Anxiety and depression relief program

There is no "universal alleviation formula" that applies to everyone. The essence of intervention for anxiety and depression is a process of dynamic matching of three dimensions: "physiological adjustment - cognitive adjustment - social support" - mild to moderate emotional distress can be improved through self-help intervention, while moderate to severe attacks must first follow the doctor's advice to intervene with drugs or professional psychotherapy. All plans that skip severity assessment and directly recommend "must-do lists" are essentially irresponsible.

I once met a girl who worked in Internet operations. She saved more than 30 "anxiety relief strategies" in half a year, including mindfulness for 10 minutes a day, running 3 kilometers in the morning, and writing a gratitude diary. However, she collapsed after less than 3 days each time, and in turn scolded herself, "I can't even regulate my emotions, so what's the use of living?" In fact, if you look through it, you will find that the underlying logic of most of these strategies is the idea of ​​​​the cognitive behavioral school (CBT): emotions are not determined by the event itself, but your interpretation of the event drags you into the quagmire. For example, if you can't catch the subway and you think, "Today is ruined, my boss will definitely have a problem with me if I have to deduct money for being late." Then standing on the platform will make your fingertips numb with anxiety. ； But if you change your mind and think, "I just went to buy a taro bun that I didn't dare to try before, it doesn't matter if I am 10 minutes late and tell the boss," then the irritation may disappear. I once had a programmer visitor who reflexively thought "I'm so useless and will be fired soon" every time a bug occurred. Later, following the practice of CBT, every time I had this thought, I listed the evidence that could overturn this idea: "The boss didn't say anything after fixing the bug last time." "Last week, he praised me for the fast progress of the project." After two months of training, when I encountered a problem, my first reaction changed from self-denial to "Let's see where the problem is first."

However, there are also many psychodynamic counselors who do not agree with this "troubleshooting" logic. They feel that now that you have changed the idea that "bugs = I am useless", the core conflict in your subconscious "I must be perfect to be worthy of being loved" has not been resolved. Next time you encounter project delays or quarrels with your partner, your emotions will still explode. I met a college teacher who had done CBT 8 times. He was usually in a stable mood at work, but when he returned to his hometown during the Chinese New Year and was urged to get married by his parents, he immediately collapsed. Later, he turned to psychoanalysis for consultation. After digging for half a year, he found out that it was the shadow of his parents who shut him down every time he didn't get the first place in the exam when he was a child. There are also consultants from the existentialist school who believe that many people's sense of meaninglessness and persistent depression are essentially due to their failure to find a connection between themselves and the world. For example, an investment bank manager with an annual salary of one million suffers from insomnia every day because he knows that what he does every day has no value other than making more money. It doesn't matter how much knowledge you give him. You must first help him find what he really cares about.

Having said that, I must first emphasize an important point. No matter which school of methods you believe in, don’t believe in the nonsense that “anxiety and depression just means you can’t think straight.” Now neuroscience has long established that long-term emotional stress will directly affect the secretion of neurotransmitters such as serotonin and dopamine in the brain, just like if you stay up late for a long time, you will suffer from endocrine disorders. You cannot just "think more" to get rid of it. There was a visitor who was an architectural designer who worked on a landmark project for three months in a row. He should have been happy on the day when the design was handed in, but when he woke up in the morning, he suddenly collapsed on the bed. He didn't even have the strength to hold his mobile phone. When he went to the hospital, he was found to be moderately depressed, and the doctor directly prescribed sertraline. He refused to take it at first, thinking, "How can I, a grown man, take medication for mental illness?" He endured it for a week and almost had an accident. Later, he took it for two weeks and told me that the feeling of a big stone pressing on his chest suddenly became lighter. Only then did he have the energy to sit down and talk to me about the grievances he had accumulated during the project. Of course, many people object to taking medicine when they have emotional problems, fearing side effects and dependence. This concern is actually reasonable. The current clinical consensus is that only moderate or above attacks need to be prioritized for drug intervention. The harm of side effects is far lower than the impact of continued deterioration of the condition. You must follow the doctor's advice on how to take and for how long. Don't buy and stop on your own.

In fact, for most people who are only occasionally depressed and have periodic anxiety, there is no need to force themselves to do those "standard and correct" things. I've seen too many people who are already bored and force themselves to exercise for half an hour and meditate for 10 minutes every day. If they can't finish it, they scold themselves for being useless. Instead, they fall into more serious internal friction. To be honest, when I am not in a good state, let alone meditating, I feel uncomfortable sitting for more than 5 minutes, so I use the "5-minute method" I have saved - or I go to the kitchen to wash two dishes, touch the cool water with my hands, and feel the detergent foam sliding between my fingers. I feel like I have to go downstairs and throw away the garbage, step on the sycamore leaves on the roadside, and listen to the crackling sound. If I really don’t want to move, I can sit on the sofa and touch my cat’s fur. It’s soft and my thoughts are brought back to the present moment from “What should I do with that report tomorrow?” in just a few seconds. Oh, by the way, don’t believe in the chicken soup that “must have positive energy”. When you feel uncomfortable, you just lie down and cry, scold the boss for being stupid, or even throw a worthless broken cup. You can feel comfortable however you want. There is no right or wrong in the emotion itself. Only if you block it will cause problems.

Many people like to carry on when they are in a bad mood, fearing that they will be rejected or called hypocritical if they tell others. In fact, it is very important to have a support system that can catch your emotions. There was a young girl who had just graduated before and told her parents that she was depressed. Their parents would only say, "We had it much harder than you at that time, you were just too busy." It made her even more uncomfortable. Later, she found a friend on the Internet who was also emotionally disturbed. The two of them would check in each other every day and tell each other what they had done today. Even if it was just "I ate three meals on time today" or "I drank a cup of hot milk tea today," they would praise each other for a long time. After three months of this, she told me that "living doesn't seem to be that difficult after all." However, I would like to remind you, don’t treat your friends as exclusive emotional trash cans. If the other person can’t handle your emotions, you would rather go to a paid psychological counselor. Spending money on other people’s emotional value is actually much more cost-effective than consuming friendships.

In fact, at the end of the day, relieving anxiety and depression is like finding medicine for someone with a cold. Some people have good resistance and can just drink more hot water to cover their sweat. Some people need to take antipyretic cold medicine, and some people need to get infusions when their fever reaches 39 degrees or above. There is no one method that is the best, and it is the one that suits you. If you feel that you have been suffering for a long time and still haven't gotten better, don't force yourself to go to the hospital and get a psychiatry or psychology appointment. There is really no shame in it.