That kind of depression where you just don't care. Have you been there? What helped?
December 13, 2012 8:47 AM Subscribe
That kind of depression where you just don't care. Have you been there? What helped?
First off, let me be clear: Not Suicidal (also: on medication and have a therapist). I'm talking about the kind of depression where:
-you feel like everything you're doing, treatment/recovery-wise, is because other people are telling you to do it.
-you don't do things you know would help, like exercise.
-you skip taking your medicine sometimes.
-you just don't feel ownership over your situation. You don't have initiative.
Have you been here? What helped? Thank you.
First off, let me be clear: Not Suicidal (also: on medication and have a therapist). I'm talking about the kind of depression where:
-you feel like everything you're doing, treatment/recovery-wise, is because other people are telling you to do it.
-you don't do things you know would help, like exercise.
-you skip taking your medicine sometimes.
-you just don't feel ownership over your situation. You don't have initiative.
Have you been here? What helped? Thank you.
Learned helplessness? Apathy? A bad case of fuck-it-all-osis?
All of these are parts of what's known as Major Depressive Disorder. Depression has mental and physical components, and the apathy, or flattening of emotions is actually a very common part of the chemical side of depression. Officially, if you're not miserable or experiencing physical symptoms like change in weight or sleep disturbance, the clinical name is "anhedonia", but what really matters is that you're having a bad time, and are frustrated about it.
You don't mention how long you've been on medication. Drugs definitely don't fix everything, but they can definitely help people to pick themselves up and do what they need to do - so I suggest discussing them with your doctor and getting her thoughts on the subject. SSRIs generally take at least a month before people notice a difference, but they have made a huge difference in several of my friends lives. I'd suggest talking to your doctor about how you feel, and asking what they think about possibly adjusting your medication. Also, I'm sure someone will mention it, but if you haven't had your thyroid checked, ask about that.
posted by DaveZ at 8:57 AM on December 13, 2012 [3 favorites]
All of these are parts of what's known as Major Depressive Disorder. Depression has mental and physical components, and the apathy, or flattening of emotions is actually a very common part of the chemical side of depression. Officially, if you're not miserable or experiencing physical symptoms like change in weight or sleep disturbance, the clinical name is "anhedonia", but what really matters is that you're having a bad time, and are frustrated about it.
You don't mention how long you've been on medication. Drugs definitely don't fix everything, but they can definitely help people to pick themselves up and do what they need to do - so I suggest discussing them with your doctor and getting her thoughts on the subject. SSRIs generally take at least a month before people notice a difference, but they have made a huge difference in several of my friends lives. I'd suggest talking to your doctor about how you feel, and asking what they think about possibly adjusting your medication. Also, I'm sure someone will mention it, but if you haven't had your thyroid checked, ask about that.
posted by DaveZ at 8:57 AM on December 13, 2012 [3 favorites]
Yes. Exactly. MeFi Mail me and I'll tell you what worked for me.
posted by RandlePatrickMcMurphy at 9:01 AM on December 13, 2012
posted by RandlePatrickMcMurphy at 9:01 AM on December 13, 2012
What worked for me was grabbing on to any little blip of encouragement or desire and holding onto it for as long as I could. Really really hard to begin with, but even something like taking a shower could lead me to having a shave. I had to get creative sometimes, with working out what could lead to what, but it slowly worked. I wasn't medicated, or under a therapist.
Attaching habits to existing habits also worked, to a certain extent. Attach taking your medication to your morning coffee, maybe. It's easier to do one thing when it's related to something else.
posted by Solomon at 9:04 AM on December 13, 2012 [2 favorites]
Attaching habits to existing habits also worked, to a certain extent. Attach taking your medication to your morning coffee, maybe. It's easier to do one thing when it's related to something else.
posted by Solomon at 9:04 AM on December 13, 2012 [2 favorites]
Yes, I have been there. What helped eventually was owning my depression and seeing it mentally as what it is. I had to really come in full glory of my depression and validate it. Once I started doing that, I started caring about me.
posted by InterestedInKnowing at 9:09 AM on December 13, 2012
posted by InterestedInKnowing at 9:09 AM on December 13, 2012
Vitamin B and Vitamin D. Sometimes these help give me that little boost to get over the apathy humps.
posted by picklesthezombie at 9:18 AM on December 13, 2012 [1 favorite]
posted by picklesthezombie at 9:18 AM on December 13, 2012 [1 favorite]
I guess acknowledging that it wasn't necessarily a matter of will, but a matter of brain-chemicals that were causing me to resist doing things to get better, made me get over the apathy to do things that were helpful.
