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Twenty years from now you will be more disappointed by the things that you didn’t do than by the ones you did so. – Mark Twain. 

There are many sources of depression but the one I think saddest (and I hear quite often) is the one of regret.  This one starts usually in patients over 40. They have settled into situations from which it is hard to disengage and try other routes.  Regret is a ticklish topic in therapy. One needs some space to bereave what is lost but one shouldn’t dwell on regret. Like the fellow in the tarot card ‘Four of Cups’ it is too easy to fixate on the Life’s losses than what you have  – or even the exit from your lot.  Indeed, too much reflection on the past worsens depression. One has to move on.  Like the sobriety prayer one has to know what you can’t change and what you can.

I recently heard the song “The Bus from Amarillo”. For thems not familiar with the tune, a woman recalls a time from her youth when got on a bus when all of life lay before her, but she got scared and got off. Now middle aged and trapped in her lot, she recalls the opportunity she missed and the what-ifs of that route.

“The bus from Amarillo I can hear it still go by

I missed my only chance and now I swear I don’t know why.”

Life is a one-way ticket to nowhere.

As I heard the song I wept a bit. I has been a very difficult work week the sort that made me wonder why on earth did I go to medical school. I too have a list of roads not taken and regrets. I won’t bother to list them; I know better than to dwell on them. All the same I wonder what my life would have been like if I had been brave enough to stay on the bus.

As I age I am more forthcoming telling my patients – especially the younger ones – to take the undiscovered journey, the less than certain route, and the scary way.  I want as little regret in life as possible.

Meanwhile I may not be able to be return to those forks in the road but I don’t have to accept complacency.  If the Bus from Amarillo has an open seat I may buy a one way ticket and go.

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