Learning How to Live Well Again

Woman balancing with umbrella

One of the strange things about recovering from depression is that the condition is so pervasive getting better can feel like learning how to live all over again.

There’s a lot of disagreement about what recovery means and whether that is even the right word to capture the changes you undergo. Because there is so much variety in the ways of healing and the goals of wellness, I’m finding it harder than I had thought to get my ideas about recovery into the form of an ebook.

It’s always tempting to summarize my own experience as universal in some ways. There are commonalities in life dominated by depression and in some of the phases most of us go through as we learn what it is and how we can deal with it. But I want to make sure I can capture the range of differences too.

It’s not just that I keep exploring approaches that others have used. I also keep rethinking what I’m going through as I learn about new therapies and ways of looking at depression.

The best way I can organize the changes in my own approach is to summarize the different mindsets I’ve had about depression and my life generally. One thing I notice in doing this is how the words I’ve used have changed to reflect changes in understanding and greater levels of openness to what I feel.

Recognizing the Need for Help

Like everyone else, I had first to figure out what was happening to me. That process took many years, partly because when I first sought treatment in the 1960s, psychiatrists had a very different response to depression than they do now.

Unless you were in a state of collapse or suicidal, depression wasn’t treated as such. The focus was on an examination of causes for distress buried deep in your family history and personality. Getting rid of the “surface” symptoms would only keep you from getting at the real issues that were disturbing your life. The symptoms were the clues that helped you get access to the past.

So the early recognition of depression was restricted to identifying low mood, low energy and low motivation. At times, I would just float with it, letting myself soak in its darkness. I guess you could call that mindless acceptance, but the only effect was to get a feeling of comfort in my immobility. That didn’t help me very much.

I never used the word “recovery” or thought of myself as ill. I was just trying to figure out my screwed up life. Unfortunately, my idea of depression didn’t include damage to self-esteem and obsessive negative thinking, so those continued to shape my idea of who I was.

Redefining Depression as Disease

Much later I learned that depression influenced me more extensively than I had ever imagined. I learned the contemporary ideas about neurobiology, cognitive dysfunction, comorbid physical illnesses and the pervasive influence of stress. I connected with the larger world, the millions of people with depression and the array of medical treatments I had had little experience of before that time.

Learning that I had a “brain disease,” a medical illness rather than a vaguely psychological and emotional “problem” was a huge relief. I eagerly embraced the medications and newer versions of psychotherapy.

It was a period of new hope and energy in dealing with depression. I was “sick” with illness like someone with cancer, not “sick” with a defective personality and less than fully human nature. Finally, there were medicines that promised to help me feel good without putting me into a stupor.

Unfortunately, the strange optimism about having a disease turned to hopelessness when I found that medical treatments didn’t work. Even though I was the energized and highly motivated partner in treatment, I was in the passive position of waiting for the latest medication or procedure that, maybe, this time, would bring recovery to my doorstep.

I put my hope in transcranial magnetic stimulation and followed the trials and FDA approval process. Unfortunately, it was an expensive treatment that required out of state travel at the time. As further discouragement, I met a friend – treatment resistant like me – who had tried it with only minimal results.

He also had a vagus nerve implant (a pacemaker-like device inserted under the skin that sends a pulse of electricity into a major nerve), and that wasn’t helping him at all. When he undertook electro-convulsive therapy, lost short-term memory and his usual fluency in putting sentences together – but was still depressed, I was scared away from trying that approach as well.

Independence and Taking Charge

In the next shift of mindset, I decided that I needed a more comprehensive approach to recovery. I went back to the starting point. I tracked my daily existence to identify all the depressive habits and symptoms that I felt were restricting me and limiting what I could do.

I wanted to dispense with the general list of depressive symptoms familiar from the diagnostic manual and self-help books and see exactly what my version of depression was like. That process helped me match specific therapies to each set of problems I wanted to deal with.

I was full of purpose to feel good about living again. I understood that I had to be as active as possible and to accept relapse as part of the process. I had a lift in mood from medication for a while, learned the techniques of cognitive therapy, drastically reduced persistent sources of work-related stress, found my way back to writing as an important guiding purpose, and opened myself more to relationships and doing things with my family.

All this and more helped me to a state of stable recovery in which any legacy symptoms of depression felt like brief diversions. Surely that was it. I had recovered, task accomplished. But that’s not the whole story of living well.

Learning to Keep on Learning

I’m in a different stage now, but I don’t know what to call it. Others refer to this as transformation or self-mastery. Those words are helpful. Instead of feeling like I’m successfully coping with an illness, I’m changing the way I think about depression and how it fits into my life.

I’m seeing the good and bad dimensions of my experience as a single whole, each aspect of which has its opportunities for discovery and fulfillment.

One way to think of it is that I’ve reinterpreted symptoms as experiences. The attitude is more open, accepting, even welcoming of what happens. Maybe it comes down to the simplicity of feeling I have my feet on the ground and of being open to exploring the terrain rather than afraid of what I’ll run into.

Talking about this flow of living and discovering in terms of stages or mindsets is, of course, misleading. There aren’t very clear boundaries where one ends and a new one picks up. But I can separate out different beliefs and expectations that influenced how I responded to depression, to myself and to the people in my life. There is as much continuity in who I am as change in awareness, and there are no endpoints to anything.

