Shimi wasn’t sleeping. It wasn’t for lack of being tired. Anyone who saw the bags under his eyes were dispelled of that notion and how. The thing was he dreaded getting up in the morning and also didn’t really care enough to get to bed, anyways. Besides, it hurt less zoning out by jump from one YouTube video to the next. Sure, Shimi felt guilty about wasting the time but it didn’t exactly feel bad either. Besides, when he would finally conk out, he ended up sleeping in until the afternoon anyway. That made up for the lost sleep, right?
There had been a lot of changes recently and nothing seemed to pan out. After getting married a few months back, he left his dorm, his friends, and his yeshiva. Imma and Abba weren’t too keen on pay for living expenses like they used to, especially after the wedding and Shimi had just been accepted into a paying Kollel to help with the mounting costs. It was supposed to be great. He felt he should be happy about being accepted into the Kollel especially considering its good reputation… but those “shoulds” just made him feel worse. What’s on YouTube?
His wife, Sarah, was working evenings now so they didn’t have the flexibility to spend time together the way they used to. He missed the evening walks with her. Worse, he couldn’t remember what it was like to not rush through supper before her shift at her online job began. It was great it brought in money but he couldn’t practice his guitar anymore. Having his old friends over was out of the question.
Sarah was worried. After only a few months of marriage she didn’t know how to talk to Shimi about what was happening with him. It wasn’t like Shimi was ignoring her. Quite the opposite – encouraging him about how much potential he had worked for a little bit but for some reason would later plunge him deeper inside himself. Shimi appreciated the warm words but they were also like a group of judges that stood over him – “Well, if I am so great,” he would think, “then why can’t I just do what I need to do? Besides, I know I’m making you miserable anyway. We can just get divorced.” Sometimes Shimi even suggested this – not out of spite, which stung Sarah most of all. He loved his wife, well… he remembered being happy with her. What he knew now was she was a really nice person and shouldn’t have to put up with his mess.
Unfortunately, the themes of depression in this story are familiar to a lot of people and it’s no wonder considering lifetime rates of Major Depression Disorder hover around 17% of the general population. That’s not considering other forms of depression that bump that number up. With such high numbers you can’t help but ask, what gives? How does depression develop in the first place?
It doesn’t make it easier that there are a lot of theories about how it develops. In all likelihood each explanation probably plays a role. Some people look at it like a disease akin to catching the cold. It happens, it’s no one’s fault, and medication can help. For some people medication is the right answer especially with severe and chronic depression. Unfortunately, there is a lot of research showing that while medication can help some people, for most people the placebo effect out performs the actual medication in the pill. Considering there is so much antidepressant medication dumped down the sink that it’s actually detectable in your drinking water, that’s a huge amount (and money) down the drain for such small gains. Others look at depression as a problem with the way a person thinks. Overgeneralizing and catastrophizing about a bad situation certainly make matters worse and there is definitely utility in training yourself to think with more nuance.
As the all too familiar story above illustrates, the problems might have started with how a person thinks, they may have even started with basic biology, but the real suffering of depression is how the things that gave life joy and meaning are knocked off one after another. It turns out that it’s not so much what started depression but it’s the little and big things in life that were lost along the way that takes a bite out of a person. This pattern of loss and pain is like a runaway train – it starts out slow when leaving the station but the longer it goes on for the more speed it builds until the thing is simply too fast and powerful to “just stop”.
To top it all off, what we do when we feel depressed actually makes a lot of intuitive sense. It’s a tantalizing trap. Why would any reasonable person want to get out of bed if life felt empty? Ask yourself, when you’re feeling extremely tired and worn out, wouldn’t you just want to sit down and rest? Staying in bed longer, chilling on the couch, and taking some personal “me time” because you feel down are all reasonable things that we all do from time to time. The tricky thing is that when a person falls in too deep into these avoidance strategies, they literally take you out of the world.
Fortunately, therapy can help. While you might not feel like changing, or doing much of anything for that matter, that is just another symptom of depression and all the more reason to seek treatment. If you suspect this is an issue, you can take the Beck Depression Inventory. It’s a simple questionnaire that can give you a sense of how serious to take your situation.
There are four key principles that are extremely effective in slowing down the runaway train of depression and turning it back towards a life that feels good.
Principle 1: Changing How You Feel First Means Changing What You Do
I don’t know about you but I don’t remember the last time I answered a phone that wasn’t ringing. In short, we generally do things we feel an inner compulsion to do. When I’m hungry, I eat. When I miss my friends, I give them a call. When the phone rings, I answer it. All of these represent stimuli that I react to. Of course, life is not always so simple. Sometimes we do things we don’t want to do in the moment but that’s because they mean something to us later down the line. When it’s raining cats and dogs and you forgot to buy a replacement umbrella after last year’s rainy season, it’s unlikely you’re so motivated to get dressed and get out to work. But once you’re dressed and at work things seem to move forward all on their own – the sense of wanting to be out and feeling accomplished follow instead of precede getting out the door. Here, the behavior precedes the stimuli.
