by Robert Duff
Now in depression, there isn’t just one specific way that the brain changes. We are still in the process of understanding all of the neurochemical intricacies involved in individuals with depression (damn that sentence sounded smart). What we do know at the moment is that there are three main neurotransmitters involved when depression takes hold. Those neurotransmitters are serotonin, norepinephrine, and dopamine. You’ve probably heard of dopamine before. This is the neurotransmitter that makes you feel pleasure. Some people call it the “feel good molecule.” Let me put it this way … a lot of “recreational” drugs act by providing a rush of dopamine that makes you feel awesome and rewards your behavior, which can eventually lead to addiction (we’ll save that for another book). There are some really interesting things that happen with neurotransmitters that can make your brain all out of whack. Remember in that description above how there were two neurons: one sender and one receiver? The space between those two neurons is called the “synapse.” When you take illegal drugs like cocaine, you artificially flood that synapse with dopamine. The result is that the receiving neuron (#2) goes, “Holy shit! I feel great, but we have WAY too much dopamine over here. HEY JOHN (neuron #1) YOU CAN STOP MAKING DOPAMINE. WE GOT TONS!” Your brain adapts quickly to changes like this to keep you in a lovely balanced homeostasis. That means that it will “down regulate” production of dopamine and will turn on those “closed for business” signs on the receptor sites of the receiving neuron. If you were to suddenly take away that drug, you brain would still be used to this new norm of not having to produce dopamine, and suddenly you have that anhedonia that we talked about. Everything feels like shit.
For depression that involves low motivation and lethargy, the outcome is basically the same, but the process is a little bit different. The second, receiving end, neuron will also turn on its “closed for business” sign if it doesn’t get much dopamine knocking at its door. It’s sort of like supply and demand. Think of it like a bar or a restaurant; if there are only a few patrons that come in throughout the week, the place is going to start reducing the hours it’s open so that it doesn’t lose so much money. If neuron #1 stops sending dopamine patrons to the pub over at neuron #2, they will start to close for business more often, and any dopamine that is produced may never result in making you feel happy. That, in turn, will make neuron #1 go, “Well screw that guy,” and start sending less and less patrons over since they always end up coming back and saying, “Dude that place sucks. It wasn’t even open when we went by.” Friends. This is why everything feels so shitty. Your brain has just acquired a really bad habit of not making as much dopamine and also not even converting the dopamine to feelings of pleasure when it is generated.
This is a WAY overly simplistic description of how it works, but I hope it helps you understand a bit more about why it can be so hard to get the damn ball rolling in the middle of a depressive episode. You are literally fighting against your biology. That’s the thing, though. Since you are a kickass human being, you do have the power to fight against your biology. You can say, “Hey asshole, I know that you’ve gotten used to the way things are, but it’s time for you to start getting back into shape.” You can literally retrain your brain to derive pleasure from things that used to feel awesome to you. Think of the bar example again. If neuron #1 suddenly starts sending a ton of patrons over to the pub at neuron #2, the doors will not reopen immediately. The owner of the pub will hear that they missed out on a ton of business and then maybe open up a few more days during the next week to see if the trend keeps up. If neuron #1 stays consistent and keeps sending people down to neuron #2 to get turnt (read: drunk), the owner of the pub will be inclined to stay open more and more often. So when you do activities that are fun and pleasurable, you will be sending dopamine into that synapse. Over time, by staying consistent and forcing yourself to do those activities that were once pleasurable for you, you can train your brain to start opening for business and feeling happiness again. Pretty fucking awesome, if you ask me. The coolest part is that once you develop your neural groove again, the happiness and pleasure will start to become more effortless. Things that you didn’t even intend to make you happy will make you happy. That way, the random goat picture on twitter is no longer “meh” and is now “OMG I JUST GOAT SO HAPPY IN MY HEART!” (Side note: please go follow @TheSassyGoats on twitter for your daily dose of happy.)
I bet a lot of you asked yourselves earlier in the chapter how doing pleasurable, unimportant activities can eventually lead to you accomplishing the important stuff in your life. I understand the skepticism, but to use the bar example one last time, there is no point in the pub at neuron #2 suddenly converting to a high class, expensive mixology bar if they aren’t getting any patrons on a daily basis. Once the demand is there, they have more wiggle room to take risks and put in more of their own effort into trying different things. In the same way, once you start this process of retraining your brain, you will have more overall motivation to work with. You can afford to expend some of it on activities that don’t always feel awesome but are important to do. More importantly, sometimes tough activities like finishing your homework or cleaning the garage DO feel awesome. The result of you continually force-feeding your brain dopamine through pleasurable activities is that you may just open up enough receptors that the accomplishment of achieving your goals feels pretty kickass too. Maybe you can remember a time that this was the case. Getting a good grade on a project that was really difficult? Beating your personal record in some athletic activity? Finally getting your fingers to cooperate when trying to learn the guitar tabs to your favorite song? That shit feels amazing. Start with your easy wins and work toward the bigger stuff. You WILL get there.
