Psychology and Stress

Another lonely night? Eyes fixed on that glowing screen as you dig into the internet looking for someone to relate with, someone who will help you find meaning in your life? Along the cyber highway you read about highly successful, physically beautiful, and exceptionally bright people. You wonder, “Why can’t I be like that? Why am I such a loser? Why can’t I be more successful?”

You’re falling into a very common coping trap when facing loneliness: Judging yourself against others who are shining examples of success or beauty. This is a flawed strategy because there will always be those better than you, and worse than you; why choose the former for comparison? For example, you might believe you have a less active social life than others, but you don’t realize you’re always comparing yourself only to the most sociable people you know. Your comparison may also be based on a faulty assumption. Consider Caitlyn, a college freshman whose self-esteem and confidence were in the toilet. Seems she was convinced that all the other students in her classes—none of whom she knew—were geniuses and she was the one dummy in the class. Her social-comparison assumption was flawed. Comparing yourself to others in this fashion is not the way to counter loneliness.

Logoff the social media, get a pencil and paper, and write down your answers to the following questions: (1) “Do I have to outperform everyone to be a worthwhile person?”  (2) ”Am I focusing on comparing myself mostly to “stars”? (3) “What are some memories I have of good times with my friends? Can I use those memories to find new things to do, things that will bring me interactions that will be enjoyable and give me a sense of purpose?”

Here’s the bottom line: Get involved in an activity that involves serving other people, and that gives you a sense of purpose, satisfaction, and stability. This sort of activity will help you nurture empathy for others; you can then compare yourself to others while being sensitive to their needs, not just yours. When you are bothered by loneliness, frustration, anger, and self-criticism, there is nothing more uplifting than realizing that others have similar problems and need understanding, too. The development of empathy is essential to healthy coping with stress. Focus on the needs of others and reach out to them. You will find you will not only help them, but also help yourself. Finding empathy will allow you to get off your pity train because you will no longer feel lonely.

I was listening to a couple of guys talking about the movie Elvis, and one of them said, “That Col. Parker [Elvis’ manager] was one smart guy. He got rich off Elvis.” The other guy agreed, adding, “I guess that’s why con men suck in so many victims. Like Barnum said, ‘There’s a sucker born every minute.’ And smart guys like Parker are ready to pounce.”

Are con artists like Parker smart? How about cult leaders—con artists all—like David Koresh, Jim Jones, Sun Myung Moon, Khem Veasna, and others? If by “smart” you mean someone is good at manipulating others and getting their money, then, yes, you can make a case for their “smarts.” By that definition you can also throw in folks like Adolph Hitler, Bernie Madoff, Donald Trump, and Alex Jones.

 Con artists, however, are not “smart” people; they are shrewd, clever, and cunning people who use their skills to enhance themselves while they ruin the lives of others. They are Machiavellian and sociopathic individuals with no sense of ethics or conscience; they harm others with hurtful, negative, and vicious actions; they are narcissists whose goal is praise, admiration, and adoration from others. They destroy what others build, and eventually destroy themselves through self-sabotaging and self-destructive lifestyles—usually taking their believers down with them. Such destructive actions are anything but “smart.”

When it comes to coping with stress, truly “smart” people do not destroy. They do not act to compromise the welfare of self and others, but act instead to enhance, improve, and enrich the lives of self and others. They are efficient at recognizing what is honest and genuine, and what is dishonest and fake; they accept, and are accountable for, their strengths and weaknesses; they are independent, task-oriented, and capable of solving problems without harming the well-being of others. Those who are “smart” in their coping actions are empathetic and socially compassionate, sensitive to the needs of others, and find meaning in their lives through service to others. “Smart” people are guided by core values, principles that exist outside of themselves—such as community, citizenship, sacrifice, justice, respect, and meaningful work.

A “smart” person will watch the changing of the guard at the Tomb of the Unknown Soldier in Arlington National Cemetery and be moved by the expression of sacrifice of life for the democratic principles embodied in the American Constitution; a “smart” con artist will watch and wonder, “Why? What was in it for them?”