One thing that really boosted my mood a few weeks ago was a local meetup, which I spent the entire day before trying to talk myself out of "because reasons" and going ended up really helping me.
Biking is another way I've been managing things, and it's is difficult to go out now that it's gotten cold, so I haven't gone in a week. I don't feel all that better immediately after a single ride so I'll often wonder what the point is, but I can tell that taking that week off has put me in an overall worse mood.
Basically, it feels like the depression is working against you to get better, so you have to kind of acknowledge that when trying to do things that will make a difference.
posted by hellojed at 9:28 AM on December 13, 2012 [1 favorite]
One thing that really boosted my mood a few weeks ago was a local meetup, which I spent the entire day before trying to talk myself out of "because reasons" and going ended up really helping me.
Biking is another way I've been managing things, and it's is difficult to go out now that it's gotten cold, so I haven't gone in a week. I don't feel all that better immediately after a single ride so I'll often wonder what the point is, but I can tell that taking that week off has put me in an overall worse mood.
Basically, it feels like the depression is working against you to get better, so you have to kind of acknowledge that when trying to do things that will make a difference.
posted by hellojed at 9:28 AM on December 13, 2012 [1 favorite]
This is a tough problem, and one I have dealt with for about the last 25 years. I don't mean to be, well, depressing, but it's a constant struggle and meds only go so far. I would make four recommendations:
posted by ubiquity at 9:28 AM on December 13, 2012 [2 favorites]
- Stick with the shrink, even if you don't think you're making progress. It's easy for depression to become a downward spiral without your noticing; you need the shrink to tell you when things are getting worse.
- Don't skip your meds. It's a pain, and the sides can be unpleasant, and sometimes you just wish you were a person who didn't need meds, but really, they work a lot better when taken as directed. Make it as easy as you can to take them. Put them on your pillow if you have to.
- Get someone else to help you exercise. What worked for me is paying a trainer; having paid for it in advance, I went to the sessions (and of course the trainer harassed me to do more, which helped). Or get an exercise buddy. Your shrink can suggest other strategies if these don't work, but the exercise helps with the depression directly, and it will help indirectly by helping your self-image.
- Make a list of what and who is important to you. If the answer really is nothing and nobody, you really are in serious trouble and you should be sure your shrink knows it. But it's probably not. If you can't do things for yourself, do them for other people. I try hard not to let my loved ones down. Staying alive, healthy and more or less human is part of that. For you it might be something else. But it's really important to understand what, outside yourself, might make things worth doing.
posted by ubiquity at 9:28 AM on December 13, 2012 [2 favorites]
Oh, and watch out for black and white thinking. Just because something won't solve the whole problem doesn't mean it might not be worthwhile to solve just part of the problem. And just because something won't solve the problem forever doesn't mean it might not solve it today. Good luck.
posted by ubiquity at 9:33 AM on December 13, 2012 [1 favorite]
posted by ubiquity at 9:33 AM on December 13, 2012 [1 favorite]
Best answer: Yes.
Anhedonia and motivational anhedonia are two (relatively) common terms for this sort of thing. You may like this article; I have a few more on my hard drive if you want to read even more of that stuff.
For me, what helps the most is consistently being in contact with motivational resources. For instance:
And lately I've been using SuperBetter. It's too early to tell whether that is working or not, but it is fun.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 9:37 AM on December 13, 2012 [8 favorites]
Anhedonia and motivational anhedonia are two (relatively) common terms for this sort of thing. You may like this article; I have a few more on my hard drive if you want to read even more of that stuff.
For me, what helps the most is consistently being in contact with motivational resources. For instance:
- NAMI support groups, DBSA support groups, Bipolar Bears support groups, etc. Also hanging out in places like the nearest clubhouse.
- Very regular therapy (every week.)
- Lots of alarms and timers and similar kinds of reminder things.
- To-do lists.
- Little posters all over my apartment that say things like "I can make good decisions even while I'm depressed" and "I contain multitudes."
- Monitoring my mood really closely and using very simple metrics. I like the PatientsLikeMe method: you just pick from great, good, neutral, bad, and terrible, basically.
