Making Decisions When Depressed

CrystalRefraction-AMagill

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 in 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?

Image: Some Rights Reserved by AMagill at Flickr

48 Responses to “Making Decisions When Depressed”

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  1. Fred says:

    I’m posting in order to subscribe to followup comments.

    I’m 12 years into my recovery process and treatment for depression. I envy people who have loved ones willing to wait for them; I was very young (22) when I had my meltdown, and my ex-fiancée did not wait for me. I had left her for someone else in a desperate attempt to stop my pain; by the time I was clear-minded enough to realize what I had done, my ex had started seeing someone else and hated me. I’m still struggling to figure out how I let that happen.

    Hoping says in an earlier post that you have to realize you’re depressed. I definitely didn’t. I felt like me; it turns out I’ve had dysthymia probably since birth, so the major depressive episode just felt like I was more intensely me, if that makes any sense. I didn’t realize that life wasn’t like that for everyone. Every decision I made felt like a life or death matter that had to be dealt with immediately. I feel like I’ll never stop paying ythe price.

    Fred

    • Hoping says:

      Hello Fred, I was one of them people who was willing to wait for my depressed Ex, She left me for another man in her desperate attempt to stop her pain. Waiting it hard when you know the one you love is ill and they dont!..and the damage they do can be bad. We in the end have to move on to protect our hearts. Like most of us here we fight that battle hopelessly trying to get the people we love to see they aren’t themselves and we all fail. I dont hate my ex i love her dearly always will, but i will never forget how worthless she made me feel. And i hope she finds the courage to find hersefls again. And im sorry you to had to suffer from this awful illness.

      • Fred says:

        Hoping, thank you for your response, and thank you for trying to hold on. I think my former fiancée would have waited longer, but her parents were very much involved in her life and I believe tbey manipulated her via finances to give up on me. She was still financially dependent on them, so they had a trump card. That in no way alleviates my guilt.

        I wish she had known I was sick. I really do think she simply thought of me as an asshole who had wasted five years of her life. I loved her, desperately so, but my sickness made her feel a million miles away. When she repeated that her parents said I was “dragging her down with me”, it was over for me. They confirmed my worst fears.

        I wish her a happy life filled with love, but I wish it had been with me, or at least that we could have parted on happier terms.

        • Hoping says:

          Whats so hard when your trying to hold on is that from the outside it can look like a normal break up, but its far from it..your blind sided when someone with depression ends things. And it takes a long to to feel normal again. I know my ex lost her connection to me..but she turned on me was cold and indifferent. Now im not sure if i want to every see that stranger again. How long did it take you to become clear? And did you see everything for how it really was? Or was it still a skewed version of you reality? Again im sorry this illness ruins good things.

  2. Rachel says:

    Whoever is reading this, I’m sure for most people it is a desperate hope to find an answer to what you are going through. I think this description of depression is the best I have found. I myself this morning was trapped in my own mind, which lead me here. These thoughts I describe are what I have decided may improve my life after reading this page.

    The biggest thing that has gone wrong is not the actual things that went wrong, although they were horrible to adjust to, but the loss of the ability to find happiness, hope and meaning. Or perhaps the ability to accept that what you do may no longer have a great deal of meaning, (for example your day job – or trying to find one if you are unemployed) but that is how your life is and when there is no practical alternative to try to believe that it is ok and that you need to be ok with yourself doing what seems like un-meaningful tasks.

    When you have no cause, it is very easy for people to try to help by telling you to find one. Of course there are many causes you would like to feel you believe in but maybe you aren’t quite attached to one yet in order for it to make a difference to how you value your life. Whether it be a faith, charity, person you love or passion (this is quite rare to find in a depressed state) I think the problem is that I don’t believe it will find you. Somehow you have to find it, even if you can’t physically go out perhaps you could find it in a book, on TV, online, another person you have contact with. Then you have to make contact with that cause – do something to feel part of it, whether it’s just a phone call, a letter or something more practical. After having a major passion and losing it through a series of bad events it makes sense for me to try to find a few little causes rather than one big one – without over complicating my life in a way that I can’t deal with when anxiety attacks or spreading my time between so many things that I have no sense of belonging. For some people it might be better to find just one cause, or sometimes I think it might be better for me to find a new one cause realising that if that one becomes difficult I will find another one. Everyone’s cause is different – but it should be your own, and not somebody else’s. You may be alone in your own mind, but you may not always be if you can let something else in.

