Has anyone ever changed from apathetic to motivated? What happened?

December 26, 2006 3:45 PM

Since developing bipolar disorder, and subsequently being out of work since April 2005, I find my motivation and concentration has gone to be replaced by apathy and what must seem to others like laziness. Has anyone else been in a similar situation and got themselves out of it, and if so, how?

I seem to have slowly become the stereotypical depressed unemployed person, getting up very late, washing as little as possible, with an incredibly untidy house, and all the outward signs of being incredibly lazy. At the same time I know my bipolar disorder has a lot to do with that, and have got treatment for it (Prozac). My problem is this - I can manage to motivate myself to do things I might find enjoyable - visit a friend, participate in online forums about social anxiety, go to the cinema. However for things most people dislike but just get on with - making job applications, cleaning and tidying, washing dishes, I really have NO motivation and literally spend hours in bed doing nothing. I don't have that nagging voice or those internal standards that get people going. Unlike some depressed people, I am all too forgiving of myself and let myself off the hook where they might be filled with self-recrimination.

In April I will have been out of work for 2 years and worry about getting into a lifestyle and habits I will struggle to get out of, and if I manage to find a job will perform poorly, perhaps drifting from job to job getting poor references from each employer.

Has anyone else ever been that depressed/ lazy guy or gal? How did you get yourself out of it? Or if you have a relative or friend who turned things around, what did they do? I have the uncomfortable feeling that my life is just drifting away, I am 37 and 50 doesn't seem as far away as it once did, so the sooner I get my act together the better. Thanks in advance for any help, and happy holidays everyone.

posted by AuroraSky to health & fitness (17 comments total)

A couple of quick things:

1. Prozac for bipolar? Consider reevaluating your meds, and possibly getting a second opinion.

2. Are you getting any other counseling or therapy? Some people respond very well to talk therapy or cognitive behavioral therapy.
posted by moira at 3:51 PM on December 26, 2006

you may want to look into cognitive behaviour therapy. theres a book, but it may be harder for you to get going going to a congitive behaviour group session or therapy.

http://www.amazon.com/Feeling-Good-Therapy-Revised-Updated/dp/0380810336
posted by butterball at 3:53 PM on December 26, 2006

My XSO's shrink used to tell her that meds were only useful in controlling the physical pathology; having had the physical pathology for a long time habituates you, and taking the meds gives you the clear-headedness to develop new habits. But you're not likely to be able to do that without help from someone. So, Moira's point 2 is very apt.

The only other suggestions I can offer will sound as though they miss the point, but I implore you to consider them nonetheless.

First, do try to create new, structured and constructive habits. Start small, for example with making it a point to brush your teeth every morning.

Second -- and this is very important -- GET EXERCISE. I am not a physically-minded person, and I have had problems with depression, and I can tell you that it makes a difference. It almost doesn't matter what you do; you just need to raise your activation state more or less every day. Again, start small, with a walk around the block or something. Very important: Do NOT over-do it, or you will provide negative feedback for yourself.

In general, you can do some of the cognitive-therapy type stuff on your own by keeping the principles of positive reinforcement in mind: Take small steps that you can feel good about succeeding with. Don't expect perfection from yourself. You will make mistakes, you will backslide, but it's important not to let that be an excuse for not getting up the next morning.
posted by lodurr at 4:00 PM on December 26, 2006

I took two years off, and while I wasn't diagnosed with anything I found that my lack of motivation was due more to resisting the decisions I didn't want to make. That is, I wasn't sure what direction I wanted to go in yet and didn't want to fall back into my old "rut" (job), so I didn't make any decisions on that topic. While I was doing things comparable to visiting friends and going to movies, I was professionally (and financially) frozen in time. Then a job fell into my lap (in my "rut" occupation), which has been fine-if-stressful (busy), but I still have a messy apartment and I still want to change direction a bit once I figure out what that is.

I'm not sure if all of that is relevant, but I figured since were near in age and having similar career breaks (which is what they call it in Europe - people tell you these things when you tell them you've been on a sabbatical/leave-of-absence), it might be useful knowledge. One of the toughest things was resisting the comments of people who are pushing you to end your break, in certain ways the attitude of some of my family and friends caused more stress during my time off than my odious busy-ness is in my current job. Make the most of your freedom, but if I can be didactic for a second I'd say "keep growth in mind."
posted by rhizome at 4:35 PM on December 26, 2006

I've heard that bipolar disorder is typically treated with two medications (one for each pole, as it were), and that simply hitting it with an antidepressant can make it much, much worse. I think that's the source of Moira's first question, and I'd second her recommendation.
posted by kimota at 4:50 PM on December 26, 2006

I was that depressed guy for a while, and the only way I got out of it was literally forcing myself to do those unpleasant things that you are avoiding. Prozac can be a great help for depression, but it isn't going to magically solve your problems. I literally forced myself to get a job, and it provided structure to my day which forced me to get out of my apartment. Once I started working, I realized hey, this isn't so bad. The same way with cleaning, washing, etc. The motivation wasn't there at first, but try cleaning your place and see how good it feels when you're done and you aren't living in a mess any more.

