[Lyris]

Part of my therapy for Depression/Chronic Pain is to try and make little goals that I can achieve each day. For example: "Take a shower", "eat something for breakfast", "put real clothes on", "brush your teeth". Sometimes, more lofty ones like "wash a few dishes".

The idea is that once you achieve these small goals, you'll feel better about yourself and you'll be able to do those every day without any trouble. Then, you can move on to more challenging goals. I know you guys know what I'm talking about.

Well, "start small" doesn't work on me, and that is a serious problem.

I do the small goals, and the immediate affect is something like, "this is utterly pathetic, i should be doing more, normal people do this every day, i want to do more, why can't i do more, this isn't achieving anything, this is not enough"
Then it spirals out of control, where doing even the smallest things are completely useless and not worth doing at all. In other words, achieving small goals makes me feel WORSE and will result in days, sometimes weeks of no activity what-so-ever. I think I'm on week 3 at the moment, of literally sitting for 14 hours playing video games and watching Netflix.

So instead, I try to do some hard goals like "do 10 loads of laundry" which then turns into "your pain levels are out of control now and you're in bed for days".
But doing the 10 loads of laundry makes me feel GREAT even though I'm going to pay for it, seriously pay, later. Doing a bigger goal is what I need, but it costs SO much to do it. My therapist tells me NOT to do this. My doctors tell me NOT to do this. EVERYONE tells me not to do this.

This is a combo question for Depression/Chronic Pain people alike. My therapist knows this issue, and yet, will tell me to continue with the small goals even though they make me feel SO much worse.

Has anyone else figured out HOW to fix this problem?

Thanks guys.

[Wild Coyote]

Hi! Welcome to PC!

I deal with depression, chronic pain conditions and a Systemic Exertional Intolerance Disorder (SEID aka CFS/CFIDS). I understand some of where you are coming from. A little doesn't seem like enough and a lot sets us back!

I think it comes down to acceptance.

I have been an avid athlete earlier in life. When I became ill, I was truly heartbroken, as I loved being very athletic and very active. It is now over 30 years later and I still miss being more physically active. However, I do work at accepting my limitations. Why? Well, if limitations have been adequately challenged and are "real," then it's wise to accept the limitations, instead of hitting my head, repeatedly, against a brick wall!

I try to boost my self-esteem in other ways. I try to find more sedentary ways to contribute and to feel okay about myself.

It's easier said than done, I know. Yet, it's also helpful to stop beating myself up for what I can no longer do.

Self-acceptance is my word of the day today!

I hope you will find a place of self-acceptance, too!


WC

[paynful]

I completely understand wanting to make progress. I understand feeling utterly restless and yet completely exhausted at the same time.

Here's the thing... you have to be reasonable.

Unless you are a laundry mat, or have an outfit change 10 times in a day... 10 loads of laundry in one day is incredibly excessive. If you want to do something like that, you have to pace yourself. Spread it out over a weekend. Stretch or do yoga in between. Otherwise, you are just punishing yourself.

Learn to accept QUALITY over quantity. It's still progress, but you won't set yourself back.

Do something that will improve tomorrow's situation.

For example:
In the morning, clean your kitchen as your coffee or tea is brewing. Drink your beverage, relax. Shower, dress, eat.
In the afternoon, go to the grocery store (with your list!). Get home and unpack your food. RELAX and snack.
In the evening, make a REAL meal. Soak the pots, pans, dishes. Clean up if you have the energy or let it wait for the morning.
The next day, you have food in the house, your kitchen is clean, and you can start in on the next room. Even that sounds like a lot for one day, but you will feel like super hero the next day ready to tackle something else. Or else, you won't be still sitting in the same mess.

No one else is going to wipe your *** (unless you have a paid nurse), and you aren't going to wipe their's. Stop comparing yourself to other people. It will never serve you.

Compare yourself to who you were yesterday. There's nothing wrong with giving your body and soul the rest that you need. If you are not happy with your lack of progress, then do something that helps, not hurts.

[cool09]

I can't do large things. I have to do small goals like hygiene, go to the grocery store. Large things are overwhelming.

Lyris, I think it will be a good investment to read Wild Coyote's comment here. He focuses on acceptance of limits and tells that that isn't easy. I know, by own experience, how hard it can be. We want to do more, but our bodies rejects. Take your time to grieve your loss (of capacity because of pain) and at the same time try to work with both your thoughts and the small jobs.

I have found it helpful to have a routine for the day. In that routine I have "baked in" time to change my thoughts. There is scientific evidence that change in thoughts will create a change in emotions. You said: "I do the small goals, and the immediate affect is something like, "this is utterly pathetic, I should be doing more, normal people do this every day, I want to do more, why can't I do more, this isn't achieving anything, this is not enough"". Your thoughts are echoes from a past when you were able to do more. If you set aside some time each day to have an appointment with yourself, you can write down all the "not good enough thoughts" you remember and ask yourself :

"What is the evidence that my thought are true/not true?" May be you find some lines to write down about how pathetic you are ("truth" the way you see it). But when you have to answer about the evidence for "not true", may be you will see that to force a person with pain to do this or that is not a good thing to do. If so, you have your first evidence about that your thoughts are not true. May be you will form a new sentence, perhaps like this: "I am not pathetic, but it is sad that I with my diseases cannot do more" or my be "I am not pathetic, but full of anger because the loss of my former work capacity." (It's only you who can decide what you shall feel).

The question is the same as a CBT therapist will ask. It is meant to help you think over your situation in a new light. (A lot of scientific studies tells that it works). Other questions in the same road are: " What are the worst thing that could possibly happen? The best? Most realistic?" "What are the benefits of this thought? The costs?" ....

