by Robert Duff
Hardcore Self Help: F**k Depression
By Robert Duff, Ph.D.
www.hardcoreselfhelp.com
Copyright © 2016 Robert Duff, Ph.D.
All Rights Reserved
Please direct all inquiries to [email protected]
Disclaimer: This is a unique book. As you might be able to tell from the title, I am not afraid to be a little colorful with my language. If that bothers you, maybe try a more straight-laced self-help book. This book is intended for mature audiences. If you are a parent buying this for your teen, I encourage you to check out the book for yourself and then decide whether it would be appropriate for them.
This is the second book in the Hardcore Self Help book series. The first was F**k Anxiety. This book is a bit longer than the first. In F**k Anxiety, I wanted you to power through the book as fast as possible and then get out there to make some positive changes. F**k Depression is a bit less rushed. I use the same tone in which I talk directly to you like a friend, but I took my time to cover each area more fully.
Throughout the book, I give you a few different resources that you can use in your quest to overcome depression. Many of these are also available in printable form at duffthepsych.com/bookresources.
Table of Contents
Introduction
Ch. 1 Are You Actually Depressed?
Ch. 2 Getting the Ball Rolling
Ch. 3 Your Brain Is a Troll
Ch. 4 A Chapter About Suicide
Ch. 5 On letting Go
Ch. 6 Let’s Get Physical
Ch. 7 A Letter to Those Who Don’t Understand Depression
Ch. 8 Be Nice to Future You
Ch. 9 Professional Help Is Self-Help
Ch. 10 Adventure Time
Thank you!
Introduction
Depression fucking sucks. There’s no other way to put it. It's a gross, heavy, disgusting monster that feels like a parasite that saps all of your life energy to sustain itself. If you are living with depression, you can probably admit you are in a vicious cycle. You want to crawl out of your depressed state, but most of the things that would possibly help just take too much energy and motivation, which you have none of because you are... well, depressed. Then you feel guilty about not doing those things that seem so easy for other people, which zaps you even more and drives you deeper into depression. It's bullshit and I understand that it probably makes you feel pretty frustrated.
That's okay. Right now, you don't need to feel confident or hopeful. I will be confident in you right now and you can pick up the reigns later. I know that you can get through this. My confidence in you is not misplaced or unfounded. You're fucking brilliant and I hope you give me the chance to prove it to you. Consider this: you are exhausted, right? Feeling like every single thing you do takes 1000% more effort because you have this annoying personal black cloud over your head as well as a backpack full of 100 heavy ass bricks that you carry around all day? There is no reason you should have picked up this book. Reading isn't all that fun and you've already learned that mostly anything you try to do to get better is pretty much useless. Here's the thing. You did it anyway. That's fucking huge.
I'm so proud of you for taking this chance. Stop shaking your head! It's a big deal and I am going to force feed you this compliment whether you like it or not. There is a piece of you that is still fighting this and I want to add a spark to that little ember and help you create a roaring fire of depression slaying badassery. You may feel numb and zombie-like, but you have not given up. We are still in this, friend. Let's get you back on track.
In the following chapters, I will teach you a bit about depression in real-person language. Let me pause here and introduce myself. My name is Robert Duff. I am a psychologist from Southern California. My goal with the Hardcore Self Help book series is to take the information that I have learned in my clinical work and in my Ph.D. education in psychology and translate it into straightforward language. In the field of psychology, there is this stupid tendency to make things way too complicated. In my opinion, you should be able to explain something simply if you truly understand it. That’s what I do here. This is self-help for people who usually don’t like self-help.
In my work as a psychologist I have had the honor of seeing real people just like you claw their way out of some really dark spots, and I would like to share some of the lessons and insights that helped them do that. Depression sucks hard, but it is not a death sentence. You are ready to move on. So let's get your ass movin'!
Ch. 1 Are You Actually Depressed?
Alright, so, many of you are probably not sure whether or not the crappy feelings you are having qualify as depression. We tend to throw around the term depression pretty casually here in the USA. You might hear someone say that they are depressed when their sports team blows it or when their favorite musical group loses a member. This points to one of the annoying things about depression: it is an emotion and it is also the name of a disorder. What I mean is, you can feel depressed without having depression. Throw in the fact that depression does not look the same for everyone and this shit can get really confusing. Let me try to clear it up a bit.
