A woman on ProjectBeyondBlue.com, my depression community, recently asked me this: “You exercise daily and eat the right things. You research and write this stuff for a living. But what about those of us who can’t get out of bed in the morning? What about when you are too depressed to exercise, eat right, or work. How do you simply get out of bed?”
The honest answer is that I don’t know.
My bed has never been a sanctuary not because I’m disciplined but because I have very painful memories of my mother’s severe depression–her living in her bed—that I experienced as a grade-schooler. When I was much younger than my kids, I woke myself up for school, made my breakfast and lunch, and walked to school. When I returned to the house, around 3 pm or so, sometimes she was still in bed, often times crying. I don’t fault her for her depression—I have cried hours and hours in front of the kids and wish I could take back those memories. However, I promised myself somewhere in that pain that I would never use my bed as an escape, especially when I had young children. The thought of a pajama day even today makes me ill.
Therefore, I posed the question to my community and to an expert. Here’s what they had to say.
1. Be depressed upright (or prepare for the voices).
Robert Wicks, psychologist and author of the bestselling book, Riding the Dragon, has debriefed professionals in Cambodia following years of torture and was responsible for the psychological debriefing of relief workers evacuated from Rwanda during the country’s bloody civil war. I figured he would be a good one to ask about the bed debacle.
“A depressed person did say to me, ‘I couldn’t do anything you asked in our last session. I was too depressed to get out of bed,’” Wicks told me. “I said, ‘Ah, that is my fault. I should have cautioned you that those voices would be there and to respond by saying: Yes, I am depressed but I am going to be depressed outside. Activity and depression don’t like to live together.”
When I really don’t want to do something, I try my best to stop the cerebral activity known as thinking, put myself in automatic mode, and “just show up,” as a running coach once told me. Preparing in advance for these thoughts is also helpful, like Wicks said, so you won’t be taken off guard when they try to manipulate you to stay under the covers. And once your body is in motion, it is much easier to keep it in motion.
2. Just make it to the shower (or break things down into tiny steps).
My standard words of advice to anyone who is heading into the Great Hole of Depression is this: “Take it 15 minutes at a time. No more than that.” Because every time I do just that—think about only those things that need to be handled in the next 900 seconds—I breathe a sigh of relief and can sometimes even touch an edge of hope.
Michelle, from Project Beyond Blue, uses the same system to get her out of bed. I thought her self-talk was worth passing on to others:
What works for me on bad days is to break things down into tiny, tiny steps. So I started saying to myself “I don’t have to go to work, I just need to get into the shower.” Then, “I don’t have to go to work, I just need to eat some breakfast.” Then “I don’t have to go to work, I just have to brush my teeth.” Then “I don’t have to go to work, I just need to get on the train.” It made me feel like I could back out as soon as something became too much and I would usually end up at work by taking it slowly like this. It sounds insane and overly simply, but it did make a big difference for me when I struggled to get out of bed.
3. Bribe yourself.
Laurie, from the community, gets herself out of bed by reminding herself how much better she’ll fell after coffee, and by recalling how much she loves to listen to music on her iPod on the ride in. Her wisdom reminded me of the tricks that Ben, my 85-year-old running buddy (I’m a slow runner), used to pull out to get me to jog 18 miles as we trained for a marathon. An hour or so before our run, he would plot out the course and hide bonbons and refreshments behind the trees every two miles. Toward the end, when I didn’t think I could run any further, all I had to do was visualize the watermelon Jolly Ranchers at the next stop. And I wondered why running made me gain weight.
4. Get a reason (or a purpose).
I apologize in advance for the irate comments this point will probably provoke: “You think it’s my choice to be depressed?” “You think I’m in bed because I don’t have a reason to get up?” Well, no. I know of people with psychomotor impairment that literally cannot get out of bed without the help of someone present. However, I also know that most of the people who responded to this question—how to get out of bed—told me that they needed something to do to get them vertical in the morning. Even though they hate having to get up at some ungodly hour five times a week for a job they don’t love, they are glad they have it. Because their work gives them the structure that is critical to their recovery.
When my mom was trying to climb out of her darkness, a therapist recommended she get a job—any kind of job—to get her mind off of her sadness. So she became a hostess at nice restaurant, and worked the late breakfast and lunch shift. I believe that was the beginning of her healing process. I know it made for much happier kids. It doesn’t have to be a 9 to 5 stressful job, of course. Agreeing to look after an elderly neighbor, or take care of a friend’s pet, or volunteering your time at the Boys & Girls Club can give you a sense of purpose that demands rising from your bed.
Join the conversation “Getting Out of Bed in the Morning” on Project Beyond Blue, the new depression community.
Originally published on Sanity Break at Everyday Health.
Thank you. I find the one-step-at-a-time method works best for me…my bed can be a hiding place but I can be brave enough to brush my teeth and take a shower. From there it’s just a morning walk and a drive to work. And I promised myself that if I feel really terrible at any point, I can return to bed. Usually I feel better.
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I too, have distant memories of my depressive mother staying in bed all day, and my own such episodes from long ago of mysterious loss, pain, confusion, isolation, and hopelessness, stretching week after week .
Therese, thank you for these clearly delineated and helpful guideposts I aspire to live by and heal, even though I no longer struggle to get out of bed. My challenge (among many, related to my MI) is to proceed purposefully through each hour of the day, staying focused on the next tiny incremental step without becoming distracted or overthinking, lose momentum, and inevitably get stuck or completely lose track (which happens a lot).
getting the day started, IS THE most challenging thing. I have to set my alarm an extra 30 mins, because its such a chore. After that, structure and work routine set in, and “life” with depression is “Ok”?
I spend 95 per cenyt of mi life in bed and it is the best way to cope with depression.