Actionable, practical strategies to get out of a prolonged depression.

January 13, 2015 1:22 PM

I've tried meds and therapy (separately and combined), and nothing is working. I've gone through a divorce and a relocation in a new city at the age of 43 and am having incredible difficulty making new friends and restarting my career. I'm beginning to lose hope that I'll ever get out of this spiral.

I go to bed and wake up with thinking about all that I've lost. The loneliness is crushing and I seem completely incapable of performing even the most basic of tasks - laundry, bill paying, hygiene etc. There are days when I hurt, physiologically. I've yet to "lose it" or even cry - though I wish I could sometimes.

I am completely estranged from my family and none of the friends I've made in the past 10 years are in contact - despite attempts to reconnect. My efforts to get out and meet people in bars (how I've always met people in the past) only serve to remind me of how disconnected I am/feel. The idea of starting over in a new city seems unrealistic as, to quote that annoying aphorism from the '70s - Wherever you go, there you are. What are some practical strategies I can employ to get unstuck? (Exerise has, unsurprisingly, been in fits and starts over the past few months.)

posted by wensink to Human Relations (19 answers total)

You have been and are going through a tremendous period of change. There are many parts of your life that are new, different, and that unfamiliarity can be terrifying. I would start by ensuring that you have the basics down. You need a routine, and you need to focus first on doing that routine. You don't mention whether or not you have a job, but I'll assume you do right now.

For you, your routine should be simple. Get up at a regular time, a time that gets you to work on time after you shower. Work through the day to the best of your ability. Exercise at least three times a day. Not because exercise will help with your mood (though it can as I'm sure you know), but because that is what you do on those days. I work out every weekday morning, and I'm not a person that gets an endorphin high from exercise. Nor do I like it. I do it because that's what I do.

Prepare meals for work, don't eat out. Find some habits to start. Keep to them as best you can.

This is a really difficult time, and you have to forgive yourself and believe that it can get better. Because it can get better. But you don't want to let yourself go (in the hygiene, mental, or metaphysical sense), because then people will be wary of spending time with you. I use Habit RPG as a simple task tracker. It's effective for me because I know that gamification is massively effective for me (I use Fitocracy to track my exercise. Many an early morning when the only thing that gets me to the gym is the thought that I need to level up in Fitocracy).

So start a routine, because that's the framework upon which you can use to support yourself. It's hard to stand up right now, lean on the routine. You're in a period of grieving and that's okay. You're going to grieve and there is nothing wrong with that. So while it's hard to stand, use the routine. Eventually you'll find joy in doing the things that you need to do as a functioning adult (pay your bills, basic hygiene), but in the meantime do them because that's what the routine demands (and in my case so that my little Habit RPG avatar doesn't die).

Stick with the meds and/or therapy. It can take a while for either to work, it can take a while to get the right kind (of both). Don't be afraid to talk to your doctor(s) about it, don't be afraid to switch doctors if you don't feel like they are helping you. Different meds and different therapies work better for different people. For me personally, medication and therapy never made me happy. What they did is they kept me from despondency, from the black hole of utter depression. They gave me the space to stand up on my own, and I built the routines and life that made me happy.

You feel like you are in a spiral, and I've been there. You feel depressed and that makes you feel depressed. For me, what I found worked is focusing less on my feelings and more on the mechanics of what needed to be done. Again, I wasn't exercising because of enjoyment, but because it's what I did. The results of all that eventually led to better moods, but it was a process. Focus on that process, step after step, bit after bit.

I wish you the best of luck.
posted by X-Himy at 1:38 PM on January 13, 2015 [5 favorites]

Response by poster: Thanks very much, X. I sort of have a job - a freelance client, which means I am working from my tiny apartment. Unfortunately for me, my career has been in digital marketing which requires a good amount of self-confidence/comfort in one's skin. Focus, concentration, discipline are major issues for me right now. And a complete lack of affirmation in my day-to-day. I've taken to building up a Twitter feed just so I can feel some degree of community and see results from my efforts. It's a major distraction as that time could be better served working for my client.
posted by wensink at 2:09 PM on January 13, 2015

The most god awful thing about depression is it feels so .. accurate.. like everything really is and always will be that shit. Until like a few days ago I had been feeling like hell.. and now weirdly I feel ok. So don't 'mistake your current context for your permanent truth'.
A film that gave me a good cathartic cry was a 'single man'.. YMMV.

