(Bio-psycho-)SOCIAL factors relevant to get better from Burnout, Depression, and Pain?!

The social factors are the ones I find most interesting and rewarding, even though it’s closer to life coaching than therapy.

Sometimes, they seem to make a more significant difference than any therapy.

Biological factors for fatigue and depression could be an enormous topic – too big to cover everything in one general text. It’s closer to a medical degree and likely irrelevant, anyway. As you can see in the “why do we get burnout/depression”-texts, there are plenty of biological reasons to get them, but you don’t need to dig deep into all of those, usually. That would be useful only if it is to be covered in text, not if we’re solving one person’s problems. If the reason is biological, a total mystery, and we expect to solve it medically, rather than with an eclectic approach where we do everything BUT medication, it would be necessary to reflect on deficiencies, hormones, and pathologies for starters. Those subjects cover a big part of physiology. If you’re ill somehow, you usually know you are through other means than depression as the only symptom. That’s your main clue if you want to do it yourself and reflect on why things are as they are.

Psychological factors are what we’re doing with a big part of how we treat depression, and it’s a big part of handling stress.

Social factors are the topic here because they are SO VERY relevant, but perhaps not what people think of most when it comes to treating these things. Social factors cover practically everything but your physical and psychological parts. There are friends and family, but also society. Think of it as everything and everyone outside of you.

It might be what I write about the least but talk about with people the most. That’s likely because it’s so personal both in the taboo-kind of way, with intimate and delicate things, and secrets that have never been told before – but also because the solutions are so very tailored for the individual.

It’s the fun and rewarding part. Digging deep and really getting involved. It’s definitely possible to write generally about the matters and hope that someone will change something because they’ve read something – but it’s far more likely to see that progress after a long deep talk about a specified subject and a really specific problem that hurts enough for someone to want nothing but a solution to that particular problem.

This is a big part of what I discuss with my clients one-on-one because they are absolutely vital to getting a good life… Unless you are some sort of philosophical or spiritual sage which can be content with practically nothing. Most of us are dependent on the outside world to thrive, but it’s tricky to rely entirely on said external things, which is why I often try to nudge people toward the idea of being less dependent on them. I want people to get slightly closer to that sage, even though I don’t demand much. I’m usually pleased enough if people get the idea and my point. Those who get more interested might do their best to achieve freedom by focusing far less on what they can’t control, which seems incredibly helpful when trying to get more content with life.

Caring less about the externals – and trying your best to change them for the better combats the problem from both ways. Try to actively achieve a better life but avoid letting your happiness rely on the outcome of your efforts, and you’ve got an ideal attitude and approach to progress towards a better and happier life, I’d say. A better and happier life solves a lot of suffering.

While “therapy” takes you from something dysfunctional or even pathological to neutral, tending to these aspects could take you to the top of the emotional spectrum. I love the methods that rather count as “therapy”, because they really work and they can do wonders –  but this is where we find what’s truly wonderful about life, rather than just allowing you to live a “normal life” as therapy usually do.

Managing life could make life worth living again. The two are far from opposites, which is why I want to use both. If you’re at the bottom, you’re there for a reason. Therapy and managing life simultaneously is one plus one, which equals not just two or three but far more because they both include so many things.

In some cases, problem-solving isn’t a bad choice of words for how we treat these things. At least partially. That’s when you actually DO have problems in life, and those are what’s pulling you down.

Social factors
Company, mindfulness, nature, peace and quiet, and cooking over the campfire. Why not use all the tools at the same time?

Why is this relevant?

The social part covers more than just the sole interaction between people, but if we start there, our ancestors relied on and lived among others practically always. We were closer to that just a couple of generations back when we lived among family for longer. Perhaps several generations in one house. Today, we’re more prone to solitude. Some are introverts, so it suits them fine… more or less, but we’re likely not made for this level of loneliness and isolation.

As kids, we are taught to sleep in our own beds, and we often get our own room. There are apartments where we live alone, and if we do live in bigger houses, everyone gets their own room there too. There are headphones to isolate ourselves when we’re out, and even when we do things with each other, we look at screens.

We look at this part because it’s vital for our psyche… And hopefully quite pleasant while being so.

Generally, we seem to care less and less. There’s too much other stuff going on in life for us to focus on and care enough about relationships and social stuff. Those are automatized and ought to just happen. But those things, the things we neglect and leave to care for themselves, often fade out. They atrophy, shrink and die. Hopefully, slowly, if they’re of value. Possibly not particularly slowly at all. With depression in the picture, you might say no to people far more often than you think, neglect or actively avoid them because you’re trying to isolate yourself and be left alone. More or less willfully… but the consequences might be the same. A big part of those I tend to who suffer from stress, depression, and long-term pain notice that the social sphere gets smaller and smaller over time. They’re not the happy little ball of light they once were. That has consequences.

