How can I break the habits I developed while I was depressed?
August 10, 2013 9:41 PM   Subscribe

About two years ago, I started a very effective course of cognitive behavioral therapy that helped me understand my depression and change my negative, self-critical thinking. Recently, I've began noticing that even though how I think about myself has changed, I haven't done anything to change the isolated, unhealthy lifestyle I developed back when I was depressed. Now that I'm out of therapy, what can I do to break these habits that contribute to depression?

For background, I'm a guy in his early 30's with a steady job, a long-term relationship, and a good family. I've dealt with depression off and on for about ten years now. My therapy involved meeting with a counselor every week for about six months. I learned the principles of CBT to avoid negative thought patterns, and even dug into the origins of why I've judged myself so harshly. It was one of the best things I've ever done for myself.

Since I left therapy about a year and a half ago, some things are much better. I no longer bombard myself with negative self-messaging about being stupid, weak, and ugly. I'm taking on new responsibilities at work and saving to buy a house in a year or two. I'm dating someone I love, with an eye towards a future together. I'm worried that relapsing into depression could damage or even lead to the loss of those things, and that's why I'm so bothered by my seeming inability to change bad habits that will only make me more vulnerable to falling into that hole again.

I've developed such an unhealthy lifestyle that I'm not sure where to begin changing it. I haven't made a new platonic friend in about four years, and have no social life to speak of outside of my relationship. (There are people at work who I get along with very well, but they seem completely uninterested in being friends outside of the job. I'm no longer in contact with old friends who live several hours away, and haven't been for years.) I have no hobbies, and I waste a great deal of time most days on web surfing and watching TV. I have access to a gym, but I never exercise. My diet is very unhealthy, and I eat way too much fast food. I'm a bad procrastinator, and on some days it seems very hard to fold a load of laundry or empty the dishwasher, much less work on projects for my job. I know these habits set me up for depression, and sometimes I wonder if my feelings of social isolation and low energy are just the natural consequences of my bad habits, or if they're the sign of something larger. I'll resolve to fix one of these habits from time to time, but I never get very far before I fall back into the same behaviors.

How can I begin to replace my unhealthy lifestyle with better habits that will keep me energized healthy, and positive?
posted by Chuck Barris to Human Relations (14 answers total) 85 users marked this as a favorite
You change your lifestyle by applying the same techniques you learned in CBT to combat the first aspects of your depression! You know now that you are not stupid, weak, or ugly. You are succesful, you have the capacity to love and maintain a healthy, stable romantic relationship, and you are thinking towards the future. Those are some fantastic things in your toolbox, and you can use that knowledge to help you parse out how you'll tackle the rest of the things in your life so they reflect your evolution as a person now that the roots of your depression have been identified and largely tackled.

Consider making a list of things that you'd like to change or goals you'd like to achieve. Based on what you've written, I think those things could be...

1. Develop social life outside of romantic relationship.
2. Start replacing one hour of TV/Internet time with a new activity every day.
3. Twice a week spend 30 minutes to 1 hour at the gym just running on the treadmill.
4. Make a point to do at least one chore every morning when you wake up before you do anything else, and one different chore in the evening before you go to bed.
5. Replace one fast food meal a day with one homecooked meal.

And ask for help when you need it. Do you still have your old therapist's number? Give them a call. Let them know how successful you've been since leaving their care and ask them to set up a meeting so you can let them know that you're concerned about relapsing. I bet they would be glad to hear from you, and they of all people would be able to help you develop more tools to transform the things that concern you. Keep it simple to start -- commit to doing 1 to 3 things a day and increase as you get more comfortable with the change in routine.

You've got the skills you need to do this. Remind yourself of that, and start moving forward. Congratulations on all the success you've accomplished thus far. That's all you, and that's really awesome.
posted by These Birds of a Feather at 9:53 PM on August 10, 2013 [7 favorites]

And I would suggest that you read The Willpower Instinct by Kelly McGonigal, PhD.
posted by lrnarabic at 10:48 PM on August 10, 2013

You can get lots of advice from books, etc. I'll tell you what worked for me personally.

I made a small list of real-life, measurable, concrete goals that I decided were the first steps for self improvement. I didn't allow myself to move onto more goals until I achieved those. First things first - I chose what I thought was essential. Examples on my list were:

- Put all of my accounts on autopay so my credit is preserved if I get lazy/forgetful (which happens sometimes)
- Meditate 25 times
- Complete a work task I had to do and had been procrastinating
- Make a budget
- Have green juice (which makes me feel very healthy) 20 times
- Post a job ad on [website] to hire someone for a task I'd been needing to do

... and some more like that. Not just "exercise more," but "go to the gym 15 times." I chose about 10 goals for my first list. It was supposed to take a month but it ended up taking me 4 months. YMMV.

When I finished a goal, I crossed it off. I wasn't allowed to make ~any~ new goals until finishing the entire list. So it was important to choose carefully.

Eventually I got through it, and that was amazing. Getting through one set of goals convinced me that I was able to take small steps, no matter how small, toward improvement. It's incredibly motivating and encouraging.

