The Problem With Giving This Advice to Someone Who Takes 'Depression Naps'

A few days ago, HuffPost published an article titled “What’s The Deal With Depression Naps?: They may seem good for you, but they’re far
from it.” It describes the phenomenon known as a “depression nap,” which is defined as “a period of time where someone takes a lengthy snooze in order to shy away from unwanted emotions or symptoms associated with their depression.”

It goes on to detail why “depression naps” may be an unhealthy coping
mechanism or at the very least, an indication that someone is going through something that may require professional intervention to be resolve.

While I agree that sleep is absolutely an essential part of our lives and, as such, can be an excellent barometer to sense deeper physical, emotional and mental issues when there are significant changes in our sleep patterns or quality of sleep, I take issue with what is suggested instead of napping. Adiane Soehner, an assistant professor of psychiatry at the University of Pittsburgh, is quoted in the article as suggesting that individuals “play a fun game, go for a short walk, or step out in the sun” in place of a “depression nap.” Michelle Drerup, director of behavioral sleep medicine at the Cleveland Clinic, recommends “finding a support group, exercising, watching things that make you feel good, spending time with a pet or expressing yourself through art, music, or writing.” While these are excellent recommendations for how to spend one’s time and cultivate self-care, I think we’re missing the point (as we often do when it comes to treating depression): If a person is depressed to the point that they would rather sleep than live their life, they are probably not going to have the will or motivation to do anything else – no matter how excellent those ideas may be for their overall wellbeing.

This happens all the time. For example, I wrote about how I went to the doctor for extreme and debilitating fatigue and was given the prescription to exercise more and lose weight. While I take issue with weight loss as the only solution to any health concern, what’s more reprehensible is that I was prescribed to expend more energy as a solution to having no energy to begin with. Now I’m not great at math, but if you’re already at zero, how will going into the negative propel you into the positive? I went to a health professional because I had so little energy it was making it impossible to keep up with my daily life and yet the solution was to add more tasks into my schedule? I don’t think so.

Another example: Google “solutions for depression” and list after list of “lifestyle modifications” and “at-home remedies” will tell you repeatedly to “exercise, eat right, and get enough sleep.” Not to be rude, but how is that helpful to someone in the throes of depression? If you’ve ever experienced depression, you know what I’m talking about. The issue isn’t that exercise, nourishing foods, and healthy sleep patterns aren’t helpful – they absolutely are – the issue is that is not always realistic for someone who’s likely so ambivalent about life they can’t get out of bed to feed themselves, much less exercise; or for someone who is so miserable that life doesn’t even seem worth living anymore. In these situations, you can tell someone to “take care of themselves” until you’re blue in the face, but if they’re not already doing it, then you’re not really addressing the underlying issue of “why?”

It makes me think of the dentist. Everyone is told to floss their teeth, and the majority of us are berated for not flossing our teeth twice a day every day each time we go to the dentist, but does that stern talking to make us more likely to floss our teeth? Probably not. Telling people what to do just because it’s good for them doesn’t really make them anymore likely to do it and certainly doesn’t address the underlying reason for why they aren’t doing it already. As humans, we’re inherently rational beings. If I knew that eating “right,” exercising, and sleeping well would solve my depression, wouldn’t I be doing it already? But it’s not really that simple, is it?

You see, depression cannot boiled down to a list of things someone isn’t doing. If it were that simple, it’d be an easy fix. Depression is a collision life circumstances, history of trauma, social status, oppression, lack of access to resources, and individualized contributing factors that are not unanimous across the board. There is no one cause of depression, and there is no one universal solution. Depression is as unique as each individual, and boiling it down to a list of “dos” and “don’ts” is a gross minimization of a complicated and life-altering disease.

When we minimize depression in this way, we cause it to lose credibility as a legitimate medical concern. As I explained in my article on constant suicidal ideation, illnesses that cannot be easily identified by changes in physiological markers are generally not taken as seriously as illness that can be quantified by their effect on the body. Since depression is an invisible illness, people with it are already at a disadvantage for getting effective treatment; but reducing depression down to a list of choices that a person is either making or not making only adds to the stigmatization of the illness and presents additional barriers to treatment.

After all, if I’m in the depths of depression and read that I should “just” eat right, exercise and find a support group, that’s just three more things I am failing at – that are my fault. In the sick way that depression twists thoughts around, I can only conclude that the depression is a result of me not doing something right. Those thoughts will only bury me in shame and hold me back from asking for help. So while “playing a fun game, stepping out in the sun, and expressing yourself through art, music, or writing” may seem like small, simple acts to a neuro-normative person not dealing with the symptoms of depression – they may be monumental, if not impossible, requests of a person with depression (Furthermore, it makes an assumption about the social class of an individual, the discretionary income they have and the free time afforded to them – but that’s a whole other article.)

So where does this leave us? The truth is, I don’t have a good answer to that. I can’t write a bulleted list on how to “solve” depression. I know those lists are meant to be helpful – to present a variety of “action items” — but they tend to come across as shaming and delegitimizing. Instead of listing what a person should be doing to deal with their illness, here’s a list of what we, as a community, need to do instead:

1. We need to stop telling people with depression what they should be doing and start taking action ourselves. If your friend is eating drive-thru for every meal because they don’t have the energy to cook, don’t tell them how “unhealthy” it is – try taking them a meal and eating with them instead.

2. We need to meet people where they are at. If that’s sleeping 18 hours a day, then let’s meet them at the side of their bed and offer them fresh water or a warm bath.

3. We need to stop pretending we know what the solution to depression is (whether that’s food, exercise, medication, sleep, sunshine, community, therapy, spirituality, meditation, art, music, etc.) and start treating the individual as the expert of their own situation. Trust them when they say what is or isn’t helpful to them. Only the individual can determine what unique combination of treatment methods is helpful to them – and that may change overtime. Just because it worked once, doesn’t mean it’ll work forever and we have to be OK with the reality that recovery from depression is rarely linear.

4. We have to stop simplifying and stigmatizing depression. We don’t do anyone any favors by reducing depression down to a series of personal choices. Choices only happen within context, and in some contexts, suggesting “healthful” choices may actually be harmful – if not directly, then because of the shame associated with not making the “healthy” choice. There is always a reason why someone makes the choices they do and berating them won’t get to the root of the problem.

If we started doing these four things, the world of mental health treatment would improve immensely. I’m not saying depression would be gone, but I am saying those with depression would be more likely to get the help, support and compassion they need to fight back at an illness that ruins and takes lives every single day. While all the techniques that Adiane Soehner and Michelle Drerup suggested are excellent ways to take care of oneself – that’s all they are. They will not solve “depression naps” because they aren’t treating the underlying depression.

It’s hard enough to practice good self-care in the best of mental states, and when depression makes you feel like you’re wearing a lead suit, the last thing you want to do is “eat right and exercise.”

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