At first, the process of retraining your brain and being productive again will feel grueling. It’s like trying to get ripped again after an entire summer of pizza and Netflix. There is also the question of how hard to push. When I’ve described this approach, some people have expressed concern that they don’t want to push so hard that they end up burning themselves out. For this concern, my advice would again be to enlist the support of others. Not only can you pick up on some of their contagious motivation and support, but they can also help serve as a gauge for you when you need to know whether you’re really pushing yourself too hard or if it seems on track. A good rule of thumb is: if you are crashing really hard and feeling more depressed after you finish one of your activities, you may be pushing too hard and should probably start with something a little easier.
If you find that no matter how hard you try, you just cannot get the ball rolling, even on these easy wins, and you have already tried the strategies that I have outlined here, it may be useful to consider medication. I talk more about this in a later chapter, but the purpose of medication for depression is basically to give you a little boost in your neurotransmitters to ease your lethargy and low motivation a bit, so you have more emotional energy available and can put in the work re-training your brain like we talked about above. More on that later.
Ch. 3 Your Brain Is a Troll
I talked a lot about the ways in which your brain trolls you in my previous book, F**k Anxiety, but it is important to talk about them here too. They also play a huge role in depression. Having depression is like viewing the world through shit-colored glasses. Everything just has a different tint to it. Even the good stuff is hard to take seriously because you are filtering it through a 50 shades of crap. Let me do a little review of the way in which thoughts screw with us and how we can take some control back.
Let’s continue with that glasses idea. When something happens in the world, whether it be to us directly or in general, we filter it through the lens of our thoughts and beliefs. This has a direct impact on the way we feel. The thing is, depression plays a lot of tricks on us, and we end up with distorted thinking patterns that tell us things like “you don’t matter”, “nothing you do is going to help”, or “nobody likes you”. Let’s go through some examples togethe
r, so I can show you how thinking gets in the way of your emotional success. The following examples are taken from real feedback that I have gotten from those of you who were gracious enough to share your thoughts with me during the creation of this book. You rock.
Here is a thought pattern that some of you have probably fallen into: blaming yourself for everything. Even if something is logically outside your sphere of influence, you assume that somehow you have to be responsible for any mishap. In turn, you feel the need to apologize and beat yourself up emotionally. I don’t mean something as obscure as seeing a plane crash on television and assuming that you somehow are to blame. Let’s say that your significant other was up for a promotion at work and didn’t end up getting it despite their confidence and hard work. Some healthy assumptions and beliefs about this situation might be that there was a better candidate for the promotion who really went above and beyond to seal the deal. Perhaps your mate’s employer is in a tight spot financially and is trying everything that they can to avoid giving out more money, so they decided to skip this round of promotions entirely. When you filter the world through your shit-colored glasses, you instead just find a way to blame yourself for what happened. Maybe it is because you got into a fight a few nights ago, and it must have been distracting them and put them into a negative emotional state. Or maybe it is because you are too needy and took up all of their time they could have spent preparing for the interview, and they were unprepared as a result. Seeing it on paper might seem a bit ridiculous, but we totally do stuff like this.
Here’s a super common one that can cause all sorts of problems: “Things never work out for me, so what’s the point?” Hopelessness is a symptom of depression. That is a really important thing to remember. That is why you feel like you are never going to overcome your depression. That’s what the depression devil is whispering in your ear all the time. Now, I’m not calling you dumb, but most of the time depressive hopelessness is not the result of logical reasoning. It’s a trick that your mind plays on you to convince you that it’s not worth trying. Let’s say that you are trying to get more physical exercise to improve your physical and mental health. Well, when you think about it, there is really no point… last time you tried to exercise, it didn’t make much difference, so why bother trying this time? This mental filter is causing you to not notice the fact that all of the positive effects of exercise are not evident right away, and you gave up last time pretty early into the process due to the very same cognitive trap that is playing out right now. This is one of the main challenges in writing a book like this. Trying to convince you that the voice in your head, the one that tells you there is no point in trying, is completely wrong.
I don’t want you to be all rosy and blindly optimistic. That’s just annoying. Instead, I want to encourage you to be more realistic. Be a good scientist. Before you jump to conclusions based on your gut feeling and the influence of the depression devil on your shoulder, give yourself the chance to examine the evidence. If it turns out that all of the objective evidence still points to something upsetting, then by all means be upset. Like I said earlier, shitty things should feel shitty. However, if you are experiencing depression, it is almost guaranteed that you are distorting the way in which you interpret the world to match gross feelings in your heart.
