Depression and free time

When people are fairly depressed, they have no energy.  They would say they have no "motivation", which only means there is nothing they actually want to do.  In spite of that feeling, they can continue to do things that they don't particularly want to do; such as jobs or tasks of various kinds, even going to the dentist or other relatively unpleasant task. They "feel paralyzed", that they "can do nothing", but that's simply not true.  Many people use the word "motivation" to denote some positive feeling toward action. When you're depressed, there are few positive feelings.   However, it is  possible to have purely intellectual motivation, a form that does not depend on how you feel but rather how you think.

The very worst thing for depressed people is to have nothing to do.  We instinctively want to lie down in a quiet and relatively dark place and hibernate when we're depressed.  But that gives us lots of time, time to think about things.  Usually the things we think about when we're depressed are pretty negative, which further increases our depression and inertia.  We disapprove of our own inertia and "laziness", which makes us feel more worthless. We get caught in a vicious circle with plenty of time to deepen the spiral.

To fight  the depression with activity is counter-intuitive.  There is a great deal of experimental evidence that supports the idea that activity of any kind, including exercise, will gradually improve the depression over a several month-long period.  In fact, the improvement is about as fast as the improvement one expects from an anti-depressant medication, but the long-range effects of exercise are clearly a lot better.  It's just that the hardest part, that of actually starting exercising, comes at the very time when the depressed person least feels like exercising.  Of course, that's where medication comes in: a short-range "jump-start" to get going with.  And it's easier to take a pill than to work out.

Having nothing to do but think while you're depressed is really the pits. So how do depressed people get started?  Well, mostly they don't.  To exercise while depressed is like going to the dentist to have a tooth drilled.  To do that we have to understand that "motivation" is neither available or necessary;  it's a luxury which depressed people have to do without for a while.  It does come back eventually, but it takes at least several months for that to begin.  For some of us (including me) exercise always has to be done without emotional motivation.  But so many things are never going to be based on "wanting to".  The world is full of unpleasant and distasteful tasks. Actually we're used to doing things we don't want to do.  Saying we "aren't motivated" is like going back to be an adolescent rebel again.

I have also noticed how many depressed patients I see who lead empty and fun-free lives, and did so for years prior to their depression.  How easy is it to get up to face a day with nothing pleasurable in it?  Why wouldn't we think "What's the use?"  It doesn't occur to us that arranging pleasurable events and experiences on an everyday basis is necessary for mental health.  Taking an anti-depressant does not provide a substitute for an interesting or enjoyable life.

"Motivation" is an award earned only by play.