Coping with adversity in your life? Choose your “smart” coping strategy carefully.

James and Jennifer Crumbley were recently found guilty of involuntary manslaughter in connection with their son’s crime, and they were sentenced to serve 10-15 years. Their son, Ethan, had previously pleaded guilty to murder and was sentenced to life without parole for the school shooting he carried out when he was 15. The shooting resulted in the death of four students, and injuries to six other students and a teacher. Legal experts say the case could set a precedent for holding parents responsible for serious crimes taken by their children.

Generally, most psychologists feel that teenagers Ethan’s age should be expected to take responsibility for their actions. Imagine a 14-year-old beating a classmate to death, and saying, “But Judge, you need to understand, my mother is a prostitute, dad is an alcoholic, I am physically and emotionally abused at home—I really should not be held responsible for taking my anger out on a classmate.” Psychologists would note that many kids have miserable environments, but they don’t go out and kill. Blaming parents for one’s actions just doesn’t measure up. Even a young kid should face the consequences of making poor choices.

Some say, however, that the Crumbley case may be different. At the parents’ trial, prosecutors argued they ignored signs their son was seriously troubled and bought him a powerful Sig Sauer 9mm handgun as an early Christmas present. Prosecutors presented evidence showing that the murder weapon was never properly secured away from their troubled 15-year-old son. In fact, the mother had taken Ethan to a shooting range a few days before the shooting. When the parents were called into the school to meet with counselors about their son’s troublesome behavior at school, the counselors showed them drawings Ethan had made. The images featured a pistol resembling the Sig Sauer gun alongside a figure with bullet wounds and phrases like “blood everywhere,” and “help me, the thoughts won’t stop.” The counselors suggested they take their son and get him professional help. Instead, they left their son at school and returned to work. What’s especially troublesome is that they never told the counselors about the gun they had given their son. A few hours after that meeting of school counselors and the parents, Ethan left a school bathroom with the gun and began firing. Prosecutors told the jury if the parents had taken a “tragically few steps,” four students would likely still be alive.

Judge Cheryl Matthews sentenced the Crumbleys to the stiffest penalty possible, but said that the sentences were not designed to send a message that families are responsible for their children’s crimes. The judge said, “These convictions are not about poor parenting. These convictions confirm repeated acts, or lack of acts, that could have halted an oncoming runaway train. About repeatedly ignoring things that would make a reasonable person feel the hair on the back of their neck stand up.” It’s not clear what the legal consequences of the Crumbley trial will be for parents whose kids commit crimes, but my bet is that in the future, the judge’s sentence will result in a lot of unfortunate and unintended consequences when assessing parental responsibility. “Poor parenting” is a vague phrase, but it may very well become a pathway to jail sentences for parents whose kids break the law.

What level of responsibility should parents be prepared to accept for their kids’ transgressions? Several things for sure: parents must be aware of their unique position as mentors and role models for their kids; they must help their kids understand responsibility for the consequences of their actions; they must be effective controllers of rewards and punishments to guide kids toward socially accountable actions, not indoctrinate them and introduce them to a world of violence, chaos, and self-absorption; finally, they should not encourage their kids to adopt the destructive actions of that brutal and aggressive world. But what if parents fall short of these ideals, and their child commits a serious crime? Should the parents be held legally responsible? Judge Matthews decision greases the slope that leads to an affirmative answer to that question.

The Crumbley case coincides with the current societal trend toward allowing, even encouraging, young people to be sheltered—usually by parents—from the consequences of making poor decisions. The result is that the kids develop expectations of entitlement and freedom from accountability. How ironic it will be if those parents who shelter their kids from responsibility will be held responsible for their kids’ criminal actions.

