How Acceptance Can Help Depression

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Imagine you've been driving for hours and you’re losing focus. You might angrily berate yourself, “I’m always late. Everything always takes me too long” and push the pedal to 90 mph—so you’ll get there faster. A minute later your head is nodding, your eyes glazing over, and you're still behind the wheel.

Or you could pull into a rest stop. Then you could decide to let someone else drive, take a nap, or check into a motel, and accept you’ll be behind schedule.

The difference between those two reactions could be life or death. Before you can make a good choice, you need to accept that you’re too tired to keep driving.

Fighting weariness puts you on the most dangerous path.

The same logic applies to depression. When you’re depressed, everything feels exhausting. It’s hard to get out of bed or sleep, hard to eat (or hard to eat well), hard to talk and hard to listen, hard to work and hard to relax. You’re always fighting your emotional weariness. And you’re at risk of running your car into the road divider just so you can rest.

To make a better choice, you may need to first stop fighting. Acceptance of depression doesn’t mean you decide you love being depressed. It means you interrupt the cycle of pushing back. You listen to your body and accept you're tired. It’s like deciding to listen to your sister or child instead of stone-walling or punishing them.

There are skills to learn here that apply to all of us, even if we don't have depressive spells. One set of practices—acceptance and commitment therapy, or ACT—has scientific backing for depression as well as anxiety, pain, and addiction. In an early book on ACT, Get Out of Your Mind and Into Your Life, author Steven Hayes invites readers to first stop fighting their thoughts and next, reshape their lives to match their values. As a weary driver, you can adopt one of many techniques to defuse the thoughts “I’m always late. Everything always takes me too long,” so they're less powerful. And then you can remember that you value being a safe driver and don’t want to kill yourself or anyone else.

In classic cognitive behavioral therapy, you learn how to catch punishing thoughts like “I’m always late” and replace them with a more useful response. You might think, "Time to figure out how long it will take to arrive and if I can last that long."

With ACT, you might sing “I’m always late,” as if you were Frank Sinatra, or shout “late, late, late, late,” or, like a graduate of a meditation class, say out loud “I’m noticing that I’m late and I’m tired.” In a 2015 review of 39 randomized controlled trials of ACT, the authors concluded that various ACT approaches did as well as classic CBT with depression.

In this video of a 2014 TedX talk, you can see the ACT concept applied to cravings for junk food and cigarettes.

Whether you seek out ACT training or more standard CBT, you can take several in-person sessions, work with a therapist online, or use workbooks. The trick will be practicing and remembering to apply the techniques even after you begin to feel better.

Biologist Chris Hart writes beautifully about how acceptance has helped him cope with his own periodic depressions. When you accept depression, he says, “You’re no longer worried about being happy, and stopping depression, and getting through your day, and pretending to be something you’re not. You’re instead only focused on getting through the next minute, or the next hour.” He can talk to himself more kindly. Instead of thinking “Gee Chris, just be f….king happy already, it’s not that f…king hard,” he thinks, “Chris, you’re going to be sad today, and be irritable, and that’s perfectly okay.” He remembers how his depression tends to progress from irritability, to sadness, emptiness, isolation, and paranoia. When he sees that big picture, he can interrupt the sequence earlier by taking action. Acceptance banishes shame and allows you to get help and help yourself.

A version of this story appears on Your Care Everywhere.