The isolation we seek when we’re depressed isn’t healthy and won’t lead to anything good. When looking at depression, social relationships might be just what we need. We’re looking for solitude when what we need is more people. That’s upside-down, but as we say in the “Analysis of the paralysis”-chapter, “Behaviors aren’t necessarily intelligent, practical, rational, and a good idea just because we’re doing them. But yet, you do something about discomfort when you experience it. It just might not be the right thing. Is it something clever or something short-term that you’ll regret later?”

There are examples of cultures where that isolation isn’t at all possible… and in said cultures, no one knows what depression is. Sadness, grief, and sorrow, sure, but not depression as we know it. But that’s anecdotal, and you don’t live in a hut.

It’s a crisis!!!

Regarding social aspects, the solution varies tremendously – because the problems do.

If the social factors are the biggest problem, that could be quite obvious. At least for someone external. It’s either noticed by asking “What is your biggest problem?” or through the Dolor Detection Diary. Then you ought to solve that misery. Reasoning about it is the easy part. Going through with the solution isn’t necessarily easy or fun. There could be divorce or quitting a job you loathe. Perhaps you need to break up with someone, and it’ll flip your entire life upside-down, and it could do the same to the other person. Not fun. But it could be necessary because being here isn’t working out for you. On the second level of Maslow’s hierarchy of needs, we find security; if we’re threatened and feel insecure, we’re in a bad spot. That won’t work over time, so you need to solve that.

Once you’ve solved the obvious crisis, you could be… quite fine. I’ve had completely ruined people as clients, where the necessary step was one of these big social things, divorce, and the results were marvelous. From a wreck to experiencing relief and freedom they didn’t know existed. I have nudged not just one or two towards divorce because of that. If your closest relationship is nothing but a burden and something negative, you shouldn’t be there. If culture or habit keeps you there, that’s not a good reason. If you hang around just because of the economy but waste your life, does that feel like a good trade? Is it worth it?

I’ve helped people with the same thing concerning their work. If work, a boss, or something similar pulls you down to the degree where you consider death to get out of there – and that weight suddenly stops – that makes a tremendous difference.

In these cases, it’s often a question of values and goals. What’s important, and where do you want to be? Is that relationship or the workplace you’re suffering in more valuable than the health you lose? Is it more important than the energy it drains you of? The life you’re wasting? Is this how you want to live?

It could be helpful to go through the values exercise before doing this, but if you’re in a crisis, that’s rarely necessary. If you’re putting your health at serious or irrational risk through work or relationships, that ought to tell you enough. It’s time to make a change. If it’s in immediate danger from your partner, you ought to do as much as possible to get out of there ASAP. Perhaps including some sort of personal protection and law.

The depression is here for a reason.

It’s vital to act on what matters.

What’s the problem?

What needs to change?

Once you’ve dismantled the biggest problems, you’ve calmed everything down, and you can focus on smaller things. Smaller than a catastrophe, bigger than mosquitos after bedtime.

What do you genuinely dislike in life?

What do you want to get rid of?

What is bothering you on a daily or weekly basis?

Life as you want it, relationships, and social context.

Relationships and a place in the world are obviously relevant to our quality of life, but do you have them?

Are you pleased with your social context?

Are you pleased with your life and what it looks like?

To solve these things, we must act and change the world around us with the means we’ve got. We need to solve the problems that bother us. But to do so, we need to know the problem. How we solve them then is a matter of what resources we’ve got and how interested we are in changing things. It’s a matter of how stubborn we are and what things are worth… But also a matter of what the world looks like right now and who you are. Most external problems aren’t entirely in your control. You can do your part in personal relationships, but you can’t force people to like you, and you can’t always affect every single outcome. This means that things might have a bad outcome, even though you do everything within your power. Then, it’s up to you to bring the grit to try again if you want it. Sometimes bridges are burnt, and sometimes you get a second chance. That’s life. You’ll have to act on the cards you’re dealt, whether you like it or not. The good life rarely falls in your lap. Start questioning things and go after what you desire most if you want to change life for the better.

Do you have a partner and a love life?

Do you have friends?

Do you have people you meet in your everyday life with whom you get along?

Do you have a job, something to do, and a place to be?

Are you geographically located where you want to be?

Do you like your home, neighborhood, state, and land?

Are you in the right place?

Do you enjoy what you do?

Do you get compensated enough for what you do?

Do you have hobbies and things that amuse you?

What gives you energy, and what drains you of it?

How does your economy look, and what can you do about it?

How can you hurt less in whatever way that matters?

How can you make a better world for yourself?

Do you have meaning?

Is your life in order?

