It is such a relief, after worrying about some health problem for a long time, to suddenly realize that that problem no longer needs acute and urgent attention. This is as true for an ankle or knee injury in sports as it is of anxiety or depression, or any other mood state that impairs our ability to function.
There is a natural wish to put the thoughts that have consumed so much time and caused so much worry aside and move on with your life.
That strategy works reasonably well for an acute injury that completely heals. It works less well for something like a recurring injury like an ankle sprain or a chronic knee problem… or a depression that has come and gone before.
The wish to close the book on a problem solved is a tendency shared by much of American medicine. It has been noted elsewhere that the American healthcare system is not very good at helping people deal with chronic health problems. The goal is usually to fix a problem and move on, and many doctors interest in helping is markedly reduced when such a “quick fix” is not possible.
And it is a tendency that crops up often in my practice. Thursday I saw a woman who has been depressed for a couple of years. Our latest treatment plan finally seemed to be working, but rather than encouraging her to continue the effort, she seemed to have decided that it was time to take a break from paying attention to her depression.
With a chronic problem like recurrent depression, turning away from thinking about the problem as soon as the symptoms are better more or less guarantees that the problem will come back sooner.
As a young man I had several sprains to my right ankle. I was a runner at the time, and irritated with having to stop my training. As soon as each sprain was healed I went back to my regular routine… But it gradually became clear that I needed to do something to stop this from happening again and a gain… and I was able to really return to full functioning only when I devoted a small amount of attention to preventing this injury from happening again on an ongoing basis.
The same thing is true of depression.
The challenge is how to find a sustainable level of ongoing attention. You can’t worry about a chronic problem all the time or it begins to dominate your life. The challenge is how to go from anxious thoughts to preventative thinking.
A few months ago, I decided that I was going to start mood charting. I’ve been recommending it to others for so long that it only seemed fair that I do it myself.
What I discovered is that it was important to connect the activity of charting to a sense of reflecting on the day. That way filling out the daily entry was a way of achieving a sense of peace and clarity about how things turned out. Peace and clarity.
In other words, I needed to make mood charting an activity that was an exercise in mindfulness. If I didn’t do that then filling out the chart seemed like a moment to reflect on failures. And when I did that, I found that I enjoyed taking that moment at the end of the day to write a few notes and reflect on my mood and my sleep.