Making decisions when you’re depressed

Many depressed clients express difficulty making decisions. It’s a classic symptom of the illness, and has several causes.  Among them are:

1. Hormonal and chemical imbalances mean that our ‘caution’ and ‘inaction’ chemicals overwhelm our ‘what the hell’ and ‘action’ chemicals.
2. Depression is a ‘defeat’ state, and in defeat state, animals lose their agency, their sense that they can influence events positively.
3. Attentionally, we lack focus when we’re depressed. This means we can’t stay ‘on-topic’ enough to see thoughts through to a resolution.
4. Confidence is at a low, and so even if we make a decision, without reassurance we can end up falling apart.

How can we help ourselves into decisions?

1. Get your ‘action chemicals’ going.  Exercise is great for this (I know it’s often said, but that’s because it’s true). Any activity is better then none, so set the bar low and work upwards.
2. Get yourself out of ‘defeat state’ by repeatedly choosing small, achievable ‘wins’, and completing them. They don’t have to be big; they just have to give you a small sense of something achieved.
3. Use trusted friends to focus the mind on a topic. Be clear to them that you want to think something through, and be prepared to consider alternatives with them, not just dismiss their input.
4. Strangely, self-compassion is a great builder of confidence.  This is because we stop judging ourselves critically and start supporting ourselves.

Consider it a kind of ‘mental conditioning for decision making’.  In summary,

1. Prefer exercise and action
2. Complete some quick wins, however small
3. Use trusted friends to think things through
4. Be self-compassionate

For example, try not to have too many days where you stay in bed, do nothing, see no one, and criticise yourself.  (I know, clinically depressed people, that’s a hard ask!)

In contrast, try to have days where you get moving, get some things done, talk to trusted friends about your important decisions, and be kind to yourself.

Easier said than done, I know, but it has some science behind it if you want to make some good decisions over time. Decision world is active, so to live in decision world, there has to be a sense of action, however small.