Depression - the elephant in the room

It is thought that 2.6 in every 100 people suffer from depression (Mind).  As common as it may be, and sometimes it is even patently clear that it is right there in front of us, it is rarely talked about.  Winston Churchill described depression as the ‘black dog’ but it seems that it seems more to be the elephant in the room.

When I start working with a client who is depressed, we look at all the potential causes, whether that is in the present, the past, an unhelpful way of thinking, or even an unhealthy relationship.  It is important to have as open a mind to the potential causes, and it is rare that the depression is attributable to one factor. 

Once we have a clear idea of what might be the potential causes, the difficult part is to challenge the status quo.  This is difficult because we often develop ways of living for a very good reason.  For example, as a child it might have been easier to believe that we were intrinsically a bad person, if this meant that it made sense of the cruelty inflicted on us by a parent. 

To let go of the belief that we are intrinsically a bad person, and so deserving of the cruelty, we have to identify, and gently start to challenge, our distorted thinking.  We need to reality-test our assumptions and replace these with more rational ways of thinking.  But how can we do this?  Here are some examples of distorted thinking, and how we can challenge these–

Perfectionism
Depression often makes us believe that we cannot do anything unless we do it perfectly.  If we do not challenge perfectionism, we will end up caught in the depression cycle.  This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed.  As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity.  To challenge perfectionism - 

• Consider the fact that there is an important learning process involved with making mistakes
• Open yourself to the moment.  There may be a certain level of enjoyment by simply experiencing the task, rather than placing expectation on any certain result.
• Realise that many people feel more comfortable with someone who is less than perfect
• Do not avoid activities, and try to set deadlines for tasks.  Perfectionism often makes someone avoid a task altogether or spend a disproportionately long time on a task.

Tyranny of the 'shoulds'
I often work with clients who are depressed because they believe that certain things should happen (I should, they should), and if these things do not happen, they are left feeling frustrated.  It can be helpful to try and challenge these 'shoulds' in the following ways - 

• Why should it be that way?  Does it matter so much that you end up feeling frustrated and stressed out when things do not go accordingly?
• Once you have identified all of the 'should' statements, prioritise them.  Some will be more important than others, so this might help you realise that your reaction is not always proportionate. Perhaps some are even so low down on the priority list that you could learn to live without them.
• Make sure these 'should' statements are about your own values and not those you have blindly swallowed from someone else.  We all grow up hearing the values of our caregivers, but sometimes these are not values we would consciously choose as an adult.  Choose to let go of those that are not really ours.
• It can ease pressure on the situation if you replace 'I should/they should' with 'I would like....but I accept that this may not happen'.

In parallel with the focus on your thinking patterns and underlying beliefs, you should take care not to fall into the depression cycle.  This is where your negative thoughts cause a low mood and you end up less willing to engage in the activities you previously enjoyed.  As a result, the reduced activity will lead to further negative thoughts, and a lower mood, and even less activity.  Break out of this cycle and set yourself simple tasks to achieve each day.  Include a mixture of different types of activities (social, educational, creative and recreational), and use an activity diary to rate your feeling of achievement for each task.  Do not expect to immediately find these tasks enjoyable, and each day, increase the frequency and number of activities.

Get in contact today.  You can telephone me on (201) 779-6917 or book a consultation online - https://www.therapyportal.com/p/cwarrendickins/

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