Depressed? Prozac can help!

You may have repeatedly heard the advice, “Get to know yourself.” You may think of therapy as a process of self-discovery. But what are you getting to know when you discover yourself? This may seem like a strange question, but it raises an important point. When most people think about getting to know themselves, they focus on such things as their feelings, beliefs, values, attitudes, personalities, and so on. All of these things are typically assumed to be inside of you. What people often leave out are the things that are outside, such as how they act around friends and coworkers, how they spend their free time, how they approach tedious tasks, and so forth. These things matter a great deal.

It can be very difficult to change how you feel, your personality, or your values, particularly if you are on prozac.It’s often easier at first to change your activities: what you’re doing, where you’re doing it, who you’re doing it with, and when you’re doing it. Changing what you do can have a direct effect on what you feel and think. But before you begin to make specific changes in your activities, you must first become an expert on what you currently do. As you observe your behavior, you will also observe what effect different behaviors in different settings have on your mood. Chapter 2 is devoted entirely to this topic.

Taking Control by Experimenting

Once you have a handle on your activities and the effects they have on your mood, you can begin to try to do some things differently. For example, Karrie observed that her mood tended to get worse when she sat in front of the television and tried to figure out what she had done wrong. Karrie and her therapist designed an experiment to see whether substituting a different activity for a brief amount of time would make even the slightest difference in Karrie’s mood. Perhaps it wouldn’t, but it was clear to Karrie that what she currently was doing wasn’t working.

Rather than watching television, she decided to spend time talking to friends on the phone or writing letters from eight to eight-thirty each evening. Then, she could return to watching television and thinking about why she was laid off. Her therapist emphasized to Karrie that this sort of change would probably not end Karrie’s depression. The goal was more modest than that: to see where small changes in Karrie’s behavior might shift her mood, even slightly, in a more positive direction. In fact, Karrie found that her mood improved consider¬ably when she was writing or talking to friends, and it got worse when she returned to watching television. Over time, several experiments like this led to the discovery of patterns in Karrie’s response to depressed mood. She was ultimately able to identify her typical ways of responding and to substitute alternative ways that had a more positive effect.

Blocking Avoidance & Prozac

Some people take prozac, but one of the most common ways people try to cope with depression is by avoiding things that make them anxious, sad, stressed, or otherwise uncomfortable. In many ways, this makes perfect sense. If you’re already depressed, why make yourself feel worse? Unfortunately, what you are doing in the short run to feel better could be making your depression worse, or it could be preventing you from solving important problems. We have worked with numerous people who cope with depression by avoiding friends and family or putting off important tasks such as updating a resume or paying bills. Although these behaviors often help to reduce anxiety and stress in the short run, it’s easy to see how they maintain depression in the long run; they feed right back into the depression loop. Learning to cope with difficult emotions while actively approaching particular tasks or situations is a highly effective way of blocking avoidance.

Sometimes what people avoid can be less concrete or obvious. For example, you may be avoiding painful emotions or situations. Endlessly worrying about finances, for example, may help you avoid strong feelings of sadness over the loss of a loved one. Approaching rather than avoiding the feelings would involve experiencing the grief and sadness, perhaps by talking with others about the loss. Often, the more you avoid experiencing negative feelings, the longer the negative feelings remain.

Another example of subtle avoidance that usually doesn’t feel like a choice is fatigue.

When things are going badly in your life, you may have an overwhelming feeling of fatigue or a need to sleep. There is no obvious connection to events or negative feelings, but you simply feel exhausted. When you are exhausted, you probably sleep. However, problems never go away when you are asleep, they are just on hold.