This latest mindset is still forming, and it will doubtless be followed by others. Perhaps the key thing is that I have kept responding to depression as an essential part of who I am. Whether I’ve thought of it as disease and disability or opportunity for discovery, I have had to grapple with forces and energies within me that I will never fully understand or master.

You can see why it’s so hard to put all this into ebook format. I keep wanting to feel like I’m finished, that I’ve done it and can help others do it too. I’m so used to talking about life having purpose, structure, direction, values, goals, processes, as if it were something I could build and shape, reach out and touch. But I can’t.

What do you think are the attitudes and mindsets that keep you going as you deal with depression?

This is an updated post from the archives.

10 Responses to “Learning How to Live Well Again”

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  1. Angel Pendas says:

    Thank you for your blog. I’ve enjoyed reading about your experience with depression. I find that accepting emotions and perceptions has helped me. BUT, I do this while meditating. In the last 10 years I have established a meditation practice with the help of other like-minded people. Meditation has allowed me to explore, analyze, and embrace negative emotions. I have rewired my brain to respond differently. I have taken distance and stopped judgments that lead to negative outcomes.
    Meditation is not easy. As a matter of fact, it takes dedication and a great deal of time. (The same as writing). It serves as a compliment to exercise, and just as with exercise, doing it with others increases your desire and makes it easier. I personally use zen meditation and practice daily by going to a zendo.
    Learning to meditate has also allowed me to not over-analyze and welcome change. THAT is very important when reshaping one’s life. Reformation is exactly that: RE-FORM. Allow the changes in your life to come. Do it slowly and measure those changes FAIRLY without comparison to others.
    Once again, thank you John for making the decision to write and help others.

  2. Judy says:

    I can certainly identify with everything you say here! I’ve been thinking about this very topic lately. My attitude toward this right now is one of trying to be open to whatever happens while also attempting to define boundaries. Looking at recovery as a work in progress is probably what keeps me motivated to keep diving in and to believe that a richer life is possible. Before I started to truly heal, I think my existence was mostly just that – everything muted, limited, safe, just to keep myself going. Now, I sometimes feel (oddly, considering my age!) like a baby bird teetering on the edge of its nest, thinking about taking off, to see if I can really fly – just don’t push me!

    • John Folk-Williams says:

      Hi, Judy –

      I like the young bird image. The ongoing discovery during a healing process is the sort of learning a young mind does. Given what we know about neural plasticity, it’s no exaggeration to talk about regenerating the mind – so I guess you could say we keep relearning how to fly.

      John

  3. Janet Singer says:

    What a thought provoking post and I definitely can relate to it as I compare your journey to my son’s journey through severe obsessive-compulsive disorder. How OCD has been treated (or not treated) over the years, what medications have and have not been used, and how the sufferer views him or herself, are all such important components in that quest for “recovery.” For Dan, I believe it was the revelation that OCD is just one part of who he is, one very TREATABLE part, that spurred him on with hope. It is an ongoing challenge, but one he is more than willing to take on for a satisfying life.

    • John Folk-Williams says:

      Thanks, Janet –

      I’m glad to know that this makes sense in terms of your son’s experience as well. I agree that Dan made the most essential discovery in coming to see OCD as just one part of him. It must be so hard to deal with the fear at the heart of OCD. Fear is so mind-crippling that I’m sure, like depression, it must take a great effort every day to keep from being swept along by it.

      Thanks for writing —

      John

  4. Wendy Love says:

    The attitude that keeps me going is to give in but don’t give up. I try to give in to the symptoms, in that I respond to them instead of pretending they aren’t there. Most of my response to most of my symptoms is to rest until some stability is achieved once again. When I say ‘give in’ I mean work with the illness rather than fight against it.
    But I don’t give up. Like you I continue to research new ideas, try new books, read blogs such as yours etc. Right now I am attempting to go through Tom Wooton’s “Bipolar In Order” which I admit I am finding difficult but I am persevering.
    As always John, I appreciate the way you approach this ‘crazy’ illness.
    By the way, I think your talent lies not in the conclusions or the end results but in the process. You are an excellent processor!

    • John Folk-Williams says:

      Thanks, Wendy –

      I’ll be interested to hear about your progress with Tom Wooton’s course. I’ve learned a great deal from it and really admire the direction and scope of his work. It’s a good way to process the experiences of depression, though some of the details of processing as you get more deeply into it sometimes feel like the working out of a concept rather than a direct response to the condition. Given the variability of the bipolar and depression, I think it’s inevitable that some of the steps in any systematic approach don’t feel quite on the mark.

      All my best —

      John

  5. The attitude that keeps me going is hope, the belief that each day I create a better life for me. When I find I am “letting myself soak in its darkness” (love that expression) there is no hope. But then things get bad enough that I don’t want to be in that place anymore, and that is the first infinitesimal glimmer of hope that there may be something better.

    I, like you, am using this recovery process as a learning tool, and now I have learned the tools to pull myself out of the darkness of depression (exercise, healthy eating, writing), I must learn the next phase – how to move forward in my life, create create creative and economic prosperity while not falling back into depression. I am walking a tightrope as I work through this, but there is also some excitement in the challenge!

    • John Folk-Williams says:

      Hi, Michael –

      Hope does survive depression. I suppose it’s the surest sign of resilience that hope keeps returning. I agree that creativity is central to moving forward – it seems like the basic path to making a really meaningful life.

      All my best to you —

      John

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