These are some of the relevant points in the social part of life. Highly relevant. If you lack people, something to do, meaning, and your place in the world, there’s not much left. These are things you solve by doing things. You won’t just stumble upon friends or a job. Relationships don’t just magically appear; if they do, keeping them around and in good shape often takes work. We often look for meaning thoroughly before we find it – even IF we find it, it might seem meaningful at first and less so over time. Similar to hobbies, they too might be amusing at first and less so a couple of years later.

It takes time and energy to create what most people call “a good life”, but it might be worth it. It might be worth doing one thing at a time and one foot in front of the other day in and day out to get where we want to go. Just doing nothing can’t possibly feel more meaningful.


Communication is a foundation in most things regarding the social parts. I often say that “communication is what the receiving end picks up”. This is simplified, but it often makes a good point. If you say something and it’s misinterpreted, you said it in the wrong way or at least in the wrong way to that person. Perhaps you didn’t validate well enough how things did get interpreted? This is likely not willfully – we generally DO want good communication – but it’s hard.

Bad communication leads to more conflicts, worse relationships, worse outcomes, and worse… most things. It could very well lead to arguments where you try to win without that being beneficial. You don’t want the other part to lose in a good, equal relationship. That’s beneficial only if you want them to feel inferior to you. Inferior and worse. If you’re going for a war that way, make sure you do so with someone you don’t wish well and never will. Marshall Rosenberg said, “Two things distinguish nonviolent actions from violent actions. First, you don’t see an enemy and second, your intention is not to make the other side suffer.” Your goal can’t possibly be to injure the other party if it’s someone you care about.

There are books upon books about communication, so I won’t cover much here in relation to that, but it could be worth mentioning something, just to get you thinking about it. How we communicate and how we are perceived matters when we’re around people. Communicate in a thought-through way, and there’s a far better chance you’ll get what you want in life.

One of the most famous “methods” to communicate well is “non-violent communication” by the same Marshall Rosenberg previously quoted. It is, quote: “not a technique to end disagreements, but rather a method designed to increase empathy and improve the quality of life of those who utilize the method and the people around them.”

Non-violent communication builds on:

Objectivity, rather than using your interpretation of what you’ve perceived. Use concrete observations, specific things that have happened, particular situations, or similar. Avoid generalization and don’t judge.

Feelings, again, without generalizations, stories, or thoughts. This could take some thinking, but it’s important to distinguish emotions from thoughts. Sad is a feeling. “Feeling as if you’ve been treated unfairly” isn’t necessarily a feeling. This is fuzzy for many people, but feeling ignored isn’t a feeling – it relates to what you think others are doing. If you feel you’re not good enough, that’s how you think you are rather than a feeling in and of itself. Feelings reflect if we experience if our needs are met or not, and that is a highly subjective thing based on perspective. Being open to feeling the emotions and sharing said feelings with others would more likely result in something good than hiding behind a facade.

Needs are what we require in this world to live well. General human needs – or yours. When it comes to this one, Marshal has said, “Everything we do is in service of our needs. When this one concept is applied to our view of others, we’ll see that we have no real enemies, that what others do to us is the best possible thing they know to do to get their needs met.” Which… Is really clever. One could say that it means that people don’t suck – they’re doing their best they know to get their needs met. Whatever they’re doing might not be great, but the intention might be good, anyway. Human needs are listed in various ways by different people. There’s Maslow’s hierarchy of needs, for example, and Marshall refers to sustenance, safety, love, understanding/empathy, creativity, recreation, sense of belonging, autonomy, and meaning. If you compare them, they’re not at all that different.

Requests are simply a question and something you would like to have, but you’re open to getting no as an answer. If a no is received, that doesn’t mean no forever. Why did you get a no? Could there be a compromise? The reason why you’re getting a no is of vital importance for you to get what you want. It’s not necessarily impossible for you to get it, if the conversation continues.

Peaceful communication should include active listening and communicating from the perspective of how you perceive things rather than from how things are.

Active listening is necessary to have a decent clue about what the other person wants to say. If you’re interested in the relationship, you ought to be interested in what the person has to say. When actively listening, don’t assume what the other person has to say. Don’t think you already know or deduce what you think is relevant because you think they’re “in that mood”. The point isn’t for you to explain why or defend yourself. Listen first, then respond with something appropriate. That’s old news, and you know this is relevant, but it’s still hard and worth mentioning.

Some guidelines could be:

Turn to the person and physically show that you’re listening.

Acknowledge what they’re saying with nods or, within reason, sounds or words.

For the most part, it’s reasonable to be quiet when the other person is talking.

Ask if they can elaborate or tell you more.

Then mirror what you’ve heard and understood. “So what you mean is…?” or “So you feel…?” followed by your words and not a direct quote.

