Category Archives: Anxiety

Anxiety, Avoidance, Depressed Anonymous, Exercise, Fellowship, Hope, Indecision, Isolation, Meditation, Purpose

Action Before Motivation, Using Behavioral Activation for Depression

Introduction

When depression, trauma, anxiety, or emotional exhaustion take hold, life often starts to shrink. We stop reaching for the things that used to steady us. We pull back from people, routines, responsibilities, and even small sources of comfort. The worse we feel, the less we do. Then the less we do, the harder it becomes to feel any sense of movement at all.

Behavioral activation is built on a simple idea, action often has to come before motivation, not after it. Instead of waiting to feel ready, hopeful, or energized enough to re-engage with life, behavioral activation focuses on small, deliberate steps that help restore structure, connection, and momentum over time.

This article is about what behavioral activation is, where it comes from, and most importantly, how to actually use it. The practical side is the real focus. We will look at how behavioral activation techniques can be used in everyday life when energy is low, avoidance is high, and follow through feels difficult. To support that, we will also look at the history behind behavioral activation, the cycle it is designed to interrupt, why it works, and how to stay with it long enough for it to help.

This is not about pretending everything is fine or trying to force yourself into a better mood. It is about understanding that small actions, repeated often enough, can help open life back up again.

Section 1, What Behavioral Activation Is, and Where It Comes From

Behavioral activation, often shortened to BA, is a structured therapeutic approach that helps people re-engage with life through planned, meaningful action. It is not just about staying busy, and it is not the same as distracting yourself until the day is over. The point is more specific than that. Behavioral activation targets patterns of withdrawal and avoidance, and helps people increase contact with activities that bring reinforcement, meaning, connection, or a sense of progress.

That matters because when someone is depressed or emotionally shut down, inactivity is often part of the problem, not a character flaw. People stop doing things because everything feels heavier, flatter, more effortful, or less rewarding. In the short term, pulling back can feel understandable, even protective. Over time, though, it usually cuts people off from the very experiences that help support mood, routine, confidence, and connection. Behavioral activation is designed to interrupt that pattern.

The basic idea is simple, do not wait for motivation to show up before taking action. In many cases, waiting is exactly what keeps someone stuck. Behavioral activation works from the other direction. It starts with manageable, deliberate actions, not because a person already feels better, but because action can help create the conditions where feeling better becomes more possible.

The roots of behavioral activation go back to behavioral theories of depression developed in the 1970s, especially the work of Peter Lewinsohn. Those early models focused on reduced positive reinforcement. In plain language, when someone has less contact with experiences that bring pleasure, accomplishment, meaning, or connection, mood can worsen. As mood worsens, people often withdraw further, which reduces those experiences even more. Later research, including work by Neil Jacobson and colleagues, helped show that the behavioral side of therapy for depression was especially powerful. That helped behavioral activation become recognized as a treatment in its own right, rather than being seen only as one part of cognitive behavioral therapy.

That history matters because it shows behavioral activation is not a motivational trend or a watered down version of something more serious. It is a well-established, evidence-based treatment approach with a clear theory behind it. It is also recognized in mainstream clinical guidance as a treatment option for depression, which places it firmly inside standard therapeutic practice, not at the edges of it.

Just as important, behavioral activation has lasted because it is practical. Many people already know they are stuck. What they do not need is another abstract explanation of why. They need a realistic way to begin moving again. Behavioral activation offers that by focusing on actions that are small enough to be doable, but meaningful enough to start changing the pattern.

Useful sources for this section include:
https://pubmed.ncbi.nlm.nih.gov/21275642/
https://pubmed.ncbi.nlm.nih.gov/20677369/
https://www.nice.org.uk/guidance/ng222/chapter/recommendations
https://pmc.ncbi.nlm.nih.gov/articles/PMC7390059/

Section 2, The Cycle Behavioral Activation Is Designed to Break

One of the hardest parts of depression, trauma, anxiety, or emotional shutdown is that they do not just change how we feel. They change what we do. We start pulling back from ordinary life. We cancel plans, ignore messages, put things off, let routines slide, and stop doing small things that used to help us feel steadier. Over time, that withdrawal can stop being just a result of low mood and start becoming part of what keeps it going.

In the moment, pulling back can make complete sense. If everything feels overwhelming, staying home can feel safer. If people feel draining, avoiding them can feel like relief. If a task feels huge, putting it off can feel like self-protection. That is part of what makes this cycle so difficult. Avoidance often helps in the short term. It reduces pressure for a moment. But the relief usually does not last.

The longer that pattern continues, the more it starts to cost us. We lose structure. We lose small moments of enjoyment. We lose chances to feel capable, connected, or accomplished. Things that once broke up the day and gave it shape begin to disappear. Life can start to feel flatter and more repetitive, with less to look forward to and less to feel good about afterward.

That is how the cycle tightens. Low mood leads to less activity. Less activity means less contact with the things that support wellbeing, enjoyment, achievement, connection, routine, movement, and purpose. That leaves us feeling worse, which makes it harder to do anything at all. After a while, the problem is not only the depression, anxiety, or shutdown itself. It is also the pattern that has formed around it.

Most of the time, this does not look dramatic. It looks ordinary. A person stops going for walks. Stops answering texts. Stops cooking proper meals. Leaves dishes in the sink. Puts off paperwork. Stays in bed longer. Skips meetings. Stops doing hobbies that used to make them feel like themselves. None of those things on their own seem huge. Put together, though, they can quietly reshape a person’s life.

This is one reason people can be so hard on themselves. From the outside, many of these tasks look small. From the inside, they can feel loaded. Once shame, low mood, and avoidance have built up around them, even opening a message or stepping outside can feel like too much. That does not mean someone is lazy, weak, or not trying hard enough. It means emotional pain is shaping behaviour in ways that are understandable, but that also keep the pain going.

That is where the central idea comes in, action often has to come before motivation, not after it. If low mood is being maintained in part by withdrawal, loss of routine, and reduced contact with things that bring meaning or relief, then waiting to feel better before doing anything can keep someone stuck in the same loop. Motivation often does not arrive first. It often has to be rebuilt through action.

That does not mean forcing huge changes or pretending things are fine. It means recognising that the cycle has to be interrupted somewhere. If avoidance brings short term relief while making life narrower in the long term, then small, deliberate action starts to make more sense.

Once that cycle is clear, the next question becomes practical. What kinds of actions actually help, and how do you use them when you feel flat, avoidant, or overwhelmed?

Useful sources for this section include:
https://pmc.ncbi.nlm.nih.gov/articles/PMC7390059/
https://www.elft.nhs.uk/sites/default/files/2022-05/behavioural-activation.pdf
https://talkingtherapiessouthwark.nhs.uk/wp-content/uploads/2021/06/1.-Introduction-to-BA-for-depression-revised-2021.pdf
https://www.gmmh.nhs.uk/behavioural-activation/

Section 3, How to Employ Behavioral Activation Techniques in Daily Life

Once you can see the cycle, the next step is not a dramatic reset. It is not getting your whole life together by Monday, building the perfect routine, or becoming the kind of person who suddenly finds all of this easy.

It is smaller than that, and harder in a different way.

Behavioral activation asks a more practical question, what is one small action that would bring a little structure, movement, connection, or meaning back into today?

That is what makes it useful. When you are depressed, overwhelmed, numb, or shut down, “fix your life” is useless advice. “Do one thing that reconnects you with life” is something you can actually work with.

And that is the heart of behavioral activation. You do not wait to feel motivated first. You begin with action, because action often has to come before motivation, not after it.

Start with the right kinds of activities

Behavioral activation is not about staying busy for the sake of it. It is about choosing activities that reconnect you with parts of life that low mood, anxiety, trauma, or exhaustion have pushed out of reach.

A useful way to think about those activities is in five categories.

Pleasure

Pleasure activities are small things that bring comfort, enjoyment, or relief.

That might be sitting outside with a coffee, listening to music, taking a bath, reading for ten minutes, watching one episode of something you actually enjoy, or eating something you like rather than whatever is easiest.

These activities matter because when life gets flat, people often lose contact with simple forms of enjoyment first. Pleasure does not have to be profound to matter. Sometimes a small moment that feels a little lighter, calmer, or more human is enough.

Mastery

Mastery activities are things that help you feel capable, organised, or slightly more in control.

That might be making the bed, washing dishes, replying to one email, paying one bill, sorting laundry, cooking something simple, or clearing one small area of a room.

These are important because depression often strips away a sense of agency. Days start happening to you instead of being shaped by you. Mastery helps push back against that. Not through positive thinking, but through evidence. I did something. I followed through. I moved one thing forward.

Connection

Connection activities reduce isolation.

That might mean replying to a text, calling a friend, attending a meeting, joining a support group, eating with someone, or simply sitting in a shared space instead of hiding away.

These do not have to be deep or emotionally intense. The goal is not perfect closeness. It is to spend less time cut off. When you have been isolated for a while, even light contact can make the day feel less sealed off.

Necessary maintenance

These are the tasks that keep daily life functioning.

Showering, brushing your teeth, taking medication, getting dressed, eating a meal, tidying up, going to an appointment, taking the rubbish out, or setting out clothes for tomorrow all count.

These tasks can feel painfully basic when someone is depressed, but that does not make them less important. Often this is the part of life that starts to collapse first, which then creates more stress, more shame, and more disorder. Sometimes behavioral activation starts here simply because this is the part of life that most needs holding together.

Values-based action

Values-based activities are tied to who you want to be and what matters to you.

