Do you have any tips on how to be Bullish when you’re going through depression, or anxiety, or other headfrying thingy? I’d love to read you on that and I think it’d help a lot of people.
– Melancholy in Melbourne
My freshman year in college, I became severely depressed. I’m not especially prone to these things. But it’s not surprising that the confluence of being away from home the first time, having absolutely no time management or schedule-setting ability and thereby sleeping and waking at bizarre hours, and moving from Virginia Beach to a dark and freezing valley in New England might have some kind of effect. While I was at Dartmouth, someone told me that the campus health center had a “sunlamp room,” where students who had Seasonal Affective Disorder could just lie around until they were less sad.
At the time, I was interested in writing fiction, and I had this idea that being depressed would make my work more profound. There may be some truth to this, or at least some correlation—many great artists have had serious mental illnesses—but very few of us are going to be great artists, and many great artists have also lived pretty jolly lives, holding loft parties and sexing up young acolytes. I was seriously disserved by the idea that depression was somehow “deep.” Looking at a tree on the campus green for twenty-five minutes because you think it’s so profound is not helpful to you or anyone else (or the tree).
I do have some tips. A few. But I’m obviously not a medical professional, so I’m adding the caveat here that what I have to say is meant to be helpful only to someone who has already sought out the help of a trained professional, or whose problems (general moodiness, for instance) are just a normal part of the human condition, and under the bar for a treatable condition.
Don’t Make Illness Part of Your Identity
Some people—certainly not all, but some people—who experience some kind of treatable mental illness avoid treatment because they feel that what’s going on inside their heads somehow has a silver lining of depth and truth, or makes them so different from other kinds of people that they can’t ever rejoin those people (so why try?), or is just a part of them. I wrote two weeks ago in Bullish Life: 6 Ways to Spring-Clean Your Life that, “Just because you’ve been doing something so long it feels like a part of you is not a good enough reason to keep doing something.”
(See also Bullish: When to Make Massive and Ballsy Life Changes for Your Career.)
So, there’s that. I think it’s hard to commit yourself to managing a mental illness if you’re on the fence about whether there’s some secret upside.
Exercise For Your Brain
I know I’m so annoying for saying this, but the evidence for exercise is compelling. Last week I wrote Bullish Life: 5 Reasons to Work Out (That Have Nothing to Do With Your Appearance), and I’m continuing on that tack here.
I also want to make sure everyone in the entire world has read Allie Brosh’s ridiculously insightful post about depression. I really don’t want to be that annoying yippy happy chick on the couch who talks doing yoga while watching the sunrise (for the record, I’ve never done yoga). So I’m going to try to not be too fucking obnoxious.
So, I imagine you’ve probably seen some of the news reports saying that exercise can be as effective as antidepressants. Here’s a particularly balanced report from Harvard Medical School, which points out that exercise performs about as well as antidepressants, but that antidepressants can provide faster relief—but that exercise provides more long-lasting effects.
The article also points out that some real, substantive exercise is required—just saying, “Oh, I’ll take the stairs at work,” or “I’m on my feet a lot at my job” will not suffice. (It drives me nuts when people call that exercise—that’s how human bodies are meant to function when they’re not exercising.)
A study published in 2005 found that walking fast for about 35 minutes a day five times a week or 60 minutes a day three times a week had a significant influence on mild to moderate depression symptoms. Walking fast for only 15 minutes a day five times a week or doing stretching exercises three times a week did not help as much.
A study in Acta Psychiatrica Scandinavica of the effects of exercise on neuroticism compared the effects of walking and jogging:
Both groups showed marked reduction of anxiety, depression and global symptoms. Joggers had greater aerobic gain, but no greater psychologic benefit. Significantly larger numbers of joggers dropped out of the study. There was no relationship between aerobic gain and reduction of symptoms at the end of the program. However, at 6 months’ follow-up, those with greater aerobic fitness had much lower anxiety levels.
So, starting out with high-intensity exercise makes people tend to quit, but it seems like the best course of action would be to start out with mild intensity but make sure to ramp up over time.
As to the fact that it’s pretty hard for depressed people to get up and exercise, professor of psychology Michael Otto of Boston University comments:
My colleague Jasper Smits and I have devised a number of activity-based treatments that break exercise up into small, useful steps. When you’re on your couch, there may be no way you’re going to get up and go running. But if you get up and put on your workout clothes, you’ll feel, I may as well move a bit, and then decide just to go outside. These small gains keep a person going, which is important because we’re working against poor motivation and the feeling that nothing matters. We prepare people for the kind of thoughts you have when you wake up in the morning—like, I really should exercise but don’t. We tell patients they need to make decisions with their awake mind, not their asleep mind.
Otto’s book is here.
He also discusses the social aspects of exercising. Some forms of exercise are social and some aren’t. Certainly I’d look for something supportive and empowering, and preferably the sort of thing where you wouldn’t want to miss a day because you’d feel like all your buddies were gathering without you. That’s pretty motivating for people who don’t really like exercise. (Did you see the episode of 30 Rock where Jack discovers that Liz is sneaking off to participate in a senior citizens’ dance squad, just for the joy of it?)
I’m definitely not an expert on medication versus therapy versus both, and it is certainly the case that some people have illnesses that require pulling out the medical big guns. But I’m a big fan of measures like exercise (and this sun lamp!) that certainly aren’t going to hurt you, and are entirely compatible with whatever other treatment you and your doctor decide on.