- Having an arbitrary goal for something I "usually" like. For instance, deciding that I WILL watch all of the X-Files. ALL OF THEM.
- Having a bare handful of "musts" that I do every day. The one my therapist and I agreed to on Monday: getting away from my bed at 7:30am every day. I can go down and sleep on the couch, or whatever. But I MUST be away from my bed at 7:30am. I've done that successfully three days running, woohoo! Taking my pills every day on time is also a top priority.
And lately I've been using SuperBetter. It's too early to tell whether that is working or not, but it is fun.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 9:37 AM on December 13, 2012 [8 favorites]
Best answer: Yup. Been there, done that, saw the movie, bought the shirt.
For me, it was scheduling. I haven't ever been particularly good at seeking treatment when I'm depressed, and I have typically white-knuckled my way out of it. Or at least, I've white-knuckled my way into a situation where I can get help.
Scheduling, for me, takes the place of the actual drive to do the things I need to do, because that drive will never come. It is 8:15. And 8:15 is when I take my pill. *alarm sounds* Okay. I suppose because the alarm said I had to take my pill, I will take my pill. The fact is that there's never going to be a better reason to do something than "because it is what you have to do."
I found that hyper-detailed schedules were most helpful. Down to the 15 minutes. Bigger chunks of time are easier to look at and go "meh. I think I will sleep instead." Or whatever your depression vice of choice is.
I heard something last night that I wish I had known when I was depressed. The idea is that you HAVE to do three things every day that you don't WANT to do. For me, that would have reduced the need to "want" to do important things to Zero. And they'd still get done. Because, three things, every day, rain or shine.
posted by jph at 9:49 AM on December 13, 2012 [4 favorites]
For me, it was scheduling. I haven't ever been particularly good at seeking treatment when I'm depressed, and I have typically white-knuckled my way out of it. Or at least, I've white-knuckled my way into a situation where I can get help.
Scheduling, for me, takes the place of the actual drive to do the things I need to do, because that drive will never come. It is 8:15. And 8:15 is when I take my pill. *alarm sounds* Okay. I suppose because the alarm said I had to take my pill, I will take my pill. The fact is that there's never going to be a better reason to do something than "because it is what you have to do."
I found that hyper-detailed schedules were most helpful. Down to the 15 minutes. Bigger chunks of time are easier to look at and go "meh. I think I will sleep instead." Or whatever your depression vice of choice is.
I heard something last night that I wish I had known when I was depressed. The idea is that you HAVE to do three things every day that you don't WANT to do. For me, that would have reduced the need to "want" to do important things to Zero. And they'd still get done. Because, three things, every day, rain or shine.
posted by jph at 9:49 AM on December 13, 2012 [4 favorites]
I only recently realized I had depression several months ago, after seeing a therapist about some other issues. It was really tricky to identify too, since I'm an aggressive person and my depression manifests as caring less about other people (and thus is more damaging to others than to myself). Here are two things that really worked for me in terms of keeping it relatively in check.
A) Writing down five positive things from each day that I was happy about. (Do this at the end of each day.) They don't have to be big things, they can be small things. For example: talking to my mom, getting complimented at work, having women message me on OKcupid, getting invited to a holiday party, seeing a movie with my friend. The idea behind this is that the brain is flexible and can be trained to see things from different viewpoints. By racking your brains each day to find the positive side of your life, you are training it to think positively until that becomes second nature.
B) Writing down three goals every that you want to accomplish that day, and making sure you follow through. They don't have to be big goals either. For example: doing the laundry, cutting my nails, exercising. Another example: preparing several meals for the upcoming week, applying to a few jobs, calling an old friend. This trains you to make constant identifiable progress in your life.
posted by wolfdreams01 at 10:33 AM on December 13, 2012 [3 favorites]
A) Writing down five positive things from each day that I was happy about. (Do this at the end of each day.) They don't have to be big things, they can be small things. For example: talking to my mom, getting complimented at work, having women message me on OKcupid, getting invited to a holiday party, seeing a movie with my friend. The idea behind this is that the brain is flexible and can be trained to see things from different viewpoints. By racking your brains each day to find the positive side of your life, you are training it to think positively until that becomes second nature.
