see the parallel to your own thinking patterns here as well. Just like the annoying party guest, you are not pretending that those thoughts and feelings do not exist. You are simply deciding to not let them run the show. You are acknowledging that they are there and then bringing your attention back to your ongoing party. In a certain way, that acknowledgment that they do exist helps to take away some of their ability to derail you. This shift of perspective that I have been describing is typically referred to as mindfulness- a term that has been a huge buzzword in the field of mental health for some time now. The reason it has become such a popular concept is that it seems to suggest a very different approach from the more cognitive based approaches, which try to help you actively fight back against your thoughts. In my opinion cognitive approaches and mindfulness actually play really well together. I think that you 100% need to fight back against the depressive mindset, but you also need to get better at sitting with the thoughts and feelings that you do have and recognize that they are not always so threatening. Let me explain mindfulness in another way.
So clouds, right? They are awesome. You can lay on your back and look up at them and see all kinds of things. Some of them are big and fluffy, like they would make an awesome bed to go take a nap on. Some of them are kinda gross and unhealthy looking. Maybe some of them remind of you different animals (I always seem to see dragons). Obviously, each of these different interpretations (comfy bed, gross darkness, awesome dragon) brings about different feelings as they pass into your awareness. Here’s the thing, though. They are all made of the same stuff. They are just water vapor up in the air. That’s it. And if we keep lying there and looking up, we can notice that the clouds will drift into our awareness, and if we allow ourselves to not fixate on them, they gently float past as well. I think of our thoughts as being just like these clouds. Some of them are happy thoughts, some of them are worrisome, perhaps some are even a bit scary. They are just thoughts though. We may have our own different interpretations of them and we like to apply labels like “good” and “bad” to them, but in the end they are just thoughts.
Often, we get stuck on thoughts and get into these huge, annoying battles with them. If instead, we take a moment to acknowledge them, just like those clouds up in the sky, they will continue to drift through our awareness at the same pace as any other thought we might have. As humans, we have a tendency to engage in something called “fusion”, where we fuse our thoughts and our behaviors together. We saw a bit of this in the motivation chapter. I feel like a bum, therefore I can’t get anything done today. In reality, you can feel any sort of way and also act in whatever way you would like. It’s not being ungenuine or lying to yourself. It’s about allowing your thoughts, emotions, and other private internal experiences to exist and not necessarily dictate all of the actions that you take. The mindful approach really helps us to move forward in our quest to eliminate depression, or rather to reduce the impact that we allow depression to have on us.
The thing about mindfulness is that it definitely takes some practice. It’s not a difficult concept to understand, but sometimes putting it into practice is a different story. Don’t worry. I got you covered. I have a simple exercise that you can do to start training yourself to be more mindful and less judgmental about your own thoughts and internal experiences. When I say training, I mean it. Think of this as a skill that you can get better and better at. So, the exercise itself is a simple breathing exercise. It is a bit different than some of the breathing exercises you have probably encountered before. Many of those are designed to put you into a state of relaxation or to relieve stress. It’s possible that this exercise could have that effect on you, but that’s not really the point. Okay. Okay. Let me just explain the damn thing.
You already have a head start in this mindful breathing exercise, because step 1 is to breathe. That’s it. Just breathe. If step 1 is a problem for you… you might want to make sure that you aren’t actually a ghost. The cool thing about this is you don’t have to do any particular sort of breathing. You don’t need to change anything. I just want you to draw your attention to your breathing. Notice your breath. Pick a place in your body that you can really feel that breath. This can be different each time. Just notice where you can feel it in your body in this moment. Maybe it is the rise and fall of your belly. Maybe it is the expanding and contracting of your chest. Maybe it is the cool air rushing into your nose and the warm air flowing out of your mouth. Like I said, just notice the place that your breath is apparent to you right now.
Now, being human (presumably), in a few seconds your mind is going to start to wander. You will realize that you are no longer focusing on the physical sensations of your breath, and instead you are thinking about what you are going to do in an hour, trying to remember if you forgot something important, feeling emo over a recent break up, or getting angry because that damn commercial jingle is still stuck in your head after 4 days straight. That’s great! You are supposed to get distracted. That’s where the training part comes in.
When the spotlight of your attention leaves your breath and instead shines on some other thought or feeling, I don’t want you to try to force it out of your head. Instead, allow it to sit in the spotlight for a moment, and give it a few seconds of acknowledgment. Allow yourself to identify what the thought or feeling is. Once you’ve given it a moment in the spotlight, gently redirect that spotlight of attention back to your breath. And that’s it! It’s seriously so simple. Don’t get frustrated when you find yourself moving your attention away from your breath very frequently at first. Be excited about it. Every time you get distracted by some thought or feeling, it is another chance to practice this attentional shift.