    I hope this works. I’m off to find a cause for myself. Thanks to all the lovely people that have posted on this page.

  3. Kim says:

    First: Thank you John for setting up this page.

    I have been writing earlier on (below) about indecision due to depression during stressful situations. Reading through this page once again helps to remind me how bad off I was just a year ago.

    My summarization below is intended to point out some of the key aspects that have helped to redirect at least one “storied mind” back to his true and usual self. Perhaps these pointers may give some good insights of how to throw out the demon of depression hiding deep inside.

    The importance of moving on – I used to be stuck “in my bed, too immobilized to eat or even go to the bathroom”. It is very important to find a way to get the momentum back in life. To start thinking ahead rather than looking back. As painful or useless as it may seem to try moving on it will still have the reward of having taken action in it. And taking action means regaining control. Do not be afraid to ask for help to get a move on. Total entrapment in unsolvable situations or unmanageable circumstances is the slow strangling killer when facing a major depression.

    The importance of realignment – I used to “hesitate to make decisions because I’m afraid they will be wrong”. Clearly and without a doubt all important decision making while being depressed should be avoided. My experience with indecision is that life will graciously always give you more opportunities that will be there for you (yet again) when you are more ready to grab them. Realignment also has a great deal to do with changing life style, present life circumstances and/ or expectations on life. It is easier to find a daily sense of gratefulness when easing up on the goals and achievements.

    The importance of others – I used to feel “isolated, imprisoned in my apartment”. Let’s just face it. If heading into major depression it is vital to have others to rely on for support (not for decision making but for the sake of recovery). I do not believe there are many people that manage to “shape up” on own without the help of a supporting friend or relative. Isolation leads to entrapment and the best way then is to avoid remaining isolated. One obvious step to help break the spell of isolation is to understand that you are not alone and that there is help to find.

    The importance of faith – I used to feel completely lost and helpless. Somehow I cannot help but stressing how important it is to be able to find true faith in God. From then on you will always be heading somewhere, whatever achievements or failures in life that you struggle with are suddenly of minor importance, and you will never ever have to be alone again. Depression always seems to arise from losing faith in oneself. My point here is that lasting faith may actually be found elsewhere.

    As far as I know the only really important decision I had to make while being depressed was to “never give up”. And that was not even much of a decision.

    Kim

  4. Alan says:

    I have to say this is the best explanation of feeling depressed that I’ve ever read. I couldn’t have put it better myself, I even recently penetrated the ‘saying NO to ending it all’ barrier, but It doesn’t get get much easier, in fact i don’t have the ‘ending it all’ crutch to lean on any more, I have to do this the hard way.

    For those that have never experienced severe depression, this is what it’s truly like, your doctor is unlikely to understand to the extent this author does, and indeed the British NHS service understood depression so badly that it only drove me closer to ending it all when I was at my worst.

    My advice; seek to understand your mind yourself, and try your best to love those around you, that will keep the hope if a better life alive. Also, confront your demons, it will seem impossible at first but once you take the first step it can only get better. (in my case i had to confront my father about childhood emotional issues)

    Despite how you might feel there are understanding people out there but don’t be fooled there are a lot of uneducated people who cannot and will not understand your condition, avoid them if you must and seek out those who are a little more emotionally sensitive.

  5. Hoping says:

    This is helpful to know, but only if your aware your depressed. My ex partner broke up with me afew months ago yet she’s depressed but in denial of it obviously not aware of it at all. It’s her reality how do I question her reality against my own?

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  1. [...] this one (Making Decisions When Depressed), John describes what it is like to make decisions while in the different levels of depression. He [...]

  2. [...] I just came upon this post fromJohn at themental health blog Storied Mind about making decisions whe…. I love his description: [...]



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