When to Push – Melancholia

Edgar Degas- Melancholy

Effie came to me with many melancholic symptoms.

Melancholia is an interesting word.  It comes from the Greek word for black bile, which is where people used to think sadness came from.  The word melan is familiar to us in words we use today, such as melanin, melanocytes, or melatonin.  All of these having something to do with darkness.

Effie had been feeling dark inside, like a black cloud was hanging over her.  Effie had so many “good” reasons to feel melancholic, as if reasons were needed.  She hurt.  She had other physical problems.  She lost her employment.  She was estranged from her family.  Isolated.

I asked her what she did every day.

Just sit there sometimes.  I just sit there and think about all this stuff.

This wasn’t my first visit with Effie.  We’d worked together for years.  Some of what she was going through, along with the biology, were her psychosocial stressors and learned negative coping skills to stress.  We had been working on these together for a long time but, beyond medications and sleep, Effie had a lot of difficulty working with her directives:

  1. Medication including supplements
  2. Sleep
  3. Connection – groups, church, internet, etc…
  4. Exercise
  5. Lose forty-five pounds to decrease multiple comorbid illnesses she was suffering from.  These comorbid problems secondary to her obesity looped back and worsened her mood.  It was like a brick in her pocket taking her down to the bottom of the sea.

Effie said,

I don’t want to do anything.  I just want to be me.  It doesn’t matter if that is good for me or not.  It just matters that it is who I am now.

Thanks to our work here at FriendtoYourself.com, I felt empowered to pull out the self-care tools and share.

Effie, you need to go to groups.  You need to connect.  If your child told you that she didn’t want to take out the trash because she didn’t feel like it, what would you say?  Maybe, ‘I’m sorry you feel that way.  You still have to do your work!’  Are you going to wait until she wants to?  Do you tell her to just be herself, that it is ok?  Is that nice if you do that?  No.  It is not nice.

Effie explained that she only came to see me because I was the only one who understood her.  She didn’t want to talk to anyone else.  Of course that is flattering but I admit, however reluctantly, that I am not that good.  There are other people out there who know what she’s going through and she’s not meeting them because of her choice to isolate.

Now folks, this is not to say that when someone is depressed, that we should tell them to bucker up and get on with it.  Nor should we say that they are being childish.  We all need to be very very very careful about that.  It’s ignorant and hurtful.  In Effie’s case, however, because I knew her so well, I pushed her a little harder than I had been.  I wasn’t saying she was being childish, so much as I was telling her that she needed to do what was good for her, rather than what she wanted.

Effie wasn’t having fun either way, groups or no groups.  And although medications had helped, they hadn’t helped enough.  As we had seen each other at least once a month, if not more, for about thirty months for this most recent depressive episode, I was as clear as I could be on what had been tried and what hadn’t.  I would not do this in anyone who didn’t have this constellation of factors.  So, I pushed Effie to do something she hadn’t done yet.

Also, we hadn’t spent enough time on the primitive coping skills Effie was using.  What I told her this day was more directed towards getting her away from those.

Being a friend to ourselves isn’t always doing what we want.  It is being better to ourselves at least than our enemies.  I don’t know many people I would allow to speak to me, the way Effie was speaking to herself.  We talked about allying ourselves with the bits inside of us that were going in a direction to benefit, and not hurt.  Not collaborating with the parts of us that would further harm us, no.  This part we would name together out loud and drive forward to it deliberately.  We would see together what happens.

All the while, we are still continuing to work with medications and other therapies directed at Effie’s biology.  However, I believe we need to do more. When to introduce different therapies differs depending on the needs and abilities of the individual.  This is how it went for Effie.

Questions:  When have you done something you specifically didn’t want to do, but knew it was friendly to yourself?  How did it turn out and was it friendly after all?  Please tell us your story.

16 thoughts on “When to Push – Melancholia

  1. It seems that the mental illnesses you have discussed in the last several months have one thing in common. Their dynamics immobilize us. We should now have that insight and knowing our enemy use self care to confront it by forcing ourselves to do the very things we don’t want to do. That is how to combat immobilization. Just little steps at first. Clean up your desk and file all those papers in an orderly fashion. When the task is finished we have empowered ourselves and the validation of accomplishment enables us to complete more tasks. If you have a dozen things to do, finish just a few and perhaps your ability to function will be enhanced. Immobilization is real but allowing it to evolve into laziness is our own fault.

