A forlorn-looking Charlie Brown is bewildered as he approaches Lucy’s psychology stand seeking help. He asks, “What can you do when you don’t fit in?” “What can you do when life seems to be passing you by?”
Lucy walks Charlie out to a vast panorama on a hillside. Lucy says, “See how big this world is; see how much room there is for everyone?” Lucy continues, “There are no other worlds for you to live in, right?” Charlie, “No.” Lucy again, “You were born to live in this world, right?” Charlie, “Right.” Lucy, “Well, Live in it then!” “Five cents, please.”
Depression is a thief, robbing affected people of their ability to place their talents and abilities on display. Just as with Charlie Brown, they shrink their world, often by building a protective cocoon – insulating themselves from the threats and fears that the bigger world is known to deliver. And the more intimate the relationship cultivated with the depression and the greater the gains, the harder it is to give up.
There are, of course, innumerable strategies and interventions for treating depression with solid, well-documented evidence supporting them. I happen to be a big fan of getting the depressed client moving, at first. And by moving, I mean actively and purposefully doing things in their best interest. I don’t recommend cognitive exercises such as thought diaries or tracking irrational thought processes at first, primarily because these folks are not yet ready or skilled at the reframing process. Also, keeping diaries and the like is tedious, making it easy to miss daily entries and eventually give up on this exercise. So, with an eye on action-oriented interventions at the outset of treatment, here are several small, uncomplicated things a depressed individual can do to place themselves in a gradually improving position:
- Start the day with a walk around the block. Go out the door and get the paper, if you get it. If you do get it, tuck it under your arm and walk around your block. If you don’t, initiate the walk anyway. Just one block at first. This is a simple way to just get the blood flowing and create energy. Eventually to help keep you accountable, enlist a buddy to walk with you.
- Clean anything. The inside of the car, the kitchen or bathroom sink are good candidates. Make the sinks shine, polish up the car bumpers. Bright, shiny objects stimulate the senses in a positive way.
- Open and categorize the day’s mail. Note the day on which the bills need to be paid on the envelope, then scan the rest of the mail, read what you find interesting and discard the rest – then and there, no carryover to the next day. This is a key organizing step which depressed people let slide because it’s very easy to let mail pile up. Organization = personal control = personal power = success = feeling better.
- Make the bed. Even if the rest of the bedroom is a mess, at least the bed will be a clean space each day. Keep up with the bed making and eventually you’ll find yourself picking up around the room to match it.
- Pack up one small box for donation. You help yourself by helping others right? And you’re decluttering.
As momentum is gained through these small, achievable activities you can do yourself, you can expand your range and reduce social isolation by inviting someone over for coffee or a meal, and joining a group or club.
Just do – at first.
Then can come some cognitive work – one of my favorites is to have the client keep a daily account of “three things that bring me joy each day.” These should be brief and described in no more than one sentence, with the focus staying exclusively on what was pleasant, rewarding and satisfying about the day.
To the best of my knowledge, Lucy van Pelt wasn’t licensed, nor did she author any best-selling books. Nevertheless, she may have been one of the best-known psychiatrists of the 20th century. In her own rudimentary way and blunt style, she’s imploring a depressed Charlie Brown – and others in a similar situation, for that matter – to get busy living in the only world they’ve got and keep expanding their horizons.
Well done Lucy. And for only a nickel!
Attribution Statement:
Joe Wegmann is a licensed pharmacist & clinical social worker has presented psychopharmacology seminars to over 10,000 healthcare professionals in 46 states, and maintains an active psychotherapy practice specializing in the treatment of depression and anxiety. He is the author of Psychopharmacology: Straight Talk on Mental Health Medications, published by PESI, Inc.
To learn more about Joe’s programs, visit the Programs section of this website or contribute a question for Joe to answer in a future article: joe@thepharmatherapist.com.