A couple of weeks ago, we talked about the psychological factors that cause people to accept conspiracy theories. Let’s follow up on that and ask, “Once someone buys into a conspiracy theory, why is it so hard for them to discard their belief in the theory?” Once accepted, the power of beliefs over a person is incredible, even when it becomes obvious to observers that the belief is literally destroying the holder’s psychological stability. The “Jonestown Massacre” occurred on November 18, 1978, when more than 900 members of an American cult called the Peoples Temple died in a mass suicide-murder under the direction of their leader Jim Jones. On March 26, 1997, San Diego County deputies discovered 39 dead bodies, active members of the religious group known as Heaven’s Gate. Their mass suicide coincided with the closest approach of the Hale-Bopp comet. 

These two examples of mass suicides demonstrate the power of a belief, and how even an irrational belief can lead people to the ultimate self-destructive action. On a more everyday level, we can see the same self-sabotaging dynamics at work in those who allow their lives to be disrupted—and their psychological stability all but destroyed—by beliefs that have no basis in fact. Becky is a 36-year-old housewife who is convinced that a local restaurant is the center of a child-trafficking enterprise run by local politicians who are pedophiles. Her belief has brought a lot of stress into her life because her husband and many of her relatives, friends, and neighbors try to convince her that this belief is totally without evidence. Becky, however, supported by her small local group of “cult” adherents and ample online support, cannot be swayed.

Becky’s case sounds extreme, but what about Roger? He’s a 56-year-old construction worker who hates Arabs. He has co-workers whose family roots are from Egypt, Saudi Arabia, and Iraq. He hates every one of them and is convinced they are spies sent to destroy America. Like Becky, Roger tenaciously holds on to his belief even though he has no evidence to substantiate it. Unfortunately, Roger’s belief has put his job in jeopardy; he has been “written up” several times at work for refusing to work closely with the “Arabs,” and his boss has threatened to fire him. Then there’s the largest mass conspiracy belief in the history of the US: literally millions of Americans believe that Trump won the 2020 election—that somehow, Biden and his minions stole it. This belief persists even though—to date—no credible, objective, or corroborative evidence has been presented to support it. This belief has already sowed discord and destruction within the country.

Conspiracy theories disseminate conflict, aggression, and destruction. Why, then, is it so hard to get people to change their belief, even when the belief also defies logic, reality, and plain old common sense? Let’s take Becky’s case, and analyze it from a psychological perspective. She’s under a lot of pressure—psychologists would call it dissonance—because so many of her friends and family criticize her and challenge her belief. How could she reduce that dissonance? The simplest answer is, “Just admit you’re wrong, Becky, and discard your belief.” Bingo! Dissonance problem solved. Note, however, that from a psychological perspective, for Becky to admit she is wrong, she has to admit she has poor judgment; she has to admit she’s gullible and easy to influence; she has to admit she’s incapable of managing her own life and must rely on others to manage it for her; she has to admit the source for her belief is invalid. Folks, those are tough admissions because they are a threat to Becky’s self-esteem, to her confidence, to her very self-identity.

So, what is Becky to do? In her mind, the answer is simple: Take the easy road to reducing her dissonance by deciding, “I’m not the one who’s screwed up. It’s my family and all those other people who are involved in hiding the pedophiles who are behind this evil plot. I’ve got plenty of support from my online groups, and there’s no way all of them are wrong. The evil ones are all the perverts, all those disgusting degenerates my groups are trying to uncover.”

Here is a basic psychological fact for you: When you’re feeling pressure and stress from holding a belief, all things being equal, the last thing you will do to reduce that pressure and stress is change your belief. Doing so will be a huge threat to your self-image, so you hold on to that image by disparaging “the others.” You reduce your dissonance by attacking them, rather than critically analyzing the logic of your belief. Using the language of our coping model central to this blog: You accept only your version of reality; you refuse to be accountable for following that version; you are arrogant and condescending toward those who challenge you; you are insensitive and unempathetic toward all but your support group. This is a self-sabotaging path, and only when the pain and frustration from following it become too intense, might you then, possibly—with appropriate guidance and support—consider discarding your irrational beliefs. Yes, it sounds simple, but it’s not an easy path to take, and most people don’t have the fortitude to take it.