Maybe go for long grade contact with people just now and shore up self care - make your bed cosy and eat well, stroke an animal. Don't look at the mountain - baby steps are fine. One day at a time. The trick is to keep breathing and putting one foot in front of the other. Things do change, just sometimes not fast enough. Hold on though.
posted by tanktop at 2:26 PM on January 13, 2015 [7 favorites]

Here are two things that have helped me during low points:

1. "I do not accept this." Start here. Take a look around you and look at your feelings and your sadness and the way you feel, and make the definitive statement that you do not accept a state of depression. It will not fix everything but it is a start. Decide that you do not accept it and that you will not stop trying to get better until you are better. No matter what, there will always be at least one person on your side, and that person is you.

2. Every day, do one thing that makes your life better in some measurable way. It doesn't matter what that thing is. It doesn't matter how big or how small. What matters is that you do one thing every day (including weekends) that makes your life better. Pay your bills, or just one if that's all you can manage. Get your hair cut. Do the dishes. Something with a visible result that makes your life better. Once you've done your one thing for the day, you can do whatever the hell else you want - spend the night watching Netflix under a blanket or whatever. But do the one thing every day.

Won't fix everything but it'll help.
posted by FAMOUS MONSTER at 2:27 PM on January 13, 2015 [8 favorites]

You've made big life changes recently and are still grieving the loss of your former life. That's okay, just be kind to yourself. It's hard to feel alone on top of everything.

To make progress on meeting people and moving forward, choose steps that are simple, easy, and that you know you can succeed at - it'll help start to build your confidence again.

Instead of bars, check out meetup.com and Facebook for local groups near your current location. There are likely activities that are free or cheap, and you don't have to go a second time if you don't enjoy it. Choose X times per week to get out and do something; start with once a week or so as a reasonable goal.

When you go to the grocery store and when you're out in general, make eye contact and smile at people. It'll feel fake, but cumulatively, it'll help you feel better and less alone.
posted by bookdragoness at 2:50 PM on January 13, 2015 [1 favorite]

This is a hard situation to be in, but you can find your way out with small steps. Some things you might try:

Meetup.com as mentioned above. In many cities, there are meetups for people in tech, and I know of some meetups specifically for content marketing and other digital marketing niches. Find as many meetups as possible in things that even remotely interest you. Assign yourself to go to one meetup per week whether you feel like it or not. Think of it as a prescription. In my experience (business and food-related meetups), the people are sane, welcoming, and low pressure. The meetups on a regular schedule, such as a weekly cafe discussion, are best, so you can start to feel like part of a group.

Find a coworking space and give yourself a work schedule there. You'll structure your day and be surrounded by other people like you. Being around other people who are focusing on their work can help you focus, and after awhile they begin to feel like colleagues. Even just getting out of the apartment can help.

Put a schedule in your calendar that tells you when you'll do laundry, when you'll work on project X, etc. Be easy on yourself at first and put just a few simple tasks per day, like take a shower, do one hour of client work, and pay one bill. Get in the habit of obeying the calendar whether you feel like it or not. If it's time to do a particular task and it seems overwhelming, set a timer for 15 minutes and tell yourself you only have to do it for 15 minutes and can then stop if you want.

All of these small steps add up, and after awhile you realize that your apartment is in better shape, you're showering every day, and you're looking forward to an interesting discussion at the cafe on Saturday.

Good luck.
posted by ceiba at 3:11 PM on January 13, 2015 [1 favorite]

I sort of have a job - a freelance client, which means I am working from my tiny apartment. Unfortunately for me, my career has been in digital marketing which requires a good amount of self-confidence/comfort in one's skin.

Oh god, I've been very close to this. You must get out of your house every day. Accept no online substitutes; you'll only be comparing your insides to some very carefully-constructed digital outsides. It's the worst, especially if you're burning tons of energy trying to come off as A Competent Freelance Professional. Coworking space, coffee shop, whatever - even if you normally hate working in those types of places, now is the time to go there anyway, even if only for an hour. Do it as early in the day as you can comfortably manage, even if you don't stay for very long. Sometimes for me that was 4PM, but you still gotta give yourself credit for getting out of the house. Build a routine, however small.