Have you ever lost a family member or favorite pet? Have you ever completely bombed a test that you needed to do well on in order to get the grade you wanted in a class? Have you broken up with a significant other? I could keep going, but what I am trying to get at is the fact that we have all encountered periods of sadness in our lives. What is distinct about the sadness that follows these sorts of events is that it is “reactional” in nature. That means you have gone through some shit and your heart is really heavy as a result. You might even have been more than “just a little sad”. Maybe you were having a hard time eating, crying almost constantly, and feeling completely drained of your energy. It is common for difficult circumstances to throw you into a sort of temporary depression. This is a good thing. It means that you are a good human and that you cared about the issue in the first place. We run into trouble when our overwhelming feelings of sadness extend beyond the immediate situation. If the situation resolves and you still find yourself in the throes of these feelings, you might need to take a step back and evaluate whether you might be depressed.
Of course, many of you are probably here because you are in a similar emotional state, seemingly for no reason. Nobody died, and objectively things are not all that bad, but you just can’t seem to stop feeling like garbage. In fact, that probably fuels the depressive fire even more. That knowledge that things could be worse. Depending on your circumstances and who you ask, there very well may be a reason for this depressed state you find yourself in … it just might take some digging to find it. Even if you feel you have no reason to be in such bad shape, it is important to be honest with yourself and consider the possibility that something clinically significant might be going on here.
And we can’t neglect to mention the people who have an easily identifiable reason for their depression. Trauma, abusive relationships, extreme poverty, a never ending series of tragedies… all of these things are damn good reasons to feel depressed. It’s tough because these circumstances are not really “your fault”. I want to stress to you that whether your depression has a clear origin or is more of a mystery, you can definitely find something useful in the contents of this book.
In the field of psychology, we use a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM) to aid in determining whether issues meet criteria for a well-known psychological issue. The DSM is one of several different standard texts that are used to diagnose mental illness. Depression is such a common issue that any definition you find will be relatively similar. These are the c
urrent DSM criteria for a major depressive episode. You need to have five or more of these symptoms that occur during the same two-week period and represent a change from previous functioning. At least one of your symptoms has to be depressed mood or loss of interest or pleasure:
● Depressed mood for most of the day, nearly every day. In children or adolescents this can look more like irritable mood.
● Lowered interest or pleasure in nearly all activities for most of the day, nearly every day.
● Significant weight loss or weight gain (change in 5% of body weight in a month) when you haven’t been intentionally changing your diet or a decrease in appetite, nearly every day.
● Insomnia (not sleeping enough) or hypersomnia (sleeping way too much), nearly every day.
● Either speeding (agitation) up or slowing (retardation) down of your activities, as noticed by other people.
● Fatigue or loss of energy, nearly every day.
● Feelings of worthlessness or over-the-top guilt, nearly every day.
● Trouble with thinking or concentrating, or indecisiveness, nearly every day.
● Recurrent thoughts of death, recurrent suicidal thoughts without a particular plan, a suicide attempt, or a specific plan for committing suicide.
For your experience to qualify as a major depressive episode, these symptoms need to be disrupting some important area of functioning such as your ability to operate socially or work effectively at school or your job. These symptoms also can’t be due to the effects of drugs, medicine, or a medical condition. Certain medications can have a depressant effect, which is definitely a valid experience, but it is considered to be separate from a major depressive episode. I should back up for a moment and clarify why I keep saying “depressive episode”. A huge number of people have a major depressive episode at some point in their lives. This is at least a two week period in which you meet those criteria that we just talked about. A smaller, but still way too large number of people experience major depressive disorder, which means that they have a pattern of recurrent depressive episodes across a portion of their lifetime. You can think of it as being similar to an eating disorder. You can have an episode of starving yourself, but that does not necessarily make you meet criteria for anorexia. It is the recurrent behavior over time that qualifies it as a psychological disorder.
Now I should talk a little bit about the fact that depression is not the same for everyone. It is difficult to stick to the books and convey what I’m trying to say about this, so please forgive me if I draw a bit more from personal experience than research here. One of the things that persistently pisses depressed people off is when they meet a mental health professional who instantly groups them into a very specific category in their mind. I’ll be totally clear that not every mental health provider does this, but there are certainly enough dumbasses out there that do. I can totally understand why it is infuriating to feel like you are put into a box before you even get the chance to explain yourself. Sure, you have depression, but that doesn’t mean that your depression is exactly the same as everyone else’s. You are more than just a checklist of symptoms, and it can be really hard to deal with people who think that your depression is the over-the-top emotional, ugly crying, arrow-to-the-heart kind of depression when, in reality, you are having more of the annoyed at everyone, angry at self, agitated sort of depression. Those are two very different flavors. Let’s talk about some of the unique ways that depression can manifest. Clearly, I won’t be able to capture every single one of you unique snowflakes here, but maybe you identify with one of these.