In May 2023, US Surgeon General Dr. Murthy released an advisory about a public health crisis of loneliness, isolation, and lack of connection in our country. Approximately half of U.S. adults reported experiencing measurable levels of loneliness, and he noted that such disconnection negatively affects our mental, physical, and psychological health.

When health experts talk about loneliness, the focus is generally on older folks and their physical health. For instance, deficiencies in being socially connected to others have health consequences for older adults that include an increased risk of heart disease, stroke, and developing dementia. Poor social connection also increases the risk of premature death comparable to smoking daily. How about loneliness in younger generations? True, the negative consequences may not show up as drastically, but the mental and psychological strains of social isolation are often notable. Loneliness and social isolation in children and young adults increase the risk of depression and anxiety—both immediately and well into the future. And with the incidence of mental illness among both young and old in the U.S., addressing loneliness and isolation becomes critical in order to fully address mental health in America.

While the epidemic of loneliness and isolation is widespread and has profound consequences for individual and collective health and well-being, there is a “medicine,” a treatment for solitude hiding in plain sight: “social connection,” or what is more commonly called “social prescription.” Social prescribing has its origins in the national health services of the United Kingdom, and its principles are also becoming a part of health care in other countries, including America.

Social prescribing is exactly what it sounds like: prescribing a treatment for psychological problems based on establishing connection to others. Formal social prescribing is performed by medical professionals who refer clients to community-based interventions to help them deal with their loneliness using available collective resources. For example, a social prescription for an older adult with limited mobility might use home-based activities and established telephone-based companionship programs available in the local community. Social connection programs have been found to be beneficial for both client health and the community. Increasing social connection can help reduce the risk of heart disease, stroke, dementia, and depression; furthermore, communities where residents are more connected with one another score higher on measures of population health, community safety, and community resilience when natural disasters strike.

Regular readers of this blog should not be surprised at these findings. A theme that runs through many of our posts is that coping with stress is particularly effective when it is based on productive interaction with others in a context of humility and empathy. Whereas it is true that a lot of coping can be done privately—such as relaxation exercises and keeping a daily diary—coping should not be done exclusively in private; confronting self-preoccupation and denial is more likely to be successful when there are also social connections based on trust, openness, empathy, and caring. Social prescribing also illustrates other important aspects of coping: it empowers clients to take control of their health and well-being; it focuses on practical, everyday social, and emotional needs that impact health; and, it  bridges the gap between medical and social models of health, emphasizing holistic well-being and individual strengths. In short, it’s a formal pathway where health providers “prescribe” social connections to improve mental health outcomes.

Do you want to do some serious damage to your efforts to cope with stress? That’s easy—just accept as many of the conspiracy theories floating around as you can. Buy into them hook, line, and sinker; let them rule your thinking and your actions. Before you know it, you will have stripped yourself of mature judgment, independent action, self-confidence, and trust and empathy toward those who genuinely care for you.

Mark Twain supposedly said: “A lie can travel around the world and back again while the truth is lacing up its boots.” In 2024, this figurative statement is now literal. In our time, information—whether true or misleading—can be disseminated worldwide in a matter of seconds. This fact is the promised land for those with evil, self-centered goals, who crave circulating “conspiracy theories” to achieve those goals. But why do people so often accept these theories, even when they are bizarre? I mean, really, would you like to have lunch with someone who believes that the 9/11 attacks on the World Trade Center and Pentagon were orchestrated by Israel in cooperation with a “deep-state branch of the FBI”? Seriously? Would you like to spend a pleasant evening with Alex Jones who—looking to gain some notoriety and sell some merchandise—propagated a disgusting, inhumane theory that the mass murder of 20 children aged 6-7, plus 6 adults at Sandy Hook Elementary School, was staged? Yeh, that’s right, staged like a Hollywood production.

