I found, through experience, that while suffering from depression it was very important for me to have a schedule for the day. In the hopes of allowing a new medication to kick in, I took nine, unstructured days off of work. In hindsight, I think this was a terrible mistake for several reasons.
I isolated myself during these nine days. I believe that isolating oneself while trying to recover from depression can be very damaging. I feared that if I went out during the day, I may bump into someone who I knew. As a public school administrator in a large urban district for more than fifteen years, I often bumped into familiar faces throughout the city. I was fearful of bumping into someone I knew whether it was a parent of a student at the grocery store or a neighbor on a walk to get fresh air. On a rare occasion, I would join a friend for a cup of coffee or breakfast. I became very anxious at those times and always tried to find the most inconspicuous seat in the restaurant, scanning the place on my way to my seat to make sure nobody was there who I knew. How would I explain not being at work? How could I be on a mental health leave, yet be out shopping or grabbing a coffee? This anxiety and isolation did nothing to support my recovery. In fact, I believe it was quite detrimental to my recovery.
Without a schedule or anywhere that I needed to be, the lack of motivation that comes along with depression only grew. I would spend time sitting on the couch and then soon laying down on the couch. I would use the excuse to my wife that my therapist shared with me that depression is like a brain injury and rest is needed. However, this turned into an excuse to retreat to my bed and hide behind the safety of my closed bedroom door. Unable to sleep, I would lie in bed for hours at a time, essentially waiting for the day to come to an end. When I managed to drag myself out of bed, I would often end up, only minutes later, sitting on our living room couch. The sitting soon turned to lying and there I was again, hoping for the day to come to a close so that I could be in the comfort of my bed, only to find myself rolling around unable to sleep. In the evening, my wife and I would make a list of simple things for me to do for the following day; fold the laundry, clean a bathroom, empty the dishwasher…none of which I could accomplish.
The isolation and lack of motivation caused more frustration with myself, fed my depression and increased the ruminations. Thoughts of myself became very negative and easy to defend. I convinced myself that I was an awful father (with four young children) and an unsupportive husband. I convinced myself that I was no good at my job. I no longer could focus on the moment, my mind always wandering into self-loathing. I noticed this while I tried to play with my children, unable to focus on the game or to really be fully engaged in conversation with them. I remember my wife taking me out to a professional hockey game with a couple from her work. Normally a very outgoing person, I struggled to engage in any kind of conversation at all with this couple I had never met. My wife would try to get me to at least focus on the game as she could tell I was ruminating in my own negative world the entire game.
In contrast, after attempting to go back to work and finding myself only getting deeper into the depression, I took three more weeks off from work and checked myself into a partial hospitalization program for what was diagnosed as major depression. This program offered me a place to be and a structured scheduled from 9:00am-3:00pm. While the program offered a great amount of learning and support, one of the most critical pieces it gave me was the structure. It allowed me to focus on my recovery, rather than ruminate between the walls of my house. I had a reason to get out of bed in the morning and a destination other than the couch in my living room or my bed behind a closed door. It offered me a sort of forced socialization that allowed me to meet others who were going through a similar experience. This structure, I believe, was critical in working towards my recovery.
Soon after returning to work, I had heard that a friend of mine had recently taken a leave of absence from their job. I contacted my friend immediately, suspecting that it may have been a leave for mental health. She shared with me that it was, in fact, for mental health. When I asked her what her plan was for her time off, she responded with a quizzical, “Plan?”. I shared with her my thoughts and offered her some resources I knew of. Within a day or two, she had entered a program and was very thankful that we had spoken.
I urge anybody who is taking time off from work to somehow create structure in their days. Whether it’s creating your own schedule of some kind or entering a rehabilitation program, I believe that having structured days will prevent the negative ruminations that often go alongside of depression.
As always, I encourage you to comment on this post.
I don’t know if I ever had shared with you that my father had major depression and took his own life as a result of this. It was in the late 70’s, when depression was not discussed and there was little helpful treatment. I admire what you are doing for yourself and for others by getting information and personal experiences out there. You are most likely reaching and helping some that would not have had this information otherwise. Thank you.
This is a very important message. We talk to people in recovery about the simple step of waking up and making the bed. The entire concept is based on structure and personal discipline helping us at our worst. I agree that this is very helpful and needed.
Thanks very much. I really appreciate you taking the time to read my blog and to comment on it, as well!
Not at all. Keep working as you are and spread the message
This is my 5th day away from work. Each day has been progressively worse than the day before. The couch ,the bed, not being able to read a book for long, do my favourite hobby. I can not think from one step to the next. Now that I have read your blog, I will try try establish a routine. This battle has been going on for about 20 years,some better than others,. This will help me a lot. Thank-you so much for taking the time to express your journey through this maze. must go my puppy is chewing in the window sill.
Thanks for sharing. I’m sorry that you’re in such a difficult place. Small steps…baby steps. Hopefully, the routines will help. Another thing that helped me was to journal. At the end of each journal entry, I wrote: “Today, to work towards recovery, I….”. Sometimes it was as small as, “I read a book to my daughter” or “I went to my partial hospitalization program” or “I took out the garbage”…anything to show myself that I WAS working at it. Good luck…know that you WILL get better…and love up that puppy!
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The importance of structure in recovery, by @allevin18
Thanks for reposting! Al
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