I seriously love this exercise. It’s beautifully simple. At first it is SO hard, though. Your distractions per minute will be too damn high. Keep practicing it! I know it might be hard to understand the usefulness of paying A LOT of attention to your breathing. The secret is, it’s not about breathing at all. It’s about becoming better and better at noticing your thoughts and feelings and not letting them derail you. It’s about growing in your ability to intentionally shift your attention back to the thing that you are focusing on. If we are continuing the spotlight metaphor, imagine that you are making a transition from a newbie spotlight operator to a seasoned theater veteran who can shift that light to any subject at a moment’s notice. You don’t necessarily need to have intruding thoughts or feelings any less. You can just become better and more efficient at quickly shaking hands with your distractions and then redirecting your attention back to the matter at hand. I have given this exercise to probably 90% of my psychotherapy clients, and many of them have come back to me and expressed how liberating it is to be able to practice something that allows them to not get so thrown off track by the thoughts in their mind. Hopefully over time, you will be able to achieve the same sort of success with this technique. You will have that damn nagging thought in the back of your mind that you have ruined things beyond repair, AND you will be able to quickly switch your attention back to taking those actions that will help you move forward in your quest.
Speaking of moving forward in your quest… you deserve it. You deserve to move onward and upward. Another stumbling block that has been expressed to me by many people is the feeling that moving on or letting go would somehow be wrong, because it would imply that you are pretending like all the shit that happened in the past didn’t actually happen. What an impossible situation. No wonder you feel hopeless! You can’t move on from the past, and you also can’t handle living with the past every day? That sucks. I think people frequently come up against this challenge when they have hit a crisis point. It can be really hard to move on from the weight of the past when you’re telling yourself that so many of the things that you did or didn’t do during that time contributed to the crisis that you find yourself in right now. It’s a nasty negative feedback loop of guilt. You feel bad for getting in this situation and the guilt makes
it hard to get out of the situation. Furthermore, sometimes at a certain level you feel that you even deserve to be in this situation due to those actions or inactions. I have a strategy that can be useful for this incredibly frustrating scenario.
Have you ever heard the term “emotional bankruptcy?” I’ve heard it a few times before in different contexts. Usually when people use it, they refer to the state of being nearly void of emotions due to having been hurt too many times. Someone who is an empty shell of their previous emotional self.
I think of it in a very different way. I think of emotional bankruptcy as a viable option for allowing you to cut your losses and move forward with your life, even though you have built up a great deal of baggage in the form of guilt and other emotions. In the world of finances, bankruptcy is there as an option that is available when you accumulate more debt than you can reasonably manage. Basically, the government agrees to absolve your debt, with some repercussions. It’s not just a blank slate. You still take a hit and have some negative consequences that will definitely remind you that you let things get out of hand. The great thing about it is that it also allows you to move on. It may not be a blank slate, but it’s an opportunity for a new start. In my weird little brain, I think it can be extremely useful for some people who are experiencing depression to declare emotional bankruptcy.
This technique is helpful for those of you who just feel SO burdened by the past that you can’t even begin to move forward. Like I mentioned above, we can sometimes feel crushed under the weight of our own guilt. How fucked up is that? We are trying to move forward, and the fact that we haven’t been able to move forward until this point is the very thing keeping us feeling guilty and preventing us from moving forward at all. If this applies to you, I want you to consider declaring emotional bankruptcy. You can’t ever deny all of the things that have lead you to this point, but it is absolutely certain that you won’t be able to improve if they are constantly overwhelming you. I hereby absolve you of your emotional debt. You don’t have to find a way to mentally reconcile every single action or inaction. I know you try. As if there were some way to think about it long enough to figure out a way to feel less shitty about it. OR you might be the type to just replay scenarios in your head over and over, as a sort of self-flagellation, because, in your mind, you deserve exactly what has happened. I call bullshit. The past is not the present. Yes, it has influenced what you are going through, but if you let it stay in the past, it will stop hurting you so badly in the present.
This is not a perfect solution. In a perfect world, you would never have to deal with this crap. I wish that were the case. Second best is to move forward from it and work on crafting a life that works for you and not against you. That doesn’t mean that you are dodging responsibility for your mistakes. In some ways, you are finally giving yourself the chance to stand up to them, acknowledge your part, and then do the responsible thing of trying to better yourself by moving forward for the sake of you and everyone around you.
You owe it to yourself to move forward. Imagine the advice that you might give to a friend in a similar situation. I’m sure that you would be WAY more gracious with them. You would tell them that it sucks that things have gotten all fucked up AND you know they can get through it if they leave the past in the past. Extend that same grace to yourself. You deserve it just as much as anyone else. Imagine everything that has happened so far will be a really crazy story to tell someone over a beer one day. You WILL look back on this as a learning experience. Let’s stop being such a jerk to you so we can get you closer to that point of looking back in the rearview mirror at all of this. You don’t need to keep all of your mistakes or all of the pain that others have caused you right in the forefront of your mind. It’s nothing that you aren’t already aware of. Let it fade into the background while you continue to focus on the stuff that you DO have control over. You got this.