Perhaps one of the more stereotypical versions of depression is what I like to call the “sorrowful” subtype. This one looks a lot like active grief. The way I can typically identify someone in this mode is by asking whether they find themselves crying at literally everything. The wrong commercial comes on, you hear a song that makes you feel all the feels, the wind changes… you hardly need an excuse to shed some tears. It’s like you’re on the verge of breaking down 24/7. This version of depression really sucks because it’s not exactly the type that you can hide easily. Not so awesome when you are trying to hold it together at work. You’re just so fucking sad that it almost literally aches in your heart. Often people start off with this type of depression and progress from there. When you first feel the bitter sting of depression and start to question whether this is just who you are now, it can be startling and incredibly painful.
Sometimes people are depressed, but nobody notices. That’s because they don’t follow the archetype that I described above. Not to be stereotypical, but in the US a lot of guys seem to fall under this umbrella. Instead of becoming sorrowful, crying, and feeling that palpable heartache, some people instead look more angry or agitated. People who are in this mode tend to feel annoyed as hell at just about everything. Someone cut you off of the freeway? Pissed. Bad service at Starbucks? Irritated. Distant relative posting ignorant political garbage on Facebook? Fucking forget about it. Now there are some people that have a low tolerance for bullshit throughout their entire life. That’s not what I’m talking about here. I’m talking about a distinct change that takes hold. Sure, all of those things are annoying in and of themselves, but that’s not really what this is about. You are mad at yourself and nearly everything in the world just serves as a reminder of that. It’s like a mirror that you are trying really hard to avoid looking into.
Both of the examples that I have mentioned are pretty easy to identify by their distinct behaviors. Another unique depressive presentation I have seen is the anhedonic type. Anhedonia literally means “without pleasure.” In this type of depression, you don’t feel much of anything. No matter if the things you encounter are extremely happy or entirely sad, you feel emotionally vacant. It’s almost as if you have no emotional energy left to give, and all that is left is this hollow feeling in your chest. The numbness should feel sad, but you just can’t quite bring yourself around to feeling sad. Typically, it is quite hard to identify what is wrong when you have this style of depression. You can’t exactly put your finger on it, but it just doesn’t feel right. You are there, but you aren’t really there. Some people will turn to self-harm or extreme behaviors in this type of depression because they just want to feel a little bit of anything.
The last flavor of depression is the physically wrecked version. This is the type where you seem to internalize all of your depression. You know Kirby? The pink marshmallow videogame character? Imagine him sucking up a bomb and swallowing it. That bomb is your depression. Sometimes, it can feel like all your sadness expresses itself through your physical body. Common complaints are constantly feeling weak, sick, and tired. Exhaustion probably plays a big role in your life. You might turn down many opportunities that could be helpful simply because the mere thought of doing anything makes every muscle in your body cry. Perhaps you are legitimately sick more often than other people, but it’s more than that. Things just seem to hit you harder than they should. This type is really hard. Maybe you have even gone to doctors and specialists to try to figure out what’s wrong and no matter what tests they give, they can’t find anything in particular that should be making you feel this way. (Now, I should clarify that this sort of depression is not the same thing as having a chronic fatigue disorder or autoimmune problems. Those can cause a lot of strange and confusing physical issues. The defining factor that would help you know that this is depression would be that it ebbs and flows depending on your emotional state. If you were feeling great physically when you were happy and things seemed pretty good in your life and once things took a turn, your body started breaking down, you might be looking at depression.)
Again, this is not mutually exclusive with physical problems. I write more about physical issues that can look like depression later on, so definitely have a look there as well.
Like I said, those are just a few of the “types” of depression I’ve encountered. It is not meant to be an exhaustive list. The point I am trying to
get across is that depression is not one thing. Sure there are similarities in each type, but they’re not identical. Think of it this way: not all dancers are the same. If you put a ballet dancer together with a break dancer, they may not feel like they are members of the same tribe. Sure they both dance, but the way in which they dance is pretty damn different. Of course they can find similarities between them and can certainly learn from one another. That’s often how it is with depression. I see this all the time in support groups. If a group is dominated by one subtype of depression, there may be a new member who feels like they just can’t relate. Just like those dancers, they eventually are able to find some common ground and learn from one another. I tried to write this book in a way that could be helpful to all of you. (If you come to the end of the book and feel like your issues were not addressed, please let me know so I can do better in the future.)
So take a nice long look at yourself. Review the symptoms and depressive presentations that I have talked about so far. Do these line up with your experience? I have to say you really should leave definitive diagnosis to professionals who have the chance to meet you in person. Our generation has this really bad habit of using WebMD and self-diagnosing… don’t pretend like you have never done it. The point of recognizing your symptoms and identifying the potential of a disorder is that you can take that information with you when you seek professional diagnosis. You don’t have to have a diagnosable psychiatric issue to benefit from the knowledge bombs I drop on you in this book. These tips can help anyone who deals with depressive symptoms regardless of whether they get to join the exclusive “officially depressed” club or not.