If you can't do it yourself, find someone to be accountable to. It can be a therapist or just an old friend, family member, or neighbor. Have him/her come check on you at your place every week; again, this will motivate you to keep your place picked up simply so that you are presentable to your friend. I know the feeling that life is just drifting away, but you can take control of your situation.

Good luck!
posted by btkuhn at 5:05 PM on December 26, 2006

While I can't speak for the meds (and I do think you should have those re-evalutated) I know all about avoidance, apathy and depression.

Avoiding stressful situations was the method that I used to cope with my life. I used to sit in a dirty house rather than clean it a little because the thought of cleaning was unpleasant and unpleasant things made me depressed. Long term, however, the same mechanism was making my depression worse. I finally twigged that the dirty house was making me just as depressed as the thought of cleaning it.

I started with small goals to try and get myself to do stuff and rewarded myself when I did them. Do the washing, and then sit down with a movie. Vacuum the house and sit in the sun with coffee and cake. If I got bored at home I went for a little walk - just around the block.

The trick is to start small. Really small. So small that it's practically no effort to do, like throwing clothes into a laundry basket. Then, do it again. Once you finally do something that you know you have to do but have been avoiding, you get a feeling of relief and a small glow of achievement. Reinforce it by doing something fun.

I still have days when I don't want to go out of the house or deal with people but I managed to get my tax returns submitted recently after ignoring them for about 5 years. It was nasty, but the feeling of relief to get them out of the way was fantastic and a reward in itself.

Remember, you don't have to do EVERYTHING. You just have to try SOMETHING.

Best wishes and good luck.
posted by ninazer0 at 6:19 PM on December 26, 2006 [5 favorites]

It has been noticed that Prozac and other SSRIs sometimes make a person into a content but amotivational person. I was on Paxil for a while and I was never happier, but never lazier, consider asking your doctor for different meds. I don't know if you've considered Welbutrin, it is used to make amotivational people more motivated, they sometimes use it for Adult ADD, it raises dopamine I think as well as seritonin.

Do you have a friend or relative who can be a sort of "motivation buddy?" Like alcoholics have a sponsor to call when they are tempted, it woul be a sort of sponsor who you can check in with and who will call you (nicely!) on your lack of initiative and motivation. At least until you can re-learn new habits.
posted by xetere at 6:26 PM on December 26, 2006

What ninazer0 said.

It's imperative that you do something. Whether that is taking a little longer to brush your teeth properly, making your bed as soon as you get up (whenever that is!) tidying up your house, anything positive. Start small and try and build on it. Taking proper care of yourself and your surroundings will probably feel like pissing in the wind at first, but you will see the benefit of small routines in as little as 4 or 5 days, and then you can start to slowly build. You must force yourself to take the first few steps, however bad it feels.
posted by fire&wings at 6:47 PM on December 26, 2006 [1 favorite]

Just to say, I forgot to mention I am on Depakote (a mood stabiliser) and Respiridone (an antipsychotic) to control the manic side, but Prozac is what's helping the depression. I am interested in CBT and have read that Feeling Good book, but in the UK CBT tends to be rationed to priority cases and there's a long waiting list. However I appreciate the self-help ideas people have suggested. It's good to hear people's experiences and know that this is a rut that can be got out of. Thanks everyone.
posted by AuroraSky at 7:03 PM on December 26, 2006

I can relate AuroraSky, because I struggled with severe depression about 5 years ago. I got so depressed I was off work, and getting out of bed became a major endeavour. During those grey days, I had a hard time talking to anyone face to face. I just felt so sad and worthless all the time. I would force myself to go to the grocery store and buy a small item, just to say hello the the checkout lady and have some human contact for the day. And I would wear sunglasses too, to avoid eye contact and hide my emotions.

What eventually got me out of that deep pit was exercise (resistance and cardio), prayer and a book called The Greatest Salesman in the World by Og Mandino. It's not an ordinary book you read right through however. Follow it's instructions carefully and it will change your life. I kid you not.

Take care and good luck.
posted by dropkick at 7:18 PM on December 26, 2006

I've been where you are. And on some of the same medications, not the anti-psychotic, though.

And let me tell you this:

I don't have a fucking clue.

I found myself doing more and being more motivated as I got older. But often the house is still a mess. Although I spent a week stripping, sanding and refinishing a coffee table my bedroom is still horrible. I write every day but I still can't seem to find the time to fix the tiles that fell out of the bathroom ceiling.


Change up the meds some. Doctors like doing that, anyway. Prozac made me suicidal. Depakote didn't do anything. Lithium gave me an allergic reaction and sent me to the emergency room. I'm on paxil and xanax now. There's some debate as to whether I'm actually bipolar or not, though.

