** Is there anything more difficult than getting things done when you are depressed? ***

#1 I made a decision to treat bipolar disorder first - above all other areas in my life. This helped me reduce my mood swings by at least half their intensity so that I could focus on my life once again instead of focusing on the illness 24 hours a day. This means that I don't focus on my relationships, work, weight issues, creativity or anything until I make sure that bipolar disorder is under control. I have learned that trying to deal with certain issues is pointless if bipolar disorder is undermining everything that I do.

#2 I became very aware of what triggers my depression and I now try to avoid these triggers. When I first started treating my own bipolar disorder in 1999, I noticed that all of my serious depressive episodes were triggered by outside events. I decided that if I could stop these triggers I could stop the episodes. This has been a huge tool for staying well. Unfortunately avoiding triggers is not always possible. A breakup of a relationship, a move to another country, war or problem people and situations are not always in my control. But by at least knowing that these events will be triggers, I have learned that I'm definitely able to get help for myself at the first signs of a down swing so that the episode does not go into a suicidal depression.

#3 Finally, I taught myself to work even when I was sick. (This is the focus of this newsletter.) It is a fact that I have bipolar disorder. It is a fact that for me the illness is totally exacerbated by outside events. This means that if I want to live life in the real world I'm probably going to be sick off and on - and I am. I know my EXACT symptoms of depression. So I at least know that when I'm in a depressive fog not getting things done is totally normal.

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There are a few reasons why it is hard to get things done when you are depressed.

*** It is a totally normal symptom of depression.

*** Your *getting things done muscles* get weak when you are sick and can get very weak if you have been sick a long time. The sad thing is that getting things done is what makes us better, but being sick seems to make it impossible to get things done. The secret is to learn to do things even when you don't feel well

*** When we are sick, we forget who is actually in charge of our lives. It's so easy to let bipolar disorder take over and tell us what to do. I want people to remember that they are in charge of their lives, not bipolar disorder.

*** Most people do not know the first signs of a down swing. Not getting things done is actually a bit down the line when it comes to depression symptoms. The first signs are usually a feeling that something is wrong or that there is no point to life. If you can recognize and treat the depression from these early symptoms you may be able to prevent it from reaching the *I can't get anything done stage.* This really does sound good on paper, and for the most part I can do this, but I am also aware that for many of us, depression is so sneaky it usually does get past the first stages which is why you have to have ideas ready to move yourself into action once you are depressed.

*** Our bipolar brains constantly tell us to negotiate and examine everything that we do. This is one of the reasons we can't get things done when we are sick. This constant tug of war takes away all of our energy and nothing gets done. We then feel terrible and the brain tug of war starts all over again. In depression, the creative ideas are very few but the self flagellation is intense. This can affect all areas of our lives from work to talking with friends to housework and the everyday tasks we all must do in life.

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Luckily, there are solutions to the problem of getting things done when you are depressed.

THE TOOLS

The following are just a few of the tools I use when I have trouble getting things done.

** Don't negotiate with bipolar disorder**

Bipolar disorder wants to get your brain in a war. It wants you to question everything you do and then get down on yourself because you never get something done. It wants to confuse you and mess up your life. I have done a lot of reading on problem relationships and negotiation and one of the main tips the books give is that if two people are in a problem situation, all it takes is for one person to walk away for the problem to diffuse. In other words, when depression tries to take over (and creates a problem relationship between your ill brain and the real you) you simply have to walk away and separate yourself from what your brain is telling you. It takes two people to play tug of war and when bipolar disorder gets you in this tug of war you can make the decision to simply let go of the rope and say - NO! I will not play this game with you. You then have more energy to treat bipolar disorder first. I do this by saying NO to the thoughts I have when I am depressed. I also remind myself that I do not negotiate with bipolar disorder and I make my own decisions.

