[Reminder] Set realistic goals for today
I often encounter a common thread when working with people who suffer from depression (or any mental illness). They often set unrealistic expectations for themselves, which often make them feel shame/resentment for never achieving those goals. Especially so, when they are experiencing an episode of depression, where (they can explain way better than I ever could), simple tasks become monumental.
Let me explain. This is an analogy I give in my practice.
Imagine that you’re on a boat. You’ve set a long term goal of traveling X miles to reach a destination. You’ve prepared your food and water to make it the X amount of miles in X amount of days.
The goal then is to travel 20 miles each day. This benchmark will let you know that you are on course and on time to reaching your destination.
Day 1, 20 miles.
Day 2, 20 miles
Day 3, 20 miles.
Day 4, you encounter the storm. The winds are howling, the waves are big and crashing, and you lose sense of direction.
The question becomes: On day 4, is your goal still to travel 20 miles that day?
Most often, people would reply with a resounding “no”. The look they give me is often of, “duh”, “how is that even a question?”.
You see, people with depression, get hit with these storms or episodes. They’re rocked to their core with feelings and sensations of anhedonia, avolition, sadness, and hopelessness.
And yet, they place the expectation on themselves to get to 20 miles that day.
“In the heart of the storm, what are you going to do?” — This is often what I ask.
The answers generally fall in line with some form of self-preservation:
“I’m going to make sure my food is safe and won’t get spoiled by the water”
“Damage control. I’m going to make sure my boat makes it out in one piece”
“Weather the storm”
Now, besides the fact that my clients and I have very limited knowledge about boating (is that what it’s called?), the answer is never, “reach my goal of 20 miles that day”.
The same response and reaction my clients give me about the absurdity of even asking whether or not making it the 20 miles while battling a storm, I mirror back to them.
When you’re depressed, day to day tasks become monumental. What’s worse, those things that never required energy or focus, become the hardest hills to climb.
Getting out of bed that day might have been the most difficult thing for you to do.
Being social, with even one other person that day, may have been the thing you needed to do most, considering that your brain and body are telling you to completely isolate yourself.
Whatever the task, your goals shift. They’re not the same as yesterday and all the other days prior. It’s about self-preservation.
I often earnestly praise clients for achieving these small goals, whether these were actual goals they’ve set for themselves or not. Getting out of bed, being social, eating when everything told you not to, and many other “tasks” that often come natural to us when we’re feeling content.
I check in with my clients utilizing the trusty old likert questions (rating scale from 1–10), asking them where their mood is. After the self-report, because they are the expert of their own experience, I ask what they realistically expect to achieve when they are experiencing whatever mood they report.
Is today the day you travel and hit your goal of 20 miles?
Is today the day you make sure your food doesn’t get spoiled by the oncoming water?
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Steve is a program director at a residential facility in Southern California. He is aspiring to become a fighter of stigma in mental health, by sharing personal stories, stories of others, and what he (believes) he has learned through his work.