That could be parenting with intention, going to a recovery meeting, applying for jobs, journaling, praying, doing service, exercising, keeping a promise, or taking one step toward something meaningful even if it does not feel good in the moment.

These matter because life is not only about feeling better. It is also about living in a way that still feels like yours. Values-based action helps remind you that even when mood is low, direction still matters.

Then make them usable

Knowing the categories helps, but the real question is how to actually use them.

Start smaller than you think

This is where many people go wrong. They decide the answer is to fix everything at once. Go to the gym, deep clean the flat, reply to everyone, rebuild a social life, cook every meal, become consistent immediately.

That usually falls apart fast. Then the collapse gets used as proof that nothing works.

Behavioral activation works better when the action is small enough to be doable even on a hard day, and clear enough that you do not have to negotiate with yourself for an hour before starting.

  • Instead of “go for a long walk,” make it “walk for five minutes.”
  • Instead of “clean the kitchen,” make it “wash five dishes.”
  • Instead of “sort my life out,” make it “pay one bill.”

Small does not mean pointless. Small means repeatable.

Be specific

Vague plans are easy to avoid.

“Do something nice” is vague.
“Take tea outside at 9 a.m.” is specific.

“Tidy up” is vague.
“Clear the bedside table” is specific.

“Reach out to someone” is vague.
“Text Sam after lunch” is specific.

Behavioral activation works best when the activity is concrete enough that you either did it or you did not.

Schedule it instead of waiting to feel like it

If the plan is “I’ll do it when I have the energy,” it often does not happen.

  • A better approach is to attach the activity to a time or an existing routine.
  • After coffee, I go outside for five minutes.
  • At noon, I eat something.
  • After dinner, I wash dishes for ten minutes.
  • Before bed, I set out clothes for tomorrow.

This matters because it makes the activity less dependent on mood and more dependent on structure. When motivation is unreliable, structure carries more of the load.

Choose based on what has dropped out of your life

Behavioral activation works best when it responds to the gap.

  • If you are isolated, connection may need attention.
  • If your space is becoming chaotic, mastery or maintenance may matter most.
  • If everything feels joyless, pleasure may need rebuilding
  • If you feel aimless, a values-based activity may matter more than another comfort habit.

You do not need a perfect balance every day. You need to notice what has gone missing and start putting some of it back on purpose.

Use a simple daily structure

A good starting point is to choose:

  • one thing for pleasure,
  • one thing for mastery,
  • and one thing for maintenance or connection.

That might look like:

  • sit outside for ten minutes,
  • reply to one email,
  • take a shower.

Or:

  • listen to music while making lunch,
  • clear the kitchen counter,
  • text one person back.

That is enough to count.

It may not sound like much, but when you are shut down or avoidant, doing three small things on purpose can change the tone of a day. Not because it fixes everything, but because it stops the whole day from being handed over to the spiral.

Scale down, do not quit

This is one of the most important parts.

On bad days, the goal is not to do the ideal version of the activity no matter what. The goal is to keep some contact with the pattern.

  • If the plan was a twenty minute walk, the scaled down version might be five minutes. If five minutes feels too much, it might be standing outside for one minute.
  • If the plan was cooking dinner, the scaled down version might be making toast and eggs.
  • If the plan was attending a full meeting, the scaled down version might be joining for fifteen minutes.

All-or-nothing thinking ruins consistency. If the only options are “do it properly” or “do nothing,” difficult days usually end in nothing. A scaled-down version still counts because it protects the rhythm.

Track completion first, mood second

A common mistake is deciding an activity failed because it did not make you feel noticeably better straight away.

But behavioral activation is not really about instant mood repair. It is about changing a pattern over time.

Sometimes the result is not “I feel good now.” Sometimes it is:

  • I feel slightly less stuck.
  • I did not spend the whole day in bed.
  • I proved I could do one thing
  • I made tomorrow a little easier.

That still counts.

A simple way to track this is to write down what you planned, whether you did it, and anything you noticed afterward. Completion comes first. Mood matters too, but not as the only measure of whether the activity was worth doing.

Ask whether the activity helps you reconnect

Not every activity helps in the same way.

Some things bring temporary relief but leave you feeling just as shut down afterward. Hours of scrolling, numbing out in front of the TV, drinking to get through the evening, or disappearing into avoidance disguised as comfort may feel easier in the moment, but they usually do not rebuild structure, mastery, connection, or meaning.

A useful question is:

Will this help me reconnect with life, even in a small way?

That question is not there to shame you. It is there to help you notice the difference between something that restores you and something that only helps you vanish for a while.

Keep the bar low enough to keep going

Behavioral activation does not ask you to feel convinced before you begin. It asks you to start where you are.

  • One shower.
  • One short walk.
  • One text.
  • One load of laundry.
  • One meal.
  • One meeting.
  • One five minute task.

Done often enough, these actions start to rebuild rhythm. And rhythm matters. It helps life feel less shut down and more lived in.

That is also why behavioral activation can look almost too simple on paper. What makes it effective is not complexity. It is repetition. Small actions, chosen on purpose and repeated often enough, can begin restoring the things depression and avoidance tend to strip away, structure, movement, confidence, connection, and a sense that your day belongs to you again.

This is the part people often underestimate. Not because it is complicated, but because it is small. But when someone has been stuck for a while, small is often exactly what makes change possible. A shower can be an interruption. A walk can be an interruption. One answered message can be an interruption. And sometimes an interruption is where recovery starts.

The next question is why this works as well as it does, not just emotionally, but psychologically and neurologically too.

Useful sources for this section:
https://pubmed.ncbi.nlm.nih.gov/20677369/
https://pmc.ncbi.nlm.nih.gov/articles/PMC11104310/
https://www.elft.nhs.uk/sites/default/files/2022-05/behavioural-activation.pdf
https://medicine.umich.edu/sites/default/files/content/downloads/Behavioral-Activation-for-Depression.pdf

Section 4, Why These Techniques Work, Therapeutically and Neurologically

The practical side of behavioral activation can look almost too simple on paper. Go outside for five minutes. Answer one message. Take a shower. Wash the dishes. Go to the meeting. Make the meal. It is easy to look at actions like that and wonder how something so small could really matter.

But that is exactly the point. Small actions can matter because depression and emotional shutdown are often maintained through small patterns too, putting things off, pulling back, losing structure, dropping routines, and slowly losing contact with anything that brings enjoyment, connection, meaning, or a sense of progress.

On the therapy side, behavioral activation works because it targets avoidance directly. When someone feels low, numb, overwhelmed, or hopeless, pulling back often makes sense in the short term. It reduces pressure. It can feel protective. But over time it usually cuts the person off from the very things that might help them feel steadier, a bit of structure, a bit of accomplishment, a bit of connection, a bit of relief. Behavioral activation tries to reverse that by helping a person re-enter life deliberately, even before they feel fully ready.

That is part of why the approach is so practical. It does not depend on winning an argument with your own mind before doing anything different. It starts with changing the pattern. In real life, that means creating more opportunities for something useful to happen, even if the effect is small at first. A little enjoyment. A little mastery. A little movement. A little contact. Not every action will feel rewarding in the moment, but over time they increase the chances that life contains more than avoidance and inertia.

The neurological side helps explain why this matters. Depression often affects reward processing, which is part of how the brain helps us anticipate, notice, and respond to things that might feel worthwhile. This is one reason anhedonia can be so difficult. It is not only that pleasure feels dulled. It is also that effort can start to feel pointless, because the brain is no longer expecting much reward at the other end of it.

That is an important distinction. A lot of people with depression do not just struggle to enjoy things. They struggle to imagine that doing anything will lead to anything good. Once that happens, motivation can collapse. If nothing seems likely to help, then even basic actions can feel irrational or exhausting.

Behavioral activation works against that by putting a person back in contact with experiences where something useful, comforting, meaningful, or relieving might happen. Not guaranteed, but possible. In that sense, BA is not just about “doing healthy things.” It is also a way of giving the brain repeated chances to relearn that action can still lead somewhere worthwhile.

That relearning matters. You go for the walk and feel slightly clearer. You shower and feel a little more human. You answer one message and feel less cut off. You make the meal and the evening becomes a bit easier. None of that is dramatic, but each one is a small piece of evidence against the idea that nothing helps. Over time, those experiences can begin shifting not only what a person does, but what they expect from doing anything at all.

There is also growing evidence that behavioral activation may help reduce the kind of stuck, repetitive mental loops that come with depression, especially rumination, while strengthening the systems involved in reward, engagement, and goal-directed behavior. That fits the lived experience of BA quite well. The person is not only doing more. They may also be getting less trapped in the mental grooves that keep them shut down and more able to move toward life again.

Put simply, behavioral activation seems to work on at least two levels at once. Psychologically, it interrupts avoidance and increases contact with structure, connection, accomplishment, and meaning. Neurologically, it may help re-engage reward-related learning and shift some of the patterns that keep a person stuck in anhedonia and rumination.

That does not mean every activity will feel good. It does not mean BA is a trick or a shortcut. It means the small actions in Section 3 matter more than they seem to at first glance. They are not random acts of self-improvement. They are repeated chances to interrupt the depressive pattern and show the brain, slowly and through experience, that action can still lead to something worthwhile.

That is also why consistency matters more than intensity. One big burst of effort rarely changes much on its own. Repeated contact does. Behavioral activation works less like a sudden breakthrough and more like teaching yourself, again and again, that life is still something you can move toward.

