# How to Persevere When Depression Persists



## David Baxter PhD (Oct 26, 2017)

*8 Ways to Persevere When Depression Persists*
by Therese Borchard, _Everyday Health_
August 11, 2016

Although I like to cling to the promise that my depression will get  better ? since it always has in the past ? there are long, painful  periods when it seems as though I'm going to have to live with these  symptoms forever.In the past, there was a time when I had been struggling with death thoughts for what seemed like forever. One afternoon, I panicked when I surmised  that they might always be with me. I embraced the wisdom of Toni Bernhard, who wrote a brilliant handbook for all of us living with chronic illness, _How to Be Sick_. While reading her words, I mourned the life I once had and made room to live with symptoms of depression indefinitely.

The  death thoughts did eventually disappear, but I'm always mindful of my  depression. Every decision I make in a 24-hour period, from what I eat for breakfast to what time I go to bed, is driven by an effort to protect my mental health.

When  I hit a painful stretch that feels like forever, I return to Bernhard's  insights and to my own strategies that have helped me persevere through  rough patches along the way.

Here are some of them:

*1. Revisit the Past*
When we're depressed, our perspective of the past is colored by melancholy, and we don?t see things accurately.

For  example, if I'm in a low mood, I look back on those years when I  experienced death thoughts and think that I felt nothing but depression  for more than 1,000 days. It?s helpful to peak at my mood journals from  that period to see that I did have some good days and good times  scattered throughout the painful stretches, which means I will have good  hours and days in coming hard periods as well.

I also look at  photo albums that bring me back to moments of joy sprinkled in amidst  the sadness; these give me hope that even though I?m still struggling,  it's possible to contribute a nice memory to my album.

*2. Remember That Pain Isn?t Solid*
Going  through mood journals is also a good way to remind myself that pain  isn?t solid. I may start the morning with excruciating anxiety, but by lunch I might be able to enjoy a nice reprieve. At night I may even be capable of laughing at a movie with the kids.

Bernhard compares  the painful symptoms of her illness to the weather. ?Weather practice  is a powerful reminder of the fleeting nature of experience: how each  moment arises and passes as quickly as a weather pattern,? she writes.

I like to think of my panic and depression as labor pains. I breathe through the anguish, trusting  that the intensity will eventually fade. Hanging on to the concept of  impermanence gives me consolation and relief in the midst of distress ?  that the emotions and thoughts and feelings I?m experiencing aren?t  solid.

*3. Maximize Periods of Wellness*
Most  people who have lived with treatment-resistant depression or another  chronic illness have learned how to maximize their good moments. During  painful stretches, I consider these moments to be the rest periods I  need between contractions. I soak them in as much as humanly possible  and let them carry me through the difficult hours ahead.

*4. Act As If*
Author and artist Vivian Greene has written, ?Life isn?t about waiting for the storm to pass ? It?s about learning to dance in the rain.?

That sums up living with a chronic illness.

There?s a fine line between pushing yourself too hard and not challenging yourself enough, but most of the time, I find that I feel better by ?acting as if? I?m feeling okay.

So  I sign up for a paddle-boarding club even though I don?t want to; I have  lunch with a friend even though I have no appetite; I show up to swim  practice with tinted goggles in case I cry. I tell myself ?do it anyway?  and operate like I?m not depressed.

*5. Embrace Uncertainty*
Not  until I read Bernhard's book did I realize that much of my suffering  comes from my desire for certainty and predictability. I want to know  when my anxiety will abate, which medications will work, and when I'll be able to sleep eight hours again. I?m  wrestling for control over the steering wheel, and the fact that I don?t  have it is killing me.

The flip side, though, is that if I can  inch toward an acceptance of uncertainty and unpredictability, then I  can lessen my suffering. Bernhard writes:

Just seeing  the suffering in that desire loosens its hold on me, whether it?s  wanting so badly to be at a family gathering or clinging to the hope for  positive results from a medication or desiring for a doctor not to  disappoint me. Once I see the [suffering] in the mind, I can begin to  let go a little.
​
*6. Stop Your Inner Meanie and Remember Self-Compassion*
Like  so many others who battle depression, I talk to myself in ways I  wouldn?t even address an enemy. I call myself lazy, stupid, unmotivated,  and deserving of suffering. The self-denigrating tapes are so automatic  that I often don?t catch how harmful the dialogue is until I?m saying  the words out loud to a friend or doctor.

We can relieve some of  our suffering by addressing ourselves with the same compassion that we  would offer a friend or a daughter. Lately, I?m trying to catch my inner  meanie and instead offer myself kindness and gentleness.

*7. Attach Yourself to a Purpose*
Friedrich Nietzsche said, ?He who has a why to live can bear almost any how.?

When  my depression gets to be unbearable, I picture my two kids and my  husband, and I tell myself that I have to stick around for them. It?s  fine if I never wear one of those "Life Is Good" t-shirts. I have a higher purpose  that I must complete, like a soldier in a battle. I must see my mission  through to the end. Dedicating your life to a cause can keep you alive  and give you the much-needed fuel to keep going.

*8. Stay In the Present*
If  we can manage to stay in the present moment and focus only on the thing  that is right in front of us, we eliminate much of our angst, because  it's almost always rooted in the past and in the future.

