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.
scott-williams.ca 
Wow this is so good! I have always tried to explain this to people, but unless they have depression, most people simple don’t get it.
When I started recovery from SA few months ago(after denying it for 2 years of course), I didn’t have money for therapy, so I had to play it by ear. I did all research I could on the subject. A lot I simply couldn’t do(yeah, working out and yoga included), but I talked a lot. I admitted my past to my closer friends, and that was huge relief and I now have good support group. I also wrote and wrote and wrote, in the blog I started, in journals, and then I talked to my partner, over and over. We talked about every detail around my abuse, we went over every feeling, and I got to many revelations. And all these months I was wondering why nothing change. I mean, work wise, I’m still where I started, and with a lot of other things too.
But when I remember the weeks where I found no reason to get up in the morning, and was throwing up even listening about SA, and didnt sleep or eat properly, finding nothing good in my life to hold onto…even though my personal life isn’t changed much yet I am still far better from how I felt then…And I’m still not sure how it happened so. I guess all the talking had good point after all.
best regards, A.
I posted a link to this from my posting and “Dialysis and Depression” on my blog site, http://www.DevonTexas.WordPress.com
thanks alot. it’s kind of humbling actually. You should write a guest blog sometime about your struggle. i would read it!
Scott, it’s been a while but you are welcome to reblog my posting/s on Depression. Let me know if there’s anything I can help with.
I am not a doctor but it sounds like great advice. I have a family member that has depression and we a;lready do what you are suggesting and it seems to work. Great heartfelt post.
thats awesome. good to know i’m not crazy!
Your post is completely and sadly true. Thanks for writing it.
depression is so misunderstood and so many clinicians are approaching it all wrong. sad.
Thank you. It takes all I can do to push myself to work, and then never feel like doing anything else despite telling myself I want to or need to. It’s as if that is the only thing I can manage to do.
Ya, depression is so hard to deal with because any change needs motivation and what does depression steal? my motivation. So how do you get motivated to get motivated?
I’m learning to set goals. 2 extraordinary goals, and one small achievable goal, so that when I cannot accomplish the major ones, the little one is done and I feel as if I did something. Even if it’s just vacuuming the room, or changing the litter in the cage.
that’s awesome, I know pacing with chronic pain is important. At the Chronic Pain clinic where I work a whole bunch of people are struggling to find a future after chronic pain has “stolen their life”.
I understand that completely. Along with my depression I was granted the unreturnable gift if fibromyalgia which lives to keep me in bed, especially in the winter. I wake myself up 30 minutes early to talk myself out of bed.
I work at a fibromyalgia/pain clinic and have seen first hand the crippling effect of FM, plus the fact the people don’t believe you, your doctor thinks you’re just depressed, and people say things to you like<"I have back pain too but I still can work, must be nice." plus irritable bowels, plus TMJ, plus plus plus
You have real challenges, thanks for taking the time to write.
scott
Dear Scott,
I don’t mind telling you that I have been severely depressed lately. This article is the most honest, realistic, refreshing articles that I have ever read about depression. I’m so tired of stupid advice from people who don’t have a clue what’s physiologically gone on in my brain. And you’re right, I would take a walk if I could get myself out of bed. It’s become humiliating and I have begun to feel incredibly isolated. I’m delighted to read what you have to say because it affirms the fact that I am not alone and that there may indeed be at least “one” other person on the planet who are experiencing what I’m experiencing. Thank you so much, Scott. Please keep writing…
God’s very best,
Ava Elizabeth Wisdom
Thank you for your kind words. You are right, you aren’t alone. Unfortunately it seems that the voices of those who are really suffering are often unheard or unappreciated. When I was seriously depressed I got lots of bad advice that I still remember. I remember feeling like a loser after seeing the doctor who did more harm than good.
I truly hope you find help.
scott
Oh Scott, God is my strength. I’ll be OK. And yes, I think most doctor’s do actually do more harm them good.
On a separate note, would you do me a favor? I came across two different blogs last night that were written by teenagers. Both are cutters. One of them really hurt my heart profoundly. Would you take a look at their blogs if you have time? Perhaps you can pray for and encourage these two that God put on my heart…
http://tragiclifeofacutter@wordpress.com
http://theurgetocut@wordpress.com
Appreciate you, friend!
God’s best,
Ava
i will check up on both of them and drop them both a line offering to talk if they are interested. I’ll do what I can.
Great advice, and incredibly insightful. I do appreciate, especially, that you own up to your own battles with depression. I see that you posted this at 3:18 am. What on earth are you up at this hour for? Enquiring minds want to know.
I write them a day or two before, so I can edit if necessary. I have my posts scheduled to appear at 1 am, my time. Thanks for the encouragement, I’m still a learner hopefully and certainly don’t know everything there is to know.