** You make the decisions in your life **

I now know that depressed people simply can't make decisions. It's one of the symptoms of depression and everyone goes through it when they are depressed. So if I know that it is part of the illness and know it's not me, I can override it and make my own decisions. I say to myself - depression can not make a decision today, but I can and I will. I remind myself that once I make the decision I don't analyze it or second guess myself. I say: I just made a decision to do something and I'm proud of myself and I move on. Period.

I don't negotiate with depression. I make the decisions.

I remember a time in 1995 that I was so depressed I would literally stand on a street corner in downtown Seattle, Washington and not know which direction to walk. My brain was catatonic. I was this way for a few years. When I created and started to use the Health Cards I saw that this fit a pattern. I finally understood that there was nothing wrong with ME. I simply have an illness and one of the symptoms is an inability to make decisions. So, I just decided that I would take over when my brain was too sick to function.

*** It's easier to just get things done than to stress over not getting things done***

Look at the time you spend worrying about being unproductive. The time you spend with these worries is usually a LOT longer than the time it actually takes to do a project. Make a deal with yourself now that when the worrying and obsessing starts you will see it as a sign that bipolar disorder is thinking for you and it's time for the real you to take over. Just make the decision to start what you need to do. You don't have to do the whole thing. You don't have to do it well. You just have to start it. 99% of the time you will actually do the project. IT IS THE FIRST STEP THAT IS THE HARDEST WHEN YOU ARE DEPRESSED. Make it a rule that you will at least do the first step when you are sick. This is one of the most productive ways to get things done when you are sick - it also kick starts your brain into action and may even get your brain to start functioning normally again.

** Judge your performance by different standards **

Don Miguel Ruiz in his excellent book The Four Agreements says: 'Your best is going to change from moment to moment; it will be different when you are healthy as opposed to sick. Under any circumstance, simply do you best, and you will avoid self judgment, self abuse and regret. '

When you are depressed, nothing will look or feel right. This is simply a symptom of the illness. The secret is to realize this and do the work anyway. Remind yourself you don't have to like what you do. In fact, you don't have to even think about it, you just have to do it to the best of your ability at the moment. You may be amazed to find that the work that looked and felt terrible when you were depressed actually looks and feels just fine when you are feeling normal. The most important thing is to do the work anyway. And then praise yourself for doing something even though you were sick.

*** Know when to let go ***

There will be some days where you really can't do anything. These are the days that I feel need to be about taking care of you. Exercise as much as you can, see friends, get a massage, go to a funny movie, have a fun dinner, but let yourself off the production hook. Do what it takes to pamper yourself so that you can change your brain chemistry. Don't do this for more than a day though. If this desire to just do nothing persists for more than a few days, it will not help if you pamper yourself. Use some of the other techniques to get yourself out of the episode.

*** Take an anti depressant ***

These drugs can really help you get things done as they help you treat depression first. I can not stress enough how important medications are for bipolar disorder. It really is just so hard to treat this illness without medications - I know, because I have to do it. If you can take medications, take them. Learn techniques that will help you reduce the dose and make sure you find medications with limited side effects, but don't stop them just because you don't think you need them. Why be so hard on yourself?

*** Put yourself in a place where you can actually work ***

If you can't focus on anything, then go somewhere that helps you focus. I like to go to the library or a coffee shop with a project and tell myself: I will work on this for an hour. I don't have to like it or think about it. I just have to do it. If I stay at home and mess around with the internet and get upset that nothing gets done I'm even more unhappy the next day so I have taught myself to be future oriented when it comes to getting things done. I know that just doing even a part of something will make me feel better when I wake up the next morning. If you need help with this, ask a friend to meet you for a work session. Explain what you are trying to do and get some support.

*** When in doubt - go outside ***

A good brisk walk is one of the best treatments for depression. I never want to walk when I'm depressed, but I always feel better after I walk. You don't have to walk far and you don't have to enjoy the walk - but it's important that you get outside and move your legs and swing your arms. The more endorphins you can create, the better you will feel.