I think I find the most useful thing is to do something to clean the house everyday. But just for 30 minutes. Just do a little job, like wash half the dishes and save the rest for the next day. Sweep but don't mop. Etc. You'll find that once you start you'll finish the job, anyway. And if not, 30 minutes a day actually adds up and soon the house will be at least partially clean.
posted by nyxxxx at 7:59 PM on December 26, 2006

Cognitive restructuring (CBT) is great, but it helps to get to the point where you can focus enough to be aware of and change your patterns of thinking. I call the things it takes to get to that point my "depression first aid." It consists of meds (if needed), exercise (the best med I've found yet), activity scheduling*, and improving my relationships with others.

Hopefully, these things can get you to the point where you can do some self-directed CBT. Don't give yourself an option; consider it your job. Set aside a time every day when you do it. The small steps suggestions were right on, too.

Consider the book "Mind Over Mood". If you choose to buy it, don't just read it. Do it. Do all the worksheets and exercises. Take notes and write in a journal if it helps. It's useless otherwise.

You will not feel motivated. Don't expect to. Expect to have to kick yourself out of bed, out of the house, out of your own head, everything. It's hard as hell, but the rewards are infinitely worthwhile. You'll find yourself in an entirely different place, a much healthier and happier person.

There was a suggestion above that you look into Wellbutrin. That might be worth considering, if both you and your prescribing doctor feel it's a good direction to take. I am mildly bipolar with recurrent chronic depression, and I did best on Depakote and Wellbutrin. To each his own, though; we all have different physiologies. I'm glad to hear you are on mood stabilizers.
posted by moira at 8:17 PM on December 26, 2006

Oops, forgot to add the *:

*Activity scheduling: generally, with depression, you don't really enjoy the things you used to, and so you don't bother anymore. Thing is, even if you don't enjoy them as much, they still function to lift your mood. The activity scheduling just consists of scheduling something to do, then doing it, even if you don't feel like it. So maybe you'd schedule going out to a park on Sunday, cleaning the bathroom on Monday, hanging out with friends on Friday, making some calls Tuesday, etc. Do things you enjoy or things that give you a sense of accomplishment.
posted by moira at 8:21 PM on December 26, 2006

Another answer to a related question.
posted by moira at 8:26 PM on December 26, 2006

I spent a great deal of my life in the (well, almost) exact situation you described in the OP. To start out, lodurr's suggestion of structured tasks and exercise really does help. Here are some additional things that I've found helpful to me:

1. Waking up at the same time everyday. On that same note, going to bed at a reasonable hour and sleeping a decent amount every night. It takes a while to get into this routine, but it really does help immensely
   
   (YMMV but for being a light sleeper I used to have a terrible time trying to fall and stay asleep for most of my life until I started wearing silicone earplugs to bed).
   
   
2. Journaling. It doesn't have to be a soul-baring collection of your misery and secrets (unless that helps you, then go right on ahead). I keep a stack of index cards clipped together in my top desk drawer (I guess you could call it a hipster PDA) where every morning I write down the date, the time I woke up, and whenever the feeling strikes me during the day I write down bits of information about anything.
   
   I write down mini grocery lists, things I want to research on the internet later, words I'd like to look up in the dictionary, interesting things I heard on the radio. This is especially helpful right before bed to your mind won't be swimming with thoughts and ideas that you desperately try to cling onto while trying to fall asleep.
   
   
3. Nutrition!! If I could pinpoint the greatest single change I made that helped me recover was learning to eat correctly. Additionally I recommend the book Potatoes Not Prozac (hokey title, I know). granted has previously mentioned (in other mefi questions) the program at Radiant Recovery for eating/craving food problems.
   
   The potato program is detailed on that website but the book contains a more thorough explanation of the program and the reasons why it works. The program works well for the problem of bad eating habits, alcoholism as well as depression (not that you have the first two, I'm just stating problems the program can be helpful for).
   
   The program marked such a turnaround for me, it might not hurt to give it a try.
   
   
4. Exercise. This was the one thing I really detested at first. It's recommended to do lots of cardio exercise to feel great but I'm just not into that (it does help though). The thing I've found that works best for me is taking quick walks around the neighborhood at least a few times a week (I walk for about 15-20 minutes, I don't keep track of the distance).
   
   Along with a short daily weight training regimen (some basic repetitions of arms curls or whatever they're called and other little 'weight training' motions. Sorry that's incredibly vague but I don't know the proper terms for my little exercises. I also do some lunges, squats & stomach crunches. This whole thing takes me about 10 minutes a day).
   
   
5. A little sunshine (outdoors, without wearing sunscreen) and a teaspoon of cod liver oil before breakfast every morning. I'm not 100% sure if they help but the cod liver oil seems to help me combat my yearly SAD episodes.

Man that was the longest post ever! The sun set while I wrote it. Feel free to email me if you'd like to know anything additional about what I've written.
posted by zippity at 4:37 PM on December 27, 2006 [2 favorites]

Oh yea and avoiding mindless television watching and finding more supportive friends helped too.
posted by zippity at 4:41 PM on December 27, 2006