Man, I love the work that I do. Truly. And recently a woman who I work with in my Boulder psychotherapy practice reminded me of this once again. What this phenomenal woman reminded me of is this: Emotional pain is excruciating, but even depression that keeps someone in a place of deep despair for much of a lifetime can be shifted. Not easily, of course, but with hard work, commitment, insight, and hope, heaviness can be lifted and emotional health recovered.
I’d like to share her list with you of the ten things that she has realized are important for her to feel well. Ten things she says that she learned in my office, but ten things that, truthfully, she has discovered on her own.
1. Pay attention to physical health and symptom reduction.
Like so many others, Lisa* spent years in doctors offices seeking help for what she believed to by physical illness. Emotional pain can be stored in the body and identified initially as physical ailments that seem ongoing. When insomnia, body pain, and other physical distractions seem unexplainable and chronic, depression and/or anxiety may be the cause. Lisa spent much of her life seeking help for these issues but now realizes that the cause of many of them was her emotional stress and depression. What she has found is that when she takes care of herself physically (through sleep, nutrition, exercise, and breath) she feels better emotionally. And, as she recovers from her depression she feels less physical pain and discomfort.
2. Acknowledge, defend, and obtain wants and needs.
Lisa is not unlike so many others who have been motivated by the shoulds in life. Lisa has been so accustomed to this that it took some time for her to recognize what her own wants and needs are outside of the shoulds placed on her by others. When Lisa was able to listen carefully to her own internally driven wants and needs, she found that she not only accessed important instincts but she also was more likely to achieve her goals. She has found that there is often a need to speak up for herself in this area and she has learned to be her own advocate regardless of the expectations of others.
3. Self-monitor and self-soothe.
Lisa learned the importance of listening for changes in the way she feels. What she found is that when she is able to notice shifts in body tension, her thought processes, and her reactions to things she is able to catch her rising stress early enough to stop it in its tracks. Lisa has found deep breathing to be an especially helpful tool, along with other coping strategies for emotional health such as taking a break, exercise, and getting outdoors.
4. Accept emotional turbulence and understanding that suffering is temporary.
As a child, Lisa was not allowed to feel anything other than happiness. Struggle (especially fear, sadness, and anger) was not welcome in her household. Because of this, Lisa had learned to dread the negative emotions that are experienced in life. Each time that she experienced even “normal” amounts of distress, she was catapulted into a deep dark hole that she felt she could not get out of. Through our work together, Lisa learned that emotional turbulence is a normal part of being human, and that if she is able to let go of the need to change or deny it, her suffering is temporary. This awareness has lifted the additional layer of stress and self-judgment that she often felt whenever she experienced anything other than happiness. This has made the suffering that she does experience from time to time more tolerable.
5. Have self-compassion and non-judgment.
Along with the above, Lisa has learned to understand the devastating impact that self-judgment has had on her well-being. As she learned to understand why she has felt the way she has with compassion and empathy for herself, her confidence and acceptance of herself has grown immensely.
6. Take pride and find value in one’s actions and life.
When she first came into my office, Lisa described who she was and her actions in life as less than adequate. She was quick to criticize herself and her role in her life and felt the ongoing effects of this on her mood. Over time, however, Lisa has realized that there is much goodness in who she is and what she does and this awareness has brought about a level of joy that she had not yet discovered. What she asks herself often is “how do I perceive what I am doing?” When she notices that she is holding a view that is critical she also becomes aware that this is probably not accurate. By learning to shift her perspectives she has also learned to value herself.
7. Be your own mother.
I think many of you can relate. Lisa did a wonderful job working to be a “good mother” to her daughter, but she missed the boat on taking care of herself. Throughout our work together, Lisa realized more and more that much of her struggle was because she was not getting what she needed to be well, and that she would never treat her daughter the way she was treating herself. A focus on her own basic needs as well as how she is speaking to herself has helped her to thrive.
8. Maintain social contact when down.
When I first met Lisa, she described herself as “socially awkward” and as someone who preferred to be alone. But what we realized together was that being alone was actually something that had occurred as an (unhealthy) coping response to her depression. When Lisa felt depressed she pulled away from others, and yet the isolation that she felt as a result of this only increased her feelings of despair. One of the first things that she now does when she is feeling down is reach out to someone who she trusts for company and support for her emotional health , even when her instinct is to pull away.
9. Be curious.
When we first met, Lisa was quick to label herself and her feelings, but she has learned over time to be curious rather than critical. Instead of telling herself that something she feels or a choice she makes is “bad” she instead asks herself “why” she feels the way she feels or made the choice that she did. By asking questions she has found that opportunities for understanding and growth are limitless. She has found great meaning and insight in who she is through this curiosity.
10. Balance play, rest, work, and reflection.
Lisa has been an “all or nothing” thinker for much of her life. She has found that she tends toward either all work, all play, or all rest (in her most depressed times this resulted in her spending all day in bed) and that she had never even considered the value of reflection that wasn’t all self-critical. In our initial work together, she often tried to define herself by one of the above ways of being (I am a “doer,” I am a “worker,” or I am “lazy.”) What she found is that she needs all of the above to thrive and that when she focuses on only one way of being, she misses out on the rest. “Balance” to Lisa has not meant equal parts throughout a day as much as it’s meant that she allows space for each. And when she feels that she is leaning too far in one direction, she pauses and asks herself what she needs at the moment to even out the imbalances.
So many women who seek support and treatment for their depression and anxiety uncover much of what Lisa has, but there was something remarkable in the way that she put it all together this way. In doing so, Lisa created a recipe for herself that she can now follow when she is in need of her own guidance. Let there be no doubt that doing so is not always easy for her — when someone has a long history of mental illness like depression there is no quick fix toward wellness. Being well is a practice that demands attention and focus. But she is on her way. And I am moved by her clarity and determination. And her willingness to share what she has learned with others.
~ Kate Kripke, LCSW
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