I'm sorry life is sucking so bad right now.
posted by deludingmyself at 3:33 PM on January 13, 2015 [6 favorites]

Also, I have to ask: I've tried meds and therapy (separately and combined), and nothing is working.

Are you trying either of these right now? Because depression makes it really easy to dismiss things as "not working," and one or both of these might provide some degree of release valve on your misery, even if they didn't make everything all better. The same summer where I was dragging my ass to coffee shops at 4PM to "start my day," the therapist I was seeing told me that I should stop trying to conceptualize therapy as a self-improvement activity, and start recognizing that what we were doing in our weekly meetings was, for the moment, trying to prevent anything from getting worse. Being told that made me feel crushed and pissed off and sad and incompetent, especially because I didn't feel like I had "real" depression, but in retrospect, she was right: I had to stabilize shit emotionally before I could actually get anywhere.
posted by deludingmyself at 3:39 PM on January 13, 2015 [4 favorites]

You're working from home? Oh geez, that's so conducive to depression in these situations. My worst depression as an adult was a breakup plus a period of WFH / consulting plus a move, so I really relate to your situation. Isolation from human contact is brutal. Could you become a regular at the gym, the cafe, the dog park...?

My tricks for fighting mild depression are:
- I try to be very realistic with myself so that I'm not letting myself down all the time. Think "what's the minimum I have to do here?" instead of "how can I create the next Sistine Chapel?" or trying to suddenly adopt an Olympic athlete's workout schedule overnight. You're trying to get by. A new social circle, thriving, "relaunching your career" may all be a bit too big to ponder now.
- I set a very small but achievable goal, so that I can feel proud of myself.
- I try to do things that build on themselves. Instead of paying my bills, I use that one hour of clarity to put them on autopay. I try (try) to get the grunt work out of the way when I'm totally grumpy ("you're already in a bad mood, doing the dishes won't make you feel any worse," I tell myself), so that I can use the next hour of clarity to do something that requires thought or ambition.
- Wherever possible, I "pay it forward" to myself. E.g., I hate making lunch for myself in the mornings before work. I mean, I have to do it, so what does it accomplish anyway??? It's just the daily grind." But! Making it the night before is some magic thing where the entire time I do it, I feel like I'm giving a gift to my morning self, and when I wake up in the morning, I either joyfully hit snooze one last time or get up and do a chore that is a gift for evening me. Doing something ahead of time creates all this good feeling.

I can imagine that part of what's going on is that you need a new life, and rebuilding that from scratch is an enormous undertaking. It's hard to keep putting one foot in front of the other in that situation. Of course, taking small actions will add up over time, but it's hard to lay the first few rows of bricks, so to speak. Maybe make four columns -- career, friends, home, health -- and in each, come up with some very basic next steps. Get a haircut. Identify three people for informational interviews. Attend business networking event. Start a twitter page (done!). Find a cafe to work in. Buy running shoes. Do 8-minute Abs workout. Buy a bookshelf at Goodwill. Order a shower curtain. Brainstorm possible hobby classes or noncompetitive sports to sign up for to potentially meet friends (e.g., woodworking, improv, the plants of the East Bay, bowling league). Research one or two of those possible courses.
posted by salvia at 5:08 PM on January 13, 2015 [4 favorites]

Two other ideas for getting unstuck -
- You could try meditation, or spending a fixed length of time writing down all your feelings, every morning and whenever the clouds gather again. (Try When Things Fall Apart for help with the meditation idea.)

- Reading or listening to books where the main character is on a quest (e.g., Ready Player One) or rebuilding their life (like after an apocalypse) might help with feeling less alone?
posted by salvia at 5:16 PM on January 13, 2015

I'm so sorry you're going through such a hard time. I agree with others that the facts of your life are really difficult right now, and a certain amount of feeling shitty is understandable.

On the other hand, I wonder if you just need to try different meds or a different therapist. Or, maybe as someone said upthread you need to give these things more time.

Self-compassion can help. So often we think that feeling bad is some sort of mistake or flaw on our part, that when we're unhappy we've somehow gotten life wrong, as though it's supposed to be a feel-good enterprise at all times, and so we feel bad about ourselves for feeling bad. But feeling bad is inevitable sometimes. That's meant to be reassuring, not dispiriting. You will get out of this ditch. But notice how you talk to yourself and be kind, the way you would be to a friend who's going through a bad patch. If you've got any inclination to try meditation, that would definitely be useful.