Useful sources for this section include:
https://www.nature.com/articles/s41398-019-0644-x
https://pmc.ncbi.nlm.nih.gov/articles/PMC4626008/
https://pubmed.ncbi.nlm.nih.gov/38951971/
https://pubmed.ncbi.nlm.nih.gov/38774780/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9577157/

Section 5, How to Stick With Behavioral Activation Over Time

Starting behavioral activation is one thing. Staying with it long enough for it to help is something else.

That matters because BA is meant to work gradually, not all at once. It helps most when you build it step by step, not when you try to force a complete turnaround in a week.

One of the biggest obstacles is waiting to feel like it. But BA is built on the reality that motivation is often unreliable when mood is low. The point is not to wait for a better mood before acting. The point is to act in a way that gives mood a chance to shift.

Another common mistake is aiming too high, too fast. People turn BA into a self-improvement project instead of a recovery practice. They try to fix everything at once, fill every hour, and hold themselves to a standard they would struggle to meet even on a good week. That usually backfires. BA works better when the plan matches your actual energy, attention, and emotional bandwidth, not the version of you that you wish would suddenly appear.

All or nothing thinking is another trap. If the plan becomes “do it properly or it does not count,” then one hard day can turn into several. BA works better when the goal is not perfection, but contact. No activity is too small to count if it keeps you in the pattern. Bigger tasks can be broken into smaller steps. A ten minute version counts. A reduced version counts. What matters is keeping some link to the routine instead of dropping it completely.

That is why bad days do not mean the approach has failed. Most of the time, they mean the plan needs adjusting. If something did not happen, the useful question is not “What is wrong with me?” but “Was this too ambitious, too vague, badly timed, or too dependent on me feeling good first?” BA works best when it stays flexible. Sometimes success means doing the smallest version. Sometimes it means postponing something and trying again tomorrow. The point is to keep working with the process rather than treating one difficult day as proof that nothing helps.

It also helps to stop judging BA only by whether it creates instant relief. Sometimes people decide an activity did not work because it did not make them feel noticeably better straight away. But that is too narrow a test. Sometimes the gain is that you kept a promise to yourself. Sometimes it is that you made tomorrow easier. Sometimes it is that you stopped the whole day from sliding further downhill. Those changes may be modest, but they still matter.

This is one reason consistency matters more than intensity. What tends to help is not one perfect day or one burst of effort. It is repeated contact with actions that restore routine, pleasure, necessity, and engagement. BA works best as a steady practice, not a performance.

Over time, that repetition can become more than symptom management. It can become a way of rebuilding trust in yourself. Depression and emotional shutdown often damage that trust. You stop believing your plans, your intentions, or your ability to follow through. BA helps repair that slowly. Not by asking you to make grand promises, but by giving you small chances to keep one.

A shower. A short walk. One meal. One text. One task done on purpose.

Repeated often enough, those actions start to say something different: I may still be struggling, but I am not absent from my own life.

That may be the most important thing BA offers in the long run. Not a perfect routine, and not a guarantee that every day will feel good. What it offers is a practical way to keep turning back toward life, even when the turn is small.

Useful sources for this section include:
https://www.elft.nhs.uk/sites/default/files/2022-05/behavioural-activation.pdf
https://talkingtherapiessouthwark.nhs.uk/wp-content/uploads/2021/06/1.-Introduction-to-BA-for-depression-revised-2021.pdf
https://www.gmmh.nhs.uk/behavioural-activation/
https://www.nice.org.uk/guidance/ng222/chapter/recommendations

 

Anxiety, Belief, Choice, Courage, Focus, Helpful, Helpful Thinking, Hope, I'll Do It When I Feel Better, Isolation, Mindfulness, Positivity, Purpose, Suffering, Supportive Actions

After Treatment Ends: Protecting Recovery When Returning to Everyday Life

Leaving treatment can feel a lot harder than people expect. You may be doing better and still feel exposed, unsteady, or frightened by how quickly ordinary life closes back in. I wanted to write about that honestly, because feeling destabilized after discharge does not mean treatment failed.

I spent 22 weeks in treatment across PHP and IOP programs, and I know firsthand how much safer, steadier, and more understood that environment can feel. I also know how daunting it is to leave it and return to a life that may still contain many of the same pressures that helped break you down in the first place. Continued support, including group sharing and Depression Anonymous, became part of how I protected my recovery, and that is part of why I am writing this.

1. Why Treatment Environments Can Feel Safer Than Ordinary Life

One of the hardest parts of leaving treatment was realizing that the progress was real, and still feeling how exposed it became once I was back in ordinary life. The progress was not fake. I was just no longer in a setting that helped hold me up.

Over the 22 weeks of treatment, I was surrounded by people who could relate to what I was carrying, not just the depression itself, but the shame, fear, exhaustion, and the painful things that can come with being unwell for too long. There is a real difference between talking about despair to people who recognize it, and talking about it to people who answer with confusion, advice, minimization, or discomfort.

For me, one of the most stabilizing parts of treatment was that I did not have to keep proving my pain was real. I was around people who understood that getting through the day can take effort, that numbness can hurt as much as panic, and that recovery is rarely neat or linear. That made honesty easier. I did not have to spend as much energy explaining why ordinary tasks felt heavy or hiding the parts of myself I felt ashamed of.

Support was built into the day. There were sessions to attend, people checking in, and I did not have to pretend my mental health was a side issue. That may sound simple, but simple things matter. Having somewhere to be can help. Knowing someone will notice if you disappear can help. Having a therapist, group, or case manager ask how you are actually doing can interrupt the kind of silent slide that so many of us know too well.

For many people, and for me, that kind of structure can feel safer than ordinary life. It is not only the therapy. It is that, for a while, recovery has room and backup.. Outside of treatment, that can change quickly. A day shaped around support can be replaced by missed meals, poor sleep, work demands, family tension, unpaid bills, commuting stress, and the pressure to act as though you are fine.

Treatment did not remove all pain, and it did not make me permanently steady. But it did give me a setting where recovery had room. If I was spiraling, there were tools close at hand. If I was exhausted, there was language for that. If I was ashamed, there were other people who knew what shame could do.That does not make treatment artificial. It means it gave me things I badly needed, structure, accountability, people who understood, and a little shelter from the pressures that were waiting outside.

Not every treatment experience feels this supportive, and not every program creates this kind of safety. But when it does, it can be one of the first places in a long time where you do not feel alone with what you are carrying. That is part of why leaving can hit so hard.

2. The Transition Shock, and Why Recovery Can Feel Fragile After Discharge

Leaving treatment can be a shock, even when it helped. Discharge is often seen as a sign that things are improving, and sometimes that is true. But it can also be a very vulnerable period. You may have worked hard, made real progress, and still feel exposed once treatment ends.

That was true for me. There was relief in having made it through treatment, but also unease in stepping away from something that had been holding me up and returning to a life that had not become easier while I was away.

Returning to the Same Stressors

Ordinary life returns quickly, and it often brings back the same pressures that helped push things to a breaking point in the first place. Work demands, family dynamics, financial strain, loneliness, conflict, and daily responsibilities do not usually pause while someone is in treatment. When treatment ends, many people find themselves stepping back into the same environments that were already overwhelming them before.

For some people the situation is even harder. They may be returning to homes or relationships that remain chaotic, hostile, or emotionally abusive. Recovery is much harder to protect when the surrounding conditions are still unstable or harmful.

In my own case, the pressures waiting outside treatment were not abstract. Financial insecurity was ongoing, and I was returning to conflict that affected both my sense of safety and my role as a parent. None of that had been resolved while I was away, in fact it had cemented. So even though treatment helped me stabilise, I was stepping back into a life that still carried real strain.

Losing the Treatment Environment

Another difficult change is the sudden loss of the community that forms during treatment. Being around people who understand what you are going through without needing long explanations makes honesty easier. In that setting depression, fear, shame, and exhaustion are recognized experiences rather than things that need to be justified.

Leaving that environment can mean losing a place where you felt seen and understood. That loss can bring a quiet loneliness that people outside treatment may not fully grasp.

When Skills Meet Real Life

The skills learned in treatment now have to work in a very different setting. In treatment they are introduced, practiced, and reinforced in a structured environment with support and space to pause. Outside treatment they have to hold up in the middle of fatigue, disappointment, setbacks, and everyday pressure.

I remember after discharge when I knew what I was supposed to do, pause, breathe, reach out, challenge the thought, and still feeling my mind race ahead of me anyway. There were times when I felt desperately alone and as though I was wrapping sadness around myself again. Understanding something in therapy did not always mean I could use it easily when life sped up.

Stress makes this harder. When pressure rises, attention narrows and thinking becomes less flexible. Energy drops and the mind often falls back on older patterns.

I noticed this most clearly in the difference between reactive and proactive skills. When something went wrong I could sometimes pause or challenge a thought. But the proactive parts of recovery were harder to maintain. Continuing behavioural activation activities was one of the first things that slipped. I could brush my teeth, shower, and keep my living space tidy, but remembering to reward myself or deliberately schedule positive activities was much harder.

There was always another stressful task to complete or another crisis to manage. It was easier to react to problems than to keep building the habits that protect recovery over time.

That can make recovery feel shakier than it actually is.

You can believe what you learned in treatment and still get thrown by a bad day, pulled toward isolation, or ashamed that you are not handling things better. That does not erase the progress. It shows how real the transition is.

For many people recovery does not become fragile after treatment because they failed. It becomes fragile because it is now happening in the full complexity of ordinary life.

3. The Role of Validation and Peer Understanding

One of the harder adjustments after leaving treatment is returning to environments where the same level of understanding may not exist. In treatment, emotional struggle is expected and discussed openly. Outside of that environment, depression is often misunderstood, minimized, or quietly avoided.