B) Writing down three goals every that you want to accomplish that day, and making sure you follow through. They don't have to be big goals either. For example: doing the laundry, cutting my nails, exercising. Another example: preparing several meals for the upcoming week, applying to a few jobs, calling an old friend. This trains you to make constant identifiable progress in your life.
posted by wolfdreams01 at 10:33 AM on December 13, 2012 [3 favorites]
Yep, I've been there.
Take your meds every day. If they're not working well, talk to your therapist about adjusting the dosage. If you can't remember if you've taken them, get one of those 7 compartment cases and load it up every week.
Do you like to dance? If so, put on your favorite music and move around. Dancing is exercise, and might be easier on you than running/biking/going to the gym/etc.
posted by luckynerd at 11:38 AM on December 13, 2012
Take your meds every day. If they're not working well, talk to your therapist about adjusting the dosage. If you can't remember if you've taken them, get one of those 7 compartment cases and load it up every week.
Do you like to dance? If so, put on your favorite music and move around. Dancing is exercise, and might be easier on you than running/biking/going to the gym/etc.
posted by luckynerd at 11:38 AM on December 13, 2012
When is the last time you fully expressed anger? Like, had an imaginary conversation (not necessary or even advisable to do this to an actual person) with someone where you were vocalizing - completely uncensored - everything that you were angry at them for? I think we do everything for a reason - constructive or unconstructive, our behaviors often have a sort of logic to them even when they aren't working for us. For example, it's possible that the urge to inaction - not taking your meds, not feeling like doing anything - can be a sort of protest, as though one feels that everything is being dictated/scripted by someone else, rather than coming from one's own desires. Try yelling at something - even the feeling itself - and then try telling yourself that it's okay to do what you want because you wanting to do it is its own justification, even if what you want to do is nothing. Just a thought.
posted by univac at 12:29 PM on December 13, 2012 [1 favorite]
posted by univac at 12:29 PM on December 13, 2012 [1 favorite]
Aside from the stuff about skipping meds, this has been my last couple of months too - I don't want to claim to understand your experience, but the frustration of going through the motions, nothing feeling good and everything seeming pointless is something I totally get. And it sucks.
I don't have any definite answers, but these are the things that have been helping me slowly pull out of it:
- Exercise. I know - I hate it, and I don't care about it, especially when I don't care about anything. I'm not talking about spending an hour in the gym every night or going to spin class or anything like that. But I changed my morning and evening routine, and now I walk 30 minutes to take a different bus to work each way. Getting outside and going somewhere purposeful is useful, and it also means that I'm getting as much daylight as is possible living at this latitude and working the hours I do.
- As much daylight as I can expose myself to (not a lot at this time of year and with my job, but whatever I can get).
- Taking my meds religiously even if it doesn't feel like they're doing anything, and talking to my doctor regularly about how that's going. I switched to a different drug just over a month ago, and the month before it had been rough and the month since then has been rough too, but I'm persevering. When I figured out I was only getting an hour or two of concentration at work the next day if I took it in the evening, I started taking it in the morning. When I felt like it wasn't working well enough, I spoke to my doctor about my options.
- Therapy once a week, also religiously. Even though it doesn't feel like it's doing anything for me right now and that I'm just treading water (I like to be able to do good work in therapy, but I'm learning to accept that that's not really feasible when I'm depressed). Using the therapy to talk about how I'm feeling.
- Total honesty about how I'm doing with both my therapist and my GP. I've never been very good at this, and it makes me feel really vulnerable, and it feels like there isn't any point to it when I'm feeling crappy, but giving them good information on where I am means they can do everything possible to help me.
- Talking to the people in my life (friends, boyfriend, family, etc.) about it. Not all day every day, but enough to let them know how I'm doing and to know that they know where I'm at if it starts getting worse or I need more support.
- Keeping a mood diary and recording the little fluctuations. This isn't something I've done before (it's part of the referral I got a couple of months ago to the local psych place to figure out if I'm actually bipolar), but it's pretty useful. I tend to paint all my down periods as uniformly bad in retrospect, but seeing the variation from day to day and also within days is useful. It's also helping me be more vigilant about figuring out how I'm actually feeling relative to how I've been feeling lately, beyond just, "I feel crappy, I've felt crappy for a long time, I'm never going to stop feeling crappy."
- Eating as close to well as I can manage, and sleeping as close to well as I can manage.
