Get reengaged with your life
What do you notice about the links between Nathan’s behavior and his mood? We noticed several things. First, Nathan generally woke up depressed and went to bed with paxil. This pattern clearly needed to be changed because mornings and evenings were his only times away from work. Moreover, the pattern probably contributed to Nathan’s sense that he was “always on lexapro.” The second thing we noticed was that there was actually quite a bit of variation in how depressed he felt during the week. For example, on Wednesday, once Nathan started working around nine o’clock, his depression level dropped to a 3 and remained that way or lower throughout the rest of the day, compared to the 5 to 8 levels on other days. This also happened to be the only day he was working outside the office and meeting many different clients on the road.
A small yet important difference occurred on those days that Nathan began his workday with a cup of coffee. When Nathan got coffee, he noticed feeling relaxed or mellow and the depression lifted somewhat, albeit briefly. Nathan became aware that part of what he liked about those few minutes was the opportunity to socialize with his coworkers, something he didn’t have much time to do given the amount of time he spent working on sales by himself. While drinking coffee, Nathan and his coworkers often shared some of the common work stresses they were going through. Nathan experienced these conversations as support and validation.
Finally, how Nathan responded to feeling depressed seemed to have an effect on how he would feel in the near future. For example, on Tuesday, Nathan had a particularly difficult meeting with his boss, during which he was told that he needed to increase his productivity by completing more sales. For the hour directly after the meeting, Nathan sat at his desk doing nothing except reliving the conversation with his boss in his head and worrying about his future. His depression stayed steady at an 8 out of 10. Then Nathan went home sick for the day (depression level 9) and slept the rest of the afternoon. When he woke up, he ate dinner and drank beer (depression level 10).
What would have happened if, rather than sitting at his desk replaying events mentally, worrying, going home, sleeping, and drinking beer, Nathan immediately began to make more calls or invited a friend out to lunch, or did some other activity designed to get him reengaged in his life? Perhaps it wouldn’t have made any difference in his mood. Perhaps it would have helped him feel slightly less depressed, which could have, in turn, helped him have the energy to stay at work and complete some tasks, which would help him feel productive. It was impossible to know without doing some experimenting. But at the time, it was very clear that Nathan had experienced a sort of mini - depression loop. His attempts to cope with depression that day seemed to make him feel worse. In contrast, during dinner on Wednesday evening, Nathan’s depression level was a 3. Rather than watching television (his usual pattern), Nathan decided to call a friend and see a movie. During his time out with his friend, Nathan reported that he felt happy for the first time all week and his depression level dropped to a 1.
