What to Do if You Are Depressed: Values Clarification

Welcome to Part VIII in our "What to Do If You Are Depressed” blog series. With this installment, we shift more from the “Awareness” and “Acceptance” phase of our journey into a more "Active Change" phase, although we will be holding Awareness and Acceptance in our minds as well. (For the previous entry see here, and to start at the beginning of this series see here).

By Active Change, I mean that we are ready to cultivate the part of you that is looking to do something different. Perhaps you might be able to say something like:

“What I have been doing has not been working great for me. For the benefit of my future self, I am willing to try some new things. It will take time and effort, and the effects will not necessarily be immediate. But if I effectively orient myself toward learning and growing and seeking and approaching 'the good' rather than avoiding, defending and withdrawing from 'the bad,' then I will significantly increase the likelihood I will find a path out of the darkness.”

To begin this part of the series, we start with a well-known concept in psychotherapy called the stages of change perspective. This refers to the idea that, when it comes to making active changes in their lives, people operate in very different spaces. Specifically, five different stages of change have been identified. They are:

1. Precontemplative, which means the person is not even conscious of there being a problem and thus is in no place to take steps to change anything;
2. Contemplative, which means that the person is aware that there is a problem and is thinking about doing something, but has not committed;
3. Preparation, which means that the person is getting ready to act;
4. Action, which is when the person is actually trying to do things differently;
5. Maintenance, which is when the person is working to maintain goals at the new, more adaptive level of functioning. When and if someone relapses, they might then return to an earlier phase in the cycle.

By clicking on these blogs, you have demonstrated that you are (at least) in the contemplative stage. And if you have followed along and were waiting for us to get to the Active change stage, then you are in the “preparation” phase. Maybe you have even engaged in some additional reflections from the blogs. For example, if you have tried to internalize things like curiosity and acceptance after reading the blogs, then you already have engaged in some action.

And that is where we are now in the series. We are getting ready to explicitly make the jump into action. The frame that we will be using to guide our general approach is what I call the “adaptive living equation.” As this blog notes, the adaptive living equation means that you realistically try to maximize valued states of being, given who you are and the situation you find yourself in.

What do I mean by "valued states of being"? Valued states of being refer to your desired outcomes in the short and long term, based on what you value and your overall situation. Put in the form of a question: Given your values, how would you want to handle the current situation and what are your desired outcomes in the short term and over the long term?

Here we can build off of our idea of depressive disorders as often stemming from maladaptive patterns of shutdown. In contrast to adaptive living, maladaptive living refers to ways of being that result in distress and dysfunction and move us away from valued states of being. As we know from our blog series, because of its paradox of shutdown and paradox of effort, depression often gets folks trapped into maladaptive cycles.

As has been discussed, this cycle often involves: (a) an individual who feels highly stressed and vulnerable who (b) hates feeling that way, and (c) is in a stressful situation that elicits negative feelings which (d) causes them to avoid and withdraw which results in them (e) doing less and less (i.e., shutting down) and (f) feeling worse and worse, completing the cycle. Given this, the key is to break the cycle of avoidance, withdrawal, and shutdown, and to find the path to a freer, more fulfilling adaptive lifestyle.

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Principle 1 of Active Change: Values Clarification

Today's blog is about actively engaging in values clarification. Values clarification involves reflecting on questions such as: What is truly important to you? What moral/ethical/religious system guides your life? How do you make meaning out of the world? What do you really enjoy? What truly nourishes your soul? How do you do what you can to live more in accordance with your values?

Let's acknowledge that these questions are hard to think about when you are depressed. They take mental energy, which is in short supply. In addition, they might make you start to feel negative feelings, because such questions might start to remind you that your life is not where you hoped it would be. Thus, let's acknowledge that maybe a part of you wants to turn away from this.

However, we should then pause and see that as part of the pattern of shutdown. You get triggered, you get a jolt of negative pain, and then you move to avoid and escape. This "Trigger Response to pain Avoidance Pattern" is called a "TRAP", and it is part of what drives folks to shutdown. In the next blog, we will get into TRAPs and understand more directly how to avoid them and stay actively engaged.

Today, though, we are interested in values. So, let's give you a chance to lean in. Here is a 6 minute video on Values Clarification by Dr. Richard Harvey that has some good information. At the very least, take the time to watch that and reflect on it. Ideally, that will lead to you taking the time and doing something more active.

For example, here is an exercise on values clarification from Smart Recovery that might be useful. If you are interested in a longer, workbook format, here is a link to worksheets from Acceptance and Commitment Therapy, which is a therapy program and philosophy I find to be quite effective and that overlaps greatly with the view that guides this blog series. Another option is to Google "values clarification" for yourself and see what pops up.

Today or in the next couple of days, please engage in some form of values clarification and start to think about how you might move yourself toward more adaptive living.

What follows over the next seven entries are seven more key principles for living with depression and for moving toward more adaptive living. They will center on the following domains:

1. Fostering activation and engagement instead of avoidance and shutdown
2. Developing “anti-depressant” habits and lifestyles
3. Fostering a healthy biology
4. Understanding how to engage in the adaptive processing of emotions
5. Developing positive ways of relating to others (and the model of others in your mind)
6. Engaging in more effective ways of thinking adaptively
7. Developing a mindful way of living that fosters growth and adaptive responses to stress

Notice that they are “principles” as opposed to "steps," which was the language of the first half of the series. The reason is that each principle represents an area of adaptive focus. The blog series is designed to first help you with awareness and acceptance through a series of steps, and then give you tools to foster adaptive living in key areas via key principles. The principles are described and then resources in the form of books, links, and blogs are offered to guide you in furthering the principle in your life in a healthy way.

The word “healthy” here refers to engaging in processes that foster more adaptive living and valued states of being. It is attempting to be in a way that fills one’s souls and the souls of the people around them.

Be aware that each of the principles described below is relatively easy to state, but they are not easy to accomplish, for anyone. They are especially difficult when one is depressed. Consider that a number of them recommend books. Of course, reading books takes effort and time. That is the nature of the game we are playing.

If you are skeptical of books, be aware that systematic research has found that when folks are in the right stage of change, good books can be very effective in helping guide people out of depressive caves (see here and here for literature reviews demonstrating positive effects that are as strong or almost as strong as psychotherapy or other treatments considered effective).

As has been noted several times in this series, the journey outside the cave of depression can be a long one, and it takes effort and practice. That is true of each of these principles. They are offered for you to consider and they represent some of the ideas that professionals have developed that have good logic and have been shown to work.

However, they only “work” when the individual approaches them with a mindset that is open and oriented toward investing and learning more. Each “principle” can be adopted as the primary focus for one’s attitude and emphasis for change, or you can try to engage in several.

In getting prepared to take more action, I would also like you to remember the “beast” metaphor from the first blog. These principles are not about “forcing” depression out of you (i.e., winning a tug of war and dragging it into the pit).

Rather, each principle involves “seeing” that the beast of depression is there and working to move toward adaptive ways of being even as one experiences its burden. As noted by Acceptance and Commitment therapists, it is possible to both accept the pain one is in and commit to work toward valued goal states.

In the next post in this series, (found here) we will explore the core principle of activation and recommend principles for fostering adaptive engagement.