Part of my depression is a degree of apathy; the more I can focus and get excited about something the more I feel I’m on the right path. I do worry, however, that it’s a mask and I’m just distracting myself.
And that’s how I feel about all this in a wider context. Treatment and therapy don’t magically make you a happy person. Instead, they mask the symptoms or provide better coping strategies, ways to head off the worst of it before it can take hold.
As somebody who has had several mental health breakdowns and three therapists in my 20s (I’m 36 now), my current perspective on therapy is that you create the world in which you’re living in and therapy can give structure (and meds, if needed) towards creating a livable world, for you. Meaning that you are actually not just getting rid of yet another veil that makes you see things more clearly - or on the contrary putting another mask on to make you see things less clearly. Instead your world can’t literaly be anything else than what you focus on. If you’re focussing on being happy, coping and so on, chances are that your world “becomes” what you see.
This is not as simple as just using willpower, however. Not least, because willpower is like a muscle and ego depletion is a real thing. It’s also because depression can be thought of as an an active but independently acting agent in your consciousness: Deciding to want to focus on something else is important, but a mental illness wouldn’t be called that, if you could ‘just decide’ and stick to counteracting it.
This is where therapy can be incredibly helpful: In my experience visiting with a therapist changes your environment, your habits, which is itself - not even taking into account their skill at treating you - an important step to creating lasting behavioral change. But therapists offer also structure on top of just existing in your environment. In my experience they offer a source of serendipity that makes it possible to reach break throughs, new frames of thinking, new ways of looking at things. By showing up and interacting with a therapist you’re making a real effort to change what you believe to be the boundaries of your current situation. Yes, this can be in the form of recipe-like coping strategies, but it can also just mean to interact with an expert on mental health. And that communication has a very high likelihood of being surprising - which is so important to feel something, anything else as regards to your current mental health.
So in short: We are and our world is what we are focussing on. There is no trick here. Nothing is revealed or hidden by engaging differently with the world, instead it is just that: A different perspective, a different world. To make a sustained effort to change this perspective for good means to change the environment (because willpower alone won’t cut it) and to being open to be surprised.
Medicine can really help in some cases. But even then it’s not guaranteed that your conscience is built to accommodate even one new way of perceiving the world that doesn’t include your mental illness. People are different, they can and can’t do different things. A goal for one person to be completely healed from depression might just simply not be in the cards for others. However: Even temporary relief or a more manageable severity of symptoms might be totally worth the effort.
Finally, there is no relief in thinking that you may never find relief and therefore doing nothing. I would like to say: Whole-ass the thing, but I don’t mean it to say “don’t do anything else”, I mean it in the sense that if you’re doing therapy, take it seriously, treat is as a creative task. The task of reinventing your world.