Another conspiracy theory claims that several years ago Coke intentionally changed to an inferior formula with New Coke, in order to drive up demand for the original product. The Coke president said that was nonsense: “The truth is, we’re not that dumb, and we’re not that smart.”Then there is QAnon, a far-right cult believing that Satanic, cannibalistic child molesters are operating a global child sex trafficking ring. It has roots in “pizzagate,” a conspiracy theory falsely claiming that the New York City Police Department discovered a pedophilia ring linked to members of the Democratic Party. And don’t forget Holocaust denial, an antisemitic conspiracy theory, claiming that the Nazi extermination of European Jews is a hoax designed to win sympathy for Jews and justify the creation of the State of Israel.

Why do people buy into these and other nonsense theories? The psychological reasons are many:  Paranoia. If you have a paranoid personality, it’s easy to accept a theory that others are conspiring against you. Authoritarian Personality. You find a leader who claims simple solutions to a problem, and then you follow that person. If your leader claims a conspiracy, you readily accept it. Need for predictability and control. Speaks for itself. Psychological Insecurities. The comfort of accepting conspiracy theories may help service hidden fears. For how many followers are their leaders father figures who metaphorically resolve the followers’ childhood paternal dysfunctions? Need for clarity. Conspiracy theories can bring sense out of a bewildering world. Social isolation. Those who are depressed or physically disabled, can surf the net and find similar sufferers, kindred spirits who might also subscribe to some conspiracy theory. Justification for supporting a cause. Speaks for itself.

There is a common thread that runs through the above list: Every factor represents a weakness—a flaw, a crack in one’s personality—that damages autonomy, independence, and conscience so much that the individual is willing to suspend rational thinking, and surrender judgment, reasoning, and empowerment to any quack who happens to be around. That’s a pretty poor way to live. You can find better ways of coping with stress. Find them. Stop letting someone else manage your life!

Lars was part of a ten-person project team at work. Unfortunately, he felt he knew more than any of the other nine members in the group, and he had a habit of stopping by their offices a couple of times every day to see what they were doing. Invariably, he would then explain that there was a better way of doing things, and he would be glad to take over. After a while, these repeated interruptions began to irritate his colleagues, and eight of them complained to the project supervisor that he was slowing down their progress. The supervisor had a talk with Lars who told him that things were moving slowly because his colleagues were messing things up, and he [Lars] should be doing their work. The supervisor removed Lars from the project. One team member, Bruce, complained about the removal. He told the supervisor, “These guys provoked Lars’ behavior by letting him get under their skin. When he comes into my office, I just ignore him—tune him out—and do my work.” The supervisor decided that Bruce did not understand the root of the Lars issue, or how his project colleagues felt about Lars, and that Bruce was not much of a team player. The supervisor removed Bruce from the project.

People hear what we say with their brains, but they listen to us with their hearts. Coping with stress often involves being a listener, and also being able to reach other listeners, an ability both Lars and Bruce lacked. When you are able to reach your listeners’ hearts, you are communicating with empathetic messages. And you know what will happen next? You will discover that your personal coping efforts will be greatly enhanced because you will realize you’re communicating with your own heart. That self-discovery will bring you independence and empowerment seasoned with empathy. The result? Your independence will be without isolation and loneliness; your empowerment will be without self-absorption.

In this blog we develop a model (AAHE) of coping with stress that involves four essential ingredients: Acceptance, Accountability, Humility, and Empathy. Acceptance means working to understand yourself, and evaluating how your values and beliefs fit with objective reality. Accountability means that you are responsible for evaluating your role in events you experience. Humility means you believe in the value of recognizing that you are not always right, and you must listen to and respect others’ opinions. Empathy means you value understanding how others feel, seeing things from their perspective, not just yours.

