Behavior

People with depression are generally working too hard but not getting anywhere. There is often a frantic, driven, compulsive flavor to their methods. Sometimes there is an obvious pattern to how they defeat themselves; at other times, the pattern, if any, is very subtle. Regardless, they never seem to make as much progress as their activity level warrants. Depressives seem to be afraid to stop, back off, take their bearings, and see if they are still headed in the right direction.

In order to recover, they must change these habits. This may come as a shock for some people, who experience their depression as something outside themselves, and who are proud of their hard work and may not want to question habits that seem part of themselves. In this chapter, you will be asked to consider your goals and priorities in life, and see how much of your actual day-to-day activity contributes to achieving those goals. You will learn to evaluate how much procrastination and other forms of self-destructive behavior interfere with productive activity, as well as relaxing and having a little fun.

Setting Priorities

A helpful way of thinking about depression and stress is that they result from our failure to live up to our own standards and goals. Psychotherapists hear over and over again from depressed patients that they are never satisfied with themselves. Often the depressed patient is too much of a perfectionist. Because of this, sometimes the patient's goals are so far out of reach that he feels too demoralized to even take the first step.

One extreme is to set your goals so low that you can be sure of achieving them, which seems to be what the current self-esteem movement is all about. Today's parents are cautioned not to be critical of their children under any circumstances. The message is that unconditional love and acceptance build self-esteem. But there is a flaw in this logic. True self-esteem requires an accurate appraisal of one's own abilities in comparison to those of others. With a healthy sense of self, you can accept your weaknesses without feeling like an all-around loser. There are real differences in abilities, which are rewarded differentially by life. Unconditional acceptance seeks to deny those differences and builds a phony self-esteem, vulnerable to puncture by life's experience.

Having goals that are either unrealistically high or too easy to attain can contribute to depression. But many people don't even know what their goals are. Some people think they know exactly what principles are important to them and what their objectives are in life. Others are mystified by this subject, believing that they never think about their values and goals. Both can be very wrong. We do live our lives by certain values and principles, and we do have a sense of what we would like to accomplish for ourselves, but these are largely unconscious. To make these conscious, we have to examine ourselves deliberately. Then we can think about whether our goals are too high or too low.

The following is an exercise in prioritizing values. If the most important thing in life to you is your family, why don't you spend more time with them? The reasons probably have to do with your difficulty in experiencing emotions. One of the most common ways we have of avoiding emotions is that we let ourselves become overwhelmed by busy-ness. If we want to do what's truly important to us, we have to make a conscious and deliberate effort to prioritize.

The steps in organizing yourself so that you are spending more time doing what is really important to you are to:

1)  Identify
2)  Synchronize
3)  Partialize
4)  Review

1.  Identify your goals. Goals are statements of how we want things to be. For example, I want to have a happy marriage, I want to be financially secure, I want to be healthy, I want to enjoy my work, etc. While these may all be nice ideas, they are too broad to have any real impact on how a person conducts their life. To be helpful, goals should be specific, concrete, and measurable. For example, I want to go out alone on a date with my spouse one night a week.

2.  Synchronize. Are we in sync with ourselves? Do some of our goals conflict with others? We have to face the fact that we can't have it all, even when it means giving up on some things that are important. And it's necessary to really give up. If you decide that a big house is not a primary goal for you, make a public commitment to giving up that dream. Talk it over with your spouse and friends. Throw out all the magazines you've been saving with beautiful pictures of mansions.

3.  Partialize. After giving up some of the goals that aren't that important to you, start making action plans about the goals you really do want to accomplish. What are your professional goals for this year? Where would you like to be in five years? At retirement? Do your goals for this year take you closer to your long-term goals? If they don't, they should. Maybe you have to focus a lot for the present on simple survival strategies, how to get through the day, week, year. But you will feel better if you can add to your daily activities something that will help you get to your long-term goals. When we feel that our everyday activities are in agreement with our basic values and take us a step further toward who and where we want to be, we can justly feel a little satisfaction. We add to our self-esteem. We have a little more evidence that we can have an impact on our fate.

Make your action plan realistic and concrete. Your goals should require some effort, but don't make them impossible. Be somewhat flexible, and give yourself leeway for your own state of mind, which may vary from depressed to euphoric. This is important work that is going to shake up your depression. Just as using the Mood Journal challenges your defense mechanisms, thinking about and working toward what's truly meaningful in your life can be upsetting and difficult. Don't expect it to go smoothly. Accept that your emotions will be in some turmoil. At times, you'll feel terrific, and at other times, you'll wonder why you started. Just don't give up.

