Breaking the Patterns of Depression

Book by Yapko Michael

How to Use this Book to Your Best Advantage

The practical methods of this book do not emphasize rehashing the past. Examining your history may explain aspects of your depression but will not change it. Rather, it recognizes that you are reading this book with the hope that things will be different in the future--next week, next month, and all the rest of your life. The focus is on change in the present with an eye on the future. With that in mind, I intend to provide new ways of looking at depression and will also provide opportunities for experiential learning, because there is not better teacher than our own experience. I must emphasize to you that the best way to benefit from this book is to participate in the activities that are suggested in each of the chapters. Action is the emphasis here, because mere passive reflection on important but abstract ideas is not likely to produce the results you want. The ideas presented in each chapter are valuable, of course, but the real help comes as you expand your range of personal experiences (and therefore your range of resources) through the structured activities presented in this book.

There are two types of participatory experiences here. One is the "Pause and Reflect" exercise, which asks you to carefully consider some important concepts related to the topic at hand. (In order to encourage you to pause and reflect on your answer to these thought-provoking questions, and thereby derive more personal value from them, I have made my responses to them a little more difficult to jump into by printing them upside-down.) The other is the "Learn by Doing" exercise, which structures a learning experience for you to actively carry out. These typically encourage the development of specific new perspectives or life skills.

I must clearly state that this book is not meant to be a substitute for personal therapy. There is a great deal a good therapist can do to expand and personalize the points I make, So I encourage you to consider seeking a good therapist to consult. I offer some specific guidelines for how to do so in Chapter 12.

There is much to look forward to as you participate in these practical methods of self-help. After all, some of the best experiences you will have in your life haven't happened yet!

Chapter 1

Depression: A Growing Problem in More Ways than One

From the time I first let others know I was researching the latest information on depression for a self-help book, many openly expressed their reservations about the project. They'd ask, "Why do you want to write about something so, well, depressing?" Or "Self-help? Hasn't Prozac made that unnecessary?" Some even suggested that "depression is just self-indulgent feeling sorry for yourself. Why try to get people to help themselves who don't really want to?"

I can't honestly say that any of these comments or questions surprised me. Having worked with depressed individuals, couples and families for the last two decades, I've heard such reactions and misstatements all too often.  To me, these responses simply highlight the necessity of this book. Someone suffering through depression, or someone who cares about a person suffering though depression, needs realistic answers to these and many other questions.  There is a great deal of current and objective information that I intend to share with you in this book, all of it designed to help. And, beyond the facts, I intend to present a way of thinking about the facts that can continue to help long after you've finished reading the book.

Let's start with people's reactions to my letting them know what I was working on. Is researching and writing about depression depressing?  The internal experience of depression is painful on many different levels, as you undoubtedly know.  It can drain the pleasure out of life and make it seem a difficult burden.  But this book isn't about experiencing depression. It's about changing it, stopping it, recovering from it, even preventing. That isn't depressing, on the contrary, it's exhilarating!  So much has been learned about depression in recent years that it is not overstating the case to say, truthfully and with conviction, that almost anyone suffering the pain of depression can be helped if he truly wants to be and is willing to take the necessary steps.  Even those who judge themselves to be "hopeless" can be helped.  After all, hopelessness about life isn't a fact. It's merely a viewpoint.

The second common response was to question the need for self-help because of the advent of so-called miracle drugs, like Prozac. While it is certainly appealing to think that "a capsule a day will forever keep the depression away," it simply isn't true, nor is it ever likely to be.  Prozac and other anti-depressant medications, although they can be effective allies in treatment, are not a total solution in most cases. They can provide symptom relief, help ease distress, even lessen other symptoms that may co-exist with depression and further complicate an already complex clinical picture.  What they can't do is magically transform most personalities (despite the optimistic excesses of some drug advocates), teach vital coping and problem-solving skills, resolve associated personal and interpersonal issues, or erect strong protection against the recurrence of episodes.  The clinical research evidence is perfectly clear on this point: psychotherapy that emphasizes skill-building and problem resolution is not only desirable but necessary.

While this book is no substitute for participating in psychotherapy with a qualified professional, it does provide many of the benefits by emphasizing many of the same things. I have made every effort to offer you important ideas and practical methods for acquiring the kinds of skills known to the mental health profession as the most vital ones for overcoming depression now and preventing late episodes. I have crystallized here the essence of many effective interventions over twenty years of my clinical experience of treating depression sufferers.  These have addressed and resolved the core components of depression, and are both sound and therapeutic. They work! The body of treatment literature supporting these views is considerable.

The third common response from others about this project was the damning suggestion that depression is a product of self-indulgent self-pity by weak people who may complain but don't really want to change. This tendency to blame the victim permeates our culture in a variety of ways, whether for rape victims who "asked for it," or for cancer patients who "caused" their cancer by not expressing anger appropriately. In the case of depression, far too many people hold the outdated and incorrect view of depression as a problem stemming from a person's character defects or moral weaknesses. This viewpoint was common in the 1940's, `50's and `60's. Those individuals who were "weak" enough to openly confess their depression may well have been given such "helpful" advice as "Pull yourself together" or "Be tough and quit complaining."

The person who went for therapy decades ago--a less common course action than is now the case--was likely to be given trite sayings to repeat: "It's always darkest before the dawn"; "Behind every cloud there's a silver lining." Worse, he may even have been blamed for his depression: "You have a decent job, a nice home, nice kids, a loving spouse, and you have your health. What can you possibly be depressed about?" The depression continued, of course, but now he felt guilty, too!

As you can appreciate, depression is a complex disorder. There is no single cause; there are many.  There is no single solution; there are many. Suggesting that depression is mere self-pity is both hurtful and wrong. No one likes the idea of being depressed and letting his life waste away, one painfully slow day at a time. No one wants to lead a crummy life. My experience leads me to believe that people want to feel good and want their lives to be worthwhile, but through their life experiences they have evolved perspectives that make a good life seem impossible. People become absorbed in their own views of relationships and careers, and these views take on the aspect of inescapable reality.  What they discover in therapy--and what you can discover in this book--is that you can escape, you can recover, and you can go well beyond what has been painful to you in the past. Experience is negotiable, not fixed.
From the Hardcover edition.