Areas › Low mood and hard feelings › When everything feels flat
Sometimes the honest answer is that there is nothing in your surroundings to feel good about. Changing them counts as treatment, not as running away.
A life with no friends nearby, no work that means anything and a steady drip of criticism will produce low mood in most people, and skills practised inside that life have a lot working against them. Moving house, changing course, leaving a job, finding one room where you are not being got at: these are real interventions. The test of whether it is avoidance is simple enough. Are you moving towards something you want, or only away from something you dread?
Qur’an and Sunnah
Respond to God and His Messenger when he calls you to that which gives you life (Quran 8:24). Moving towards what gives you life is described as answering something, not as escaping.
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
Deliberately re-entering activity that means something is one of the better supported approaches there is. Across randomised trials, behavioural activation outperformed control conditions for depression and was as effective as full cognitive behavioural therapy. What it changes is what a person's days actually contain, which is close to what a change of setting does.
Ekers, D.; Webster, L.; Van Straten, A.; Cuijpers, P.; Richards, D.; Gilbody, S. (2014). Behavioural Activation for Depression; An Update of Meta-Analysis of Effectiveness and Sub Group Analysis. PLoS ONE doi
BA comparable to full CBT protocols.
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
If the surroundings are what keeps the mood going, the surroundings are a fair thing to change.
When not to
Big moves made in the worst week rarely land well; if you can, decide it with someone who knows the whole picture.
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
For some young people self-harm carries something besides relief: belonging, recognition, a name for who they are among friends who do the same.
Ask why the tablets take weeks. That one question sorts the honest accounts of how they work from the tidy story about a chemical being low.
Put something in before you take something out. Removing the only way a person has of coping leaves them with nothing, which is not safer.