Hello, my dear friends.
I wanted to make an emergency plan for those who are struggling with anxiety and depression that becomes so heavy, you can't even get out of bed or stop crying.
I want to preface this with: I have been there, I get it. Yes, therapists struggle too. Just because we are therapists, doesn't mean we get a "pass" on heavy emotions. And because I have been there enough times in my life (and because of my education), I know exactly what to do... even if I don't want to.
So, enjoy this post and use it as your emergency plan for when you struggle so hard you can't get out of bed or become tearful.
Make an appointment with your doctor and therapist -
Get a therapist if you don't have one. Now there are tons of platforms you can join where you don't have to wait. I am a therapist on Betterhelp, so obviously, I'm going to recommend that platform. You get paired with a therapist quickly and can often begin talking to someone the day you sign up. You need a treatment team. If you can't get out of bed and are tearful the majority of the day and struggle to even do simple tasks - you. need. help. And reaching out for help isn't a sign of weakness, it's a sign of strength. You do not have to do this alone, you are not required to do it alone, and doing it alone does not make you stronger than anyone else. It isolates you, which is a symptoms of anxiety and depression.
Second step: know that sometimes medication is the best route.
I know, there is such a stigma out there against medication. But if your quality of life is affected so greatly you can't stop crying or get out of bed, this is a sign your body's physiology is out of whack and needs some help. It is not a sign that you are weak. I repeat: you are not weak for experiencing anxiety and depression. Your brain is an organ, just like your heart and liver. It is responsible for a great many things in your body and some of that is producing hormones. Sometimes, it produces too much or not enough of some hormones. And medication can help balance your system so you can find relief and then develop tools that you know will help. This is what I call lifting the veil. Sometimes depression and anxiety is too heavy to lift on your own. Once the veil is lifted, finding coping skills that are helpful is much easier and will help you generate the strength to do the rest of the heavy lifting.
Nervous about taking meds? Many people are - I recommend coming in with a list of questions, side effects you want to avoid, and also your hesitations so your doctor or therapist can help explain things and put your mind at ease regarding these things.
Give yourself enough time to allow for the medication to kick in and avoid alcohol, marijuana, and other substances that may interfere with the effectiveness. Continue to talk to your doctor about what you're experiencing, if the medication is helping, if you're noticing any side effects and know - sometimes it can take a while to find the perfect one. Be able to count on yourself and rely on yourself enough to accept that it will take time and that you won't give up on yourself. I know the process can be frustrating. But relief does exist and there are medications that can offer you this.
Next step: behavioral activation.
If you're a client of mine struggling with depression or anxiety, you are familiar with this term because I speak on it often. The CBT (Cognitive Behavioral Therapy) model states: Thoughts ---> feelings ----> behaviors. But think of it more like a triangle, like the picture below shows. Where they can all generate each other.
Thoughts and feelings and behaviors can all cause one another. For example: Let's say Susie is deeply depressed. She wakes up and immediately feels hopeless and sad. She thinks "I'm so sad, I'm so weak. What's wrong with me? I can't even get out of bed to shower! I don't want to even go to work." Then the behavior is: Susie calls into work, and stays in bed all day. Which then further cements her feeling depressed, hopeless, and thinking thoughts of low self-worth. So, what behavioral activation says is this: Despite how Susie is feeling, she is going to get out of bed, shower, and go to work (behavior). In doing this, she then thinks, "Wow, I actually got out of bed. Good for me. And, hey, I'm having a good hair day too. Maybe work won't be so bad after all. It'll be good to distract me." The resulting feeling? Accomplishment, pride, motivation, and energy. So, when addressing behavioral activation start with the basics, and keep them simple: get 8 hours of sleep, exercise 2-3x a week, keep up with the house chores. Click here for my blog on happiness hacks and ideas of things you can do. And here for my blog on generating energy.
Lean in for support
Listen, I know depression and anxiety is isolating. You may not want to be a "downer" or a "burden." But trust me - your friends and family want to support you. You don't have to use them as your therapist and you shouldn't create codependency on your friends in making it their responsibility to make you feel better. But a burden shared is a burden halved. You can let your supports know you're having a hard time. They may offer you an ear, a hug, or you can even say, "Hey, I need to get out of the house - can we make plans for lunch?" Then... don't cancel and keep your plans. Trust me on this - getting outside of your own energy and being around others can be helpful.
Know your tools and use them
In the process of healing, you'll develop coping skills and tools. You'll begin to discover what you need and what helps. Test out different tools - meditation, journaling, exercise, reading, time away from your phone (read more social media and the impacts on mental health here), self-care nights, creative work... Develop these tools, use them often enough to create a habit out of them and when you find yourself slipping, identify what tools you need to use. You can fine tune these with your therapist. If you have some time to scroll around my website, you might find a lot of tools that may be helpful.
Finally...
If what you are feeling is generating dark thoughts and you are experiencing suicidal ideation, know the crisis number in your location (google it and save it! many countries even have a line you can text). Tell your therapist, develop a safety plan (if they don't mention one - you mention it!), and if you find these thoughts are uncontrollable and you have a plan, go to the hospital. I know, it's not ideal but neither is feeling the way you are feeling and if you are a danger to yourself, this warrants emergency action. You can work with the doctors to develop a treatment team where you together can work on improving your mental health and finding you relief. It does exists, even when it feels like it doesn't. I promise.
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