Depression Management for the Layperson

Dear Dr. Hurd:

My sister has been living her life for the past 8 years unsure of what she wants to do. She’s always been interested in an array of things and can never make up her mind on which path to take, and always seeks out the opinion of others. She has this self-defeating view where she thinks she isn’t good enough, and that she should pursue something that is of benefit to the world.

Her aimless life culminated in her having depression for some 2 years where she was also on medication and seeing a psychologist at the time. I can’t say whether this helped since I didn’t notice any changes, nor are there any now; if anything, she’s worse in her indecision.

I’ve tried directing her to Ayn Rand’s work, and I got her started on The Fountainhead, but as with anything else, she stopped reading the book a few days in. She lacks motivation (something she was once full of).

She’s collected an assortment of self-help books over the years, but most of these are either half read or not at all.

I try to talk to her in rational terms, and she agrees with everything I say, but she lacks the motivation.

She recently came back from a year long trip where she taught English in Turkey (Istanbul) and traveled a little bit around Europe. I expected her to come back a new person, but she’s just the same as before she left. She said she just wants to travel but I can’t think of any immediate job that would offer this, on top of being an actual career.

Is there any advice that you could offer? Or any useful books to direct her to?

Dr. Hurd’s reply:

It sounds like your sister is pursuing a contradictory path. One, she’s trying to be a good person. Two, she’s trying to be happy.

Being a good person and being happy? These ARE congruent and logically consistent goals—but only if one defines ‘moral goodness’ as happiness in life on earth. If one views moral goodness as sacrifice of self for the sake of others, then nothing but emptiness and bitterness will result.

Your sister appears to define goodness as benefiting the world, even if at the expense of herself. I base this on your observation that she views herself as never good enough. I realize she may agree with you intellectually. But if your emotions are in conflict with your intellect, your intellect alone cannot rescue you. Deep down, she might not believe you.

If she doesn’t have the patience or motivation to read Ayn Rand’s ‘The Fountainhead,’ then assess her willingness to have a conversation about what’s good. Challenge her. You’ll have to be concise, because her attention won’t tolerate much due to her lack of motivation. For example, ask her, ‘Why can’t just being happy be enough? Why isn’t that good enough?’ Don’t even expect an answer, although welcome her to think aloud with you. Just plant the seeds. The thinking will be up to her, as you will never be able to make her think.

I’m not surprised that conventional psychiatry and psychology haven’t helped. Most of it is designed to—at best—address the symptoms. But your sister is down and depressed for underlying reasons. These reasons, as you clearly see, are much more fundamental than the pills or small talk of any typical psychotherapist or psychiatrist.

Your sister needs some ‘tough love.’ What I mean by this is an expression of the fact that she’s doing this to herself. No, she doesn’t mean to make herself depressed. But so long as she clings to ways of thinking that don’t make sense, and are self-defeating in nature, then her feelings will respond in kind.

Additionally, she’s looking to others to tell her what’s right and true. Others don’t agree with each other, and she often won’t agree with others. She must decide what’s right and true for herself, objectively but on her own. So long as she doesn’t, she’s going to feel incapable and unworthy — and like it or not, it’s her own fault.

I once read that emotions are simply a different form of thought. When someone tells me, ‘I’m depressed,’ my first response is, ‘What are you thinking while you’re depressed?’ Usually if not always, the thinking taking place in the person’s mind while depressed consists of faulty beliefs.

Examples of false beliefs that I believe your sister has, based on what you wrote me:

‘I’m not worthwhile if I’m living for myself.’ Wrong. There is no worth in life without bringing value to the self. The world can only benefit from the presence of an additional happy, productive, self-fulfilled person—of which there are far too few.

‘I have to wait until I find the perfect job.’ Wrong. Take risks. Try one job and see it through. Stop hesitating to take a risk, out of fear that it might be the wrong move. Wrong moves are correctable. It’s no moves at all that lead to inertia, and the kind of depression she’s experiencing.

‘It’s possible to live a life without purpose.’ Not so. While it’s great to travel, read and live the most comfortable life possible, none of these things are valuable if there’s not some defining purpose. For some, this is their career. For others, it’s raising children. For others, it’s some kind of financially non-profitable but still personally profitable quest. Human beings, for the bulk of their lives, need a sense of purpose to define what they do. Travel and other recreational things are necessary—but only in the context of refueling, not as ends in themselves. If recreation—even sophisticated, intellectual recreation—becomes the end in itself, then a sense of futility, boredom and depression will usually develop.

Any good therapist could get to know your sister and help her identify any or all of the mistaken beliefs she’s holding. The “tough love’ comes in by helping her face the fact that she’s doing this to herself, by letting herself think in self-defeating ways.

Perhaps on some level you’ve tried all this. Trying is all you can do, because in the end she will only fix herself. You or others can help her fix herself. Sometimes, in the worst cases, people don’t want to fix themselves. They fear or loathe something that might work, precisely because it might work. Encourage her to weigh the pros and cons, for herself, of getting better versus not getting better, as strange as it may sound. You’d be surprised what this sometimes unleashes in people, and how it unblocks them.

My website contains recommended reading on any or all of this. My first vote is frankly for fiction, and my second for biographies. Self-help reading has its limits, and in some cases it’s even toxic for reinforcing rather than changing all the false beliefs people hold. I’m not surprised her self-help books sit there half-read. They probably should.

I don’t have to tell you not to give up on your sister. But try to keep in mind that the thinking or changing will always be up to her, and her alone. By simply not giving up on her, you’ve done more than you will probably ever know.


Dr. Michael Hurd’s book “Bad Therapy, Good Therapy (And How to Tell the Difference)” describes how to handle these issues with and without therapy.


Be sure to “friend” Dr. Hurd on Facebook. Search under “Michael Hurd” (Rehoboth Beach DE). Get up-to-the-minute postings, recommended articles and links, and engage in back-and-forth discussion with Dr. Hurd on topics of interest.