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 In a depression we don’t “feel” like doing anything. And we may be waiting to “feel” like engaging in our lives. This is an understandable, but not generally effective strategy. For starters, when we are not actually doing anything, we are most often thinking about how bad we feel, or of what we might do, or how we might think, differently in order to feel better. In the previous post I wrote about how this doesn’t usually work, about how it actually perpetuates the cycle of depression. It’s called rumination.
I’ve also written about how it is that we come to hold certain positions as truth and how they just come to be the seemingly solid ground of our experience. One such example has to do with this notion of feeling like doing something before we do it when we are depressed. The assumption is that some internal change has to take place in order to feel better. This assumption persists even when we know that, for example, getting some exercise will make us feel better. We still wait to feel like exercising.
Beyond the fact that you are waiting in agony is the fact that the longer you are depressed, the more likely it is that you will stay depressed. Additionally, the research suggests that the length of an episode is also a predictor of future episodes. Now as I said, the waiting to feel like it position is understandable and one of the reasons this is so is due to the prevailing public misconception of depression, which is that it is simply a chemical imbalance in the brain. I say public misconception because the science gets simplified for various reasons, not the least of which is the fact that there is a tremendous amount of money to be made off this simplistic notion. So from this simplified version comes two really big assumptions: one, that it is an internal imbalance, and two, that it exists solely in the brain.
The more complete picture that objective science presents is that it is a combination of biochemical, genetic and environmental factors that interact in a really complex system. And when looked at in this way, it stands to reason that the system can be altered from more than one point in the system.
As a related aside: did you know that serotonin, the neurotransmitter targeted by the SSRI class of antidepressants, is synthesized in the central nervous system and the gastrointestinal tract? So maybe diet is another important point in the system.
 A really important point in the system that is often overlooked is our behavior. I know this may seem unbelievable. I mean, after all, what could be more obvious? Well, consider it another example of “things are not always as they seem.” Much of our behavior becomes automatic, habitual, and over time comes to function below our awareness. A good example is driving a car. I’m sure you’ve had that experience of driving along thinking about something else when something unexpected happens and you are jolted into what you are actually doing - moving at a relatively high rate of speed in a heavy vehicle amidst a lot of other people doing the same thing. You become aware of the false sense of security you had just a moment before that car pulled out in front of you. When this happens, we pay more attention for a while until we are lulled back into automaticity - a fancy work for being on auto pilot.
So, in Mindful Action Therapy, we have a process in which we take a look at our day-to-day behavior. I call it the Lifestyle Assessment & Design Process (L.A.D.P.) and it has much in common with Behavioral Activation therapy, which was a component of cognitive behavioral therapy until it was tested on its own and found to be effective. At MAT we are combining mindfulness practice and behavioral activation. With mindfulness we cultivate the capacity to actually wake up to our behavior, day-to-day, moment-to-moment and to actually ascertain what of our behavior is actually serving us. What we find is that some of what we are doing is actually contributing to our depression.
Then we find alternatives. We design a life which consists of behaviors that promote good feelings. Often these behaviors are those that provide a sense of accomplishment, behaviors that are in alignment with our values and aspirations. We can do this even if we do not feel in touch with those values and aspirations. This is where our memory can serve us well. We can also turn to our closest allies to help us remember. This is also a skillful use of our minds, as we design the life we want intellectually and then live into it with our behavior - even if we do not feel like it. And as we refine, through mindfulness, our capacity to notice subtle shifts in mood, we begin to notice that by altering our behavior we can alter our mood. In behavioral activation this is known as working from the outside in.
Now there are many steps in this process that I’ve not gotten in to and there are other strategies to deal with the obstacles that arise. This is what we specialize in at MAT. It’s all in the name, Mindful Action Therapy. Your first action step is to call or write us for a free consultation.
From someone who has been there and back,
Devin Liles
therapist/founder
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