(Weirdly, sleep deprivation is being studied as a treatment for depression. It’s hard to endorse sleep deprivation without a good reason, but it is safe to say that a crazy-ass sleep schedule in which you rarely see daylight is really bad for you. Sometimes the best thing you can do is just throw yourself into bed at a reasonable hour, even if you self-identify as a creature of the night.)
A lot of people have some issues with exercise, so I think it’s probably especially helpful to think of exercise as something you do for your brain, and so all your parts work right. Virtually everyone over 50 at the gym is there for the same reason. Look to them as your people! Even in my thirties, I’ve reached the stage where a stellar diet and regular exercise are necessary to being physically comfortable and feeling okay.
I enjoyed this interview with Sofia Vergara, who hates to exercise:
I think it’s important to accept that it’s part of modern life—that it’s been proven that it helps you with everything. It’s going to improve the way you look, the way you feel, the way you age, everything. If there are women out there like me who don’t love it, you have to make a conscious decision to do it if you want to age well and live longer.
Manage Your Work Schedule
If it turns out that you’ll never be “cured,” but can expect to need to manage your condition indefinitely, think seriously about what kind of working life would provide you enough flexibility to work a lot sometimes and not so much at other times, but enough structure and support that you don’t slip too far.
There’s nothing wrong with working in seasons. Seasonal work is actually kind of built into us—you sow seeds, you reap a harvest, you have an orgiastic harvest celebration, you go inside for the winter and start making borsht.
Consider the farmer. Sometimes farmers are harvesting day and night, accompanied by every single family member and as much hired help as they can afford, and sometimes farmers are just checking in on things, watching the kale grow. In many careers, there is a time to create, a time to promote and sell your work, a time to meet people and do your networking, and, ideally, a time to make some time for yourself.
Even in 9-to-5 jobs, it is sometimes possible to engineer a situation where you work on a huge project part of the year, and tend to routine matters other parts of the year.
Or it’s possible to gravitate towards the kind of work that you can’t get behind on, work where you respond in the moment. When the paramedics get a call, they don’t put it on a depressingly long to-do list; they get in the van and go.
You Are Not Built to Live Entirely In Your Head
When I was reading the research on exercise that I quoted above, I was struck by one comment about how the exercise needs to be intense enough and long enough to really get out of your head:
We’re talking about half-hour chunks, the time necessary to get people past ruminative thinking. For me, for example, my brain shuts off at around 22 minutes into a run.
Exercise isn’t the only way to get out of your head, which I’m sure is one reason many people self-medicate with sex, alcohol, etc.
Other ways to get out of your head include hiking, gardening, building stuff, and working with animals. In fact, I think the very fact that so much of our lives are lived intangibly is a breeding ground for mental dysfunction. All your accomplishments? Stored virtually. Shut off the laptop, they seem to disappear. Someone posts mean comments about you on Twitter, and they take on a life as large as something you worked on for a year. Things lack a natural sense of proportion because they have no physical reality.
The summer before my senior year in high school, I was going a little nuts, as many teenagers do in the pressure-cooker of the U.S.’s college admissions process. Like a good college-bound student, I had already fulfilled almost all of my graduation requirements. I had my high school’s course catalog, which was a newsprint-bound booklet featuring photos representing every department, including those of the vocational-technical school that you could take a mid-day bus to if you were not planning to go to college—at least not directly after high school—and instead wanted to train to be a cosmetologist, plumber, auto-repair technician, etc. (I strongly support these programs, especially when updated for modern professions.)
So, I worked out this theoretical schedule such that I could take a couple of Advanced Placement classes in the morning, and then get on the Vo-Tech bus and go learn masonry.
Of course I didn’t. I think I mentioned this plan to my parents, who assumed I was joking. And I kind of was. Girls don’t sign up for masonry classes in high school, especially if they’re going off to college and masonry takes literally half the schoolday. I was supposed to be class-climbing, I guess, and this wasn’t it.
But I think my college problems—as relatively mild as they were—might have been prevented if I had had a physical skill to practice, some confidence in my ability to affect the world even when my brain couldn’t quite process Goethe, and adult living, and boyfriends all at the same time.
There’s a reason I picked masonry. If making things is good for your soul, I suspect it’s a case of the bigger the better. I don’t think canning jellies or knitting socks is quite the same. I wanted to make brick walls. You cannot argue with a brick wall. I mean, that’s an expression we use to talk about something completely different. But seriously, brick walls are the opposite of intangible. A friend of mine from college has become a forest ranger. She recently participated in a controlled burn of a forest. A bunch of smart people set a forest fire on purpose and then waited and then put it out. It was shockingly hot, I hear, but the job got done. ARGUE WITH THAT. You cannot. Properly maintaining a fucking forest provides a certain kind of undeniable center.
Maybe so many of us find that our brains go haywire occasionally, or often, because we are overusing them. We’re the neurotic equivalent of that dude at the gym with the frightening, veiny biceps. How much of life should be about biceps? How much of life should be dedicated entirely to intangible things? As much as intellectually-oriented people might like to live in a world of intangibles, I don’t think human evolution has caught up. It’s not good for us.
(So, that’s my answer: MASONRY. Tell your friends!)
Finally, please let me direct you to the work of someone who knows more about the topic than I do, Esmé Wang.
First published on The Gloss.