How would the AAHE model can be used to explain the compulsive, habitual liar? I’m not referring to someone who occasionally “spins a tall tale,” but someone who makes a habit of lying and builds most of their life around falsehoods. Former congressman George Santos comes to mind. He claimed his Jewish grandparents managed to escape Hitler’s holocaust; his mother was in the South Tower of the World Trade Center on September 11; he claimed he attended Baruch College on a volleyball scholarship and got degrees in economics and finance in 2010; he added he had knee replacements from playing volleyball at Baruch. In an interview with WNYC following his successful bid for Congress, Santos also said he lost four employees in the 2016 Pulse nightclub shooting in Orlando. Santos, of course, is not alone as a habitual liar. Some folks falsify their resume’; others regularly claim they were present at some momentous event (“Kennedy’s limo drove right by where I was standing when the shots rang out.”), or lie about achievements (“I was high scorer on my high-school basketball team.”).

We all have coping strategies to help us handle the stress and conflicts that come our way. Some people choose lying as a primary coping strategy. Their lies appear designed to elevate them in the eyes of others; they are so dissatisfied with their “real self,” so filled with self-loathing and self-disgust that they must build an entire new identity, living in a fake world of their own creation. In the context of AAHE, they cannot accept their lack of notoriety in the real world; they refuse to evaluate their responsibility for their failures to achieve; humility is a threat to their fragile ego, and not an option because it would force them to face the real self they abhor; their expressions of empathy are phony and serve only to reinforce the fake world in which they are supreme. In short, they are tormented by deep unresolved personality conflicts that flood them with anxiety.

Most people lie occasionally for any of a variety of more superficial reasons than those noted above: to maintain control of a situation; to avoid disappointing respected people in their lives; to make themselves look good in the eyes of others; to avoid hurting someone; to harm someone; to cover up shortcomings in themselves. The thing is, most people are not compulsive, obsessive, or habitual in their use of lies; rather, their lying is functional, situational, and transient. Lies based on core personality conflicts, however, are unrealistic, baseless, and irrational; they service deep psychological insecurities in a desperate and futile attempt to cope with a disliked self-image that causes anxiety and self-directed anger.

Virtually all of us lie now and then, and most of them are not so bad when you think about it. Alicia asks Beth, “How do you like this dress I bought?” Beth hates it, but doesn’t want to criticize her best friend’s taste, so she says, “Oh, Alicia, it’s nice and looks good on you.” Conflict and hurt feelings avoided, right? The real problem with even those “little white lies” is when they are used habitually and automatically to cope with unpleasant situations. Eventually, you will earn a reputation as hypocritical, lacking in judgment, and someone whose words can’t be trusted; then your coping efforts will be compromised.

As a general of thumb, when it comes to using common defense mechanisms – such as lying, rationalization, projection, distraction, scapegoating, manipulation, etc. – keep it occasional. If your use of these ego-protection actions become habitual, you will lose the coping battle. Stick with AAHE.

            Disciplining a child without the use of physical punishment is a preferable parental style these days. As society moves more and more to conservative practices, however, it’s possible that harsh childrearing techniques, including spanking, may return. Most people do not want to see a return to childrearing practices that deny decades of sound psychological research into the cognitive, emotional, and social development of children. That research shows that physical punishment is ineffective in changing behavior, potentially contributes to childhood trauma, and can have adverse consequences that extend into adulthood.  Still, there are some disturbing trends: reputable media sources are reporting an increasing trend of allowing corporal punishment in schools. Some school districts have been designing policies that – with written parental permission – allow teachers to “paddle” children. Such a policy begs the question: what kind of parent would permit a teacher to inflict pain on their child?

