Areas › Low mood and hard feelings › When everything feels flat
A medicine that lifts drive is not the same as one that settles anxiety, and for some people the energising kind makes the worry louder.
Bupropion is the clearest example: often good for flatness and lack of motivation, often unhelpful on its own when anxiety and a racing, sleepless mind are the main problem. If you are anxious as well as low, say so at the start rather than after a fortnight of feeling more wound up. Anyone supporting a person who has just started something new and become jumpier can say the same thing on their behalf.
Qur’an and Sunnah
Respond to God and His Messenger when he calls you to that which gives you life (Quran 8:24). What gives life and what quietens fear are not always the same call.
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ ٱسۡتَجِيبُواْ لِلَّهِ وَلِلرَّسُولِ إِذَا دَعَاكُمۡ لِمَا يُحۡيِيكُمۡۖ وَٱعۡلَمُوٓاْ أَنَّ ٱللَّهَ يَحُولُ بَيۡنَ ٱلۡمَرۡءِ وَقَلۡبِهِۦ وَأَنَّهُۥٓ إِلَيۡهِ تُحۡشَرُونَ
Believers, respond to God and His Messenger when he calls you to that which gives you life. Know that God comes between a man and his heart, and that you will be gathered to Him
Qur’an 8:24read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Flatness has a fair claim to being its own problem. A review of reward function in adolescent depression makes the case that a blunted response to things that should feel good is a core feature of depression rather than only a consequence of low mood. Treating it as a target in its own right follows from that.
Forbes EE, Dahl RE. (2012). Research Review: altered reward function in adolescent depression: what, when and how?. Journal of child psychology and psychiatry, and allied disciplines doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Something that increases drive will increase whatever is already running, worry included.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Ask what the behaviour does for them, and then ask how they would like to feel instead. Both questions open more than telling them to stop ever does.
When someone tells you they have been hurting themselves, keep your face steady and stay curious. Alarm closes the conversation, and you need it open.
The same medicine can be dangerous given one way and safe given another. Slow release is not a marketing word.