Hoping for More than Remission of Symptoms

Here’s a question for you. if you could get rid of depression, what would you want your life to be like? A lot of people think of recovery as an unending process of managing the symptoms of depression. That’s also the impression I get from looking at psychiatric treatment protocols.

Remission of symptoms rather than recovery seems to be the expected outcome. I don’t know about you, but I’ve always needed a more hopeful goal to aim for.

Image by Cornelia Kopp

Before thinking about what’s ahead, however, there’s the enormous task of getting the most crippling effects of depression under control. I don’t mean ending them altogether, but reducing the extremes. Only then is it possible to think straight about the work of getting rid of depression and to imagine what full recovery might mean. If it’s possible to get that far, you might find it as empowering as I have to keep focused on the goal of restoring a full life rather than accepting remission of symptoms as the best you can hope for.

In looking back at how I’ve lived with depression, I think the most important thing I’ve been able to do has been restoring hope. To do that, I’ve had to move through the deadly stillness of depression, the reawakening period of recovery and the creative experience of reconnecting with life.

Depression

Depression is the freezing of life and the ability to learn from experience. It’s the static, steady state that won’t change. Part of the frustration of living with it was the repetition of the same symptoms over and over again. I was always tormented with the question: Why does this keep happening? I know what it is, I work on stopping it all the time, and yet it’s always the same. I felt powerless and expected that I would never be free of it.

Sure, the symptoms might come in different combinations and greater or lesser degrees of severity. But I believed depression was always there, lurking in the background, touching me lightly as a reminder that it could grab me whenever it wanted to. It was like being chained to a treadmill – a lot of motion but no forward movement or hope for getting anywhere.

I had no ability to adapt to the flow of experience because to me nothing was changing. I wasn’t in that flow. I was filtering out its variety and reducing it to the common denominator of despair.

Recovery

Recovery is a new awareness of the possibility of change. With it comes hope and the determination to get moving again. After that new consciousness is in place, then it’s all about practice, slow steps, relearning life skills, changing beliefs and expectations about myself and the future. Every treatment has given me something new to work with. But it was common to lose all awareness of what I’d been learning in the midst of a major depressive episode. There was lots of backsliding, lots of discouragement.

One of my problems during recovery was to expect too much from each new tool. If I followed the right diet, went running frequently, meditated, practiced new cognitive skills, took medications, went to therapy, then surely I could turn this around and get rid of depression forever. When the breakthrough didn’t happen, I only got more discouraged, coming back to the dependable cause of failure – me.

Then it dawned on me that expecting big changes all at once was slowing me down. If I kept my eye on the bigger picture, I’d have a more realistic sense of the pace of recovery and start to get somewhere. It’s like learning how to handle a car on the highway. You move toward the spot you focus on. If you look at the road right in front of you, you oversteer while trying to stay in the lane and quickly start crossing the line. If you focus far ahead at where you’re going, you unconsciously adjust the steering wheel and drive straight ahead.

Realistic expectations supported the will to keep going. The slow process of recovering finally brought me to what I was after – the chance to come back to life.

Reconnecting

Life is motion, the ability to adapt to whatever happens, to see myself as part of a complex world going through infinite changes. I needed to be in it again, out of the still, rigid world of depression, tightly bounded by my own mind. Recovery was the long preparation and training to get there.

Getting back into life means seeing it clearly and seeing it whole. It means pulling away the dark filter that allows a depressed mind to project its own reality and dim expectations over everything and everyone you see.

I think reconnecting to life happens through a constant interchange with others, not in the isolation that is so typical of depression. Discovery and learning from experience comes from the responses people have to each other – if they are open to receiving them. There is a constant giving back and forth and from that each person is enriched.

That’s what I’m aiming for – rather than thinking that the rest of my life will consist of perpetual management of symptoms. I guess everyone figures out what recovery means in terms of their unique experience. I’ve had to develop a private definition that really works for me. It supports the determination to get better that was one of the first steps toward change.

3 Responses to “Hoping for More than Remission of Symptoms”

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  1. Donna-1 says:

    John, do you ever feel like you have had to lower your expectations of life (and of yourself) in order to get to a place of feeling better? I used to strive always to be #1, the best, the brightest, the most competent. And when depressed, I kept thinking, “This is not me and I am not this. I am capable of so much more. I can do better, and I know it.” Now, I feel more comfortable knowing that I can probably apply myself and achieve what I want to achieve, but I’m not so keen on pushing myself 100% all the time. And part of it is realizing that I’m not young anymore (relatively speaking.) I don’t have 60 more years in which to make a name for myself. And it no longer seems important to do so. We can’t all be Shakespeare or Picasso. And I don’t feel like I am putting constraints or limitations on myself as much as just accepting the fact that realistically, there ARE limitations.

    • Hi, Donna –

      That’s a great question – I’ve had a draft post on this problem for a while, and I guess I’ll get to it now. For me, I suppose it’s a yes and no answer. I always tried to be first-rate in everything. In my (hypomanic??) periods, I’d spin out ambitious goals, more like futures, and stayed high with them through the initial stages. But it had a lot to do with fighting the internal sense of worthlessness. After a while, depression set in, and I’d keep falling short in meeting the expectations I had set – and that others counted on my meeting. After depression got worse and worse over the last ten years, it was clear I was falling apart in my profession – but it had always been a strain to push myself into it. So after retiring I put the whole unhappy experience way out of mind and switched to writing – what I’ve always wanted to do. That’s been deeply energizing and was decisive in getting me out of depression. It’s really another career I’ve launched, and I love it. But I’ve had to keep the stress level low and tone down the unrealistic expectations. So in a sense I expect less, but it feels more like realism and doesn’t change my enthusiasm. There’s a lot more to this – so it’s back to writing that post. 🙂

      John

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