Is getting a dog an option? Dogs are the best.

And since you seem to have been at least a sometime exerciser in the past, I'm going to say: EXERCISE. There's lots of research about the benefits of exercise when it comes to mood and depression. I can say that for me one of the biggest and most consistent antidepressants in my life has been exercise. Can you force yourself to the gym, or outside for a run, or whatever it is you like to do? I know you're having a hard time doing basic things like laundry, but there's not a lot of payoff with laundry, but with exercise there is. If you think you need help committing to an exercise routine, look into BJ Fogg's Tiny Habits, where you build little habits slowly that turn into big habits.

Most of all, don't be fooled by thoughts that tell you these feelings will last forever. You will feel better. Good luck!
posted by swheatie at 5:41 PM on January 13, 2015 [3 favorites]

I went through a situation that was somewhat similar to yours. Therapists just irritated me, and the medications just made me sleepy and fat. My last therapist did make one suggestion that helped me a lot: He suggested that I do volunteer work. I resisted the idea at first, but then I tried it. What happened afterwards is a long story, but the gist of it is that I didn't especially like the volunteer work itself (at least, not at first), but it got me out of the house and eventually led to a great full-time job.
posted by akk2014 at 7:51 PM on January 13, 2015 [2 favorites]

Tour the new city. Then, tour it some more.

Get on craigslist or some local website and say you are new in town and would love to be shown around.

Library is a great place to work from. Hopefully with a frozen yogurt shop nearby.
posted by serena15221 at 9:33 PM on January 13, 2015 [1 favorite]

Yeah, definitely get out of your house if that's an option (if you have a laptop). Go to a library, go to a coffeeshop, go to the food court in a mall, or mix it up. Just be somewhere that isn't home, and that ideally has some people there. You don't want to get into the habit of never leaving your home unless absolutely necessary, because that can be a bad habit to break. Make leaving your house every day part of your habit.
posted by X-Himy at 8:15 AM on January 14, 2015

Get a cat or two. They help.
posted by Jacqueline at 1:28 PM on January 14, 2015

Response by poster: Thanks very much, MeFi. A slightly better day today due largely to all of your thoughtful responses and support.
posted by wensink at 2:34 PM on January 14, 2015 [1 favorite]

Do you meditate? There are some good communities, at least where I am, surrounding meditation. As a bonus, it's an effective approach to treating depression.
posted by namesarehard at 11:04 PM on January 14, 2015

I went through a divorce pretty recently and here's what got me through.

1. Stopped drinking for several months (you should probably not be drinking on anti-depressants anyway). It either made me sad or stupid (as in being tempted to contact him). Nothing good ever came of drinking in those first few months.

2. Stopped all contact with my ex unless absolutely necessary for legal reasons. Blocked him on social media. Told friends & family not to bring him up.

3. Threw out, gave away, or put into storage anything that reminded me of him.

4. Gave myself LOTS of time to grieve. This is like a death of a part of your life and you can't just snap out of it, that part will always be dead. If you've had a loved one literally die, you know that you get twinges of emotion years later. This will be the same.

5. Started walking, not as exercise per se, but as a means to explore my new neighborhood and get out of my own head and away from the Internet. If you think it's too cold, memail me for advice on base layers.

6. Went to mefi meetups, made some new friends.

7. Started volunteering at the Humane Society. Dogs are always happy to see you. Shelter cats are happier to see you than random cats. If you don't have a pet, get one, or foster one.

8. GOT. LAID. If you're a straight guy, it's probably harder to find NSA sex than it is for me, but it's worth pursuing. Get back on the horse, it will build your confidence. However, I wouldn't try to date while you're in the midst of this depression. (Uh, I don't know why I assumed you were a straight dude. If you like guys, you are in business! Try OKC. For serious, getting laid on the regular has been the best thing for me to start anew.)
posted by desjardins at 10:28 AM on January 15, 2015 [1 favorite]

I agree with Jacqueline about cats, but even better, get a kitten, or maybe two. They aren't much work, and their cute, silly antics will make you laugh several times a day.
posted by islandeady at 10:52 PM on January 16, 2015