When I started learning about Acceptance and Commitment Therapy (ACT), the idea that I was doing depression rather than having it as an illness didn’t make a lot of sense to me. I could understand that avoiding painful situations could worsen depression and that I often acted in self-defeating ways. But weren’t those the effects or symptoms of an underlying illness?
Knowing that I had an illness called depression explained so much of my experience that I found it hard to suspend that way of thinking and consider an alternative. I had enough awareness, though, about the habits of depressive thinking that I could take another step backward to look at my assumptions about illness.
Before getting into this, however, I want to make it clear that I’m not suddenly abandoning the idea that depression is an illness. Nor am I going to rewrite every post on this blog that starts from that assumption. Thinking of depression as an illness was an enormous step up from identifying and blaming myself as an inadequate or crazy person. It helped me gain a distance from depression that marked the beginning of recovery.
This series is an experiment in changing perspective radically to see if it will help me move further toward the fulfilling life I want to live. I’m not recommending that this will work for everyone. I’m not even sure it will work for me. But it’s exciting to try something new, and anything that keeps me active in learning how to live well is worth the effort. So, back to the story.
I’ve relied in the past on tracking depressive symptoms in order to map out a plan for recovery, so I started by revisiting this method to get into the ACT approach. This time, instead of looking at symptoms and triggering events, I looked at my actions and what followed from them. Since I’ve gotten better in recent years, I mostly looked to the past when I felt completely locked into depression.
This became an inventory of the habits that had guided my life for many years. As soon as I thought of these patterns as a way of doing depression, I wondered how I could have missed it. Many of the problems that I had thought of as symptoms or impacts of an illness could also be seen in this different light. It was more than the act of avoidance, or not doing something. I could see that I had actively done things that made my life more painful, and I had repeated them over and over again.
At different periods in my life, I felt that the stress of my work was killing me, and I came to dread showing up. I realized I was handling assignments less and less effectively, even though I knew how to do the job well and had succeeded many times in the past.
I assumed that symptoms of depression were undermining my skills and acted to end the symptoms. But I did more than that. I convinced myself that because of depression, I could not make a living doing anything else. I stayed in the same line of work, even though I grew more and more anxious and panicky about doing it. I not only stayed with it, I acted with great persistence to drum up more clients so that I would have even more work to do.
There was also a strange undercurrent that I paid less attention to. It was a background feeling of resentment at being trapped. As a result, I was refusing to act effectively. I know that sounds bizarre, but there it was, like a kid’s reaction to being forced by his parents to do something he didn’t want to do.
Deep down, I’d be feeling: I don’t want to be here, so why I should I do anything for these people. Afterward, I’d take all the blame for a failed job and be plunged more deeply into depression. I berated myself for failing and spend hours in anguish and shame. I resolved that next time I would to do all the things I knew how to do instead of holding back. Then I would go out and do the same thing all over again.
In the meantime, I knew what I really wanted to do. More than anything, I wanted to write. That was the work I valued most, but I convinced myself that two things made it impossible. Depression as an illness was at the heart of both.
Because of limitations caused by the symptoms, I wouldn’t be able to earn enough money in this way. Even more fundamentally, I had a block about writing itself. When I made time to write, I would be depressed and deeply anxious. My mind blanked out and often shut down in sleep. So I would busy myself with taking notes and other tasks but avoid the act of creative work as much as possible. I stopped trying to write because of the fear, even panic it aroused.
Then I would go through the same process all over again, feeling trapped, trying to write, convinced I couldn’t, getting panicky, stopping in frustration, blaming depression. Yet every step of the way, I was making decisions and acting on them without changing the strategy in any way.
When it came to treating depression, I looked only to the elimination of symptoms and never thought about trying to act differently. I took medication, and I did psychotherapy with the goal of feeling better. Neither method was very effective.
I remained depressed, with occasional periods of relief, but this was the same cycle I had always lived with. The change seemed to be that periods of depression became longer and the symptoms more dominant. Yet I kept treating depression in the same way because I was afraid that things would get worse if I stopped.
I could extend this list to include most aspects of my life, but the pattern was similar. In ACT terms, as I understand them, that pattern goes like this:
- I fused with my thoughts and mental rules about myself, about depression and about the choices I had. The thoughts owned me, and my mind was purely reactive to them.
- I tried to control depression by avoiding problems, sometimes even cutting myself off emotionally and mentally from a situation while in the midst of it.
- I knew what I valued in life but believed I could not act on those values. So I acted on different values that were not mine.
- I tried to get out of the trap I was in by acting in ways that kept me in the trap.
No, this doesn’t make much sense, but the ACT experts help you see how little awareness you have when you’re struggling with depression. There are a lot of rules you learn and apply in the belief that you’re helping yourself. But I do have to ask: how many times do you have to knock your head against the same wall before you get the idea that it hurts?
Have you looked at your experience of depression as a pattern of actions rather than a set of symptoms? It’s not easy because you have to suspend judgment and many of your assumptions. You could think of it as a thought experiment. Do you find yourself doing depression?