That whole looking back scenario can also serve as the basis for another helpful activity. Imagine sitting with a friend over a beer, coffee, or whatever equivalent situation comes to mind. Picture yourself in the future. Don’t be particular about the details. It’s just been enough time for this difficult period to be a memory that you can reflect on. As you sit there with your friend, you tell the story of all of the crazy shit that happened and how it all contributed to you feeling really upset, sad, and hopeless. This is a story of triumph, though. You also tell them about how you were able to overcome some of your personal demons and the roadblocks that were keeping you at a standstill. You tell them about the lessons you learned along the way. Don’t be shy about dropping some knowledge on this friend. You learned these lessons the hard way. I encourage you to get out a piece of paper and actually write this narrative down, or even speak it out loud to the voice memo thingy on your phone as if you were literally talking to that friend.
There is actually some magic to this technique. Writing from this future perspective is great, because it forces you to automatically adopt the assumption that you are capable of getting through the muck that you currently find yourself knee-deep in. You can upload some of the burden onto the pages of your journal and relieve a few pounds of that heavy pack you carry all of your worries and regrets in. Like before, I don’t want you to think for one second that I am asking you to be blindly optimistic. I don’t roll like that. Essentially, this is a visualization exercise, and visualization exercises seem to be much more effective when we are realistic. Don’t imagine that you are suddenly a superhero with thick skin that is impervious to the stupid offhand comments that gnaw at your self-confidence. Don’t imagine that you one day found all of the motivation in the world to complete every single project you had previously abandoned. Instead, imagine yourself struggling. That’s right. Imagine that you had to put up the fight of your life against this crap, but you did it. You got through it one way or another. Visualize yourself putting in the work and learning all of the lessons that come along with enrolling in the School of Hardknocks. I’m talking Rocky-style montages of getting your ass kicked over and over while you learn the best ways to rise above each setback. In the end, you get to look back on this period of progress and shake your head at how fucking wild it was. Maybe you can even laugh a little bit at how it simultaneously feels so far away and like it was just yesterday that you were having such a hard time. Emotionally, it feels miles away. That is a great feeling to have. You will get there. I mean it.
Ch. 6 Let’s Get Physical
Depression is a sneaky little asshole. One aspect of depression that is vitally important to understand is that it is not always what it seems. If you are feeling very surprised by the symptoms that you are having, especially if the pieces don’t seem to add up, you might be experiencing depression caused by some other primary issue. Unfortunately, there are a ton of things that can mimic depression by causing symptoms that are very similar or identical.
In a differential diagnosis, which is something that you need to leave to us professionals (we need jobs too), it is always important to consider the possibility that the depressive symptoms are better explained by some other factor. This does NOT mean that the strategies and advice in this book will not be helpful for you. I just want to make sure that you aren’t off relentlessly pursuing a false trail while you investigate the source of why you are feeling so poorly. There are really a ton of potential sources for your depressive symptoms that could be right under your nose. I won’t be able to cover all of them here, but I want to give you some of the categories and specific issues that I have most often come across during my professional work as a psychologist. Let me please reiterate that this is not an exhaustive list and you should ask your doctor about any and all potential sources of your depressive symptoms.
The first thing to mention on this list is medication. Medication is awesome. It can help you with so many different medical issues, including depression. However, as we say in the biz, there is no such thing as a biochemical free lunch. In other words, we haven’t
found a way to eradicate all medication side effects yet. Aside from weight gain and sexual dysfunction, one of the most annoying side effects is … you guessed it: depression. Some of the medications that can cause depression are pretty intuitive. For instance, anticonvulsant medications, which are the type of medications that you use to treat seizure disorders, can definitely have depression as a side effect. When you think about what it would take to prevent seizures, it makes a lot of sense. You are basically trying to bring your nervous system down a few notches so that you stop having electrical storms going off in your brain. When you try to slow down the activity in your brain, a side effect is sometimes feeling slowed down in other ways, which can look a whole lot like depression. Many other medications such as Accutane for acne, blood pressure medications, and contraceptives can also have depressive symptoms among their potential side effects.
Don’t let this freak you out and make you stop taking all of your medications. Actually, definitely don’t do that before you check with your doctor. It’s important to realize that just because a medication has depression as a potential side effect, that doesn’t automatically mean that it’s the culprit. Side effects are listed in a pretty conservative manner. Basically, the drug companies want to make sure their asses are covered, so if a certain number of people report a given side effect during the research trials, they include it as a potential side effect (just so you can’t say they didn’t warn you). This means that side effects, like depressive symptoms, are not always present when taking a given medication. The important thing here is to go to your doctor and rule it out. (I need to repeat myself here because I know that I am speaking to the WebMD self-diagnosis generation. Don’t just decide to go off of a medication on your own because you read that depressive symptoms might be a side effect for some people. Work through the process with your medical doctor. Ruling out medication side effects is absolutely a vital part of any good differential diagnosis for depression, but it needs to be done carefully. One good aspect of living in an age of oversaturation when it comes to pharmaceuticals is that there are often many different options for any given medical issue. Your doctor might switch your blood pressure or anticonvulsant medication to one of a different variety. After that point, if your depression persists, you have more data that supports the hypothesis of that depression being due issues other than medication.)