The list above by These Birds of a Feather is not nearly specific enough. Rather than "develop social life outside of a romantic relationship," it could be, "Go to two meetups."

Also, stuff like, "Replace one fast food meal a day" is going to be really hard to stick to, so you'll probably mess up on a busy/stressful day and get discouraged. It's better to choose something that is absolutely possible, even if it takes all year: "Spend 15 periods of 3 days without fast food." That gets you going stretches without fast food, but it's not impossible, and if you can achieve that goal even if you miss some days and eat fast food. It'll just take longer. And if you're really motivated, you can do 6 days at a time without fast food, and cross two periods off your list.

The point is to pick goals you can actually achieve, then cross them off.
As you get better at accomplishing small stuff, you can make harder goals. It's like leveling up.
It feels awesome to cross off a full list, and toward the end of the month you're so proud of yourself and can't wait to make the next list because you know you can actually make things happen. It's a rewarding, powerful feeling.

So basically, small tangible goals are the key. "Make new friends" will never get done. "Go to two meetups" actually has a chance of getting done. Learn to understand what types of actions are in your capacity to do, and what types of actions are not.

And if I may be philosophical for a minute... getting into ruts where you have a crappy lifestyle has to do with not understanding that distinction. So if I have just one piece of advice, it's: Start by setting one list of goals that you can actually achieve.
posted by htid at 11:48 PM on August 10, 2013 [111 favorites]

Just to be clear, the list I specified was general because I do not presume to know what your actual goals are. I leave that up to you, though for me my list looked just like what I wrote in my first response to you and I can attest to its usefulness because sometimes general goals are motivation enough to help you figure out what the mini goals are later.
posted by These Birds of a Feather at 12:12 AM on August 11, 2013

goals that you can actually achieve

are crucial, as are unambiguous success criteria.

I'll resolve to fix one of these habits from time to time, but I never get very far before I fall back into the same behaviors.

I don't believe it's possible to "fix" an unhelpful habit. Closest you can get is creating a new, helpful habit that deprives the unhelpful one of triggers.

For example, if you're in the habit of pulling into a fast food joint on your way home from work, resolving not to do that simply leaves you fighting against habit every time you approach that fast food joint. Less stress in the medium to long term could be achieved by designing a new way to get home that doesn't involve driving past fast food joints, and practising that consciously until you find yourself doing it habitually.

There's a strong tendency to view inability to resist habit triggers as a sign of weakness or moral failing. That tendency is unhelpful, and is something you can use your CBT experience to address.

If you're trying to live with more skill, you absolutely need a clear-eyed understanding of what it is you're working with. If you do things that would only make sense if you were in fact a perfectible consciousness somehow separable from your imperfect body, your progress will be very slow. On the other hand, if you make a careful study of habitual behaviour as a thing-in-itself, treat what you learn as straightforward, strictly factual self-knowledge rather than some basis for unproductive self-criticism, and learn to work with the you you have rather than the you you wished you had, you will probably achieve the changes you'd like to at a pace you find quite pleasing.
posted by flabdablet at 4:09 AM on August 11, 2013 [6 favorites]

Spend less time at home. Home = comfort = sameness. For people like you and me, home is (correct me if I'm wrong!) like a gravitational well of sloth and misery. You don't have to be the city starlet, but you can read a magazine at the library, go for walks in the park, eat out, go out and drink beer with your date, whatever. If staying home isn't your default activity, you'll be exposed to more random stuff, you'll feel more alive and connected, opportunities will arise. And home itself will be more special, a real sanctuary.

This demands some work. But it's an exhilaratingly great thing to embark on with the person you're dating. I love the feeling of asking someone out on some interesting new thing instead of just meeting up at the same old coffee shop ("where do you wanna go?" "I dunno..."). Tell your date "hey, I'm trying to explore more random stuff in the city, if you find out about events or something I'm up for anything."
posted by mbrock at 4:26 AM on August 11, 2013 [6 favorites]

Start small and get other people on board! I made several significant changes in my life a couple years ago by starting small and joining the MeFi HealthMonth team. If health month doesn't appeal to you, and it's definitely a matter of taste, you can enlist the help of your girlfriend, the co-workers you are friendliest with at work and who seem like they'd be supportive, your facebook circle, etc.

The one thing I would start with is cutting back on TV. No virtue of commission (in the sense of something positive you do, as opposed to a virtue of omission where you refrain from doing something bad) is going to happen unless you make room for it in your life. In my case, I started rolling back the start time for my workday by 15 minute increments. I wound up with a work start that was at least an hour and a half earlier than when I used to start (8:30ish to 6:45-7:00 am) and this opened up so much more time in my day to fit in things like exercising, practicing an instrument, or cleaning and doing chores.
posted by drlith at 4:58 AM on August 11, 2013 [1 favorite]

I'll point out that Health Month is great for setting goals in non-absolute terms, like make dinner 5 days a week, limit TV to 2 hours 4 days a week, exercise for 30 minutes, 4 days a week, etc., and for tracking your progress over the long term as you start easy. One of my first goals was: no sugary sweets, a whopping 2 days a week. That way I didn't feel like I'd failed the other 5 days a week if I had a cookie or whatever. I eventually cranked it up to 5 days a week, which was still a little challenging but not as hard as it would have been if I hadn't practiced not eating sweets on SOME days, and not as challenging as an absolute "no cookies, ever" goal would have been.
posted by drlith at 5:04 AM on August 11, 2013 [2 favorites]