  2. I first heard the word melancholy when I was in elementary school…I fell in love with the way it swept across my tongue and sounded to my ears. I was disappointed when I learned it’s meaning. I still hold the word dear to me though I am not depressed etc…Not sure why. I know this is not the comment you were looking for, sorry.

  3. Some time ago, since last October, I’m pretty sure I answered this question but I can’t find it so I’ll write it again. (Undoubtedly it was another question but I answered it this way.) I was a hermit. I went out only for doctor’s appointments and talk therapy or pastoral counseling sessions (four times a week!). I, like Effie, pretty much sat in the house and thought about how awful life was. My family was frantic…but my daughter is a genius! I’m an artist and had been an art teacher; she teaches at a school for special needs kids; they wanted a storybook mural painted on the cafeteria wall. All the artist needed to do was face the wall and paint. No interaction with anyone. Just paint. Easy. So I drove to the school, sat in my car and cried, and drove back home – innumerable times – and then I got up enough nerve to go in. Two years later the mural was painted. I had gotten kids involved in the process, I was pushing wheel chairs, helping in classrooms, singing in the staff chorus and doing sets for concerts and proms. (All of which my husband I continue to do 13 years later!) I was also going to the grocery store alone, talking with people in church, seeing my therapist only weekly, and actually working on things around my house. Noone said I had to. Noone said they were ashamed of my depression or my fear of going out. Someone just loved me enough to find a way to help me find myself. At the time I didn’t know that it was self care. Now I do!!

  4. you know you have a big point there and i like it Do what is friendly, not necessarily what feels good you know i am doing that on thursday i am going to this interview there are a lot of challanges got my assignment done i have a 3 day brake well i did have im really scared on thursday but i am not staying in my comfort zone i suppose we could all do that but it doens mentaly test us im not going for the job one thing i have learnt in the past is not to get my hope up to high and expect to utch of myself i thought i would bring this as well my firend over there in the states the other night decided to drive into the on coming traffic delibritly and she expected me to be angry i wasnt i was hurt and then it made me realise i must of hurt her so many times and she just got mad at me where talking fine again now she has settled down a bit what pushes that button to send someone over

  5. I knew I was isolating myself and that I needed friends but really had none. I made myself go to a women’s bible study. That was 10 years ago. I have many friends a couple of very close friends, more like family, and am busy and have a life I enjoy. I am happy to get up in the morning. And I still am a memeber of the bible study–but now I am a children’s teacher.

  6. Maybe I’m on the brink of all this. Having suffered from depression since my earliest memories, I was engulfed by a particularly powerful brain and life quake. It swallowed me whole and just spit out a few bones. That quake began in 2006. I lost my job, my house, my pets, my motorcycle, many friends, and entered into a dark world of addiction. I went through multiple treatment centers for months on end, electro convulvise therapy, and many, many meds. I moved in with my parents. I was on disability. Many days I concluded I would never work again. I came out of the worst of it, got another teaching job, and started socializing a little. That’s where I’m at. A recent brek up has left me depressed again. I’m supposed to move out of my parents’ house but I’m scared to death to take care of myself. It’s funny…I was just chatting online with a friend about how self absorbed I am (which he agreed:) But your whole blog is about self care and I don’t do any of it. So am I absorbed with myself or with something darker…and not absorbed with myself at all! My classroom is a mess, I have unpaid parking tickets and other bills, I let checks bounce, my room is a mess, I can’t find my belongings, I don’t exercise, I don’t usually wash my face at night….it’s all so overwhelming I dont know where to begin. or how. Or do I just not want to? Take care of myself? Why bother? She’s garbage. No one else wanted her. Why should I take her in and treat her well? For what? So she can have her affairs in order when she dies alone?

    I keep thinking that I just need to pick one thing…and do that thing. I’m still thinking…

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