How do I do it?

For a long time, I gave up trying. It sure made things easier and less painful in the short run. But it's obviously no way to live in the long run.

For me the SI absolutely came from the belief that, after so many years, it was impossible and hopeless and nothing but pain was there. I have been there, and it's horrific. I am so sorry.

I can only speak from my own experience, but maybe some of this will help (sorry for the length)...

I really needed to break things down into smaller pieces. Thinking about where I want to be and the big ticket items is just way too much most of the time. I know it seems disheartening to set your goals temporarily lower, but it's no good setting yourself up to fail. I need to build myself up.

Cut myself some slack. It's going to take time. The longer I beat myself up and feel like a messed-up burden, the longer I'll be a messed-up burden.

Physical things are easier than social and mental things. I found this especially true when dealing with anxiety and terrible self-esteem. Walking, breathing, getting out of the house, seeing and doing things all lessen the physical discomfort and clear the head a little. It may seem pointless, but would I rather keep feeling awful anyways or get some small relief even for a short time? Even when I really don't feel like it, I exercise my better judgment and move my muscles which at least follow instructions (unlike my moods). Put one foot in front of the other. When things are bad, I find the behavior element much more personally effective than the cognitive stuff.

I was so desperate that I finally started trying things I had no real interest in and didn't particularly want to do. Even when I didn't want to do *anything*. It was better than the pain. (I started with exercise. I didn't have to think.) That's what I meant by trying different things. You really never know. What I had being doing hadn't helped enough after all. And I've learned and experienced new things, which makes life less awful. Just stay away from things you actually hate where possible. Be gentle with yourself.

Ruminating is not being mindful of my emotions. I learned to recognize it, and not confuse it with experiencing emotions or useful problem solving thinking.

When I can't do positive thoughts, I stick with not being negative as much as I can. That's good enough to start.

I have to start over sometimes.

I have never found any grand epiphanies or techniques that just lifted the veil and made it better. I don't think such things exist for people with chronic severe depression. The only real success I've had is an accumulation of many and varied little things. A little bit of CBT, DBT, ACT, and others. Experiment and see what parts work for you. Maybe think of "trying" not as effort or willpower, but as tinkering with different approaches and modifications.

At the very least, reading up on psychotherapy made me feel like I was doing something potentially productive. It also allows me to state my needs more clearly to the therapist and evaluate the effectiveness of the sessions better. I feel like less of a passive patient who is hoping the therapist knows what they are doing and that it will work out.

You may think, "All those myriad little things! That's so much work! It will take so long!" Maybe. But it's actually easier. It's not overwhelming. Little failures are only little. You can feel a little better as you go along, rather than punishing yourself with heroic effort for some big possible payoff at the end.

Sorry if I'm rambling a bit, but I hope some of this helps a little.