Depression and CBT, Part One

Feelings, and feelings, and feelings. Let me try thinking instead. – C.S. Lewis

Clinical depression is a beast. It’s like waking up with the flu and then someone makes you run a marathon with a pile of rocks strapped to your back. It’s physically and mentally exhausting.

There are a number of reasons why depression might rear its ugly head: genetics, trauma, loss, and as well as other physiological issues. Just as there are many reasons why depression may occur, there are also many ways of healing from depression, ranging from psychotherapy to medication to other holistic modalities.

One form of psychotherapy is Cognitive Behavioral Therapy (CBT). Specifically, CBT can be cognitive therapy, Rational Emotive Behavior Therapy (REBT), or multimodal. Generally speaking, CBT is aimed at discovering the underlying beliefs and/or negative thinking patterns that influence our feelings and actions. It tends to be short-term and direct.

As someone who has a family history of depression, there is a particular CBT tool that I really appreciate. If you’ve ever been around someone with clinical depression, or experienced it yourself, you will recognize many of the following Cognitive Distortions:

1. Mind reading: You assume you know what people think, “Oh, she didn’t smile when I said, ‘Hello.’ She must be mad at me.”
2. Fortune telling: You predict future outcomes, assuming the worst.
3. Catastrophizing: You make mountains out of molehills and go from, “I got a C on this paper,” to “I’ll never get into college and I’ll end up homeless and alone.”
4. Discounting positives: You disregard compliments or positive events/comments as not valid or true.
5. Negative filter: Your glasses are more Eeyore-colored than rose-colored.
6. Over generalizing: You take a negative thing and apply it with a wide brush, “I don’t get along with Sue… I’m terrible at making friends.”
7. Black and white thinking: Another name for this? Rigid thinking or all-or-nothing thinking.
8. Personalizing: You assume everything is your fault/your doing/result of your failures somehow.
9. Unfair comparisons: You interpret events in terms of standards that are un-realistic; for example, you focus primarily on others who do better than you and find yourself inferior by comparison. “She’s more successful than I am” or “Others did better than I on the test.”
10. Focus on past regrets: You find it hard not to ruminate on past mistakes or negative interactions. This can keep you from moving on in the present.
11. Emotional reasoning: You let your emotions decide what’s true and real, even if you have evidence to the contrary. “I feel depressed, therefore my life is worthless.”

Maybe you experience some of these, maybe most of them. But what happens when we listen to this distortions and let them drag us further down the doubt and depression spiral? Typically, you feel worse, or at best, maintain your current cruddy feeling.

That, my friends, ends part one of this series. Since I tend to write posts that are way too long, I thought I’d give y’all a break this week.

Tune in next time for the series follow up! I’ll bring in some spirituality to this topic.