When I?m  in a painful stretch, one day at a time is too long. I have to break it  down into 15-minute periods. I tell myself that for the next 15 minutes,  my only job is to do the thing in front of me, whether that's helping  my daughter with homework, doing the dishes, or writing a column. When  15 minutes are up, I commit to another 15 minutes. That way, I patch  several days together, and before long, one of those days contains some joy.


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## Daniel (Feb 19, 2018)

_A new, related article by the same author:
_
9 Ways to Let Go of Stuck Thoughts
by Therese Borchard
February 19, 2018

Stuck thoughts … the brick walls that form a prison around your mind. The harder you try to get rid of them, the more powerful they become. I’ve been wrestling with stuck thoughts ever since I was in fourth grade. The content or nature of the obsessions have morphed into many different animals over the course of 30-plus years, but their intensity and frequency remains unchanged. Here are some strategies I use when they make a surprise visit, techniques that help me free myself from their hold.

*1. Don’t Talk Back
*
The first thing you want to do when you get an intrusive thought is to respond with logic. By talking back, you think you can quiet the voice. However, you actually empower the voice. You give it an opportunity to debate with you and make its case. The more you analyze the obsession –“That is a silly thought because of reasons A, B, and C” — the more attention you give it and the more intense it becomes. In “The Mindful Way through Depression,” authors Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn write, “Sorting things out and forcing a solution will always seem like the most compelling thing to do … but in fact focusing on these issues in this way is using exactly the wrong tools for the job.”

*2. Know It Will Pass
*
I can do anything for a minute. Most things for an hour. A considerable amount for a day or two or three. Most of my intrusive thoughts—the intense phase, anyway—have a life span of two or three days. I find the obsessions much more manageable when I compare them to the cravings for alcohol I experienced in my first years of sobriety. They came with intensity and then they left. All I had to do was to bear with them for 24 hours and refrain from doing anything stupid. Then my brain would be mine again. Your stuck thoughts are not permanent. They will be gone soon enough.

*3. Focus on Now
*
Your stuck thought is most likely based in the past (feelings of regret, etc.) or the future. Rarely are we obsessed about something that is happening in the present because we are too busy living this moment. It can seem impossible to engage with what’s happening in our world in real time when we have a riveting made-for-TV drama unfolding in our heads, but the more successful we are at tuning into the here and now, the less tormented we will be by our stuck thoughts. I try to be around people and have conversations so that I have to concentrate on what they are saying to me, not the text messages of my chattering mind.

*4. Tune Into the Senses
*
An effective way to anchor your mind in the here and now—and away from the obsession du jour–is to tune into the senses. Our five portals to the world — seeing, smelling, tasting, feeling, and hearing — can transition us from the doing mode to the being mode. For example, I was hanging out with my daughter on her bed the other night as I obsessed about something that had happened that day: theorizing why it occurred and arriving at 342 solutions to solve the problem. My daughter grabbed my hand to hold, which rarely happens these days, and it occurred to me that I was missing out on a precious moment because of some stupid stuck thought. So I made a conscious effort to focus on her soft hand in mind. Concentrating on the texture of her skin and the sweetness of that moment led me out of my head and into reality.

*5. Do Something Else
*
If you can, distract yourself with some other activity. You need not start an ambitious project to change gears. I mean, painting your bathroom walls could definitely do the job, but so could walking around the block or working on a word puzzle.

*6. Switch Your Obsession
*
You might try to replace your obsession with another one that isn’t so emotional or damaging. Example: I was obsessing about something the other day when I headed to Panera Bread to write. I was intent on getting a booth, so I hung out at one of the smaller tables until I could secure one. I studied the people, their gestures … are they leaving? Another woman came in with her laptop and was also scouting tables to set up shop. I panicked. I knew she wanted a booth too. All of a sudden, all I could think about was securing a booth before she did. My old obsession vanished in light of this new, benign obsession.

*7. Blame the Chemistry
*
I experience great relief when I remember that I am not obsessing about something because that thing is crucial to my existence and should replace priorities one, two, and three, but rather because the special biochemistry inside my noggin is wired to ruminate A LOT. The subject of the obsessions isn’t all that important. There is no catastrophic problem that needs to be solved in the next 24 hours. In fact, the unstuck thought might be 100 percent fluff, a made-up story the brain fabricated because it couldn’t find anything interesting enough in real life to warrant ruminations.

*8. Picture It
*
I know a grade schooler who is besieged by stuck thoughts, too. He doesn’t have the life experience or the knowledge to know that these thoughts aren’t real, so when they say, “You can’t do your homework because you’re stupid,” he panics, throws pencils, shouts some crazy stuff, and exhibits bizarre behavior because he is convinced that he can’t do his homework because he is stupid. Watching this temper tantrum is helpful for me because it serves as a display of what’s going on inside my head, and when I can visualize it, I see how ridiculous it all looks.

*9. Admit Powerlessness
*
If I have tried every technique I can think of and am still tormented by the voices inside my head, I simply cry Uncle and concede to the stuck thoughts. I get on my knees and admit powerlessness to my wonderful brain biochemistry. I stop my efforts to free myself from the obsessions’ hold and allow the ruminations to be as loud as they want and to stay as long as they want because, as I said in the first point, I know they will eventually go away.


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