Marriage and Family Therapist
Julie Cohen is a licensed Marriage and Family Therapist MFT and a Child Mental Health Specialist with a private practice in Los Angeles. Her areas of focus include: depression, anxiety, panic, post-traumatic stress, bipolar…
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Climbing out of the black hole of depression
Posted in Anxiety by Julie Cohen on Sep 28, 2009

People living with depression know all too well the desire to break that cycle while often feeling powerless over the strength of it.  That helpless feeling often feeds the depression and makes it worse.  This cycle is one that must be broken in order for recovery to begin.  I wish there was a one rule book of how to cure depression. It would bring such relief for so many who deal daily with the debilitating symptoms if we could just put a cast around the depression just like an arm when it breaks.   Instead it becomes more like an old passed down recipe where one of the ingredients is missing and you're constantly trying different ones until you get it right. 

Growing up my mother used to make a pumpkin chiffon pie every thanksgiving.  That pie was magical and months prior to the holiday my family would begin pining for it.  When my mother passed away, I couldn't find a copy of that recipe anywhere. Every year as I try to recreate it, I can't figure out what ingredient or ingredients did I get wrong or completely missed.  It's extremely frustrating!  Of course I know that trying to recreate a recipe is not at all the same caliber of pain and frustration as recovering from depression but I think the concept is similar. 

We usually have no say in when a depressive episode strikes but we must have a say in the healing process or it will never happen.  Making the decision to do whatever it takes to get out of the black hole of depression is one of the most difficult parts of the process.  It's get even harder if there have been many attempts with little success. 

One ingredient in breaking the depression cycle is bravery.  Being brave enough to try again is a starting place.  In my private practice, the clients who did whatever it took to climb out were the ones that had the most success rate managing their depression.

The next ingredient is to act.  Choose to accept help and cooperate regardless if you have faith it will work.  Belief in getting better is often at a minimum when depression is in full swing.  Sometimes recovery depends on accepting help regardless if you initially believe it will work. 

Finally, understand that if you try a help method and it doesn't work you have to be brave again and move on to another type of help.  Some options include:

  • Accepting all invitations to be social as isolation feeds depression.
  • Psychotherapy.
  • Alternative healing methods such as acupuncture and meditation.
  • Spirituality
  • Volunteering
  • Medication
  • Exercise
  • Healthy eating
  • Talking to friends and family about how you feel

Again, these are some options. You may have ideas of your own and should try them.  What is most important is that you find the right ingredients that work for you. 

 

 

 more about julie cohen at: juliecohenmft.com AND linksforshrinks.com 

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31
Hi Julie - Thank you for your article.
I have a long history of coping with recurrent depression. When faced with a situation that will take personal bravery to participate in (but is not intrinsically dangerous), how do I know whether going for it is a good idea that may lead to a brighter future (if successful) or a rotten idea that may lead to a depressive downslide (if unsuccessful)? How do I know when is it wisdom to ignore fear and proceed, or wisdom to care for myself and hold back?
By macca47  Jan 18, 2010
30
MY HOLE IS IS SOOO DEEP IT HIT CHINA ....
By LOSTDAZEDANDCONFUSED  Jan 05, 2010
29
attempting to climb out once again after year in darkness, it is taking a lot to be on this site.
By nicetobeme  Dec 14, 2009
28
Thank you, I really needed to read this. You talk about being brave and climbing out of the hole. I would like to point out that I have climbed out of that hole a few times just to fall back in. Nothing left to do but climb back out and get the heck away from the darn thing! Thank you.
By Imgoodenough  Dec 04, 2009
27
@balab: On the surface, your comment sounds like you want to explain some dire event in your life but don't know how. As Julie mentioned, it takes courage. Not only in speaking out, but in finding someone you feel you can trust who won't press you to reveal anything for which you are not ready. It's difficult. I wish you best in finding what you need.

