Making Decisions When Depressed

Written by john

CrystalRefraction AMagill 437x450 Making Decisions When Depressed

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Like so many, I experience depression in various forms, yet each in its own way knocks out the decision control center in my mind. At times, I scramble in anxiety and can’t focus enough to pick out one among many possibilities. At other times, I don’t care about choosing – or anything else for that matter – and I let the alternatives fall where they may. Or I make all kinds of decisions, even life changing ones, but none of them seems like a choice. Each one is do-or-die. If I fail to do it, I’ll go right over the edge.

Varieties of Indecision

Depression isn’t one thing but a series of moods along a continuum from mild to severe. I used to move regularly with this perverse flow toward desperation. At the mild end, I might wake up knowing that something is wrong, feeling at once that everything is a bit off. I want and need to get a lot done, but I’ve lost my sense of where to begin and what’s most important. Then I get anxious.

There’s a steady snowfall of tasks, floating free of deadlines and priorities. I feel the anxiety and tension about getting them all done, so I pick one out of the air – yes, I’ve got to do that! Then I realize after a few minutes of continuing worry that I’ve got to do that other one in a hurry too. So I grab that and start working. And then another and another. It’s like picking snow flakes out of the air, each melting at once, a drop of moisture in my hand. I’ve got to get everything done, but I’m going crazy because I can’t grab hold of anything.

Then there are those times when I’ve felt nothing and could care less about making decisions. That’s happened most often when I’ve been on the antidepressants targeting serotonin, like Prozac. I think I’m fine because I don’t feel depressed, but then everything else, including close relationships, seemed far away and empty. I could drop them in a minute, and that might well seem to be the logical thing to do. The thinking brain can still function but cut loose from any tie to feeling. Decisions based on logic and indifference can be the most dangerous of all.

But on the other end of the spectrum, where major depression waits, there is plenty of feeling, but it’s all desperation. My survival is at stake. I have to be alone and shut the door on everyone I know. I have to quit this job, or it’ll destroy my life. Seeing this therapist makes me sicker, and I’ll go off the deep end if I don’t quit. This relationship is a trap that’s ruining my life. There are only relentless drives here, and everything I do or desperately feel I need to do simply has to happen. I have no power of choice. It’s easy to argue that a decision has been made. But I can’t see it that way, any more than I would say that someone under torture makes a choice to confess and stop the unbearable pain.

What Does It Take to Decide?

The psychologist James Hillman wrote a book called Kinds of Power Making Decisions When Depressedin which he presents an interesting take on decisions. This may sound a bit pedantic, but he looks at the root meanings of the word from a Latin verb meaning to cut or to kill. Decision/decide shares this root with words like incision and homicide. Cutting away or killing off are useful metaphors because that’s what I have to do to pick one among many possibilities.

Cut away the extraneous possibilities and narrow down to specific action that will accomplish something: here’s what to do, now do it. Choices must be made to keep life and mind moving. But to do that, I need a clear vision of what I want, confidence that I can do it and belief that I can improve my life by acting in this way. When depressed, those are exactly the qualities I know I don’t have.

Depression brings the whole world inside me. I look at people and everything around me, and I’m not seeing anything but evidence of how bad I am. I’m dancing with my own nightmares. Even if I’m only mildly depressed and feel suspended amid a thousand possibilities, no one of which I can choose, I’m assuming that whichever I might pick will not take me anywhere. I’ll move in an endless circle.

Or else I’ll feel nothing, and there is no point in wanting anything. I put on a good show, pass for happily adjusted to life but only see blankness ahead – if I take the trouble to look. And in the most desperate state of severe depression, I’m running for my life. The idea of choosing a different path doesn’t enter my mind.

What’s common to all those ways of being depressed is an all-or-nothing thinking. Nothing good can result from what I do, and so there is no vision that I can choose of my own will. Everyone else is better than I am, and each seems a powerful presence that only makes me smaller still. Whatever I do will not work and only confirms the worst. All the creative possibilities I might see when I’m healthy become so many triggers of obsessive thinking.

When I began to recover some years ago, I started with a single decision. I can’t explain how it happened when I was so close to believing that I should do the world a favor and just disappear. But something snapped. All I could hear in my mind, louder than any sound I knew, was NO, I won’t go there, and YES, I’m getting out of this. I will do it. It was more than a survival instinct, or fear of where I was headed. I had to push hard against the current that was forcing me in the wrong direction, and suddenly the strength and purpose were there. I felt in my bones that I did have a choice, and I’d better make the right one.

Most people don’t have to make a decision like that. They can take self-respect for granted and get on with living. I guess people with severe depression have to work harder to master the most basic dimensions of life, to keep going and to kill of the impulse to stop.

How are you doing at deciding things these days?

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Related posts:

  1. A Clear Voice Amid Depression
  2. Working in the Dark
  3. Talking Honestly about Depression
  4. Why Depressed Men Leave – 2
  5. Theater of Depression

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10 Comments to “Making Decisions When Depressed”

1. Posted by Wendy Love, September 24th, 2009 at 7:44 am

This is so good, so well-written and so true! The way you break down the process of thinking and deciding and ruminating etc. impresses me. I tend to be a bottomline kind of writer and your details add so much. I decide when I am well, then regret when I am not well. One way or the other, it is a difficult process. I used to be very decisive and so being undecisive is a change which I have not yet adjusted to. Thanks for the challenging ideas.