Many people mean well but still struggle to respond in ways that feel supportive. Some move quickly to advice. Others try to reassure in ways that unintentionally dismiss the depth of what someone is experiencing. Sometimes people pull away when recovery does not look simple or when the conversation becomes uncomfortable. Even when care is genuine, a lack of understanding can make it harder to speak honestly about what is still difficult.

Those responses matter because shame grows easily in places where distress is minimized or treated like a personal failing. When someone already feels exposed after treatment, being misunderstood or dismissed can increase the temptation to retreat into silence. It becomes easier to say you are fine than to explain what you are actually dealing with.

Silence can be especially risky during early recovery. When people stop speaking openly about how they are doing, it becomes harder for others to notice when things are slipping. Isolation can grow quietly, and the effort to appear stable can add another layer of pressure.

This is where peer understanding can make a meaningful difference. Spaces where people share similar experiences can reduce the need to explain or justify what you are going through. Instead of starting from skepticism, the starting point is often recognition. That kind of recognition does not solve every problem, but it can interrupt the belief that you are uniquely broken or failing in some special way.

Peer support can also make honesty easier. When people hear others talk about setbacks, shame, or difficult days without being judged or dismissed, it becomes easier to admit those experiences in themselves. That honesty can help interrupt the isolation that depression often feeds on.

For many people, continuing contact with peer groups after treatment helps bridge the gap between the structured support of treatment and the complexity of ordinary life. These spaces do not replace therapy, medication, or other forms of care, but they can help protect recovery by keeping connection, validation, and honest conversation available.

Sometimes the most stabilizing response is not a solution. Sometimes it is simply being able to say, this is hard, I am struggling, and hearing someone answer, I understand, and you do not have to carry it alone.

4. When Skills Stop Working the Way You Expect

Even with understanding and support, another challenge often appears after leaving treatment. Many people discover that the coping skills they learned do not always work as smoothly in ordinary life as they did in treatment.

That can be deeply discouraging. During treatment, those tools may have felt helpful or even transformative. But once you return to everyday life, they can feel harder to reach or less effective than you expected.

I experienced this myself after discharge. I knew many of the techniques I had learned. I could sometimes pause, breathe, or challenge a thought when something went wrong. But knowing what to do did not always mean I could access it when life became stressful again.

Stress changes how the mind works. When pressure rises, attention narrows and thinking becomes less flexible. Energy drops and the brain tends to fall back on familiar patterns. For someone living with depression, that can mean self criticism, hopeless conclusions, or the urge to withdraw appearing much faster than expected.

Timing plays a role as well. Many coping skills depend on noticing what is happening early enough to pause and choose how to respond. In real life situations often escalate quickly. By the time you recognize what is happening, you may already feel overwhelmed or mentally exhausted. In those moments the skill itself may still be useful, but reaching for it becomes much harder.

Another challenge is that recovery rarely depends on a single skill. In treatment, skills are often introduced one at a time and practiced deliberately. Outside treatment, problems rarely arrive one at a time. Stress, fatigue, conflict, uncertainty, and practical pressures can pile up together. When that happens, relying on a single technique may not be enough. Recovery often depends on several supports working together over time, routines, habits, relationships, and coping strategies reinforcing each other.

This became very clear to me when I was dealing with ongoing pressures that did not easily resolve, including financial insecurity and legal conflict related to my son. Those situations carried emotional weight that did not disappear simply because I understood the tools I had learned in treatment.

When stress stays high for long periods, it becomes harder to consistently reach for coping strategies. Energy gets spent managing immediate problems, and the mind shifts toward reacting rather than planning. In those conditions it can feel as though the skills you worked so hard to learn have slipped out of reach.

Experiences like this can be deeply discouraging. Many people interpret them as proof that they are doing something wrong or that recovery is slipping away. In reality, it often reflects something simpler. The skills did not fail. The conditions around you became harder.

Treatment introduces tools, but learning to use them consistently in the complexity of everyday life takes time, repetition, and continued support.

5. Using Treatment Skills in Everyday Life

One of the harder parts of recovery after discharge is that knowing a skill is not the same as being able to use it in real life. Treatment can teach useful tools, but ordinary life does not offer the same structure, reminders, or support. That can make those skills feel harder to reach, even when they were helpful in treatment.

Stress is part of why. When pressure rises, the mind often becomes more reactive and less flexible. It gets harder to pause, reflect, and choose a response. Old patterns can return faster, especially when someone is already tired, ashamed, overwhelmed, or pulled in too many directions at once. In those moments, the problem is not always that the skill stopped working. Often it is that stress made it harder to access.

Practical ways to keep using skills

This is why continuing to use treatment skills after discharge often has to be more deliberate. It can help to keep reminders close by, a short list in your phone, a few coping steps on paper, or a simple note about what usually helps when you start to spiral. It can also help to learn your earlier warning signs, so you have a better chance of using a skill before things gather too much speed. For some people that might mean noticing changes in sleep, irritability, hopeless thinking, avoidance, or the urge to isolate.

It also helps not to rely on only one tool. Sometimes a breathing exercise helps, but sometimes what is needed is a combination, pause, drink some water, text someone safe, step outside, challenge the thought, or do one small grounding task. Recovery is often steadier when several supports work together rather than placing too much pressure on a single skill to fix everything.

Why repetition matters

Another important part of this is practicing skills when things are relatively calm, not only when everything is already going wrong. Repetition matters. A skill usually becomes easier to reach when it has been used enough times in ordinary life that it starts to feel more familiar and less forced. That process can be slow, and it can feel frustrating, but it is part of how treatment tools become more usable outside treatment.

For me, this helped explain why progress after discharge could feel uneven. Insight came first. Consistency took longer. I could know what was supposed to help and still struggle to do it when life was moving fast and my mind was under strain. That was not proof that treatment failed. It was part of the work of carrying those skills into the life I actually had.

Over time, what first feels effortful can begin to feel more natural. Skills that once seemed hard to reach can gradually become more available under pressure. Not perfectly, and not all at once, but enough to help recovery hold more steadily in ordinary life.

6. Rebuilding Structure After Leaving Treatment

One of the hardest parts of leaving treatment is losing the structure that helped hold recovery in place. In treatment, there are routines, appointments, check-ins, and people around you who notice if you are struggling. Once you leave, that support is no longer built into the day. That does not mean recovery matters less. It means more of the structure has to be created and protected in ordinary life.

That shift can be harder than people expect. Without some kind of routine, days can start to blur. Sleep slips, meals get irregular, plans fall away, and too much empty time can leave room for withdrawal, rumination, or shutting down.

Why routine helps

Structure helps counter that drift. It gives the day a shape to return to, even when motivation is low or emotions are unsteady. It does not have to be rigid, and it does not have to be impressive. What matters is having a few dependable anchors that make the day feel more manageable.

For many people, this is part of what stabilizes recovery after treatment. A regular rhythm can make it easier to sleep, eat, follow through on plans, and notice when things are beginning to slide. It can also reduce the sense that every day has to be built from scratch.

What structure can look like in daily life

What replaces treatment structure is usually not a perfect schedule. It is a handful of steady habits that support stability. A regular sleep and wake time can be one of the strongest anchors. Planning a few basic activities for the day can also help, especially things that are simple and repeatable, like getting dressed in the morning, eating at regular times, taking a walk, going to an appointment, doing one household task, or leaving the house once a day.

These actions may seem small, but small actions often matter a great deal in recovery. They help stop the day from collapsing inward. They also create a sense of movement, even when energy is low and nothing feels easy.

Why support still matters

In treatment, support is often built into the environment. After treatment, it usually has to be maintained on purpose. That might mean continuing therapy, attending peer support meetings, checking in with trusted people, or staying connected to a recovery community.

These forms of contact do more than offer comfort. They help reduce isolation, reinforce coping skills, and make it easier to notice when things are starting to slip. Recovery is harder to maintain alone, especially after leaving an environment where support was constant and visible.

Building something sustainable

Recovery outside treatment is often supported by ordinary things done consistently. Sleep, daily activity, social contact, nourishment, and basic self-care may not seem dramatic, but they help create the conditions for greater stability. When those patterns start to break down, it often becomes harder to cope. When they are protected, even imperfectly, recovery can feel less fragile.

So what replaces the structure treatment provided? Usually, it is not one big answer. It is a set of small, reliable supports built into daily life. A routine wake-up time, a loose plan for the day, regular contact with supportive people, and a few habits that are kept even on difficult days can all help. The goal is not to become rigid. It is to build enough structure that recovery still has something to stand on once treatment is no longer carrying so much of the weight.

7. When Setbacks Happen During Recovery

One of the hardest parts of recovery is what happens when things get worse again. After treatment or a period of stability, it is easy to hope that the worst is over. When symptoms return, or coping starts to slip, many people quickly conclude that they have failed, that treatment did not work, or that they are back at the beginning.

That conclusion is understandable, but it is not necessarily true. Recovery is often uneven. In depression especially, difficult periods, relapse, and recurrence are common. A setback does not mean the progress was fake. It means recovery has become harder again, and needs attention again.

Why skills can suddenly feel out of reach

Setbacks can be frightening partly because they make it harder to do the very things that usually help. When stress rises and emotions intensify, it often becomes harder to think clearly, stay organized, make decisions, or remember what works. Skills that felt usable before can suddenly feel far away.

That does not mean they are gone. It often means the person is overwhelmed. In those moments, people may withdraw, shut down, ruminate, cancel plans, or fall back into old patterns. This is part of why setbacks can feel so defeating. You may still know what helps, but feel less able to reach for it.

