By the time I checked into a psychiatric institution in May 2018, I was feeling desperate. Less than three months had passed since I’d left the last psychiatric institution. I had left there feeling good, only to find that my happiness existed in a vacuum. My medication was working, but trying to deal with the real world was still overwhelming.
I was starting to lose hope. What would be different this time? What could I possibly learn in this psychiatric institution that would transform my life, when everything I had learned in the first had come up short?
Fortunately, I found an answer. It turned out that dialectical behavioral therapy (DBT) was the treatment I needed. But it was one particular lesson in DBT that opened me up to recovery.
The Fear That Held Me Back
My first major depressive episode was bad. It is no exaggeration to say that it was by far the worst thing I had ever gone through. It lasted just over a week.
My second major depressive episode was somehow worse. Seconds felt like minutes, minutes felt like hours, hours felt like days. Even if time had passed quickly, I would have struggled to see any end to the torture. But it did end after about a week and a half.
My third major depressive episode made the first two look like child’s play. I had forgotten how bad the previous two were and had made the decision to go off the meds that didn’t seem to be working. It was the biggest mistake I have ever made, even if it was ultimately a step on the path to recovery.
Going into the second psychiatric institution, I wasn’t looking for relief. I was looking for a solution. The terror that I would ever experience anything like that major depression had taken hold of me. I needed to find a way to never feel like that again. That fear ended up holding me back in the first days of treatment.
The problem was that no matter how well a day seemed to be going, the thought that it was just one day in the context of my life could ruin it. It was as if happiness meant nothing unless it lasted my entire life. And finding everlasting happiness was impossible because anything can happen in the future.
Living in The Present
Dialectical behavioral therapy (DBT) is a modern Western treatment that utilizes ancient Eastern mindfulness at its core. While there are components of it that teach behavioral strategies which are incredibly important for people battling mood and personality disorders, it ultimately hinges on the recognition of existence as it is.
That may seem like a tough ask. What kind of process of learning do you need to go through in order to see existence as it is? But it is actually quite simple. We look at existence as a never-ending timeline. However, all that ever really exists is right now.
Recognizing that only the present exists can seem terrifying. After all, what if you are suffering in the present? However, living in the present makes that suffering much more manageable. What turns pain into suffering is the fear that comes with it. The fear that it will never end. Seeing it that way is unhelpful, as you cannot permanently put an end to pain.
When you are only confronting the present, that pain becomes far more manageable. You don’t need to find an answer that will free you of suffering for the rest of your life. You deal with what you are going through now, and when you go through pain in the future, you will deal with it then.
Treating Depression in The Present
By the time I left the psychiatric institution, I felt incredible, armed with a toolbox of skills to help me live a happy, fulfilling life. However, I had no guarantee that I would never experience a major depression again. Since then, I have not had to manage a major depression, but I still have no guarantee that I won’t have to sometime in the future.
It was learning that I did not need to fix the future that gave me the space to learn to live in the present. This is not to say that the thought of another major depressive episode is not terrifying. The difference is that I can acknowledge that fear and let it go, rather than holding onto it while I try in vain to find a solution.
This is why mindfulness is being touted as a cutting-edge mental health treatment. It takes something that seems too big to handle and shows you that you don’t have to.
It must be mentioned that mindfulness is not about ignoring the future. Making plans and working towards goals are still important. But you do so in the knowledge that all plans are provisional. Things change and you can adapt along the way. There is no need to have all the answers at any one time.
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