Chronic depression and discerning what I want



Claude Monet, "Weeping Willow." http://en.wikipedia.org/wiki/File:Claude_Monet_Weeping_Willow.jpg



When my therapist and I do the CBASP therapy (Cognitive Behavioral Analysis of Systems Psychotherapy) for chronic depression, one of the key points in the session is to pinpoint my desired outcome of the specific interpersonal interaction we’re discussing.

Those specific interactions are what the therapy is built around. Every week I bring in an example—positive, negative, or a little of both—of an interaction with another person, and we analyze it in a systematic way.

There are two types of outcomes we discuss.

The actual outcome is based on what actually happened. It’s the last thing I did or said during the interaction.

The desired outcome is the best possible outcome given the circumstances.

That’s where I’m having the most trouble, deciding what the desired outcome should, or could, be.

Sometimes I literally draw a blank when my therapist asks me, “What did you want to happen during this interaction?”

It’s not unusual, my therapist said, for people with chronic depression to not know what they want.

In my mind, I view “the right thing” or “the best thing” in opposition to “what I want.” I tend to think of “what I want” as the selfish thing.

What I want?

I don’t mean I have trouble deciding what flavor ice cream I want, or which outfit I should wear.

I mean decisions about what I want out of life: what is good for me and what is not, when to speak up and when to be quiet, how I want to spend my time, what I should be doing with my life, what my purpose is—the big but basic wants.

Effects of depression

Depression can suck the energy right out of me. Sometimes I feel dull and lifeless and all I want to do is sleep. I don’t want to do the things that I usually enjoy, like reading or cross stitch. The thought of doing anything overwhelms me, so I don’t spend a lot of time thinking about what I want. I don’t care.

I also sometimes have a difficult time knowing if I’m making a decision based on my depression or on an understanding of what I want in life.

And the hallmark of chronic depression is a sense of hopelessness. So to consider what one wants begs the question, what does it matter?

So how can I help myself?

At this point, it’s important for me to consider what I want—something novel to me—and then consider whether or not it’s the right thing.

There are some ways that help me decide what I want. Most of them involve quiet activity:

*Writing helps me sort through my thoughts. Often while writing a post, I will figure out what message I’m trying to convey only after I write it.

I can relate to the writer Joan Didion, who said, “I write to find out what I’m thinking, what I’m looking at, what I see, and what it means.”

With better thinking, I can gain better self-understanding.

*Quieting my mind helps me to focus. The best way for me to slow down my thoughts is to sit quietly in meditation, listening to my breath and the other sounds around me, imagining my thoughts passing through my mind.

As the frenetic pace of the thoughts slows, I can pay better attention to what’s going on now.

I have found that if I meditate regularly, I am calmer and better able to attend to now. The key is regular meditation.

*Nature helps me. Sitting by the river and listening to the water, talking a walk, and biking through fields and trees soothes me and calms me.

It’s a process. I’m still having a difficult time discerning what I want out of an interaction. But I’m working on it.

  Do you ever feel that what you want is in conflict with what is right? How do you resolve that conflict? And how do you discern what it is that you want?