As for me, Mondays are the worst. Mondays are when the reality of my surroundings come crashing back together to remind me that I'm still unemployed, I still can't sell a house I can no longer afford, that my seasonal affective disorder is gearing up, and I don't know who my friends are. This article has "me" written all over it.
By mstelly  Oct 05, 2009
26
People always assume that everyone has someone. That everyone has family, friends, somewhere to go. But not everyone has these things - not just as a feeling - as a fact. Like me, I don't have a family. I have lived with a secret my whole life so I have no N O friends. If I get help out there in the world, then people will want me - press me to file a report or something about what happened. I can't do that. What are people like me to do?
By balab  Oct 05, 2009
25
I believe hope and faith is the key here,when all hope dies then we die with it,When you total give up the fight, then your lost in that cycle,but as long as your willing to keep trying, then you have hope, it is my expierience that my faith in God has been the whole key of my survival, When things get so bad,your faith in a higher power, which is God to me, is the only Hope you have.The struggle from day to day can be very tireing, but one thing we don't realize is that life contiunes to march on, we feel stuck in that black hole, desperate,but if we were to stop long enough to realize that life is not stuck, and that each night we go to bed brings a new day, sometimes those days are as the day before, but then sometimes there different, better,life is manageable,we live and think and breath just like the next person, and as in my case before you know it 20 + years have gone by, your childern have survived, you have survived, you may be a grandparent, and you wonder how did I ever get to this point.Are you still depressed ( Bipolar )YES,But life did march own and so did we, We can gain strength from this if we allow ourselves to.But so many times, which I figure it safe to say most of the time, when were in that depression it doesn't feel like 20 + years, it feels just like the first time we became depressed, were hopeless,empty,scared,lonely,were full of anxiety,we panic, we see no way out;But if we could allow ourselves permission to just go with it, not fight it,to take it easy, until it subsides, then we could look back over the years as a learning experience, But yet instead most of us,myself included, kick and scream,and yell we don't want this, until we ourselves make the black hole so deep we can't see the light and if we can't see the light then we can't see to get out. PERMISSION SLIPS, I like that , allowing ourselves a couple of days rest, until it subsides, this could be our answer, any thing beats kicking and screaming.Have you ever seen a child really get what they want kicking & screaming, No, they get what they want by staying calm. we need as Bipolar people learn to stay calm,don;t panic,this too shall pass, I know we get tired of hearing this , but its true, with the right help, it never last's forever, it just seems like it............
By survial101  Oct 04, 2009
24
I enjoyed reading your words, Angela. I could see myself in the first couple of paragraphs, and then saw what I'm not doing in the last paragraph. My biggest problem now is fear of going out of the house, because I don't feel myself so much of the time, and I don't trust myself. My physical self is in bad condition too. I gained a lot of weight with the Seroquel and the antidepressants and anti-seizure medications made me forgetful and insecure. I am a Christian, but I feel ashamed to constantly beg God to lift me out of this hole I've put myself in, so I don't pray unless it's for my children to be safe and surrounded. I have the guilt, I really have that. I envy you, which I know isn't spiritually advisable, but I do. I feel like I'm in this bubble and I can't seem to claw my way out of it. It's like I'm watching my life as if it's a badly directed movie. Pray for me, please? Thank you.
By RaeDreams  Oct 04, 2009
23
As a bipolar person, depression was always about changing circumstances I couldn't control, and the anger and agonizing tearing, ripping sensation of loneliness and despair. After I became a Christian, these moods swings gradually became more shallow, as God led me to do many of the above things. I also prayed for God to show me things. Like I hated myself for living as a closet gay. Like I didn't have to everything my husband said. It was ok to take control of my life.

My husband also suffers from major depression and doesn't want to talk about it or discuss it. He has isolated himself behind a wall of fear, and is afraid to change anything or let go of control. He has survivor guilt and won't get counseling and labors under a weight of guilt and low self esteem. He basically does none of the above, and he is reaping the consequences.

