What is radical acceptance (and how it can help with depression)?
If something in your life truly sucks the way depression does, and you’ve ever been told to practise “radical acceptance” around it, you may have felt a rage hot enough to fry an egg on. It feels like you’re being told that what is happening is actually fine, or that you should either lie down and take it or magically get over it. I would if I could, you probably want to scream. Thankfully, that isn’t what radical acceptance is about at all. So what is radical acceptance really? Read on for an explainer on radical acceptance and how it can help you deal with depression.
Radical acceptance: where the concept comes from
Radical acceptance is a concept born out of Buddhist philosophy and later developed in Western psychology by Marsha Linehan through Dialectical Behaviour Therapy, which she originally developed for work with chronically suicidal people with borderline personality disorder. Nowadays, radical acceptance is a concept widely used for a variety of mental health concerns including depression. Radical acceptance is about the complete acceptance of reality without resisting or avoiding, especially in very challenging or painful circumstances. But far from being about passivity or ‘giving up’, the practice of radical acceptance offers great transformative potential for emotional regulation, and by extension problem-solving. When it comes to depression then, radical acceptance means accepting that your depression is here right now, but not that it is permanent or untreatable.
Does radical acceptance mean giving up?
No, radical acceptance doesn’t mean giving up. It means ceasing that internal fight against your current reality that takes up so much of your energy. Far from being a “just give up” mentality, radical acceptance can open up more space for action. Because when you stop resisting the things you can’t change, you have more energy to change the things you can.
Radical acceptance is NOT:
- Approval of your situation
- Endorsement of another person’s harmful behaviour
- Pushing your feelings down
- Giving up
- A complete fix for every problem
- A reason to stay in a harmful or dangerous situation
How can radical acceptance help with depression?
Radical acceptance can help with depression by ceasing the internal struggle against your present reality (you are feeling depressed) – which then leaves you with more energy to actually give yourself what you need.
Julia Abolina, Integrative Psychotherapist at The London Psychiatry Centre says: “Accepting that you are depressed today is not the same as accepting that you will always feel this way. It simply means starting from where you really are, rather than from where you think you should be.”
What is radical acceptance’s role as a tool for depression?
How radical acceptance can help with depression:
- Ceases the second layer of distress: The initial pain you’re experiencing is bad enough, but the “second layer” of distress that comes from judging or fighting your feelings makes it worse. (You can find this second layer in thoughts like: I’m stupid to feel this way. Why is this happening to me? I shouldn’t be depressed. What is wrong with me?) Radical acceptance gives you more space from those “thoughts about the feelings”.
- Frees up mental and physical bandwidth: Continually fighting against your feelings or attempting to deny them drains your mental and physical energy. Releasing this state of resistance gives you back more energy and time.
- Lessens rumination: Depression tends to capture the mind in continuous negative thought loops that include catastrophising and punishing self-talk. By helping to ground you in present-moment awareness, radical acceptance can provide some relief from those loops.
- Facilitates action: Acceptance often makes change easier. Radical acceptance can free up space and energy to take the steps that could help you feel better – such as loving self-care, reaching out to people close to you, or seeking treatment for depression.
Ways to practise radical acceptance with depression
Radical acceptance is a skill that can be learned and practised bit by bit. When it comes to radical acceptance and depression, the goal is not to magic depression away, but to practise letting go of the resistance that causes the “second layer of distress” so you have more space to give yourself what you need.
So what is radical acceptance in practice? There are a number of ways to practice it. Here are some steps to practise in-the-moment radical acceptance when you’re struggling with depression:
- Spot the “shoulds” that keep you trapped in the resistance of reality. Notice when you find yourself saying or thinking things like “it shouldn’t be this way”, “I ought to be better by now” or “it’s not fair”.
- Take a slow breath with a longer exhale. This can help trigger your parasympathetic nervous system, calming your body and helping ground your mind in the present moment.
- Notice the sensations in your body with nonjudgmental awareness. What does the depression feel like? Where does it sit in your body? For example you might feel heaviness in your legs or tightness in your chest or a sense of fog in your head. Whatever is there, don’t try to push it away, just notice and be present with it.
- Gently affirm reality as it is right now, using statements of acceptance such as: “I am dealing with depression right now. I am having a hard time at the moment. Depression is a real mental health condition that affects many people.”
- Ask yourself: what is one thing I can do for myself right now? Such as having a lie down, going for a walk, reaching out to a friend, or getting something to eat.
For other self-help resources on radical acceptance, you can visit Radical Acceptance: Skills, Worksheets, Videos, Exercises.
What to do if medication or therapy doesn’t help with depression?
When first-line medications and talking therapies don’t help with depression, it is called treatment-resistant depression. Clinicians usually identify treatment-resistant depression when someone has tried at least two different antidepressants at an adequate dose and duration and it hasn’t worked. Treatment-resistant depression generally necessitates different medical strategies and adjustments.
Here at The London Psychiatry Centre, we have a highly effective protocol for treatment-resistant depression. It involves rTMS (repetitive transcranial magnetic stimulation), an effective, safe, evidence-based solution for treatment-resistant depression without pills. As the pioneers for this now NICE-recommended treatment in this country, we are the UK’s most successful and experienced in rTMS and have delivered it to the highest number of patients. You can read more about rTMS here. If depression feels overwhelming, you can reach out for help.
The London Psychiatry Centre is the UK’s foremost private mental health clinic. Successfully treating depression for decades, we take appointments both in-person and online. Contact our friendly team today on 020 7580 4224 or email info@psychiatrycentre.co.uk to schedule a consultation.