Is it possible to learn to live well using an acceptance approach to depression rather than the strategy of trying to suppress or avoid it? That’s the question I’ve been exploring.
Most of the treatments for depression I’ve used have been based on avoidance. Reduce stress, overcome depression, control anxiety, conquer anger. Get rid of them with medication, psychotherapy, ECT or any of the other available methods that help you stop the pain.
What else can you do but try to root out such disabling disorders and all their destructive allies? If you can’t stop them completely and avoid all the life-breaking pain they bring, at least you can manage them with careful monitoring and ongoing treatment.
Everything I read, every therapist and psychiatrist I worked with, all supported this view. Even though this approach never worked very well for most of my life, I kept on with it, hitting my head against the same wall over and over again. That was treatment as I knew it.
Learning about Acceptance
What was I to make, then, of a newer set of therapies that advised just the opposite. Don’t try to avoid depression. Accept it, live with it “mindfully,” learn from it, take it into the comfort zone of your life.
At first, these ideas sounded bizarre, even insulting. I lumped their advocates in with the condescending “depression is a choice” crowd or hopelessly naive new-agers who weren’t really talking about depressive disorder at all but some spiritual unease. Gradually I dropped the resistance and tried to understand what acceptance was all about.
For one thing, they recognize their limits. Each of these approaches stops short of the extreme of suicidal depression that demands fast treatment, including medication, hospitalization and whatever other treatment is necessary to help a person regain a basic hold on reality.
Most of the lives of those of us with recurring depression demand that we deal with less extreme conditions, but they still lead to the collapse of our ability to function. This is where the therapies based on mindful acceptance can be effective.
At first, I looked to these approaches primarily to figure out how I had achieved my own recovery of the past several years. I couldn’t understand what had caused the change after all those decades of muddling through, all the downtime lost to depression – despite the use of every therapy and medication I could try.
Getting more deeply into mindfulness helped me see how some of the changes might have occurred, but now I want to go much further in exploring these approaches. I want to work with them actively to see if I can accept and learn from the experience of depression, letting it guide me to a different sense of my life.
That’s a radical shift from thinking of depression only as a destructive illness to be ended as quickly as possible. I’ve had a lot of experience avoiding painful experience in my life generally as well as in the treatment of depression.
Avoidance as a Way of Life
I had lived by avoiding fear and shame-triggering events from my childhood on. The practice became deeply embedded in my way of doing things. I even made life-changing decisions rather than take on these dangerous situations.
No matter how much I might accomplish or how much I was praised, I ran from possible careers at the first important rejection. Those experiences wiped out everything that had gone before. I was filled with shame, convinced I would never be any good at that kind of work. Rejection was proof that all the worst things I believed about myself were true. Get out now!
It was easy to adopt the same approach when anxiety, depression and stress became much worse. When overwhelmed with the severe feelings that seemed to paralyze me, I started avoiding any situation that brought on the symptoms.
Refuge from Depression
There were many of those. I canceled meetings when I was so depressed I could hardly string two ideas or words together. I fled huge parties with dozens of strangers. I put off difficult phone calls, presentations and face-to-face conversations. I cut off close relationships out of fear of rejection.
There was safety in retreat, a chance to recuperate before taking on the world again. It was a great strategy for immediate relief, almost addictive, certainly habit forming. But the relief never lasted long. The reality was that the solitude I sought for rest soon became the isolation that deepened depression.
I felt ashamed that I couldn’t handle things. I learned nothing about coping with the inevitable next time when I would not be able to avoid or put off what I didn’t want to face. Fear and anxiety would build up again as I thought about the upcoming encounter.
I learned the hard way that avoidance came with a high price.
Avoidance as Treatment for Depression
When it came to dealing with depression, the strategy of avoiding its symptoms promised the return of a decent life rather than continued loss. I know it’s not customary to use the word “avoidance” in connection with treatment. But the word fits.
As I’ve often mentioned in these posts, the strategy of stopping depression and avoiding its effects never worked. My attitude about recovery became pessimistic. Since I couldn’t get rid of it, I felt that depression had become the ever-present background of my life.
After I realized that major episodes usually began without any triggering events, I felt I had to adapt to the inevitable. The best I could do was try to prepare for a hard impact as the illness followed its own rhythm.
With the help of medication and therapy, I tried to cut the deepest part of the cycle, but those methods were only half-effective at best.
A Deeper Recovery
After decades of this, I was suddenly surprised to feel a much deeper shift and came to believe that depression was behind me. It wasn’t a matter of the symptoms disappearing but rather of my living with them in a different way.
This is the outcome I want to explore more deeply. With the help of the therapies based on mindful acceptance of the experience of depression, I want to see what further changes in my way of living I can learn.
That’s what I will be writing about in this occasional series of post, and I’d like to get your ideas and reactions every step of the way.