I went back to school to get my MDiv. and am learning and growing. I also work out 6 days a week,, spend a lot of time reading the Bible and praying, which is foundational. I always eat organic vegetarian, which is vital in my health. I was on up to 5 drugs for 10 years, and now I am down to 2 sleep meds, which I am only on because it is to hard to sleep with shingles. It was a slow, discipline process, getting out of the hole, but I think I have been quite successful - I can't remember the time I was depressed, and the anger is mostly gone. There is hope and it is possible, and all the above are important.
By Angela53510  Oct 04, 2009
22
I sit and I read this, trying to hard to see what I can do out of all the suggestions, and I see that I have tried them all. Least of effective, I've found, was the cognitive therapy. I'd have to struggle against horrific panic attacks and agoraphobia to even get to the appointments, only to feel worse having had to dredge up all my fears and faults time and time again. I'm on 150 mg. of Effexor XR now, plus 50 mg. of Seroquel, and recently was diagnosed as menopausal on top of my bipolar/borderline personality disorder, and I'm just flat-lining emotionally and feel like I could just cease to exist at any moment from the sheer strain of it all. I just can't see the light. I know I need help, but I can't drag myself to anymore torture sessions, and when I tried to get off the Effexor, I felt like I had electrical shortages rampaging through my head and body. Why are so many of us like this? I sit and wonder, and I cry.
By RaeDreams  Oct 03, 2009
21
Thanks for the reminder. I find it difficult now because depression comes with nausea, dizziness, flue like symptoms. I make it a point to call someone each day, go to my AA meeting no matter how I feel. Today I sent a message of encouraagement to my friend who has cancer, I visited her Wednesday and I invited my sister over for a few days to take my mind off myself and let myself be pampered. ACCEPTANCE OF THIS SITUATION IS FIRST AND FOREMOST AND LIVE IN TODAY. :)
By star11  Oct 03, 2009
20
Best to say, Thank You, in this initial foray; however, yours is but part of the mosaic coming into focus in my mystery-chemically-unbalanced state of being.

I have recently weaned myself off a daily dose of 20mg Lexapro; yes, I truly weaned, and am now following up with a highly recommended Washington, D.C. psychiatrist who also specializes in helping people who are also experiencing significant other health issues. That's ME.

I may be 'only' ChronicLL; but my illness has forced me to change paradigms more than once. Up to this point, I've been rolling with the proverbial; however, it has taken this seemingly invisible Cassandra, a.k.a, Scarlett O'Hara to new levels of self-actualization. Being able to show off my memory of Kool words is definitely a plus in this Jill Price world that drifts through my consciousness uncontrollably.

Anyway, I know I need help, always have. They call me The Hot Potato in my toxic world; so, it's up to me to take action... there is nothing I can do further to assist them in seeing the beauty of my bliss.

So, always fighting the Scarlett in my nature, and taking care of business in a way that works in the real world, I wish you heart smiles...

... A list of some recently-experienced-hints-to-what-I-can-do-to-help-myself, cause it really IS all about you; After all, what other basis does anyone really have? Seems to me, that's a real good clue right there...
... anyway:
- Listening to an audio performance of Laryy Brown's A Miracle of Catfish (don't know how to underline here). Marvelous performance by somebody whose name is floating away from me right now... Larry Streitfuis or something like that... sorry.
- Listening to an audio performance of the drier Jill Price with Bart Davis The Woman Who Can't Forget - A Memoir. Oh boy, did that one ever open some mental stores of heretofore overlooked experiences...
-Watching s special on the Howard University PB station about Autistic Adults... Marvelous validation for me; it hit another significant fastening spear with full contact on it's horizontal surface.
- Healthful eating; right, YOU are healthy if you eat healthfully. Every healthful diet needs greens.
- finding this wonderful article...
-
Any more? Not now... looking for an agent;; might as well try to fit in with my attitude about money and possession.. If Jill Price can help people to help themselves by sharing her memory machinations; then, maybe I can help other people like me.

I need your help: I live within a 2 hour drive of Johns Hopkins Hospital Center in Baltimore, MD and I want to be able to donate all of my chemically-ridden physically-expired self to a teaching hospital when I cease to function in this biological existence... with luck, maybe somebody with a need for a body part can be helped as well. I've been looking at JHHC Mental Health adjunct with Kay Redfield Jamieson as co-honcho, and want to be able to further research actual physical causalties of other people like me.

Then again, I am a Chronic, and Chronics don't seem to matter as much in this Acute world.


One of the first items on the agenda with Dr. N next week, at our 2nd session, will be to discuss a plethora of testing instruments which we may decide to use to get to the bottom of my particular so-called "chemical disorder",(sounds like another virus to me).

