It's different for everyone. Probably if said person had any idea how much better they'd feel if they were on an SSRI, they'd be breaking the speed limit to get to the nearest chemist's.

Create a purely intellectual recognition that that there's no other decent solution to depression aside from taking action to combat it. All other solutions inflict undeserved harm on self and others.

Also, become willing to believe that the recommended treatments will work, or at least stop telling yourself they won't work or can't possibly work and acknowledge that they may work, if attempte with as much good faith effort as possible.

In my case, it wasn't an SSRI that got me off my bum, it was my reluctance to take one when a doctor was telling it me it was my only solution. I did much better on my alternative therapy, exercise.

And I agree with chuckdarwin that if you could a glimpse of how you'd feel without depression, you'd be astounded at how much it's weighing on you when you've got it. The sneakiest part of depression is how it tells you that all attempts to throw it off are futile. It helped me to recognize that that was not my 'real brain' talking - it was a symptom of the disease.

When I was depressed, I wanted my life to be less painful. And I became willing to try things others recommended, because I was out of ideas.

"Probably if said person had any idea how much better they'd feel if they were on an SSRI, they'd be breaking the speed limit to get to the nearest chemist's."

Don't bet on it, especially if said person already went through one SSRI that didn't work. Those puppies can have some wicked side effects, not to mention SSRI Discontinuation Syndrome.

"How does a person who's potentially depressed find motivation/desire to feel better?"

Some days are better than others. Frustration and/or boredom reach a breaking point. The fear of suicide is greater than a particularly strong urge.

Also, some depression is truly emotional, other depression is purely a chemical imbalance, while yet more are a combination. I can't speak for the emotionally depressed but my epiphany came when I started the slide into the combination. For me, I can feel a huge difference between an artificial emotion and when a real one develops. I didn't take SSRIs long, I couldn't handle the side effects.

I don't think depression is a lack of desire to feel better. Rather it's a lack of understanding that it's possible for that particular person to feel better. He or she may see others having fun, but won't recognize that the same happiness is available to him or her. There's a negative thought loop that says "no matter what I do, I'm never going to feel better, so why bother getting out of bed?" [maybe that's just my own experience]

The way to challenge this is to get out of bed anyway and do something, anything, even if you don't think you will enjoy it. The way to get to that point is to realize that if it doesn't matter either way (staying in bed vs. living life) you might as well get out of bed to stop loved ones from pestering you about it.

So, if you're asking on behalf of a friend, and they're genuinely depressed vs. something situational like a recent death, pester them. Make it uncomfortable for them to stay in bed. Drag them to social functions, to a movie, to the grocery store. They may initially hate you, and they will certainly resist, but without the external motivation they may have no reason to try such things, and thus have no way to get that glimpse of hope. Also, it's easier for me to do something for others when I'm depressed, because the worthless feeling makes it impossible to do anything for myself.

If you're asking on behalf of yourself, enroll a friend in pestering you. Have said friend make sure you do something every day. Being accountable to someone else will force you out of the mental muck.

Yeah, yeah, it's no one else's JOB to help someone out of their mental state, but if this isn't what friends are for, I don't know what is.

Probably if said person had any idea how much better they'd feel if they were on an SSRI, they'd be breaking the speed limit to get to the nearest chemist's.

When you're depressed the hoops you have to jump through to get SSRIs make getting them too hard to even contemplate.

Plus what mischief said.

Plus, in the states anyway, it'll be on your record the rest of your life. God help you if you want reasonable insurance or to work in certain positions, especially in the military or criminal justice systems.

/rant

To answer the question, the only thing that has worked for me is just knowing it's not permanent, or at least that I can make it less severe.

And the only way I got to this knowledge was by living long enough. When I was a teenager my depression was incredibly severe because I didn't know it would end- I thought that's just the way the world was. (And so I might as well sit under the stage at school, eat Frusen Glädje, and stay up all night reading.)

Now that I'm older I think: "Fuck, here's that god damned depression again. I had better get my diet in order, ride my bike to work, not read/watch depressing things, and sleep as normally as I can manage." And eventually it lifts enough that I can enjoy things again.

Part of it is being hard enough on myself to get myself out of the apartment, and the other part is being easy enough on myself to let things go if I'm not up for them.

Logistically this means I stop going way out of my way for the people around me. I do the minimum and that's it. Sucks, but - if I don't get myself healthy I'm REALLY not going to be any use to the people who need me.

Wow. That's really really long. Sorry.

Thanks for the responses so far. There's a lot to think about here. It's such a complicated issue isn't it? It seems so much easier to stay in the "negative" instead of trying to imagine a reason to want to feel better...

The tedious staying in the negative gets. For me that's become a good motivation to get rid of it.

I didn't grow up with any romance about melancholy, thank god. If I were an artist I might have a harder time.

oops. That should have been "The older I get the more tedious staying in the negative gets."

