Depression is a complex mental health condition influenced by various factors, including our behaviours and thought patterns. How we act and the way we think can significantly impact our mental well-being. In this blog post, we will explore how changes in behaviour and mindset can contribute to depression, and what we can do to improve our mental health.
How Behaviour Affects Depression
Loss of Rewards: Have you recently lost something important like a job, friends, or a close relationship? People who face big life changes and do not cope well are more likely to become depressed.
Decrease of Rewarding behaviour: Are you doing fewer things that made you happy before? Depression often leads to inactivity and withdrawal. Depressed people might spend a lot of time doing passive, unfulfilling activities like watching TV, staying in bed, dwelling on problems, or complaining. They do less of the things that are challenging and enjoyable, such as socializing, exercising, having fun, learning, or working productively.
Lack of Self-Reward: Many depressed people do not reward themselves for good behaviour. They rarely praise themselves or spend money on themselves. They might feel so unworthy that they avoid self-praise, fearing it will make them lazy or complacent.
Not Using Skills: Are there social or problem-solving skills that you are not using? Depressed people might struggle with assertiveness, maintaining friendships, or solving problems with others. This can lead to more conflicts and fewer chances for positive experiences.
New Demands: Are there new challenges in your life that you feel unprepared for? Moving, starting a new job, becoming a parent, or ending a relationship can be very stressful and contribute to depression.
Feeling Helpless: Staying in a situation where you cannot control what happens can lead to depression. Feeling sad, tired, uninterested, and hopeless often comes from believing you can’t improve your situation. Jobs or relationships that feel unfulfilling can cause these feelings.
Continual Punishment: Being in a situation where you are constantly criticized or rejected can also lead to depression. Spending time with people who hurt you can make you feel worse.
Avoidance and Passivity: Avoiding difficult experiences or feelings can lead to fewer positive outcomes and more feelings of helplessness.
While these factors can make someone more likely to become depressed, they do not have to. How you think about and respond to stress and loss matters. For instance, experiencing a loss might lead someone to engage in new rewarding behaviours, learn new skills, focus on new goals, or become more assertive.
Certain negative thought patterns, like blaming yourself for everything, believing nothing can change, or thinking you need to be perfect, can increase your risk of depression. Cognitive therapy aims to identify, challenge, and change these negative thoughts.
How Thinking Affects Depression
Certain ways of thinking can lead to depression. Here are some examples:
Negative Automatic Thoughts: These are spontaneous thoughts that seem believable but are distorted and bring about negative feelings like sadness, anxiety, anger, and hopelessness. Examples include:
Mind Reading: "He thinks I'm a loser."
Labelling: "I'm a failure," "He's a jerk."
Fortunetelling: "I'll get rejected," "I'll make a fool of myself."
Catastrophizing: "It's awful if I get rejected," "I can't stand being anxious."
All-or-Nothing Thinking: "I fail at everything," "I don't enjoy anything," "Nothing works out for me."
Discounting Positives: "That doesn't count because anyone could do that."
Unhealthy Assumptions: These are beliefs about what you think you should be doing. They are the rules that depressed people think they must follow. Examples include:
"I should get everyone's approval."
"If someone doesn’t like me, it means I'm unlovable."
"I can never be happy doing things on my own."
"If I fail at something, then I'm a failure."
"I should criticize myself for my failures."
"If I’ve had a problem for a long time, I can't change."
"I shouldn’t be depressed."
Negative Self-Image: Depressed people often focus on their flaws, exaggerate them, and ignore any positive traits they have. They may see themselves as unlovable, ugly, stupid, weak, or even evil.
Dwelling on Negative Thoughts: Many people get stuck on their negative thoughts and feelings, leading to greater passivity and avoidance.
What is Cognitive-Behavioural Treatment of Depression?
Cognitive-behavioral therapy (CBT) is a structured, practical, and effective way to treat depression. It focuses on identifying and changing the behaviours and thoughts that contribute to depression. Here's how it works:
Focus on the Present: CBT focuses on your current thoughts and behaviours. You and your therapist will look at how your actions, or lack of actions, affect your mood. There are steps you can take to start feeling better.
Changing Negative Thoughts: You will also examine the negative and unrealistic thoughts that make you feel depressed. Therapy will help you develop more realistic and positive ways of thinking.
Measuring Symptoms: At the start, you and your therapist will identify your symptoms and how severe they are. You'll fill out forms or questionnaires, like the Beck Depression Inventory–II or the Quick Inventory of Depressive Symptomatology—Self-Report, to measure your symptoms.
Setting Goals: You will choose goals you want to achieve, such as improving self-esteem, communication, reducing shyness, or decreasing hopelessness and loneliness.
Monitoring Progress: You and your therapist will track your progress by referring to your initial symptom measures and seeing how close you are to reaching your goals.
In summary, CBT helps you change negative behaviours and thoughts to improve your mood and overall mental health.
How Effective is Cognitive-Behavioural Therapy for Treating Depression?
Many research studies from major universities worldwide show that cognitive-behavioural therapy (CBT) is as effective as antidepressant medication for treating major depression. Additionally, most patients who undergo CBT maintain their improved mood even two years after finishing therapy. The goal of CBT is not only to reduce your symptoms but also to teach you how to prevent them from returning.
Are Medications Useful?
Several medications are effective in treating depression. It usually takes 2 to 4 weeks for the medication to reach a therapeutic level in your system. Some medications may have side effects, which can be temporary and lessen over time. In some cases, side effects can be managed by combining different medications.
What is Expected of You as a Patient?
Cognitive-behavioural therapy (CBT) for depression requires your active participation. Here is what you can expect:
Frequent Sessions: In the beginning, your therapist might ask you to attend therapy twice a week until your depression improves.
Self-Assessment: You will need to fill out forms to evaluate your depression, anxiety, and other issues. You’ll also read materials specifically about depression treatment.
Ongoing Evaluation: Your therapist may ask you to regularly complete forms to assess your progress.
Homework: You might receive exercises to help you change your behaviour, thoughts, and relationships.
Even if you feel hopeless about improvement, there is a very good chance that CBT can significantly reduce your depression.
Conclusion
In conclusion, both our behaviours and thinking patterns play a crucial role in depression. By understanding how our actions and thoughts contribute to our mood, we can take steps to improve our mental health. Whether through changing negative thought patterns or engaging in more rewarding activities, there are practical ways to manage and reduce depression. Remember, seeking support and making positive changes can lead to significant improvements in how you feel.
References:
Leahy, R. L., & Holland, S. J. (2000). Treatment plans and interventions for depression and anxiety disorders (pp. 88-91). New York: The Guilford Press.
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