There are a few ways that we can counteract this process and bring about a healthier pattern of thinking. One big piece of advice I have is to avoid keeping it to yourself. If you have people in your life that you can talk to, tell them a bit about what you are struggling with internally. Help them understand your thought process and then invite their feedback about whether it makes sense. You should tell them that you aren’t just looking to be told that everything will be okay, but rather that you want to know how they would think about this situation if it were happening to them. (I should interrupt here to mention that this works much better when you enlist the help of people who are not also depressed. Substituting one distorted thought process for another is not going to do much good.)
There are a couple barriers to asking people for their opinion of your thoughts. For some people, that will feel very exposing and scary. Opening up is not always easy and I think it is even scarier when you know deep down that your current thought process might be a bit skewed. No one likes to be thought of as crazy. If this is a barrier for you, it might be most useful to enlist the help of the top 1% of people in your life that you really trust and who you are almost certain will be there for you no matter what. If your life is an ever changing equation, these people are the constants. This is different for everyone. For some people, a parent provides that unconditional support. For others, they have a best friend from school who will always call you on your bullshit but never love you any less. Start with these people and recruit them as your logical barometers. Don’t ask them whether you should be upset. Ask them if your line of thinking makes sense. Ask them how they would think about a given situation. There is no right or wrong here. You just want to get some alternative perspectives so you can really consider all sides of the evidence before you conclude that you truly deserve to feel like shit.
Another potential barrier is a lack of people in your environment that you can access. Luckily, technology like the Internet and texting has given us unprecedented access to friends and family whenever we may need them. Sometimes it just isn’t possible or convenient to reach out to someone else, though. For those situations, I would encourage you to envision someone that you care about. As before, this can be a friend, family member, or miscellaneous loved one. Now, think about that person coming to you and describing a similar situation. What feedback would you have for them? This works exceptionally well with that “best friend who calls you on your bullshit” I mentioned earlier, because you can imagine yourself saying, “Dude, you’re an idiot. That doesn’t even make sense.” What holes can you poke in their logic that might explain exactly why they feel so terrible about the situation at hand? Even better, you can combine these two approaches. You have some people in your life that serve as logical barometers for you. You reach out to them every so often and request feedback about your patterns of thinking. Over time, you start to internalize their voices and their thinking styles. So when the depression devil pops up on your shoulder and whispers some stupid self-sabotaging pseudo-logic in your ear, you also have your panel of trusted advisors that pop up and provide some alternative approaches that they would be more likely to employ. In the end, the decision about how to proceed is always yours, but using these strategies gives you the best shot at success. It’s fairer and is one step in the direction of being less of a dick to yourself.
I also want to talk for a bit about a psychobabble term that you may have heard before. Have you ever heard of schemas? The word schema (skee - muh) basically just refers to your own unique pattern of thinking. It’s how you selectively pay attention to certain things while ignoring others and then make overall conceptualizations about the situations that you encounter. The reason that I bring this up is that when you are depressed, you tend to develop a nasty little schema in which your negative view of yourself leads to a negative interpretation of things that happen to you in the present and eventually to negative predictions about things that have not yet come to pass. You can probably see how having a stable negative schema might lead to the feelings of hopelessness that are common in depression.
One valuable exercise is to try and identify your own schemas. We often apply these as sort of fake rule sets that we hold ourselves to. For instance, we might say something like, “I must get good grades if I want to please my family. They won’t love me if I fail. If I don’t excel, I have essentially failed.” Obviously, these are not completely logical. We don’t necessarily say these things verbatim to ourselves, but when you scratch beneath the surface of your assumptions and reactions to everyday situations, sometimes these are what you are left with. Another negative schema might be, “Nobody likes me. People think that I am awkward. I won’t
ever find love because I am not comfortable around people.” Each of these negative patterns serve as one of those shit-colored filters that we talked about and can lead to some pretty serious cognitive errors when we apply them indiscriminately.
I am sure that you are guilty of sometimes overextending these “rules” and applying them to circumstances that they do not fit. For instance, I’ve had someone tell me about a situation in which their schema about being too awkward to ever find love really bit them in the ass. They were at a get-together at a friend’s house (first red flag: if they were that awkward, they wouldn’t have any friends), and they wound up talking to a girl that they thought was cute and charming. They got on a topic that he was passionate about: video games. Before he knew it, the guard was down and he launched into a mini rant about the state of gaming, microtransactions, and stupid pre-order nonsense. The girl he was talking to said something to the effect of, “Aww how nerdy.” Now this simple expression, when filtered through his own unique brand of shit-colored glasses, meant that he was an idiot for revealing his true awkward self and ruining any chance that he might have had. In reality, she was totally into it. He learned later on that she actually thought his passionate rant was endearing because it is nice to find a guy who actually gives a shit about anything these days. However, since that possibility did not fit into his narrow negative schema, it didn’t even come close to crossing his mind. As a result, he started acting like an asshole. He shut down and found a way to abruptly end the conversation. The self-fulfilling prophecy was thus fulfilled.
