Depression, apathy and staying in bed

Picture of the outline of a person in a chair leaning forward with their head in one hand. The background has a lot of words in different sizes relating to mental ill health and isolation. These include 'Unimportant', 'Broken', 'Useless', 'Hopeless' and many more. The person looks like they are experiencing despair.

Anyone that has experienced a significant bout of depression is probably all too aware of just how difficult it can be to do seemingly simple things like getting out of bed, showered and dressed. Bed can feel like the one place that you’re in control of. It can give a sense of comfort. Frankly, the rest of the world can feel unmanageable scary. Plus, these days you can do an awful lot from bed. You can work on your laptop, play with your phone, speak to people all over the world and get support through social media. You basically don’t need to get up, you can make your home office right there in your bedroom. That is all true, but it doesn’t take into account the impact on your physical and mental health of doing so. What we are all trying to do when we stay in bed it to feel safe, but the effect is often quite the opposite.

Extending time in bed can be harmful to your sleep cycle, mood and can even increase inflammatory responses according to one 2014 study. In just 2 weeks someone that had otherwise healthy sleep habits and who wasn’t at the time experiencing depression or anxiety began showing symptoms when they extended time in bed by just 3 hours (even though they weren’t asleep all that time). That is some scary stuff right there. Another article found an association between increasing sleep by over 2 hours a day and risk of diabetes. There is also a long established link between too little (under 6 hours) or too much (over 8 hours) of sleep and mortality rates. Extra time in bed is correlated with extra sleep and/or poorer sleep.

So, there is really good evidence that it is a good idea to leave bed – even if you decide lying on the sofa is your alternative. Just the fact of getting out of bed is likely to be good for your mental and physical health, especially if you do it every day. If your baseline is that you are finding it very difficult to get out of bed, here are 5 things that might help:

1) Break things down into manageable chunks

If you break down larger tasks into 10-15 min chunks it can make it much easier to get started, especially if you remind yourself that you only need to do this for 10 minutes. For example, if it would take an hour for you to get up and dressed, maybe you can just take a shower, and then think about the next thing after that. Creating manageable chunks really helps to get started. You’re probably getting up to go to the loo, can you also clean your teeth? Can you take a shower? Can you get dressed? By adding something small it may make the next step achievable in a way that it wasn’t when you were thinking about all the things.

2) Bribe yourself

Recognise that right now it is really hard to get up. It is hard to do pretty much anything. You deserve to be rewarded for managing to get out of bed. Find ways to reward yourself – whether it is reminding yourself that you really will feel better or deciding that you will get to listen to some of your favourite tracks after you get up. Rewards work for some people, and if they work for you then use that!

3) Get a to-do list

This may sound ridiculous, but ticking things off to-do lists can be really satisfying. When you write your to-do’s make sure you include everything. Cleaning teeth, getting dressed, showering, eating, everything. Include a time by which you should be doing these things. Especially if you’re struggling. When you’re back into a routine and finding it easier to get out of bed then maybe you might decide to remove some items from your list, but until then make them things that you get the satisfaction of ticking off to show yourself that you’re achieving something. My favourite app for this is Wunderlist. It syncs across multiple devices and you can get it to remind you to do things daily.

4) Find a way to include purpose, connection and pleasure in your life and reason to get up

It turns out that we operate best when we are including 3 main things in our lives. Purpose, connection and pleasure. If you think about your own life you can probably think of things that fit into all these categories. Sometimes people try to make themselves get out of bed purely so they can do the purposeful things in their life and feel productive. They can ignore or overlook the important role that pleasure and connection play. When you are thinking about things to get out of bed for try to think about what you can do in each category. There are some great books that talk about this, like happiness by design and I can’t be bothered to do anything (which is really short and comes with helpful worksheets).

5) Remember that the gremlins will try to make you stay in bed

So, this sucks. Your brain will try to make you believe that bed is the safest and comfiest and best place to be while you feel shitty. Or maybe while you don’t feel much of anything. For the vast majority of people this isn’t the case. So, when you think ‘urgh, I don’t want to get up’ or ‘it would feel better to stay here’ or ‘It is too hard and there is no point’ you need to remember this is perfectly normal, and try to do it anyway. So perhaps try thinking ‘there may be no point, but I’m going to try getting up and see whether it helps or not’. It will be hard, and your brain will try to keep you in bed where it feels safe. Working on acknowledging the thoughts and getting up anyway is often critical to managing to claw your way out of depression.

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