# Making Decisions When You?re Depressed



## David Baxter PhD

*How to Make a Decision When You?re Depressed*
by Therese Borchard
July 22, 2016

Paper or plastic? For here or to go?

 Cash or credit?

 These are simple questions that most people don?t think twice about. But to a person in the midst of a depressive episode, answering  any one of these queries can be utter torture. I?ve sat there looking  at a grocery cashier like a deer in the headlights, tormented by the  choice between a paper bag and a plastic bag ? as though the rest of my  life depended on the decision between which kind of material would  transport my eggs and granola to my car.

 The inability to make a decision is one of the most infuriating symptoms of depression.

 According to a study published in August 2011 in _Cognitive Therapy and Research_, a few things factor into the difficulty a depressed person has in making decisions.

 For starters, good decisions happen when people have the ability to  evaluate alternatives and make judgments that are free of bias. In a  depressed state, strong emotions and incorrect predictions of the future  negatively impact a decision; the pessimistic thinking and heightened  sense of potential disappointment in the outcome cloud rational  thinking.

 Listlessness and passivity affect decisions, as well as a lack of  confidence, an inaccurate appraisal of personal resources (?I could  never do that?), and a hopelessness about the future.

*Depression, Decisions, and Regrets*
 Several studies have shown that depressed people are especially likely to regret their decisions, so the anticipatory regret handcuffs them and they can?t make future decisions. According to the authors of the _Cognitive Therapy and Research_ study:Anticipatory regret likely serves as a warning mechanism,  protecting a decision-maker from bad decisions and prompting them to  reevaluate possible alternatives. Inappropriate or excessive regret can  thereby impair future decision-making.

 Given the common tendency of people to experience more regret for active, rather than passive, choices,  anticipatory regret may bias a person toward inaction. People may  believe, irrationally, that by accepting a default choice passively they  are avoiding making a decision and thereby minimizing their  responsibility for the outcomes of that choice.

I know how painful any simple decision can be for the person who is assailed by a biochemical storm in the limbic system (the brain?s emotional center).  You brace yourself for any sentence that ends with a question mark and  requires a response. Panic descends. ?Oh God, no, not another decision!?  That?s why tasks like grocery shopping can be so laborious and humbling  for a person in a depressed state.

 Like the scarecrow in _The Wizard of Oz_, I have been without a brain for about six months now, trying my best to make decisions despite my inability to assess situations and facts  accurately. I thought I?d share a few techniques that I?ve been using  to help me arrive at a ?yes? or ?no,? ?plastic? or ?paper? response when  my brain can?t help me.

*1. Let Someone Else Decide*
 I know this sounds like the pansy?s way out. I reserve it for those times when I?m completely disabled by my depression.

Earlier this year, I had three weeks where any kind of minor decision  incited so much panic in me that I couldn?t stop obsessing and crying. I  was overwhelmed with fear and regret and therefore terrified to make  even a simple decision. During this period, I removed myself as best as I  could from every decision and had my husband decide for me.

 This included big decisions ? like starting TMS  and determining how much to continue the treatment ? as well as smaller  decisions, like whether or not I was capable of going to my cousin?s  wedding shower and how I would get there.

 For three weeks, I essentially gave my husband the power to make most  of my decisions, and told myself that I was going to have to trust him  and then let go. Even if you?re not in crisis mode, it can be helpful to  give your brain a break and have other people make decisions for you ?  especially if they aren?t all that important, like where to go for lunch  or what day to meet up for coffee.

*2. Flip a Coin*
 This is my standard way of making a decision when I?m depressed. I  flip a coin so often when I?m in an episode that sometimes I get scared  I?m turning into Rain Man and will soon be counting straws.

 But it?s a clean, easy way to make a decision on just about anything when your brain won?t cooperate.

 Sometimes for the bigger decisions, I will incite the help of my  deceased father or God or someone else in heaven, asking for a little  guidance, and then flip the coin.

 Then the trick is letting it go and not continuing to flip, looking  for 3 out of 5, or 7 out of 10, or 82 out of 100. Sometimes, though, you  find out what you really want to do because you?re disappointed with  the result ? which you wouldn?t have known had you not flipped the coin.

*3. Go With Your First Instinct*
 Researchers say that our first thought is often our best, and that  we?re right to trust our gut instincts. A University of Alberta study published in January 2011 in _Cognition and Emotion_ found that the unconscious mind is smarter than we think, and can be a great motivator in working out future goals.

 Of course when you?re depressed, it can be extremely difficult to discern that voice: The whisper is usually crowded out by SOS signals.  When we do hear it, though, it?s best to go with it and try to do our  best to arrest the insecurities and anxiety that follow it, trusting  that science says that our first decision is the best one.

*4. WWXD (What Would X Do?)*
 In the midst of a depressive cycle, most of us have self-confidence issues.  We?re quite positive that we will screw up just about anything left up  to us, which then leads us to the inability to make decisions.

 That?s why I sometimes have to ask myself, ?What would Mike do?? Mike  is one of the wisest people I know on this planet. He makes great  decisions. Or ?What would Eric do?? My husband is also extremely  insightful, grounded, and makes good decisions. Sometimes I?ll ask  myself, ?What would my doctor say??

 For example, I was recently deliberating on whether or not to  volunteer at an event at my kids? school. I very much wanted to ? I want  to be the type of mom who can pull off being the class mom, work a  full-time job, be in great physical shape, and cook a gourmet, organic  meal for her family each night.

 But I know that right now I?m extremely fragile, and my first  priority has to be getting well. I think that Mike, Eric, and my doctor  would all tell me that there will be plenty of years that I can  volunteer for all kinds of activities at school, but for right now, I  should concentrate on getting blood work done, swimming, trying to sleep  as much as I can, and writing my column. I think they would also say  that I?m fine the way I am, even if I?m never class mom or a gourmet  chef.​


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## Pop Alexandra

Thanks, David! Just started reading some of your articles on the forum and it really puts things into perspective for me.


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## forgetmenot

Very helpful article.  I did not know that what i was feeling was just part of depression thought i was just being a little be crazy really.

  Just cannot make decisions and i do like stated end up crying or in panic state so it is good to know that what is happening is for a reason. 

 So hard when one use to be is so much control.   So now i know it is ok to just let someone else make the decisions i am unable to make at the time.


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