ACT on the Paradox of Depression

ACT on the Paradox of Depression

“In order for the light to shine so brightly, the darkness must be present.” – Francis Bacon

Depression can manifest itself in a variety of forms and impact people’s lives in a multitude of ways. It’s quite different from feeling sad every now and then, or even grief-stricken in the face of loss. For some people, symptoms of depression can become debilitating to the point of jeopardizing their relationships, careers, or even their own lives. The paradox of depression concerns the behaviors often associated with depression, such as avoidance of people and activities, which generally serve to maintain or even worsen the depression itself. Fortunately, it is possible to end this toxic cycle… one step at a time.

It is important to recognize that uncomfortable internal states such as fear and anxiety are not inherently “bad” or “wrong.” In fact, as with all emotional experiences, fear and anxiety can serve valuable functions and provide crucial information. In the useful workbook, ACT for Depression, Dr. Robert Zettle explains that “anxiety becomes problematic with deliberate efforts to avoid, regulate, or in other ways control the experience of it.” Within the context of Acceptance & Commitment Therapy (ACT), this process is referred to as experiential avoidance.

Paradox of Depression

The paradox of depression is often maintained by experiential avoidance. It is paradoxical in the sense that the experience of depression increases the likelihood of avoiding the very activities that may serve to alleviate the suffering associated with depression. For instance, when one is depressed he or she may not have the physical energy or hope for the future necessary to facilitate an action that was once as routine as rising out of bed in the morning.

No matter where your starting point is, remember that all one can do is take steps – one by one – in a given direction. If you find yourself falling into or stuck in a cycle of depression, know that your present moment experience is absolutely valid. Also… the constant of life is change, and this present moment will become a new fresh present moment as time passes. No matter how challenging this moment is, I encourage a part of you to allow for the mere possibility that the future just might be different… and better.

Self-Compassion & Healing

You have the power to make choices in this moment that will affect the likelihood of a more meaningful and enjoyable future. Try to actively practice self-compassion, especially when taking those first small steps towards the possibility of a brighter future. For some people, it’s not uncommon to compare their “depressed selves” to the memory of their “healthy selves,” which can understandably lead to setting unrealistic expectations… and feeding into the paradoxical cycle of depression.

This doesn’t mean that you are somehow “less than” the best version of yourself – it simply means that you are, in a sense, injured, and need time to heal. Imagine if you had broken your arm or leg… would you have the same expectations of yourself to be able to engage in regular physical activity or care for yourself in the same ways? Probably not. Depression is just as “real” as a broken limb, even though you aren’t wearing a cast or can point to it on an x-ray. Try keeping this in mind as a means of being kind towards yourself as you heal.

Experiential Avoidance vs. Acceptance

One way to counter the effects of experiential avoidance and begin to gradually shift your mindset is through the process of acceptance. It’s important to remember that acceptance does not necessarily equal approval. Rather, acceptance facilitates the creation of fresh mental and emotional space for internal experiences (i.e., thoughts, emotions, or sensations) that may be unpleasant or uncomfortable. In a way, this newfound space for previously suppressed experiences can be a powerful step towards decreasing unnecessary suffering. It is within this new space that you will begin to have room to begin working with your present moment circumstances just as they are… warts and all.

How to Practice Acceptance & Cognitive Defusion

Try reading through these strategies for practicing acceptance and cognitive defusion. Notice what ideas resonate with you as personally meaningful or doable:

  • Allow thoughts and emotions to occur without the impulse to take immediate action.
  • Acknowledge difficulties or struggles in your life without minimizing or avoiding them.
  • Mindfully observe how you internally talk to yourself during difficult moments.
  • Take a step back from your internal dialogue… ask yourself what evidence you have to support any negative self-talk.

If you are currently experiencing depression or have concerns about your emotional well-being in any way, it is important to meet with a qualified mental health professional to collaboratively determine the best potential treatment for your individual needs. If you, or someone close to you, is struggling with or has expressed thoughts of either self-harm or suicide, know that there are credible free resources (see below for some suggestions) that you can access for support, referrals, or information.

The National Suicide Prevention Lifeline can be reached 24/7 at (800) 273-8255.

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Resources:

Strosahl, K.D., & Robinson, P.J. (2008). The mindfulness & acceptance workbook for depression: Using acceptance & commitment therapy to move through depression & create a life worth living. Oakland, CA: New Harbinger Publications, Inc.

Zettle, R.D. (2010). ACT for depression: A clinician’s guide to using acceptance & commitment therapy for treating depression. Oakland, CA: New Harbinger Publications, Inc.

Featured image: Young freedom by Aiky RATSIMANOHATRA / CC BY-NC 2.0

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