This is an extract from my coming book on depression. I am posting it because I need help. Please read it, then leave a comment at the bottom, listing one or more rewards you have noticed (for yourself or others) for acting depressed.
Every problem has some benefits. Depression is no exception. This is not to say a sufferer deliberately pretends, or makes matters worse. All the same, there are payoffs.
This is best illustrated with physical pain.
Fiona was a 43-year-old mother of two. She had suffered migraines for many years. As part of a complex attack on the problem, she analyzed her family’s reaction to her suffering. She found that when she had one of her headaches, the children didn’t squabble. Usually they did. Husband and kids took over almost all the household tasks. At other times, she needed to argue and cajole to get them to do their fair share, even though Fiona had a full-time job.
She didn’t develop a headache in order to gain considerate, caring attention from her family. Nevertheless, it was a fact that this was what she always got when a migraine struck her, and never when she felt well.
Part of her cure was to reengineer family dynamics. All four members of the family signed a contract, involving the fair distribution of household tasks. Husband and kids agreed to “reward mom for NOT having a migraine” instead of rewarding her for having one.
Fiona also learned how to identify the triggers for her headaches, to spot early warning signs. She then took analgesics before the pain struck, and used relaxation techniques to short-circuit the mechanism of a migraine. But removing the secondary gains was a big part of her success.
OK, can you think of possible payoffs for acting depressed? A payoff is the reward that might come your way, e.g., getting out of something you’d rather not do, receiving sympathy, or being able to withdraw from a situation. Once you have gathered enough information, you can then re-engineer your life to get rewards for defeating the problem rather than rewards for suffering it.
What I wrote in my book, thanks to the several helpful comments:
After I wrote this section, I posted it on my blog, with a request to my friends to suggest rewards for acting depressed from their own lives, or those of others. This was very educational for me. I only received one explicit suggestion. Margaret Goodman wrote, “Some people… can be rude and cruel and then claim that the depression made them do it.”
Instead, there was a collection of strongly felt descriptions of what depression is like from the inside. Jean, a friend and colleague I deeply respect, put the problem with my request the most clearly:
- Problem is, depression constricts your thinking. It is almost impossible to see outside the box of despair. If the depression were mild, or intermittent, it would be possible. But a full-fledged clinical depression, no. It would take a compassionate, tactful, and patient outsider to point out the benefits. Hopefully you, in your book, will be that person to many others. The only benefit I experienced from years of unremitting depression was validation that there was truly something wrong with me.
I have got rid of my depression decades ago. Now that I look back, I can see the secondary gains it used to get for me. But I have to agree with Jean. If someone had asked me to spot them back then, I probably would have been unable to do so. All the same, getting out of that box, and seeing my behavior from the outside, would have been a great tool for liberating me.
So… Do you know anyone else who is struggling with depression? Suppose that person came to you, asking for advice on spotting secondary gains.
Here is a small selection of the kinds of things you would look for in helping your friend:
- “Oh, I can’t do it” means I can get out of trying.
- Self-harming and suicide attempts have people notice me, for once.
- I’ve slept in again. Oh well, no point going to school this late.
- I just couldn’t get to sleep last night, then I kept waking up. Sorry, I can’t concentrate.
- Wearing my sad, hopeless face usually induces Mary to do kind things for me.
- Acting grumpy gets others to tiptoe around me, which gives me a sense of power.
- When I lock myself in my room, I usually get out of my household tasks.
- Saying “Oh, I am so tired!” often results in Jim doing most of my share.
- Those wretched girls don’t bully me when I spend lunchtime sitting in a quiet corner somewhere, doing nothing.
- People leave me alone when I stride up and down just to get rid of energy. (This is “psychomotor agitation” in the list on page 15.)
- A sure way to get reassurance is to cry and say it’s all my fault.
- When I fail at something, I get confirmation that I was right: I truly am hopeless and useless.
- I don’t have to put up with all that empty chatter and socializing when I choose to isolate myself.
If you can spot patterns like this in someone else’s life, I reckon you can spot some in your own.
This then you gives enormous power: the ability to see yourself from the outside at least to some extent, and for a time. Each occasion you manage it, you grow.
The next step is, there are probably people in your life who know you well: those you live with, or used to live with, those you spend many hours with at work, and so on. Some of them are people you can trust to be kind. Ask such people to help in the way I’ve described for your analysis of someone else’s patterns.
Your helper might spot that she has a pattern of being kind to you when you are unable to eat much dinner. Be thankful for that, but also, the two of you can use this new insight to ensure the kindness will not be tied to lack of appetite in the future.
And the next step is, “What else may I be doing to fish for kindness?”
You have climbed out of being a helpless prisoner in the box, and are now an active agent in reengineering your life.