on the past to find answers. Instead, we’ll look at what’s going on in your life right now.
Your problem area (or areas) — whether it’s conflict with another person, grief that won’t go away, a life change, or lack of supportive relationships — may be connected to what happened years ago, but we’ll be keeping the focus on what you’re experiencing in the present and what you can do in the here and now to feel better. In Week 4, we’ll describe each of the problem areas in detail and help you pick one to work on. (To be true to interpersonal psychotherapy, which is a short-term approach that helps people feel better in eight to twelve weeks, we talk about “weeks” throughout the book. Ultimately, the pacing is up to you. Read as quickly or slowly as you like!)
You Deserve a Break Today
You may need to take a temporary break from some of your day-to-day responsibilities and commitments to work on feeling better.
It’s another good reason to think of your depression as if it were a broken leg. When we have a broken leg, our priorities have to shift. Recovery becomes our most important job, so we go to medical appointments, do the exercises the physical therapist prescribes, and put our feet up (literally) when we’re tired. We won’t be taking the kids to the park, hitting the dance club, spring-cleaning the house, or hosting the big family dinner. It’s obvious that we can’t do what we’d normally do, so we don’t try. And we might even accept the help that others offer us.
Depression is a medical illness as legitimate as that broken leg. We need to give ourselves permission to take the time we need to figure out what interpersonal problem is contributing to our unhappiness and learn new skills to cope. Taking time off isn’t forever. It’s just until we’re back on our feet.
Depression is hidden — often even to ourselves — so we think we have to power through it. We beat ourselves up for having a short fuse, not being able to concentrate, feeling tired, lacking drive, missing deadlines, or being indecisive.
The temptation to suck it up and keep going will be very powerful if you feel you’re the only one keeping your family’s boat afloat. You might be working three jobs and still struggling to make ends meet; have an ill parent, a child with a disability, a partner who can’t manage without you, a demanding job, or an unsympathetic boss; or there may be strong cultural expectations for your role.
Sometimes to take care of others, you have to put yourself first. Go for coffee with a friend instead of volunteering at the food bank. Sit down with your spouse to discuss how to divide up the household chores to lighten your load a little. Take your social media accounts down for a while. Ask your sister to take the kids for a weekend. Talk to your boss about next week’s deadline. You might discover that some of the things you thought others needed you to do for them are actually your own expectations of yourself. Think of taking care of yourself as a job. Make a list of self-care tasks and schedule them on your calendar.
PEP TALK: The world isn’t on your shoulders alone. Sometimes when you step back, it makes room for others to step forward.
Work is often the last place we want to lighten our load. We worry that the boss may not be willing to modify workloads or change deadlines or that asking for time off or light duties may affect our next promotion — or worse, we’ll be demoted or fired. We may not have any sick days or disability insurance.
If these are your concerns, here are some ideas. Check with your human resources department in case there are resources available at your workplace that you don’t know about. If you can’t talk to your boss, maybe you can speak with a coworker or two. They may have some advice or ideas about how to manage, and they may offer to help.
In the end, if you have to keep your depression hidden at work, that’s okay. Just make sure your friends and family know that a lot of your energy is going toward keeping your job and that you may need some extra help at home.
Now, not everybody has to give something up in order to feel better. Becky, for example, has no one relying on her now that her brother has died, so she sleeps a lot during the day. She’s already stopped going to school, answering emails and texts, picking up the phone, and seeing her friends. She doesn’t eat much. Showering is always optional. Becky already has the space in her life to make positive changes — she just needs help taking that first step.
Tell Someone about It
If you’ve been keeping your depression to yourself, it’s time to share the burden with someone else. If we let others know about our temporary limitations, we’re more likely to receive support for our efforts and new ideas for how to cope. Opening up also gives others the opportunity to share their struggles with us — experiences we may never have known they had. Suddenly, we don’t feel so alone anymore.
It’s normal to feel shy, scared, embarrassed, and anxious about telling people. Many of us — me included — have our feelings of self-worth tied up with being seen as one of those people who have their act together. (It’s common among people in helping professions. We help others, but we don’t always have the skills to help ourselves.) If you’re used to being the capable one, it can feel uncomfortable to admit to others that you’re struggling. Plus, if you haven’t reached out for help before, you don’t know it’s possible for someone to offer you support and show they care.
The first step is to acknowledge that being strong isn’t always a strength. The next is to imagine a different future, one where there’s a little more give-and-take in your relationships. Many people will want to help you as much as you want to help them. Let them in.
PEP TALK: When you share your depression with someone you trust, you’re admitting that you’re human. It can make your relationships stronger!
Don’t feel you have to tell everyone about your depression. Start with one or two people who are affected by your illness or who you think will be understanding.
It’s usually helpful to share the symptoms of depression with the person you’re confiding in. That way you both have the same understanding of the many physical and emotional impacts of the illness and can speak a common language. Let the person know that you’re working hard to feel better. Explain that you need to take a break from some of the things you usually do to give yourself the time and energy to make positive changes. Reassure them that the situation is temporary. Listen to their concerns, and be open to their suggestions.
Some people will really understand. Some may offer to help. (Don’t refuse the casserole.) Some might not get it; you can sense they’re trying, but they’re struggling to empathize. If that person is close to you or you need their help with some of your responsibilities, try sharing this chapter of the book with them. Of course, you won’t want to assign reading homework to a person who isn’t a reader. Instead, show them the book and talk them through the important information, as in a highlight reel or postgame recap. They’ll get the point that your information comes from a credible source — the book — but they won’t have to read it themselves.
Unfortunately, some people might not be supportive at all. You can’t change that. But at least you’ll know who you can turn to the next time you need advice or assistance. Try not to blame those who don’t understand. They may show their support through actions, not words, by doing things like fixing the car or spending more time with the kids.
Many people who have depression stop socializing, and their isolation may be compounded by other circumstances, for example, a move to a new city, the arrival of a new baby, a spouse who travels a lot, or the lack of a strong support system. John, for example, never felt he had kind, caring friends or family. Admitting to himself