Depression, as an action, is basically falling back on good short-term strategies that makes for poor long-term living. For Shimi, a lot of problems in life built up. He lost his friends, financial security, time with his wife, a meaningful hobby, and ultimately, he lost a sense of purpose that was replaced with a lot of self judgement. Taking your mind off your pain by watching YouTube does do the trick but it’s like sprinting a marathon – at a certain point the body shuts down. The same is true for depression on an emotional level. Getting out of depression doesn’t mean feeling different first. It means first acting differently. It requires a person’s hands to teach the heart how to feel better again. You kind of need to answer “a phone” that isn’t ringing – doing first which will allow “feeling like it” to slip in second.
Principle 2: Map Out in Detail What is Draining Your Life Away to Find the Road Back
Getting out of depression means rebuilding your life. To do that it’s vital to figure out two things. First, you need to know what actions or habits are connected to feeling depressed and really get detailed about them – what is going on before the action, how does the ball get started, and what ends up happening afterwards? It can be hard to be interested about anything, especially this, when depressed. A good therapist who can play the part of a crack investigative reporter getting down the “Five W’s and the How” is crucial here. It’s through this stage a path out of depression is discovered. With a conceptual map of depression in hand, step two is acting differently. This is not a “just do it” philosophy because the hard part is not so much in the doing, anyway. The hard part is hitting the wall of, “The only thing I want to do is nothing at all!” This leads to Principle 3.
Principle 3: Doing Differently Instead of Doing Better or Just Doing It
Willing yourself to be happy isn’t going to cut it. Getting out of bed, one day, to go about your business full steam ahead isn’t the solution. If it was, everyone would be able to find their way out of depression because this is exactly what everyone first tries to do. Depression’s secret weapon is the fact it isn’t synonymous with laziness. People give everything they got and then depression says, “You tried, you failed, you’re worthless.” It’s hard not to believe it after that. To dump depression, you can’t try harder. You have to try differently.
The key is being willing to experiment and start small. Change is difficult even in the best of moods and taking on too much all at once is self-sabotaging. Instead, one needs to be willing to experiment and to take stock of what it’s like to make the small changes in the moment. For Shimi, he hasn’t opened up a Gemara in months but he used to be able to knock back three blot, a perek of Mishna Berura, and some mussar on the side. It’s going to take some time to get back to that place. Some first good steps for Shimi might be going out to get the right Gemara for the upcoming zman or packing up his bag and then taking time to notice how different it feels to get his bag together in the morning as opposed to lying in bed wishing he could. The point is setting winnable goals.
What is equally important is starting with things that are naturally reinforcing in the moment. Feeling rewarded about learning is a fairly sophisticated type of enjoyment. Packing a bag might be too big a step as its not inherently rewarding. A good place to start might be calling up some friends or to get out of the house to feel what it’s like to have the sun on your face. Taking a walk to the mini-mart to buy a cold can of Coke is a good, and tasty, first step. The key is relearning that the world you live in can feel pretty good when you expose yourself to it.
Principle 4: Having Someone In your Corner
While a therapist makes the first three principles come to life in explaining how depression works, figuring out what actions are increasing depression, setting up change goals to reduce depressions hold, and creating easy and naturally reinforcing daily goals, getting a therapist ensures there’s a caring professional around who won’t let you give up and can directly challenge Depression’s convincing arguments. The therapist needs to act like a coach keeping things going in the right direction. Of course, as every good coach knows, he can’t actually play the game but he’s the one planning out the game strategy, giving the “in game” suggestions, and keeping up morale.
Summing things up, the biggest problem with depression is not so much how it started but what it ends up taking away. The road out of depression means rediscovering joy and meaning in life and no amount of intellectual philosophizing is going to do the trick. At the end of the day, life feels good when it is lived. With that in mind, finding a therapist who can outline this reality, map out the traps of depression, scientifically, through experimentation and homework, rebuild a life worth experiencing, and most importantly is in your corner is the clearest way out of suffering and back to your meaningful life that is still their waiting for you.
Rabbi Yonasan Bender, LCSW, graduated from Hebrew University’s School of Social Work. He works with adults, couples, and children in his private therapy practice in Jerusalem. He holds several semichos from Rav Yitzchok Berkovits, shlita. To share your thoughts, experiences, questions, or a different perspective, you can reach Rabbi Yonasan Bender LCSW at 053-808-0435 and at firstname.lastname@example.org. Learn more about Rabbi Bender and his work at www.jerusalemtherapy.org.