When Depression hits - focus on the Vitals
If you are neurodivergent or have OCD, you might have an old frenemy in the form of depression. Depression is a process that can happen to anyone, regardless of neurotype. But if you tend to run high in anxiety, it’s common to at some point find yourself stuck in mucky disillusionment energy of depression. This is not a welcome visit, but it’s one we can learn from.
Depression is a mood state characterized by lack of interest or pleasure in things you once enjoyed (called anhedonia), hopelessness, fatigue or low energy, negative appraisal of self and the world, and a general sense of “what’s the point?” People describe the experience of depression as a heaviness, like extra weight or burden, or a dense fog. When depression lasts for two weeks or more, you have a depression episode, and with a few more characteristics such as negative impact on work or relationships, you may meet criteria for Major Depressive Disorder. When depression hangs around in lower intensity for much longer, it’s may be Persistent Depressive Disorder. I’m going to focus less on the DSM-V criteria and “disorder” side of things, and more on the depression state that can happen when life is out of balance.
DEpression in Context
Depression can be triggered by a variety of life events and chronic conditions, including OCD. In the case of OCD, I often see anxiety become unmanageable or run a person ragged, or compulsions shrink life so that much less seems possible.
Overwhelm is another common depression trigger, as are: grief, big change, isolation, rejection, setbacks or burnout.
I think about depression with two different frames in mind: The ACT (Acceptance and Commitment Therapy) frame, where depression is a process we participate in, and the IFS (Internal Family System) frame, where depression is a protective part trying to tell us something. In my opinion, both frames can be helpful and compatible with one another, especially when compared to the disease model of depression, which frames it as an illness or affliction. First we’ll take a look at the ACT framing, and we’ll end on some IFS based insights.
The depression process
In the ACT modality focuses on processes that we participate in - in other words, the kind of suffering that we may have some influence over, as opposed to the every day suffering that can befall us by surprise or over which we have little to no control. The suffering process of depression is twofold: first, depression can feel physically and emotionally awful. These feelings may come about by valid means, given something difficult that has just happened. Sometimes we may feel awful not because of the immediate thing that happened, but due to an extended period of pushing through and ignoring basic needs in order to achieve something or to survive, or living in unsustainable conditions. The second layer of suffering is the judgment, analysis, and efforts to numb or escape feelings or depression symptoms, and these efforts tend to dig the depression hole deeper. People with depression can have a talent for then judging the judgment, and judging that, stacking on struggles with themself and getting into mental binds.
When we are physically and emotionally feeling awful a very practical response would be to take really good care of ourselves. However, depression comes with significant fatigue, as well as urges to ruminate, isolate, criticize, blame, and numb. These urges, when followed, lead to more negative feelings, feeling further away from joy or loved ones, and lowering motivation to take good care of ourselves.
I try to encourage people experiencing depression to give themselves permission to focus on the vitals. This sounds obvious when you are not depressed, but in the midst of depression, there are all sorts of reasons not to take care - don’t deserve it, it’s too hard to do, something will go wrong, don’t feel like it, it won’t help enough. It’s important to keep acts of vitality extremely simple at first, even if there is an urge to judge this simplicity.
Simple acts of vitality look like:
Getting fresh air or sunshine each day (in the morning if possible, for sleep support)
Follow a regular bed time and wake time
Spend some time moving the body in a way that feels good or ok. A few minutes is better than no minutes
Eat regularly, adding in nutritious food that tastes good if possible. Keeping it really simple if need be
If on medication, take meds every day at the same time. Get a pill case and set an alarm if that will help
Carry a water bottle, drink, and refill it
Talk to someone each day. Barristas count. Texting counts.
We can expect there will be protests to these acts, and we can acknowledge these protests without obeying them. We can also expect caring for ourselves to eventually raise our resilience and baseline, even if it doesn’t immediately do much for our mood. The mood improvements, problem solving, seeking help, and reconnection with important activities that we ultimately must do when depressed are all much more doable when we have fair to good vitals. First give yourself a fighting chance by attending to physical needs. Even when your brain screams that it’s pointless (yes, this is hard).
Connect with the protective parts
Another process, borrowed from IFS, that can help early on in the depression cycle is to regard the things your mind is telling you with curiosity. Expect that depression might possibly be a form of protection, however unwanted. Depression can, for example, make it nearly impossible to overcommit or overextend yourself. It can also try to keep your expectations low after a big disappointment, or give you time away from others when you’ve been hurt socially. Although depression is more of a quagmire than a useful solution, it has a certain logic to it. There are good reasons why you might need a little extra protection right now.
IFS can lend the insight that there are no bad parts, but rather parts in outdated or overburdened roles. It helps people experience their different states with more clarity, and get curious about the vulnerabilities and the burdens they carry.
IFS and ACT are both therapeutic processes with nuance and methods that take skill and expertise to implement. If you find some of these ideas helpful, and you need some support with depression, you can contact me here or check out directories of ACT providers and IFS providers
