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Tuesday 13 March 2012

Hidden Symptoms of Depression: The Inability to Monitor

This is part of a series of posts on some of the less-talked-about symptoms that tend to go along with depressed mood. As stated in earlier posts, however, it’s important to note that each of these “hidden symptoms” can also occur at other times in our lives. Don’t fret if you see yourself in these experiences.
What are they talking about?

Depression’s Social Impact

Depression generally affects people’s social motivations. Rather than wanting to see their friends, they may want to be alone. So the temptation is to isolate. That would be fine, except that isolation makes depression worse. A snowball effect is born: depression makes me want to isolate, isolation makes me more depressed.

As is so often the case in depression, the key is to move in the opposite direction to the temptation. I often work with people on welcoming and permitting the temptation to isolate, but not allowing it to take charge of behaviour; instead, it can be used as the cue to ramp up social contact (yet another example of the principle of opposite action).

But if people can swim against the current and get themselves into social settings, another problem often becomes apparent …

“I can’t hear what they’re saying.”

You go out with friends, and several conversations are going on at once. Normally this isn’t a serious problem. You can screen out most of the talk, and pay attention to the one conversation in which you are engaged. You’ve been doing this all your life: in pubs, at restaurants, at parties, and over the sound of the ads before movies.

It is as though someone in your brain turns up the volume of the conversation you want to hear, and turns down the volume on all the others. In fact, the people who mix sound for movies routinely create precisely this effect when the action takes place in a crowded space. The actor you’re following goes into the party, which sounds loud and confusing, then starts a conversation with someone – and the other sounds fade into the background.

But when you are depressed, you will probably notice that this act of monitoring, or screening out extraneous conversation, is significantly more difficult. You try to pay attention to the person you are speaking with, but the volume on all the other conversations doesn’t change. They continue to intrude on what you’re saying. “I can’t hear myself think!”

When you’re depressed it’s hard enough to carry on a conversation. Your concentration is poor, you’re distracted by powerful emotion, and you secretly believe that no one would be interested in anything you say anyway. Add a bunch of ambient noise that you can’t screen out, and you can lose track of the discussion altogether.

The resulting temptation is to give up. “What’s the point of going out? I can’t carry on a conversation anyway, and I feel like an idiot. I don’t understand what people are saying to me when there are a lot of distractions, and I just lapse into silence.”

So what do you do?

Retreating back into solitude is a lousy idea, but going to your usual haunts may seem futile. The best thing to do is to push social contact, but to pick your settings. Here are some tips:

Control your environment. Maybe you’re used to chatting with people while the television or radio are on. When you’re depressed, make a point of reducing these distractions so that you can pay closer attention to the conversation. Choose instrumental music rather than songs with lyrics, because the words will pull at your attention.

Meet outdoors. The main problem is extraneous conversation. The noise of traffic, wind, or waves isn’t nearly as distracting. Walking outdoors gives you some exercise, allows you to communicate without staring into the other person’s face (which can be distracting or difficult), and takes you away from other people’s conversations.

Go to quieter restaurants. Your usual favourite restaurants or other meeting places have a certain noise level – a level that may not normally be a problem. When you’re depressed, however, those places may be too loud or distracting. Try to socialize about as much as you formerly did, but choose places where you can think. Go for restaurants with a lot of fabric, with narrower tables (so you can hear the other person more clearly), or with separate booths.

Steer out of the crowd. If you are at an event like a party, look for the quieter spaces where there are fewer people. Gently and casually lead the people you talk to away from the crowd, and face the periphery rather than the centre of the group.

Lighten up in silence. If you go to loud places, recognize that you may have some difficulty. Let yourself be quiet and don’t pressure yourself to leap into the discussion as much as you might ordinarily do. Avoid criticizing yourself for not being more social.

Will I ever get it back?

Yes. As depression lifts, the ability to selectively attend to conversations returns. Often this ability seems to lag behind a bit, but it comes back eventually.

Next up: Anticipatory Flatness.

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