Why catching it early matters

Timing matters. It is usually easier to respond when a setback is just beginning than when it has already taken hold. Early signs may include changes in sleep, appetite, energy, motivation, irritability, isolation, hopelessness, or rumination. These shifts can seem small at first, but they are often worth noticing.

Once things deepen, it usually becomes harder to interrupt the pattern. That is why early action matters. Taking a change in mood or functioning seriously is not overreacting. It is often one of the most protective things a person can do.

What a setback can look like

A setback does not always look dramatic. Sometimes it looks like sleeping at odd hours, ignoring messages, cancelling plans, skipping routines, letting basic tasks slide, or telling yourself every day that you will deal with it tomorrow. Sometimes it looks like numbness, irritability, exhaustion, or the quiet return of hopeless thoughts.

This matters because setbacks often build gradually. They are easy to minimize when they first appear, especially if the person feels ashamed or thinks they should be coping better by now. Naming these patterns early can make it easier to respond before things get worse.

Responding without turning it into failure

The goal is not to panic. It is also not to turn the setback into proof that nothing has changed. What usually helps more is a practical response, returning to basic routines, reaching out to a therapist, going to a meeting, telling a trusted person that things feel harder, or focusing on the smallest next step instead of trying to fix everything at once.

How the setback is interpreted matters. If it becomes a reason for shame, coping often gets harder. If it is understood as a sign that more support and structure are needed again, it becomes easier to respond with care rather than self-judgment.

Recovery includes beginning again

Part of recovery is learning that beginning again is not the same as starting over from nothing. A setback may interrupt momentum, but it does not erase insight, effort, or everything already learned. Needing support again does not mean recovery has failed. It means recovery is still being lived, and sometimes that includes finding your footing more than once.

8. Protecting Self Trust and Taking a Realistic View of Recovery

One of the dangers in recovery is not only the setback itself, but the meaning depression attaches to it. A hard week can quickly become, “I am back where I started,” or, “Nothing has changed.” Depression often pushes interpretation in that direction. Rumination and negative thinking can turn a difficult period into apparent proof of failure.

Protecting self trust means learning not to accept that conclusion too quickly. A setback may mean stress has risen, support needs to be strengthened, or routines have slipped. It does not automatically mean recovery is gone. Part of resilience is learning to notice when depression is interpreting events more harshly than they deserve.

Self trust is not built by staying well all the time. It is built by seeing that when things get difficult, you can still respond. Each time you notice yourself slipping, return to a routine, use a skill, reach out for support, or begin again instead of giving up, you build trust in your ability to live through hard periods without letting them define everything.

This also points to a more realistic view of recovery. Recovery is usually not a perfect or permanent state. More often, it means learning how to navigate difficult periods with more awareness, more support, and less shame. Over time, episodes may still happen, but they may become shorter, less severe, or less disruptive.

Recovery, then, is not about never struggling again. It is about knowing that struggle does not cancel progress, and trusting that when things get harder, you can respond rather than disappear.

Conclusion

Leaving treatment can mean losing the structure, support, and reinforcement that made recovery feel more possible. That transition can be difficult, and when setbacks happen it is easy to believe they erase everything that came before. They do not.

Recovery after treatment often depends on building structure, continuing to use skills, staying connected to support, noticing difficulty early, and resisting the urge to treat every setback as proof of failure. The aim is not perfection. It is to keep returning to what helps, and over time to build a life in which recovery is supported by practice, honesty, and the willingness to begin again.

References:

Please see this link for references used

Acceptance, Anger, Anxiety, Avoidance, Blame, Choice, Denial, Depressed Anonymous, Honesty, Hope, Positivity, Purpose

DARVO, Depression, and the Erosion of Self Trust

Section 1, Scope and Intent

This article looks at a pattern often referred to as DARVO, and how it can intensify depression, anxiety, and self doubt, especially when it shows up repeatedly, or in relationships where power, safety, or dependence are not equal. My focus is not on diagnosing anyone, assigning blame, or deciding what something “counts” as. My focus is on impact, patterns, and why some interactions leave you feeling confused, ashamed, or smaller than you did before.

I am writing this for people who live with depression and find themselves repeatedly destabilized by certain conversations, particularly when those conversations involve someone they cannot easily avoid. I am also writing this for people who notice that, under stress or shame, they become defensive or reactive in ways that do not reflect who they want to be, and who want language for that without turning it into self punishment.

DARVO is used here as a private lens for clarity and support, not as a label to use in arguments, and not as a tool to prove anything.The aim is stability and dignity, a way to protect self trust when it feels fragile. You do not need certainty, confrontation, or a verdict to deserve care.

Section 2, Starting With the Lived Experience

Before naming any theory or pattern, it helps to start with what this can feel like from the inside.

You may notice that after certain conversations you do not feel relieved or resolved, but more unsettled than before. You might feel pressure to apologize or take responsibility without being clear what actually changed. You may leave interactions doubting your memory, your intent, or even your character, replaying what was said and how you reacted, trying to locate the moment where you went wrong.

For some people, the strongest feeling is not hurt but a heavier sense of being “bad,” or unsafe to be around. For others, it shows up as confusion, exhaustion, or a fog that makes it hard to trust your own thoughts. Over time, this can turn into rumination, anxiety before contact, or a shrinking of what feels safe to say.

If you recognize yourself here, you are not alone. The purpose here is orientation, not proof, so pause and come back if you need to.

Section 3, What is DARVO?

DARVO is an acronym that stands for Deny, Attack, Reverse Victim and Offender. It describes a pattern of response that can show up during conflict or moments of accountability.

In everyday terms, it can look like this. A concern is raised, or harm is named. Instead of that concern being addressed, the harm is denied or minimized. The focus then shifts to attacking the other person’s reaction, tone, or character. Finally, the roles reverse, and the person who raised the issue is treated as the problem, while the other person may end up positioned as the one who has been wronged.

A simple example can make this clearer.

  • You say, “That hurt me, I wish you had not said it like that.”
  • They say, “I did not do anything wrong, you are overreacting.”
  • Then, “You are always so sensitive, you make everything a problem.”
  • And finally, “You are attacking me right now, I am the one being mistreated.”

What matters most here is not the acronym, but the effect. Conversations that follow this pattern often leave one person feeling confused, ashamed, and responsible, rather than heard or resolved.

A few clarifications help keep this grounded and safe. DARVO describes behavior, not a diagnosis. People can fall into parts of this pattern under stress or shame and still come back later, acknowledge harm, and repair. One instance does not define a relationship. The pattern becomes most harmful when it is repetitive and one sided, especially across different topics and over time, and it can feel even more destabilizing when the relationship involves unequal power, safety, or dependence.

DARVO is not being named here so you can confront someone with it. In this article, it is offered as a private lens for understanding patterns and impact, particularly when interactions leave you feeling worse rather than clearer. The goal is not to decide who is right or wrong, but to understand why certain interactions may be eroding your sense of safety and self trust. 

Section 4, DARVO Versus Ordinary Defensiveness

Not every difficult conversation, sharp response, or defensive moment is DARVO. People get reactive when they feel criticized, misunderstood, or overwhelmed. That is human, and on its own it does not signal a harmful pattern.

A more useful starting point is what happens after the heat of the moment.

In ordinary conflict, even if someone denies, deflects, or snaps, there is often movement back toward repair. The person may return later, acknowledge impact, clarify intent, or make a change. The conversation may still feel messy, but it does not reliably end with one person carrying confusion, shame, and responsibility for both sides.

When DARVO shows up as a repeating pattern, the topic may change, but the ending stays the same. The concern is minimized or dismissed, focus shifts to your reaction or character, the roles flip, and you leave feeling blamed or unsure of yourself. Time passes, but repair does not arrive, or it arrives briefly without changing the structure.

You do not need a final conclusion. You are noticing direction over time. Do things become steadier and more mutual, or more destabilizing and one sided.

Section 5, Why DARVO Can Land Harder When You Live With Depression

DARVO can be destabilizing for anyone. When you live with depression, it can land harder and take longer to recover from.

Depression often affects concentration, emotional regulation, and confidence in your own judgment. You may already question whether your feelings are “too much,” whether you are being unfair, or whether you are the problem. When a conversation follows a DARVO shaped pattern, it can hook straight into that self doubt. What felt confusing starts to feel like confirmation that you are flawed.

It helps to say this clearly. Depression can reduce confidence in your perception. It does not automatically make your perception wrong. You are still deserving of fairness, and a shared understanding of what happened.

There is also a nervous system component. Under emotional threat or intense shame, many people freeze, shut down, or go foggy. Words disappear, working memory narrows, and details get harder to access. Later, that gap can become fuel for rumination, because the mind tries to reconstruct what it could not say at the time. Difficulty thinking clearly under stress is a biological stress response, not proof of guilt or manipulation.

When character or intent is repeatedly questioned, the injury can shift from “I was hurt” to “I am bad.” That shift is part of the damage, and it is one reason this pattern can deepen depression. Depression can also make someone more likely to defend with denial, attack, or reversal when shame or frustration spikes, especially when they feel misunderstood.

Vulnerability to harm is not the same as responsibility for harm. If symptoms worsen after particular interactions, that may be information about context, not a personal failure. 

Section 6, When It Keeps Happening, How the Impact Accumulates

When DARVO appears repeatedly, especially alongside depression, the impact is not limited to individual conversations. Over time, it can reshape how you think, feel, and relate to yourself.