*** Don't wait until you want to do something ***

Depression never wants to do anything. EVER. Just accept this and do things anyway. This will change your brain chemistry and before long your desire to do things will come back. So if you have the thought that you don't want to do something, accept that it is just depression talking and IGNORE IT!

*** Know the signs of psychosis ***

Psychosis is very scattered. If you can't get things done because your brain is constantly talking, smelling weird smells or seeing and hearing things that are not real such as seeing yourself get hit by a car or hearing someone call your name when there is no one there then you need to talk to your doctor about psychosis. Psychosis can be a part of depression and mania

*** Don't make big to do lists ***

Making lists can be a way for you to organize a scattered brain. If you are constantly making big lists and then getting on yourself for not getting anything done - the list making needs to stop. I was a chronic list maker for years. Some of my lists were ridiculous - not even Madonna and Martha Stewart combined could have done all of the jobs I thought I should be doing in a day. For example: Yoga for 30 minutes, clean room, write a book, exercise more, make a good lunch, study French, write friends, be nice to Ivan (my partner at the time), call a friend, try to find a job, write in journal, make a photo album with all of those pictures you have lying around, do something artistic, watch the video you rented, work in the yard, make dinner. Etc Etc. I am not joking when I say my lists actually looked like this. I of course was so depressed I couldn't even do one thing on the list- so this made me even more depressed.

Here is the rule I now use. When I am sick I only have to do one project. That's right. Just one. I don't have to finish it or do a good job. I just have to do one project. Maybe it's cleaning my room. Maybe it is making a nice lunch. Maybe it is writing for an hour on a new book. But that is my only requirement for the day. When my brain starts to tell me I HAVE to do more, I know it is a sign that I need to be kind to myself because I'm sick. And when I do that one project I have to PRAISE MYSELF. I have to say, You did such a good job Julie. I am so proud of you. I literally say this all day if I'm depressed. You went to the store. Good for you Julie. You did not take your irritation out on another person. Good for you Julie. You wrote a newsletter, good for you Julie. And I do it until the depression is gone. I always know it is sign that I am either depressed or manic when I start these huge lists.

What if you HAVE to get things done and don't have the option of just doing one project. First, decide what is really necessary. Believe me the house cleaning can wait, someone else can get dinner, the letters and calls and emails to friends can wait, the television can turn off, the kids can just chill out for a while and let you be. Then you can have time to do what you have to do. If you have to go to work, then by all means go to work, but go with a simple goal. Say to yourself, I know that I'm depressed and this means that today will be tough at first. I'm going to be kind to myself. I'm going to praise myself every single hour that I'm on the job. I'm going to do my best and take depression into account when I look at my work. I'm going to make it through my day the best I can because I know I will feel better tomorrow. I am going to let people know that I am having a tough time and I'm going to ask for help. And then I am just going to do my work. This means that you will not wake up guilty the next morning for being sick. You will wake up and know that within the limitations of depression you did an INCREDIBLE JOB!

GOOD FOR YOU!

*** Become your biggest fan***

I spent most of my adult life getting down on myself for being a failure. I never got things done the RIGHT way. I never met my potential (as so many people so kindly pointed out for 15 years). I was never enough. Then, when I started to treat my own bipolar disorder I realized that I was AMAZING! We are all amazing to live with this illness. I'm so kind to myself now. I really am my own best friend. I survive depression, suicidal thoughts, psychosis, hypomania, spending problems, sleep issues and relationship challenges and I still get out of bed every day. Wow! Good for me. It's a miracle that I'm alive much less writing books and running a web page. So, if you have not met someone else's potential or don't meet society's standards for success, SO WHAT! You are a success if you live with this illness. You deserve praise and recognition every single day. And if no one else is there to give you this praise, then I'm giving it to you now and you can learn to give it to yourself. Remember, you are the only person who really knows you - be kind to yourself. Don't let your bipolar brain say mean things about you. You know who you are. You are wonderful.

Julie Fast, February 15/03