Trying To Cope With Depression When “I Just Can’t.”

Immediate Help for Depression

If you are experiencing depressive symptoms, make an appointment with your doctor or find a therapist as soon as possible. For immediate help that can’t wait, there are many numbers you can call, including:

• 911, in case of emergency
• US Suicide Hotline: 1-800-784-2433
• 988 Suicide and Crisis Lifeline: Dial 988
• Suicide Prevention Services Crisis Hotline: 1-800-784-2433
• Suicide Prevention Services Depression Hotline: 630-482-9696
• Crisis Text Line: Text NAMI to 741-741
• National Youth Crisis Hotline: 1-800-448-4663
• The Trevor Project: Call 1-866-488-7368 or text START to 678-678 (for LGBTQ+ youth and young adults)

Understanding Your Depression

Depression, also known as major depressive disorder (MDD), is a complex and pervasive mental health condition characterized by depressed mood and loss of pleasure or interest in hobbies or previously enjoyed activities.

Depression can cause significant impairment in functioning, affecting a person’s appetite, energy levels, sleep habits, and ability to meet obligations.[1-4]

Signs and Symptoms

Depression can range in severity and everyone’s symptoms may present differently. Generally, to be diagnosed with major depressive disorder, your symptoms must be present for at least two weeks and disrupt your functioning. Some common symptoms associated with depression include:[1-4]

• Experiencing thoughts of suicide or death
• Problems concentrating, thinking, or making decisions
• Feeling guilty, worthless, or helpless
• Fatigue
• Sleeping too much or too little
• Changes in appetite resulting in unintentional weight gain or weight loss
• Loss of interest in previously enjoyed hobbies
• Feeling sad or depressed
• Feeling irritable or restless
• Physical issues like headaches or pains that don’t have a clear physical cause
• Inability to sit still or feeling very fidgety
• Experiencing slowed movements and speech

Causes of Depression

Because depression is a multi-faceted and complex medical condition, it doesn’t have a single cause. Rather, many risk factors and vulnerabilities can influence the development of depression, including:[1-3]

• Differences in neurotransmitters
• Genetics or family history of depression
• Personality traits, such as low self-esteem, pessimism, or low distress tolerance
• Neglect, abuse, and exposure to violence
• History of trauma

When Depression Feels Insurmountable

Sooner or later, most of us who try to cope with depression feel so overwhelmed that all we can hold onto is: I just can’t do it. I can’t stop being depressed. I can’t stop it from coming back.

When “I can’t” comes rushing out, it feel like the response to an accusation. Sometimes, I feel the weight of other people’s expectations. “If you really wanted to get well, you could at least get up and get moving.” Sure, they don’t understand, they don’t get it. But I’m asking the same question of myself.

I’m answering my own accusation. “So why can’t you handle this? You’re a completely worthless weakling!” “But I just can’t!” is my only answer. I’ve internalized the stigma and prejudice and feebly try to respond. I don’t trust myself. What if I am faking this? What if I’m just afraid to face things? I know that isn’t true, but there’s the inner belief that I ought to be able to snap out of depression.

But there’s nothing left to fight with. Everything deserts me: vitality, willpower, feelings, the ability to think clearly about getting well, to make choices, to take action. The inner drive to get well is replaced by the depressive drive to get worse or simply stagnate.

It’s impossible to do any of the things that self-help books advise, and each book contains hundreds of suggestions. I can’t do a yoga warrior pose, I can’t get out and see people, I can’t meditate, I can’t do push-ups and I can’t get a good night’s sleep.

When I’m trying to cope in that condition, all I can do is to start where I am. Since I can’t do anything, just where would that starting point be?

Using Awareness When You Can’t Cope

I do have one thing left. Awareness. At first, I’m only aware of what I can’t do. Mental confusion and the inability to focus are usually mentioned in the list of depression markers, but I’m not at all confused about everything that’s wrong.

Depression gifts you with extraordinarily vivid, powerful, detailed memories of all your mistakes, failures, weaknesses, embarrassments. You have absolute clarity of mind for the negatives, and they build a case of shame and worthlessness. Severe depression, after all, really wants to destroy you, literally if possible. So it leaves you the mental and emotional equipment to undermine your life.

That’s what I’m obsessed with. At the same time, though, I’m aware that I’m tearing myself down. I see what I’m doing to myself, and another level of awareness opens up. I want to stop the depression. I really want to feel better. I may not be able to do much to end it, but I know I want to come alive again.

I can start there. I hear a debate going on in my head. There’s one me who is lost in depression, and then there’s another me wanting to get better.

Usually, I’m still too tense and self-obsessed to get any clear idea of what to do.

It’s hard to understand now, but it took forever for me to get beyond that point. But one time, that changed.

I stopped and realized that I was aware of one more thing. I was breathing. I admit that’s pretty basic, but when I was that far gone I didn’t think what my body was doing. This time, I could focus on my breathing and felt how tight and restricted it was. There was a twisting in my chest that tensed every muscle.

Breathe deeply! For God’s sake, you can do that. So I pulled in as much air as I could – two, three, four times. That was relaxing, and I needed to settle down a little to think about something positive for a change.

And I could think of one more thing. Walk out the door. Just get some air – the real thing, not the stale smoke of your mental closet.

Breathing deeply outside felt good. Something opened briefly in my head, and I could look more closely at what I was going through.

Awareness is the ability to step back a little from what your feeling-mind is doing and to see it in action. In my case, that small distance enabled me to see that I really couldn’t handle depression on my own. It wasn’t just a complaint or a despairing outcry this time. I took the words literally.

I can’t do it on my own. That meant: I need help.

I had resisted saying that to myself for years. The reason was simple: I did get better. Even severe episodes eventually wound down, though it would usually take months to do so.

When an episode ended, I felt great and could hardly believe I had ever been depressed. I put the whole thing out of my mind – until the next episode. Then I’d scream at myself. Not again! Why can’t I stop this! I should be able to … but I just can’t!

With the help of a little breathing and a little fresh air, I realized that if I was ever going to learn how to cope with depression, I needed a method, skills. I had to learn what to do, and I needed someone to help me figure this out, someone I could trust.

This all seems so basic and obvious now, but it was a revelation at the time. I got lost in depression many times after getting help, but at least I had more skills to work with. I could remember one thing to begin a comeback.

Start where I am.

Take the first step towards managing depression – start with a depression test.

Professional Support: Getting Started

If you are struggling with depression, you aren’t alone. And you don’t need to manage your condition on your own. Professional help is available. Here’s what to do if you aren’t sure how to find a mental health professional:

• Research psychologists, therapists, psychiatrists, and counselors online
• If you have health insurance, look for in-network providers
• Consider the different treatment approaches and the type of therapy you may like most (cognitive behavioral therapy vs. dialectical behavior therapy vs. psychodynamic therapy)
• Contact the mental health professional, ask questions about their approach and availability, and then schedule a consultation.

Starting therapy may be stressful or anxiety-inducing, but making sure you are prepared can help put you at ease. Here’s a checklist for preparing for your first therapy session:

• Clarify your goals for therapy, such as reducing depressive symptoms
• Bring relevant information, such as medical history and medications
• Write down any questions you may have for your therapist, such as their approach
• Write down any concerns or reservations you may have about therapy so your therapist can acknowledge them and ease some of your anxieties
• Discuss practicalities, such as your schedule and frequency of sessions

Sources

1. American Psychiatric Association. (2020). What is Depression?
2. National Institute of Mental Health. (2023). Depression.
3. Substance Abuse and Mental Health Services Administration. (2023). Depression.
4. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596