Alice is 52 and appears to have withdrawn from life. Her youngest child just graduated from college and has gone off to another city to pursue her career. Alice feels like her usefulness in life has ended; for 30 years she has devoted her life to raising three children, running the household, and supporting her husband as he moved up the career ladder. But now, Alice thinks, “It’s gone, all gone. I’m not worth much anymore.” She begins seeing a psychologist “to try and get my life in order.” The counselor diagnoses her with persistent depressive disorder – dysthymia – and recommends she get a prescription for an antidepressant from her physician.
Many psychologists would say, “Hold on. Let’s not rush into medication. Alice’s problem is not depression. Depression is the symptom of being confronted with stressors in her life. Alice needs to confront these stressors and do realistic evaluations of how she might handle them.” From this perspective, the psychologist might help Alice develop a treatment plan that involves working toward a new sense of purpose in her life, and committing herself to actions that will help her face and work through her stress, not be immobilized by it. The goal will be to find actions that, when combined with motivation and purpose, will bring Alice to a greater sense of being worthwhile and productive. Note, the emphasis is not having Alice focus on changing the symptom – depression – or asking her to change her thoughts and fears, which are normal states of anxiety and sadness resulting from the “empty nest.” Instead, Alice needs to see that she can act in ways that will give her a renewed sense of purpose, and not rely on medication.
But first, Alice must examine her values. What things matter to her? “I like to help others,” she says. “It’s important to me to be a source of support and guidance to those who feel a little lost and looking for meaning in their lives. I always did that with my kids. I didn’t tell them what to do, but said to see what sorts of things are important to them, things that they value, and we’ll go from there.” Alice pauses. “Good lord, that’s where I am right now, isn’t it? I’m like one of my kids looking for guidance and help from others.” She chuckles. “How about that!”
Once Alice had a grasp on her issues, she worked with the psychologist on listing her values, and finding activities that would be a good substitute for her parenting, which was now minimized, at least on a daily basis. She focused on volunteer activities and came up with five programs that she felt would work for her: Big Brother/Big Sister; Be a Mentor, providing a role model for kids, just as she did with her own; Hospice volunteer, which required 12 hours of training, plus Alice liked the fact that she would be challenged by needs for those at the end of the road, not the beginning: JustServe community volunteer, where she could use her vast knowledge of her local community; Mentoring programs at local high schools, an activity that would also make her feel like a needed parent again. She contacted each one to determine which would work best for her.
Laura is a recent high-school graduate who works at Walmart. She is unsure of what she wants to do with her future: College? Marriage and kids? Stay at Walmart? She admits that her uncertainty is affecting her self-esteem, and she gets a little depressed about it all. She found herself joining her friends and buying into all sorts of conspiracy theories about what was going on in the world. “I felt more secure living in a simple world.” When people outside of her circle of friends would challenge her about the conspiracy beliefs, she would justify those beliefs by criticizing them and ignoring their contradictory information.
At some level, Laura began to feel uncomfortable with so much denial, and she began to ask herself, “Is it really me and so many of my friends who are correct, and everyone else is wrong? Does feeling I’m a loser because I’m uncertain about my plans, does that make me a loser?” Laura began to dip her toes in the water of critical thinking. She will swim in those waters when she is able to say, “I am what I do. I am not defined by my thoughts, beliefs, and feelings. I won’t feel better by simply thinking or feeling my way out by following some of my friends’ beliefs. I must be guided by what I value.”
Maybe Laura will eventually realize a basic truth about coping and learning how to evaluate your life: “Your thoughts do not make you good or bad. They are natural for you and part of what makes you human. You do not have to feel guilty about your thoughts or feelings. Every person has some extreme, distorted, bizarre or self-centered thoughts from time to time. Your thoughts and feelings do not define you. Your freely-chosen actions define you. That is what you need to concentrate on – your actions, not your thoughts and feelings.”