I heard someone say something one time about the stuff that "binds one to one's predicament."

I thought that was a useful term.

In my dealings with people, I find, a lot, that some people are more comfortable feeling miserable than working to get out of whatever misery they are in. They will fight against possible solutions, at times.

I wrote a blog post about why it's easier to be self-destructive (not why it's GOOD, just why it's easier). Sorry for the selflink, but it's less cluttery than c & p'ing the whole thing here.

Wow, lot of clear thinking above... I understand how once you get "down" it's easier to remain miserable, self-destructive. The jump towards doing something positive seems to be based on a choice to see a reason for a positive outcome, and believe that you should live a life not mired in negative. (if I have that right)
Now, there's the challenge.

But s_r, and perhaps myself, have found a good way to cope:


Fuck it, man, let's go surfing.

mightshould, if you're asking this question for yourself, support and well wishes to you. I've never been at a point where I felt life wasn't worth it. I'm an optimistic person that believes better days lie ahead. I generally have a cheerful, positive personality. I have that Pollyanna attitude that life is beautiful, life is great, let's all be glad, etc. But, I'm depressed too. I wouldn't consider myself terribly unhappy, I've just been functioning at a lower level than I'm used to. A year or so ago I noticed I was becoming apathetic. My interest in hobbies and friends were declining. I didn't like myself. I didn't want to go anywhere.

My needs were met. My children's needs were met. I maintained decent hygiene. I would show up at work and perform well while there. I would drag my kids and myself to activities outside the home. I enjoy people and surprisingly, people enjoy me. I was still depressed. Not a suicidal depressed, but a blah-I-don't-want-to-be-bothered depressed.

I've never been formally diagnosed, but it's not rocket science. Intellectually I know that I probably should have tried medication a long time ago. I'm generally against taking medication, which is ridiculous. Drugs save lives. I just don't want to take them. I probably should have a prescription. I'm still reluctant. I don't think I'm depressed enough to take them. More ridiculous thinking. I always blamed my depression on other afflictions -- laziness mainly. I always thought it was my fault that I wasn't feeling better.

A while ago I couldn't take it anymore and decided to see someone. I highly recommend talk therapy. It has made such a difference in my life in a relatively short period of time.

My mental health is affected greatly by physical activity. I've always felt the most "normal" and even-keeled when I'm regularly exercising. Since I know this as fact, you would think I would make exercise a part of my daily routine. It isn't. Sometimes I'd rather sit on the computer and eat cheese and crackers. I suppose this is a self-destructive habit desjardins speaks of.

At this moment I don't want to go out tonight. I have a dinner and movie date with friends. I don't feel like getting in the shower. I don't feel like getting ready and driving there. But, I'll force myself and feel a little bit better for it. I realize that severely depressed people cannot force themselves to do anything. It's extremely difficult.

It's a struggle, but I know that by mental health is something that can be managed. Yours is too.

I not sure this post has a point.

I hope you see someone. Good luck and keep us updated if you feel inclined.

Fuck it, man, let's go surfing.

But first I had 10 humiliating years of wetsuit hunting- I was too big for all of them.

God bless Henderson Hyperstretch!

And how are you supposed to find the energy to interview therapists when you're too depressed to get out of the apartment? It's such a catch-22.

i don't wanna be the one to say this but i'm gonna say this:
Go to a doctor.

Seriously.

Make an appointment with your gp or a gp, if you can afford it, or go where you can, whatever is available.
What you want is to tell someone what is going on and get tested for what ever condition might be causing it. It could be a lot of things that might be easily corrected and you want to have an objective opinion.
Besides all this, it's this first doctor's job to refer you to whatever specialists or organizations might help you in your area, as they should know and have the connections.
Whether you end up at a therapist's or a nutritionist's or the holistic hoohahouse, it's all one big ball o' wax, interconnected and interdependent.

The longer you wait, the worse it can get. The longer it takes, the harder to get out of whatever pathways are being burned.

Just get it out of the way already.

i have known so many people who have lived with low to high levels of depression that this question just pisses me off, because i have known so many people who waited for it to be so intractable and intolerable that even though they might be "better," they still act like they did when they were "depressed." They haven't unlearned the habit of its hallmarks and behaviors.

i'm gonna go scream now.

(ethylene, can I assume you have socialized medical care?)

"The older I get the more tedious staying in the negative gets."

That's what I refer to as: "Finally getting it stuck in a box for awhile."

I'm mired in this myself and have been to varying degrees for many years, so your question is very interesting to me. Let me just ramble off the top of my head for a minute. If anything I say doesn't sound at all helpful to you, then please just ignore me. Obviously, what I'm thinking hasn't helped me a lot, since I have the same problem.

How does a person who's potentially depressed find motivation/desire to feel better?

