Currently in the depths of a terribly depressive cycle punctuated by chronic fatigue, low motivation, and extreme anhedonia. I've been through countless medication with no improvement over the last year and while therapy and shuffling through different modalities have been able to temporarily abate these symptoms, nothing has come close to providing long term relief. I've tried different coping mechanisms like trying to break down tasks to the smallest pieces but nothing seems to motivate me into action. It all feels crushing, how do you cope with this?

Question

Emily Teague · Answer

Lean In: Steve, although I only know you through this app, I’ve noticed that you are an incredibly thoughtful and cerebral person. You give great advice, and it’s clear that you genuinely care about people and the world around you.

And while I wish I could carry your grief for a little while and give you some relief, I don’t know how to do that. Grief is hard. And hard is hard. But somehow, it does become less hard.

Until then, please remember that you have this community. A community you’ve helped in so many ways. So lean in, our friend.

And here are a few things that have helped me:

Lying beneath my favorite trees, aspens. Just lying there and leaning into the ebb and flow of grief rather than fighting it. Finding a place where you don’t have to do anything but simply be.

Trying something completely new. Sometimes occupying a different space and place can interrupt the cycles our minds get stuck in. A change in surroundings can shift your perspective just enough to think a little differently, and sometimes that eventually helps us feel a little differently too.

Sleeping under the stars. I don’t know why looking up at the stars helps me, but it does. Being grounded to the earth while staring into so much mystery makes me feel connected to something bigger than myself, and somehow more connected to myself, too.

And if none of those things feel possible right now, that’s okay. You don’t have to fix anything.

So our friend, yes this is a hard place to be, but this time we are here with you.

Soph · Answer

The wound makes the medicine: Short but potent. Like someone holding ur hand as you navigate the sads in life. Grief can feel like sucking salt water up your nose, but in a soul way… for however long it needs to. But the wound itself makes the medicine. Getting comfy with that medicine feels like a balm against society’s endless ways of distracting us from it.

Ashlie · Answer

Ketamine treatments: I’m so sorry you’re going through this.  My dad had been severely depressed most of his life.  Two years ago, at the age of 72, his therapist suggested ketamine treatments.  It’s been life changing for him.  He said it was like a cloud lifted.

Take care!  I hope you find some relief and joy.

Grier · Answer

Coping with Grief (Joy Fowlkes): Just came across this collection. I hope it helps🙏

Steven Weill · Answer

Regular Ice Baths/Cold Showers: Trust me I understand how this sounds - forget about any of the Win Hof-y proposed benefits - the parasympathetic response to the cold shower/ice bath will not ever cure depression, but it will consistently give you a window to build momentum on. Check out the attached study. Tricking your body into the psychological benefits of a near death experience never came so easily, safely or cheaply.

Kate · Answer

meditation based stress reduction (MBSR): This is an eight week course that takes meditation out of a wo-hoo religious context and into a scientific one. Lots of MDs prescribe it for chronic pain and anxiety. It had a major impact on depression.

I learned a bunch of good tools, but the best part was the people. Getting to regularly gather and learn from people at all walks of life in a vulnerable place was incredible. 10/10, recommend to anyone going through life.

I took it through my local university, just google MBSR + your city.

Lida Richardson · Answer

Notice the patterns ~*~*~*: First of all, I am so sorry you’re going through this. I know it’s so much more painful than words really have the power to communicate, and it’s so hard when it feels endless, especially because you kind of run out of ways to explain it to people. To be clear, I am saying this not to invalidate at all, but just to point out something I notice in myself when it gets really bad. I noticed you said that various things have helped abate the symptoms but fell short of providing long term relief. That’s really real and so frustrating, and it’s so messed up that so much mental healthcare can feel like a bandaid. But I also wanted to say that something I notice is that when I feel really really low, my brain is like, ultimately, it’s always been like this, and it’s always going to be like this, and all the moments of relief are flukes. Depression loves a very flawed kind of pattern recognition, where the cycle feels endless and unchanging, and any bright spots are just kind of greyed out. And the tricky balance for me is validating that very real emotional and mental experience that is observing a true and deeply difficult thing, and also saying, hey, my brain might not be seeing every single piece of the picture right now. Like for me, when I’m in a depressive place, it feels like that place is THE real place, the place I keep coming back to, the only real truth. But when I’m not particularly depressive, I see it more as a cycle I go through, and I know the ups and downs are both true parts of it. So I just wanna say that it sounds like this year has been truly brutal, and I’m so sorry and empathize so deeply. But I also hope you don’t discount the hard work you’ve put into those moments of relief,  or the fact that one of those next moments could become something longer. Does that make any sense?? I guess what I mean is that depression is really fucking awful because not only does it actually suck, it also changes your perspective so that everything both behind and ahead of you sucks even more, and it feels like there’s no escaping it. So anyway, I sometimes tell people that I feel lucky I’ve been depressed on and off for so long, because now I have all this data I can’t really discount. I don’t know the specifics of your situation or what it feels like, so again, I know it’s really real, and I’m so sorry that what you’ve tried so far hasn’t helped. But I really believe that something can and something will.

Practically, the biggest rescues for me are probably routine and structure. Like, waking up at the same time every day, going to sleep at the same time, whatever little routines that you can build into your life. I have this whole really unchanging morning routine that helps me start out the day on stable footing. I’ve realized that a big thing that’s helped me stay kind of okay while sick and mostly stuck inside my house rn is just being really rigid about my routines, bc that feels like the opposite of depression to me. You can start really small and work your way up. In the past, I’ve found walking every day / some form of time outside really helpful, but since I currently have an illness that makes exercise impossible I never want to assume that works for everyone.

Also — something small to really care about. For me, that means reading/writing/ taking even just one class, but it can be all sorts of things. Also generally helps me to have other people relying on me, because it’s wayyyy easier for me to let myself down than other people.

Sending solidarity and strength. Really hope any of that’s useful, feel free to disregard any part of it that isn’t!!!

Maryn · Answer

Finch: Self-Care Pet:

A completely silly but wonderful app that helps you take care of yourself by taking care of a birb (bird). Highly recommend