Posted by: jedwardswright | November 21, 2010

Uncertainty and Depression

Depression means expecting the worst. This is such a universal tendency among us that I feel confident making it a general rule.

We are not only “glass half-empty” people – we are “the glass is going to break and we will have no water at all” people. At the best of times (and we will rarely admit to any “best times”), we expect disappointment as a part of our daily routine.

“Can you please pass the butter? And yes, I failed to get the promotion again and my boss still hates me.”

“Well, at least you still have a job.”

“True, but as soon as my car breaks down again they are sure to fire me. Where’s the salt?”

When presented with a genuine serious uncertainty, anyone can get anxious. Depressed people have the potential to lose it completely.

Whether it is an impending transfer, meeting the prospective in-laws, or waiting for medical test results, we don’t simply expect the usual bumps on the road. We have the car crash mapped out in our minds. Disaster is not merely a possibility; it is a certainty. Our nervous imaginings rapidly develop into full-fledged nightmares in the confines of our minds.

Physical symptoms begin to multiply. Hyper-ventilating, shaking, sweating, sleeplessness, headaches, and upset stomachs abound. If medical tests are called for, we acquire all the classic indications of the worst disease which could conceivably be found.

Either we are drawn to decadent food like a magnet to metal, or we can barely eat enough to survive. Anorexia, bulimia, and self-mutilation may escalate. We participate in risky behaviors, or refuse to leave the cocoon of our beds. Obsessive-compulsive thoughts or actions could overwhelm our lives. Gambling, shop-lifting, and even addictions we once left behind come back to haunt us. Anything, we will do almost anything, to quiet the relentless apprehension cycling through our heads.

Whether or not we end up with the catastrophe we forecasted, we have already put ourselves through agony anticipating a horrible outcome.

Our minds are chemically inclined towards negative thoughts. How can we counter that powerful pull and gain some semblance of peace?

  • Brainstorm many possible endings for our uncertain situation. Doing this makes it more difficult to concentrate on just one negative result, and opens our eyes to other, less negative outcomes.[i]
  • Consider possible opportunities that could arise as a result of challenges or changes in our lives. For example, a person transferring to a distant part of the country would have the chance to make a fresh start, meet new friends, and visit many new places.
  • Consult with a doctor about short-term medication for anxiety or sleeplessness.
  • Reach out for support from friends, family, medical professionals, therapists, social services, or charities as applicable. People with social support handle uncertainty better than more isolated individuals.[ii]
  • Journal or blog about our feelings and concerns. Getting at all down can have two beneficial effects: it provides emotional release, and may help us gain some needed perspective on our situation.
  • Use relaxation recordings or soothing music to calm ourselves.

Usually, when faced with uncertainty, depressed people expect the worst. Our natural (or unnatural) pessimism can lead us, often unnecessarily, into increasing anxiety and emotional distress. Consciously choosing to take control and use these ideas to reduce our level of apprehension can help us cope when the path ahead is unclear.

[i] Mark Tyrell, “How Depression Causes negative Spin,” Clincal Depression Learning Path,n.d. (accessed November 21, 2010).

[ii] Heeyoung Lee, PhD, APRN, Karen G. Schepp, PhD, APRN, FAAN and Youngmi Jung, PhD, RN, “Testing a Theoretical Model Predicting Uncertainty and Depression in Patients Undergoing Renal Replacement Therapy in Korea,” Asian Nursing Research: Korean Society of Nursing Science, Vol. 2, Issue 2, pp. 91-101, June 2008, (accessed November 21, 2010).

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