My friend Ilya used to call me periodically to ask about couch time. That was her way of asking whether depression was ruling my life. Frequently it was. Anti-depressants kept the extreme sadness and morbid thoughts at bay, but I was spending days or even weeks barely moving, sitting on the couch. The TV was usually on and I often had a book in my hands, the better to convince myself that I wasn't "doing nothing" - I was watching TV or reading. Ilya's phone calls were sometimes annoying.

I didn't want to pull myself from my little self-indulgent corner, or even acknowledge that I had once again given in to the lethargy that defined my depression. Her concern penetrated, though, and helped motivate me to get moving. I didn't want to lie to her (she knew me too well anyway!) and hated admitting my paralysis. I had to do things so I could honestly tell her that I wasn't sitting on the couch. Those pesky phone calls helped me reclaim my connection to the world outside my four walls.

I don't think I was conscious of having an actual plan to combat my couch potato lifestyle, but in hindsight it's clear that I did. I imposed rules on myself: no more than an hour a day online, two hours of prime-time TV viewing (never, ever turning on the set during the daytime) and reading only at bedtime. I made commitments to activities away from home.

Commitment to community activities: I was already serving on the board of our homeowner's assoctiation. Over the last few years I've begun participating in other community efforts. I helped map our deteriorating coral reefs, became an advocate for our homeless population and participated in a grassroots organization that distributes shoes, toys and other holiday gifts to children living in housing projects and on the beaches. People counted on me to fulfill my role once I signed on to each project, so their reliance helped me stay focused and motivated.

Commitments to social activities: Monthly book club meetings and six performances at my favorite community theater each year might not seem like much of a social life, but those activities were the first that got me out of the house. Friends expected my presence, so that motivated me to go even when I wanted to skip out.

Commitment to myself: This one is sometimes the hardest for me. There are times when I'd rather just sit at home than get out and do something. I know, though, that giving in to the urge to vegetate just makes it easier to fall back into old habits, so I pamper myself with "me time." I go snorkeling or spend an afternoon gardening. I go to festivals, community fairs and farmer's markets. I've even made myself go window shopping instead of doing my usual fifteen-minute, grab-the-necessities-and-go routine.

Midlife hormonal changes may account for some of what I've experienced. Changes in lifestyle certainly contributed - I did not make a smooth adjustment to empty-nesting when my son moved away the same week my father died. Having no family nearby made it easy to wallow in aloneness. Such situational factors can kick clinical depression into high gear. I needed the anti-depressant medications and counseling that helped me get my life back under control. They helped me get to the point where I could begin to function again. I can't discount my own efforts, though. There are still days when I'd rather stay in bed than actually participate in life, but I remind myself that if I don't control my actions, depression can and will. That's a place I don't want to go again, so I get up each day, get moving and make my life happen.

How have you handled depression and the instinct to withdraw from life? Do you have any advice for those of us who sometimes find the couch potato lifestyle a little too attractive? The Good Health-athon is about our mental and emotional states as well as our physical health and fitness. Share your stories and insight!

Hey Ilya? Thanks. Love ya.

Related links:

Depression in midlife women

Maybe getting a motorcycle would help

The National Association of Social Wokers looks at Women in Midlife