4. Review. Finally, regularly review your goals, and your progress toward them. Make sure that you have given yourself permission to change your goals. Don't get stuck in feeling bad because circumstances and your priorities have changed. For goals that remain important, look at your action plans. Are these things that you should be doing differently? Build some time into your routine when you can review your progress-at New Year's, on your annual vacation, monthly when you pay the bills, on a regular date with your spouse. Give yourself credit for doing what you've done, make new plans for doing what could be done better, and let the rest go. When you are depressed, it's hard to take action. But do take some action, and give yourself a lot of credit for doing it.

Working Productively

Most people who are depressed have a hard time being productive. Work-everything from paid employment to child-rearing and housekeeping to the kinds of "work" we assign ourselves, like reading a good book or planting a garden-is a chore to the depressed. It drains us, leaves us feeing as bad as before, physically worn out and emotionally depleted. As with so much of depression, there is a real chicken-or-egg question-is work so difficult because we're depressed, or are we depressed in part because we can't accomplish anything? As with so many chicken-or-egg situations, the truth is, poor work habits and depression reinforce each other.

Most depressed people are great procrastinators. Procrastination means putting off for a later time what "should" be done now. The "should" may come from without, as with the teenager who dawdles over homework, or from within, as with a person planting their garden. When it comes from without, it's easy to see the rebelliousness that procrastination expresses. When it comes from within, it's hard to see immediately what purpose procrastination serves.

Most procrastinators don't really know how work works. They assume that all really productive people are always in a positive, energetic frame of mind that lets them jump right in to piles of paper and quickly do what needs to be done, only emerging when the task is complete. On the contrary, motivation follows action instead of the other way around. When we make ourselves face the task ahead of us, it usually isn't as bad as we think, and we begin to feel good about the progress we start making. Work comes first, and then comes the positive frame of mind.

Closely allied to this misunderstanding about motivation is the idea that things should be easy. Depressed people assume that people who are good at work skills always feel confident and easily attain their goals. Because they themselves don't feel this way, they assume that they will never be successful. But again, most people who are really successful assume that there are going to be hard times, frustrations, and setbacks along the way. Knowing this in advance, they don't get thrown for a loop and assume that they're at fault whenever there's a setback.

Procrastination can also help protect the depressed person's precarious self-esteem. We can always tell ourselves we would have done it better if circumstances were different. For example, the college student who puts his term paper together in one rushed all-night session. The student protects himself from the risk of exposing his best work by never having the time to do it right. The fantasied sense of the self as special, uniquely gifted, is preserved. This is allied to the depressed person's tendency toward perfectionism. Trying so hard to make every single little piece of a project perfect, we doom ourselves to disappointment and frustration-but at the same time, we always have the safety of knowing that we could have done it better if only we'd had more time.

In The Feeling Good Handbook by David Burns, there is a five-step process for beating procrastination:

1.  Cost-Benefit Analysis. Choose a task you are procrastinating on. Make a list of the advantages of continuing to procrastinate. Now make a list of the advantages of getting started. Be very honest. You may be procrastinating on some tasks because it is not in your best interests to complete them, but you haven't recognized that yet. After listing the advantages and disadvantages, weigh them against each other on a 100-point scale. If the advantages outweigh the disadvantages, now make a similar list of advantages and disadvantages of getting started today, and again weigh them against each other on a 100-point scale. If the advantages of starting today outweigh the disadvantages, go on to step 2.

2.  Make a Plan. Write down the time today when you will start. Now make a list of any problems or obstacles you can think of that might interfere with getting started. Next, for each of those problems and obstacles, identify what you will do to overcome them. Now you have no excuses.

3.  Make the Job Easy. Set realistic goals. Don't expect a perfect product. Don't expect to work for five hours straight. Decide in advance about what you can reasonably expect to accomplish in the reasonable amount of time you want to allocate to this project. Decide which steps must come first. If you want to paint the house, maybe getting to the store to buy the paint is enough progress for the first day.

4.  Think Positively. Identify any negative thoughts and feelings that are associated with the task. For instance, "Painting is boring" or "The house will look okay for another year" or "I should wait till I'm more in the mood." Now for each of those negative thoughts, think of alternative positive and realistic thoughts that will help you feel more productive and motivated. For instance, "I can listen to the radio while I paint" or I'll be proud of the house when it's done" or "I'll feel good about getting started."

5.  Give Yourself Credit. Review your progress when you've accomplished the first day's goals. Take time to let yourself feel good about what you've done, which includes taking a step toward dealing with procrastination. Make a reward-an ice-cream cone, time with a book, a relaxing bath-contingent on accomplishing the first day's goals.

On the next page we will discuss Self Destructive Behavior.