Communicating from the perspective of how you perceive things is a method to avoid conflict by practically avoiding both attack and defense. You could be furious or feel many other emotions, but with some practice, you could express things peacefully anyway. Note that avoiding conflict like this isn’t synonymous with avoiding the problem. The point is for you to tell your part of the story. In short, one way could be to say, “When x happens, I feel Y.” or “When you x, I feel Y”. We want this to be founded on objectivity and clarity, rather than namecalling and throwing sand.

Some guidelines could be:

Explain your emotions and thoughts about the problem diplomatically. Instead of “You’re horrible to talk to”, use “I feel as if we’re having a problem talking lately”.

Use tangible examples rather than just explaining with emotions and how you value what’s happening. “When X happens, as it did yesterday and this morning, I feel Y and think Z” would likely be a better explanation.

Ask the other person for advice or come up with an idea about how to solve the problem – and ask if it’s a good one – rather than telling how things are, and that’s it.

In some cases, it helps to say something positive about the other person to make them feel you’re on the same side and having a discussion, rather than war.

That’s peaceful communication – but that’s not always what you want.

In some cases, you need to make things uncomfortable to make a change. That is usually when you’ve been adapting for far too long without clarifying boundaries. If you’ve always been extremely comfortable to deal with, a sudden no could very well be uncomfortable. Perhaps for everyone. You’re not used to it – and the receiving end won’t be either.

In some cases, you just need to say no.

If you’re far too uncomfortable doing so, that’s a matter of practice, I’d say. Practice – and values, once again. What do you want out of life, and who’s to determine where you’re going and what you’re supposed to do? You or that other person?

To always succumb to what others want is bad for real. It’s often taught through bullying one way or another. Whether it’s from a parent, other students in a school, or a spouse doesn’t matter. It’s often taught at an early age, even though people can be broken down entirely even when they’re grown up; it’s just harder. It’s taught, and then… it just sticks, usually. It often comes along with low self-esteem and self-respect, which go both ways.

You can’t say no because of your low self-esteem – who are you to tell others no?

Avoiding saying no and standing up for yourself keeps that self-esteem low.

With enough practice and grit, it’s definitely possible to get out of, though. To do so, knowing your values is once again very valuable. If you want to be a slave to others and let them run your life, you shouldn’t say no. But if you want to be confident and independent, saying no is an essential skill to have.

To begin reflecting on if it’s worth the effort, you need to get a decent picture of those values and think of the pros and cons of saying no to some things.

Short-term, it’s usually comfortable.

Long-term, it’ll hinder you from doing what you’d want with your life.

Would others like you less if you did say no?

If yes, does that matter more than getting control of your life?

What do you think of people who never say no?

Is it an attractive trait?

How do you respond when others tell you no?

Do you break down or accept their will?

If people would get upset because you tell them no – does that matter more than having control of your life?

Who benefits from you always saying yes or no?

Those who matter?

Those you like or those you dislike?

We don’t say no just because we can. But to have that good life we want, it’s an absolutely necessary option to have.

Get some excitement in there!

A big part of the changes I do with people is to become better and feel better.

For most people monotony isn’t amusing. It could be quite horrible if you’re trying to do something about depression. It could increase the feeling of meaninglessness and just apathy.

If you’re mainly bothered by the stress, monotony could feel like a safe zone, as you recover, but it’s rarely particularly intellectually stimulating. So once you’ve recovered decently, I often prefer if people do something more.

Some people want monotony and that’s how they prefer to live, of course. An old friend of mine is just like that. He wanted the same road from and to work every day. Same tasks to do when he got there. Same routines at home. Hit the gym Monday, Wednesday, and Friday. Friday is more relaxed and the workout is finished with the sauna. He preferred the same people at the gym when he got there and he had his little routines. Nothing dysfunctional and nothing really weird. He just liked the routines and the stability. Some are like that, and that’s fine. If you want to eat the same lunch day in and day out, because it’s convenient, that’s great.

But if it’s possible I usually shove my clients toward a little bit of excitement once they’re well enough. Once you’re done with the threats and you’ve gotten rid of everything that is bad for you you got to do exciting things to make life worthwhile! Do something interesting, and do something out of the ordinary.

Perhaps it’s even a good idea to get some risk in there? Life can’t be just stability and boredom if you depend on more to thrive. If you want to get those positive emotions and you’re not one of those who loves routine, you might have to get out there and look for excitement. That doesn’t have to include bar fights and walking on the train tracks. Perhaps it’s starting your own small business, making your first investment, learning something entirely new by purchasing a course, or getting out on the market and starting dating again?

Nothing will ever solve itself. You’ll have to do something about it if you want ta change.

These are tricky things, so it’s hard to generalize a cure-all solution for you right here. If you do need help, I’m always available at www.mbdolor.com/contact

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