Depression and Fantasy

One of the hallmarks of mental illness is a growing inability to distinguish between reality and fantasy. Therefore, one could say that the hallmark of mental health is a clear-eyed, quiet understanding and acceptance of: fact vs. fiction, the probable vs. the improbable, and an ability to see the reasonable connections between events.

      For example, the word “ratio” is used in mathematics to describe the relationship and correct proportion between two events or things. When I’m in my “right mind,” I know that the odds of winning the lottery are roughly 1 in 292.2 million (Powerball) and 1 in 302.6 million (Mega Millions.) If I feel secure and confident of tomorrow, it is easy to ignore the lottery tickets at the convenience store. However, if I’m stressed out about money and the future looks grim, the fantasy becomes stronger. In light of that, I believe the following is true:

the deeper the depression, the stronger the fantasy grows.

It makes sense really. Depression is often described as a feeling of being “helpless/hopeless.” The common thoughts are:

• “Things will never change.”
• “I’ll never be happy again.”
• “Why try, I know I’ll just fail again.”

      Then enters the fantasy:

• “My knight on the white horse will save me.”
• “This new internet love affair will finally give me happiness.”
• “If I could only live somewhere else, I know I would finally feel content.”
• “Everyone would be better off without me.”

      As the fantasy grows stronger, the consequences seem to disappear precisely because depression has begun to impair my thinking. The consequences of drug and alcohol abuse or an extramarital affair or gambling my money away in a Las Vegas casino virtually disappear because I am looking to the fantasy to rescue me from my misery.

      Depression creates a kind of desperation from which people will do almost anything to escape. Suicidal thoughts, the ultimate escape fantasy, can seem perfectly reasonable in a certain state of mind. After listening to literally thousands of suicide stories from patients at the hospital, one patient described this process perfectly. He said he had struggled for many years with thoughts of suicide. However, that basic instinct of self-preservation, which acts like a strong wall or boundary, always kicked in and prevented him from actually doing it. One day though, he said, “I woke up and suddenly the wall was gone. And I did it.” Thankfully, the paramedics got to him in time and he was happy to still be alive. I can tell you, the vast majority of suicide survivors are happy to be alive. One could say that this very dangerous fantasy eventually eroded his primal instinct to stay alive.

How to Tame the Fantasy

      James Clear, in his book, Atomic Habits, has a chapter titled, The Goldilocks Rule: How to Stay Motivated in Life and Work. He gives the example of a sport like tennis. If I play tennis with a tennis pro who wins every game and leaves me gasping for breath after each match, I will tend to get discouraged and give up. On the other hand, playing tennis with someone who can barely return a serve is no fun either. The goal is to find that person with whom I am more evenly matched. In other words, if a task is too difficult, I get discouraged. If it is too easy, I get bored.

      Depression traps us with both boredom and discouragement. It takes the color and excitement out of life and leaves us overwhelmed with its difficulty. It is both the bully that intimidates and the droning, monotone voice that bores. No wonder I feel “helpless and hopeless.” It’s too difficult! It’s too boring! It just isn’t worth it! As one patient said so eloquently, “I don’t care and I don’t care that I don’t care.” It is very similar to having a serious flu with fever, nausea, and fatigue. Even something as simple as getting water from the kitchen requires an incredible amount of energy and determination. Similarly, when it comes to serious depression, even the smallest efforts can seem gargantuan. Then enters the fantasy; “when I move away,” “when I win the lottery,” “when I meet that special person.” It is like wisps of fog; insubstantial and temporary. Instead of dreaming about uncertain futures, the way to tame the fantasy is to focus on the present. To find the Goldilock’s place that is “just right.”

Work on the “Helpless/Hopeless” Dynamic

      A friend shared his process with me once. He said, “If I wake up and I’m very depressed, I will say to myself, ‘I’ll have some coffee and if I’m still depressed, I can call in sick at work.’ Then, after coffee, I will say, ‘Let me take a shower and see how I feel. If I’m still depressed, I can call in sick at work.’” You get the picture. Little by little he talked himself into going to work and, of course, after he got to work, he felt much better.

      Finding a way to feel less helpless, by doing something (anything) constructive, is a way to transform this dynamic into something positive. When I do something, when I complete a task; I feel less helpless and therefore, more hopeful. This, in turn, motivates me to do the next thing. Grandiose (manic) thinking leads me to believe that I can control everything. Depression leads me to believe I can control nothing. Both are wrong. The path of wisdom is to find that “ratio” or rationality that understands the difference.