I imagine you already have a desire to feel better. Everyone wants the best life they can get. The problematic part is the motivation part, and believing that it is possible to feel better about life and doing things. But I'm just probably just parsing your words too closely here.

Where does the desire to change come from?

Again, I don't think it's desire so much as believing in the possibility and gathering the energy/motivation to actually do anything about it. More on that later.

Does it have to get so bad they cannot function?

No. But I think that many people do reach that point. "Hitting bottom" before making the decision to help yourself seems to be a popular image, but I'm not sure how often it really happens that way. I suspect that those who recover from depression do so at a whole variety of stages.

if they don't think life is worth it, how can the person get beyond that point?

This, for me, is the crux of the matter. It seems that the amount of change required to get life back on track is not worth the potential payoff of the improved life. On my worst days, it seems this way to me. (And really, I'm just projecting here. This post is all about me and my way through depression. Again, ignore me if this doesn't apply at all to you.) However, this is the depression talking. It's making you think that the changes required will be harder than they really might be. It's also making you think that the payoffs of an improved life will be less than they really might be.

I'm assuming here that you've read the many metafilter threads about depression and know all about the various forms of medical help and self help you can do. Definitely see your doctor and be honest with him/her. Fix your exercise/diet/sleep routines. Read and follow Feeling Good. Etc., etc. I'm assuming you already know all this.

Finally, here's a few ideas about gaining some motivation.

Look at your thoughts when you have an idea to do something that at least some part of you wants to do. It could be a spur of the moment thing or a long term desire. What thoughts do you have that convince you not to do it? Perhaps some fear, or a prediction of failure, or a feeling of wasting time, or a sense that you might not enjoy it even if you did it [fill in the blank]. This is where you can either dispute the thought (people do this everyday, or I used to enjoy this, so I probably would again, etc., fill in the blank), or you can tough it out and do it anyway even if it doesn't seem worth doing or likely to succeed. A person can't always "tough it out", but sometimes they can. A person can't always dispute the thought, but sometimes they can. In terms of making the first few steps, it may have to be one of these. The common remedies for depression, antidepressants and various forms of self-help, can make these steps easier.

Another thing to do is to look for inspiration. I found this post about Randy Pausch's last lecture in the blue very motivational. I loved his energy and enthusiasm. The book Exuberance tells lots of stories of people who were highly motivated. Other motivating books and movies might be useful. They often help me get going on something.

Finally, think about childhood dreams or interests you always wanted to take up. Begin with some easy and specific related to one of these. Any little success with these might help you become motivated to go farther.

(Note: if anything here seems inappropriate, I'd ask the admins to just delete this. Thanks.)

Goodness, lots of good info here. And unconditional sharing. Now, that's inspirational. There's hope for us all.
Thanks.
Thanks much.

For me, yes, it definitely had to get worse before it started getting better. I lived with a state of clinical depression for a period of ten years, before I finally said to myself—enough is enough—I don’t want to be this person anymore. Of course, the change wasn’t easy, or quick, since I’d gotten used to my depressed self so much, that I didn’t know how to enjoy life anymore. So it was kind of like a relearning for me. And failure was a big part of that, because I would get easily agitated if I didn’t get the results I was hoping for. The key is to not do too much too soon. Baby steps, and remember that you won’t succeed at first, but you’ve got to keep trying. Don’t give up, because every time you do, it’ll be that much harder to regain your balance. It’s okay if you don’t feel “happy” all the time, but just make sure that you don’t wallow in self pity and loathing too much. Go out, go for a walk, talk to a friend. I know how irritating this advice might sound (it did to me when I’d get it; I had this huge cloud over my head and all people could tell me was go out, as if that would help!), but it does. It takes your mind off of yourself. You see the beauty in the things around you. And soon, you’re not feeling so shitty anymore. At least that’s what I hope. And, if you still feel like you’re not able to snap out of it, a good doctor would be the appropriate solution. I see a psychiatrist once a month, and am on medication right now for Cyclothymia. (Hope you feel better soon!)

You've got to have something to live for. While my life was/is depressing, my potential future life is so amazing I can't help but go on. There are just so many things I haven't done. If I hit rock bottom, I could always just start walking the earth. Haven't been there yet, but I have that option. So unless it comes down to that (which is not a bad ending in my mind at all), I know I've still got room to fall. Consequently, life's not so bad*.

*When you establish a baseline, or zero, it makes things easier. Everything's infinitely bigger/better than zero.

The jump towards doing something positive seems to be based on a choice

I think this is the single thing you need to know.

Don't wait to want to feel better. Depression will not take its foot off your neck long enough for you to want to - just assume it's going to cling onto you until the mo,ent you realize you aren't actually immobile, and then each thing you do to combat it peels one of its fingers from your skin. Just make the choice to take an action or two (doctor, exercise, get involved in a charity, etc) - regardless of how you feel.