Making New Year’s Resolutions Work

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With the new year, people vow to implement change—hoping to improve their quality of life, lose weight, get healthy and much more. Gyms get an influx of people suddenly exercising vigorously; time is carved out for, and effort put into, mind-expanding yoga and meditation; and, people embark on all sorts of often faddish diets. Why don’t they succeed? Many of the steps people take on with such gusto fizzle almost as quickly. Yes, change is difficult, but one common and underappreciated reason efforts fail is that the focus of effort is too narrow, setting up even the most committed person for an overwhelming sense of failure.

The most common strategy is to attempt improvement through excessive use of willpower, ignoring other factors such as psychosocial issues, depression, or anxiety. When and how to incorporate different modalities into your strategy varies; there is no set-in-stone way to success, but it is important to be mindful of obstacles. Evaluate your progress as you go. Process what worked, what didn’t work, and why, and adjust your strategy as needed.

Someone I met with for the first time in December of last year came for an evaluation on the suggestion and referral of his therapist. It took him a few months to contact me to schedule an appointment:

“My therapist suggested I see you for an evaluation for medication but I’m not sure I want to go down that road. Every few weeks she would bring it up and by the end of our session I would be motivated to contact you, feeling stuck and hoping medication would help, but then I would forget about it until the next time she brought it up. I feel like I should be able to get myself out of this by taking better care of myself, but I can’t get motivated.”

He was a high school teacher, married and had a child. His initial complaints were feeling dissatisfied with everything in his life. He had difficulty falling asleep and when he did fall asleep, he woke up frequently and had trouble going back to sleep. He was tired and irritable all the time. Unable to experience pleasure in anything, he was anxious and worried. He struggled with headaches and often complained of body aches and pains. He had multiple medical exams and they were inconclusive. Every day, he reported, “I need one-two cocktails before I am able to ‘relax’.”

During our initial evaluation, it seemed medication was indicated, and we discussed the options. He didn’t want to take medication, vowing instead to make good on annual resolutions. He left with the plan to exercise more and continue psychotherapy. A month later he followed up:

“I started out good. I went to the gym three-five days a week. I watched my diet. After two weeks I still felt depressed, so I gave up. I think I need to start medication.”

We started medication and adjusted as needed to arrive at the right dose. Six weeks after starting the medication, he came for a follow-up and told me he stopped his psychotherapy:

“I don’t feel depressed anymore. I don’t feel happy though. I just feel like I’m here, existing. I notice some changes with the medication: I’m sleeping better; my headaches are still there but not as bad. But I am still not exercising enough and still feel like I don’t have the things I want that would make me happy. I can’t see myself being happy until I can go into a store and buy whatever I want without worrying about it.”

It did seem clear that the medication was having a positive effect and it was possible that an increase in medication would help, but he was now lacking the psychotherapy component of his treatment. We left the medication at the same dosage and I suggested he go back into therapy. I also suggested a self-care regimen that included exercise, eating well, and getting enough sleep. Sound like his new year’s resolution, right? It took him about a month before he re-engaged in therapy.

A few months after he was back in therapy, was on the correct medication, and was taking good care of himself, we had a follow-up appointment:

“We went to a concert in the park last weekend, have you ever done that? You should, it was great. We took the dog and had a picnic. It was for free and there was a lot of people, but it wasn’t overwhelming. Everyone was in a good mood.” He was smiling while talking. And, you know, my job is pretty good. The other day a student confessed that something I had told him in class made him feel good about himself. I think I may be making a difference in people’s lives."

“Sounds like you are actually feeling happy, possibly even content."

Re-evaluating how you are feeling and making new year’s resolutions is often thought of as a quick fix to put you on the path to a better life but the truth is that the resolutions are targeting symptoms of an underlying process that needs to be addressed.

Some ways to increase your chance of being successful with your new year’s resolutions:

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• However, you start, start! If will power is what you choose, then go with it. If it doesn’t work, don’t consider it a failure; it is a signal that something else needs to be addressed.
• Engage in self-exploration of why you chose these goals.
• Be honest with yourself about your needs, desires, and your abilities.
• Get psychotherapy to explore what may be too difficult to admit or too hidden from you.
• Explore treatment with medication for underlying depression and anxiety that may be interfering with the process.
• Remember to go step by step and try to avoid dramatic shifts that are difficult to uphold.

Make resolutions but don’t be fooled into thinking, presto-change-o, your life will be different. There’s no such thing as a quick fix. Change is complicated but if you go slowly, get help and, most importantly, pay attention to the reasons you are failing, you might just succeed. The secret to making new year’s resolutions work is. . .work.