My "recipe" for how to cope better with physical constraints and feelings are 1) do the small things - they are steps to being able to do more as time goes, 2) look at your thoughts, 3) allow yourself to grieve (sad, anger ...), 4) work on your acceptance of your limitations and acceptance of yourself the way you are now..

If a person has an accident and has to learn to walk again, that person has to walk one step at a time until he can walk the best he can after the accident. May be he will have to use a crutch for the rest of his life, - give up former interests. The good news is that he may use some time to find new interests.

Point five: Be good to yourself.

last week I made it to the shop (not far from my house at all, not even a 5 minit walk)

people are like oh well done, you did wwell didn't you?.

I'm like shut the **** up. it was hard, and I'm not doing it again without my medication.

guess what makes it worse for me is that I was never good at accepting compliments

I'm usually like... really?. do you not mean someone else?

[Lyris]

Thank you for the replies, people.
I am extremely low functioning at the moment. I shower maybe once every 2 weeks, and that is a hard thing to admit because yes, it's gross. But I don't care. And when I do shower, it does not have an affect on making me feel accomplished.
That is my point, whether or not people think I should do small goals, they do not provide a reward for me. This is probably a chemical issue, I would guess, having a total lack of dopamine. My brain's reward system is broken, and I am not sure how one goes about fixing it other than medication (which I do take). So while I have tried small goals for an extended period, I feel no different months later on that path of therapy.
With what I have described, one would think my house is like an episode of hoarders. But it's not, I do have a line drawn where I find a level of grossness unacceptable, and I will take steps to fix it, but what I am trying to do is raise that line higher and it won't budge.
Most of the advice here has been what I've already tried, and has not worked. So now I'm wondering what a person does with their life when their brain's reward system is broken, and cannot be trained to function properly even with medication.

[paynful]

Okay, I see what you're saying now. When there's nothing you want (no cookie as a reward), it doesn't seem like there is a point. I get that more than I can say.

A lot of times, I don't even feel like a real person, because I don't want anything. Like... anything ...for myself ....out of life... nothing. If there's no motivation, there is no point in doing life or what I like to call "adulting".

(This next confession is silly and embarrassing for me.)

When I'm at my lowest, I try to pretend I'm doing these things for someone else. I find it easier to force myself into action if someone has needs greater than my own. I pretend I'm babysitting or something. The kid needs to have healthy snacks, drink water, get fresh air (even if it's just sitting outside the front door), and have their attention on something that isn't a screen.

Most of the time, it still doesn't work. But the moments it does work, I guess it's worth the ridiculousness.

Originally Posted by Lyris

Part of my therapy for Depression/Chronic Pain is to try and make little goals that I can achieve each day. For example: "Take a shower", "eat something for breakfast", "put real clothes on", "brush your teeth". Sometimes, more lofty ones like "wash a few dishes".

The idea is that once you achieve these small goals, you'll feel better about yourself and you'll be able to do those every day without any trouble. Then, you can move on to more challenging goals. I know you guys know what I'm talking about.

Well, "start small" doesn't work on me, and that is a serious problem.

I do the small goals, and the immediate affect is something like, "this is utterly pathetic, i should be doing more, normal people do this every day, i want to do more, why can't i do more, this isn't achieving anything, this is not enough"
Then it spirals out of control, where doing even the smallest things are completely useless and not worth doing at all. In other words, achieving small goals makes me feel WORSE and will result in days, sometimes weeks of no activity what-so-ever. I think I'm on week 3 at the moment, of literally sitting for 14 hours playing video games and watching Netflix.

So instead, I try to do some hard goals like "do 10 loads of laundry" which then turns into "your pain levels are out of control now and you're in bed for days".
But doing the 10 loads of laundry makes me feel GREAT even though I'm going to pay for it, seriously pay, later. Doing a bigger goal is what I need, but it costs SO much to do it. My therapist tells me NOT to do this. My doctors tell me NOT to do this. EVERYONE tells me not to do this.

This is a combo question for Depression/Chronic Pain people alike. My therapist knows this issue, and yet, will tell me to continue with the small goals even though they make me feel SO much worse.

Has anyone else figured out HOW to fix this problem?

Thanks guys.

The way to fix this is to not listen to professionals and just do your own business

[Fuzzybear]

[Kaysey]

Originally Posted by Lyris

Thank you for the replies, people.
I am extremely low functioning at the moment. I shower maybe once every 2 weeks, and that is a hard thing to admit because yes, it's gross. But I don't care. And when I do shower, it does not have an affect on making me feel accomplished.
That is my point, whether or not people think I should do small goals, they do not provide a reward for me. This is probably a chemical issue, I would guess, having a total lack of dopamine. My brain's reward system is broken, and I am not sure how one goes about fixing it other than medication (which I do take). So while I have tried small goals for an extended period, I feel no different months later on that path of therapy.
With what I have described, one would think my house is like an episode of hoarders. But it's not, I do have a line drawn where I find a level of grossness unacceptable, and I will take steps to fix it, but what I am trying to do is raise that line higher and it won't budge.
Most of the advice here has been what I've already tried, and has not worked. So now I'm wondering what a person does with their life when their brain's reward system is broken, and cannot be trained to function properly even with medication.

I totally understand where you are at. I am in a similar place. I have been trying to do the small things, but feel no sense of accomplishment. I worry that I could fill my days with doing things and still not enjoy any of it. I am looking for the same answers you are.

[Shazerac]

Small goals don’t always work for me either. I experience self loathing when the only triumph I can count is dragging my a@@ out of bed in the morning. I try to keep in mind that I need to be gentle with myself. Pushing yourself to do 10 loads of laundry and then being be ridden because of it is a kind of self abuse.