What to do if you're so depressed you cant get out of bed

Depression manifests in various forms and affects individuals differently. Many people with depression experience a loss of interest in previously fun or exciting activities, they feel a sense of hopelessness about the future, and often a sense of guilt or self hatred. What some people don’t realize about depression is that in its more advanced forms, depression can start to affect biological functioning, leading to insomnia, eating difficulties, severe fatigue, or an inability to get out of bed. Experiencing such a severe depressive episode can make you feel trapped and angry with yourself. When depression is really bad, just “snapping out of it” isn’t really an option, and gentler, compassionate approaches are necessary.

Acceptance

If you can't just will yourself out of your state of being, you need to find a way to work with the resistance that is present for you. While it may seem counterintuitive, it can be helpful when you are feeling really depressed to face the fact that yes, you are very depressed, and today may be a day where getting out of bed does not really feel like an option. Instead of beating yourself up about it, or wishing that it wasn’t the way that it is, try telling yourself “today I’m so depressed I can’t get out of bed” with acceptance and compassion.

It is not a pleasant place to be, for sure, but often in depression we experience the primary pain of the depression itself, which is the fatigue, inability to motivate, and hopelessness, but then we often add on top of the primary pain a secondary layer of pain and hurt which is the judgements and self blame about how we are feeling. The self imposed blame and judgements we heap onto our depression are not helpful or compassionate responses, and they don’t actually help you motivate. Start by accepting your current situation and circumstances, breathe into the space where you are right now, and then we can move on to the next steps and work on facing the day.

While compassion and self acceptance are key, you want to balance acceptance with encouragement and genuine attempts at self care. Don’t sacrifice self compassion for motivation, in other words, if you can’t motivate yourself with kindness, then go back to step one and work on acceptance some more. If, however, you are able to maintain self compassion, acceptance, and kindness, you may find that there are gentle and effective ways to move yourself forward. While self-compassion is crucial, it's equally important to gently push yourself towards activities that uplift you.

Breaking it down into small steps

When you are ready to face the day and move forward with compassion and acceptance, the next step is to break down the overwhelming tasks of the day into small, manageable steps. If you think about your whole day and all the things you have to do, you may feel overwhelmed and you might retreat back under the covers. However, if you can break your to-do list into very small manageable steps, you might find that you can motivate yourself one step at a time.

A morning to do list for a severely depressed person might look like this:

1) Remove the covers

2) Transition from lying down in your bed to sitting up

3) Stand up out of your bed

4) Walk to the bathroom

5) Wash your face

6) Brush your teeth

Or something like that. These may seem like small and simple steps, but when you are struggling with severe depression, your brain and body might only be able to handle one of these steps at a time, and you may need to take a break in between each step.

Prioritize resourcing activities

No one really knows for sure if depression is primarily a chemical imbalance or a behavioral pattern. What we know for sure is that depression has multiple factors that influence its prognosis and that there are some activities that are known to reduce depressive symptoms. If you can prioritize activities in your day that expose you to sunlight, socialization, increased heart rate, and cleanliness, your depression will most likely feel a bit more manageable than if you spend your day isolated, using drugs or alcohol to cope, and sedentary. This is NOT to say that depression is your fault as a result of the choices you are making in your life, there is for sure a genetic and chemical component, however you DO have some influence over the choices you make and those choices do affect your levels of depression. Existing in this paradox between self acceptance and forward momentum is key to managing severe depressive episodes.

Here are some activities you could prioritize today that will support your relief from depression:

1) Exercise - Even just a walk around the block, or 5 push ups

2) Spending some time outside - can easily be combined with exercise for a great one-two punch of depression relief

3) Healthy eating - Fresh fruits, vegetables, meats, grains

4) Staying hydrated

5) Sobriety

6) Socializing

7) Meditation - even just 5 minutes

8) Yoga

9) Reading, listening to podcasts

10) Cleaning

And on the contrary, here are some activities that are known to increase depression:

1) Using drugs and alcohol

2) Isolation

3) Being sedentary

4) Excessive use of technology

5) Sugar, highly processed foods

6) Pornography

7) Negative self talk - watch out for engaging with media or online communities that encourage negativity and self hatred

Think long term

Once you have gotten through the day with acceptance, broken down tasks into manageable chunks, and engaged in a few supportive activities in your day, you need to start thinking about the long term of how you are going to support yourself through your depression. If you are so depressed that you can’t get out of bed, then there is something seriously wrong in your life that needs addressing. You can work towards alleviating your depression, but if you don’t examine and address the underlying causes and conditions that are leading to your depression, then you will stay stuck. Maybe you had a traumatic childhood you haven’t dealt with that is manifesting as depression, maybe you are living in an unsupportive living environment which makes you feel depressed, maybe you’re unhappy in your relationships or your job or your life as a whole. Understanding and addressing these causes and conditions in your life that are leading to your depression is invaluable as you navigate life with depression. You might be able to conquer a single day with the tools laid out above, but you need a fundamental and substantial shift in order to win the war.

Some bigger picture shifts that may be necessary in order to shift your relationship with your life include:

1) Psychotherapy (talk therapy)

2) Psychiatric support (medication evaluation)

3) Changing living environments

4) Changing jobs

5) Changing friend groups or relationships

6) Quitting drugs, alcohol, pornography, or other negative habits in your life

7) Starting a regular exercise routine

8) Improving your diet

Overall, the bigger changes in your life are best done with the support of a compassionate psychotherapist. If your depression is bad enough, your therapist may refer you to a psychiatrist to assess if medication would be supportive as well. Your therapist should be able to help you understand your situation in more depth and gain insight into what is happening in your depression from new perspectives that you can’t see when you are inside of the experience. If you’ve been let down by therapists in the past then maybe it's time to try a different therapist, a different treatment modality, or it's time to add medication into the mix. Studies show a combination of therapy and medication to be the most effective treatment for depression.

In Conclusion

Whether you are battling the day to day struggle of getting out of bed, or assessing the big picture of navigating life with depression, there are tools and approaches and resources out there to help you in your struggle. If you’re looking for a therapist who can support you, I offer depression therapy in Santa Cruz and online for anyone in California. Reach out today to schedule a free phone consultation.