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CHOICE THEORY, REALITY THERAPY AND DEPRESSION In Reality Therapy and Choice Theory, depression is seen as a way of dealing with the gulf between what we have and what we want. Because depression is seen in this way, Choice Theory always holds out the possibility of overcoming depression. And, as is clear below, Choice Theory does not see depression as being bad all the time. Sometimes it is better than the alternatives - what is important is not to trap ourselves in depression. What is more important is to know that the path out of depression begins with changing what we want or changing how we behave.

Depression can do four things for us and knowing what these are can help us to begin the climb out into the light. These four things can be thought of under the letters ACHE.

A for Anger

Depression is often considered an alternative to anger and sometimes it can be better to choose depression than anger. If you make a habit of lashing out when anything goes wrong, you can alienate other people and often make matters worse. Consider how many relationships anger has destroyed. Consider how many lives anger has destroyed. Anger has its place, and it often gives us the energy for change, or the energy to stand up for ourselves. But it can be destructive too. Depression can be a safe, temporary alternative to anger. It becomes unsafe when it goes on for too long or we use it too readily.

C for Control

Depression gives us a certain amount of control over people and situations. It may help us to avoid taking risks, to stay in a safe environment. To a certain extent, people will try to avoid upsetting us when we are depressed. If we are absolutely devastated by something that has happened, depression may give us the only control over our lives that we can handle at the time. The price for this control, of course, is very high because of the suffering that comes with depression. By definition, nobody enjoys depression - if we did, it would not be depression.

H for Help

Depression brings us a certain amount of help. This may be help from friends, from a doctor or from an institution. Some people need this help for a time. Again, if it goes on too long people may stop helping us and in any event depression is a high price to pay for the help we get. But why don't we just ask for help? For many of us, it isn't such an easy thing to do, to say "I am in a bad way, please help me." Many of us have the tendency, when asked "What's wrong?" to reply, "Nothing," even though there may be a great deal wrong. Depression can get us help without us having to ask for it.

E for Excuse

Depression can excuse us for not doing what we should do. It can be a way of avoiding pain. If I am depressed, how can I be expected to get out and about, dress well, work, face my problems etc? Yet, very often, it is only by doing these things - even, at an extreme, by doing something, anything at all - that I can start to climb out of a depression.

So if I am depressed Choice Theory would say that I can begin to climb out of the depression by taking action.

I have no direct control over the feeling of depression. I may, if I am in the depths of depression, have little or no control over my thoughts. All I can control is what I do. Maybe all I can do is get out of bed and sit by the window, or get out of bed and go downstairs.

When I can do a little more, I should try to do something more. Ideally I should focus on small things that I want and that I can get.

Maybe I want my children back living with me, but I can't get that, they've grown up and flown the nest: but maybe I can telephone or write to them, maybe I can spend more time with my friends or more time doing something else that I want to do and that is unattainable.

I also need to change what I want - in this case to accept that my children will never return to live with me.

Is this easy? No, sometimes it's very difficult and takes a long time. Our feelings, thoughts and actions are linked but sometimes we have to do something for quite a long time before our feelings follow and become positive.

Although this work can be slow (though it isn't always slow) it's worth the effort. Injunctions to "snap out of it" and to "pull yourself together" are often ineffective - if we could snap out of it, we would. The work of changing our behaviour even while our feelings remain low will be far more effective in the long run.

Medication and Depression

Dr William Glasser, who developed Reality Therapy, has a great deal to say about medication in his books. He has the qualifications to discuss medication. I do not, and my attitude is that I have nothing useful to contribute on the topic. But I believe that, whether you are on medication or not, the practice of Choice Theory can make your life better.