Rose was a depressed patient in my previous outpatient clinic in a famous hospital. At that time she was in her twenties, with a goose egg face, arched eyebrows and a few fashionable features, and was often accompanied by her husband to her appointments. She smiled shyly every time she picked up her medication. Gradually I also remembered her smile. Then I ended up working in that hospital as an outpatient. She surprisingly inquired about the hospital I was at and followed me to my outpatient clinic.
The most immediate annoyance was my mother’s nagging
There weren’t as many outpatients as there are now, so I had more time for her. The problems she later talked about were no longer symptoms of depression, but about her family, which made me think that her depression was no longer so simple.
Chance’s parents divorced when she was in middle school. The reason for the divorce was that the father was having an affair. The mother was unrelenting and made a lot of noise, and finally the divorce was finalized. Since then, her mother has been endlessly counting her father’s faults in front of her. At first she was sympathetic to her mother, but gradually she felt that her mother’s complaints were a kind of torture. Whenever she heard the scolding of “what about your father”, she almost went crazy. She wanted to leave home, but her father came back from overseas to visit. Her father said to her, child, with your character, you should really go out and make a go of it. With her father’s encouragement and support, Qiang Wei, who was still in high school, went out into the world on her own.
Her father’s judgment was correct, and Qiangwei did make a good living out there. She started a company with her friends, did sales, and earned a lot of money. But she is not as happy as she would like to be in terms of marriage: she and her first boyfriend have been talking for several years, and they have come to the point of marriage, but they could not agree on the issue of treats, and they broke up. Now the husband is the second boyfriend, the two began to be as good as glue, after the wedding but Qiangwei regrets, how to see the man is not man enough. But the other side refused to divorce no matter what. In the midst of the argument, Rose was depressed.
Previously, I was not her first doctor, but she was prescribed medication when she happened to arrive at my clinic. After taking the medication, the depressive symptoms gradually improved, but left behind a problem that was difficult to talk about: sexual apathy.
Because her mood had returned to a normal level, the symptoms that accompany depression, such as loss of appetite, loss of libido, and sleep disturbances, should have improved. I once suspected that it was physiological, and for this reason, suggested that she eat a lot of pigeon meat from the perspective of dietary therapy. Of course, it did not help much. However, this problem did not seem to be urgent for her. Her main concern was whether she could avoid a relapse of depression in the future. She was very resistant to this daily medication thing, so after stopping it, she started psychotherapy with me.
Currently, the exact cause of the onset of depression is unclear and is related to a variety of factors such as genetics, family environment, parenting style, childhood experiences, stress, personality, and interpersonal relationships. At least three of Rose’s close relatives have a psychiatric disorder, i.e., a positive family history. In addition, poor family relationships since childhood are influential factors in the onset or exacerbation of depression. Therefore, she was very concerned about the recurrence of depression. Of course, for her, the most immediate worry was her mother’s nagging.
Originally, her mother was in her old home and felt lonely and isolated, so she defected to her and lived with her. But her mother was almost a troublemaker, always finding life unsatisfactory: at first, she suspected the nanny of stealing things from the house, quarreled with the nanny for this reason, and drove several nannies away or got angry; later, she went over old scores and talked about all the faults of her ex-husband. At this point in time, Rose had grown up and was able to understand her father from an adult’s point of view. She felt that even if her father did not want to betray her mother, he would not be happy with such a woman for a long time.
So, she would defend her father every time. In this way, the mother’s nagging eventually turned into a war between the two. After each fight, she would be in a bad mood for several days in a row. Thus, her relationship with her mother became the subject of psychological counseling and therapy during that time.
”Non-violent non-cooperation” is an effective way to cope
My advice to her at that time was to adopt a “nonviolent noncooperation” attitude toward her mother’s nagging. If her mother started an unpleasant topic and Rose confronted her mother out of rebuttal, there would inevitably be conflict. But the conflict is the mother’s need, not Rose’s. And Rose’s confrontation, precisely “with” the mother, so the conflict will be maintained.
This is a kind of cooperation to “violence”, that is, “violence to violence”. There is no winner in such a conflict with a loved one. If the mother’s nagging is ignored and ignored, the conflict will not arise because “a slap on the wrist does not make a sound. Of course, this is a very ideal state. At first, she was able to put up with it for a while, but eventually she couldn’t help it and got into a heated argument with her mother.