Best answer: Behavioral activation is the idea that depression is maintained by an unrewarding set of life habits. When you get depressed, you withdraw, and the things you used to like stop feeling fun. You don't do anything anymore. So by building up positive experiences both things that are fun and those that make us feel accomplished, you break that depressive cycle. BA alone is an effective treatment for depression. This is a nice workbook that walks you through it. Basically, start building momentum by starting small, scheduling activities for yourself and giving yourself positive feedback (rewards, good job, me!, etc.) To a certain extent you'll have to kick yourself in the butt to get going, but once the momentum is there it is easier to get going. If you're not adverse to profanity, Unfuck Your Habitat is a nice blend of no-nonsense motivation, education and before and after posts of people struggling to do some of the same things you might be. Of course, if you feel like you've given it a good shot on your own, I'd say go back to a therapist. It sounds like you did some great cognitive work. But sometimes, as you've experienced, it takes a while, and a lot of hard work to get behavior to go with the thought changes. A good therapist can help you with motivation, problem solving and help you get that side of the equation too.
posted by gilsonal at 9:32 AM on August 11, 2013 [9 favorites]

Best answer: Agreed that the goals should be specific. Write them down, and use a calendar to track progress. Give yourself a small reward for goals completed, even if it's a star on the calendar. Associating completion of the behavior with a reward will increase completion of the behavior. Give yourself bigger rewards for X number of stars per week. The achievement of the goal seem like it would be its own reward, but there's been a lot of research showing that even when you value the goals, really want to achieve them, etc., rewards significantly improve your likelihood of doing the things you want to do.

1. Develop social life
- Find a hobby or interest and meet some new people.
- Get the newspaper when it has the Events section (Thursday where I live), get free newspapers, check the web, and find new activities. Schedule 2 of them a week.
- Recent Ask.Mes about making friends.
2. Start replacing TV/Internet time
- Go to the Library 1 day a week, get a book, read, repeat.
- Have a tv-free day once a week.
- Pay close attention to what you watch. Schedule your tv so you watch only stuff you really like.
3. Twice a week spend 30 minutes at the gym.
- and twice a week, take a walk during daylight, either at lunch or at home. Exercise and sunshine are both depression-fighters and energy-boosters.
4. Set a basic standard for housekeeping, set up a schedule, reward yourself.
5. Reduce reliance on fast food.
- There have been many Ask.Me threads about meals. Come up with a plan.
- Get healthier fast food. Panera and Chipotle come to mind. If you go to McBurger Fried Tacos, at least get the least unhealthy menu choices. They have salads. They have grilled chicken, etc. Your grocery store probably has some pretty fast choices, as well.
6. See your doctor.
- Get blood work done, making sure you have adequate D and B vitamins. Check your thyroid, etc.
posted by theora55 at 10:50 AM on August 11, 2013 [4 favorites]

Response by poster: It seems pretty clear that I'm going to need to start setting specific, measurable, and realistic goals with definite timetables. I'm going to have a talk with my girlfriend about helping me develop those goals and following through on a rewards system. In the past, I haven't done a good job of sticking to a system where I'm only accountable to myself. I'm going to take some time to set up these goals and buy a desk calendar that will help me plan out when I'm going to do certain things to meet the goals.

Of all the goals I have, I feel like the social one will be the hardest to achieve. I live in a relatively small city where most people are married with small children by the time they are my age, so meeting new friends can be tough. I've checked for my area before, but the events are always for political or religious groups with viewpoints that I don't share. I'm really not sure how I'm going to meet other people who have similar interests and the time to devote to friendships outside of their family life.
posted by Chuck Barris at 1:17 PM on August 11, 2013

You can start groups or meetups yourself. I have done that in the past & it worked out quite well.
posted by studioaudience at 2:24 PM on August 11, 2013

I've discovered that if I don't hit the gym in the morning, I probably won't hit the gym. I haven't managed to make the gym feel like a habit. It feels more like something that takes will power, and I seem to have more will power in the morning. I'd rather establish it as a habit, but until I figure out how to do that, I'm trying to rely on stronger will power in the morning.

Also, there's an app call "CARROT" that I just started using. It's seeming like a good tool for motivating me to get through short term "to do" items. It rewards you for getting things done and acts comically upset when your progress slows down.
posted by agog at 9:18 AM on August 14, 2013

1. Your lifestyle is fine. It can be better, but don't think of it as bad; just as something to build on.

2. Problems making new platonic friends in your 30's is *incredibly* common, especially without having friends to introduce you to more people already. Seriously, this isn't your problem, but the problem of every single person who moves to a new city, burns bridges, or otherwise finds themselves finding new contacts after college.

3. It'll work out well, as long as you keep aiming for it; don't get yourself down when things don't go right, as that's guaranteed to happen, just change what you're doing so it doesn't go wrong again the same way.
posted by talldean at 8:39 PM on August 14, 2013

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