It may be hard to see how acceptance can help your depression. You want to feel good and strong. But acceptance in the moment doesn’t mean it’ll last forever.
Imagine you had been driving for hours and you’re losing focus. You might think “I’m always late. Everything always takes me too long,” and get angry and push the pedal to 90 mph — so you’ll get there faster — and a minute later your head is nodding and your eyes glazing over.
Or you could pull into a rest stop. Then you could decide to let someone else drive, take a nap, or check into a motel, and accept you’ll be behind schedule. Before you can make a good choice, you need to accept that you’re too tired to keep driving. Fighting weariness is the worst choice of all.
The same logic applies to depression. When you’re depressed, everything feels exhausting. It’s hard to get out of bed or sleep, hard to eat (or hard to eat well), hard to talk and hard to listen, hard to work and hard to relax. You’re always fighting your emotional weariness. And you’re at risk of running your car into the road divider just so you can rest.
To make a better choice, you may need to first stop fighting. Acceptance of depression doesn’t mean you decide you love being depressed. It means you interrupt the cycle of pushing back. It’s like deciding to listen to your sister or child instead of stone-walling or punishing them.
Acceptance and commitment therapy, or ACT, does have some scientific backing for depression, as well as anxiety, pain, and addiction. In an early book on ACT, “Get Out of Your Mind and Into Your Life,” author Steven Hayes invites readers to first stop fighting their thoughts and, next, reshape their lives to match their values. You’d adopt one of many techniques to defuse the thought “I’m always late. Everything always takes too long,” so it was less powerful. And then you’d remember that you value being a safe driver and don’t want to kill yourself or anyone else. The goal is to help you stop avoiding, denying, and struggling with your emotions. Instead, you accept your deeper feelings as appropriate responses to situations so they do not prevent you from moving forward with your life.
In classic cognitive behavioral therapy, you learn how to catch punishing thoughts like “I’m always late” with neutral observations like “I did something that didn’t have the outcome I hoped for.” Ideally, that would help you reach the point where you pull into the rest stop.
With ACT, you might sing “I’m always late,” as if you were Frank Sinatra, or shout “late, late, late, late,” or like a graduate of a mindful meditation class, say out loud “I’m noticing that I’m late and I’m tired.” In a 2015 review of 39 randomized controlled trials of ACT, the authors concluded that various ACT approaches did as well as classic CBT with depression.
In this YouTube video of a 2014 TedX talk, you can see the ACT concept applied to fighting cravings for junk food and cigarettes.
Whether you seek out ACT training or more standard CBT, you can take several in person sessions, work with a therapist online, or use workbooks. The trick will be practicing and remembering to apply the techniques even after you begin to feel better.
Biologist Chris Hart writes beautifully about how acceptance has helped him cope with his own periodic depressions. When you accept depression, he says, “You’re no longer worried about being happy, and stopping depression, and getting through your day, and pretending to be something you’re not. You’re instead only focused on getting through the next minute, or the next hour.” He can talk to himself more kindly. Instead of thinking “Gee Chris, just be happy already, it’s not that hard,” he thinks, “Chris, you’re going to be sad today, and be irritable, and that’s perfectly okay.” He remembers how his depression tends to progress from irritability, to sadness, emptiness, and isolation and paranoia. When he sees that big picture, he can interrupt the sequence earlier by taking action. Acceptance banishes shame and allows you to get help and help yourself.
April 06, 2020
Janet O’Dell, RN