I am getting SO DAMN TIRED of reading discussions about depression in which people say "you shouldn't recommend exercise to a person with depression; I have depression and my inability to make myself exercise just makes me more depressed" or "you shouldn't recommend antidepressants" or "you shouldn't mention eating a healthier diet" or anything like that.
So just what the hell DO you recommend, then? "You shouldn't even bother"? "You should just lie down where you are and die"? Thanks, no, my depression tells me that enough already, I don't need to hear it from you.
I think part of what pisses me off about this is that this usually comes up in the course of a discussion in which the people making the recommendations have self-identified as having experience with severe unipolar depression. This isn't people pulling things out of thin air, or referring to something they read in Reader's Digest, or what Oprah said — this is people who have in-depth personal experience with being unable to leave one's residence for weeks on end, or being unable to feed oneself reliably, or going into the kitchen to find that the dirty dishes in the dishpan are invisible under an eighth-inch-thick layer of moldy scum floating on the water, or losing a job due to the depression, or any of the other myriad horrible experiences of life with depression.
Something specific that somebody recommends didn't work for you? Fine. Not terribly surprising. For all our commonalities and the few universals ("oxygen required", check; "nutrition and hydration required", check) we humans are highly variable; something that helps one person may not help another.
THAT DOES NOT MEAN THAT IT IS BAD ADVICE.
If somebody is struggling with depression, they will be better off if they can get themselves moving than if they can't. Yes, part of that is simply that being able to make yourself do something is likely an indicator that your depression is less overwhelming than the depression being experienced by somebody who can't make themself do something, but most of it is the fact that there are few exceptions to the rule that exercise and physical activity is just plain GOOD for animals.
Speaking from the perspective of somebody who has spent 35+ years struggling with this damn disease, the more time goes by the better I (think I) understand that compassionate like a brick wall aspect that Zen teachers get. It can feel like getting hit with a bucket of cold water to pour out your pain and sadness and suffering to this supposedly-enlightened, merciful teacher and in response get "Yes, and...?" *shrug* "That's just feeling. That's just emotion."
It can feel like having a door slammed in your face to be told that as far as getting better from depression, nothing's going to work until you make it work.
But it's the truth. Somebody who's stuck in a place of helplessness and believing that there's nothing they can do and that their only hope is from others (whether they're doctors or therapists or spiritual leaders) is unlikely to ever recover from the depression.
You have to make it work. You have to do something.
Maybe it takes all the energy and willpower you have right now just to pick up the phone and call your doctor. That's great — that's doing something. Maybe it's deciding to take your medications consistently. That's doing something. Maybe it's deciding that you will walk around the block once a day... and when you realize it's been three days and you haven't done it you go walk around the block instead of letting the depression tell you that flaking for three days proves you're hopeless. That is doing something.
But if all you're doing is saying "Don't recommend [x], don't recommend [y]" you're not doing anything to help yourself and you're not doing anything to help anybody else.