2. Posted by Louise, September 25th, 2009 at 10:01 am

I am finding your blog most helpful and enjoyable; and, I agree, you have a great writing style!

I wish to share a book that caused a shift for me: Mystic Path to Cosmic Power by Vernon Howard (or any work by Vernon Howard). Yes, it’s a corny title, but it contains authentic answers to worry, heartache, and suffering.

An excerpt: “We must see what happiness is not. It is not exterior activity; that is merely a distraction from inner unhappiness. What, then, is happiness? The answer is not complex. Happiness is simply a state of inner freedom. Freedom from what? With a bit of self-insight, every individual can ancer that question for himself. It is freedom from the secret angers and anxieties we tell no one about. It is freedom from fear of being unappreciated and ignored, from muddled thinking that drives us to compulsive actions, and later, to regrets. It is freedom from painful cravings that deceive us into thinking that our attainment of this person or of that circumstance will make every right. Happiness is liberty from everything that makes us unhappy….it is formless; it cannot be fitted into the frame of our demands. We insist upon this wife or husband, this career or achievement, this home, this secrity, excitement, or distraction. Even if we get our demand, we are no happier than before; we have merely covered our unhappiness. It is still there, and it will inevitably show itself when change occurs. We must break the frame altogether, and just let life happen; then, we enter an amazing new world whose existence we never before suspected.”

“For a happy life is joy in the truth.” (Augustine)

3. Posted by Ellen, September 25th, 2009 at 2:16 pm

Hi John,
I um ’suck’ at making decisions. Recently I was trying to decide on a therapy method and therapist, and ended up just going with whatever was closest to hand. Not the best way.

However, I also found that sometimes I would try to hedge my discomfort with decisions by doing a lot of research – for me, research can lead to endless detours and procrastination and in the end, I would still have to make a decision. I spent about two years trying to decide on a brand of car – in the end, I just went with a Honda because I’d had one before and liked it. A lot of research and agonizing wasted really.

Now what I’m trying to do more is to discern what I really want – what is it I really like, emotionally? That’s kind of a small voice inside, not so easy for me to hear. But that way, at least I choose something I genuinely desire, whether in the end it was the best choice or not. Kind of trying to respect my own personality.

Now, what do I really want for dinner, truly? Perhaps pasta…with something green. Yes, that will make my heart glad!

Cheers,
Ellen

4. Posted by john, September 25th, 2009 at 10:44 pm

Thanks, Wendy -

You’re too kind! It interests me that you changed from being very decisive. I went through perhaps a similar shift at midlife as measured by Meyers Briggs. From being a very cocksure and decisive INTJ to an INFP – much less interested in reaching sharp conclusions as in exploring possibilities – often for far too long to get things done.

Thanks for your comment.

John

5. Posted by john, September 26th, 2009 at 4:28 pm

Hello, Louise -

That is a beautiful passage. It’s amazing how many writers I keep discovering who’ve been around for a long time and have inspired millions.

Thank you for letting me know about his work and also for your kind words about the blog.

All my best –

John

6. Posted by john, September 26th, 2009 at 4:38 pm

Hi, Ellen -

That sounds so familiar – two years for a car is impressive. Of course, you don’t want to rush into anything. I’m busy at every procrastination sale and always come home laden with bargains.

But you’re so right, you have to get clear about what you want. If only that were a simple thing to do! It’s embarrassing how long it takes me to figure out what I’m really trying to say in these posts. At least I’m able to keep asking that question and staying with it until I’ve cleared away all the digressions. But it takes way too much time, given all the other things I’m trying to do.

I like that idea of respecting your own personality. Perhaps that’s a key part of this inability to decide – not accepting the legitimacy of your own wants and desires but trying to import them from somewhere else – like research into what other people think you should want.

Best of luck – I hope you enjoyed that dinner.

John

7. Posted by Wendy Love, September 27th, 2009 at 5:10 am

John,
Here is another article on decision making and depression which may shine some more light http://www.bphope.com/Item.aspx?id=592

8. Posted by Wellness Writer, September 28th, 2009 at 11:19 pm

Dear John,
Terrific piece. Yes, I know how difficult it is to make decisions during a depression. In some cases, I learned that I was better off not making them because my judgment was impaired.

In other cases, I couldn’t seem to make a decision no matter how hard I tried. And perhaps some of that was because I had become terribly confused about what I wanted or thought I wanted.

What’s interesting to me is that an inability to make a decision is contrary to my nature when I’m well. One of my best skills is my analytical ability, and I like making decisions. So…it was always so disturbing to be so wishy-washy.

Susan

9. Posted by john, September 29th, 2009 at 7:47 pm

Wendy -

I finally had a chance to look at the article you mention. People had to make choices under (mild) stress and went with the safer one, associated with smiling faces. That makes sense – though that sort of stress – momentary distraction while trying to make the choice – doesn’t capture the sustained impact of depression. Retreating to safe ground when the mind isn’t free to do its work sounds like a good strategy.

Thanks for the reference.

John

10. Posted by john, September 29th, 2009 at 7:52 pm

Thank you! I know well what you mean about acting against your nature when depressed. I have endless experiences with that, all of them things I wish I could just forget.

Holding off from deciding sounds exactly right. Trying when you have half a brain to work with only adds to the torment.

All my best to you –

John

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