Cognitively, confusion can grow. You may replay conversations trying to find where things shifted or what you “missed.” Reflection is normal, but relentless replay drains energy rather than restoring clarity. The mind keeps searching for certainty that never quite arrives.

Emotionally, shame often moves to the center. Instead of feeling hurt, you may feel exposed or fundamentally flawed. Anxiety can rise, especially before contact. A message notification, a phone call, or an upcoming conversation can trigger a stomach drop or a tightening in the chest. Over time, the nervous system can stay braced.

Some people withdraw, speak less, or minimize themselves to reduce risk. Others become more reactive because their system is already strained. Both are understandable responses to repeated pressure.

One of the deepest impacts is on identity. When intent, integrity, or character are repeatedly questioned, the injury can shift from “that interaction hurt” to “there is something wrong with me.” This is the erosion of self trust.

Naming these impacts is not about proving harm. It is about understanding why the inner world may feel more fragile than it once did. The argument ends, but the self doubt stays.

Section 7, The Feedback Loop, How Self Doubt Becomes the Outcome

When a DARVO shaped exchange happens once, it can be upsetting. When it happens repeatedly, it can create a loop where self doubt becomes the default outcome.

  • A concern is raised.
  • The concern is denied or minimized.
  • The focus shifts from the issue to your reaction, tone, or character.
  • The roles flip, you become the problem, the other person the victim..
  • Your nervous system reacts; fog, shutdown, anxiety, shame.
  • You reflexively try to make it stop, over explaining, appeasing, apologizing etc.
  • You leave destabilized, the original issue remains unresolved.
  • Rumination fills the gap, you replay it trying to recover clarity.
  • The next conversation starts with less self trust, and the loop is easier to repeat.

This is not about assigning a villain. It is about seeing how repeated reversal can train the mind and body to associate speaking up with losing your footing.

Section 8, Early Recognition Without Escalation

Early recognition is not about catching someone out. It is about protecting clarity before you get pulled into the loop.

Early signs can include

  • Your concern is not addressed, and your reaction becomes the topic.
  • You feel an urgent pull to explain, justify, or prove.
  • You notice a body shift, tight chest, stomach drop, heat, mind going blank.
  • You start fact checking in your head mid conversation, doubting your memory.
  • You feel yourself shrinking, appeasing, or apologizing just to end the tension.

Stabilizing moves can include

  • Slow down, shorten sentences, speak less.
  • Name a limit without arguing, I cannot do this clearly right now, I need a break.
  • Step away and return later with support, or do not return until you feel steady.

This is a skill, not a test. Noticing sooner and pausing sooner reduces cumulative damage.

Section 9, When You Notice It in Yourself

Under stress, shame, fear, or overwhelm, many people can slide into pieces of this pattern. The point is not self condemnation. The point is what happens next.

Depression can increase the risk of this in a specific way. When energy is low and frustration is high, small disagreements can feel like threat. If someone is already carrying shame or helplessness, accountability can land as humiliation. In that state, denial can feel like self protection, attack can feel like regaining control, and reversal can feel like the only way to be seen.

It is also possible for two people to move into this pattern in the same conflict, especially when both feel cornered. That does not mean both are equally responsible in every situation, and it does not erase power differences or safety issues. It simply means the dynamic can become mutually destabilizing, and depression can make it harder to step out of it once it starts.

Some common reflexes include denial, minimizing impact because it feels threatening, attack, going sharp or contemptuous to regain control, and reversal, positioning yourself as the injured party so you do not have to face the original concern.

A simple self check is this.

  • Did I respond to the concern, or did I make it about their tone, character, or motives.
  • Did I deny or minimize impact because I felt threatened, instead of staying curious.
  • Did I flip the roles so I became the injured party, to avoid accountability.

If any of those are true, an interrupt can be simple.

Pause. Lower the temperature. Return to the original concern. Name impact. Make one concrete commitment.

That can sound like:

“I hear you. I got defensive. I can see how that landed. I am sorry. I will handle it differently.”

If that cannot happen in the moment, it can still happen later. Repair is not self punishment, it is integrity, and it is one of the most protective moves against shame driven escalation.

Section 10, Repetition and Repair

A single defensive exchange is not the same thing as a repeating pattern. The more useful question is what happens over time, and whether repair is real.

To spot direction over time, these questions help.

  • Does the original concern ever get addressed, even later, or does it keep getting rewritten.
  • Does accountability show up, or does it consistently shift into tone, flaws, and intent.
  • After conflict, do both people get steadier, or does one person reliably end up destabilized.
  • Do apologies lead to change, or do they reset the conversation without changing the pattern.

Depression often turns repetition into proof that the depressed person is the problem, because it is already looking for reasons to believe that. Try to treat repetition as information, not a verdict. Direction is often enough to make safer choices.

Section 11, Rebuilding Self Trust After Reversal

The hardest part of repeated reversal is not the argument itself, it is what it does to the relationship with the self. Over time, the question stops being what happened, and becomes can I trust my own mind.

Rebuilding self trust starts small. Confusion, shame spikes, the urge to over explain, and the body tightening before contact are not proof on their own, but they are information. It is reasonable to take information seriously.

It also helps to separate ideas that depression loves to merge.

  • Someone can be imperfect, and still deserve fair treatment.
  • Someone can make mistakes, and still be telling the truth about their experience.
  • Someone can feel uncertain, and still set boundaries that protect them.

When spiraling starts, it can help to return to one simple line.

My experience counts, even if someone disagrees with it.

Self trust returns when choices consistently protect that clarity, especially in small ways.

Section 12, Safety and Support

If any of this is landing hard, it helps to end simply. This does not have to be carried alone. If a situation feels unsafe, physically or emotionally, safety comes first. That might mean stepping away from a conversation, reaching out to someone trusted, attending a meeting, talking to a professional, or choosing distance where distance is possible.

Support can be asked for without diagnosing anyone. Someone can speak from the “I,” what happens internally, confusion, shame, rumination, loss of self trust, and ask for help staying grounded. Another person does not need to be named for that experience to be real.

And if someone notices themselves getting defensive or reversing under pressure, it is still possible to come back later and repair. Pausing, calming down, and returning to the original concern with ownership is part of recovery too.

The point of naming DARVO here is not to sharpen conflict. It is to reduce confusion, reduce shame, and protect self trust, so that depression does not get extra leverage.

Bibliography

Deny, Attack, and Reverse Victim and Offender (DARVO)
Author: Sarah J. Harsey
URL:https://www.tandfonline.com/doi/full/10.1080/10926771.2020.1774695

The Influence of Deny, Attack, Reverse Victim and Offender (DARVO) and Apologies on Observers’ Judgments in a Sexual Violence Scenario
Authors: Sarah J. Harsey, Jennifer J. Freyd (and co authors, see paper)
URL: https://pubmed.ncbi.nlm.nih.gov/37154429/

DARVO (history and definition, primary source page)
Author: Jennifer J. Freyd
URL: https://www.jjfreyd.com/darvo

Gaslight, APA Dictionary of Psychology (definition supporting memory doubt and perception undermining)
Author: American Psychological Association
URL: https://dictionary.apa.org/gaslight

The role of rumination in depressive disorders and mixed anxiety depressive symptoms
Author: Susan Nolen Hoeksema
URL: https://pubmed.ncbi.nlm.nih.gov/11016119/

Rethinking Rumination
Authors: Susan Nolen Hoeksema, Blair E. Wisco, Sonja Lyubomirsky
URL: https://journals.sagepub.com/doi/10.1111/j.1745-6924.2008.00088.x

Rumination as a Mechanism Linking Stressful Life Events to Symptoms of Depression and Anxiety
Authors: Lauren C. Michl (and co authors, see paper)
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC4116082/

Anxiety and Shame as Risk Factors for Depression and Related Outcomes (discussion of shame concepts and depression links)
Authors: Hannah Weingarden, Tyler Renshaw
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC5026856/

Fear and the Defense Cascade, Clinical Implications for Understanding Trauma Related States (fight flight freeze type responses)
Authors: Kasia Kozlowska (and co authors, see paper)
URL: https://pmc.ncbi.nlm.nih.gov/articles/PMC4495877/

Self Compassion, Theory, Method, Research, and Intervention (evidence base linking self compassion to reduced shame and distress)
Author: Kristin D. Neff
URL: https://self-compassion.org/wp-content/uploads/2023/01/Neff-2023.pdf

 

Acceptance, Anxiety, Avoidance, Choice, Courage, Despair, Helpful, Isolation, Mindfulness, Negativity, Positivity, Stress, Suffering

DBT Grounding Techniques – Part 5 Putting It Into Use

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Part 5: Putting It All Together – Creating Your Grounding Ritual

You’ve now explored Mindfulness, Distress Tolerance, Emotion Regulation, and Interpersonal Effectiveness—each offering powerful tools to help you stay grounded in difficult moments. But real-life challenges don’t always fit neatly into one category. That’s why the final step is about combining these techniques into a structured grounding ritual that you can turn to whenever you need stability.

When emotions overwhelm you, drawing from all four DBT modules can create a powerful and structured grounding ritual. Combining these practices helps you address the physical, emotional, and relational aspects of distress, guiding you toward calmness and control.

By integrating skills from all four DBT modules, you can create a personalized approach to managing distress, regulating emotions, and staying present—even in the toughest moments. Let’s explore how to bring it all together.

Step 1: Pause and Breathe Deeply (Mindfulness)

Start by grounding yourself in the present moment. Mindfulness creates the mental space needed to approach the situation with clarity.