If you are like most parents, and believe that physical punishment is inappropriate with kids, and just teaches them that violence is the best way to deal with conflict, here are some steps to follow to help you adopt a child-punishment style that avoids physical actions: (1) Accept that you are at times tempted to lash out physically; that is normal. In other words, you are not a robot habitually in a steady state. (2) Identify situations that make you want to engage in physical punishment. Examine and evaluate those elements and your reactions so you can consider alternative ways of reacting. It may be a particular time of day; or when running errands in the car with the kids in the back seat; or when the kids first return from school wound up higher than a kite ready to release energy. Being aware of the situations where you are more likely react impulsively and lose control will make it easier for you to manage your emotions appropriately. (3) Remember that you are the one who controls rewards and privileges. (4) Be consistent in how you apply that control, and practice exercising it without physical punishment. (5) Use positive methods like approval and rewards to control your child’s behavior. (6) If you are habitually using physical punishment against a child, seek professional help because relying on physical punishment will likely escalate into child abuse.  

High-functioning depression is a popular everyday conversational phrase used to describe a level of depression that doesn’t interfere with maintaining daily life activities. Depressed people described as high-functioning go to work, take care of their families, and participate in social activities; but they also experience distress and unhappiness in their lives. Outwardly, they look productive and OK, but inside they are faced with sadness and worry. Two cornerstones appear to be (1) feeling empty, with the blues; (2) finding little or no enjoyment or fulfillment in activities that used to be pleasurable and satisfying. Other common symptoms include feelings of hopelessness, pessimism, or worthlessness, plus irritability, anxiety, social withdrawal, fatigue, and trouble focusing on tasks.

High-functioning depression is not a formal professional term, and you won’t find it in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). You will, however, find a condition in the DSM that sounds a lot like high-functioning depression: Persistent Depressive Disorder (PDD)—also known as Dysthymia. Symptoms include sadness, emptiness, and feeling down; loss of interest in daily activities; fatigue; low self-esteem and self-criticism; difficulty focusing and making decisions; irritable and impatient; social avoidance; appetite and sleep problems. Sound familiar? PDD sufferers are described as “silent sufferers,” and like depressed folks described as high functioning, PDD victims go to work or school, care for loved ones if necessary, and generally function day-to-day. But they have this gnawing feeling that prevents them from enjoying life like others seem to do.

Both high-functioning depression and PDD have strong cognitive components, typified by a way of perceiving and thinking about life events in a negative way. When you think negative thoughts, especially about yourself, you are going to feel rotten—you are going to avoid challenges and become more likely to add to your depression. Negative thoughts compromise positive actions, and without positive actions in your life you will never feel fully satisfied and productive.

Both PDD and high-functioning depression generate avoidance behaviors. Sufferers develop long-standing actions to avoid facing challenges and stressors. Unfortunately, these are the very stressors they must learn to confront. As a result, they get caught in a vicious cycle of avoidant action patterns that are difficult to exit, and often resistant to anti-depressant medications. The depression is accompanied by actions that rob them of energy, motivation, and positive attitudes needed to break free of the avoidance vicious cycle. As a result, the depression creates problems in many areas, such as social interactions, concentration and focus, alcohol/drug issues, etc.

A term like high-functioning depression is kind of redundant when you think about it. Why do we need it if it’s so similar to PDD? The answer to that question should be obvious: If you’re tormented by symptoms of mild depression, what would you like to say to a friend or relative: “I’m a high-functioning depressed person,” or, “I have Persistent Depressive Disorder?” “High-functioning” vs. “Disorder.” There is a lot of secondary gain to be had from using the former term, especially if someone says, “Well, at least you’re not mentally ill!”

The coping lesson here is clear: If you have the symptoms of high-functioning depression, you need to restructure your thinking and actions concerning your life, and to stop relying on avoidance patterns of action when you are faced with challenges. Describing yourself as high-functioning is only giving you another avoidance card to play: “Sure, I’m down and blue, but at least I’m not bipolar or have major depression. I have my high-functioning qualities going for me.” That sort of avoidance thinking puts you on a spiral road that takes you in only one direction: farther down. In the context of our AAHE coping model—Acceptance, Accountability, Humility, Empathy—your first task is to accept the reality that carrying baggage loaded with low self-esteem, no enjoyment in previously-enjoyable activities, and empty and worthless feelings, is not at all high-functioning.