None of these are curatives, and depending on your situation they might not all be possible. There's also the immense frustration (which I've been dealing with a lot lately) of feeling like you're doing absolutely everything you're meant to and still not feeling any better. In the past, I've always had the mental get-out clause of, "well, I'm not in therapy and I'm not getting any exercise so no wonder I don't feel any better", whereas this time it's been a case of, "I am doing everything everyone tells you to do to fix this stuff and I still feel like balls". Which sucks.
There are no promises with this kind of thing, no quick fixes, no cures. But I'd recommend at least speaking to your doctor about your meds and trying to take them every day. Doing all the stuff you're meant to do treatment & recovery-wise just because you feel like you should or because other people are telling you to blows, but so does being depressed, and doing it for other people might not be the best reason but it's still a reason. If you can't do it for you, but you can do it, that's still a win. Especially if it starts helping eventually.
I really hope that this stuff starts sorting itself out for you soon, 'cause it's a sucky place to be stuck in. MeMail me at any point if you want to talk more (even just to complain about feeling bad).
posted by terretu at 2:18 AM on December 14, 2012
I don't have any definite answers, but these are the things that have been helping me slowly pull out of it:
- Exercise. I know - I hate it, and I don't care about it, especially when I don't care about anything. I'm not talking about spending an hour in the gym every night or going to spin class or anything like that. But I changed my morning and evening routine, and now I walk 30 minutes to take a different bus to work each way. Getting outside and going somewhere purposeful is useful, and it also means that I'm getting as much daylight as is possible living at this latitude and working the hours I do.
- As much daylight as I can expose myself to (not a lot at this time of year and with my job, but whatever I can get).
- Taking my meds religiously even if it doesn't feel like they're doing anything, and talking to my doctor regularly about how that's going. I switched to a different drug just over a month ago, and the month before it had been rough and the month since then has been rough too, but I'm persevering. When I figured out I was only getting an hour or two of concentration at work the next day if I took it in the evening, I started taking it in the morning. When I felt like it wasn't working well enough, I spoke to my doctor about my options.
- Therapy once a week, also religiously. Even though it doesn't feel like it's doing anything for me right now and that I'm just treading water (I like to be able to do good work in therapy, but I'm learning to accept that that's not really feasible when I'm depressed). Using the therapy to talk about how I'm feeling.
- Total honesty about how I'm doing with both my therapist and my GP. I've never been very good at this, and it makes me feel really vulnerable, and it feels like there isn't any point to it when I'm feeling crappy, but giving them good information on where I am means they can do everything possible to help me.
- Talking to the people in my life (friends, boyfriend, family, etc.) about it. Not all day every day, but enough to let them know how I'm doing and to know that they know where I'm at if it starts getting worse or I need more support.
- Keeping a mood diary and recording the little fluctuations. This isn't something I've done before (it's part of the referral I got a couple of months ago to the local psych place to figure out if I'm actually bipolar), but it's pretty useful. I tend to paint all my down periods as uniformly bad in retrospect, but seeing the variation from day to day and also within days is useful. It's also helping me be more vigilant about figuring out how I'm actually feeling relative to how I've been feeling lately, beyond just, "I feel crappy, I've felt crappy for a long time, I'm never going to stop feeling crappy."
- Eating as close to well as I can manage, and sleeping as close to well as I can manage.
None of these are curatives, and depending on your situation they might not all be possible. There's also the immense frustration (which I've been dealing with a lot lately) of feeling like you're doing absolutely everything you're meant to and still not feeling any better. In the past, I've always had the mental get-out clause of, "well, I'm not in therapy and I'm not getting any exercise so no wonder I don't feel any better", whereas this time it's been a case of, "I am doing everything everyone tells you to do to fix this stuff and I still feel like balls". Which sucks.
There are no promises with this kind of thing, no quick fixes, no cures. But I'd recommend at least speaking to your doctor about your meds and trying to take them every day. Doing all the stuff you're meant to do treatment & recovery-wise just because you feel like you should or because other people are telling you to blows, but so does being depressed, and doing it for other people might not be the best reason but it's still a reason. If you can't do it for you, but you can do it, that's still a win. Especially if it starts helping eventually.
I really hope that this stuff starts sorting itself out for you soon, 'cause it's a sucky place to be stuck in. MeMail me at any point if you want to talk more (even just to complain about feeling bad).
posted by terretu at 2:18 AM on December 14, 2012
This thread is closed to new comments.
posted by griphus at 8:54 AM on December 13, 2012 [7 favorites]