How to Practice:

  • Take a deep breath, inhaling for 4 counts, holding for 4, and exhaling for 6.
  • Visualize your breath as a wave, washing tension out of your body.
  • If your thoughts wander, gently guide them back to your breath without judgment.

Why It Works:
This activates your parasympathetic nervous system, calming your body and quieting your mind so you can think more clearly.

Step 2: Splash Cold Water on Your Face (Distress Tolerance)

Engage your body to interrupt the cycle of emotional overwhelm. TIPP skills are especially useful for regaining control in the moment.

How to Practice:

  • Use cold water, hold an ice cube, or place a cold compress on your forehead or cheeks.
  • Pair this with paced breathing to further calm your system.

Why It Works:
The temperature change triggers your dive reflex, reducing heart rate and calming the body. This brings you back to the present.

Step 3: Challenge the Thought Causing Overwhelmedness (Emotion Regulation)

Once your body feels calmer, examine the thoughts driving your emotional reaction.

How to Practice:

  • Ask yourself: “What triggered this feeling? Is it based on facts or assumptions?”
  • Use the “Check the Facts” technique to reframe exaggerated or unhelpful thoughts.
  • Example: Replace “I can’t handle this” with “I’m feeling overwhelmed, but I can take it one step at a time.”

Why It Works:
Shifting your perspective helps you address emotions logically, reducing their intensity and making them easier to manage.

Step 4: Communicate Using DEAR MAN (Interpersonal Effectiveness)

If another person is involved in the situation, use DEAR MAN to express yourself effectively and maintain the relationship.

How to Practice:

  • Describe the situation: “When you didn’t respond to my message…”
  • Express your feelings: “…I felt hurt and unsure if you were upset with me.”
  • Assert what you need: “I’d appreciate a quick reply, even if it’s just to say you’ll respond later.”
  • Reinforce the benefit: “This way, I’ll know everything’s okay between us.”

Why It Works:
Clear, calm communication reduces misunderstandings and fosters connection, even in emotionally charged moments.

Creating a Flow for Your Grounding Ritual

  1. Pause and Focus (Mindfulness):
    Take 1-2 minutes to ground yourself through breathing or observing your surroundings with the Five-Senses exercise.
  2. Shift Your Physical State (Distress Tolerance):
    Use a temperature-based TIPP skill or self-soothing technique to calm your body. Radical Acceptance of the situation may assist now or at the next stage in this flow.
  3. Examine and Adjust Your Thoughts (Emotion Regulation):
    Check the facts or use opposite action to address unhelpful emotional patterns.
  4. Engage With Others Mindfully (Interpersonal Effectiveness):
    If the situation involves another person, use DEAR MAN or FAST to maintain your boundaries and self-respect while fostering understanding.

Example in Practice:

Scenario: You’re feeling overwhelmed after receiving criticism from a colleague.

  1. Mindfulness: Step outside for a moment, take a deep breath, and focus on the sensation of the air against your skin.
  2. Distress Tolerance: Hold a cold water bottle against your wrists to calm your body.
  3. Emotion Regulation: Ask yourself, “Was their criticism factual, or am I interpreting it as a personal attack?” Reframe the thought: “This feedback is an opportunity to grow, not a judgment of my worth.”
  4. Interpersonal Effectiveness: Use DEAR MAN to address the issue with your colleague:
    • Describe: “When you shared your feedback earlier…”
    • Express: “…I felt caught off guard and a bit overwhelmed.”
    • Assert: “I’d like to understand more so I can improve.”
    • Reinforce: “This will help me meet expectations better in the future.”

Why This Works

By integrating techniques from all four DBT modules, you address the emotional, physical, and relational aspects of distress. This holistic approach helps you regain control, navigate challenges effectively, and build resilience over time.

12 Step Meeting, Anger, Anxiety, Belief, Choice, Depressed Anonymous, Depressed Anonymous Workbook, Fellowship, Grief, Higher Power, Journaling, Negativity, Purpose, The 12 Steps

When you’re depressed all you’re interested in is survival – Dorothy Rowe

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THE ORIGINS of MISTRUST

I want to share with you how Dr. Fitzgibbons, a psychiatrist, provides examples how our lack of trust can originate in early childhood. Patterns of isolating behavior and negative thinking, grow strong in a home environment where the child is not loved and nurtured.

Dr. Fitzgibbons, tells us “that the seedbed of mistrust resides in childhood. Many times this lack of trust, of others and ourselves and the world around us, may have begun with the loss of a parent, sister, brother, or a close friend. A serious illness in a parent, sibling or oneself can be the cause of depression. Many times mistrust comes about because of an alcoholic parent so that a child never knows if a drunken loved one is coming home, or in an angry drunken stupor. Anger and rejection by caregivers and/or peers can also have an effect on the ability to trust. Parental divorce or separation can have an effect on a child. Also a cold distant, and unloving parent can have a negative effect on a child. Add to this, a legacy of mistrust and fear in the family will negatively influence a child. Finally, poverty may also be a cause of mistrust”

Brenda, (not her real name ) shares with us some of her own story:

“I have often reflected on how a lack of trust in myself and in others, had a crippling effect on my early childhood development. It was only until I began examining my own childhood, later in life, that I discovered reasons for my mistrust of others. I accomplished these discoveries by getting in touch with those early negative feelings that constantly bombarded my everyday thinking. Most of these early feelings remained unconscious and hidden, until I started to examine my childhood relationships, especially with those significant others who were my caregivers.”

By utilizing the Depressed Anonymous Workbook with its’ 12 STEP COMMENTARY, and questions, directed toward one’s early life experiences, special attention was centered on those caregivers and significant others in one’s family, who, charged with caregiving, to provide the child with the love that a child deserves. For many children, who grew up in a home environment, filled with anger, parental arguing, and violence, made it impossible for a child to defend themselves against such abuse, including mental, sexual, and physical abuse. Some children create fantasy worlds, some with imaginary friends, with whom they can confide in and feel secure in a home environment where chaos reigns.

In our Depressed Anonymous fellowship, we can begin to open up to group members, giving us that opportunity to share and trust, others, who are like ourselves. We happily discovered that we are now no longer alone. Most of us come to our program of recovery, looking to find help, and that welcome relief from the daily crippling burden of depression, which has forced us to isolate from others, believing that we are not good enough.

Earlier, Dr, Fitzgibbons has listed some of the major causes of our childhood depression, and we can resonate with them within our hearts and minds. And in your moments of personal quiet and reflection, celebrate who you are and not who others say you are.

So get a notebook, and begin to write down your answers to those questions in the DA Workbook, which hold meaning for your own personal life and recovery, to which you can relate. Share your DA Workbook with your therapist, sponsor or friends in Depressed Anonymous at the ZOOM meetings online, and/or face to face meetings.

So now, not only will you be a survivor, you will no longer be a victim of those circumstances, which made you believe that you were worthless, unlovable and unacceptable. Progress, not perfection.

By completing my Fourth Step inventory, it became possible to uncover those areas of my early life which made trusting an impossibility. As mentioned earlier, and later into my early adult life, it was my own spiraling downward, into the darkness of depression, the only thing that I could think of was my survival. I was desperate to stop the descent into the darkness and physical pain. I knew that I must get active, preventing my paralyzing desire to take comfort in sleep and shut out the world.

My life is very different now. I continue to take inventory of my life on a daily basis and I finally believe in myself and the Higher Power that has helped me believe that I have a purpose and a meaning for my life. I also believe in a power that is greater than myself and who continually leads me, everyday, on this wonderful journey of hope! Progress and not perfection.

TRUST IS A FEELING OF BEING SAFE IN RELATIONSHIPS AND IN LIFE.

HUGH S., FOR THE FELLOWSHIP

12 Step Meeting, Anxiety, Despair, Fear, Fellowship, Grief, Pain, Powerlessness, Stress, Suffering, Supportive Actions, The 12 Steps

Proneness to depression

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“It must be repeated again that I consider, injustice, discrimination, material deprivation and painful disappointments as such and as causes of depression and depression-pro ness. What causes depression is the discrepancy between what children–and adults have learned to believe and expect, and the reality they meet. This discrepancy, when uncomprehended, causes chronic lack of self-esteem, or the loss of self-esteem that, writes Birling, has been associated with severe depression. Men and women can bear a remarkable amount of misfortune and grief, as long as they need not see them as a result and proof of their own inferiority.”

Excerpt from Emmy Gut, Productive and Unproductive Depression. Harper, SanFransisco. 1990. p.195. as quoted in THE ANTIDEPRESSANT TABLET (1991) SUMMER VOLUME 2:4. p.3

Anger, Anxiety, Depressed Anonymous Workbook, Honesty, Hope, Positivity, Supportive Actions

How do I deal with anger in my life?

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DECISION 8: I WILL BE MORE ACCEPTING OF ANOTHER’S ANGER AND NOT ALWAYS TAKE IT PERSONALLY.

When you are both the focus and the cause of the person’s anger, you will need to find responses other than cutting yourself off from the person, by doing that, sharply reinforces your barrier of loneliness.

D.Rowe tells us that we find the cause of the anger and discuss the matter. For whatever reason for the anger, it might be best to write a letter the person. Or, Possibly, a friendly visit between the two of you will help solve the problem.

Making an apology when we see ourselves trapped, weak, worthless and hopeless, by making an apology to the person who caused the anger, seems frightening and humiliating.

Making amends, an apology to those we have injured us, seems gracious and creative, allowing a relationship to be strengthened and resumed.

In some families, there was no teasing, absolutely not. Maybe outside the family it might be allowed. Everything in the family was 100% serious. If a family member was teased, then this could result in a sulk and long term silence.

