In his masterpiece, “Against Depression,” Peter Kramer (the author of “Listening to Prozac”) talks about the similarity between how tuberculosis was discussed before it’s cause was understood and how depression is discussed now. Tuberculosis was considered a rather romantic illness, associated with people of weak constitutions and fragile sensibilities. Treatment was bed rest. Likewise, depression is spoken of as a kind of disorder of the emotions, and its cause associated with a lack of psychological resilience. “Mopey” and “glum” are cartoon feelings: round faces with upside down smiles. I get glum when my internet connection is too slow for Hulu to work.

We know now, of course, that tuberculosis is a disease. It’s treated with antibiotics. Once antibiotics were discovered, TB was essentially erradicated. If you contracted TB today, no one would say you did so because you had a fragile constitution: you caught a disease and need to get treated immediately.

Likewise, Kramer argues, we now understand depression to be an actual disease. Its course — it actually destroys brain tissue — can be viewed using MRI technology — which didn’t exist 15 years ago. Some treatments are effective, some aren’t: science hasn’t found the cure yet, but doctors have an array of very effective tools. I’m not sure that St. John’s Wort is at the forefront of that arsenal.

If you had prostate cancer, the statement, “I haven’t been very productive,” would be met with raised eyebrows. It would be, as we say these days, an inappropriate response to what is obviously a debilitating disease. I guess I’m raising my eyebrows about this post. “Things will be fine. I’ll be exercising. I’ll be eating well. I’ll feel good about myself. Then, one day, I’ll have no motivation. I’ll stay in bed half the morning, reading or surfing the web. I’ll stop at the convenience store for Sno-Balls.” These aren’t the symptoms of someone who is mopey. These are the symptoms of someone who is depressed.

In a recent Get Rich Slowly post, you talked about nearly having a panic attack while sitting in your office, as a consequence of feeling isolated. You felt better after going down to the coffee shop and spending some time among people.

Something serious is happening here, JD. I know from past experience that I’m likely to get an e-mail from you telling me that I’m over-reacting. Exercise generates endorphins, among other things: your mood will undoubtedly improve if you start exercising. The chain of causation that you describe here, however (“Things will be fine. I’ll be exercising. I’ll be eating well. I’ll feel good about myself. Then, one day, I’ll have no motivation.”), suggests that you’re fighting a disease that is going untreated, not that you let your level of exercise decline below some optimal level that holds mopiness at bay.

Different subject: “When I bike, I make it into this huge gearing-up thing, and that’s a very real barrier. I need to get on the damn bike and go!” This statement has Muney’s fingerprints all over it. Good! You still haven’t told us whether biking creates more heel pain or not. I hope you’ll let us know.

The only thing worse than an injury is a re-injury. I don’t know how things are in the States, but in Canada a visit to a clinic is covered, and they can quickly tell you if you need to be referred to a physiotherapist, require an x-ray, or should just get more rest. If nothing else, getting an accurate diagnosis will at least set your expectations for how long you will be off the track.

Re: running – make sure that you have good footwear, and avoid jogging on cement/concrete when possible. Aim for grass and chip-trail whenever possible. Some people complain that it’s harder to run on a chip-trail, but harder is better when it means you’re making your body work more, and we only get one set of knees, so I think we should do everything in our power to preserve them (and this generally means letting them rest and wearing adequate footwear, rather than taking supplements with vague claims of healing your knees, such as glucosamine).

http://blog.penelopetrunk.com/2009/07/08/how-to-have-more-self-discipline/

I especially like her points (not unfamiliar but worth repeating) that our efforts snowball, whether we’re tackling debt or fitness or diet, and that when you fall off the wagon, so to speak, you need to find an accessible point of re-entry.