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This month resident counsellor Douglas Holwerda answers the question about dealing with depression.

 

Dear Douglas,

 

I have been dealing with depression on and off for much of my life. I am a 44 year-old expat living in Hanoi, working in an English language centre. I love my work but it causes me to work too much and to ignore developing a social life and other interests. The problem is I feel so depressed that I am missing work a lot and feeling totally unmotivated to face the growing amount of unfinished work that is piling up. I just want to sleep and to avoid everything and hope it goes away. My boss and colleagues have been supportive and patient, but I am afraid that will run out soon. My apartment is a mess and I cannot organize myself to even go get groceries when I need them. I feel exhausted and am feeling more and more desperate.

 

What should I do?

 

— Mary

 

Dear Mary,

 

It does look like you are headed for a crisis unless you find a way to get support from a mental health professional who can help you develop a plan and strategy to work your way out of the downward spiral you are in. So, the first step is to go to the website for the Hanoi Counseling Psychology Group to see who is trained to help you.

 

Depression feeds off our tendency to avoid aspects of life that we must inherently face if we are to find a balanced and healthy life. Responsibilities are part of adulthood, but can sometimes overwhelm us when life throws us challenges or we don’t know our boundaries and limitations.

 

You share that you love your job and that it has become a big percentage of what you do to the detriment of other parts of your life. While many of us do what you do — throw ourselves into our work with passion — it is a recipe for the kind of depression that causes us to feel overwhelmed. There is more to say about the value of a balanced life, but you might already be beating yourself up for having gotten into this mess.

 

The important part is to find a way out. There is not a script that tells us what to do, so we have to make changes that are steps in the right direction and that are based on what is needed and what is realistic. It strikes me that it is important to have a discussion with your boss to ask them to work with you in order to find steps that lead to a good outcome. A letter from your psychologist or a medical report that validates your mental health issue can help the employer, or school, understand the serious nature of what is happening. That report would offer a recommendation about what the treatment plan might be.

 

If a person comes in for therapy early enough, the depression can be managed and the person is able to continue to function to a reasonable level. They may need to create a structure that helps them set good boundaries, address their own expectations, and identify ways to integrate restorative activities into their life.

 

When a person is overwhelmed and has shut down, all activities seem to be too much and their instinct is to curl up in bed and try to sleep time away. This calls for a more radical intervention that structures either a partial break or a full break from the responsibilities of life. A partial break might be for a week or two or might be to reduce the daily hours or responsibilities at work or school. This can be planned as a “see how it goes” strategy to find what is realistic. If that proves to be too demanding, it is best for a person to be admitted somewhere to be cared for and to be given realistic tasks that offer them a chance to reclaim the benefits of taking responsibility.

 

In Vietnam, there are few, if any, of these types of facilities for English speakers. It means sometimes returning to one’s home country. The disruption to one’s work or school life adds another layer to what feeds the depression, but is sometimes needed in order to get daily life in order and to fully recover.

 

Psychologists and other mental health counsellors would also work toward gaining insights that help understand if the depression is rooted in one’s personal history, self-concept, traumatic experiences or other forms of dysfunctional coping.

 

Mary, avoidance is a short-term strategy and now is the time to seek help to find support. Many people overcome depression. It is the most diagnosed mental health problem and no one is at fault for becoming depressed. It is rarely easy, but with support, you will find your way out of it.

 

I wish you wellness.

 

— Douglas

 

Do you have a question you would like Douglas’s help with? You can email him at This email address is being protected from spambots. You need JavaScript enabled to view it.. Personal details will not be printed.

 

Douglas Holwerda

Douglas is an American trained psychotherapist, writer of the Dear Abby-esque monthly column in the Word, "Dear Douglas". He holds to the notion that the living of life is a creative endeavour... an eternal adventure without promises. And that we are both shaped by the journey and the shapers of what is possible. Our greatest hope is to find love and connection along the way. Live it all.