I discussed with her some ways to cope. First, there needed to be some reasonable explanations for her mother’s behavior, such as the fact that both her father and brother suffered from mental illness, and that her mother might biologically have certain personality traits similar to mental illness; in addition, her mother had been widowed for many years and had lost her marriage and love in the prime of her life, and this lack of life could make her resentful.
With these realizations, Rose’s attitude toward her mother in terms of perception has changed greatly. Instead of treating her mother with confrontation, she has more sympathy and understanding, and partially accepts her mother’s behavior. But her mother’s complaints were ultimately an unpleasant irritant, and her attitude changed dramatically. Instead of confrontation, the mother was treated with more sympathy and understanding, and her behavior was partially accepted.
But her mother’s complaints were ultimately an unpleasant irritant, so whenever she opened her mouth, Rose would turn around and walk to another room, or immediately interrupt, or simply pretend that the mosquitoes were barking in her ears, and do what she had to do. With these responses, slowly her mother’s nagging could no longer affect her mood. Chance also slowly developed some methods, such as regularly asking her mother to visit relatives, or go back home, or travel, and even once asked someone to introduce a partner to her mother.
Although so whenever her mother opened her mouth, Rose would turn around and walk to another room, or immediately interrupt, or simply as mosquitoes in the ears, they should do what they do. With these responses, slowly her mother’s nagging could no longer affect her mood. Rose also slowly developed some methods, such as regularly asking her mother to visit relatives, or go back home, or travel, and even once asked someone to introduce her mother to a partner.
Although the other person broke up after only three months of living together because she could not stand her mother’s temper, after some time, Rose told me that she is now immune to her mother’s nagging.
Emotionally beneficial activities should not be underestimated
But then something happened that made Rose fall into depression again: a puppy she had for years died. The dog had been with Rosemary all her life, and her sudden death broke her heart. She was depressed for a while, crying a lot and having trouble sleeping at night. But Rose did not want to take medicine again. During that time, she did not seek me out, but remembered the advice I had given her before: as long as the depression was not too severe, she should not simply rest at home, but encourage herself to do something she likes and can stick to, such as exercise, or do a job, and encourage herself to participate in human interaction.
The tenacious Rose found a way to do this. At that time it was popular to put diamonds on cell phone cases, so Rose bought materials from the Internet, put diamonds on cell phone cases during the day, and went to lively places like Houhai at night to peddle them. Her sales target was some lovers. At that time she was not short of money, so that is to give herself something to do, rather than let herself drown in a bad mood.
She soon found it to be a particularly interesting thing to do. She got a lot of positive comments from buyers, saw the joy of her lovers when they bought her work, and witnessed the beauty of love. And, of course, gained a good income. After a while, she finally came out of her emotional slump.
When she recounted these experiences to me, I felt very relieved and touched. I have spoken to quite a few depressed patients about similar advice that may seem banal, but if done, it can really make a difference or even a miracle. Unfortunately, many patients don’t even try, allowing their depression to overwhelm them. Some patients insist on doing it, including exercise and many other emotionally beneficial activities, and although it is only an adjunct to treatment, the effect cannot be underestimated.
A few patients who insisted on exercising gave me feedback that after a period of time, they not only had better moods and fell asleep faster, but they were also healthier. After Rose did this, her confidence in recovery was greatly improved. Her experience reminded me of the saying that the best management is self-management and the best treatment is self-healing.
Rose’s fortune has been good since then, and has opened several stores, all of which have brought in a good income. A year later, she excitedly told me that she was going to be a mother! While I sincerely congratulated her, I thought that postpartum depression might be a test for her. The incidence of postpartum depression is already high, and the risk of relapse is even higher if there is a previous history of depression. Happily, Rose got through the postpartum period without any problems.
Later, Rose had several more counseling sessions and her depression did not recur.
Sometimes depression can be solved by medication alone, which is like a medical disease at this point, while others require systematic psychotherapy to eliminate some triggering or aggravating factors. In this case, doctors need to help patients to eliminate the blocks in their hearts, but also need to mobilize their own energy to complete self-help. But no matter what, depression appears, positive face is the most important!