Where the f**k do I start?

As a psychologist I want to help you feel better – less anxious, less depressed, less stressed, less ashamed. But emotions are quite tricky to target on their own. For example, has anyone ever said to you “just don’t be anxious” or “don’t be depressed”. Does it work? Do you feel better? Probably not. That’s because we are in less control of our emotions than we think and it takes time and effort to really regulate our emotional state, and often when someone comes to therapy, they’re pretty distressed. They want help NOW. 

Emotions also don’t exist in isolation. There is something that is driving that emotional state – an interpretation of a situation (i.e., a thought) or a behaviour. 

Let’s start with thoughts. These are the things that are brains create, the stories we tell ourselves– sometimes helpful, often not. We can work with thoughts, and we can develop strategies to address our unhelpful cognitions, but again, this takes time – you’ve likely been thinking a certain way for most of your life – we have to be patient. 

That’s where behaviour comes in. When I first start working with someone who is depressed, I always look at addressing their behaviour first. Why? It’s the easiest thing to change and it gives motivation for therapy. Usually, when we are depressed, we struggle to do ‘stuff’ – enjoyable activities (getting a coffee with a friend) but also important tasks (showering or brushing our teeth). A core symptom of depression is a lack of pleasure or interest in previously enjoyed activities, not to mention fatigue. So, it makes sense why we find it so damn hard to do anything when we are depressed. I visualise this by a dementor (from Harry Potter) sucking the motivation out of you – leaving you with no want or desire. 

Unfortunately, this doesn’t go away on its own. We need to start doing some behaviour or increasing our behaviour to experience some emotional shift. But we want to start small – maybe that’s brushing your teeth if you haven’t been able to do that, or making your bed, or scheduling a doctor’s appointment. It may also be activities that are more enjoyable (or that you used to enjoy), such as going for a coffee with a friend, or having lunch with coworkers and not alone. 

At the end of the day, we know the result of not changing the behaviour – you stay where you are. By changing a behaviour or by increasing our behaviour, we are giving ourselves the opportunity to feel a different emotion. Worth a try, right? 

Pick one thing. Start small. Do the behaviour. See what happens. 

Nothing changes if nothing changes.