Some people with depression believe that medication is THE answer. Typically this means that they or a loved one expect to see their GP for an antidepressant and then they’ll be ‘fine’. Given that two-thirds of people using medication report little or no improvement with medication alone, this expectation sets up an already depressed person for further bad news.* The good news is that all forms of depression improve with a simple skill with a really bad name: Cognitive Behaviour Therapy.
Depression triggered by life events
While research continues to throw new light on what exactly depression is, what we do know is that most of the time, a depressive episode is triggered by a life ‘stressor’, events like difficulties in our relationships, problems at work, leaving home, having a child, being isolated, the end of a significant relationship, starting a course, trauma, death of a loved one etc.
While these life stressors are unique events in our lives, it appears that people with depression tend to think and react to such events in a remarkably similar manner. People with depression share a similar ‘thinking style’. It’s based on the idea that your past experience effects how you interpret current events. In people with depression, this interpretation appears to be overly negative.
A restructure at work with more work, more hours, same pay.
Person A: Bloody hell! I don’t know what to do! I’ve got bills, mortgage. I’m the main provider. I’ll chat to my wife.
Person B. Bloody hell! I don’t know what to do! I’ve got bills, mortgage. I’m the main provider. I can’t talk to my wife. It’ll only stress her out more. I’ll sort it.
It may not seem like much a difference, and the intention in the second response is thoughtful and caring, yet the outcome is often increasing isolation, a key stressor for depression.
Our reactions in one situation tell us more about ourselves than just about that situation.
They tell us about a possible common view, a common coping strategy to life in general. If I had a dollar for every client who said they didn’t want to burden loved ones but yet felt so isolated … Mind you these same people are often first in line to offer help. They just can’t seem to ask for it when they need it.
Of course depression and thinking styles are about more than just allowing yourself to ask for help. They also reflect seeing the glass half-empty or half-full. ‘This is the end of me’ versus ‘Man, it’ll take some time to work through this!’ Again same problem, completely different response. One confirms certain failure, the other confirms an unwanted challenge, resolve and hope.
I recently spoke to a client who was convinced that her boss was disappointed in her. She stated it as ‘I’m disappointing’. She struggled with the idea, that her conviction of her as a ‘disappointment’ might be inaccurate or even incorrect. She even got angry that I suggested such a possibility! When she eventually asked her boss for feedback, her boss was surprised about her concern of being a ‘disappointment’. Her boss instead replied that she too had had similar difficulty with the same work issue and appreciated her sticking at the problem.
I could provide many examples of people’s thinking that has a negative mindset to it. Such negative mindsets create unpleasant emotions such as sadness, regret, anger at self, hopelessness. Such people often believe their thoughts to be facts rather than thoughts about an event open to various interpretations.
The answer is NOT positive thinking.
Cognitive Behaviour Therapy (CBT) is not a ‘warm and fuzzy’ take on the world through rose coloured glasses. What CBT asks is to be more accurate in your thinking. Yes, your boss might be disappointed but you don’t know that. Your boss might a) not have thought about you at all b) be too preoccupied with her own concerns c) think you did a good job considering d) think you disappointing etc. People with negative thinking styles only see half the picture.
There is no argument that depression can be a debilitating illness and that medication can be an integral part of that treatment, however more than medication is required.
Simple thinking skills like CBT, with practice can help you to challenge your thinking and create hope where before you had convinced yourself of the worst. Such changes are small but open new avenues in dealing with old problems.
It’s time to start challenging the way that you think.
*Rates of effectiveness vary from study to study but appear to agree on this one-third description. One-third benefit and one third report some improvement.