People seeking treatment for major depression and bipolar tend to do well if they have two related characteristics. The first is persistence: the ability to keep doing what needs to be done, no matter the mood. The second is willingness to do whatever it takes, even if that means giving up control over which treatments are acceptable and which are not.
“Do whatever it takes” means that you remain focused on the goal: relief from depression. In our practice we have found that people with this approach do better than those who focus on the process and use their own preferences to second guess possible treatments. “I don’t want to take medication” or “therapy doesn’t work for me” are both pre-set notions that limit your ability to reach the end goal, and set up artificial road blocks that distract from the whole purpose of seeking professional help in the first place. Our strong advice is to keep the end goal always in sight and be open to the many different pathways that might get you there.
Persistence may be the most important quality of all. Dealing with depression and bipolar is a marathon, not a sprint. Real results may be slow to appear, and it seems like a long, slow slog to make any progress at all. The people who don’t give up, who stick to it no matter what, are the ones who do, eventually, see results and find themselves building a fulfilling life in which mental illness is not the center of attention all the time.
In our interview a few years back with Dr. Descartes Li at the University of California San Francisco, we were impressed with his emphasis on persistence: “I have been inspired by how people who have ‘hit bottom’ can work their way back up. It can be a multi-year process, it isn’t out of the question for it to take five or even ten years. In the beginning the effort can seem hopeless. But gradually people work their way back. Now I feel much more positive about impossible or hopeless situations. If people keep at it they can find solutions to terrible and overwhelming problems.“
“Gradually people work their way back”. This is the mind set of persistence. The mind set that gets things done, and eventually sees results. The beauty of it is, what you do matters. It’s easy to fall into a pattern of learned helplessness where you can tell yourself “nothing ever works”, but the reality is, helplessness is the illusion. Persistence is what pays dividends over the long haul, and persistence is in your hands every day, just keep on keepin’ on, because that’s what we have seen work in people time and again over the years. The ones who stick with it, because what they do matters are the ones who move forward and live their good lives.