I hate walking. We have a corner store at the end of our block (seven houses away) and I have, on occasion, driven there for licorice. This made the advice from the counselor even more problematic. I was depressed and the thought of walking it off was a million miles away. If I didn’t want to walk when I was healthy, why would I consider it now?
They sit across from me, and tell me a story. They have been to see counselors for depression and were given what seemed to be helpful advice, “Do something”. Take a walk, get out of the house, socialize, join a group, go to church, or join a gym.
Seriously? Anyone who has had serious depression can tell you that this is terrible advice. If someone is having difficulty getting out of bed, is feeling despondent, is wondering if life is worth it, is too exhausted to have a shower; what is the chance they will go for a walk tomorrow morning?
There is no way you could do the things he/she asked you to do. When you went to the psychologist you had depression. Now you have depression and you feel like a failure.
Thanks for nothing.
I would like to suggest that It is a serious error for clinicians to give such counsel to a patient who is seriously depressed and has had difficulty coping and functioning on the most basic level. It is perhaps the most misused advice about depression that I have encountered. People who are struggling with intense depression cannot ‘do’ much of anything. It is a miracle that they made it to their appointment for counseling.
In therapy I often tell patients that dealing with depression begins with what is easiest. So what can they ‘do’ that has huge gains for little effort? Dealing with depression correctly starts with changing the way we think about what is going on. I tell the patient, “Change your mind and your ass will follow”. It is almost impossible to change your circumstances when you are starting out. Getting out of bed is a major chore; going for a daily walk is laughable. Most people cannot, or will not, engage in regular physical activity when they are clinically depressed.
The second mistake is trying to start by changing how you feel. Emotions are the least reliable and most difficult thing to change. Some nights I feel like working out so I think to myself, “I should get up really early tomorrow and do some martial arts, maybe write a few blog posts, and make a big breakfast for the family!”
That all sounds completely doable in the evening. When the alarm goes off at some ungodly hour the next morning, however, I rarely ‘feel’ like getting up. What was I thinking? What a ridiculous idea! It seemed like such a smashing idea the night before; when I was already awake. A great idea, in fact, in theory.
I am learning that doing something only when I feel like it, especially something that requires discipline or commitment, is a horrible way to live one’s life. I never ‘feel’ like going to the dentist, or taking an eight-hour martial arts test, or paying my taxes. Unfortunately the tax department ‘feels’ like making me pay anyway.
So what can you talk about in counseling for depression then? When patients come to see me I tell them that most likely nothing significant will change in the first month. All I’m going to ask them to do is talk; about their situation, their past, their attitude; their coping mechanisms. In turn I will talk to them about our propensity to employ cognitive distortions, how to stop their mind from ‘going there’, mindfulness, radical acceptance. We will look at the ‘why’ questions, find out if there has been trauma, and help them address their dysfunctional thoughts, feelings, and actions.
The interesting thing is, about a month or two into therapy the patient will come to a session and report that they are starting to see improvement and change. If I ask them why they will often say that they are not sure. Things just ‘happened’. This is because they have begun to view life through a different lens and cope in different and functional ways. There are many counselors who will tell you that this strategy works, even if it doesn’t seem to initially make sense. For some reason talking to a good counselor can change your life. If you’re like me, and I know I am, you will probably never get enough counseling to like going for walks though.
I’m not a miracle worker…
p.s. – if you are a counselor/therapist why not consider writing a guest blog about your unique perspective, an interesting experience, or what you are learning. I have learned so much from others who have shared their heart and skills with me and would appreciate any input you might have.