But in school, children might be teased, but never knowing how to tease back. We want to distinguish between friendly and malicious teasing. We could put bullying at the top of the list as one of the most harmful ways of malicious teasing. When I make an effort to get along with other people, distinguishing between friendly or imaginary teasing, this makes our relationship stronger, the other builds barriers.

TOMORROW DECISION 9: I WILL IMPROVE MY SKILL IN DISTINGUISHING BETWEEN REAL AND IMAGINARY ENEMIES.

12 Step Meeting, Act As If, Anxiety, Avoidance, Depressed Anonymous, Depressed Anonymous Workbook, Fear, Isolation, Mutual Aid, Purpose, Step 01, Step 02, Step 03

LEAVING LONELINESS BEHIND – DISMANTLING THE BARRIERS

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Leaving loneliness behind. Dismantling the barriers.

THE TWELVE DECISIONS
What is loneliness?

“Loneliness is the state of being cut off from other people, through fear of other people. Loneliness is felt as a barrier and an emptiness between yourself and other people. You reach out to other people but the barrier intervenes. You take a step toward other people, but there is no place to put your foot. People come towards you and your loneliness shuts them out.”

“It is your loneliness rather than the absence of other people that leads you to be alone.” Dorothy Rowe. Ph.D
The only person that is going to take your loneliness away is you. This is what you do. You make 12 decisions and carry them out.

DECISION 1. BECAUSE I VALUE MYSELF AND ACCEPT MYSELF I WILL END MY LONELINESS.
In our planned conversation about how to leave our loneliness behind, I have noticed my own presence, as at a Depressed Anonymous meeting, whether on ZOOM or Face to face, each of us is provided a way to risk telling others who we are and what we are not. This presence gradually instills in our mind the fact that “Hey, I feel more with others when I can share.” I no longer feel so alone now. After our sharing at a DA meeting, others in the group connect with who we are.This personal sharing tells others how we intend to live out our lives. We share how our lives were before coming to the meeting of others like ourselves.

I believe this personal sharing and risking things about ourselves, will carry out beyond this one hour of meeting, having a gradual and positive effect in our world where we live out our lives. Now, you are able to maximize a good experience (group sharing) being being accepted and loved. This online group or a face to face group, is like a surrogate family. Whereas, when you were born into a family–not of your own choosing, you make a decision to choose this DA group as your family. I make a choice as to who I share my life. By making the decision, you will begin to value yourself as a worthwhile person. At the meeting, people really listen to what I have to say.

It helps to get close to others by helping them tell us who they are. We will hear their stories. And to get closer to others, you can do this by asking questions, asking how they are, what they are interested in, and other areas of their lives. They will begin to let you into their private world. You will let them into your world. A barrier has been dismantled.

This sharing at our DA meetings, a place of feeling safe,I can allow myself to chip away the barriers that once made me feel alone and afraid. THe old thoughts that we once felt we had to defend ourselves against, by erecting walls, built during our childhood days, will no longer be needed.

It is this first decision that we make, to value and accept ourseves and risk sharing my story with others. This will be the start, for breaking down those barriers which kept me from telling others who I am.

Tomorrow, we will Share Decison 2: “I will take the risk of approaching others.” Stay tuned.

Hugh S.

NOTE: Quotations are from Dorothy Rowe’s “Breaking the bonds. Understanding Depression, finding freedom. Fontana, 1991. London, UK.

Anxiety, Focus, Purpose

Slow is smooth, smooth is fast

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Slow is smooth, smooth is fast.
– Navy Seal credo

If I am in a frantic state, I will make many mistakes. Then I need to do things over again and that takes even more time.

If I do things slowly and follow a process I am far less likely to make mistakes. I need to do things right the first time. The best way that I know to do that is to follow a process. I can have processes about many things: how I shave, how I iron a shirt, how I troubleshoot a problem in my professional IT career, how I approach my recovery from depression and anxiety.

Sometimes in a highly excited anxious state it seems incredibly hard to slow down and calm my mind. I sometimes see my issues with anxiety as a block of wood with really rough edges. I may not be able to have a smooth block of wood immediately. I can however start the process of sanding down the roughest edges of my anxiety. My anxiety may be so intense that I can’t go from frantic to calm and serene. But perhaps it is possible to lessen my anxiety by 1%. I will be in a better place of mind. I want to be serene and calm, but in this moment I may only be able to achieve a 1% reduction.

Progress not perfection.
– 12 step recovery slogan

Another benefit of having a process is that you will develop muscle memory about the process. When in the thick of a fight, or deep in anxiety, it may not be able to think clearly. Wouldn’t it be great to have muscle memory about a process that you can follow?

It is better to sweat in training, than to bleed in war.
– Wisdom sometimes heard in military training

This week at work there were some major problems. Systems critical to the business were not functioning preventing action on revenue generating jobs. There was immense pressure to get those systems back online and functioning again NOW. As I felt the anxiety in me rise I would repeat the mantra several times and my anxiety would lessen a little bit. I had a process and it helped.

Slow is smooth, smooth is fast.

Yours in recovery, Bill R

12 Step Meeting, Acceptance, Addiction, Affirmations, Anxiety, Attachment, Compulsion, DA Literature, Fellowship, Grief, Hope, Purpose, The 12 Steps

The Circle Dance

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If you have ever been depressed or are depressed at this moment, you are familiar with the Circle Dance.

I know the dance steps well, and in fact, I could share with you some of the basic steps, illustrating familiar dance steps.

First of all, let me say that you already know those steps that automatically get you to perform the “Circle Dance. You get caught up emotionally, the moment certain negative thoughts come bouncing across the dance floor into your mind. You know them as that painful hollowness in your gut, a desire to quit the dance and lay down, or to bash yourself with thoughts of how bad you feel.

Sometimes, starting with those life events from childhood, when your caregivers, be they parents or guardians, made you feel worthless and unwanted. These thoughts and feelings are constantly triggered by those with whom you share this life. You avoid people, think of yourself as unlovable –and the dance goes on and on in your head.

The Feelings of hopelessness produces unpleasant feelings. The feelings produce an unpleasant mood and the dance begins. The mood speeds up the dance and whisks you away into that painful circle with its attendant anxieties, sucking you down into the mental quicksand, swallowing you with all the terror and fright of losing all hope, much less your future. The Circle Dance will take you, everyday and in every way, to where you know you don’t want to go.

This dance is familiar. It is like the helpless insect caught in the web of the spider. The why of this hellish addiction to sadness, is never fully addressed with any solutions or answers. We want to know how to stop it. How to control it. We ask ourselves, how is it that I am depressed? How did I get into this terrifying circle, this loop which keeps me locked in a mood of hopelessness and despair. Where did all this sadness, anxiety originate? Will I ever find a way out? Is the dance, on automatic pilot, going to destroy me? Am I, a victim, without a source of help? Is this the way life is for me to be–forever filled with misery?
So much of the time I feel like I am on a train, heading toward a precipice, with no way of stopping it or escaping disaster?

Through all this, pain and confusion, you become an expert dancer, in fact, you know of others who like you, are expert dancers — trapped in dancing within their own Circle Dance.

The dance, it is so familiar. It is a defense, a comfort. We gradually learn to use it to protect us from the pain, without ever having a clue as to how it took over my life.

“A famous psychiatrist, a Dr. Freud, once theorized “that the reason a person continues to do the Circular Dance within themselves, is an effort to touch an unpleasant early life behavior or that long since forgotten event, buried in one’s unconscious. The Circular Dance promotes our addictive nature and the compulsion to repeat, is an effort by our mind to remember what it was that is the cause of our present cycle of misery, spinning us around and around – looking for answers as to what we do and why we do what we do and feel the way that we do, but never able to unlock the prison of our sadness.”

The Depressed Anonymous 12 step fellowship provides us with a possible solution to this question of no longer allowing the Circular Dance to determine the our life’s direction.

It is my belief, after participating in Hundreds of Depressed Anonymous meetings, over three decades or more, that the compulsion to repeat these sslf-destructive thoughts and images, may be linked to early childhood periods, accompanied with their painful, traumatic events. It is in those early days, that our Circular Dance took root and began to keep us locked down in its circular loop.

It is here, in the 12 Step Fellowship of Depressed Anonymous, that those unpleasant feelings, resultant from physical. emotional and mental abuse by significant others (parents and/or guardians, others) can be shared, voiced and talked about safely, and confidentially in the light of the accepting fellowship that we experience in all of our mutual help meetings.

It is possible that with time, patience and work, that these early feelings of hurt and feeling worthless, to name just a few, can be identified and shown how they have affected us negatively in the way we feel about ourselves today. With the help and work of the group, we are able to locate and make conscious those early life experiences that have been pushed aside. Because the feelings were too powerful and painful to examine and so they were buried in our unconscious. Basically, we can say, that there is no longer a need for that compulsive and addictive Circular Dance that our mind had used to punish us with guilt and shame. We now have the freedom to live life, recover from the wounds of the past, and live life today with hope and purpose. That is my wish for you this day.. And for myself.

No one puts me down, for saying that I am depressed. We never hear a “Snap nap out of it” at our meetings. If we could “snap out of it” there would be no need for our meetings. With work, time and the fellowship we no longer need a dance that goes nowhere but down. Now we are spiraling upward. We thrive!

Hugh S., for the Fellowship

Copyright(c) Hugh Smith (1986, 2013) 2nd Edition. I’ll do it when I feel better. Depressed Anonymous Publications. Louisville, KY.
Pages 64-65.