Thank you, and heart smiles.
By artsense  Oct 02, 2009
19
isolation feeds depression.... hmmmmmm.. I have heard that said often but thought nothingof it but now that I see it actually writtenout it is actually sinking in... thanks julie for opening my eyes to this.
By AngelEleven  Oct 02, 2009
18
I didn't realize all my volunteering was a self imposed treatment until you just mentioned it in your article. Then it just clicked. be careful where you spend your energy though. Make sure it makes you feel good and you don't feel used.
By bluehurricane  Oct 01, 2009
17
my husband has been severly depressed for about a year and a half with panic attacks. he used to drive a truck for a living but he no longer can work. non of the anit depression medications have worked for him. we are finanically strapped and are trying to sell our house and move in with his parents for the time being. is there anything out there that could help him? i just want my husband back
By danrachie  Oct 01, 2009
16
I was in a depression last year that came out of nowhere and lasted 7 months. It was the most severe episode I have ever experienced. I would sit and stare at the wall, I was so paralyzed. I tried everything--you name it, everything named in this article and these comments and more. Then finally my husband said : enough and put me in the hospital to receive ECT treatments 3 times a week. After two weeks of this, I received 2 treatments per week, then one. By this time I started to come out of it. Life became life again. Everyone seems terrified of ECT. I need to tell you--it is not bad at all and has become quite routine. It has a very high success rate. Memory loss is a bit of a downside, but I don't really want to remember this bad time anyway. ECT needs to come into its own; it needs to be on your list, Julie. The associated stigmas are incorrect.
By IndianaJones  Oct 01, 2009
15
My wife has climbed out of Depression after 8 years. No meds just therapy. Her solution for her sadness was to walk out on me and a 20 year marrage. She says she would like to work it out but I need to get help. My therapist has said that my wife really needs more therapy. She has focused on one little part of her unhappiness.

For those that are fighting to climb out of Depression please don't turn your back on the people around you. They have been there for you and support you.
By SRC3  Sep 30, 2009
14
MaryMargaret (No. 11) and Redheadedgranny (No. 13) express my thinking too. There is an old Baptist hymn (Elvis made a great recording of it) called *Precious Lord Take My Hand* that has this verse:

Precious Lord, take my hand,
Lead me on, help me stand.
I am tired, I am weak, I am worn.
Through the dark, through the night,
Lead me on to the light.
Precious Lord, take my hand,
lead me home.

It helps me to sing that to myself and know the light is ahead, and that it will never get so bad that the light will go away ... it is only that I might stop looking ahead.

C.S. Lewis says in *Mere Christianity* that when you do not feel, act as if you did -- act as you did when you felt -- and habit will carry you through until once again you do. Its kind of like engaging rusty gears or priming the pump. Have faith that it will engage and keep trying at whatever pace you can.

Finally, as my old Southern Granny used to say, *If you cannot be cheerful, be as cheerful as you can.* We must not despair because we are not yet perfect. And cut other people plenty of slack as well -- perhaps that drooping flower in your office is doing the very best she can. Instead of admonishing her to Turn That Frown Upside Down, tell her that her hair looks nice today, or that you like that scarf. Give her reason to believe someone cares if she lives or dies. You may be the only one who does.
By Appleby  Sep 30, 2009
13
And sometimes we cause our own depression because we decide to live in the past where the hurts began. What we don't realize is that over time it becomes ingrained in us to continue to be upset without actually seeing that the other parties involved have gone on their merry way and go to parties, their jobs, college or change their attitudes and way of life. I believe most depression is ANGER turned inwards and the only way we can express it is by becoming so down on ourselves we can't see the way out.Learn to let go of your past and not live by your FEELINGS. Hard? Yes, but it is done everyday. Forgive them then forgive yourself for losing so much of your valuable LIVING TIME, go to a party, college, work or change your attitude and lifestyle, and begin to enjoy life.
By redheadedgranny  Sep 29, 2009
12
I had terrible experiences w/anti-d's. And I will never risk my physical & emotional health again by using them. All they did was dumb me down and keep me from dealing w/many things including several major losses. They also caused a huge weight gain, and 'coinsidentally' my thyroid and cholesterol went out of whack shortly after starting them. And there is so info out there that points to that being a side effect. And there are so many other serious side effects too. They really don't know what the long term effects are.

The dosage has to be correct or it can either make you more depressed, &/or suicidal, increase anxiety &/or panic attacks, or make you so blah that you don't give a crap about anything. Then there's the problems w/trying to get off of them, as another poster already mentioned.

There's also something called situational depression. In many cases, one's whole life could be classified as situational depression. That's because a person could be living in a seriously dysfunctional, abusive, &/or alcoholic, etc. home. I was amazed that once I got out of my 'situation,' that I started feeling better. It's been slow, but I'm in therapy. I also use alternatives like meditation, journaling & volunteering.
By MyTrueColors  Sep 29, 2009

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